Can Prenatal Testing Errors Lead to Preventable Birth Injuries and NY Malpractice?

Prenatal testing exists for a reason. The screenings, bloodwork, ultrasounds, and genetic panels done throughout pregnancy aren’t just routine checkboxes. They’re designed to catch problems early enough to actually do something about them. When those tests are mishandled, misread, or skipped entirely, the consequences can reach far beyond a missed diagnosis. They can change how and where a baby is delivered, and in some cases, they contribute to birth injuries that might have been prevented.

This article breaks down how prenatal testing errors happen, what kinds of injuries they can contribute to, and what New York law says about accountability when those errors cause real harm.

What Prenatal Tests Are Actually Supposed to Do

Prenatal screening and diagnostic testing covers a wide range. Early in pregnancy, providers use blood-based screening and cell-free DNA (cfDNA) testing to look for chromosomal conditions like Down syndrome. Mid-pregnancy ultrasounds, particularly the anatomy scan done around 18 to 20 weeks, are designed to catch structural issues with the heart, brain, spine, and other organs. Later in pregnancy, testing shifts toward monitoring the mother’s health (screening for gestational diabetes and preeclampsia, for example) and tracking fetal growth and positioning.

The goal behind all of this isn’t just information for its own sake. It’s delivery planning. When a provider knows in advance that a baby has a complex cardiac defect, they can arrange delivery at a hospital with an on-site pediatric cardiac surgery team. When testing reveals a large baby or signs of placental trouble, they can plan for a cesarean section rather than a high-risk vaginal delivery. When gestational diabetes is caught and managed, macrosomia (abnormally large birth weight) becomes less likely, and so does shoulder dystocia and the nerve injuries that can come with it.

That chain of events (from the test, result, adjusted care plan, and safer delivery) is the whole point. When a link in that chain breaks, it can set off a cascade of problems.

The Most Common Types of Prenatal Testing Errors

Not all prenatal testing errors look the same. Some are obvious in hindsight; others require a careful review of the medical record to identify. According to clinical literature, the most frequently documented patterns include the following.

Failure to order indicated tests. Guidelines from the American College of Obstetricians and Gynecologists (ACOG) and state-based prenatal care protocols outline specific tests that should be offered based on gestational age, medical history, and risk factors. A provider who skips a glucose tolerance test in a patient with risk factors for gestational diabetes, or who doesn’t recommend a detailed anatomy scan or fetal echocardiogram when the pregnancy history warrants it, may be departing from the accepted standard of care.

Misreading or misinterpreting results. Ultrasound interpretation requires training and attention. An anatomy scan that appears normal but misses a cardiac defect or a neural tube abnormality can leave a family and their care team completely unprepared for what’s ahead. Similarly, an abnormal serum marker profile that gets dismissed or not followed up with additional testing represents a missed opportunity to investigate further.

Failure to act on or report abnormal findings. One of the more insidious errors is when a test comes back with an abnormal result that doesn’t trigger any action. This can happen when results are filed without a follow-up plan, when a provider fails to refer a patient to maternal-fetal medicine (MFM) after an elevated risk finding, or when communication between the lab and the clinical team breaks down entirely. A 1995 study published in CMAJ found that failing to adequately inform parents of abnormal blood test results was a documented pattern in prenatal screening-related litigation, particularly in cases involving children born with serious disabilities that could have been better anticipated.

Sample mix-ups and documentation errors. Errors in the handling, labeling, or documentation of specimens can send an entire prenatal care plan in the wrong direction. A result that belongs to one patient gets attributed to another, or a follow-up recommendation never makes it into the clinical notes. These administrative failures carry the same downstream risks as a misread test.

How a Missed Prenatal Test Can Lead to a Birth Injury

The connection between a prenatal testing error and an actual birth injury often runs through the delivery itself. Here’s how that typically unfolds.

Gestational diabetes that goes undetected because the glucose tolerance test was never ordered (or the results were ignored) can result in a baby that grows significantly larger than expected. A large baby increases the risk of shoulder dystocia during a vaginal delivery, a situation where the baby’s shoulder becomes stuck behind the mother’s pubic bone. Shoulder dystocia, when mismanaged, is one of the leading causes of brachial plexus injuries, a type of nerve damage that can affect arm and hand function, sometimes permanently.

Missed placental abnormalities, including placenta previa or early signs of placental abruption, can mean a provider is caught off guard when an emergency develops during labor. The delay in responding to a suddenly compromised blood and oxygen supply to the baby is a well-documented pathway to hypoxic-ischemic encephalopathy (HIE), a form of brain injury caused by oxygen deprivation around the time of birth.

Structural anomalies that aren’t detected prenatally can mean delivery happens at a community hospital instead of a specialized perinatal center equipped to handle complex neonatal needs. A baby born with an undetected severe heart defect who needed immediate surgical intervention and didn’t get it fast enough because no one planned for that possibility is a direct consequence of a prenatal diagnostic failure.

Reviews published in epidemiologic and obstetric journals have noted that advances in prenatal diagnosis and surveillance have reduced certain types of birth trauma, which cuts both ways. It confirms that better prenatal testing produces better outcomes, and it means that failures to follow those standards can be causally connected to the harms that improved testing was designed to prevent.

What “Standard of Care” Means in Prenatal Testing

The phrase “standard of care” comes up constantly in medical malpractice cases, and it’s worth understanding what it actually means in the context of prenatal testing.

