The American College of Obstetricians and Gynecologists (ACOG) must be distinguished from the American Board of Obstetricians and Gynecologists (ABOG). ABOG is the group that board-certifies obstetricians and gynecologists. ACOG, on the other hand, is a group that provides education and resources for those physicians.
ACOG puts out regular practice bulletins on specific issues in order to inform its membership. Likewise, it also publishes the medical journal Obstetrics & Gynecology. In some fashion, these educational materials are meant to keep obstetricians up-to-date on changes and expectations in the medical field. However, ACOG often crosses the line from education into advocacy, and that advocacy, unfortunately, bleeds into these educational pieces and contaminates the courtroom.
The “Green Book”
Because it represents the interests of obstetricians, ACOG advocates for medical malpractice reform, often in the form of damage caps. When the educational materials work against the interests of a negligent doctor, they will try to distinguish the materials from the care given. ACOG itself believes that it is “the body which establishes standards of care for the ob-gyn profession” (11-01-11 letter from ACOG to FDA).
Even more importantly, some educational pieces put out by ACOG specifically set up hurdles in the way of injured children who are attempting to prove that their birth injuries were caused by negligence. In particular, the 2003 publication Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology, also called “the green book,” purports to establish essential criteria and other persuasive evidence that is necessary to show the connection between asphyxia near the time of birth and cerebral palsy.
Much of the green book’s support comes from misapplied scientific articles or sub-par research. There is no doubt that the document was created solely to combat birth injury lawsuits. ACOG effectively changed the conversation in medical malpractice trials by trying to establish a list of necessary prerequisites that is not based on good science. In fact, the article is outside the scope of expertise of ACOG—it does not deal with the standard of care necessary for obstetrics. Instead, it covers other issues—neonatology, pediatrics, radiology, and neurology.
Many states have arbitrary limits on the damages that a jury can award. In most states, the limit is on non-economic damages—this is a limit on the amount of money a judge or jury can provide to a person for pain, suffering, mental anguish, disfigurement, physical impairment, inconvenience, and other items that are not susceptible to easy calculation. In some states, this figure is as low as $250,000, regardless of how negligent the medical provider was or the degree of permanent injury to the victim. The juries are not told of these limits.
We believe that these limits are unconstitutional and prevent a judge or jury from fully and fairly compensating a victim for their injuries. If a jury believes that a certain amount of money is necessary to make a victim whole, why do we have the right to take that away? In some states, these laws have been ruled unconstitutional and overturned.
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Our Ohio medical malpractice lawyers have handled birth injury lawsuits across the country. If you would like to learn more about the laws in your state, or if you want to know whether your child’s birth injuries were preventable, contact us at (440) 252-4399 or send us an online request for more information.