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Understanding Hypoxic Ischemic Encephalopathy (HIE)

Hypoxic Ischemic Encephalopathy, or HIE, is a form of infant brain damage caused by oxygen deprivation and reduced blood flow to the brain. Because HIE is a dangerous condition with life-altering and fatal risks, proper medical care and timely intervention is critical to both preventing HIE, and minimizing its severity.

As few parents are prepared for the gravity of an HIE diagnosis, and because many have questions about whether it was preventable or may be grounds for a birth injury lawsuit, understanding the condition is important – particularly from the perspective of medical malpractice and the potential for holding at-fault parties accountable.

What is HIE?

One way of understanding HIE is to first understand its terminology.

  1. Hypoxic – HIE is brain damage caused by reduced supply of oxygen (hypoxia) to the brain and other organs.
  2. Ischemic – In HIE, oxygen deprivation is compounded by reduced blood flow (ischemia) to vital organs.
  3. Encephalopathy – HIE is a condition caused by a lack of oxygen and blood in the brain, as are all conditions described using “encephalopathy.”

As a birth injury, HIE is caused by oxygen deprivation during the perinatal period, or the period of time (a number of weeks) just before and after delivery. It’s the leading cause of infant death in the U.S., and the primary source of severe impairment.

HIE Symptoms & Effects

HIE can be diagnosed immediately after childbirth, especially if difficult deliveries and complications warrant further assessment. It may also be confirmed using various tests (i.e. CT and MRI scans, echocardiography, ultrasound, and EKGs or EEGs) when certain symptoms are present, including:

  • Low heart rate
  • Poor muscle tone
  • Weak breathing / lack of breathing
  • Pale or blue skin coloration
  • Excessively acidic blood
  • Meconium stained amniotic fluid

While some oxygen deprivation is tolerable for newborns, prolonged periods of oxygen and blood flow deprivation can cause permanent brain damage, if not death. As such, the duration of oxygen deprivation can influence whether the condition and its symptoms are mild, moderate, or severe, as well as what effects it will have on a child. It may take several years (around age 3 or 4) before the true severity and effects of HIE are known.

In many cases, children with mild HIE symptoms are able to live full and productive lives, but more severe symptoms can be devastating to their ability to perform activities of daily living independently. These may include:

  • Cognitive and developmental delays
  • Impaired motor function
  • Epilepsy
  • Neurodevelopment problems
  • Vision impairment

Causes of HIE

There are various causes of Hypoxic Ischemic Encephalopathy, and those causes may stem from risk factors, complications, or even medical mistakes before, during, or after childbirth.  Rick factors include:

During Pregnancy / Just Before Birth

  • Maternal diabetes and vascular disease
  • Preeclampsia (high blood pressure in the mother)
  • Cardiac disease / complications

During Labor & Delivery

  • Placental abruption / internal bleeding
  • Umbilical cord complication
  • Abnormal fetal position
  • Trauma during birth
  • Low maternal blood pressure

 After Birth

  • Premature birth
  • Low neonatal blood pressure
  • Cardiac or pulmonary disease

When Malpractice Is Suspected

The unique facts and circumstances surrounding pregnancy, labor, delivery, and postpartum care – as well as the conduct of treating medical professionals – are immensely important in determining whether any case of Hypoxic Ischemic Encephalopathy could and should have been prevented.

There are accepted medical standards, and the doctors, nurses, and other health care providers who facilitate childbirth have legal obligations to treat mothers and babies in accordance with those standards. Failure to do so (when any reasonably skilled professional under the same or similar circumstances would be able to) is medical malpractice.

What constitutes medical malpractice or professional negligence is a complicated analysis, is highly fact-dependent and requires significant medical and legal expertise.  Some more common examples of medical negligence that can cause HIE include:

  • Failure to monitor fetal heart rate and respond to signs of fetal distress (which indicate oxygen deprivation) in an appropriate and timely manner.
  • C-section errors (failure to perform a C-section or delaying a C-section) which cause or exacerbate the severity and duration of oxygen and blood deprivation.
  • Failure to accurately diagnose and identify risk factors and appropriately address them (i.e. failure to treat maternal infections, preeclampsia, umbilical cord complications).
  • Medication errors, including the negligent use of labor-inducing medications such as Cytotec or Pitocin, which can overstimulate contractions and cause oxygen deprivation.
  • Improper use of forceps and vacuum extractors, causing traumatic injury.

Even when doctors don’t directly cause trauma or oxygen deprivation to the baby, they must still respond appropriately and provide adequate treatment immediately when signs are present.

Proven Birth Injury Lawyers Helping Families Understand

Power Rogers & Smith, L.L.P. is a Chicago-based law firm that’s become one of the most accomplished, trusted trial practices in Illinois. Our attorneys have helped clients recover more than $4 billion in compensation, have resolved many complex and high-value birth injury claims, and have secured the largest medical malpractice verdict in Illinois state history. Just last year, or team recovered $35 Million for a child who suffered a traumatic HIE injury at birth.  We know how to help families through these difficult experiences, and how to handle these immensely challenging legal cases.

Families have many questions following birth injuries like HIE, and turning to the right team of caring, compassionate, and experienced professionals can make all the difference. Let our firm help your family learn more about your rights and options. Call (312) 313-0202 or contact us online for a free consultation. Power Rogers & Smith, L.L.P. serves clients across Illinois.

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