All parents need the facts about this birth injury. While it seems there is a whole medical vocabulary to learn, our attorneys answer parents’ most pressing questions in the FAQs section below. Understand the signs and symptoms of kernicterus, the treatments, and become proactive in protecting your child’s future.
Excessive Newborn Jaundice – A Preventable Birth Injury
After delivery of a healthy baby, new parents return home with their newborn. Over the following days, their baby doesn’t seem quite right. He is hard to wake, his skin and eyes have a yellowish tint, and he has trouble nursing. They take the infant to their pediatrician for a check up, and learn that their baby has severe jaundice. They also learn that it’s too late to treat him – and that their child has suffered irreparable brain damage because of something called “kernicterus.”
A form of brain damage that can attack babies who have newborn jaundice, kernicterus occurs when a substance in the baby’s blood − bilirubin − builds to toxic levels and leaks into the brain tissue.
This event is especially tragic because it is preventable. Is medical negligence to blame? Too often, the answer is yes.
Most newborns have mild jaundice to some degree. The signs of jaundice are well known and treatment is standard procedure. The trouble begins when high bilirubin levels are not immediately monitored and treated.
When levels of bilirubin become excessive and the jaundice becomes severe, a baby can suffer devastating damage to his or her brain and neurological system. Severe cases can end in the child’s death. Babies that survive suffer from a range of disorders including forms of cerebral palsy, hearing and vision loss, developmental impairments and mental retardation.
Ratzan Weissman & Boldt stands ready and able to represent victims of this crippling birth injury throughout Florida and across the United States. In our 20-year history as medical malpractice attorneys, these cases stand out to us because they should never occur.
Kernicterus Information for Parents
What Our Clients Say
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, 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 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
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
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.
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
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
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
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 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
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
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
Kernicterus, also known as Chronic Bilirubin Encephalopathy, is a rare but severe complication from abnormally high levels of bilirubin in the blood (hyperbilirubinemia). Bilirubin at high levels is toxic to the cells of the brain – particularly the regions known as the basal ganglia and the brainstem. If left untreated, these high levels of bilirubin may cause severe and permanent brain injury.
Bilirubin is a yellowish byproduct of the breakdown of hemoglobin in red blood cells. Newborns have a higher rate of red cell breakdown with a level of bilirubin production leading to increased levels of bilirubin in the blood. High levels of bilirubin are deposited in the skin and the whites of the eyes causing a yellowing known as neonatal jaundice or jaundice of the newborn.
Jaundice is typically seen 2 to 3 days after birth. Under normal conditions (physiologic jaundice), the increased bilirubin peaks on day 3 or 4 of life and normalizes within 10 to 14 days. The bilirubin is converted by the baby’s liver into a form that can be removed by the body and the jaundice resolves without any complications.
Hyperbilirubinemia is defined as bilirubin levels above 5 mg per deciliter (dL). Jaundice is abnormal (pathologic jaundice) when the jaundice is not physiologic. Features of pathologic jaundice include the appearance of jaundice within 24 hours after birth, a rapidly rising total serum bilirubin concentration (increase of more than 5 mg per dL per day), and a total serum bilirubin level higher than 17 mg per dL.
Some babies have risk factors that cause the bilirubin to rise abnormally high either due to increased red cell breakdown or the inability of the liver to convert it to an excretable form, leading to toxic blood levels. When this occurs, the bilirubin is taken up by the brain leading to brain injury known as kernicterus. The condition resulting from kernicterus is called bilirubin induced neurologic dysfunction (BIND).
There are many risk factors that may lead a newborn to have hyperbilirubinemia. They may include conditions associated with the mother and those associated with the birth.
Maternal (parents) risk factors for Hyperbilirubinemia (either and/or both parents):
- Blood type incompatibility with baby (AB or Rh incompatibility)
- Breast feeding
- Certain drugs given to the mother such as diazepam (Valium), oxytocin (Pitocin), promethazine (Phenergan)
- Ethnic background – Asian, Native American, Mediterranean descent
- Gestational diabetes
- Genetic diseases of hemoglobin (thalassemias)
- Prior pregnancies with newborn jaundice
- G6PD Deficiency (a condition causing red blood cells to break down in response to certain medications, infections, or other stressors)
Neonatal (childs) risk factors for Hyperbilirubinemia:
- Birth trauma including bruising to the head
- Drugs given to the baby such as Pediazole or Chloromycetin
- Infections in the baby
- Polycythemia (increased red cells in the blood)
- Previous sibling with hyperbilirubinemia and/or newborn jaundice
- Male gender
- Liver disease
All newborns with jaundice should be evaluated with bilirubin levels. While in the hospital, routine assessment for jaundice should be every 8 to 12 hours. If the baby is discharged before 72 hours, they should be evaluated for jaundice within 2 days after discharge as the bilirubin levels may peak after the baby is discharged and jaundice missed.
