Few things are as heartbreaking for parents as learning their child has suffered a brain injury due to a hypoxic event at birth. This life-altering diagnosis, whether discovered immediately or later in a child's development, is often caused by preventable medical errors.
At The Becker Law Firm, our HIE attorneys are dedicated to helping families affected by hypoxic-ischemic encephalopathy (HIE) seek justice and financial relief for the lifelong challenges that come with this condition.
What Is Hypoxic-Ischemic Encephalopathy (HIE)?
Hypoxic-ischemic encephalopathy (HIE) is a type of brain injury that occurs when a baby’s brain does not receive enough oxygen or blood flow during or near the time of birth. This condition is also known as a hypoxic brain injury birth trauma or a hypoxic birth injury.
Oxygen deprivation in newborns most often occurs due to complications like umbilical cord issues, delayed Cesarean sections, or placental problems. While babies can sometimes recover from brief interruptions in oxygen supply, prolonged periods of hypoxia can lead to HIE brain damage, a condition that often results in significant developmental and physical challenges.
Brain Damage Caused By Ischemia & Hypoxia
Ischemia occurs when the fetus experiences a shortage of oxygen. Hypoxia is a complete lack of oxygen. Reduced blood flow during birth can affect the overall health of the fetus, but it primarily causes damage to the brain. This brain damage can result in HIE. Obstetrical caregivers must be prepared to treat ischemia, hypoxia, and other emergency conditions. If they fail to recognize the symptoms and respond appropriately, the child could suffer permanent brain damage.
The Difference Between Anoxia and HIE
Anoxia refers to a total lack of oxygen supply to the brain. It is a condition that can rapidly cause brain cell death.
Hypoxic-Ischemic Encephalopathy (HIE), in contrast, is the brain injury resulting from both oxygen deprivation (hypoxia) and reduced blood flow (ischemia). Ischemia worsens the injury by cutting off nutrients and waste removal.
While anoxia is about oxygen absence alone, HIE involves complex damage mechanisms that lead to brain dysfunction, making it a broader and often more serious diagnosis.
HIE Causes and Risk Factors
The tragic and sad truth is that many cases of HIE are preventable. Medical professionals should timely diagnose, treat, and manage conditions and circumstances that put a baby at risk for HIE. Some of the most common HIE causes and risk factors are:
- C-Section Issues: A delayed C-section, or the failure to perform a C-section when the baby is in distress can cause oxygen deprivation;
- Labor Issues: Prolonged and arrested labor, misuse of labor-inducing drugs, and excessive uterine contractions can result in a lack of oxygen or blood flow to the baby;
- Umbilical Cord Issues: A baby’s brain can be denied oxygen when the cord is wrapped around his or her neck, knotted, collapsed, compressed, prolapsed, or is too short. Often, electronic fetal monitoring will indicate if the unborn baby is sustaining an umbilical cord problem;
- Placental Issues: When the placenta covers the mother’s cervix, detaches from the uterus, or when the placenta does not have the necessary blood volume, oxygenated blood cannot properly flow from the mother to the baby;
- Positioning of the Baby: When the head or body of a baby is too big to fit through the mother’s pelvis, the baby is in the breech or face position, or when forceps or other delivery tools are misused, the baby can be deprived of oxygen or blood flow for an extended period of time;
- Amniotic Fluid Issues: Having too much or not enough amniotic fluid, or having the fluid sac break too early can lead to HIE through either cord compression or infection;
- Timing Issues: When a baby is born prematurely or after the due date, the risk of HIE increases;
- Medical Mistakes: Obstetricians or other medical personnel can improperly treat the mother’s health issues, such as anemia, high blood pressure, preeclampsia, or gestational diabetes, or fail to notice the baby’s health issues, such as an infection or breathing problems. In addition, the failure to treat within six hours of birth with head or whole-body cooling, may lead to HIE.
- Infection: Obstetricians and obstetrical nurses should recognize mothers and fetuses at risk for medical infection and treat prophylactically. Failure to treat the infection either timely or adequately can lead to encephalitis, meningitis, sepsis, or septic shock with resulting brain damage.
These situations require prompt medical intervention. Delays or mistakes in treatment can lead to hypoxic-ischemic brain injury symptoms or permanent brain damage in babies due to lack of oxygen.
What Are the Stages of HIE?
Recognizing the early signs of hypoxia in newborns is critical for proper diagnosis and treatment. The stages vary based on the severity of the condition, ranging from mild HIE to severe Hypoxic-Ischemic Encephalopathy cases.
Mild HIE
- Symptoms include irritability, hyper-alertness, slight muscle stiffness or limpness, feeding difficulties, and abnormal reflexes.
- Seizures are generally absent.
- Symptoms usually resolve within 24 hours without lasting effects.
- Infants may exhibit normal EEG results and remain generally awake.
Moderate HIE
- Characterized by lethargy, reduced responsiveness, low muscle tone, weak reflexes, seizures, and breathing irregularities.
- Symptoms persist between 2 to 14 days and may require medical treatment.
