HIE Birth Injury Lawsuit Attorneys

Our attorneys handle HIE lawsuits in all 50 states.  Our birth injury attorneys focus on maximizing settlement amounts and jury payouts of these claims to provide families and children a lifetime of compensation for the harm done by hypoxic-ischemic encephalopathy injury during childbirth.

This page is about HIE during labor and delivery as the result of medical negligence. Our attorneys explain how these HIE malpractice lawsuits work, which ischemia cases are most viable, and the typical settlement amounts and jury compensation awards our birth injury attorneys see in these cases.

Childbirth presents a risk of injury from oxygen deprivation. Some of these complications are from medical malpractice. One of the most serious is hypoxic-ischemic encephalopathy (HIE) or perinatal encephalopathy. This brain injury is caused by a lack of oxygen during birth.

HIE Is Under the Perinatal Encephalopathy Umbrella

The term perinatal encephalopathy means “brain damage of unknown etiology from the birth trauma.”   It is an unbelievably broad term that includes every premature baby and infant who has low Apgar scores. It also includes a lot of children who have no significant injury that will impact their lives.

This broad term includes a ruptured uterus, obstructed or twisted umbilical cord, trauma or separation of the placenta, and a whole host of other things that we know and don’t know about. One of the significant concerns is hypoxic-ischemic encephalopathy because of how vital oxygen is to a newborn.

HIE – Hypoxic-Ischemic Encephalopathy

Hypoxic-ischemic encephalopathy is more specific and is cause for greater concern. The term hypoxia refers to a lack of oxygen to organs or tissues. Ischemia is a restriction of blood and the oxygen it carries that creates tissue or organ damage.

Encephalopathy is a term for brain injury. Hypoxic-ischemic encephalopathy is a consequence of a deficit of oxygen supply to the brain. Potential complications from HIE run the gambit of awful: brain damage, death, and cell damage and death in an infant’s central nervous system.

HIE is a broad term that refers to the loss of oxygen from anything, including drowning, carbon monoxide poisoning, etc. But the focus here is the loss of oxygen when kids need it the most: before and after birth. A fetus can be permanently brain damaged or killed as a result of oxygen deprivation and lack of blood flow to the fetal brain during the antepartum, intrapartum, and postpartum periods.

Obstetricians, nurses, nurse practitioners, and nurse midwives need to be aware that conditions such as eclampsia, a prolapsed or compressed umbilical cord, a ruptured uterus, or placental abruption can cause oxygen loss that can cause permanent brain injury or kill a child. Abdominal trauma, high uterine pressures, hyperstimulation of the uterus, high blood pressure, or seizures in the mother may also lead to a lack of blood and oxygen reaching the baby’s brain.

Cause and Effect with HIE

It is hard to overstate the risk of HIE. Approximately 15%–20% of these infants die. One in four develops neurological injuries that include mental development delays, learning disabilities, seizures, epilepsy, physical movement development delays, cerebral palsy, and speech problems or delays. The remaining 55%-60% of children with perinatal hypoxic-ischemic encephalopathy do quite well.

So there is no question that HIE is extremely variable from child to child. Brain insults that seem on the surface to be seemingly similar in two different children may completely spare one child and cause a lifelong injury to the other. Why is this? No one knows. Some theorize that modern medicine cannot accurately quantify the scope of the magnitude of the impairment in utero. So “seemingly similar” may not be because we just do not have the tools to measure the real extent of the brain insult with HIE.

• Answers to frequently asked HIE questions
• NEC lawsuits: NEC is more common when the child has HIE

What Causes HIE?

What causes HIE in the first place? There are a few primary causes of HIE, including separation from the placenta, placental trauma, fetal stroke, eclampsia, complications with the umbilical cord, abdominal trauma, and uterine complications. It is also believed that excessive maternal sedation by anesthesia can cause or contribute to HIE.

When one of these complicating conditions occurs, oxygen is diverted from the child’s brain to the heart and lungs to keep the child alive. Once this begins, brain cells start to die; the longer the brain is without oxygen, the more cells die. As this process continues, the risk of severe and lifelong harm increases literally by the second. The timeline for HIE is short: a child can go from healthy to irreparably damaged in five minutes or less.

How Doctors and Nurses Must Manage HIE Risk

The most effective way to monitor and manage the HIE risk factors is using a fetal monitor. This device tells a physician about the child’s heart rate and other vital signs that show how the child is doing during contractions and labor.

