The body requires oxygen to function properly, especially the brain. When the brain is deprived of oxygen for an extended period, the results can include permanent brain injury or even death in the most severe cases. These types of pediatric brain injuries come in two categories—hypoxic and anoxic—and are unfortunately a common cause of birth injury during labor and delivery.

If your baby sustained a hypoxic or anoxic brain injury during labor and delivery, our Indianapolis medical malpractice lawyers may be able to help you recover compensation from the negligent doctor or hospital. We have been helping victims of all types of brain injuries obtain justice for nearly 50 years. Our attorneys have published and lectured extensively on traumatic brain injury (TBI) litigation, and our firm is active with the Brain Injury Association of America and the Brain Injury Association of Indiana.

Hypoxic and Anoxic Injuries

Hypoxia and anoxia are technical medical terms used to describe the effects of a lack of adequate oxygen to the body.

Hypoxia: a lack of adequate oxygen to the body in general or to specific parts of the body
Anoxia: complete deprivation of oxygen to the body or to a specific part of the body

In other words, hypoxic injuries occur when there is inadequate oxygen, while anoxic injuries occur when there is total oxygen deprivation. Both of these injuries can occur during childbirth as a result of medical malpractice.

Brain Damage Caused by Lack of Oxygen

Hypoxic-ischemic encephalopathy (HIE) is a condition in which the entire brain does not receive enough oxygen. HIE can be used to refer to an oxygen deficiency to the brain as a whole but is normally associated with newborns who have suffered from difficult births. HIE occurs in about two out of every 1,000 babies born.

As brain cells lose oxygen, they start to die quickly – within as little as five minutes of oxygen deprivation. As brain cells die, they emit a chemical that can harm other cells around them. HIE can cause long-term damage, including mental retardation, delayed development, seizures, and cerebral palsy. In some instances, HIE can be fatal.

Cooling Procedure to Reboot Brain

Jennifer Maize knows about HIE; after laboring for 15 hours, including pushing for three of those hours, her doctors performed an emergency Cesarean. She was sedated for the surgery and woke to find herself without her husband and without her baby. Her son, Drew Tillman Maize, had been born blue and lifeless. Baby Drew had been rushed by helicopter to Phoenix Children’s Hospital.

Phoenix Children’s is using and testing new technology to help babies less than six hours old who have been deprived of oxygen at or immediately after birth. The procedure cools the baby’s temperature until the midbrain temperature drops, at which point the cells stop dying and the brain essentially starts over.

Dr. Cristina Carballo, medical director of the neuro neonatal intensive care unit (NICU) department, brought the procedure to the area. She explains that medical crews begin to lower the babies’ temperatures on the way to the hospital. Once the babies arrive, they are placed on a cooling mat and connected to monitors. When a baby’s core temperature reaches 92.3 degrees, it brings the midbrain temperature down to 82.4 degrees, which “reboots” the brain. After sufficient time, medical staff begins the process of raising the child’s temperature back to normal levels, which can take up to six hours.

Although being used across the nation, only two facilities provide full monitoring, including follow up visits with neurologists, psychiatrists, speech pathologists, occupational therapists, and others. Phoenix Children’s Hospital is one of the two.

HIE Outlook with Cooling Procedure

Without the procedure, 10 to 15 percent of infants with HIE die during the neonatal period. Approximately 25 percent of those that live suffer permanent neurologic damage. Phoenix Children’s Hospital has used the cooling technology on 73 babies since April 2008. Most are developing at a normal rate.

Eight days passed before Jennifer Maize was able to meet baby Drew face to face. Since then, he has been doing well, hitting all of his developmental milestones. The couple hails the hospital for its advanced technology and efforts with Drew.

Birth and Delivery Negligence

Not all parents and babies receive the benefit of care from facilities with the resources and dedication of Phoenix Children’s Hospital. Every year, babies suffer from HIE-related complications and other birth injuries. While some tragedies are sadly unavoidable, in cases of negligence or medical malpractice, the injury could have been prevented or mitigated.

In the emotional wake of a new birth and an immediate injury, new parents may not be able to discern whether negligence occurred. The following list provides some examples of birth injuries; parents should speak with an attorney about their specific circumstances and details:

Hypoxic-ischemic encephalopathy (HIE)
Brain injuries
Cerebral Palsy
Complications resulting from failure to perform a C-section
VBAC (vaginal birth after cesarean) injuries

In a lawsuit, it is not enough to show that the injury occurred; the parents must be able to demonstrate what the appropriate standard of care was, that the doctor or hospital breached that standard and that the breach resulted in the injury to the baby.

Medical malpractice may be compensable but claims must be brought within strict time frames. Parents of children with birth injuries should contact a lawyer to discuss the injury and whether a claim for damages exists. While it may be difficult to concentrate on money damages in a time of family crisis, a medical malpractice attorney can protect financial interests and seek compensation for medical bills incurred or those that lie ahead. Serious birth injury or trauma can require multiple surgeries, lengthy rehabilitation or even lifetime accommodation.

Brain Damage Caused by Lack of Oxygen ∙ Fetal Heart Monitoring (FHM)

During labor, the mother’s contractions squeeze the umbilical cord, causing the baby’s heart rate to go down because of lack of oxygen. After each contraction, the heart rate should rise back up to a normal level. This heart rate fluctuation is a natural part of the birthing process. Fetal heart monitoring (FHM) is the system that health care providers use to monitor the child’s heart rate during labor and delivery. There is a simple pattern when the child is losing too much oxygen during the mother’s contractions and the heart rate is not rising to a normal level.

The most important job of the nurses in the delivery room is to read and interpret the signals coming from the fetal heart monitoring system. In some cases, however, the nurses do not have the training or ability to understand the system’s signals, or they are negligently inattentive to the FHM during labor and delivery.

If the child’s heart rate is not rising fast enough and proper steps are not taken in a timely fashion, the child could suffer hypoxic-ischemic encephalopathy (HIE), or brain damage as a result of lack of oxygen or blood flow. In many cases, this lack of oxygen at birth will prevent the child and parents from ever being able to live normal lives, and in the most tragic of cases, the child may die.

You can also view our TBI Resource Guide for advice on dealing with the pain of living with a brain injury.

Contact Us Now for a Free Consultation; No Attorney Fees Unless We Win Your Case

At Doehrman Buba Ring, our Indianapolis brain injury lawyers have represented many hypoxia and anoxia victims and their families, and we are here to help you. If your child suffers hypoxia or anoxia due to your doctor’s negligence, call us now for a free consultation. The medical malpractice statute of limitations is short and it is important to move quickly.