In obstetrics, the standard of care isn’t one doctor’s personal preference or one hospital’s in-house protocol. It’s defined by peer-recognized guidelines, the kind published by ACOG, the Society for Maternal-Fetal Medicine, and similar bodies, as well as state-based prenatal care standards including those aligned with New York Medicaid’s collaborative prenatal management guidelines. These guidelines reflect what a reasonably trained and informed provider should do in a given clinical situation.

A provider who omits a clearly indicated test doesn’t get to simply say they made a judgment call. If ACOG guidelines recommend aneuploidy screening for a patient’s age and risk profile, and that screening wasn’t offered or documented as declined, that gap in care is measurable against an established benchmark. New York courts look to exactly these kinds of standards when evaluating whether a provider’s conduct was appropriate.

It’s also worth noting that the standard of care applies to the entire chain of testing, not just whether a test was ordered. Ordering the test but then failing to communicate an abnormal result to the patient, or failing to refer to a specialist when the result indicated elevated risk, can be just as significant a departure as never ordering the test at all.

When a Prenatal Testing Error Can Support a Malpractice Claim in New York

Medical malpractice claims in New York require four elements to be present: duty, breach of the standard of care, causation, and damages. In prenatal testing cases, each element has a specific shape.

Duty is straightforward. A provider who has taken on the care of a pregnant patient has a duty to that patient and, in many circumstances, to the developing baby.

Breach means the provider’s conduct fell below the accepted standard of care. In prenatal testing cases, this is typically established through expert testimony from an obstetrician or maternal-fetal medicine specialist who can explain what a competent provider should have done and what actually happened instead.

Causation is often where these cases are most carefully examined. It’s not enough to show that a test was missed or misread. The question is whether the error made a difference. If the missed information would have changed the delivery plan in a way that would have prevented or reduced the injury, causation is much stronger. If the outcome would have been the same regardless, the claim becomes harder to sustain. New York courts and legal commentary have consistently emphasized that expert testimony is required to draw this specific connection between the testing failure and the birth injury that followed, as seen in cases reviewed by New York appellate courts.

Damages in birth injury cases are often significant and long-term. They can include the cost of ongoing medical care, therapy, adaptive equipment, and lost future earning capacity, alongside the non-economic harms that are harder to quantify but no less real.

Types of Prenatal Testing Claims Seen in New York

New York birth injury litigation involving prenatal testing tends to cluster around several distinct fact patterns.

Negligent screening for maternal conditions. Cases involving missed gestational diabetes, undetected preeclampsia, or failure to identify intrauterine growth restriction (IUGR) often involve providers who either didn’t order the appropriate tests or dismissed elevated readings without follow-up. These conditions, when unmanaged, create the exact circumstances that lead to emergency deliveries with higher rates of birth trauma.

Failure to detect structural or chromosomal anomalies. When a detailed anatomy scan is performed but a major defect is missed due to inadequate technique or interpretation, and delivery subsequently takes place at a facility that isn’t equipped to handle the baby’s needs, the gap between what was known and what should have been known becomes legally and medically significant.

Failure to refer to maternal-fetal medicine. When a result indicates elevated risk and a referral to a specialist is never made, the patient misses the benefit of the higher level of surveillance and intervention that MFM care provides. Courts look at whether that referral was indicated under the applicable standards and whether the failure to make it contributed to a worse outcome.

Communication and reporting failures. These cases often hinge on the medical record. If a lab result came back abnormal and nothing in the chart reflects that anyone followed up on it, that gap speaks for itself. Providers have a responsibility not just to receive test results but to act on them and document that they did.

The Difference Between a Missed Finding and an Actionable Error

This distinction matters and it’s worth being clear about it.

Not every condition that goes undetected before birth is the result of a prenatal testing error. Some structural anomalies are simply not visible on ultrasound at the resolution available during the exam. Some conditions develop after the window when standard screening would have caught them. Medicine has limits, and courts understand that.

What separates a missed finding from an actionable error is whether the condition was detectable using the testing that should have been ordered and performed according to the applicable standard of care, and whether a competent interpretation of that testing would have identified it. If the answer to both questions is yes, and if that detection would have changed the care plan in a way that prevented or reduced the injury, then the error is potentially actionable.

This is why the detailed review of prenatal records matters so much in these cases. The question isn’t just “was something missed?” It’s “should it have been caught, and what difference would catching it have made?”

What Families Should Know If They Suspect a Prenatal Testing Error

If you’re reading this because something went wrong and you’re trying to make sense of it, a few things are worth understanding.

The medical record is the foundation of everything. Prenatal charts, lab results, ultrasound reports, and communication logs are the primary evidence in any inquiry into whether testing was properly conducted and acted upon. Requesting and preserving those records as early as possible is important.

The timeline matters. New York has a statute of limitations for medical malpractice claims, and in birth injury cases involving infants, there are specific rules that affect when the clock starts and how long you have. Consulting with an attorney who handles New York birth injury cases is the appropriate next step if you believe an error occurred.

Not every bad outcome is malpractice, and not every malpractice case is straightforward. But when a preventable birth injury traces back to a testing failure that violated an established standard of care, New York law provides a framework for accountability. Understanding that framework is the first step toward knowing whether it applies to your situation.

This article is educational in nature and does not constitute medical or legal advice. If you have concerns about a specific situation, please consult a qualified medical or legal professional.