What Causes Lack of Oxygen to the Brain of a Baby, and When is It the Result of Medical Malpractice?

Hypoxic ischemic encephalopathy (HIE) is a severe brain injury also referred to as birth asphyxia. It can occur among adults, but also during the labor and delivery of a baby when it is deprived of oxygen. In fact, the occurrences of asphyxia at birth according to MedScape are more common than one may realize, accounting for 23 percent of neonatal deaths worldwide –equivalent to about 840,000 deaths per year.

When a baby is deprived of an adequate supply of oxygen, the tissue and cells within the body, particularly in the brain, start to die resulting in permanent brain damage. Permanent disabilities can result when the oxygen deprivation and brain damage reach a certain level. These can include intellectual disabilities, seizures, ADHD, cerebral palsy, learning disabilities, cognitive functioning problems, lack of swallow reflex, inability to blink, and delays in development.

In certain cases, HIE occurring in an unborn child or a child in the process of labor or delivery may be due to the negligence of medical personnel, such as the mother’s obstetrician or attending labor nurses. If responsibility rests upon the obstetrician or other medical professionals for injuries suffered by the child resulting from HIE, they may be held liable for damages in a medical malpractice lawsuit.

When the flow of blood and oxygen is restricted

A baby in the womb receives oxygen from the blood that is conveyed through blood vessels in  the umbilical cord.. Between the placenta and the uterus, blood vessels, referred to as uteroplacental circulation, function like lungs in a gas exchange that occurs in these vessels. The blood flows to the baby in this order:

1. Maternal circulation
2. Uterus
3. Placenta
4. Uteroplacental circulation
5. Umbilical cord
6. Fetal circulation

If this blood flow is inhibited in any way it can affect the level of oxygen the baby receives. Therefore a drop in the mother’s blood pressure or other problems with the umbilical cord, placenta, or uterus may bring about the condition of birth asphyxia for the baby. In certain serious situations, the baby can be completely deprived of oxygen-rich blood, with only fetal reserves to draw upon. In these cases, the baby must be brought to delivery before the deprivation of oxygen inflicts brain damage.

Legal liability for HIE childbirth injuries

Childbirth injuries due to HIE can occur due to medical malpractice during the stages of pregnancy, labor, or delivery. Any action or inaction that cuts off oxygen to the brain of the child can precipitate HIE. Obstetricians and medical professionals are responsible for noticing symptoms that can lead to HIE. Some of these symptoms as outlined by the American Academy of Pediatrics (AAP) include lack of fetal movement, low maternal blood pressure, and falling or erratic fetal heart rate.

An obstetrician or medical professional who fails to detect these and any other signs of fetal asphyxia during any stage of pregnancy or childbirth may be found liable for HIE injuries that result.

Negligence during pregnancy

Certain conditions can occur during pregnancy that cause oxygen deprivation to the unborn child. For example, if the umbilical cord becomes wrapped around the neck of the baby during pregnancy, the child may experience asphyxia. Obstetricians are trained to recognize and quickly respond to this condition – also known as nuchal cord. If they fail to do so, either through an emergency Caesarian section, or some other course of action, they may be held liable for medical malpractice.

An unborn baby may also experience an HIE injury if the mother’s high blood pressure is not diagnosed and treated in a timely manner by the obstetrician. The obstetrician may be held liable for negligence if he or she failed to diagnose and treat the condition in a timely manner and it was found to have caused the child’s HIE injury.

Negligence during labor or delivery

Medical professionals may also exhibit negligent care during labor and delivery of a child, resulting in fetal asphyxia and HIE. If a child is delivered by vacuum or forceps, there are very strict guidelines to follow.  If these Rules are not followed by the medical professional, the baby can suffer devastating injury.  Additionally, actionable negligence and liability on the part of medical personnel can exist if they fail to monitor the mother and her baby’s vital signs which indicate the presence of fetal distress and then fail to timely deliver the baby.  Any of the types of negligence above can be the cause of an HIE injury

At McGowan, Hood, Felder & Phillips, LLC, our experienced South Carolina OB/GYN malpractice attorneys understand the devastating consequences your child may be experiencing due to a birth injury. If the injury was the result of negligence by a medical provider, you may be able to recover compensation for your losses. To set up a free consultation about your case, call our office today at 803-327-7800 or fill out our contact form.