Hypoxic Ischemic Encephalopathy Attorney

Hypoxic-ischemic encephalopathy (HIE) is a type of brain damage that occurs when an infant’s brain does not receive adequate oxygen and blood.  A child diagnosed with hypoxic-ischemic encephalopathy (HIE) due to an error made during birth or during the prenatal period can be devastating and lead to lifelong challenges.  

Our hypoxic-ischemic encephalopathy lawyers have won many HIE cases, including a $5.7 million birth injury case against a hospital and OBGYN.Despite clear contraindications, hospital nurses breached their own policies by administering Pitocin to induce labor. When the child was born, he suffered from severe hypoxic-ischemic encephalopathy, or brain damage as a result of lack of oxygen. With Ikuta Hemesath’s proven track record, our HIE lawyers are here to ensure an optimal outcome for your unique case.
The term Hypoxic-ischemic encephalopathy breaks down as follows:

Hypoxic: Lack of oxygen

Ischemic: Reduced blood flow

Encephalopathy: Disorder or disease of the brain

Causes of HIE

HIE can result from a variety of events or conditions before, during, or after birth, including:

  • Placental Abruption: When the placenta detaches from the womb prematurely.
  • Umbilical Cord Complications: Such as cord prolapse or cord compression.
  • Prolonged or Difficult Delivery: Extended periods of pushing or complicated birthing scenarios can reduce oxygen delivery to the baby. For example, this is often due to a shoulder dystocia.
  • Blockage in the Infant’s Airway: This could be due to birth defects or meconium aspiration, where the baby breathes in a mixture of meconium (first stool) and amniotic fluid.
  • Inadequate Blood Circulation: This could result from a serious infection, heart problems, or high or low blood pressure in the baby.
  • Premature Birth: Premature babies are at a higher risk for many complications, including HIE.
  • Severe Fetal Anemia: Which can prevent the baby’s blood from carrying enough oxygen.

Seeking an HIE Attorney in Orange County

Seeking the expertise of an attorney in cases of hypoxic-ischemic encephalopathy (HIE) can be vital for several reasons:

  • Determine Liability: HIE can result from various causes, and some may be related to medical negligence during labor, delivery, or postnatal care. An attorney can help determine if medical professionals or institutions failed in their duty of care.
  • Navigating Complexity: Medical malpractice cases, especially those involving birth injuries like HIE, can be complex. They involve understanding intricate medical information, procedures, and standards of care. An attorney with experience in HIE cases will be equipped to navigate these complexities.
  • Gathering Evidence: An attorney can collect relevant medical records, engage medical experts to review the circumstances of the birth, and gather necessary evidence to support a claim.
  • Assessing Damages: Children with HIE may face lifelong challenges that can result in substantial medical costs, therapy expenses, educational needs, and more. An attorney can help quantify these damages and ensure families seek appropriate compensation.
  • Negotiating Settlements: An experienced attorney can negotiate with responsible parties (like hospitals or doctors) or their insurance providers to secure a fair settlement. They’ll be adept at understanding what constitutes a reasonable offer given the circumstances.
  • Litigation: If a fair settlement cannot be reached, a case may proceed to trial. Attorneys will then represent the family’s interests in court, presenting evidence and making legal arguments to support the case.
  • Support and Guidance: The process can be emotionally taxing for families. Having an attorney can provide a sense of support and guidance throughout the process, ensuring families understand each step and their rights.
  • Statute of Limitations: There’s a limited timeframe in which families can bring forth a lawsuit for medical malpractice or birth injuries. An attorney ensures families act within this timeframe.
  • Maximizing Compensation: Given the potential long-term needs of a child with HIE, securing appropriate compensation is crucial. This isn’t just about recouping current costs but anticipating future needs. An attorney can ensure families seek the maximum possible compensation to provide for their child’s future.
  • Advocacy: Beyond individual cases, bringing attention to instances of medical negligence can help drive changes in medical practices, potentially preventing similar instances in the future.

