Neonatal hypoxic ischemic encephalopathy (HIE) occurs when a newborn infant sustains neurological damage due to severe oxygen deprivation and limited blood flow to the brain around the time of delivery. Between 10% and 60% of newborn infants afflicted with HIE will die during delivery or subsequent to birth, and approximately 25% of infants who survive this condition suffer incapacitating brain injuries that cause lifelong neurological deficits. The longer the infant has been exposed to low levels of oxygen, the more widespread and debilitating the brain damage will be.
    APGAR test scores, which measure a newborn infant’s wellbeing shortly after birth, are low in HIE patients indicative of cognitive and motor deficits. For example, newborn infants with HIE might appear lifeless, semiconscious or comatose due to the absence or impairment of key brainstem reflexes, such as the regulation of normal breathing patterns. These infants might suffer hypotonia, or low muscle tone of the limbs. Consequently, movement may be inhibited due to the inability to crawl, walk and support oneself in a seated position. Compromised neurological and motor skills may also result in the inability to talk, bladder and bowel incontinence and swallowing dysfunction, which may necessitate a gastrointestinal feeding tube to deliver proper nutrition to the infant. Newborn infants afflicted with HIE sometimes experience seizures as early as the first or second days of life, and those diagnosed with particularly severe cases of HIE might develop epilepsy, a neurological disorder that necessitates the long-term use of anticonvulsant medication to control recurrent seizures. In addition to causing epilepsy, the irreversible brain damage found in HIE patients can also lead to cerebral palsy, learning disabilities, developmental delays and mental retardation.

    Hypoxic ischemic encephalopathy often results from complications that arise during labor that prevent an infant from receiving a sufficient amount of oxygenated blood to the brain. An infant who sustains umbilical cord injuries can suffer significant brain damage. For example, compression of the umbilical cord or intertwining of the umbilical cord around the fetus’ neck may impede the passage of oxygen-rich blood to the baby’s brain. Prolapse is another dangerous condition that occurs when the umbilical cord is expelled from the uterus before the infant. Uterine hyper-stimulation, also called tachysystole, occurs when the rate of contractions of the uterus is too high during labor. Too many consecutive contractions may exert excessive pressure on the fetus and decrease the amount of oxygenated blood transported from the placenta to the infant. If the uterus does not “recover,” or return to a resting state between contractions, the fetus may also suffer oxygen deprivation. Uterine hyper-stimulation can result in uterine rupture, a tear that sometimes leads to the displacement of the fetus into the mother’s abdominal cavity. Other complications leading to the diminished delivery of oxygenated blood to an infant’s brain include placenta previa, in which the placenta partially or entirely blocks the cervix, the canal that the baby moves through during delivery, and placental abruption, in which the placenta partially or completely detaches from the uterine wall. Furthermore, preeclampsia and eclampsia are two conditions that can cause HIE in infants. A mother who suffers preeclampsia during pregnancy experiences elevated blood pressure, swelling of the extremities and increased levels of protein in urine. In the case of eclampsia, rising blood pressure can result in seizures, coma and death.

The law firm of O’Connor, Parsons, Lane & Noble has significant experience representing families whose infants have suffered hypoxic ischemic encephalopathy and other types of severe brain damage due to perinatal negligent care. There are different ways in which the development of HIE could warrant a lawsuit. For example, a physician or nurse may be held liable in a medical malpractice claim if he fails to identify fetal distress by misinterpreting warning signs on the fetal monitor, such as a lack of variability in the fetal heart rate or bradicardia, an abnormally slow heart rate. If an infant is exhibiting signs of oxygen deprivation, failure to immediately induce labor or failure to perform an emergency C-section are grounds for medical malpractice lawsuits. A physician might be held liable if he postpones the delivery of an oxygen-deficient infant because delayed delivery might exacerbate hypoxia, a lack of oxygen, and result in anoxia, the complete absence of oxygen, thereby worsening the extent of brain damage. In addition, physicians should closely monitor women who experience excessive uterine activity during labor to track the number of contractions in a given time frame and take necessary measures to lessen the possibility of uterine rupture. Medical professionals should also provide proper treatment for women who experience high blood pressure during pregnancy that is characteristic of preeclampsia and eclampsia.