- Approximately 25-75% of infants with moderate HIE face serious long-term disabilities or death.
- Some symptoms include small pupils, slow heartbeat, and poor feeding reflexes.
Severe HIE
- Infants typically are unresponsive or in a coma, with no muscle tone and absent reflexes.
- Frequent, severe seizures may occur, along with vital function impairments like irregular breathing and heart rate requiring intensive care.
- Prognosis is poor, with a high risk of permanent brain damage, severe neurological disabilities such as cerebral palsy, developmental delays, or death.
- Symptoms may last for weeks, including fixed pupils and respiratory failure.
Parents should also monitor for developmental delays, motor impairments, or behavioral changes as these are signs of hypoxia-related brain injuries.
HIE Diagnosis
Diagnosing HIE involves a combination of clinical assessment and diagnostic tests including:
- Monitoring Apgar scores immediately after birth.
- Physical examination of neurological symptoms and reflexes.
- Brain imaging techniques such as MRI or CT scans to identify areas of injury.
- Electroencephalograms (EEG) to detect abnormal brain activity or seizures.
- Blood tests to check oxygen levels, acid-base balance, and metabolic function.
Early diagnosis allows for timely treatments like therapeutic hypothermia (cooling therapy), which must be initiated within six hours of birth to reduce brain damage severity.
Is HIE Associated with Medical Malpractice?
Many HIE cases result from preventable medical errors during labor and delivery, making medical malpractice a common factor, including:
- Failure to recognize or respond to fetal distress signals.
- Delayed or improper emergency C-sections.
- Negligent monitoring of oxygen levels or fetal heart rate.
- Improper use or failure to use delivery instruments.
- Failure to treat infections or maternal conditions like preeclampsia.
- Delayed or inadequate resuscitation efforts after birth.
Families affected by HIE due to medical negligence should consult experienced HIE attorneys or birth injury lawyers to investigate malpractice and pursue compensation for lifelong care.
Is Hypoxic-Ischemic Encephalopathy Curable?
While early treatment can improve outcomes, HIE is not curable. Therapy, medical interventions, and adaptive technologies can help affected children achieve a better quality of life. Early intervention, such as therapeutic cooling administered within six hours of birth, can reduce the severity of brain damage.
Lifelong Challenges for Children with HIE
Complications and disabilities caused by HIE may not be readily noticeable. The challenges a child born with HIE can face range from developmental delays and gross and fine motor impairment to lifelong issues such as:
- Neurological disorders, such as cerebral palsy, epilepsy, dysautonomia, and seizure disorders;
- Sensory issues, such as vision loss, hearing loss, crossed eyes, nystagmus, and;
- Physiological problems with the respiratory, endocrine, digestive, skeletal, and musculoskeletal systems.
Providing adequate care for the medical challenges these issues pose is a lifelong endeavor. In addition to needing medical procedures, children with permanent brain damage from HIE often require one or more types of therapy. Some children may need both physical and occupational therapy, while others may need special education and speech or language therapy. Adaptive and assistive technologies and recreational therapy may also be helpful to children born with HIE.
How Our HIE Attorneys Can Help
The Becker Law Firm has decades of experience representing families in Cleveland and throughout Ohio in HIE birth injury cases. Our hypoxic ischemic encephalopathy attorneys understand the medical complexities of these cases and work with trusted experts to uncover negligent medical practices that could have prevented your child’s injuries.
We handle all aspects of the legal process so families can focus on their child’s care. Our priority is to ensure that the responsible parties are held accountable and to secure compensation for medical expenses, therapy, and lifelong care needs.
Hypoxic-Ischemic Encephalopathy Settlements and Verdicts
Families impacted by hypoxic birth injuries often face overwhelming financial burdens. Settlements for HIE cases are designed to provide for a child’s medical needs, specialized care, and quality of life.
The Becker Law Firm has recovered substantial verdicts and settlements on behalf of our clients, helping them access the resources they need to support their children.
How Long Will an HIE Birth Injury Case Take to Settle?
The timeline for resolving an HIE case varies based on the complexity of the circumstances and the cooperation of the responsible parties. While some cases settle within months, others may require extended litigation, especially when going to trial. Rest assured, our experienced HIE attorneys will pursue the best possible resolution for your case as efficiently as possible.
Contact a Cleveland HIE Lawyer Today
The Becker Law Firm has represented the families of children suffering from brain injuries like HIE for more than 40 years in Ohio. We are committed to doing everything in our power to hold medical professionals accountable for the long-lasting injuries caused due to negligence or malpractice.
The Becker Law Firm can and will help you find answers to your questions. We have medical experts on our staff and employ a team of physicians to understand every aspect of your case. We also know the additional questions that need to be asked to get to the root of the negligence that either caused the harm to your baby or allowed it to happen. We stay up to date with the newest and most common defenses to HIE cases, and we are prepared to rebut them. Contact our office to discuss your case.
If you would like to discuss your legal options with a Cleveland HIE lawyer at The Becker Law Firm, call us at 216-621-3000. Your initial consultation is free.
