When a baby doesn’t get enough oxygen and/or blood flow before, during, or shortly after birth, it causes a condition known as Hypoxic-Ischemic Encephalopathy (HIE). When brain cells don’t get enough oxygen, they can be injured or die. The damage can spread over time, leading to a lifetime of problems.
Cases of HIE can range from mild to severe, but even in mild cases, the injuries can be long-term. In severe cases, these injuries may require a lifetime of treatment, therapy, and care.
HIE Symptoms
- Seizures or abnormal jerking movements
- Weak muscle tone (too “floppy”) or unusually stiff muscles
- Trouble breathing, needing extra oxygen, or a ventilator
- Poor feeding, weak suck, or vomiting
- Low responsiveness, extreme sleepiness, or difficulty waking
- Abnormal reflexes or unusual eye movements
- Signs of organ stress (heart, lungs, kidneys, liver) in more severe cases
Although it’s a very serious condition, many symptoms of HIE are the same as those of other neonatal injuries. These symptoms may be related to a less severe injury, but are actually signs of HIE.
That’s why it’s critical that healthcare staff carefully monitor newborns with HIE symptoms to make sure they’re treated properly.
What causes Hypoxic-Ischemic Encephalopathy?
HIE can be caused at any point before, during, or shortly after birth when oxygen and/or blood flow drop too low and cause injury to the brain. In some cases, there is a clear event that happens that causes the problems. In other cases, it’s not so obvious, but how the situation is handled is still very important.
During labor and delivery, emergencies may occur that rapidly reduce oxygen and blood flow. These can include issues with the umbilical cord, uterine rupture, and placental abruption. In difficult births, the baby can experience severe oxygen deprivation or serious problems with their heart or lungs.
In some cases, infections have been linked to blood and oxygen issues in newborns.
Serious injuries caused by HIE
HIE is known to cause severe cases of brain damage that lead to a lifetime of issues with communication, movement, and learning. Depending on the part of the brain that is injured, children may have trouble with speech and language, memory and attention problems, behavioral issues, or experience cognitive delays.
Many of those issues have also been linked to cerebral palsy, which can be caused by HIE.
HIE has been linked to seizures and epilepsy, which may require specialized care and medication to treat. HIE is also known to cause injuries to multiple organs, which can be life-threatening.
Many of the injuries caused by HIE require families to seek long-term support for therapy, medical visits, equipment needs, and special education support.
How does medical malpractice make Hypoxic-Ischemic Encephalopathy worse?
While HIE isn’t always preventable, missed signs of fetal distress or failure to act quickly can allow HIE to develop. Healthcare staff have a duty and responsibility to monitor symptoms closely and respond promptly when treatments, such as delivering oxygen, are necessary.
Staff who don’t communicate clearly, respond to complications, or fail to recognize emergencies can lead to costly delays. When every second matters, a preventable delay can turn a normally reversible oxygen issue into a long-term brain injury.
After birth, staff must continue to properly monitor the baby if any symptoms of HIE have been noticed. This includes making sure the baby is properly warmed, if necessary, and administering other time-sensitive treatments.
The most severe cases of HIE can permanently change the lives of you and your baby, leading to years of treatment, therapy, medication, and more. If your newborn has been diagnosed with HIE and you suspect a medical mistake was involved, don’t wait another day to contact Weisser Law.
Brain Injury FAQ’s
How is anoxic brain injury related to Hypoxic-Ischemic Encephalopathy (HIE)?
Anoxic brain injury and Hypoxic-Ischemic Encephalopathy (HIE) are closely related but not identical. HIE occurs when the brain receives both reduced oxygen (hypoxia) and reduced blood flow (ischemia). HIE is one of the most common causes of brain injury in newborns and can happen during labor and delivery. Anoxic injuries may contribute to or overlap with HIE, but not all anoxic injuries are considered HIE. Both conditions can lead to severe and permanent neurological impairments if not treated promptly.
How quickly can birth asphyxia cause brain damage?
Brain damage can begin within minutes when oxygen supply is reduced. In newborns, the brain is extremely sensitive to oxygen deprivation. The longer the brain goes without oxygen, the greater the risk of irreversible injury.