The reported incidence of birth asphyxia, hypoxic-ischemic encephalopathy, or post-asphyxial encephalopathy in term or near-term infants ranges from 1 to 8 per 1000. Arguably, the real answer is probably lower, an estimated 1.6 per 10,000.

A CT scan, MRI, EEG, EKG, or ultrasound can confirm the diagnosis of HIE. In the past, a limited number of treatments for infants with HIE have been available. These included ventilation, NICU care, minimizing cerebral swelling, and preventing seizures.

Today, body and head cooling have been shown to decrease neurological problems caused by oxygen deprivation. This cooling process involves subjecting the infant to 72 hours of 33.5-degree temperatures. A study published in The New England Journal of Medicine found that this therapy reduced the risk of infant death and decreased the probability of long-term disability.  A new study published in November 2021 indicates that cooling combined with melatonin might help ward off brain injuries from childbirth. Stem therapy may also help.

Children with HIE can require long-term care including rehabilitation, surgery, and possibly life-long aide or accommodation. Families who have a child
ren with HIE might be entitled to compensation if the HIE injury resulted from a physician or hospital breach in the standard of care.

Malpractice Lawsuit Question: Was the HIE During Childbirth?

Sometimes, there is an honest debate about whether a child suffered an HIE injury during childbirth. To figure this out in cases where the doctors question our belief that the child suffered this injury, our medical experts look at the baby and ask questions. Was there asphyxiation during childbirth? Did the child need resuscitation?

What were the cord and fetal blood gases and the arterial and venous pH levels? Was there a seizure? Did a brain MRI show injury in the thalamic and basal ganglia areas of the brain? Was there hypotension or metabolic acidosis? Is there an abnormality in the child’s tone, reflexes, and activity level? These are potential markers for encephalopathy.

HIE Settlements Amounts and Jury Compensation Payouts

Below are some HIE settlements and verdicts in recent years. Remember that these are not meant to represent the average HIE case. They can be a tool for figuring out the settlement amount and jury compensation awards in HIE lawsuits. But they are just one tool.

Prior verdicts without other tools do a poor job of predicting the settlement value or jury compensation awards of future cases. That said, jury payouts and settlement amounts in successful HIE cases tend to be quite large, and these examples do reflect that.

