Practice area
Cerebral palsy and HIE
Hypoxic-ischemic encephalopathy (HIE) is a brain injury caused by too little oxygen or blood flow around the time of birth. It can lead to cerebral palsy. Whether it could have been prevented usually comes down to timing, and timing is something a careful review can often answer.
What this can look like
- Signs of fetal distress on the monitor that were not acted on
- A delayed emergency C-section
- Umbilical cord problems or uterine rupture not managed in time
- Resuscitation after birth that was slow or incomplete
- Cooling therapy not offered to an eligible baby within the first six hours
- Newborn infections or low blood sugar that went untreated
From the delivery room to a diagnosis
HIE and cerebral palsy are often connected by a timeline that runs from the last hours of labour to a diagnosis many months later. This is the path our reviewers follow.
-
Labour and birth
Fetal monitoring, the decision to deliver, and how long it took. Apgar scores and cord blood gases are recorded.
-
First six hours
Babies with moderate or severe HIE may be offered cooling therapy, which works best when started early.
-
First weeks
An MRI shows the pattern of injury. Different patterns point to different timing.
-
First two years
Missed milestones lead to evaluations. Cerebral palsy is often diagnosed between one and two years of age.
-
A lifetime plan
A life care planner and an economist estimate therapy, equipment, care and lost earning ability for life.
What the law asks you to show
All four must be true. Most cases are decided by the third one.
- 1.Duty
- The delivery team and the newborn team owed care through labour, birth and the first hours of life.
- 2.Breach
- Experts agree the warning signs called for faster delivery, better resuscitation or cooling therapy.
- 3.Causation
- The MRI pattern and the timeline show the injury happened in the window when care could have prevented it.
- 4.Harm
- Your child's condition, and the care, therapy and support they will need over a lifetime.
Who reviews it
Independent experts who do not work with the providers involved. We pay their fees.
- An obstetrician and a neonatologist
- A pediatric neurologist and a neuroradiologist
- A life care planner and an economist to measure lifetime needs
Records that help
You do not need these before you call. With your permission, we request them.
- Fetal heart monitoring strips
- Apgar scores and cord blood gas results
- NICU records, including any cooling therapy
- All MRI and head ultrasound images
- Therapy and early intervention reports since
Deadlines can be short
Rules for children differ by state. Some give extra time, some do not, and claims against public hospitals can require notice within months. Ask as soon as a diagnosis is made. Rules differ by state.
Deadlines, explainedQuestions we hear
What does a lifetime of care include?
Usually therapies (physical, occupational and speech), equipment such as wheelchairs and communication devices, changes to the home, attendant care, schooling support, and the earnings your child may not be able to make. A life care planner documents each one.
We were told the injury happened before labour. Can that be checked?
Yes. The MRI pattern, the monitoring strips, cord blood gases and the placenta report often show when an injury happened. Sometimes the earlier explanation is right, and we will tell you so.
Other practice areas
Questions about your child's birth? Start here.
A parent or guardian can fill in the evaluation. Our nurse reads the birth records first, and we tell you honestly what they show.