Medical Malpractice

During a woman’s pregnancy, the baby develops critical organs. It is at this time that the brain remains extremely vulnerable to various threats. Dangerous conditions that impact the brain can result in permanent damage. This is especially true if dangerous conditions are not recognized and addressed early on.

Brain cooling conditions are something that occurs once in every 1,000 births. Brain cooling is a method used to address various brain injuries. One of the most common conditions treated with brain cooling is hypoxic-ischemic encephalopathy (HIE). HIE is the cause of roughly 20% of all cases of cerebral palsy. 

Due to the severity of these and other brain injuries, adequate and thorough medical care and examinations are key to recognizing any distress, oxygen deprivation, and other dangerous conditions that impact a developing brain. Should your baby suffer brain cooling injuries as a result of negligence, it is crucial that you reach out to a medical malpractice attorney at your earliest convenience.

The Malpractice Group strives to help families get the justice they deserve after their children are subjected to injuries caused by medical negligence. Our team advocates on behalf of families to ensure they hold wrongdoers accountable so they can get the maximum amount of compensation available for medical treatment and various other damages. Contact our law firm at your earliest convenience to discuss your case and see how our medical malpractice attorneys can help you.

Warnings Signs of Brain Injuries

During pregnancy, labor, and childbirth, signs and symptoms of brain injuries are noticeable. Medical professionals will need to monitor the mother and the child throughout the pregnancy to ensure the baby continues to grow and develop in a healthy manner. In some devastating cases, babies suffer hypoxic-ischemic encephalopathy and other brain injuries due to a lack of oxygen to the brain. This condition can evolve and worsen over time, which makes it imperative for adequate and timely treatment. Within a span of several hours, babies can endure life-altering injuries that cause permanent brain damages.

When oxygen and blood flows are prevented from reaching the brain, the body goes through a series of responses in an attempt to repair itself. The body’s ability to rectify the issues are only practical when the HIE is mild. Babies who suffer moderate to severe cases of HIE can be left with permanent brain damage, even if the body attempts to fix itself. The damages babies incur are not always immediate. Instead, the conditions are the end results of gradual chemical reactions. Due to the worsening state and threat of permanent brain damage increasing over time, it is imperative that these injuries are detected as soon as possible to minimize the potential for long-term damages and disabilities.

Treatment Options Before Brain Cooling

Before brain cooling was widely identified, doctors utilized supportive care when tending to patients with brain injuries. Doctors, nurses, and other medical support professionals would use physician support, NICU care, care from specialty physicians, and ventilation in an effort to encourage the baby’s body and brain to repair itself. These methods were not always proven effective. 

As a result, the method referred to as hypothermia therapy was explicitly introduced to help babies suffering from hypoxic-ischemic encephalopathy. Brain cooling was found to be an effective method as it slowed the process of cell death and effectively reduced the severity of neurological injuries.

Signs Suggesting Brain Cooling May Be Needed

Under normal circumstances, a doctor, nurse, or physician will do everything in their power to ensure a baby is as healthy as possible. There are certain signs that indicate when a baby may be at risk for oxygen deprivation. Some of these indications include:

  • A difficult delivery
  • Mothers experiencing preeclampsia
  • Fetal anemia
  • Premature birth
  • Meconium in the amniotic fluids
  • Delaying the C-section process
  • Babies born too large or too small for their gestational age
  • Having a lack of oxygen in the mother’s blood before birth
  • Umbilical cord problems during the delivery process
  • Premature birth

If any of these conditions are present, it may indicate that some type of oxygen deprivation occurred. If oxygen deprivation is noted, brain cooling therapy may be considered.

Brain Cooling Treatment

Brain cooling therapy is an effective treatment option for babies suffering from brain injuries, like hypoxic-ischemic encephalopathy. This treatment involves placing a cooling cap on the baby’s head. A machine then attaches to the cap and circulates cold water throughout for up to 72-hours. The water is set to decrease the temperature of the baby to around 91 degrees Fahrenheit to ensure moderate cooling. Brain cooling treatment has been shown to affect the following in a positive way:

  • Apoptosis
  • Excitatory amino acids
  • Cerebral blood flow
  • Nitric oxide production
  • Cerebral energy
  • Cerebral metabolism

After the treatment, the infant is warmed back to normal temperature. Lowing the body temperature of the baby helps slow the metabolic rate, which allows cell recovery over a longer period of time. This helps to avoid further damage, which would otherwise occur due to restoring normal oxygenation of blood flow to injured cells too quickly. 

The neonatal staff will be in charge of adequately monitoring the baby throughout the entire process. Nurses and other medical professionals will need to monitor the baby’s temperature continuously. The nurses will also need to closely monitor heart rate, respiration, brain wave activity, and oxygenation. Physicians will use all of this data to determine how the baby is responding to the cooling therapy they receive.

It is imperative to keep close watch of the time throughout the entire process of hypothermia treatment. The most favorable outcomes of cooling treatment are generally noticed when brain cooling therapy is started as soon as possible after birth. Treatment started within six hours of birth is most promising. 

