There’s nothing more life-affirming than the joy of a healthy newborn child. The nine months of anticipation is replaced with the happy reality that you now have a brand-new baby; the apple of his or her grandparents’ eyes. This happiness can be destroyed when something goes wrong during the delivery or in a neonatal intensive care unit (NICU).
Your baby may need to spend days, weeks, or longer in a NICU for various reasons. The physicians and other healthcare professionals who work in a NICU should anticipate the problems that are likely to occur. These healthcare providers should constantly monitor your child and immediately respond to any dangers. When the proper care isn’t provided, your child could suffer severe injuries which may be permanent or catastrophic. Medical malpractice in a NICU can result in breathing disorders, seizures, heart damage, brain damage, and many other disorders including death.
What types of medical mistakes cause severe NICU disorders?
Newborns, especially preemies, require constant monitoring, timely responses, and quality care. Failure to provide these things can put your baby’s life in danger. Some of the more likely acts of medical negligence can include:
- Medication mistakes. Medications are a common treatment for many of the disorders discussed above. Doctors who fail to understand which medications to give, what doses are required, and when to give the medications can cause catastrophic harm or even death. Heparin and morphine can be especially dangerous when given to a new baby.
- Breathing mistakes. If doctors fail to treat breathing disorders such as apnea in time, a newborn’s brain may not get the oxygen it needs which can cause cerebral palsy and other severe disorders. Doctors and the medical staff should understand how to insert breathing tubes properly and how to monitor ventilators so newborns don’t lose too much CO2.
- Improper placement of various instruments. Feeding tubes, IV lines, and other health equipment must be used properly and precisely.
- Failure to respond in a timely manner. Delays in treatment such as when a newborn is having a seizure can result in irreversible injuries or death.
Other acts of medical malpractice include:
- Making an incorrect diagnosis
- Errors during surgery
- Failing to monitor the newborn
- Many other errors, depending on the type of medical disorder the newborn has
What are some of the common medical disorders treated in a NICU?
Some of the serious complications that may arise in a NICU, according to Johns Hopkins All Children’s Hospital, include the following:
- Anemiais a low number of red blood cells in the blood. Newborns with anemia may develop apnea, low blood pressure, and a high heart rate. This condition is diagnosed using a complete blood count. Some newborns (especially premature infants who weigh less than 2.2 pounds) may need red blood cell transfusions. Physicians need to treat any underlying conditions.
- Newborns should breathe at least once every 20 seconds. Newborns who can’t meet this threshold are diagnosed with apnea. Many premature babies have apnea. Treatments may include medicines and a “special nasal device that blows a steady stream of air into the airways to keep them open.”
- This heart condition is usually due to low oxygen blood levels or apnea. The underlying condition must be addressed. Some newborns may need to be examined by a pediatric cardiologist.
- Bronchopulmonary Dysplasia (BPD), also called Chronic Lung Disease (CLD). This disorder usually isn’t diagnosed until several weeks after birth. Treatments may include steroids, which can have severe side effects. Various medicines such as diuretics may help. Some newborns with BPD need ventilators (breathing machines) at home. A tracheostomy may be required. BPD is a serious condition that calls for longer stays in the NICU, sometimes up to several months.
- This condition, commonly called “water on the brain,” is a “buildup of cerebrospinal fluid that surrounds the brain and the spinal cord causes hydrocephalus. It can be caused by bleeding from an intraventricular hemorrhage or an abnormality of the brain or skull that blocks the flow of the fluid.” Doctors should use an MRI or a CT scan to confirm this condition which is treated (if severe) through surgeries that insert a tube in the brain that drains the fluid from the brain. Some newborns may need to stay in the ICU for months. Seizures and developmental delays may result.
- Intraventricular Hemorrhage (IVH). This condition is bleeding in the brain. Doctors need to know what symptoms such as a weak suck or high-pitched cry may indicate IVH. Doctors should use ultrasound to look for collections of blood in the brain. IVH may lead to severe hydrocephalus. Newborns with IVH may at risk for cerebral palsy and seizures later in life.
