Hypoglycemia is a condition in which a person's blood glucose levels fall below normal levels to a level that causes the brain not to function normally. As a result, the brain shuts down functions that it does not feel are necessary.
This may lead to varied reactions that can cause catastrophic impact, particularly on an infant. Our birth injury lawyer have seen cases where the child has a blood glucose level of literally zero. The risks of this kind of severe hypoglycemia include loss of cognitive function, speech problems, and anxiety attacks, among others.
As symptoms are sometimes mild and resolve after eating foods or fluids containing carbohydrates, hypoglycemia can often go undiagnosed. However, some more serious health issues can lead to hypoglycemia including liver or pancreatic problems and diabetes mellitus. Hypoglycemia must be diagnosed early to ensure that there are not more serious issues involved during the pregnancy.What Causes Hypoglycemia in Newborns?
The most common metabolic problem in newborn infants is hypoglycemia. Hypoglycemia in newborns is often caused by the failure to properly control the mother's diabetes, which is often but not always the fault of the OB/GYN. Other factors include a mother who received poor nutrition, and when mother and child have incompatible blood types.Mother's Hypoglycemia
Symptoms of hypoglycemia during pregnancy are similar and include shaking, sweating, hot flashes, anxiety attacks, intense hunger, dizziness, headache, confusion, vision difficulties, and sudden irritability. Hypoglycemia in pregnancy is usually not diagnosed until labor though symptoms may be present before that time.How to Spot Malpractice
Normal glucose is between 60 and 100 mg/dl. Anything lower than that could deprive the body's cells of a vital source of energy. Medical malpractice occurs when a physician ignores the mother's complaints of hypoglycemia or blood work that clearly shows low blood sugar. Similarly, medical malpractice may happen if a physician fails to respond to the child's low blood sugar after birth. Hypoglycemia is a perfectly treatable condition, but it requires paying attention to the signs and symptoms.
Hypoglycemia should be treated immediately upon noticing symptoms to prevent effects such as low blood sugar and hypoglycemia in the unborn child. In diabetics, the risk of miscarriage, preterm birth (the biggest risk factor for hypoglycemia), stillbirth, fetal macrosomia (high birth weight), congenital malformation increases with worsening glycemic control. Unfortunately, treatment can be difficult as often pregnant women are prone to dizzy spells and loss of consciousness.
Preventative care includes proper nutrition and evenly spaced meals, which often includes consultations with a physician and dietician to ensure adequate glucose levels are maintained throughout the day for the duration of the pregnancy.The Child's Hypoglycemia
Neonatal hypoglycemia occurs when a newborn child's blood sugar drops to an abnormally low level. The appropriate levels change with age. But, by way of example, a normal glucose level for a 40 minutes old child is approximately 40 mg/dL. Low blood sugar can cause brain starvation at a time when children need brain development the most. From the doctor's standpoint, there is no sign that the child is injured - you have to see the hypoglycemia coming.
How do you see the hypoglycemia coming? There are several risk factors. The most important is growth retardation with low birth weight. Additionally, the presence of possible fetal compromise coupled with the need for post-delivery resuscitation, are also risk factors for the development of hypoglycemia. when you have these factors, glucose monitoring is indicated.
The peer-reviewed medical research makes clear that severe or prolonged hypoglycemia is associated with neurological injury to newborn children. The probability is high that infants with severe hypoglycemia or with abnormal imaging studies will manifest subsequent neurological and neurodevelopmental problems.
Because neonatal hypoglycemia is a common disorder that may result in serious neurologic sequelae if left untreated, screening strips and devices should never be used as a basis for the diagnosis of neonatal hypoglycemia without confirming the diagnosis by measuring the plasma glucose in the laboratory utilizing something called the glucose oxidase method. Screening test results with blood glucose values less than 40mgs/dL should be immediately followed up with this better test.
How do you treat a baby with hypoglycemia? Treating a baby with hypoglycemia can be as easy as giving the child a glucose and water mixture. The key is getting the glucose levels right. The failure to take the simplest of steps to help the child can lead to lifelong injuries that change the future of a newborn baby.How Do You Know If Your Child Suffered a Hypoglycemia Birth Injury?
Initially, It is hard to know whether your child has a birth injury. The signs of hypoglycemia during the infancy are subtle and nonspecific. They include irritability, hypotonia, jitteriness, hypothermia, lethargy, and poor feeding
Another sign of a problem is a delay in reaching developmental milestones. But children miss milestones for many reasons, many of which are harmless and will resolve quickly or over time. Certainly, if there is evidence in the child's records that suggest the possibility of a brain injury and there are significant delays in meeting milestones, the child may get an MRI that looks to see if there is a loss of white matter loss in the brain.
