Pregnant with her first child, Louise Huart was rushed to the hospital when her contractions became so rapid that they occurred two minutes apart. Shortly after arriving, Louise’s water broke. Her amniotic fluid was thick with meconium, which indicated that her baby was in distress. The fetal heart monitor showed that her baby’s heart rate was dropping, which is another sign of fetal distress. Despite this, the physician told Louise that her baby was fine. Four hours after being admitted, at 7:30 a.m., Louise’s contractions stopped completely. For the next three hours, Louise was repeatedly encouraged by the medical team to deliver her baby naturally, even though she was having no contractions. At 10:30 a.m., the physician finally ordered a C-section.
Baby Keegan James was born with meconium aspiration syndrome, which is when the baby inhales a mixture of meconium and stool into his lungs. Keegan was also in hypovolemic shock at birth caused by sepsis. Sepsis is an infection in the blood that causes decreased circulating blood volume, which means Keegan’s heart couldn’t pump adequate blood throughout his body. This, among other things, caused reduced oxygen delivery, and his brain suffered oxygen deprivation. Keegan was diagnosed with pneumonia and hypoxic ischemic encephalopathy (HIE) shortly after birth.
Louise is expected to sue the hospital for multiple areas of negligence, one if which is failure to quickly deliver her little boy when distress was evident on the fetal monitor.
What is Meconium Aspiration?
When a baby is in the womb, there is no actual “breathing” occurring; the baby receives his oxygen from the supply of oxygen-rich blood he gets from his mother through the umbilical cord. At about 9 weeks, however, the baby starts to “practice breathe.” He does breathing-like movements, and as it gets closer to the time of delivery, he moves some amniotic fluid in and out of the lungs. This helps with lung maturity.
If a baby becomes distressed, which occurs when he is being deprived of sufficient oxygen, he might have his first bowel movement in the womb. This stool will become mixed with amniotic fluid, which is called meconium. If this meconium gets inhaled deep into the baby’s lungs, serious lung problems can occur. There may be blockage in the upper airway, and the smaller airways can become inflamed and constricted. This can cause respiratory distress and pneumonia. Sometimes the baby may not be able to breathe at birth and will need to be resuscitated. The lung inflammation may be so severe that the baby has to be placed on a breathing machine, called a ventilator, right after birth. Ventilators can cause overventilation injuries, which can cause HIE and cerebral palsy. Respiratory distress and pneumonia can cause further oxygen deprivation in the baby and create an even bigger risk for HIE.
What is Newborn Sepsis?
Sepsis is an infection in the baby’s bloodstream. It can be caused by infection in the mother that travels to the baby at birth, such as Group B strep and other infections that cause chorioamnionitis. Prolonged rupture of the membranes, difficult or prolonged labor and meconium aspiration are all risk factors for sepsis. Early sepsis, which is what Keegan had, often manifests as pneumonia and meningitis.
Indeed, sepsis is very serious because it can cause hypovolemic shock and meningitis, both of which can cause permanent brain damage, such as cerebral palsy. Hypovolemic shock causes a severe drop in blood pressure, with decreased circulating blood. There are numerous damaging events that occur as a result of septic shock, but the result is inadequate oxygen in the baby’s tissues, including brain tissue. Meningitis is also very serious. Sepsis can cause meningitis by direct infection of the baby’s central nervous system, or it can cause meningitis by causing brain inflammation.
What is Hypoxic Ischemic Encephalopathy (HIE) and What Causes It?
Hypoxic ischemic encephalopathy (HIE) is a brain injury caused by a lack of oxygen in the baby’s blood (hypxemia / hypoxia) and / or a restriction of blood flow in the baby’s brain. It often occurs during or near the time of delivery, and it is the most common cause of seizures in a newborn. Hypoxic ischemic encephalopathy is also known as neonatal encephalopathy (NE), birth asphyxia, or intrapartum asphyxia.
There are many things that can occur during or near the time of delivery that can cause a baby to experience a lack of oxygen to her brain. In Keegan’s case, he was showing signs of distress on the fetal monitor at the beginning of labor, which means he was suffering from oxygen deprivation. Additional evidence of his distress is the fact that there was meconium in the amniotic fluid.
Fetal distress and oxygen deprivation during labor are usually caused by problems with the uterus (womb), placenta or umbilical cord. The placenta and umbilical cord essentially act like the baby’s lung. Oxygen-rich blood from the mother travels to the baby, through the placenta and then the umbilical cord and into the baby’s circulatory system. Complications with that can affect oxygen delivery to the baby include the following:
- Placental abruption
- Uterine rupture
- Nuchal cord: This occurs when the baby’s umbilical cord is wrapped around his or her neck.
- Umbilical cord prolapse
- Short umbilical cord
- Cord in a true knot
- Umbilical cord compression
Other complications that, if not properly managed, can cause a lack of oxygen to the baby’s brain include the following:
- Brain bleeds and hemorrhages caused by forceps and vacuum extractors
- Brain bleeds caused by prolonged labor, abnormal presentations (breech or face presentation), cephalopelvic disproportion, and shoulder dystocia
- Hyperstimulation caused by Pitocin and Cytotec, which are labor induction drugs that cause intense and frequent contractions
- Anesthesia mistakes
- Meconium aspiration
- Premature rupture of the membranes (PROM)
- Oligohydramnios (low amniotic fluid)
When these complications occur, brain injury can be prevented if the medical team pays very close attention to the fetal heart monitor and quickly delivers the baby at the first signs of distress. A C-section delivery is usually the safest and fastest method of delivery when distress occurs. In Keegan’s case, the physician waited 3 hours after distress appeared on the fetal heart monitor, leaving the little boy in oxygen-depriving conditions for far too long.
Hypoxic ischemic encephalopathy (HIE) is very serious because it can cause seizures, cerebral palsy, intellectual disabilities, developmental delays and motor disorders. Poor Kegan also had sepsis, which means he may develop meningitis, which can also cause cerebral palsy and seizures. Keegan’s septic shock and pneumonia may make it difficult for him to oxygenate and ventilate while he is in the neonatal intensive care unit (NICU), which can cause further brain damage and HIE.
Michigan Cerebral Palsy and HIE Lawyer Helping Children Nationwide
If you are seeking the help of a birth injury or HIE lawyer, it is very important to choose an attorney and law firm that focus exclusively on birth injury and birth trauma cases. Reiter & Walsh ABC Law Centers is a nationally-recognized birth injury law firm that has been helping children for nearly three decades.
Birth injury and HIE lawyer Jesse Reiter, president of the Reiter & Walsh ABC Law Centers, has been focusing solely on birth injury cases for over 28 years. Since most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy (CP), he has the experience and knowledge necessary to win these complex cases. Jesse is currently recognized as one of the best medical malpractice lawyers in America by U.S. News and World Report 2014, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with a birth injury such as cerebral palsy, a seizure disorder or hypoxic ischemic encephalopathy (HIE), the award winning HIE attorneys at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized birth injury firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our firm’s award winning lawyers are available 24 / 7 to speak with you.