80 Years of Combined Experience and Results in Medical Malpractice Cases
When an infant is diagnosed with Hypoxic Ischemic Encephalopathy (HIE), it can be a devastating experience for parents, families, and the child. Families are faced with not only the pain and suffering and challenges of caring for a disabled child but also the drastic associated expenses.
When HIE is the result of negligence or medical malpractice, the pain is even greater as parents can feel betrayed by the very health care providers they trusted to ensure the health of their baby.
If your child was injured at birth, consult with a Florida birth injury lawyer at Ratzan Weissman & Boldt with over 80 years of combined experience. Let us find out exactly how this tragedy occurred and whether you are entitled to compensation. If you suspect that medical negligence caused your child’s injury, we can help you get to the bottom of it.
Few injuries are more devastating to a family than a birth injury. The delivery of your child should be one of the happiest events of your life.
When a doctor, nurse, or other healthcare provider does not deal with a medical situation properly, your newborn may suffer injuries that can leave him or her damaged for life. In the worst cases, medical negligence during childbirth may result in death.
Recognized for our commitment to effective medical malpractice litigation, we selectively handle the most complex and devastating medical malpractice claims in Florida and across the United States. No city or state is too far. Our medical attorneys have represented hundreds of victims in cases involving numerous types of injuries and medical conditions, and the results speak for themselves.
What is Hypoxic Ischemic Encephalopathy (HIE)?
Hypoxic ischemic encephalopathy (HIE), also referred to as neonatal encephalopathy, perinatal asphyxia, or birth asphyxia, is a condition experienced by a baby at birth stemming from a lack of oxygen, resulting in permanent injury to the baby’s brain. There are numerous causes for HIE, many of which arise from medical negligence by the baby’s healthcare providers.
The term encephalopathy refers to a brain disorder. In this situation, the disorder stems from a lack of oxygen and reduced blood flow to the baby’s brain.
How Does HIE Happen?
While the baby is still in the womb, the baby’s lungs are not yet fully developed and functioning, and the baby depends on the oxygen transferred from the mother. The mother’s blood contains oxygen and is delivered to the uterus. In the uterus, the oxygen is transferred to the placenta where the baby’s blood absorbs the oxygen and carries it to the baby via the umbilical cord. The oxygen-rich blood is then delivered to the baby’s organs and tissues via the baby’s circulatory system. Oxygen is necessary to sustain the health of the baby’s organs and tissues.
Any event or condition that affects the delivery of oxygen along this pathway from the mother to the baby will affect the health of the baby.
HIE may occur during pregnancy, delivery, or even after birth during the postnatal period. For a baby’s brain to function and survive, oxygen must be delivered to the cells of the brain. HIE may occur in premature or full-term infants.
What Our Clients Say
I remember the deposition [where] one of the [defense] lawyers asked me "how much money would satisfy you"? This is really not about money and it wasn't about money for Stuart, I realized that - it was really about justice. This is what the trial afforded us - going through the process and getting justice.RWB Client
At one of the most uncertain times in our lives, we reached out to Ratzan law firm. They helped us uncover the truth and fought for our son so that he could get the care he needed due to medical negligence. Ratzan and Weissman were responsive and attentive to our case and working with them, on behalf of our son, was positive and rewarding.RWB Client
Stuart [Ratzan] and his firm, and I'm adding his firm - not just Stuart - every single member of his staff treated me and my family, or whoever talked to him on my behalf as if they were just...family. Every single member of his staff - and that has gone on, it didn't just end when the case ended, it still continues, our relationship with the firm.RWB Client
I, and my whole family, feel that we are blessed that RWB represented us during the most tragic time of our lives. They helped facilitate the legal process in a very professional manner. I always felt their support and protection. I have no words as to how satisfied I am not only with their legal services but also with the case results.RWB Client
Yo, y toda mi familia, nos senitmos muy benedicidos que ésta firma de RWB nos representaron en un tiempo muy trájico en mi vida. Ellos me ayudaron con el proceso legal muy profesionalmente y muy humanamente. Siempre sentí que ellos me apollaban y me protegían y yo quedé muy satisfecho con los servicios legales y los resultados de mi caso.
