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.
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Top Case Results"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 processes because we knew they had our family’s very best interest at heart and wanted justice for our son.
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.
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.Learn More
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