Birth injuries from hypoglycemia often show on an MRI as "diffuse lesions" in the brain. Periventricular leukomalacia is a brain injury that can be caused by hypoglycemia. But it is the most common ischemic brain injury in premature infants so medical experts are critical to sorting out whether the injury was from hypoglycemia. Another possible sign of hypoglycemia brain injury: some experts say that hypoglycemia injuries tend to be occipital injuries.
- An example hypoglycemia birth injury lawsuit filed in 2018 against St. Agnes in Baltimore City after the hospital allegedly failed to properly diagnose and treat a fetus whose brain was deprived of glucose.
We have not seen many hypoglycemia verdicts in Maryland. Why? There are not all that many hypoglycemia cases and most birth injury cases settle before trial with ironclad confidentiality clauses.
- Trabue v. Atlanta Women's Specialists (Georgia 2017) $45 million: Plaintiff was 38-years, significantly overweight and with an extensive history preeclampsia and blood pressure issues. 3 days after a c-section delivery she suffered a cardiopulmonary arrest causing a hypoxic brain injury that left her completely mentally disabled and requiring care and assistance the rest of her life. She sued the doctors for negligently failing to recognize and manage the risks presented by her preeclampsia and post-delivery blood pressure. Defendants insisted that their pre-delivery labs and testing did not indicate preeclampsia. The jury in Atlanta's Fulton County found in favor of the plaintiff and awarded a staggering $45 million in damages.
- Plaintiff Mother v. Defendant OB/GYN (New York 2017) $975,000: Mid-30s plaintiff experienced serious preeclampsia before and during delivery. After delivery, the headaches and hypertension from the preeclampsia continued but she was discharged from the hospital anyway. 2 days after her discharge she called the doctors complaining that her headaches were worse but they told her to take pain medication. The next morning she suffered a large hemorrhagic stroke. Plaintiff sued for malpractice claiming that in light of her significant preeclampsia she should not have been discharged. Plaintiff also alleged that when she called about her headaches the doctor should have told her to go to the hospital. Defendants disputed proximate cause and claimed that even if she had been told to go to the hospital, it would not have prevented her stroke. The case settled just before trial for just under policy limits at $975,000.
- OG Pro Ami v. Kaiser Foundation Hosp. (California 2016) $4.5 million: Plaintiff had diabetes and allegedly exhibited signs and symptoms of preeclampsia including a headache and blurred vision. Despite these indications of preeclampsia, doctors did not perform an immediate c-section delivery. Instead, they waited another 2 weeks. Plaintiff claimed that this delay was negligent and resulted in baby suffering a hypoxic brain injury. The baby was born with spastic cerebral palsy and had significant mental and physical disabilities. The case settled before trial with $2 million of the settlement put into an annuity and $1,296,266 to be placed into a special needs trust.
- Santiago Guzman v. USA (New York 2015) $4.6 million: Plaintiff, 20-year old single mother, alleged that defendant failed to recognize signs of preeclampsia, including edema in the legs and rapid weight gain. Despite these symptoms, the defendant sent her home instead of admitting her to the hospital where her blood pressure could have been monitored. By the time the baby was eventually delivery the next week, the mother had severe preeclampsia and her blood pressure reached 210/120 at one point. The baby was born healthy but the mother claimed to suffer permanent physical injuries and could not walk without a mobility aid.
Infants with hypoglycemia often display no physical symptoms at all. If symptoms are present they typically include: pale or blue colored skin (cyanosis), rapid breathing or apnea, lethargy, and floppy muscle tone.
Hypoglycemia in a newborn can be definitively diagnosed with a blood glucose test. The key is for doctors to recognize symptoms of infant hypoglycemia or identify babies who are at higher risk and perform the blood test immediately. Early diagnosis is critical to avoiding permanent harm to the baby.
Treatment for infant hypoglycemia usually involves giving the baby dextrose (glucose) through an IV to immediately increase the levels of glucose in the baby’s blood to acceptable levels. If a dextrose IV is not an option, glucagon can administer subcutaneously.
If infant hypoglycemia is not promptly diagnosed and effectively treated it can result in neurologic damage resulting in permanent disabilities such as cerebral palsy.
If you believe your child has a brain injury from hypoglycemia, you may have a medical malpractice case for which you and your child could receive compensation. If so, call 800-553-8082 or get a free online consultation to find out if our law firm can be of help to you.