Articles Posted in Hypoxic Ischemic Encephalopathy

At 31 weeks gestation, Linnoska Correa had a prenatal visit with obstetrician Dr. Luis Pardo Toro. Correa’s blood pressure during the visit was 136/86 mm Hg, which was appreciably higher than other blood pressure readings during her pregnancy.

The next day, Correa complained of severe stomach pain. She was admitted to the hospital HIMA-San Pablo in Puerto Rico where she was diagnosed as having severe preeclampsia. She was given antibiotics and magnesium sulfate.

Two days later, Correa’s daughter was delivered by cesarean section. The Apgar scores at the time of delivery were 7 at one minute and 8 at five minutes. Correa’s daughter, who is now 8, suffers from severe neurological injuries and quadriplegia, which necessitates 24-hour care daily.
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Doe was born prematurely and underwent surgery. He was prescribed home oxygen therapy in anticipation of his discharge. While still hospitalized, Doe kicked his pulse oximeter off of his foot, prompting an alarm.

A respiratory therapist allegedly adjusted Doe’s nasal mask and repositioned him. Less than an hour later, a desaturation alarm sounded. A clinical assistant at the hospital allegedly silenced the alarm and subsequent alarms while providing care over the next 26 minutes.

Doe became cool to the touch. The clinical assistant allegedly attempted to auscultate a heartbeat. Unable to revive the heartbeat, the clinical assistant called for nursing assistance. When a nurse arrived, Doe was limp and unresponsive.
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Tammy Esquivel was admitted to Contra Costa Regional Medical Center to deliver her baby. During her 26-hour labor, her contraction pattern became abnormal. She experienced intense abdominal pain. The fetal monitor showed a prolonged severe deceleration, prompting nurses to reposition Esquivel and discontinue Pitocin.

A new deceleration occurred. A special response team was then summoned to the bedside. Approximately an hour later, Esquivel’s daughter was delivered by emergency cesarean section.

The baby was later diagnosed as having suffered severe hypoxic-ischemic brain damage. The baby is now three. She requires a feeding tube and suffers from seizures among other medical problems.
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Ms. Doe presented in active labor on an evening to Providence Regional Medical Center’s Pavilion for Women and Children. Ms. Doe, whose full-term baby was healthy at the time of her admission, was administered Pitocin and remained in labor throughout the night.

The next morning at around 5 a.m., significant signs of fetal distress occurred, including prolonged decelerations. Nurses informed the on-duty obstetrician, who was in surgery with another patient. The doctor ordered an operating room be opened for Ms. Doe.

Approximately three hours later, Ms. Doe’s daughter was delivered by cesarean section; the procedure was performed by a different obstetrician. The baby was diagnosed as having hypoxic-ischemic brain damage and — tragically — died just nine days later. The baby was survived by Ms. Doe, the baby’s mother, and her husband.
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D.W. was born at 25 weeks gestation at Jamaica Hospital Medical Center. The baby was diagnosed as having suffered hypoxic-ischemic brain damage resulting in spastic quadriplegia.

D.W. is now in the 6th grade. He attends special education classes and will never be able to live independently as a result of his brain injury.

A lawsuit was filed against the hospital and two doctors who provided care during D.W.’s delivery, alleging that they chose not to timely deliver D.W. by way of a cesarean section; the suit also alleged lack of informed consent and negligent post-delivery care. This included a failure to offer cranium cooling.
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At the end of her pregnancy, Ms. Doe experienced bleeding and pain. She went to the triage unit of Grove Hospital where she was seen by a midwife and first-year resident.

Ms. Doe was attached to a fetal monitor system, which showed decreased variability and some deceleration.

Although allegedly called, Ms. Doe’s treating obstetrician did not initially come to the hospital. An hour later, a nurse summoned the physician who arrived at the hospital more than two hours after Ms. Doe first presented to the hospital.
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At three different obstetrics appointments during the 37th and 38th week of pregnancy, Ms. Doe’s blood pressure readings showed hypertension. When she returned for another appointment toward the end of her 38th week, she had severe hypertension and decreased fetal movement.

Ms. Doe was sent to a hospital where the fetal heart monitor showed the fetal heart rate of 140 beats per minute, minimal to absent variability, and late decelerations.

The attending obstetrician ordered diagnostic testing and then attended to another patient. By the time Ms. Doe underwent a Cesarean section about two hours later, the fetal heart rate had dropped to zero.
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Ms. Doe was pregnant with twins; they shared a placenta but had their own amniotic sacs. During her pregnancy, one of the twins, Twin B, had an abnormal velamentous cord insertion and exhibited persistent absent end-diastolic flow, which indicated underlying fetal vascular stress. Velamentous cord insertion is a complication of pregnancy in which the umbilical cord is inserted in the fetal membranes. In a normal pregnancy, the umbilical cord inserts into the middle of the placenta and is surrounded by the amniotic sac.

At 24 weeks, a Doppler ultrasound revealed reverse end-diastolic flow (REDF) in Twin B’s umbilical artery. Reversal of the umbilical artery end-diastolic flow or velocity can be an ominous sign when detected after 16 weeks of pregnancy. In extreme situations, such as severe intrauterine growth restriction, the arterial blood flow can reverse directions at the end of diastole. This is referred to as a reversed end-diastolic flow.

When this condition was recognized, Ms. Doe’s treating maternal-fetal medicine specialist did not hospitalize her but continued seeing her every week until 27 weeks gestation. Two weeks later, Twin B died.
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Ms. Doe, who had a history of preeclampsia, was admitted to New York-Presbyterian Hospital to deliver her baby. She was administered Pitocin but was discontinued on order by one obstetrician before another doctor restarted it.

Despite all of this, Ms. Doe’s labor failed to progress, and the fetal monitor showed persistent variable decelerations.

Ms. Doe’s baby, a son, was subsequently born in a depressed condition, with Apgar scores of 0 at one minute and 1 at five minutes.
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Anna Scott was admitted to Jefferson Healthcare to deliver her first child. She was at first attached to a fetal heart monitor, which showed that her baby was healthy. She was then taken off the monitor for a six-hour period until her treating physician performed an artificial rupture of the membranes, after which Scott was then reattached to the fetal heart monitor.

The fetal heart monitor revealed that Scott’s baby had developed a worrisome heart rate pattern of repetitive variable decelerations with intermittent minimal variability.

Several hours later, Scott began to push. Her daughter, Lana, was born almost four hours later in a depressed condition with the umbilical cord wrapped tightly around her neck. Lana required 30 minutes of resuscitation. Lana’s Apgar scores were 3 at one minute and 4 at five minutes.
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