What is Hypoxic Ischemic Encephalopathy (HIE) and is it caused by maternity care negligence?
When parents are told their newborn baby has suffered a brain injury at birth it is, of course, a hugely distressing and worrying time.
Suddenly they are forced to contemplate a very different life ahead for themselves, their wider family and their child – one where they are likely to need a huge amount of support and assistance.
At Hudgell Solicitors we have helped many families in this position and understand the challenges that they face.
Hypoxic Ischemic Encephalopathy (HIE) is a serious complication which affects 1 in 1,000 babies in the UK each year.
It is caused by a lack of oxygen and/or blood flow to a baby’s brain before, during labour or at birth and it can be caused as a result of medical negligence.
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What is the prognosis for babies born with Hypoxic Ischemic Encephalopathy (HIE)?
Some newborns with Hypoxic Ischemic Encephalopathy (HIE) recover fully, while others may experience long-term neurological impairments, including cerebral palsy, developmental delays and learning disabilities.
The prognosis will depend upon the severity and duration of oxygen deprivation during pregnancy, labour or birth, and also the treatment provided immediately after birth.
Early and aggressive intervention is crucial for babies with HIE and needs to be focussed on minimising brain damage, supporting vital functions and improving long-term outcomes.
What signs and symptoms may indicate a possible HIE injury?
Midwives and doctors should be checking for signs and symptoms of brain injury and Hypoxic Ischemic Encephalopathy in the first few hours of a baby’s life and over the following days.
The first indication may come from a baby’s initial appearance, as they may be blue or of a pale skin colour. This should be noted following a test which should always be performed on babies a minute after their birth, and again five minutes later.
This test (the APGAR score), is also comprised of assessments relating to breathing, heart rate, muscle tone and reflexes. Midwives and doctors should be checking for a low heart rate, difficulty breathing or floppiness in the muscles.
Other signs of a possible HIE injury include abnormal responses to light or abnormal levels of consciousness, as well as problems with feeding.
If you were made aware of any of these concerns with your baby at around the time of their birth, but you were not made aware of clinicians taking any specific action to provide treatment this may indicate a failing in the care provided.
How should an HIE injury to a baby be treated?
If deemed appropriate, lowering the baby’s body temperature to 33.5°C (92.3°F) for 72 hours – often referred to as ‘cooling’, is a process which can be started within six hours of a baby being born with HIE.
Babies who have HIE often also require assistance with breathing and may need resuscitation and ventilation immediately after birth. They may also need intravenous fluids for nutrition if they are struggling or unable to feed orally.
It is imperative that a baby born with a HIE is comprehensively monitored using an EEG to monitor brain activity and detect seizures or abnormal patterns, ensuring that immediate treatment can be provided if any concerns are raised.
Is HIE in babies always due to negligence in maternity care?
A hypoxic-ischemic brain injury can result from a variety of factors, many of which are not preventable or foreseeable even with the best medical care, such as severe infections, preeclampsia, eclampsia, or premature birth meaning that a baby is born with underdeveloped organs and systems.
We see many cases where the injury is caused or contributed to by negligent care, including:
- Failure to carry out appropriate tests during pregnancy.
- Misinterpretation of scans, leading to an incorrect diagnosis or treatment or risk assessment of a mother.
- Failure to act upon reduced baby/fetal movements during pregnancy.
- Failure to act when a mother’s blood pressure reaches dangerous levels.
- Failing to call a doctor or consultant when there are concerns during labour.
- Failure to interpret the fetal heart rate patterns (CTG) during labour.
- Delayed or inadequate treatment after birth, such as resuscitation, ventilation and cooling.
If you believe that your baby’s birth injury was caused by any of the failings detailed above, we would advise you to speak to our expert team today about making a possible claim, as this could help you gain access to support services to assist you and your child towards the best possible future.
This can include securing interim compensation payments to cover the cost of much-needed therapy, equipment, rehabilitation, accommodation and care, and will ultimately focus on helping with any long-term care needs required for you or your child, to reach their potential or in some cases to support independent living.
Will I be told that negligence may have caused my baby’s brain injury?
Under the Duty of Candour, which is imposed on NHS Trusts, they are required to be open and honest with patients or their families when things go wrong that can cause harm.
In our experience, given that such cases can lead to significant compensation for the individual, NHS Trusts can be reluctant to make full admissions of liability relating to errors which may have contributed to or caused a baby’s brain injury, and in many cases, they strongly defend legal cases against them even when evidence of negligence is clear.
Following criteria set by the NHS, parents of a baby who has suffered a birth injury such as an HIE should be offered a ‘birth debriefing’, a meeting aimed at providing an opportunity to speak to the relevant midwives or clinicians and to discuss the medical assessments and decision-making processes which were made during labour and birth.
You may also be informed that your treatment is the subject of a review by the Trust. Such reviews can lead to Serious Incident Reports (SIRs), Root Cause Analysis reports (RCA), Serious Untoward Investigation reports (SUI) or a Patient Safety Incident Investigation Report (PSII) being produced.
Should any of the above happen in your case, we would strongly recommend seeking advice from a specialist birth injury claims solicitor, who can begin further investigating what happened to your care during pregnancy, labour and birth, and at the outset, they will request the medical records of yourself and your baby to gain a better understanding of the events that took place and what treatment was provided.
Your treatment will then also be assessed by an independent medical expert, who will identify if there have been any failings in the care provided and whether this caused an avoidable injury.
Our specialist solicitors have an excellent understanding of birth injuries such as those relating to HIE and they are able, together with assistance from our in-house midwives if appropriate, to assess whether there is a potential case.
Why choose Hudgell Solicitors?
Our team of birth injury solicitors have supported hundreds of families affected, providing them with expert legal support to question and challenge the care they received whilst securing damages to compensate for the impact it has on their lives.
Clients often praise the compassionate and understanding approach of our team, alongside their determination to ensure that we hold individuals and organisations to account so that questions are answered about the treatment provided.
We seek to ensure that the families we work with are fully supported to seek damages to maximise your child’s potential and to assist your child have the best possible quality of life in the long term.
In many cases, we secure significant interim compensation payments to cover the cost of any immediate needs such as equipment, accommodation, rehabilitation and therapeutic care and support.
As well as offering legal support with the benefit of no win no fee agreements (Conditional Fee Agreements), we also offer Legal Aid funding for certain cases involving children who have suffered a neurological injury that has resulted in severe disability, which has been sustained either through pregnancy, during the birth or the first eight weeks of the child’s life.
Our medical negligence team is committed to campaigning for the improvement of UK maternity care and in 2024 we made representations to the All-Party Parliamentary Group (APPG) Birth Trauma Inquiry, which was launched by UK Parliament to investigate the reasons for traumatic births and to develop policy recommendations to reduce the rate of birth traumas.
