Medical Malpractice
Jaundice is a common medical condition occurring in recently born babies. More than 80% of newborn infants experience some degree of jaundice after birth. Even untreated jaundice typically resolves after a few days or weeks.
But parents and doctors cannot ignore newborn jaundice. When not properly monitored and managed, newborn jaundice can become a major health risk, leading to developmental delays, permanent injuries, and death.
Our lawyers handle medical malpractice cases when pediatricians, nurses, and other healthcare providers fail to properly monitor or treat jaundice nationwide.
If you believe your doctors failed to properly manage and monitor your child’s newborn jaundice and it caused injury, contact our newborn attorneys at Miller & Zois. Call 800-553-8082 or get a free, no-obligation online consultation.
Current Newborn Jaundice Guidelines
The American Academy of Pediatrics updated its newborn hyperbilirubinemia guidelines in 2022. Those guidelines remain current in 2026.
One of the most important changes in how newborn jaundice is managed is that doctors should not simply look at the baby and decide whether the jaundice appears serious. Every newborn should have at least one transcutaneous bilirubin or total serum bilirubin measurement between 24 and 48 hours after birth, or before discharge if the baby leaves the hospital earlier.
A baby who develops jaundice during the first 24 hours needs even closer attention. The AAP recommends measuring bilirubin as soon as possible when jaundice appears that early because early jaundice can be a sign of hemolysis or another problem that causes bilirubin to rise quickly.
But doctors need to dig a little deeper in these cases and interpret the bilirubin number in context. The baby’s age in hours, gestational age, risk factors, and how close the bilirubin level is to the treatment threshold need to be baked in into the calculus.
This is a big deal in a medical malpractice lawsuit because a bilirubin number standing alone often tells only part of the story.
What Are Jaundice and Bilirubin?
Jaundice, whether in an adult or infant, occurs when the bilirubin in the bloodstream is too high.
Bilirubin is a natural byproduct of red blood cell breakdown. Red blood cells in the body only have a lifespan of about 120 days. So the body is continuously breaking down and disposing of old red blood cells.
Bilirubin is a waste product left over from that process. The liver normally processes bilirubin so it can be excreted primarily through bile and eventually leave the body in stool.
When the liver is working properly and bilirubin production is not excessive, only relatively small levels of bilirubin remain in the bloodstream. An infant’s liver can usually manage enough bilirubin that there are no complications. But a newborn’s ability to process bilirubin is not as efficient as an adult’s, particularly during the first few days after birth.
Most jaundice is harmless that ends up being nothing. But when unconjugated bilirubin rises to very high levels, you are running a real risk of serious complications. If the concentration gets too high, bilirubin enters brain tissue and becomes neurotoxic. This can cause acute bilirubin encephalopathy and, in the worst cases, permanent kernicterus.
Usually, the problem is not diagnosing jaundice. The yellow color in the eyes and skin is noticeable to everyone. Most medical malpractice lawsuits are not failure-to-diagnose-jaundice cases. They are cases where healthcare providers failed to recognize the risk, measure and interpret the bilirubin correctly, arrange appropriate follow-up, or treat the baby when treatment was required.
Why Newborn Babies Develop Jaundice
Jaundice in adults can be an indication that something is wrong with the liver. One reason newborn babies frequently have jaundice after birth is that their livers are still developing and are not as efficient at processing bilirubin.
During gestation, bilirubin from the baby can cross the placenta and be processed by the mother’s body. After childbirth, the baby’s liver has to take over that function and it frequently struggles to keep pace, especially in the first few days.
This causes many newborn babies to have elevated levels of bilirubin in their bloodstream and the bilirubin levels are often high enough to produce visible jaundice.
Eventually, the baby’s liver usually starts to get caught up on bilirubin processing and jaundice gradually resolves.
But liver immaturity is not the only reason bilirubin can rise. Prematurity, blood type incompatibility, hemolysis, G6PD deficiency, bruising from delivery, inadequate feeding, dehydration, infection, and other conditions can increase the risk of significant hyperbilirubinemia.
That is why doctors cannot assume that every yellow baby simply has routine newborn jaundice that will go away.
What Bilirubin Level Is Dangerous in a Newborn?
Parents understandably want a number. What bilirubin level is too high?
There is no single bilirubin number that is dangerous for every newborn.
The treatment threshold depends on the baby’s gestational age, age in hours, bilirubin level, and whether the baby has additional risk factors for bilirubin neurotoxicity.
A bilirubin level that might only require monitoring in an older, full-term healthy newborn may require treatment in a younger or premature baby with additional risk factors.
This is one reason these malpractice cases require careful review of the medical records. You cannot simply look at the highest bilirubin number and determine whether the doctors followed the standard of care. You need to know when the number was obtained, how quickly bilirubin was rising, how premature the baby was, whether hemolysis or another risk factor was present, and what follow-up was ordered.
