An appropriate ultrasound, repeat study, or detailed examination may not be ordered when symptoms, risk factors, or earlier findings call for further evaluation.
Understanding Fetal Ultrasound Errors
Fetal ultrasound errors can involve problems with ordering, performing, interpreting, reporting, or following up on prenatal imaging. This page can help families understand what an ultrasound can and cannot show, how a possible error may affect care, and what options may be available when a mother or baby is harmed.
What is a fetal ultrasound error?
A fetal ultrasound, also called an obstetric ultrasound or sonogram, uses sound waves to create images of the developing baby and the mother’s uterus and ovaries. During pregnancy, ultrasound may be used to estimate gestational age, confirm the number of fetuses, assess fetal heartbeat and growth, evaluate fetal and placental position, measure amniotic fluid, and look for certain structural abnormalities.
A fetal ultrasound error is not a medical diagnosis. It is a term used to describe a potentially preventable breakdown in the imaging process that may delay recognition of a maternal or fetal condition. An error may occur when an appropriate study is not ordered, necessary images are not obtained, findings are misinterpreted, results are not communicated, or recommended follow-up does not occur.
Ultrasound has important limitations. It cannot identify every fetal abnormality, and a limited ultrasound is designed to answer a focused clinical question rather than provide a complete fetal anatomy evaluation. A condition that was not diagnosed before birth does not, by itself, prove that an ultrasound error occurred.
Possible signs that an ultrasound error may have affected care
Families may not know that a problem occurred until later in the pregnancy, during delivery, or after birth. The following circumstances may justify a closer review of the ultrasound images, reports, and prenatal records:
- An ultrasound report described limited or incomplete views and recommended another study, but no follow-up appears in the medical record
- An abnormal or uncertain finding was documented but was not communicated to the parent or the treating medical team
- A fetal, placental, growth, or pregnancy-related condition was identified later, raising questions about whether earlier imaging showed warning signs
- Measurements or reported findings differ significantly from later imaging or clinical findings
- A documented ultrasound finding called for additional evaluation or care planning, but the recommended next steps did not occur
These circumstances do not prove negligence. Ultrasound quality and visibility can be affected by gestational age, fetal position, maternal anatomy, the type of examination performed, and other clinical factors. A qualified medical review is needed to determine whether the care was reasonable under the circumstances.
What can contribute to fetal ultrasound errors?
Ultrasound examinations involve several steps and may include a referring provider, sonographer, radiologist, obstetrician, maternal-fetal medicine specialist, and other members of the care team. Problems can arise at any point in the process, including:
- Failing to order an ultrasound, repeat study, or more detailed examination when clinically indicated
- Using a limited examination when a standard or detailed study is needed to answer the clinical concern
- Obtaining incomplete or poor-quality images without recognizing or documenting the study’s limitations
- Recording inaccurate measurements or incorrectly labeling images
- Misinterpreting or overlooking a finding on the images
- Using equipment that is defective, malfunctioning, or not appropriately maintained
- Failing to prepare a clear report or communicate significant findings to the parent and treating providers
- Failing to arrange recommended follow-up imaging, testing, or referral
Not every limited image or missed finding results from substandard care. The relevant question is whether the providers responded appropriately to the information and limitations available at the time.
When a fetal ultrasound error may be medical malpractice
Not every missed prenatal diagnosis, ultrasound limitation, or unexpected outcome is medical malpractice. A claim generally requires evidence that a healthcare provider failed to meet the applicable standard of care and that this failure caused harm. Circumstances that may point to negligence include:
- Failing to order a clinically indicated ultrasound or recommended follow-up study
- Performing only a limited examination when a broader standard or detailed examination was indicated
- Failing to obtain or document necessary images, measurements, or views
- Failing to recognize and report that an examination was incomplete or technically limited
- Misreading findings that a reasonably careful and qualified provider should have identified under the circumstances
- Failing to communicate significant, urgent, or abnormal findings to the parent or treating providers
- Failing to recommend further testing, repeat imaging, or specialist referral after abnormal, uncertain, or incomplete results
- Using equipment known to be malfunctioning or inadequately maintained without taking appropriate corrective steps
Wais, Vogelstein, Forman, Koch & Norman, LLC works with qualified medical experts to review ultrasound images, reports, prenatal records, and the care that followed to determine whether the standard of care may have been breached and whether that breach caused harm.
Treatment and long-term outlook after a missed or delayed diagnosis
An ultrasound error itself is not an injury and does not have a specific treatment. Medical care depends on the maternal or fetal condition that was missed or diagnosed late, whether the delay changed pregnancy or delivery management, and whether the mother or child experienced harm.
After a possible missed or delayed diagnosis, care may include additional imaging, laboratory or genetic testing, referral to maternal-fetal medicine or pediatric specialists, delivery planning, surgery, medication, developmental monitoring, and physical, occupational, or speech therapy. The appropriate plan is different for every family.
The long-term outlook depends on the underlying condition, its severity, when it was identified, and how quickly effective care began. Some children require little or no ongoing treatment, while others may need long-term medical, developmental, or educational support. A child’s treating physicians can provide the most accurate guidance about care and prognosis.
Common Errors: Fetal Ultrasound Errors
Recognizing common forms of fetal ultrasound error.
Understanding where the ultrasound process may have broken down can help families organize their questions and identify which medical records may need review. These categories describe possible errors in care, not clinical stages of an injury.
Ordering and timing errors
Interpretation and reporting errors
A provider may misread an image, overlook a finding, use incorrect measurements, or issue a report that does not clearly describe important or uncertain results.
Image acquisition and quality errors
Necessary views or measurements may be incomplete, inaccurate, or poorly documented. A potential concern may also arise when known technical limitations are not recorded or addressed with follow-up.
Communication and follow-up errors
Significant findings may not reach the parent or treating team, or recommended repeat imaging, testing, referral, or care planning may not occur.
Frequently Asked Questions
Common questions about fetal ultrasound errors.
It is understandable to have questions after learning that a prenatal condition may have been missed or diagnosed later than expected.
Can a prenatal ultrasound detect every birth defect or pregnancy complication?
No. Obstetric ultrasound can identify many important findings, but it cannot detect every fetal abnormality or pregnancy complication. Visibility can depend on gestational age, fetal position, maternal anatomy, the type of examination, and the condition being evaluated. Additional imaging, testing, or specialist review may be appropriate when results are incomplete or a concern remains.
Is a fetal ultrasound error always caused by medical malpractice?
No. A missed diagnosis or unexpected outcome does not automatically mean malpractice occurred. Some conditions are difficult or impossible to detect on ultrasound, and some examinations are appropriately limited. Medical malpractice may be considered when a provider failed to meet the standard of care and that failure caused preventable harm.
What treatment is available after a missed or delayed prenatal diagnosis?
Treatment depends on the condition and the harm involved. A mother or child may need further diagnostic testing, specialist care, delivery planning, medication, surgery, developmental monitoring,or rehabilitative therapies. The treating medical team should create an individualized plan based on the family’s needs.
How long do families have to file a fetal ultrasound error claim?
The deadline, or the statute of limitations, varies by state and may depend on when the alleged error occurred, when the injury was discovered, the child’s age, the providers involved, and other circumstances. Some jurisdictions also have notice or procedural requirements. Because missing a deadline can affect a family’s rights, it is important to speak with a birth injury attorney as soon as concerns arise.
