Symptoms, Risks, and Legal Help
An extremely high-risk procedure, surgery on a newborn can also save a baby’s life. Soon after birth, some babies need surgery to correct problems with heart defects, bowel problems, airway problems, bleeding, infection, or other serious conditions.
Because the baby’s brain is still developing, it requires steady oxygen, blood flow, blood pressure, blood sugar, and temperature, and careful monitoring during surgery. If there are problems with any of those requirements, newborns can be at risk for brain injury and, in severe cases, brain damage.
If the baby’s brain does not receive enough oxygen or blood, because of a stroke or bleeding event, because of seizures, or because the baby becomes dangerously unstable after surgery, brain damage is possible. Newborns are particularly at risk when the surgery involves major surgery, especially cardiac surgery and complex neonatal procedures.
Symptoms of Post-Surgical Brain Injury in Newborns
In some cases, symptoms may appear in the NICU shortly after surgery, and in others, become more noticeable as the baby grows. Parents should always report changes in feeding, breathing, movement, alertness, or behavior after surgery.
Possible symptoms include:
- Seizures.
- Abnormal jerking, twitching, or stiffening.
- Limpness or poor muscle tone.
- Unusual stiffness or arching.
- Trouble breathing or repeated apnea episodes.
- Poor feeding or weak sucking.
- Trouble staying awake for feeds.
- Extreme sleepiness or hard-to-wake behavior.
- Irritability or high-pitched crying.
- Weak cry.
- Abnormal eye movements.
- Poor temperature control.
- Low oxygen levels.
- Slow heart rate or unstable vital signs.
- Bulging soft spot on the head.
- Abnormal head growth.
- Delayed milestones.
- Weakness on one side of the body.
- Trouble with movement, coordination, or muscle control.
- Later problems with speech, learning, vision, or development.
Neonatal seizures can be caused by serious problems such as hypoxia-ischemia, stroke, bleeding, infection, and metabolic issues. In a post-surgical newborn, seizures should never be treated as a minor issue.
Injuries Caused by Post-Surgical Brain Injury
Brain injury suffered post-surgery can have a lifetime impact on a baby. Although some babies recover with early treatment and follow-up care, others face long-term issues. These problems may affect movement, learning, feeding, vision, hearing, speech, or development.
Babies may develop cerebral palsy if the injury affects the parts of the brain that control movement and muscle tone. Cerebral palsy can cause stiffness, weakness, poor coordination, delayed motor milestones, and trouble walking as the child grows.
Others may suffer from epilepsy and recurring seizures. Babies who have seizures after surgery may need anti-seizure medication, EEG monitoring, neurology care, and long-term developmental follow-up.
Post-surgery brain injury is also linked to delays in speech, language, learning, attention, or behavior. Other possible long-term effects include feeding problems, vision problems, hearing problems, muscle weakness, poor coordination, developmental delay, intellectual disability, and the need for physical therapy, occupational therapy, speech therapy, or special education support.
Possible Medical Malpractice That Can Cause Post-Surgical Brain Injury
Medical malpractice isn’t always a cause of post-surgery brain injury, as newborns are extremely fragile, and some surgeries carry serious risks even when doctors and nurses provide careful care. However, negligence may be involved when a baby’s injury was caused by preventable mistakes, poor monitoring, delayed treatment, or failure to follow accepted standards of care.
Possible examples of medical malpractice may include:
- Failure to properly monitor oxygen levels during or after surgery.
- Failure to respond quickly to low oxygen levels.
- Failure to monitor or treat low blood pressure.
- Failure to recognize dangerous blood loss.
- Failure to replace fluids or blood products when needed.
- Anesthesia errors or poor airway management.
- Medication dosing errors.
- Failure to monitor blood sugar after surgery.
- Failure to recognize or treat seizures.
- Failure to order EEG testing when seizures are suspected.
- Failure to order brain imaging when signs of injury appear.
- Failure to recognize stroke symptoms.
- Failure to diagnose or treat infection or sepsis.
- Failure to monitor temperature, blood gases, or acid-base status.
- Poor handoff communication between the NICU, surgical team, and anesthesia team.
- Delay in transferring the baby to a higher-level NICU or specialist center.
- Discharging the baby without proper follow-up when warning signs are present.
Neonatal anesthesia guidance emphasizes the importance of handoffs between the NICU team, anesthesia team, nurses, and surgical team. Failure to communicate effectively during these transitions can be dangerous because newborn surgical patients often have complex needs that must be clearly understood by all providers involved.
Post-Surgical Brain Injury in Newborns FAQs
What symptoms should parents watch for after newborn surgery?
Post surgery, parents should keep a close eye out for seizures, unusual twitching, stiffness, limpness, poor feeding, weak sucking, trouble breathing, repeated pauses in breathing, unusual sleepiness, high-pitched crying, abnormal eye movements, or trouble waking for feedings.
