What is HIE?

HIE (the abbreviation for “hypoxic ischemic encephalopathy”) is a birth injury to the brain that may occur in a baby during pregnancy, labor, or delivery. This birth injury takes place when the supply of oxygen to the baby’s brain is cut off or severely reduced for a period of time.

When the blood flow to the baby’s brain (that carries the oxygen) is reduced, it deprives the brain of oxygen, nutrients, and glucose which will cause the baby’s brain cells to die. This results in a brain injury called HIE.

The severity of brain damage in HIE depends on how long the brain is deprived of oxygen. Loss of oxygenated blood for just a few minutes can lead to HIE and cerebral palsy. HIE may sometimes affect other critical organs as well, such as the heart, lungs, and kidneys.

HIE stands for hypoxic ischemic encephalopathy. These three words can be simply explained as follows:

• Hypoxic – lack of oxygen to the brain
• Ischemic – decreased cerebral blood flow
• Encephalopathy – brain damage

According to researchers, HIE can result in severe birth complications. About 40 to 60% babies with HIE may either develop permanent disabilities (such as cerebral palsy, intellectual disabilities, and epilepsy) or, in the most severe cases, die before the age of two. In the US, up to 2.5 babies per 1,000 births suffer an HIE brain injury.

Despite advancements in medical technologies, fetal monitoring, and improved obstetric care, the incidence of HIE in the US has not declined. Medical negligence is one of the most important factors that may contribute to HIE, and eventually lead to cerebral palsy. Most importantly, medical negligence and medical malpractice is the most preventable cause of HIE and cerebral palsy.

Although the precise cause of HIE is not always known, some of the risk factors and pregnancy complications that should alert doctors and nurses to an increased risk of HIE include:

• abnormal fetal heart rate readings (“fetal distress”)
• placenta previa
• placental abruption
• uterine rupture
• umbilical cord prolapse
• maternal infection
• preeclampsia
• breech presentation
• gestational diabetes
• macrosomia
• oligohydramnios
• PROM
• shoulder dystocia (baby’s shoulders getting stuck during vaginal delivery)

If obstetricians and labor and delivery nurses quickly respond to these warnings signs, including considering an emergency c-section, HIE is often completely preventable. Immediately after childbirth, the medical team may notice the manifestations of HIE brain injury through low APGAR score, poor umbilical cord gases (low acidic levels or high base deficit), presence of meconium stained fluid, or the need for respiratory support to the baby within the first few minutes after birth (called “neonatal resuscitation”).

The injury causing events that lead to an HIE brain injury occur in two stages: (a) primary energy failure; and (b) secondary energy failure.

Primary Energy Failure

Blood is the carrier of oxygen to the baby’s brain. During an HIE brain injury, as the blood supply to the brain decreases or is completely cut off, the brain cells are deprived of oxygen and vital nutrients (such as, glucose). When the oxygen deprivation continues for some time, the brain cells begin to die.

Secondary Energy Failure

After the initial HIE injury, the secondary energy failure occurs about six to 48 hours later. This occurs as a reaction to the initial oxygen loss. The oxygen deprivation in the brain gives rise to certain brain particles or molecules capable of destroying brain cells. This results in further brain cell damage after the primary brain injury.

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Parents whose children are suffering from an hypoxic ischemic encephalopathy (HIE) want and deserve answers as to whether errors by the doctors and nurses during or just after the delivery contributed to their child’s birth injury.

At Miller Weisbrod Olesky, our award-winning cerebral palsy attorneys have represented families all over the United States in their time of need after a birth injury like HIE. We use our skills and expertise to obtain for you and your child a medical malpractice settlement that will help provide specialized medical therapy in order to maximize the quality of life and independence of your child throughout their life.

• Were there signs of birth injury or birth complications during the pregnancy, labor, and delivery process, or presence of risk factors, which were either not recognized or properly treated?
• During the labor and delivery, were there clear indications that the baby was suffering from fetal distress, but appropriate actions were not taken by the maternal fetal specialists, obstetrician or nurses?
• Was there a delay in diagnosis of a likely premature birth that led to later complications, including brain injury?
• Did the medical team fail to order a series of tests to diagnose this birth complication in a timely manner?
• Was the decision to perform a cesarean delivery delayed leading to birth trauma during vaginal delivery or labor?
• Did the neonatal resuscitation team fail to quickly begin important breathing support?
• Should brain cooling (also called “hypothermia therapy”) have been provided to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?

Our birth injury attorneys have recovered millions of dollars in settlements for families of children that have suffered a birth injury. At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do, no matter how long or tough your case is.

Most birth injury law firms will employ one or two nurses to assist the review of cases and medical research. But Miller Weisbrod Olesky offers an unmatched number of nurses and nurse-attorney employees support to both the birth injury attorneys and our clients.

Our team of registered nursing staff and nurse-attorneys bring a deep level of medical and personal insight to every client’s case. Our nursing team includes both an experienced labor and delivery nurse as well as an ICU nurse. Working closely with the rest of the team, they investigate the reasons behind a birth injury and how medical professionals breached their standard of care.