Therapeutic Hypothermia (Neonatal  Cooling) Errors

Therapeutic hypothermia (brain/body cooling) is a relatively new treatment option for newborns with hypoxic-ischemic encephalopathy (HIE). It involves cooling the baby to about 91 degrees Fahrenheit (33 degrees Celsius) for around 72 hours. This is achieved either by attaching a cooling cap to the baby’s head or using a cooling blanket. The purpose of therapeutic hypothermia is to slow the baby’s metabolic rate, giving injured brain cells time to recover and minimizing the spread of damage to other parts of the brain. Research has shown that babies given therapeutic hypothermia have better survival rates and are less likely to develop permanent disabilities such as cerebral palsy (1).

Babies with HIE should receive therapeutic hypothermia within six hours

Timing is critical when administering therapeutic hypothermia. Research indicates that the most favorable outcomes occur when brain cooling is started as soon as possible after the birth injury/oxygen-depriving event occurs. Most experts agree that the treatment should be started within six hours. The Academic Medical Center Patient Safety Organization (AMC PSO) also recommends that therapeutic hypothermia only be given if the newborn is at least 34 weeks gestation, has shown signs of brain damage or neonatal seizures, and at least one of the following has occurred (2):

• A complication before delivery, such as umbilical cord prolapse, uterine rupture, or profound fetal bradycardia
• An Apgar score of five or lower at 10 minutes of life
• Prolonged resuscitation at birth
• Acidosis
• Abnormal base excess within 60 minutes of birth, as shown in umbilical cord gas or neonate blood gas
• A collapse after birth that results in hypoxic-ischemic injury

For more information on eligibility criteria for therapeutic hypothermia, please click here.

Most medium- and large-sized medical facilities today have neonatal intensive care units (NICUs) and therapeutic hypothermia readily available. Community hospitals usually do not have NICUs or the necessary neonatologists on staff. Instead of providing therapeutic hypothermia, they will immediately transfer newborns to larger hospitals or medical facilities that can administer this treatment.

Medical malpractice in therapeutic hypothermia cases

Sometimes errors in judgment or practice by medical professionals can occur in HIE and therapeutic hypothermia cases. In fact, if your baby required therapeutic hypothermia as a result of HIE/birth asphyxia and is permanently disabled, there is a good possibility that negligence occurred and may be responsible for your child’s injuries.

Medical errors in HIE and hypothermia therapy cases include:

• Failure of medical professionals to prevent hypoxic-ischemic encephalopathy/birth asphyxia in the first place, by:
  • Misdiagnosing or inappropriately treating uterine rupture, umbilical cord problems, placental abruption, or other labor and delivery complications
  • Mismanaging VBAC (Vaginal Birth After C-section)
  • Delaying or failing to order an emergency C-section
  • Fetal monitoring errors
• Failure to diagnose HIE
• Failure to inform the parents of hypothermia therapy as a treatment option.
• Failure to begin hypothermia within six hours of birth.
• Failure to transfer infant to an appropriate facility with hypothermia capabilities.
• Failure to have in place and follow organizational policies and protocols for hypothermia therapy.

Trusted legal help for hypothermia therapy errors

Michigan HIE attorneys with a national presence

Children with hypoxic-ischemic encephalopathy (HIE) may require costly treatments, equipment, and round-the-clock care. It can be difficult for parents to afford these necessary expenses. An HIE/birth injury attorney can help obtain settlement money to cover these costs and maximize your child’s future. Pursuing a case also keeps doctors and medical organizations accountable for their mistakes.

Feel free to reach out to the HIE attorneys at ABC Law Centers for a free case evaluation. We will never charge any fees until you win your case. We pride ourselves on our transparency and individualized attention for all of our clients. If you are interested in learning more about the legal process before contacting us, please click here.

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Video: birth asphyxia (HIE) and brain injury

Watch a video of Jesse Reiter and Rebecca Walsh discussing how a lack of oxygen at birth can cause a brain injury.

More information on hypoxic-ischemic encephalopathy (HIE)

• Hypoxic-Ischemic Encephalopathy
• Causes and Risk Factors
• Diagnosis
• Treatments
• Long-Term Outcomes and Care

More information on hypothermia therapy (neonatal cooling)

• Neonatal Requirements for Hypothermia Therapy
• Therapeutic Hypothermia: Overview
• Hypothermia Therapy Past, Present, and Future: Where is Brain Cooling Headed?
• Research Update: Combining EPO and Hypothermia Therapy to Treat HIE
• Hypothermia Therapy May Be Effective 6-24 Hours After Birth

Sources

1. Davidson, J. O., Wassink, G., van den Heuij, L. G., Bennet, L., & Gunn, A. J. (2015). Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy – Where to from Here?. Frontiers in neurology, 6, 198. doi:10.3389/fneur.2015.00198
2. The Academica Medical Center Patient Safety Organization (AMC PSO) Neonatal Encephalopathy Task Force. (2016). Therapeutic Hypothermia in Neonates: Recommendations of the Neonatal Encephalopathy Task Force[Pamphlet].