• $35,182,818 Verdict (New York 2023): The mother, 9-months pregnant, fell on her abdomen and went to the hospital. The hospital staff told her everything was fine and discharged her with little diagnostic work. They failed to diagnose that the fall had triggered a placental abruption in a timely manner.  The baby suffered HIE and was born with severe brain injuries, leaving him with no independent functional movement and no vision.
• $500,000 Settlement (Kentucky 2022): The obstetrician and nursing staff at the defendant (a federally funded hospital) attempted to use a vacuum extractor to assist with the vaginal delivery. The vacuum was used negligently, resulting in external damage to the baby’s head from excessive force. This caused a subgaleal hemorrhage that eventually resulted in hypoxic-ischemic encephalopathy. The birth injury malpractice case was settled for $500,000. This is not a large HIE settlement so you have to assume there was some flaw in plaintiff’s case not readily apparently in this summary.
• $1,525,000 Settlement (Nevada 2021): The baby reportedly sustained hypoxic-ischemic encephalopathy during childbirth, resulting in cerebral palsy, seizures, major intellectual disabilities, and impaired vision (a condition which required eye surgery). The lawsuit alleged that the defendants negligently failed to recognize the signs of fetal distress, which should have prompted them to order an emergency C-section instead of continuing with a vaginal delivery.
• $6,000,000 Settlement (Michigan 2020): A baby was born at a federally funded hospital. She suffered hypoxic-ischemic encephalopathy and respiratory distress. The girl developed cerebral palsy. She suffered from seizures and permanent cognitive impairments.  The girl’s parents alleged negligence against the federal government. They claimed the hospital staff failed to address fetal distress, prevent fetal injuries, and timely perform a C-section. This case settled for $6,000,000.  
• $6,000,000 Settlement (New York 2019): A hospital was allegedly negligent in failing to properly identify clear signs of acute fetal distress and perform an emergency C-section in response. As a result, the infant suffered significant oxygen deprivation, causing hypoxic-ischemic encephalopathy. This brain injury left the child with the most severe type of cerebral palsy (spastic quadriplegia) and dependent on a feeding tube. This HIE lawsuit eventually settled for $6 million.
• $4,200,000 Settlement (Maryland 2018): An obstetrician and a nurse are sued for failing to act on a fetal heart rate that plaintiffs believed indicated fetal distress and the need for urgent delivery. Tragically, the baby has cortical blindness, seizures, and significant developmental delays. This birth injury claim settled out-of-court for a settlement amount of $4.2 million.
• $33,153,912 Verdict (Florida 2017):  A child has HIE secondary to a brain bleed during the birthing process. The blood that should have supplied oxygen to the brain was stuck between the skull and scalp. As a result, the child suffers tragically permanent brain injuries. At age 18 months, the child was being fed through a PEG tube, could not stand, crawl, or support himself, and had a tracheotomy that required suctioning every three to five minutes. The family hired an HIE lawyer and filed a HIE lawsuit. The birth injury lawsuit alleged that a C-section would have avoided the birth trauma the child endured. The claim also alleges that excessive Pitocin to speed up the delivery was given. Plaintiffs claimed that all of this was evident if they had interpreted correctly the message the baby was sending via the fetal heart monitor. The jury obviously accepted this version of the facts, coming back from deliberations with a whopping $29,413,495.91 compensation award for the child and the balance to the parents.
• $2,500,000 Settlement (Florida 2017): A newborn suffers hypoxic-ischemic encephalopathy, seizures, respiratory failure, hearing loss, and developmental delays. Plaintiff’s HIE lawsuit alleges that the doctors and nurses failed to timely and appropriately diagnose and treat the child and mother and should not have induced labor at 35 weeks.
• $4,750,000 Settlement (Florida 2016): A newborn baby born at Elmhurst Hospital Center in Queens is in immediate distress. He requires immediate resuscitation. He now has cerebral palsy. His lawyers argued that his cerebral palsy was the result of hypoxia that could have been avoided if the doctors and nurse had listened to what the child was telling them via his heart rate monitor. They hired a cerebral palsy attorney who successfully argued the claim that an immediate C-section was the only reasonable choice.
• $4,250,000 Settlement (Massachusetts 2013): After presenting with contractions, a woman was admitted to a Worcester County hospital where the attending physician elected to induce labor. After about 24 hours, the woman was only 4 cm dilated. Less than 12 hours later, the physician determined the woman was fully dilated and should begin pushing. The physician’s decision was quickly overruled after the managing OB/GYN determined the woman was not sufficiently dilated and should stop pushing. However, the woman demanded a cesarean section be performed as she noted the infant’s head was pushing into her spine. Instead of adhering to the mother’s request, the OB/GYN spent 20 minutes convincing the woman to save her energy for two more hours of labor. During this predicament, the fetal heart rate monitor was disconnected for 50 minutes as the fetal heart rate variability lessened. A cesarean was not performed until four hours later. Within hours after birth, the infant began to experience seizures. She was ultimately diagnosed with hypoxic-ischemic encephalopathy. The mother sued the hospital and its physicians for negligence. The plaintiff contended that after demanding a cesarean section, the defendants were required to adhere as it was apparent the fetus was distressed. The defendants denied the allegations, claiming their actions fell within the standard of care. Defendants also claimed the infant’s brain injury was inflicted before the time Plaintiff came under their care. The parties agreed to settle for $4,250,000.
• $3,141,825 Verdict (Maine 2012): A soon-to-be mother was admitted to a hospital for labor and delivery. Upon her arrival, she began experiencing contractions at more than normal frequency, and the fetal monitor was demonstrating fetal distress and lack of oxygen. The nurse midwife spent 45 minutes attempting to deliver the infant before consulting the on-call OB/GYN. It was determined that an emergency cesarean section was necessary. Unfortunately, due to the lack of oxygen, the infant was diagnosed with hypoxic-ischemic encephalopathy, resulting in cerebral palsy and cortical blindness. The mother and father hired a HIE birth injury lawyer and sued the hospital, and the nurse midwife and her practice for failing to consult the OB/GYN when it became apparent the fetus was in distress. Defendant Midwife denied allegations, claiming the infant suffered a condition called Kabuki Syndrome that results in mental retardation. Defendant Hospital denied liability, claiming Defendant Midwife and her practice rented the space from the hospital and are not monitored as if they were employees. The jury found the midwife 100% liable for the infant’s injuries and rendered a $3,141,825 verdict.
• $144,000,000 Verdict (Michigan 2011): An infant was delivered at William Beaumont Hospital in Royal Oak after her mother was induced into labor. Upon delivery, it was discovered the infant had a fractured left clavicle and was suffering from respiratory distress on top of seizures and swelling of the scalp. She is now a paraplegic and requires permanent 24-hour care. The mother sued the hospital for malpractice, claiming the defendants failed to determine the size of the fetus before delivery as the fetus was more extensive than expected because of gestational diabetes. The plaintiffs alleged that the Defendant failed to recommend a cesarean section, resulting in the infant being crushed in the birth canal. Defendants denied liability. An Oakland County jury ruled in favor of the Plaintiff and awarded an astounding $144,000,000 verdict.
•  $5,500,000 Settlement (Maryland 2011): An infant, who after delivery weighed just under three pounds and was showing normal APGAR and chord PH scores, had to have umbilical artery and venous catheters inserted. A chest X-ray was taken to confirm placement. But a follow-up X-ray revealed the catheter had advanced into the heart. Three hours later, a third X-ray showed the catheter had advanced further. An additional X-ray was performed the following morning and confirmed the inappropriate position of the catheter. Soon the infant became hypotensive, but it was not until 20 minutes later that a doctor was called to assess the hypotension. By the time the catheter was removed, the infant had suffered hypotension, bradycardia, and a decrease in cerebral profusion, resulting in hypoxic-ischemic encephalopathy. The mother sued the hospital on the infant’s behalf for failing to reposition the catheter after multiple X-rays revealed the improper location. The defendant denied liability, claiming all actions were within the standard of care. The matter proceeded to trial, where a Baltimore City jury ruled a $5,500,000 verdict for the Plaintiff.
• $800,000 Settlement (Virginia 2010): A woman was admitted to Reston Hospital for labor induction. However, there were difficulties in delivery, and the physicians elected to use a vacuum extractor. About six hours after delivery, the infant began to develop seizures. He was soon after diagnosed with hypoxic-ischemic encephalopathy, resulting in right arm paresis and cognitive deficits. His parents sued the hospital and its physicians for malpractice, claiming they failed to timely perform a cesarean section after excessive use of a vacuum extractor. The plaintiff claimed that due to the failure to perform a cesarean section, the infant suffered insufficient oxygen and blood flow. Defendants disputed liability, claiming the child’s injuries were caused by a perinatal stroke before birth. The parties agreed to settle for $800,000.

