Georgia Hypoxic-Ischemic Encephalopathy (HIE) Attorneys
Birth injury firm serving Georgia statewide
Has your child experienced birth asphyxia, or received a diagnosis of hypoxic-ischemic encephalopathy (HIE)? Many parents aren’t aware that these issues are often a consequence of medical malpractice. An HIE diagnosis creates many questions for parents. Here, we provide a broad overview of birth asphyxia and HIE, so that parents and loved ones can better understand what may have happened and explore their options.
What is birth asphyxia? What is HIE?
“Birth asphyxia” describes oxygen deprivation during or near the time of birth. Consequently, “HIE” is a type of brain damage caused by an insufficient flow of oxygenated blood to the brain. HIE has been estimated to occur in about 1.5 per 1,000 live births, and it is the cause for 23% of neonatal deaths worldwide (1). Survivors of HIE may later develop permanent conditions such as cerebral palsy (CP), epilepsy, or intellectual disabilities (2).
In many cases, birth asphyxia and HIE can be attributed to medical malpractice during pregnancy, labor and delivery, or the neonatal period.
Causes of HIE
Any complications that occur during pregnancy or labor and delivery must be monitored and handled by medical staff immediately. If the medical team fails to follow guidelines and standards of care and it causes HIE or another birth injury, it constitutes medical malpractice.
Medical complications and errors that can cause HIE include, but are not limited to, the following (3):
- Abnormal fetal position/presentation
- Anesthesia errors
- C-section errors and delays
- Fetal stroke
- Forceps and vacuum extractor injuries
- A high-risk pregnancy (e.g. one involving gestational diabetes, preeclampsia, or obesity)
- Infections in newborns
- Intracranial hemorrhages (brain bleeds)
- Meconium aspiration syndrome (MAS)
For more detailed information about the causes and risk factors for hypoxic-ischemic encephalopathy, visit our main page on the topic here.
Signs and diagnosis of HIE
If a baby experienced a traumatic delivery or birth asphyxia, medical professionals should consider the possibility of HIE. If there are signs of fetal distress, physicians can recognize HIE while the baby is still in utero. If a baby exhibits signs of distress, doctors should order diagnostic tests for HIE. These signs include, but are not limited to, the following (3):
- Breathing problems or need for resuscitation of the newborn
- Low APGAR Scores
- Seizures shortly after birth
- Difficulty feeding, such as the inability to latch, suck, or swallow
- Abnormal neonatal reflexes (e.g. the baby fails to respond to loud sounds or movement, does not grasp onto objects such as a finger, etc.)
- Profound metabolic or mixed acidemia in an umbilical artery blood sample (the baby’s blood is acidic/has a low pH)
- Hypotonia (low muscle tone/limpness)
Conducting diagnostic tests early is essential because more obvious signs of brain damage may not become apparent until several years after the injury, when a child begins to miss developmental milestones or show signs of disability. If HIE is not diagnosed within hours of birth, then medical professionals miss the window to provide critical treatment and other early interventions that can minimize symptoms.
Therapeutic hypothermia and other treatments for HIE
The most effective treatment for HIE is therapeutic hypothermia (also called hypothermia therapy or neonatal cooling). It’s important that it is administered very shortly after birth, or after the oxygen-depriving event. Therapeutic hypothermia cools down a baby’s brain and reduces the metabolic rate, which gives brain cells more time to heal. This treatment can prevent or minimize the extent of permanent disabilities caused by HIE (4). The exact outcome depends on the severity of the initial injury, including other factors (3). In addition to cooling, newborns with HIE may need treatments such as the following:
- Breathing assistance
- Seizure medications
- Temperature management (some babies are ineligible for therapeutic hypothermia, but it is still very important for medical professionals to ensure they do not develop hyperthermia)
After the neonatal period, medical professionals generally recommend that the child be closely monitored and, if necessary, enrolled in Early Intervention and therapies to help reduce the risk of developmental delays (5).
What should you do if your child was diagnosed with HIE?
One of the most important things that you can do after an HIE diagnosis is begin therapy (e.g. physical therapy, occupational therapy, and/or speech therapy) for your child at a very young age. The earlier a child gets therapy, the more they may be able to maximize their abilities. Speaking to a birth injury attorney can answer many questions and provide critical help, since a birth injury verdict or settlement could help pay for the costs of your child’s care that aren’t covered by medical insurance.
Trusted birth asphyxia and HIE attorneys
Legal cases involving birth asphyxia, HIE, and other birth injuries are very complex – they require a thorough understanding of both legal procedure and medicine, as well as a network of medical experts who can serve as consultants. That’s why it’s very important to choose a firm with extensive experience in this area of law.
Other firms that say they handle birth asphyxia and HIE cases may also take a wide variety of personal injury or medical malpractice cases involving things like pharmaceutical issues, dog bites, slip-and-fall injuries, and car accidents. Those kinds of firms may only handle a few birth injuries a year; many handle none, and instead refer all birth injury cases to niche practice firms.
At ABC Law Centers (Reiter & Walsh, P.C.), we focus exclusively on birth injury. Our verdicts and settlements, awards, and client testimonials all attest to our dedication and success. Firm partner Rebecca Walsh is admitted to practice all over Georgia and is devoted to ensuring that families who have experienced a birth injury get the justice they deserve. Rebecca is a sustaining member of the American Association of Justice (AAJ) and co-chair of the Birth Trauma Litigation Group (BTLG). She has been recognized in U.S. News & World Report’s Best Lawyers of America in Medical Malpractice and Personal Injury law for the past seven years, consecutively.
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- Kurinczuk, J. J., White-Koning, M., & Badawi, N. (2010). Epidemiology of neonatal encephalopathy and hypoxic–ischaemic encephalopathy. Early human development, 86(6), 329-338.
- What is the global prevalence of hypoxic-ischemic encephalopathy (HIE)? (2018, July 26). https://www.medscape.com/answers/973501-106461/what-is-the-global-prevalence-of-hypoxic-ischemic-encephalopathy-hie
- Hypoxic-Ischemic Encephalopathy Lawyers | Reiter & Walsh. (n.d.). https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/fetus-or-newborn-medical-problems/hypoxic-ischemic-encephalopathy/#causes
- Hypothermia Therapy | Treatment for Hypoxic-Ischemic Encephalopathy. (n.d.). https://www.abclawcenters.com/practice-areas/treatments-and-therapies-for-birth-injuries/hypothermia-cooling/
- Treatments for Hypoxic-Ischemic Encephalopathy (HIE). (n.d.). https://www.abclawcenters.com/treatments-for-hypoxic-ischemic-encephalopathy-hie/