Warning Signs and Risk Factors Doctors Should Not Ignore
Most infant jaundice is harmless. The job is figuring out which babies are at risk for severe hyperbilirubinemia before the bilirubin reaches a dangerous level.
Important warning signs and risk factors include:
- Jaundice appearing during the first 24 hours after birth
- Premature or lower gestational age
- A bilirubin level close to the phototherapy treatment threshold
- A rapidly rising bilirubin level
- Blood type incompatibility or other evidence of hemolysis
- G6PD deficiency
- Significant bruising or a cephalohematoma after delivery
- Poor feeding or inadequate intake
- Dehydration or excessive weight loss
- Sepsis or other serious illness
- A previous sibling who required phototherapy or an exchange transfusion
None of these risk factors automatically means the baby will develop kernicterus. But they can change how aggressively the baby’s bilirubin needs to be monitored and how quickly doctors need to act.
Can a Baby Die of Jaundice?
In rare cases, a newborn baby can die from complications of severe hyperbilirubinemia.
What happens is that the baby’s bilirubin level continues to rise instead of resolving. If unconjugated bilirubin reaches sufficiently high levels, it can enter the baby’s brain and cause acute bilirubin encephalopathy.
If that injury progresses, it can result in kernicterus, which is permanent brain damage caused by bilirubin toxicity.
Severe untreated hyperbilirubinemia can cause athetoid or dyskinetic cerebral palsy, physical and cognitive injury, hearing loss, abnormal eye movements, developmental disability, and death.
The frustrating part in malpractice cases is that this is often a preventable injury.
Proper Monitoring and Management of Newborn Jaundice
The doctors and nurses caring for a newborn are responsible for diligently monitoring and managing newborn jaundice. Once jaundice is identified, its progression needs to be monitored and the bilirubin level needs to be interpreted based on the baby’s age and individual risk factors.
The problem is that pediatricians sometimes fail to monitor newborn jaundice as closely as they should. Infant jaundice is so common and so frequently benign that doctors can have a tendency to discount it. So they do not always monitor the development of what can become a medical emergency as closely as they should. This leads to harm to the child and is the fact pattern in too many medical malpractice lawsuits. Untreated hyperbilirubinemia can quickly move from relatively benign to dangerously severe.
Direct sunlight is not the recommended treatment for significant newborn hyperbilirubinemia. Modern treatment is based primarily on phototherapy using controlled therapeutic light when the baby’s bilirubin reaches the appropriate treatment threshold.
If bilirubin becomes extremely high or reaches an emergency escalation level, more aggressive treatment may be necessary. This can include an exchange transfusion, in which the baby’s blood is gradually replaced to rapidly lower bilirubin.
As long as jaundice is properly monitored for signs of abnormal progression, doctors can almost always intervene before it causes major permanent harm. Phototherapy and, when necessary, exchange transfusion are very effective methods for treating serious newborn hyperbilirubinemia. The key is identifying jaundice, measuring bilirubin, understanding the baby’s individual risk factors, and distinguishing the few potentially dangerous cases from the thousands of normal cases.
Although very uncommon, untreated severe hyperbilirubinemia can lead to a very serious and life-changing brain condition called kernicterus.
When Failure to Treat Jaundice Becomes Medical Malpractice
A baby developing jaundice does not mean there was medical malpractice. Jaundice is incredibly common.
The malpractice is usually what the doctors do or fail to do after the risk becomes apparent.
The most common allegations we see in these cases involve:
- Failing to measure bilirubin before discharge
- Failing to recognize jaundice during the first 24 hours of life
- Failing to properly interpret bilirubin based on the baby’s age in hours
- Ignoring a rapidly rising bilirubin level
- Failing to recognize risk factors for severe hyperbilirubinemia
- Misreading or failing to communicate laboratory results
- Discharging a high-risk baby without appropriate follow-up testing
- Failing to start phototherapy when it was indicated
- Failing to escalate treatment when phototherapy was not enough
- Ignoring a parent’s report that the jaundice, feeding, or baby’s condition was getting worse after discharge
One recurring theme in these cases is a newborn who is discharged, the jaundice worsens at home, and the parents are reassured when they call the pediatrician. When the baby is finally brought back, the bilirubin level is dangerously high.
That is exactly the kind of case where the timeline is everything.
Recent Newborn Jaundice Settlements and Verdicts
Below are a few settlements and verdicts in medical malpractice cases involving a failure to properly diagnose, monitor, or treat infant jaundice.
You cannot assume the verdict or settlement payout in your child’s medical negligence case will be the same even if the facts are similar. But there is no question that the trial and settlement compensation in untreated jaundice cases can be extremely high because the injuries can be extreme.