Diagnosing HIE

Diagnosing hypoxic-ischemic encephalopathy (HIE) involves a combination of clinical observations, laboratory tests, and imaging studies. Several factors, such as evidence of acidosis, MRI findings, and Apgar scores, can help establish a diagnosis of HIE.


  • Umbilical Cord Blood Gas Testing: Shortly after birth, a sample of blood from the umbilical cord can be analyzed to assess the baby’s pH level and the presence of acidosis. A low pH (typically below 7.0) can indicate that the baby experienced a lack of oxygen before or during birth.
  • Metabolic Acidosis: This is a condition where there’s an excess of acid in the baby’s blood. Metabolic acidosis can be identified through blood tests and often suggests that tissues in the body (including the brain) were deprived of oxygen.

MRI (Magnetic Resonance Imaging):

  • An MRI can provide detailed images of the brain and is one of the most effective tools for diagnosing HIE. Specific patterns of injury seen on MRI can help confirm a diagnosis of HIE.
  • Typically, MRI is done several days to a week after birth as the patterns of injury from HIE become more evident over time.
  • Diffusion-weighted imaging (DWI) can be particularly helpful in the early identification of ischemic brain injury.

Apgar Scores:

  • The Apgar score is a quick assessment done at 1 minute and 5 minutes after birth, and sometimes at 10 minutes if the scores are low. It evaluates the baby’s heart rate, respiratory effort, muscle tone, reflex irritability, and skin color.
  • A low Apgar score (especially scores below 3 persisting beyond the 5-minute mark) can suggest that the baby has been deprived of oxygen. However, a low Apgar score alone does not diagnose HIE; it is just one piece of the puzzle.

Neurological Assessment:

Clinical examination of the baby’s neurological status, including tone, reflexes, and activity level, can also provide clues about potential brain injury.

Other Tests:

Electroencephalogram (EEG) to check for seizure activity and evoked potentials to measure the electrical activity in the brain in response to stimuli can also provide information related to brain function and potential injury.

Diagnosing HIE requires a comprehensive approach, considering all the aforementioned factors. Once a diagnosis is made, timely interventions, such as therapeutic hypothermia, can be initiated to potentially improve outcomes. Collaboration between neonatologists, radiologists, and pediatric neurologists is often essential for accurate diagnosis and management.

Symptoms of HIE

Symptoms can vary depending on the severity of the injury and which part of the brain is affected. However, common long-term symptoms of HIE include:

  • Developmental Delays: This can manifest as a delay in reaching milestones such as crawling, walking, or talking.
  • Seizures: Seizure disorders requiring medication such as Keppra is not uncommon.
  • Motor Disorders: Challenges with movement and coordination. Cerebral palsy is a common motor disorder associated with severe HIE.
  • Epilepsy: Recurrent seizures that might start in the neonatal period or later in life.
  • Cognitive Challenges: Difficulties with thinking, reasoning, memory, and learning.
  • Sensory Impairments: This might include vision or hearing problems.
  • Behavioral and Emotional Difficulties: These can include attention-deficit/hyperactivity disorder (ADHD), anxiety, or other behavioral concerns.


It’s essential to note that not all babies with these symptoms have HIE, and some babies with HIE might not display obvious symptoms immediately after birth. Early intervention and timely medical assessment can help improve outcomes for babies with suspected HIE. As the child grows, various therapies, such as physical therapy, occupational therapy, or speech therapy, may benefit children with HIE-related challenges.

Contact an HIE Lawyer in Orange County

The HIE attorneys at Ikuta Hemsesath have decades of experience in litigating medical malpractice lawsuits and obtaining favorable results on behalf of our clients. Medical malpractice lawsuits, particularly HIE lawsuits, can be complicated and difficult. Our HIE attorneys in Orange County have the necessary knowledge and experience to achieve the best possible outcome, contact us now.

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