I feel very fortunate that my family was able to work with Ratzan Weissman & Boldt as our attorneys during our family’s case. Throughout our case they treated our family with sensitivity, respect and kindness. Going through a malpractice lawsuit can be very emotional on a family, and they always understood and supported us. We never questioned any of the process because we knew they had our family’s very best interest at heart and wanted justice for our son.RWB Client
I was blessed to find Ratzan Law Group for my case. From my first phone call to that office up until the end of my case, I felt lucky to have such a strong team on my side fighting for justice for me. They truly cared about me as a person. They treated me like family. Ratzan and his firm are patient and explain the process to you as you go along. When I didn’t have a ride to get to the office, they had a driver pick me up. It was so comforting to know that they were taking care of me, taking the burden off my shoulders. I had no doubt in my mind that God put me in the right hands. I will always be grateful and thankful for Ratzan and his team for protecting me, guiding me, and representing me in the hardest time of my life.RWB Client
What I liked most [about working with RWB] was the way in which Stuart embraced us, the way in which he made us feel welcomed and that we were the only clients he had. You just got that feeling, you came to the office or you called him he was never too busy, he was never not available. Every single question he would ask you for your decision, he would want to clarify things, he was constantly back and forth telling you what the next steps were-totally transparent, there was not one decision he made without asking for your opinion.RWB Client
The first takeaway for me [when it comes to my experience working with RWB] was Stuart's need to understand who we were and what my family was about. He actually came to the island [my home] for about three days to visit to get to know who my Son's friends were. He met his Godmother, he went to my Son's school, and we went to the cemetery to see the grave. To me, that was unbelievable, that an attorney would want to be part of who we were to really understand who it was that he was fighting for.RWB Client
I was extremely satisfied with the offices of RWB. They obtained a successful recovery for my accident. I felt they cared about me and really wanted to help me. They fought for justice to be fair compensation for the negligence I experienced.RWB Client
Yo quedé muy satisfecho con la representación del bufete de Ratzan. Ellos adquieron un buen resultado para Mi accidente. Yo me sentí que ellos realmente querián aydarme a recibir un monto justo para el Los daños que me occurrieron.
What I learned from the case over the period of about 2-3 years that it took, when I felt sometimes that I just wanted to give up and forget about it- there were too many things, what I came to learn is that the process and the extent of the investigations, the research that was done, the experts that were brought in, it gave me a full sense of what really happened with my Son that night. That brings me a lot of comfort, that I got to know exactly what happened and we got justice.RWB Client
During the worst time in my life, and after losing my son, the Ratzan team embraced me and my family. They actually became my family. I received excellent, professional and warm support from them to which I am very grateful.RWB Client
Mr. Ratzan took on my case and helped me finalize a fair amount of compensation for me and my girls. I can’t thank him enough. He and his firm fought relentlessly to obtain a successful result and they really care about their clients. I was extremely satisfied with his representation for my case.RWB Client
I cannot express my gratitude enough to my attorney Stuart Ratzan for representing me in my case. Mr. Ratzan and everyone his firm were kind and understanding about what I was going through. They held my hand through the whole process and really made everything as easy as possible. Stuart Ratzan did not just represent me, he defended me and not just the case. He made me feel that he really cared about me as a person, and understood what I went through. It’s a wonderful feeling knowing that Stuart Ratzan and his firm gave their all to obtain a fair compensation for me. I believe they are the best at what they do.RWB Client
There are many causes of HIE. Sometimes, these causes are preventable and at other times, they are not. However, they all stem from the interruption of oxygen to the baby’s brain.
Causes of HIE During Labor and Delivery
- Uterine hyperactivity
- Shoulder dystocia
- Overdosage of medications such as Pitocin
- Rupture of uterus
- Placental abruption
- Umbilical cord problems
- Abnormal fetal position
- Maternal low blood pressure
- Prolonged late labor
Post-Delivery Causes of HIE
- Infant low blood pressure
- Infant low blood sugar
- Cardiac arrest
- Respiratory failure
- Premature birth
- Severe infection
- Severe heart or lung disease
- Trauma to the infant’s brain
Causes of HIE During Fetal Development
- Disruption of blood transfer from the uterus to the placenta
- Heart disease
- Drug or alcohol abuse
- Congenital fetal infection
- Lung malformation
- Fetal anemia
- Preeclampsia (a potentially dangerous pregnancy complication characterized by high blood pressure)
- Maternal diabetes and vascular disease
Infants that experience HIE may not initially show any signs of brain injury. Often, healthcare providers and parents will not appreciate the full extent of the injury until the child grows and develops as expected developmental milestones are not met. In other cases, HIE is immediately suspected based on the history of the birth and the baby’s condition after birth. Some of the common signs of this injury include:
- Baby’s condition after birth
- Low Apgar scores
- Abnormal level of consciousness (the infant may not show signs of being alert)
- Breathing difficulties
- Lack of reflexes (for example, the infant may not respond to noises)
- Feeding problems
- High or low muscle tone
- Birth history
- History of cord compression (cord prolapse) or cord wrapped around the baby (nuchal cord)
- Maternal bleeding (uterine rupture, placenta previa, placenta abruption)
- Non-reassuring fetal heart tracings during labor
- Difficult delivery (shoulder dystocia)
- Maternal blood pressure problems during labor
Unfortunately, the signs of HIE may become apparent only as the child develops. The effects of the injury can be extremely complex and unfold at various times as the child grows. Therefore, it may be difficult for healthcare providers to determine the best treatment early on in a baby’s life.
Depending on the extent of the oxygen deprivation, effects can vary. The longer the baby’s brain is deprived of oxygen, the more severe the injury and complications of HIE can be.
The result of this injury can vary widely from temporary effects to severe and permanent injury with significant disability. Some cases may involve mild cognitive issues. Others, however, experience extreme disability and developmental delay, and some may not survive past infancy.
According to Newborn and Infant Nursing Reviews, “40-60% of affected infants die by 2 years of age or have severe disabilities.” This injury is among the most severe injuries that affect full-term infants. Worldwide, HIE causes 23% of neonatal deaths. Some serious conditions associated with HIE include epilepsy, cerebral palsy, and cognitive impairment.
