Articles Posted in Brain Injury

More than a few studies have been conclusive showing that infants with hypoxic-ischemic encephalopathy have benefited when cooled to a temperature of 30 degrees Centigrade in a median time of 58 minutes. The cooling of newborns inspired oxygen requirements in a test involving six infants diagnosed with HIE.

Five of those infants required inotropic support during the cooling procedure. The cooling would be progressively reduced after 1-2 days. Inotropic support is the intensive care of newborns to stabilize circulation and to optimize oxygen supply.

Over the years, HIE has been recognized much more frequently. The onset of cases of HIE are caused by stroke, compressive forces or changes in oxygen circulating through the fetus before and immediately after delivery.
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Two weeks after Baby Doe’s premature birth, she developed signs of jaundice. Seven hours later, a check of her bilirubin revealed a severely elevated level of 29. The attending doctor ordered retesting of the bilirubin level but did not order any treatment.

Hours later, when a second bilirubin test showed a level of 27.1, the same doctor was notified by nurses of the out-of-balance level. By the next morning, the child’s bilirubin level increased to 32.1. Another physician began treating Baby Doe the next morning and ordered phototherapy, which began more than 17 hours after Baby Doe’s first bilirubin test was reported to the first doctor. Phototherapy is the usual treatment for jaundiced newborns.

Baby Doe suffered kernicterus resulting from severe jaundice. Kernicterus is a kind of brain damage caused by excessive jaundice, just as Baby Doe had endured. Baby Doe is now 10 years old. She suffers from cerebral palsy and cannot speak or walk. The Doe family sued the health system that employed the doctors involved alleging that they chose not to timely test Baby Doe’s bilirubin level at the first signs of jaundice and chose not to timely treat the jaundice. That failure caused the child’s permanent and severe injuries.
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In this lawsuit, the mother identified as Ms. Doe was admitted to a hospital to deliver her first child. Although the labor and delivery were prolonged, the treating obstetrician, Dr. Laura Fortner, advised Doe to keep pushing for another 30 minutes.

The obstetrician returned an hour later and used forceps and a vacuum extractor to deliver the baby who had become stuck in Doe’s birth canal. The baby’s Apgar scores were one at one minute and five at five minutes, requiring resuscitation.

The child, now age 16, has been diagnosed as having suffered hypoxic ischemic encephalopathy (HIE), which affects his cognitive, social and fine motor skills.
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Illinois is not one of the many states that have enacted non-economic damage caps on medical malpractice lawsuits. However, Illinois lawmakers have three times voted to enact such laws; each was found unconstitutional for a variety of reasons.

According to a paper completed by Rutgers Law School Professor Sabrina Safrin, caps on non-economic damages in medical malpractice cases have no effect on a procedure that’s among the most commonly undertaken in operating rooms across the United States: cesarean sections. “C-sections are arguably the poster child for so-called-defensive medicine,” the professor wrote in her paper.

C-sections involve cutting through a mother’s abdomen and uterine wall to remove the fetus. In many cesarean delivery cases, the fetus may have been observed to be in distress. By delivering an emergency C-section child, the purpose is preventing brain damage, cerebral palsy and other life-altering birth injuries.
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In this confidential settlement, the case arose after Ms. Doe was admitted to a hospital in pre-term labor at 29 weeks gestation. During her 39-hour admission, she received medication to prevent a premature delivery. The hospital staff then discharged her. One day later, laboratory results revealed that she had an E-coli urinary tract infection and that she was positive for Group B strep.

Within a week, she went into labor and delivered her baby by Cesarean section. The baby has been diagnosed as having brain damage, resulting in cerebral palsy, developmental delays and learning disabilities.

Doe sued the hospital and several treating healthcare providers alleging that they chose not to administer antibiotics before discharging her from the hospital based on her pre-term labor and preliminary lab results, which were available before her discharge.
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The United States government has withdrawn its appeal after a U.S. District Court judge in Pennsylvania signed a judgment order in the amount of $42 million for the parents of a young boy who was disabled from brain injuries apparently caused by the use of forceps during his birth.