Immediate medical intervention—such as emergency delivery or resuscitation—can significantly improve outcomes.
Can babies recover from HIE?
Recovery depends on the severity of the injury. Some infants with mild HIE may recover with minimal long-term effects, while moderate or severe cases can lead to lifelong disabilities. Early medical interventions, including therapeutic hypothermia (cooling therapy), are recommended by the American Academy of Pediatrics to help reduce brain damage when treatment is started quickly.
What Is the Difference Between Intracranial Hemorrhage and Intraventricular Hemorrhage in Newborns?
In the most simple terms, all intraventricular hemorrhages (IVH) are intracranial hemorrhages, but not all intracranial hemorrhages are intraventricular.
Intracranial hemorrhage is a broad term that applies to any bleeding inside a baby’s skull. The bleed can happen in different areas of the brain, including in the brain’s ventricles, tissue, or generally around the brain.
On the other hand, IVH refers to a specific type of brain bleed that starts in a fragile part of the brain, known as the germinal matrix. From there, the bleed spreads into the ventricles. IVH is most common in premature babies as their brain blood vessels are not fully developed.
The distinction between the conditions is important because the location and severity of a brain bleed affect both the treatment and long-term outcome for patients.
What do the grades of IVH mean?
Cases of IVH are graded on a scale that identifies the severity of the bleed. Grades 1 and 2 are considered smaller bleeds that generally have a better chance of recovery with minor impact on the baby. Grades 3 and 4 are much more serious and can cause lifelong injury.
Grade 3 means the blood is causing pressure within the ventricles, while grade 4 means the bleeding is also affecting brain tissue.
By assigning grades, doctors can better explain how serious the injury is, the type of monitoring needed, and whether the baby is at higher risk of developmental or neurologic complications later on.
What long-term damage can kernicterus cause?
Kernicterus often leads to permanent neurological injuries that impact the child for their entire lives. Children may develop movement disorders, hearing loss, vision problems, and cognitive impairments. These conditions can require lifelong care, therapy, and financial support. For families, the emotional and financial impact can be overwhelming.
When these injuries are caused by preventable medical errors, holding the responsible parties accountable can help secure the resources your child needs for their future.
What are the most common medical errors linked to neonatal stroke?
Common errors include failing to monitor fetal heart rate, delaying an emergency C-section, mismanaging prolonged labor, and ignoring signs of oxygen deprivation. Monitoring for those conditions is critical because oxygen interruption and blood flow issues are major stroke triggers. After birth, mistakes such as failing to respond to seizures, poor feeding, or abnormal muscle tone can delay diagnosis when time is of the essence. These errors can allow brain damage to worsen, turning a treatable condition into a life-altering and possibly permanent injury.
Why are premature babies at higher risk for PVL?
Premature infants are at a significantly higher risk for PVL because their brains are not fully developed, particularly the white matter. Fragile blood vessels and immature brain tissue make preterm babies especially vulnerable to fluctuations in blood flow and oxygen levels. Even a few minutes of instability in blood or oxygen flow can cause damage.
On top of that, premature infants are more likely to experience complications such as infections, respiratory distress, and bleeding in the brain, all of which increase the likelihood of PVL. That’s why careful monitoring and specialized NICU care are essential for preterm babies.
Can a skull fracture happen during a normal delivery without malpractice?
Yes. Several factors can cause a skull fracture that has nothing to do with the healthcare provider’s actions. Pressure on the baby’s head during pregnancy or delivery can cause a fracture, even if no tools are used during delivery.
Regardless, any skull fracture should be reviewed closely to determine what happened during labor, delivery decisions made, fetal monitoring, and post-birth care. Examining these steps can reveal negligence if providers mishandled a difficult delivery or missed clear warning signs.
How to get legal consultation for a Hypoxic-Ischemic Encephalopathy (HIE) Injury?
Our experienced team of medical malpractice attorneys will carefully review your medical records, listen to your story, and give you a realistic expectation of what options you have and what they might be worth.
Serious injuries demand serious representation. With over 50 years of experience in courtrooms across Florida, the team at Weisser Law has the reputation and record you need to secure every dollar of compensation you deserve. Weisser Law, where exceptional experience means exceptional results.