- Anonymous v. Anonymous (Illinois 2024) $17.5 Million Settlement: A newborn girl had a significantly elevated bilirubin level at 33.5 hours old, but the plaintiffs alleged that no treatment or repeat bilirubin testing was ordered before she was discharged. The following day, another bilirubin test was approximately three times higher. The pediatrician initially believed the result might be a laboratory error and requested another blood draw. The baby then suffered a seizure and was hospitalized, where she received hydration, phototherapy, and an exchange transfusion. She was left with permanent bilateral hearing loss. A Chicago-area hospital and pediatrician agreed to pay $17.5 million shortly before trial.
- Anonymous v. Anonymous (Louisiana 2023) $2.5 Million Verdict: The plaintiffs alleged that their newborn daughter had both major and minor risk factors for developing hyperbilirubinemia, but the hospital and its staff failed to take appropriate steps to lower her bilirubin levels. The baby was discharged approximately 41 hours after birth. The plaintiffs alleged that the untreated hyperbilirubinemia caused kernicterus and bilirubin-induced neurologic dysfunction, which eventually led to her death. The jury awarded $2.5 million.
- Rodriguez v. NYCHHC (New York 2017) $6 Million Settlement: A baby was at increased risk of infant jaundice because of a blood type incompatibility with his mother. Despite this risk, the baby was not immediately put in the nursery or NICU but left in the room with his mother. When his bilirubin levels were eventually checked, they were dangerously high and an emergency exchange transfusion was ordered. During the transfusion, the baby suffered cardiac arrest and brain injury from oxygen deprivation. The injury left him cognitively impaired and unable to talk. The case settled for $6 million.
- Smalls v. Ouachita County Medical Center (Arkansas 2017) $46.5 Million Verdict: Doctors failed to properly monitor and manage severe newborn jaundice that eventually developed into kernicterus and caused severe brain damage. A blood test shortly after birth showed that the baby was at high risk for hyperbilirubinemia, and nurses later documented jaundice, but the plaintiffs alleged that the results were misinterpreted and phototherapy was not started. The jury found the doctor 85% responsible and the medical center 15% responsible and awarded $46.5 million.
- Turner v. NYCHHA (New York 2008) $4 Million Verdict: A premature baby born at 34 weeks developed significantly elevated bilirubin. Initial jaundice was treated with phototherapy on Day 2, but when the jaundice returned several days later, the plaintiffs alleged it was largely ignored. The baby developed respiratory acidosis and brain damage. The plaintiff’s expert testified that phototherapy should have been restarted when the jaundice returned. The jury awarded $4 million.
- Frederick v. Howard (Wisconsin 2007) $7.9 Million Verdict: A newborn was noted to be slightly jaundiced at 40 hours old and moderately jaundiced five hours later. Despite worsening jaundice, he was discharged without treatment. After discharge, his mother called the doctor’s office because the jaundice appeared worse and the baby was not feeding, but she was told not to worry and to wait for the scheduled visit. By the time he returned, he had lost 20% of his body weight and had dangerously high bilirubin levels. The severe jaundice progressed to kernicterus and caused permanent brain damage. The jury awarded approximately $7.9 million.
How Much Is a Newborn Jaundice Malpractice Case Worth?
There is no useful average settlement amount for a newborn jaundice malpractice case.
The reason some of these verdicts are so high is not jaundice itself. It is what happens when severe hyperbilirubinemia is allowed to progress to kernicterus and permanent brain damage.
A child with severe kernicterus may need medical care, physical therapy, occupational therapy, speech therapy, assistive technology, hearing treatment, home modifications, attendant care, and other support for the rest of his or her life. Those future medical and care costs can be enormous.
The value of the case also depends on the strength of the malpractice evidence. A case where the bilirubin was never measured despite obvious risk factors is different from a case where reasonable testing and follow-up occurred but the child’s bilirubin unexpectedly rose.
Some of the strongest cases involve a bilirubin result that was dangerously high but was misread, ignored, not communicated to the parents, or not acted upon. The stronger the malpractice case, the more “guilty” the doctor is for lack of a better phrase, impacts value.
The injury also matters. A child with permanent cerebral palsy, severe hearing loss, cognitive disability, or lifelong care needs has a very different damages claim from a baby who required several days of phototherapy and made a complete recovery.
The verdicts above show what juries have awarded. But even if the case sounds like yours, it does not predict your outcome. Why? Many variables shape settlement value or the jury’s calculation when rendering a verdict.
Contact Miller & Zois About Newborn Jaundice
If you believe your doctors failed to monitor or manage your baby’s newborn jaundice and it caused injury, contact our newborn jaundice lawyers at Miller & Zois. Call 800-553-8082 or select here for a free consultation.