Jaundice (yellowing of the skin) is common in both term and preterm infants in the neonatal period, affecting about 60% of infants. It is caused by bilirubin, which is produced during the normal breakdown of red blood cells in the body.
Bilirubin is normally removed from the blood by the liver, but when an infant’s liver is unable to remove enough bilirubin, the excess amount in the blood causes the skin to take on a yellowish color. Excess bilirubin in the blood is called hyperbilirubinemia and is easily treated.
Kernicterus occurs when hyperbilirubinemia is left untreated and bilirubin reaches dangerously high levels in the blood. This can cause permanent brain damage and even lead to death.
Many infants that do survive kernicterus experience avoidable impairments such as vision and hearing loss, mental retardation, developmental delays, and cerebral palsy. Permanent deficits caused by kernicterus are unnecessary and wholly preventable with proper medical care.
If your child suffered permanent injuries or death as a result of untreated jaundice, you likely have a malpractice case. Contact the Ohio kernicterus attorneys at The Becker Law Firm by calling 216-621-3000 us today.
Stages and Treatment of Kernicterus
Unlike jaundice, kernicterus is rare. It is a medical emergency that usually develops between the first and third weeks of life. The excessive bilirubin builds up and collects in the brain, which can cause permanent injuries and begins affecting the brain immediately. Careful doctors and nurses must monitor the infant so that they can timely diagnose kernicterus injuries.
The symptoms of kernicterus by stage include:
- Early stage kernicterus: extreme jaundice, no startle reflex, sleepiness, poor sucking reflex, fever
- Mid-stage kernicterus: high-pitched cry, bulge in the head’s soft spot (fontanel), seizures, arched back
- Late-stage kernicterus: hearing loss, movement disorders, seizures, muscle rigidity, mental retardation
The American Academy of Pediatrics recommends that bilirubin levels be measured within 24 hours of the first symptoms of jaundice. Furthermore, infants discharged from the hospital within 24 hours of birth should be evaluated by 72 hours—earlier if the baby has risk factors.
A simple blood test can diagnose kernicterus. Some doctors make the mistake of delaying treatment while blood tests are repeated. The infant should usually be placed on phototherapy (a process where special lights help the body to get rid of the excessive bilirubin) and given fluids. In severe cases, the baby may require blood transfusions.
Most cases of kernicterus are observable, and severe injury is almost always preventable. Health care providers must pay attention to the warning signs, and act immediately when those warning signs occur. In particular, blood transfusions may take some time to set up, so doctors and nurses must be proactive. Upon discharge, all parents should be warned of the signs and symptoms of jaundice and kernicterus. If parents are not aware of these symptoms, the child may experience brain damage before treatment is possible.
Can Kernicterus Be Prevented?
Kernicterus is prevented by closely monitoring an infant’s bilirubin levels, and beginning treatment early to avoid unnecessary permanent brain damage and death. Once hyperbilirubinemia is suspected, bilirubin levels should be evaluated by your infant’s physician. If hyperbilirubinemia is diagnosed, treatment should begin immediately so as to keep bilirubin from reaching dangerous levels.
Was My Infant Treated In Time?
Medical negligence and mismanagement of hyperbilirubinemia leading to kernicterus can arise in many different manners:
- Delay in the treatment of excessive bilirubin by waiting for lab results and/or repeat lab results
- Negligent assessment of hyperbilirubinemia or acute bilirubin encephalopathy (ABE)
- Negligent assessment for signs of acute kernicterus
- Failure to compare serial bilirubin levels with age-specific norms
- Delaying or interrupting phototherapy for diagnostic tests
- Allowing bilirubin to reach dangerously high levels before initiating treatment
The deficits an infant suffers caused by kernicterus are devastating, and are wholly avoidable when managed properly. The Ohio kernicterus attorneys at The Becker Law Firm represent children harmed by the mismanagement of hyperbilirubinemia and kernicterus by doctors and nurses.
Call 216-621-3000 to schedule a free, no-risk consultation today.
