In Trial Work, Edwards Left a Trademark

n 1985, a 31-year-old North Carolina lawyer named John Edwards stood before a jury and channeled the words of an unborn baby girl.

Referring to an hour-by-hour record of a fetal heartbeat monitor, Mr. Edwards told the jury: "She said at 3, `I'm fine.' She said at 4, `I'm having a little trouble, but I'm doing O.K.' Five, she said, `I'm having problems.' At 5:30, she said, `I need out.' "

But the obstetrician, he argued in an artful blend of science and passion, failed to heed the call. By waiting 90 more minutes to perform a breech delivery, rather than immediately performing a Caesarean section, Mr. Edwards said, the doctor permanently damaged the girl's brain.

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"She speaks to you through me," the lawyer went on in his closing argument. "And I have to tell you right now — I didn't plan to talk about this — right now I feel her. I feel her presence. She's inside me, and she's talking to you."

The jury came back with a $6.5 million verdict in the cerebral palsy case, and Mr. Edwards established his reputation as the state's most feared plaintiff's lawyer.

In the decade that followed, Mr. Edwards filed at least 20 similar lawsuits against doctors and hospitals in deliveries gone wrong, winning verdicts and settlements of more than $60 million, typically keeping about a third. As a politician he has spoken of these lawsuits with pride.

"I was more than just their lawyer," Mr. Edwards said of his clients in a recent essay in Newsweek. "I cared about them. Their cause was my cause."

The effect of his work has reached beyond those cases, and beyond his own income. Other lawyers have filed countless similar cases; just this week, a jury on Long Island returned a $112 million award. And doctors have responded by changing the way they deliver babies, often seeing a relatively minor anomaly on a fetal heart monitor as justification for an immediate Caesarean.

On the other side, insurance companies, business groups that support what they call tort reform and conservative commentators have accused Mr. Edwards of relying on questionable science in his trial work. Indeed, there is a growing medical debate over whether the changes have done more harm than good. Studies have found that the electronic fetal monitors now widely used during delivery often incorrectly signal distress, prompting many needless Caesarean deliveries, which carry the risks of major surgery.

The rise in such deliveries, to about 26 percent today from 6 percent in 1970, has failed to decrease the rate of cerebral palsy, scientists say. Studies indicate that in most cases, the disorder is caused by fetal brain injury long before labor begins.

An examination of Mr. Edwards's legal career also opens a window onto the world of personal injury litigation. In building his career, Mr. Edwards underbid other lawyers to win promising clients, sifted through several dozen expert witnesses to find one who would attest to his claims, and opposed state legislation that would have helped all families with brain-damaged children and not just those few who win big malpractice awards.

In an interview on yesterday, Mr. Edwards did not dispute the contention that the use of fetal heart rate monitors leads to many unneeded Caesarean deliveries or that few cases of cerebral palsy are caused by mishandled deliveries. But he said his cases, selected from hundreds of potential clients with the disorder, were exceptions.

"I took very seriously our responsibility to determine if our cases were merited," Mr. Edwards said. "Before I ever accepted a brain-injured child case, we would spend months investigating it."

As for the unneeded Caesareans, he said, "The question is, would you rather have cases where that happens instead of having cases where you don't intervene and a child either becomes disabled for life or dies in utero?"

A Talent for Trials

Lawyers in North Carolina agree that Mr. Edwards was an exceptionally talented lawyer, endowed with a prodigious work ethic, native self-confidence, good looks, charisma and an ability to talk about complicated subjects in accessible language.

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