Regan Safier, the attorney for the family of the minor child, identified only as D.A., commented that the government found that an appeal of the judgment would not be successful.

The U.S. attorney, David J. Freed said, “We respect the court’s decision in this matter and wish nothing but the best for the minor child and his parents.” The verdict of $42 million was entered in Harrisburg, Penn., after a 6-day trial in 2016.
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The mother, Doe, age 38, was 30 weeks into her pregnancy and considered in a high-risk pregnancy when she was admitted to the Roe Hospital due to preeclampsia. Several days later, during overnight hours, the fetal monitor showed severe late deceleration of her unborn baby, which continued for two hours. Despite orders for a STAT Caesarean section, the procedure was not performed until 90 minutes later.

Ms. Doe’s anesthesia wore off prematurely following the delivery. When the attending anesthesiologist attempted to intubate Doe, her abdomen filled with air. Doe subsequently coded and suffered profound brain damage. Ms. Doe lived in an institutional setting until she died almost six years later. She is survived by her husband and the baby who was delivered at that time and also suffered brain damage.

Ms. Doe’s sister, on behalf of her estate, her husband and her injured child, filed a lawsuit against the hospital and anesthesiologist claiming improper handling of fetal distress, late performance of the Cesarean section and negligent intubation.
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Vashti Daisley went to a hospital complaining of a lack of fetal movement during the late stages of her pregnancy. Dr. Donna Kasello, an obstetrician, performed a biophysical profile, which resulted in a score of two.

Dr. Kasello consulted a maternal-fetal medicine specialist, Dr. Kimberly Heller, and the patient later underwent a repeat biophysical profile, which resulted in a score of eight. Dr. Kasello discharged Daisley after 30 additional minutes of fetal monitoring.

The next day, Daisley’s treating obstetrician performed an emergency biophysical profile. The results were not reassuring, leading to the delivery of Vashti Daisley’s son by Cesarean section.
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Kara Smalls was delivered by way of a Cesarean section surgery at Ouachita County Medical Center. Two hours after her birth, Kara’s bilirubin level was 5.5, which is an indication of high risk of hyperbilirubinemia.

Hyperbilirubinemia is a condition in a newborn in which there is too much bilirubin in the blood. When red blood cells break down, a substance known as bilirubin is formed. Babies are not easily able to rid themselves of bilirubin, and it can build up in the blood and other tissues of a baby’s body. The symptoms of hyperbilirubinemia are jaundice, which includes yellow tinged skin and the whites of the eyes, normally starting at the head and spreading down the body. The baby can also run a fever or be fatigued. Other symptoms include weight loss, vomiting and paler than usual stools. Jaundice in a newborn is fairly common, particularly in babies born before 38 weeks gestation or preterm babies.Infant jaundice occurs most times because the baby’s liver isn’t mature enough to rid itself of bilirubin in the bloodstream.

In this case, over the next two days, nurses noted that Kara was mildly jaundiced. Nevertheless, the family physician, Dr. Jonathan Lewis, discharged the baby instructing her mother that everything was normal and that she should follow up with him in ten days.
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T’Miaya Smith’s son, J.H., began having seizures after his birth. A CT scan revealed ischemic injuries to his brain. Ischemic injuries result from the lack of blood flow to the brain causing brain damage. Smith, on behalf of her son, filed a lawsuit against Lauren Braswell, a midwife who provided care to Smith during her labor and delivery. The suit also named Atlanta Women’s Health Group, which was Braswell’s employer.

It was alleged that Braswell was negligent in the management of Smith’s labor and delivery. The defendants filed a motion to exclude the testimony of one of Smith’s expert witnesses. There was also a motion to exclude causation testimony from any of Smith’s expert witnesses and there was a motion for summary judgment. The trial judge granted the defendants’ motions. Smith appealed for the following reasons, but the appellate court affirmed.

Smith appealed to the Georgia Appellate Court to reverse the trial judge’s order excluding the testimony of the maternal-fetal medicine expert. The court stated, “The determination of whether a witness is qualified to render an opinion as an expert is a legal determination for the trial court and will not be disturbed absent a manifest abuse of discretion. The admissibility of expert testimony in civil cases provides:
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