The presence of risk factors should alert healthcare providers to suspect HIE when a newborn has an abnormal presentation. The diagnostic workup for a child suspected of having HIE includes:
- A consultation with a pediatric neurologist
- Radiologic studies (such as an MRI) to assess for brain injury
- A brain ultrasound
- An electroencephalogram (EEG) to look for abnormal brain electrical activity, such as seizures
- Additionally, physicians may order other diagnostic studies to assess for injury to other organ systems
The most common type of HIE treatment offered to infants soon after HIE is diagnosed is Brain Cooling. This form of treatment, called therapeutic hypothermia, cools the infant’s brain and body below the normal temperature. This cooling reduces the injury to the brain by decreasing the oxygen requirement of the brain cells and reduces the formation of toxins caused by the initial injury.
This treatment should be provided within six hours of the infant’s birth and may last up to 24 hours. During therapeutic hypothermia, the baby is given medications for comfort and then placed on a cooling blanket to reduce the baby’s temperature. Once the cooling is complete, the neuro-intensive team will warm the baby’s body back to a normal temperature. Further testing following the hypothermia will be performed to assess the baby’s brain function. Therapeutic hypothermia may decrease the extent of long-term complications and disability experienced by a child with HIE.
Other Treatments for HIE
- Mechanical ventilation for pulmonary complications
- Medications to support the heart and circulation
- Antibiotics for infections
- Anti-seizure medications, and support for decreased kidney and liver function
As the baby grows, other therapies are required to overcome the long-term complications of HIE. These include physical therapy, occupational therapy, and speech therapy, special education, and corrective surgery. Adaptive devices may be required for injuries that affect walking and movement. For children whose hearing and vision are affected, adaptive aids will also be required.
Although not completely preventable, in many cases HIE is preventable if healthcare providers recognize the conditions that place a baby at risk for HIE and manage those issues before permanent injury occurs.
Generally, preventing HIE is dependent on the proper monitoring of the mother’s health during pregnancy. If the pregnancy is considered high-risk, health care providers will need to provide her with more frequent monitoring to ensure the health of both the mother and infant.
When health care providers detect the signs indicating a potential risk for HIE, they can take steps to improve fetal oxygen. If these steps are not successful, the health care providers can deliver the baby by a cesarean section.
It is the healthcare providers’ responsibility to understand and recognize the risks of HIE; provide proper monitoring when indicated; recognize the signs of impending injury, and make the correct decisions and take action when there are threats to the baby’s well-being.
When health care providers fail to monitor for HIE; fail to assess the risks; fail to recognize the signs of impending injury, or fail to take the proper corrective actions, the healthcare providers may have acted negligently and be found liable for committing medical malpractice.
HIE can result from medical malpractice during or after the birth of the infant.
Medical malpractice cases associated with HIE most commonly stem from:
- Inexperienced medical staff
- Mismanagement of issues related to the placenta, umbilical cord, or the mother’s uterus
- Not properly using a fetal heart rate monitor
- Failing to recognize non-reassuring fetal heart patterns
- Mismanagement of high-risk pregnancy (not taking appropriate precautions)
- Failing to provide therapeutic hypothermia when HIE is suspected (or should be suspected)
If you or your child experienced any of the following situations, you may have a valid medical malpractice claim.
Hypoxic Ischemic Encephalopathy Lawyers
At Ratzan Weissman & Boldt, we don’t believe that any amount of money can adequately atone for a birth injury. Yet if your child has been hurt as a result of medical malpractice, you must choose a law firm that can protect your family’s rights, safety, and welfare.
You need a team that has the legal and medical resources, expertise, and commitment essential to successfully pursue a birth injury claim. We can help you sort through the most complicated issues to reveal the root cause of what happened, helping you determine if you have a medical malpractice claim involving HIE.
Because lives are at stake, negligent doctors, hospitals, and staff must be held to the highest standards and must be held accountable for their actions. It’s their job to protect us all; it’s what they’re paid to do. Many of them do this every day with excellence. Unfortunately, some do not. As a victim, you have the legal right and the urgent need for just and fair compensation and the power to hold those who have caused harm accountable.
Recognized for our commitment to effective medical malpractice litigation, we selectively handle the most complex and devastating medical malpractice claims in Florida and across the United States. No city or state is too far.
Our medical attorneys have represented hundreds of victims in cases involving numerous types of injuries and medical conditions, and the results speak for themselves.
Ratzan Weissman & Boldt is a Florida-Based National Medical Malpractice Law Firm
Our attorneys are devoted to improving the lives of our clients and the communities they live in. If your life or that of a loved one has been undone because of medical negligence, talk with us. If you have experienced the death of a loved one due to the negligence of a hospital, doctor, nurse, or other health care provider, call us. We are here to help you. No case is too complex and no venue is too far.
Ratzan Weissman & Boldt is a contingency-fee based practice. This means there are no fees or costs to you unless we prevail through a favorable settlement or jury verdict and judgment. Because we don’t bill by the hour and only get paid when you do, our priority is maximizing the results in your case.
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