What is the APGAR Score?

When a child is born, all a parent wants to do is get acquainted. However, there are formalities to deal with. At one minute and five minutes after birth, a test of sorts is given to the newborn to quickly assess his or her health and cognitive function. Named after the anesthesiologist who developed it, the Apgar score is thought to be an accurate way to tell whether a newborn needs immediate medical attention. It is done at every birth in the United States that occurs in the presence of a medical professional.

What The Score Means

Though the test was named after Virginia Apgar, the name is also used sometimes as an acronym for the criteria the test is measuring. A baby’s Apgar score measures five things. They are:

  • Appearance – skin color, et cetera
  • Pulse – Heart rate
  • Grimace response – reflexes and facial response
  • Activity – muscle tone and ability to respond normally
  • Respiration – breathing sound & effort

The total score will be a number out of ten points; ten is maximum, but very rarely scored. A seven, eight or nine is considered normal, with no need for emergency treatment. However, a low score at one minute is not immediate cause for concern – most of the time, the score will improve to normal by five minutes. Low scores are most common if there has been anything unusual about the birth – for example, cesarean section or breech birth.

The score is also meant only to assess immediate health concerns; if your baby scores low, it is not necessarily indicative of any long-term medical conditions.

Legal Ramifications

It is rare, but plausible, that an Apgar score can be falsified or mistakenly recorded by the reporting physician. The test is always conducted by a physician other than the delivering obstetrician, but if there is any kind of relationship, the score may be altered. For example, a recent case in Philadelphia involved an infant with a five-minute Apgar score of 7, but the raw scoring was not documented on the child’s chart. It was later determined that the testing physician was married to the delivering obstetrician, and inflated the score to shield their spouse from any potential punitive consequences.

The main time that an Apgar score can come into question in a civil suit, however, is when it is used as evidence that a child sustained a brain injury or other condition in some other manner than at delivery. Sometimes, in actions for medical malpractice, the defense attempts to use a child’s Apgar score as proof that they were in good health while their client had charge of them. For example, if a child is diagnosed with cerebral palsy, but had a listed five-minute Apgar score of 7, the defense can use that as evidence that the diagnosis was not due to any kind of medical negligence.

For example, a California woman delivered a healthy infant with Apgar scores of 8 and 8, though with low platelets. That child later was diagnosed with hydrocephalus and suffered a massive brain bleed, causing neurological injuries. In the ensuing lawsuit, it was alleged that since the infant’s Apgar scores were within normal range, that the delivery was not the proximate cause of the infant’s later bleeding and trauma. The jury disagreed, finding for the plaintiff.

Contact A Birth Injury Attorney

A low Apgar score does not mean a lifetime of disability for a child, but a high Apgar score does not necessarily mean that nothing has gone wrong. If you or a loved one has a child who has sustained a birth injury, we can help. The firm of Meinhart, Smith & Manning, PLLC has years of experience in these cases, and we will do our best to put it to work for you. Contact our Louisville office today for a free consultation.

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