- This medical disorder of the liver occurs when the newborn has a high level of bilirubin in the blood. A blood test is used to diagnose jaundice. The treatments vary depending on whether the bilirubin is direct or indirect.
- Extremely high levels of bilirubin can cause brain damage, so infants are monitored for jaundice and should be treated quickly, before bilirubin reaches dangerous levels. Standard treatment includes providing plenty of fluids and light therapy (where a baby spends time under a special blue-colored light). Some cases may require a blood transfusion.”
- Necrotizing Enterocolitis (NEC). This intestinal disorder occurs in nearly one percent to five percent of NICU infants. Premature babies are at higher risk of NEC which means doctors should look for this condition if the baby is born prematurely. Many conditions including infections, poor blood flow, and milk feeding may cause NEC. An X-ray of the abdomen is used to diagnose NEC. Treatments vary. If there doesn’t appear to be a rupture, treatments include antibiotics, stopping all intestinal feeding, IVs, and draining the newborn’s stomach. Surgery to remove the diseased section of the intestine or to “make an incision in the abdomen to allow the infected fluid to drain” is required if there is a rupture.
- Patent Ductus Arteriosus (PDA). The ductus arteriosus (DA) “allows blood to bypass the lungs while a baby is still in the womb.” Premature babies may suffer respiratory problems if the ductus arteriosus doesn’t close properly after birth. Doctors should look for breathing difficulties or a heart murmur. Ultrasound is used to make the diagnosis. Medicine may help. If necessary, surgery is used to close the DA.
- Periventricular Leukomalacia (PVL). This brain injury happens in the newborn’s brain tissue. The condition affects “the white matter that provides connections between the brain and the muscles of the body.” Bleeding in the brain may be a factor. Doctors normally use a head ultrasound or an MRI to detect periventricular leukomalacia. The condition can cause developmental delays. There is no specific treatment.
- Respiratory Distress Syndrome (RDS). RDS causes difficulty breathing. It’s common in premature infants. It occurs when the lungs don’t produce enough “surfactant.” X-rays are used to diagnose RDS. Expectant mothers may be given a steroid medication for a premature delivery to help prevent RDS.
- If needed, artificial surfactant can be given to a newborn through a breathing tube immediately after birth and several times later. Many premature babies who lack surfactant will require a breathing machine, or ventilator, for a while, but the use of artificial surfactant has greatly decreased the amount of time they spend on the ventilator.
Other NICU conditions which may occur if doctors fail to act competently include:
- Retinopathy of Prematurity (ROP). An eye disorder that may lead to blindness.
- A harmful response to an infection that may require antibiotics. Complications include meningitis, organ damage, and death.
- Transient Tachypnea of the Newborn (TTN). Rapid breathing which may be caused by pneumonia, lung problems, or a blood infection.
Other signs and symptoms that NICU doctors and staff should look for, when premature babies are admitted, include difficulty regulating a newborn’s body temperature, high or low blood pressure, feeding difficulties, reflux, and infections,
The South Carolina attorneys at McGowan, Hood, Felder & Phillips, LLC have been fighting for medical malpractice personal injury victims including mothers and newborns for 20 years. We have nearly 20 lawyers who are ready to file personal injury claims and wrongful death claims. We work with a network of doctors who understand the standards for competent NICU care. To discuss your right to compensation, call our offices or complete our contact form today. Consultations are always confidential.
Randy is the former President of the South Carolina Association for Justice. He has been certified by the American Board of Professional Liability as a specialist in Medical Malpractice Law which is recognized by the South Carolina Bar. Randy has also been awarded the distinction of being a “Super Lawyer” 10 times in the last decade. He has over 25 years of experience helping injured people fight back against corporations, hospitals and wrong-doers.
Read more about S. Randall Hood