Tennessee Hypoxic-Ischemic Encephalopathy (HIE) Lawyers

Hypoxic-ischemic encephalopathy (HIE) is a brain injury where a baby is deprived of oxygen at birth. This can be due to numerous factors – a baby may ‘get stuck’ in the birth canal during labor, have shoulder dystocia (where the baby’s shoulder is caught on the pelvic bones) or have the cord wrapped around their neck, or the mother may have had a placental abruption or uterine rupture (resulting in heavy bleeding, which decreases blood flow to the baby). Ventouse (vacuum-assisted) or forceps deliveries are also associated with HIE.

HIE is often a preventable injury and is very strongly associated with medical malpractice – in many cases, a parent can closely follow prenatal care guidelines, and a child may still have HIE due to a medical staffer’s mistakes in monitoring, birth and delivery. This is why understanding the causes of HIE are important – we find that parents sometimes think back to their delivery and begin to suspect that doctors may not have followed standards of care, then reach out to us to help them determine if medical malpractice occurred, and whether they can get help funding their child’s future care. Please reach out to us if you are concerned about your child’s development, whether you are in Nashville, Memphis, Knoxville, Chattanooga, Clarksville, Murfreesboro, Jackson or any other Tennessee city.

HIE can look different based on individual circumstances, so it is always best to reach out to a birth injury attorney to determine the cause of the HIE on a case-by-case basis. However, there are several common risk factors and causes of HIE that parents should be aware of. If these risk factors are present, it is likelier that a baby may have an HIE diagnosis:

• Umbilical cord abnormalities and compression
• Placental issues
• Preeclampsia
• Pregnancies longer than 40 weeks
• Viral or bacterial infections in the mother or child
• Meconium aspiration syndrome (when a baby breathes in their stool)
• Improper presentation
• Size mismatches between the mother’s pelvis and the baby’s body/head
• Delayed C-section
• Improper fetal monitoring
• Traumatic delivery
• Severe bleeding

HIE can be visible to the eye (when parents notice seizures or trouble feeding, for example), or it can show up in imaging (such as MRIs, CT scans or ultrasound imaging). There are specific signs of HIE that can commonly occur, including:

• Seizures or repetitive twitching
• A need for resuscitation at birth
• Low APGAR score (The baby being limp, floppy, and white or blue at birth; Unresponsiveness or lowered consciousness
• Acidic blood
• Indications of brain damage during imaging
• Presence of seizure activity during EEG monitoring
• Trouble feeding
• Disturbed sleep patterns

• Missing developmental milestones
  • Basic reflexes such as the Moro reflex persist instead of going away
  • Child does not roll over, crawl, walk or talk at expected times
  • Does not make eye contact or respond to social cues
  • Does not appear to hear or see properly
  • Favors one side of the body more than another before it is developmentally appropriate
  • Trouble with speech or language

There are several long-term effects of hypoxic-ischemic encephalopathy, and the extent of the impact is highly dependent on numerous factors, including extent and severity of injury, whether or not the child had hypothermia therapy, and how well the child responds to early intervention programs. Cerebral palsy, motor impairments and learning/cognitive/intellectual disabilities are often a direct effect of hypoxic-ischemic encephalopathy, along with (in some cases) emotional or behavioral difficulties.

There is exactly one treatment for HIE called hypothermia therapy. This treatment is divided into two types: whole-body and head cooling; both are effective in helping minimize the spread of brain damage after a baby is oxygen-deprived at birth. With head cooling, the baby’s head is tucked into a cooling cap that circulating cooling fluid around the skull, while in whole-body cooling, the baby is placed on a cooling blanket which cools their entire body. Both these techniques allow the baby’s brain to be cooled to prevent the spread of cellular damage that occurs after an oxygen-depriving event. Both types of therapy are effective within 6 hours of birth; after this point, research has not found them to be effective.

The first thing that parents should do after receiving a diagnosis of HIE if their baby was just born is to ensure the baby gets hypothermia therapy. This is the first critical step in helping to ensure the child’s functional abilities will be maximized. There are several locations where hypothermia therapy is available; one of them – The University of Tennessee Medical Center – is even celebrating 60 years of operation. The facility  is the region’s academic medical center, with a Level III NICU and a state-designated regional medical center.

Once this is done, parents should enroll their child in various therapies (occupational, speech and physical therapy among them) and work with a team of specialists to help develop a treatment and therapy plan as part of an early intervention strategy. Once the child reaches preschool or school age, they may have an IFSP or IEP, which will help with the child’s developmental and educational needs.

If a parent is worried that they will be unable to afford their child’s care, they have some options, especially if the HIE resulted from a medical staffer’s mistake. This injury is commonly the result of medical malpractice, and the professionals who made the error must be held accountable for their actions, as such medical mistakes have profound and life-changing consequences for these babies. Parents can talk to a birth injury attorney in order to see what their legal options are in terms of securing their child’s future care, medical expenses and therapy.

There is a time limit regarding when a person can file a lawsuit for medical malpractice, and the rules regarding these timelines can differ vastly from state to state. Talking to a Tennessee birth injury attorney is the best way to determine if and/or when you can seek legal help for you child’s injuries.

If your child suffered a birth injury (cerebral palsy, hypoxic-ischemic encephalopathy, learning or developmental disabilities), you may be able to secure your child’s future with the help of Reiter & Walsh ABC Law Centers. We are birth injury attorneys first and foremost – we focus exclusively on birth injuries, unlike other large firms that deal with vastly different practice areas like auto accidents, pharmaceutical side effects, or adult surgical malpractice. Our focus of birth injury and track record of results make us uniquely equipped to help you with the details of your Tennessee birth injury case. We have worked with numerous families whose children have been impacted by HIE, be it from an instrument-assisted delivery, botched C-section, delayed delivery, or unmonitored underlying health issue. Note that we will never charge out any out-of-pocket fees – we only get paid if we make a recovery for you. Feel free to reach out to us 24/7 for a free consultation.