If the baby is noted to be jaundiced, a bilirubin level should be obtained. Testing can be done with a blood sample for total serum bilirubin (TSB) or using a light to assess the bilirubin level (Transcutaneous bilirubin – TcB).
The risk for kernicterus is based on the bilirubin level and the baby’s age in hours using a chart known as a nomogram. Further testing is indicated based on the risk on the nomogram
Additionally, other laboratory tests should be obtained to determine whether the baby has risk factors for pathologic hyperbilirubinemia such as maternal fetal blood incompatibilities or genetic diseases of hemoglobin (thalassemia).
Missing jaundice and not properly monitoring bilirubin levels may lead to toxic levels of bilirubin and result in kernicterus.
If the bilirubin levels present a high risk for kernicterus, hyperbilirubinemia can be treated to prevent a rise to toxic levels:
- Phototherapy or light therapy – the baby is exposed to a special light that converts the bilirubin into a form that can be excreted by the body.
- Blood exchange transfusion – a baby’s blood is exchanged with blood from a matched donor.
In addition to having jaundice, babies with kernicterus may present with more severe signs. These include:
- Lethargy / excessive sleepiness
- High-pitched crying.
- Lack of appetite or difficulties feeding
- Floppy or limp body
- Absent reflexes e.g., the moro reflex
- Uncontrollable movements / muscle spasms
- Arching of the head and heels back (like a bow)
- Lack of wet diapers
- Unusual eye movements
Signs of Kernicterus often do not arise until a few months or years into a child’s life. This is usually because when a child has not reached expected milestones. If kernicterus is suspected as a cause of neurologic dysfunction, an MRI may demonstrate brain injury.
Kernicterus is preventable. If the risks of kernicterus are missed because bilirubin levels were not properly monitored and treated, the result will be severe and involve devastating complications. These include:
- Athetoid cerebral palsy – a movement disorder caused by brain injury
- Lack of muscle tone
- Muscle spasms
- Difficulty with coordination
- Problems maintaining normal eye movements
- Hearing and vision loss
- Developmental impairments
- Communication difficulties including speaking
- Intellectual and learning disabilities
- Poor development of the teeth
Kernicterus Lawyers Take Strong Action
Treatment to prevent kernicterus is readily available. The failure to identify this medical emergency is wholly avoidable. When allowed to go untreated, the result is a lifetime of disabilities, hardship, and long-term medical costs.
Healthcare professionals must be aware of the warning signs of excessive newborn jaundice. Failure to act quickly and properly may mean that they are liable for medical malpractice for harm suffered by the child because of their inaction.
Each family struggling with kernicterus has a unique story and set of challenges. We experience these struggles with them. For these families, our kernicterus injury lawyers work tirelessly to secure the financial compensation they so desperately need to offset their pain and suffering, and the massive costs of caring for a child with brain damage.
We believe in giving a powerful voice to those who would otherwise have none. We believe in seeking and speaking the truth. We crave justice.
Contact Ratzan Weissman & Boldt – National Kernicterus Malpractice Law Firm
If a doctor failed to treat your child for excessive jaundice that resulted in kernicterus-related brain damage, medical malpractice may have occurred. Our law firm can help you best determine how to proceed. When medical negligence is to blame, our attorneys will go to work immediately to build and pursue a powerful case on your child’s behalf.
To have your case reviewed, contact our kernicterus lawyers here or by telephone at (305) 374-6366. It costs nothing to call and ask us to evaluate your case – we are here to help. We are a contingency-fee based practice. What this means is that there are no fees or costs to you unless we prevail through either a favorable settlement or jury verdict.Contact Us
Top Kernicterus Case Results
$18 Million Recovery for a Baby Who Developed Kernicterus as a Result of Untreated Jaundice
To consult with our professional team, please fill out the form and submit your request.