Brain Cooling Treatment Between 6 and 24 Hours After Birth

A recent study published by the Journal of the American Medical Association found that brain cooling therapy may be useful for treating babies if treatment is started between 6 hours and 24 hours after birth. A study performed in 2017 focused on the effects of brain cooling on 168 babies with moderate to severe hypoxic-ischemic encephalopathy. 

Although the results in a follow up between 18 months and 22 months were non-significant under traditional frequentists’ analysis methods, they suggest that brain cooling therapy may still be helpful if started 6 hours after birth. Doctors further stress that more research is still needed to determine if there is an improved prognosis in even a small percentage of patients.  

A crucial finding for this study is that, although the results are not promised for every case, there was no evidence of any commensurate injuries. Therefore, the benefits of this treatment far outweigh the costs. 

In any case, it is crucial that babies are treated for hypoxic-ischemic encephalopathy as soon as possible to decrease the possibilities of suffering life-threatening and potentially fatal injuries. 

When babies suffer negative consequences, due to the negligence of medical professionals, it is crucial that their families contact a medical malpractice attorney as soon as possible to protect their legal rights.

Timing is Of The Essence

The initial injuries noted from oxygen-deprivation are not all-inclusive. Instead, these injuries set off a chain reaction, which ripples outward from the initial site. Oxygen deprivation can cause the cells in the brain to gradually die off. This can cause the release of toxic substances within the brain, which can have a damaging impact on the surrounding tissues. For this reason, it is crucial to act quickly to prevent these injuries from becoming widespread. With timely treatment, some reversal or slowing of the injuries may be possible. 

Given the fact that studies surrounding treatment started after 6-hours are rather limited, it is important to begin treatment for hypoxic-ischemic encephalopathy as soon as possible after birth. Timing is critical as studies find that quicker treatment promotes the possibility of more promising outcomes. Findings from the Academic Medical Center Patient Safety Organization suggest that therapy should begin ideally within six hours after birth. Under certain circumstances, therapy can be beneficial for babies if it is started within 12 hours after birth.

The sooner the treatment begins, the greater the chances of minimizing the baby’s potential disabilities. Before brain cooling is started, babies must meet certain criteria to qualify. One or more of the following conditions must be met.

  • The baby has an Apgar score that was five or below at 10-minutes of life.
  • The baby experienced acidosis that was severe.
  • The baby underwent a prolonged resuscitation process.
  • The baby suffered a birth injury that resulted in oxygen-deprivation.
  • The baby had abnormal neonatal blood gas test results.
  • The baby was born with an abnormal umbilical.

In addition to the above criteria, the baby must have shown clinical signs of brain damage or experienced seizures.

It is important to note that these criteria can change depending on the hospital or birthing facility used. Not all hospitals have the machines necessary to perform therapeutic hypothermia. However, no matter where a baby is born, the facility should have the ability to transfer the baby to a larger facility or a specialized hospital where they can undergo brain cooling. 

It is important to note that some babies should not receive therapeutic hypothermia. Generally, babies that are born under 34 weeks into the pregnancy and those weighing less than 1,750 grams are not candidates for this treatment. Additionally, babies who suffer congenital abnormalities, have overwhelming septicemia, those who experienced any major intracranial hemorrhaging, and any babies who show evidence for having blood clotting disorders are not well suited for therapeutic hypothermia. These conditions can make treatment dangerous and could potentially have life-threatening consequences for the baby.

The Rewarming Process

The exact ways brain cooling protects the brain are not fully known at this time. However, one of its purported benefits is that it drastically reduces the chances of babies suffering reperfusion injuries. These injuries occur when the blood flow is restored too quickly to the injured areas of the brain. When blood flow is restored too quickly, it can worsen any existing brain damage.

After babies undergo hypothermia therapy, they have to be rewarmed back to their normal body temperature. This process can be time-consuming as the temperature of the baby can only be increased by 0.02 to 0.05 degrees celsius until it reaches 36.5 degrees celsius. Due to the fact that there is an increased risk of seizure activities during the rewarming process, doctors should utilize EEG monitoring during this process. 

The Malpractice Group Can Help You

Seeing your newborn struggle with birth injuries can be difficult. This is the fate for thousands of new parents every year. Numerous children are left with impairments that resulted from negligent and reckless behaviors during the pregnancy, labor, and delivery process. If your child suffered a birth injury, and you believe it was the result of a negligent doctor, nurse, or other medical professionals, it is crucial that you reach out to a medical malpractice attorney as soon as possible. 

The Malpractice Group’s team of attorneys help families get the justice they deserve after newborns endure injuries. Our team investigates claims for victims and determines the best legal options available to ensure they are able to hold wrongdoers accountable and receive the justice and compensation they deserve. Contact our medical malpractice attorneys at your earliest convenience to see how we can help you. By calling (312) 561-4324, we can schedule a free case evaluation to explore the circumstances surrounding your claim.