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Hypoxic-Ischemic Encephalopathy (HIE) Birth Injury Lawyers

Hypoxic-ischemic encephalopathy or HIE refers to a permanent brain injury in infants, which is caused by oxygen deprivation or from a reduced flow of blood to the infant’s brain during birth. When oxygen supply to the brain in limited or cut off during birth, the child’s brain cells are catastrophically affected, leading to widespread and often, permanent damage. What is important to know is HIE is preventable in a vast majority of cases. Doctors have the ability to limit the damage caused by HIE by performing specific treatments.

When a doctor fails to properly diagnose or recognize the condition and provide the necessary treatments, the child often ends up suffering irreversible brain damage. If your child has suffered HIE and permanent brain damage as the result of a medical professional’s negligence or incompetence, you may be able to seek compensation for the injuries, damages and losses. An experienced New York birth injury attorney will be able to offer more information regarding your legal rights and options.

Understanding Hypoxic-Ischemic Encephalopathy

HIE is a brain injury suffered by a newborn. The injury is caused by oxygen deprivation, which occurs in two to nine cases per 1,000 live births. Neonatal encephalopathy is a term that is commonly used to describe any type of neurological issue in a newborn child. HIE is a potentially lethal problem. Anywhere between 10 to 60 percent of babies who experience HIE at birth die after they are born.

About 25 percent of babies with HIE survive, but end up living their lives with permanent brain damage and long-term neurological problems. Brain damage results in a host of complications including physical disabilities, mental impairments such as learning disabilities, seizures and cerebral palsy, which is a disorder of movement, muscle tone or posture caused by brain damage during birth, etc.

For newborns with HIE, the extent of brain damage depends on a number of factors including the severity of oxygen deprivation, the length of time for which the child is oxygen-deprived, the condition of the baby before the oxygen deprivation and the how the medical team manages the baby during the time of crisis when the child became oxygen-deprived. When a child goes without adequate oxygen for a longer period of time, the extent of brain damage is likely to be more severe.

The symptoms of HIE often depend on the extent and severity of the brain injury and on which areas of the brain were affected. Infants born with HIE may appear floppy and unresponsive to sights or sounds. They may have abnormal movements or seizures. Infants with HIE may also have problems feeding because of weak muscles in their throat and mouth. They may show signs of organ dysfunction involving the heart, lungs, kidneys, liver and blood, and have a feeble cry.

What Causes HIE?

Hypoxic-ischemic encephalopathy may occur when oxygen-carrying blood doesn’t flow to the child’s brain during birth, etc. For infants, lack of oxygen, even if it’s for a very short time, may have a devastating impact. Oxygen deprivation during labor and delivery may occur when the child is still in the uterus, during a difficult labor or shortly after delivery. There are a number of factors that are linked to HIE during labor and birth.

Umbilical cord complications: The umbilical cord, which connects the baby to his or her mother during pregnancy, carries oxygen and nutrients from the placenta into the baby’s bloodstream. A “nuchal cord” is a condition where the umbilical cord gets knotted around the child’s neck. When this occurs the baby may get asphyxiated preventing the flow of oxygen-rich blood to the baby’s brain. The longer the baby is in this precarious situation, the higher the likelihood of permanent brain damage.

Another complication involving the umbilical cord is known as a “cord prolapse” This is when the cord goes down the birth canal along with the baby and creates an obstruction between the baby’s head and the mother’s pelvis. This may put a lot of pressure on the child’s head causing the blood flow to the child to completely stop. When this happens, doctors must remove the child immediately with a Cesarean Section because it is considered a life-threatening emergency. Failing to do a prompt C-section may have devastating consequences for the child including HIE, brain damage and even death.

Macrosomia: This refers to a situation where a baby is larger than average and does not fit through the mother’s pelvis. Cephalopelvic disproportion or CPD is a condition where the baby’s head is too large for the birth canal. Both of these conditions may lead to a prolonged and difficult labor. Oxygen flow may be limited as the child becomes trapped in the birth canal and is forced to withstand more contractions. In such situations, medical professionals may try to get the baby out by using birth-assistive tools such as forceps and vacuum extractors. These tools, when improperly or incompetently used, may lead to head trauma, HIE and brain damage.

Preeclampsia: This is a condition caused by high blood pressure in a woman who is pregnant. Preeclampsia may cause blood flow to the baby to decrease. High blood pressure causes constriction of blood vessels including those in the placenta through which the baby receives oxygenated blood. Women should be monitored throughout their pregnancy for high blood pressure and preeclampsia, and should be properly treated for this condition. Failure to do so may lead to devastating birth injuries and serious problems for the mother as well.

