The Role of Cooling Therapy in HIE Birth Injury Malpractice Cases

As leading birth injury plaintiff’s lawyers in Oklahoma City, we’ve represented many amazing families who have experienced the trauma, distress, and lifelong impact of birth injuries caused by the negligence of healthcare providers. In particular, our team specializes in representing birth injury cases that involve HIE (hypoxic-ischemic encephalopathy) and/or cerebral palsy. 

We know it shouldn’t be this way. Having a baby should be a beautiful experience that marks the joyful and peaceful entrance of new life into the world. As we work with our clients across Oklahoma, we’re tireless advocates because our firm’s birth injury team knows the importance of seeking justice for the harm caused by the negligence of a healthcare provider.

Today, we’re specifically discussing HIE caused by the negligence of a healthcare provider and the vital role of cooling therapy (or therapeutic hypothermia) after suffering severe blood flow and oxygen deprivation to the brain during labor and delivery.  

What is HIE? 

HIE is the acronym for hypoxic-ischemic encephalopathy. HIE is the term used to describe a situation where there is restricted blood flow and oxygen deprivation to the baby’s brain. HIE can occur before birth, during labor and delivery, or after birth. 

There is a limited window of time where a baby can be completely cut off from blood flow and oxygen (acute profound hypoxia-ischemia) before they begin to sustain brain damage. Babies that suffer HIE during labor and delivery often end up with catastrophic neurological disabilities due to their brain damage. 

The signs of HIE are varied, and for some babies, they may not show immediately. Signs include: 

  • Decreased alertness
  • Low or high muscle tone 
  • Lack of typical reflexes 
  • Abnormal movements 
  • Breathing/respiratory problems 

What Are the Causes of HIE? 

Often, HIE is caused during pregnancy because of issues with blood flow to the placenta, preeclampsia, umbilical cord compression or prolapse, heart or lung formation problems in the baby, anemia in the baby, or other issues that develop during the pregnancy. 

However, our attorneys regularly represent the families of otherwise healthy newborn babies who suffered severe blood flow and oxygen deprivation to their brains during labor and delivery, causing permanent hypoxic-ischemic brain damage. When HIE is caused during labor and delivery, it may be due to the negligence of a healthcare provider who does not meet the standard of care.  

HIE can typically be prevented through careful fetal monitoring and timely intervention when complications arise. Doctors and other medical providers should have a plan and hospital policies to reduce the risk of missing complications resulting in HIE or negligence causing HIE. 

How is HIE Related to Cerebral Palsy? 

Babies that suffer HIE during labor and delivery often end up with catastrophic neurological disabilities due to their brain damage. In fact, many of these children go on to develop severe forms of cerebral palsy, which is a motion disorder caused by damage to the areas of the brain that control motor function, balance, and posture. 

Most of our cases involve children with spastic quadriplegic cerebral palsy (CP), the most severe form of CP, which causes increased muscle tone or spasticity that affects a child’s all four limbs, the trunk and face. Children with spastic quadriplegic CP usually cannot and never will walk and often have other severe neurological and developmental disabilities such as profound intellectual disability, seizures, and problems with swallowing, incontinence, eating, vision, hearing, speech, and communication. Many require PEG tubes for feeding, and some even require tracheostomies for breathing and respiratory problems.

What is the Impact of HIE in the Long Term?  

It is hard to overstate the impact of HIE on the lives of children and their families. When a child suffers HIE, the long-term neurological and physical harm can be life-altering for a family financially, physically, and emotionally and can impact the household as a whole in innumerable ways.  

Additionally, in HIE cases, because of the complexity of birth injury obstetrical malpractice or negligence cases, it can be very challenging and expensive to pursue justice after suffering because of a provider’s neglect. However, we do believe justice is worth pursuing. Our team at Maples, Nix, and Diesselhorst is experienced in representing families of children with CP and HIE diagnoses, and we are skilled in building cases that show the breach of standard of care and clear causation. 

Cooling Treatment and HIE 

Therapeutic hypothermia or cooling is a treatment used to try and slow down or minimize the injury process in a baby’s brain from the progression of HIE. Research shows that if given within 6 hours of birth,  and lasts for 72 hours, cooling therapy can allow the brain to recover from a hypoxic-ischemic injury.  

Timely therapeutic hypothermia treatment can have a miraculously positive effect on a baby’s ultimate neurological outcome. It is so important for babies suspected to have acute HIE, and it can improve outcomes and save some babies from the often catastrophic neurological sequelae of severe intrapartum HIE. 

A baby must meet very strict inclusion criteria to qualify for this treatment. These inclusion criteria almost mirror the ACOG clinical and physiologic “Neonatal Signs Consistent with an Acute Peripartum or Intrapartum Event.” 

In other words, the families of babies who meet the criteria for cooling treatment likely have a HIE case where there may have been medical negligence, and causation is much easier to prove, but it will still be a complex case. Therefore, families whose babies were treated with cooling therapy should consult with an experienced birth injury law firm like Maples, Nix, and Diesselhorst

How Cooling Treatment May Prove Causation 

The strict inclusion criteria required for a baby to qualify for cooling treatment can help prove causation for a plaintiff in an HIE case. This is especially effective when the baby is admitted to the NICU and receives cooling therapy at the same hospital where the labor and delivery and the alleged negligence occurred. 

We have seen this firsthand in cases. In one case in particular, our team established that the defendant hospital’s own neonatologists, using their own protocols, found that a baby’s clinical, laboratory, and physiologic condition and diagnoses qualified him for cooling treatment. This, in turn, means that the defendant Hospital itself acknowledged that, shortly after the delivery, this baby had more likely than not suffered acute asphyxia and hypoxic-ischemic brain damage during his labor and delivery. 

As plaintiff’s attorneys handling HIE cases, our team of experienced Oklahoma City lawyers at Maples, Nix, and Diesselhorst are knowledgeable and up to date about the medicine in these cases. No one should be permanently injured because of the negligence of a healthcare provider, and we can be your experienced advocates as you navigate the medicine and the law in your HIE case. 

We Stand with You

As experienced childbirth malpractice attorneys, we are here to stand with you. No family should suffer a birth injury due to the actions of someone else, and we can help you as you seek justice for the wrong you have experienced. 
If you believe your baby has suffered a birth injury due to hospital or doctor’s negligence, our team is prepared to help you. If your child has experienced HIE or the use of therapeutic hypothermia, contact our dedicated team for a free consultation.

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