Spina Bifida Lawyers: Medical Negligence & Missed Prenatal Diagnosis Claims

Medical Failures Behind Preventable Spina Bifida Harm

Spina bifida cases that reach our attorneys don't usually involve mystery. They involve specific, identifiable departures from the standard of prenatal, intrapartum, and neonatal care — including:

• Failure to order or follow up on the maternal serum AFP (alpha-fetoprotein) screen
• Misread or under-performed anatomy ultrasound at 18-22 weeks
• Radiologist failure to identify the "lemon sign," "banana sign," or ventriculomegaly
• No referral to maternal-fetal medicine after an abnormal screen
• Inadequate preconception and prenatal folic acid counseling
• Negligent prescribing of teratogenic medications during pregnancy
• Failure to plan a controlled cesarean delivery for a known open neural tube defect
• Delayed neonatal surgical closure of the open lesion
• Failure to diagnose and shunt hydrocephalus (Chiari II malformation)
• Hospital-acquired infection of the exposed neural tissue

The American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, and CDC guidelines all set out what proper prenatal screening looks like. Doctors and hospitals are supposed to find spina bifida early enough to give families real choices — not deliver the diagnosis in the delivery room.

The most common medical failures behind spina bifida malpractice claims:

Missed prenatal diagnosis on ultrasound - The 18-22 week anatomy ultrasound should detect open spina bifida in the overwhelming majority of cases. Sonographers and radiologists are trained to recognize the cranial markers — the "lemon sign" (frontal bone scalloping) and "banana sign" (cerebellar deformation) — alongside direct visualization of the spinal lesion. When the scan is performed by an inadequately trained technician, when poor image quality is accepted instead of a repeat scan, or when a radiologist signs out a normal report on an abnormal study, families lose the entire window in which fetal intervention is possible.

Failure to act on elevated maternal serum AFP - Elevated AFP at 16-18 weeks is the single strongest biochemical signal of an open neural tube defect. Standard of care requires prompt follow-up: a targeted Level II ultrasound, MFM consultation, and in some cases amniocentesis for amniotic AFP and acetylcholinesterase. Buried lab results, ignored values, and "we'll watch it next visit" responses are textbook deviations from accepted protocols.

Inadequate preconception and prenatal counseling - The CDC recommends 400 micrograms of folic acid daily for all women of reproductive age and 4 milligrams for women with a prior neural tube defect pregnancy or who take certain anti-seizure medications. Obstetricians and primary care physicians who fail to identify high-risk patients — those with diabetes, obesity, family history of NTDs, or on teratogenic drugs — and fail to counsel them appropriately can be held to that standard.

Mismanaged delivery of a known myelomeningocele - Once spina bifida is diagnosed prenatally, delivery planning matters. Vaginal delivery of an open lesion risks rupturing the sac, contaminating the exposed cord, and worsening neurological injury. The standard of care typically calls for a planned cesarean at a tertiary center with neonatal neurosurgery on standby and surgical closure within 24-72 hours. Deviations from that plan — including unplanned vaginal birth, delayed closure, or transfer delays that expose the lesion — are recurring themes in birth injury litigation.

Failure to diagnose and treat hydrocephalus - Roughly 80-90% of children with myelomeningocele develop hydrocephalus from a Chiari II malformation. Postnatal monitoring requires serial head circumference measurements, neuroimaging, and timely ventriculoperitoneal shunt placement. Missed or delayed shunting causes additional, preventable brain injury on top of the underlying spina bifida.

Negligent prescribing and toxin exposure - A smaller subset of spina bifida claims involves prescription drugs and environmental exposures during early pregnancy. Valproic acid (Depakote), carbamazepine (Tegretol), and certain other anticonvulsants carry well-documented neural tube defect risks. Off-label use of medications such as Zofran (ondansetron) for morning sickness, and occupational exposure to industrial solvents and pesticides, have also drawn scrutiny. The spina bifida cases we handle address the doctor failures and turn on what a doctor missed, not what a drug company hid.

Our medical malpractice lawyers have handled the full spectrum of these cases. The harm to a child with untreated or mismanaged spina bifida is lifelong, and the families who carry that weight deserve to hold the responsible providers accountable.

When healthcare providers fail at this stage of care, families pay for it for the rest of their child's life.

A missed AFP screen turns a manageable, surgically-corrected lesion into permanent paraplegia and bowel and bladder dysfunction.

A misread anatomy ultrasound forecloses fetal surgery — the only intervention shown by the MOMS trial to reduce the need for shunting and improve motor function.

An unplanned vaginal delivery of a known myelomeningocele turns a controllable injury into a sepsis emergency in the NICU.

If a missed diagnosis, prescribing failure, or delivery error contributed to your child's spina bifida, contact our legal team right away.