Rupture of the uterus: A uterine rupture occurs when the womb tears open, sending the child out of the uterus and into the mother’s abdomen. This may happen if the mother has had a prior C-section and attempts a vaginal delivery. When the uterus tears, the mother may suffer significant blood loss and the baby may become deprived of oxygen. Such a rupture may also cause the placenta and the umbilical cord to stop receiving blood, which may lead to HIE. In cases where women have had prior C-sections, it is important to make a decision as to whether going for a vaginal birth may increase the risk of HIE or other complications.

Breech birth: Typically, a baby is in a head-first position before being born. However, when a baby is in breech position (feet-first), there is an increased risk of umbilical cord prolapse and a risk of the head getting stuck in the birth canal. These types of complications may result in oxygen deprivation and HIE. In cases where a breech birth is anticipated, it is important to decide if a C-section is the best option.


Meconium aspiration:
Meconium is the baby’s first bowel movement. There are times when babies breathe meconium, which is a combination of the stool and amniotic fluid, into their lungs. This may cause respiratory issues, which may in turn lead to oxygen deprivation and HIE.

Placental complications: The placenta is a critical organ, which connects the developing fetus to the uterine wall allowing for nutrient uptake and waste elimination through the mother’s blood supply. The placenta also produces hormones that support pregnancy. When the placenta separates prematurely from the uterus, there may be significant blood loss leading to a decreased supply of oxygenated blood to the baby. This separation or placental abruption, which may be partial or complete, can also cut off the placenta and the umbilical cord from the mother’s blood supply.

Failure to perform a C-section: When any risks or complications occur, it is important that your doctor performs a quick C-section. Experts agree that especially in cases involving umbilical cord prolapse or placental abruption, the baby should be delivered via emergency C-section. This means that the hospital or medical facility should have the ability and the personnel with the required skills to promptly perform a C-section if the need arises. If a C-section is not performed in a timely manner, the infant is likely to suffer oxygen deprivation and HIE.

HIE Prevention and Treatment

There are steps that should be taken to prevent HIE during birth. First, medical professionals must make sure they are closely monitoring the mother and child so they are able to detect any symptoms of fetal distress or imminent distress. The next important step is to deliver the baby in a timely fashion when there are major risk factors or signs of distress. The chances of detecting such distress are higher when the mother and baby undergo routine prenatal testing. If you are going through a high-risk pregnancy, you will need more frequent prenatal testing.

When the mother is admitted to the labor and delivery unit, a fetal heart monitor should be attached to her body, which will help ensure that the baby’s heart rate is being monitored continuously. The mother should also be consistently monitored for complications such as cord or placental complications. If this happens, a C-section delivery should be performed. When fetal distress does occur, the medical team should prepare for an emergency C-section while taking steps to resuscitate the fetus that is still in the uterus.

One of the treatments for HIE is “hypothermia therapy” also known as “brain cooling” or cooling therapy. In fact, this is part of standard care when a child is diagnosed with HIE. This therapy should be performed in a timely manner. The treatment consists of lowering a newborn’s body temperature for a period of 72 hours. This allows cells to recover over a longer period of time and helps prevent further damage. Failure to perform such treatment on a newborn child who is displaying symptoms of HIE may be considered as medical negligence.

Children with HIE may develop a number of other associated conditions such as cerebral palsy (CP), which will also require a variety of treatments including physical and occupational therapy. If your child has suffered brain damage due to HIE, you may face significant ongoing medical expenses. If the condition was caused by medical negligence, you may be able to file a medical malpractice lawsuit against a number of at-fault parties including the doctor, obstetrician, hospital, members of the medical staff, etc.

Contacting an Experienced Lawyer

The parents of a child who has suffered hypoxic-ischemic encephalopathy or HIE as the result of a doctor or medical team’s lack of proper fetal monitoring or not performing a timely C-section surgery, etc. may be able to file a medical malpractice lawsuit. Families of children who suffer disabling birth injuries may be able to seek compensation for damages including, but not limited to, medical expenses, lost future income and benefits, cost of rehabilitation including physical and occupational therapy, counseling, cost of medication and medical equipment, permanent injuries, disabilities, past and future pain and suffering, etc.

If your child has suffered an injury from complications during birth and medical negligence, the experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you.

One of our clients secured a $43,940,000 verdict for a child who was diagnosed with cerebral palsy. The hospital failed to diagnose fetal distress, which led to brain damage and cerebral palsy from lack of oxygen supply to the brain. The delay in diagnosing the fetal distress and ordering a C-section delivery caused the child’s condition. Defense attorneys argued that the child’s injuries were caused by premature birth and that the obstetrical care was appropriate. The $43,940,000 verdict was eventually reduced on appeal, because the verdict was so huge.

In another case, our client obtained a $4,500,000 settlement where the doctor negligently used forceps to deliver a baby cutting oxygen supply to the child’s brain. The infant suffered from cerebral palsy as a result. We were able to prove that a C-section should have been performed, which would have prevented the cerebral palsy from occurring.

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