As that baby grows, warning signs can include delayed milestones, poor head control, weakness on one side, feeding problems, vision problems, or developmental delays. Some symptoms can be subtle, especially in newborns in the NICU.
Parents know their baby’s behavior better than anyone, so if something seems wrong or if their baby’s condition changes after surgery, it’s important that they seek medical care right away.
What causes brain injury after newborn surgery?
Brain injury may be caused by low oxygen, low blood pressure, blood loss, poor circulation, stroke, brain bleeding, seizures, infection, low blood sugar, or unstable breathing. Babies who were born premature, have congenital heart disease, have a serious infection, or need emergency surgery are already at a higher risk.
However, the risk of brain injury increases when warning signs are missed or when treatment is delayed. Newborn surgical care requires careful monitoring because a baby’s brain can be harmed when oxygen, blood flow, glucose, or temperature are not kept within safe ranges.
Can anesthesia cause brain injury in a newborn?
While anesthesia can be part of the risk picture, it’s not always the direct cause of a brain injury. In general, newborns are very sensitive to changes in breathing, oxygen, blood pressure, blood loss, and circulation during anesthesia. If a baby’s airway is not managed properly, oxygen levels drop, blood pressure falls too low, or blood loss is not recognized quickly, the brain may be injured.
Anesthesia teams are expected to monitor newborns carefully and respond quickly to dangerous changes. A careful review of anesthesia records may help show whether the baby had unsafe oxygen levels, blood pressure problems, or other complications while receiving anesthesia.
Are babies who have heart surgery at higher risk for brain injury?
Yes. Babies with complex congenital heart disease are known to have higher risks for neurologic and developmental problems. That’s especially true when they need surgery early in life. These risks may come from several sources, including abnormal blood flow before surgery, low oxygen levels, cardiopulmonary bypass, blood pressure changes, stroke, seizures, or post-operative instability.
According to the American Heart Association, children with complex congenital heart disease may need long-term developmental monitoring. This does not mean every poor outcome is malpractice, but it does mean doctors must take these risks seriously and monitor the baby closely.
How do doctors know if a newborn has a brain injury after surgery?
Doctors may diagnose brain injury through exams, EEG testing, blood work, ultrasound, CT scan, or MRI. EEG testing helps detect seizures, including seizures that may not be obvious from the outside. An MRI is useful because it can show patterns of injury, such as stroke, bleeding, swelling, white matter injury, or oxygen-related damage.
Doctors may also review the baby’s oxygen levels, blood pressure, heart rate, blood sugar, blood gases, and surgery records. These records can help show whether the baby had a period of instability before the injury was discovered.
Can a post-surgical brain injury cause long-term problems?
Yes. Some babies recover well, especially when the injury is mild, and treatment begins quickly.
However, in more serious cases, babies may develop long-term problems such as cerebral palsy, seizures, developmental delay, speech delay, feeding problems, vision problems, hearing problems, learning disabilities, or behavior challenges.
Some issues may not be apparent during the newborn period, and the baby may need follow-up care from neurology, developmental pediatrics, physical therapy, occupational therapy, speech therapy, and early intervention services. Long-term monitoring is important because children may show new challenges as they grow and are expected to meet more advanced milestones.
When could post-surgical brain injury be medical malpractice?
When a preventable mistake causes or worsens the baby’s brain injury, it can be a form of medical malpractice. This can include failure to monitor oxygen or blood pressure, delayed response to low oxygen levels, failure to recognize blood loss, medication errors, anesthesia errors, failure to treat seizures, delayed imaging, poor communication between teams, or failure to transfer the baby to a higher-level NICU.
It’s worth noting that a bad outcome alone does not prove malpractice. The key is to prove that providers failed to act as reasonably careful medical professionals would have acted under similar circumstances. Hiring an experienced medical malpractice law firm like Weisser Law can help answer those questions.
What records are important in a newborn post-surgical brain injury case?
Important records may include the operative report, anesthesia records, NICU notes, nursing notes, medication records, blood pressure and oxygen logs, blood gas results, lab results, imaging reports, EEG reports, transfer records, and discharge instructions. These records may show whether the baby had low oxygen, low blood pressure, blood loss, seizures, infection, low blood sugar, or other warning signs.
Parents should also keep notes about what they were told, when symptoms appeared, and how the baby changed after surgery. These details may help doctors, specialists, or attorneys understand what happened, when, and who might be responsible.
Why should parents contact Weisser Law if they suspect medical malpractice played a role?
Because those important records can be difficult to interpret without legal and medical review, contacting Weisser Law is the smartest choice parents can make. Weisser Law will investigate what happened before, during, and after surgery, review whether warning signs were missed, and determine whether providers failed to meet accepted standards of care.
A brain injury can affect a child for life, and families may need compensation for medical care, therapy, future treatment, special education needs, lost income, and long-term support. Our firm has won millions of dollars for our clients who’ve suffered as a result of medical malpractice.
Contact us today for your free, zero-pressure consultation where you don’t pay until we win your case.