Understanding HIE

There is a great deal of confusion about HIE, particularly in the malpractice litigation context.  These are some of the most common questions our birth injury lawyers get about this brain injury:

How a Malpractice Lawyer Helps Your HIE Lawsuit

These awful birth injuries are not always the result of a doctor or nurse’s mistake. Awful tragedies sometimes happen, and no one is to blame. Bad things happen to good people. But, sometimes, far too often, a doctor’s error caused the child lifelong injuries.

What happens? Sometimes, the doctors, nurses, and midwives who are responsible for the safe delivery of these infants into the world do not adequately monitor the condition of the fetus. Sometimes, they wait too long to perform a C-section.

When these things happen, the child can suffer lifelong injuries or death. Harm to any child is awful. But, in some ways, this harm is worse. Because it so easily could have been avoided. Parents and families can stay mad forever. And it is impossible to blame them.

Ultimately, what we may be able to do for you is get you and your child compensation for a horrific loss. That is all we can do. But the settlements and verdicts in these cases can be extremely high. Does that make it all better? Of course not. But money can help make a difference for your child.

How a Malpractice Lawyer Helps Your HIE Lawsuit

If you want to investigate your potential child injury claim or if you are a lawyer looking for help evaluating your client’s claim, our neonatal encephalopathy law firm can help you anywhere in the country. Call our birth injury malpractice lawyers at 800-553-8082 or get a free online consultation.

More Information

• HIE Frequently Asked Questions
• Medical Malpractice Overview (information on malpractice cases generally)
• An Overview of Birth Injury Lawsuits
  • Birth Injury Lawsuits
    • Erb’s palsy
    • Kernicterus
    • Shoulder dystocia
    • Herpes encephalitis
    • Brachial plexus
    • Caput Succedaneum
• Malpractice During Pregnancy That Causes Birth Injuries
• Herpes Encephalitis Lawsuits (an overview)