Michigan Hypoxic-Ischemic Encephalopathy Lawyers
What Can I Do if My Baby Was Oxygen-Deprived at Birth in Michigan?
Hypoxic-ischemic encephalopathy (HIE) is a brain injury where a baby is deprived of oxygen at birth. Fetal oxygen deprivation can cause serious and irreversible brain damage. The extent of damage and disability varies from infant to infant and depends on a number of factors at the time of birth. Other terms you may hear for hypoxic-ischemic encephalopathy include birth asphyxia, neonatal encephalopathy, intrapartum asphyxia, and perinatal asphyxia.
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 birth trauma attorney. Throughout this page, we’ll discuss the basics about HIE, including causes, diagnosis, risk factors, treatment, next steps, and legal help.
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What Causes Oxygen Deprivation in a Baby?
Oxygen deprivation 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.
Birth asphyxia happens in two stages. The first stage occurs is the initial cell damage that happens during the period of oxygen and blood flow deprivation. The second phase – called reperfusion injury – occurs when the blood flow and oxygen is restored and the toxins that build up in the damaged cells are released into the body causing further harm.
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 Detroit, Grand Rapids, Kalamazoo, Traverse City, Marquette or any other Michigan city.
HIE Has Many Risk Factors
There are many conditions and risk factors that can contribute to HIE. Many of these factors are things that medical professionals can closely monitor and properly treat. In many cases, proper monitoring and treatment will help prevent complications and medical emergencies that can cause HIE. Conditions that can require heightened monitoring and intervention include:
HIE Can Cause Varying Levels of Disability
HIE can vary in severity. This means that some children with HIE may have very few to no functional impairments, while some children may have very severe impairments that can substantially limit their physical or cognitive function. HIE can impact different parts of the brain, but it can often manifest itself as:
- Cerebral palsy
- Problems with coordination and walking
- Intellectual and developmental disabilities
- Learning or cognitive disabilities
- Seizures and epilepsy
- Blindness or visual impairment
- Deafness, hearing impairments
- Speech problems
Detecting Hypoxic-Ischemic Encephalopathy in Your Child
HIE can look different based on individual circumstances. Some children are diagnosed with HIE immediately while some aren’t. Some parents of kids with HIE are only told that they have the diagnosis, not necessarily why it happened. Sometimes, hospitals won’t fully explain why a child has HIE, or might otherwise deflect their answer. This is why 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.
There are several common risk factors and causes of HIE that parents should be aware of. The following risk factors may increase a baby’s likelihood of experiencing hypoxic-ischemic encephalopathy:
- Umbilical cord abnormalities and compression
- Placental issues
- 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:
HIE at Birth:
- Seizures or repetitive twitching
- A need for resuscitation at birth
- The baby being limp, floppy, and white or blue at birth; Unresponsiveness or lowered consciousness
- Indications of brain damage during imaging
- Presence of seizure activity during EEG monitoring
- Trouble feeding or breathing
- Disturbed sleep patterns
- Low APGAR Scores (0-3) for longer than 5 minutes. An APGAR score assesses the overall health of a newborn over the first few minutes following birth. It assigns scores to things like the baby’s skin color / complexion, pulse rate, reflexes, muscle tone, and breathing.
- Hypotonia (low muscle tone)
- Blue skin
- Profound metabolic or mixed acidemia in an umbilical artery blood sample (the baby’s blood is acidic/has a low ph.)
- Multiple organ problems (e.g., involvement of the lungs, liver, heart, intestines)
- No brainstem reflexes (e.g., breathing problems and an abnormal response to light, and only blood pressure and heart function reflexes are functioning)
HIE After Birth:
- 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.
How Is Hypoxic Ischemic Encephalopathy (HIE) Diagnosed?
Once hypoxic ischemic encephalopathy is suspected, neuroimaging tests are usually done to confirm the diagnosis. These include:
- PET scans
- CT scans
- Blood glucose tests
- Umbilical cord and arterial blood gas tests
- Lactate results
How Is Hypoxic Ischemic Encephalopathy (HIE) Treated?
Traditionally, treatment of HIE has been supportive care that focuses on preventing further brain damage. This meant lengthy NICU stays, mechanical ventilation, seizure management, blood glucose and blood pressure maintenance, and minimizing brain swelling.
However, now, we have a treatment for HIE. This treatment is 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 by dropping the baby’s temperatures to around 91 degrees Fahrenheit. Both types of therapy are effective within 6 hours of birth; after this point, research has not found them to be effective. This therapy lasts for about 72 hours (3 days).
There are other intensive therapies that parents can enroll their children in, such as physical therapy, occupational therapy or speech therapy. While this will not treat the underlying cause of the injury, it can help children learn critical skills and assist in their development.
Your Baby Was Diagnosed with HIE in Michigan. What Are Your Next Steps as a Parent?
After parents receive an HIE diagnosis, it can be helpful to speak to your child’s doctor about hypothermia therapy (if the child was just born), or about other treatment and therapy options if the six-hour window has passed. 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, including the University of Michigan Medical Center. 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.
When Can You File a Medical Malpractice Lawsuit for Your Baby with HIE?
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 Michigan birth injury attorney is the best way to determine if and/or when you can seek legal help for you child’s injuries.
Getting Help for Your Child’s Michigan Birth Injury
If you believe your child’s injuries were the result of medical malpractice, we encourage you to reach out to the team at 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 Michigan 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:
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Read more about cooling therapy:
- Hypothermia Therapy in the News [External Link: Wall Street Journal]