Hypoxic-Ischemic Encephalopathy (HIE) is a devastating brain injury that occurs when a baby’s brain is deprived of oxygen during labor, delivery, or shortly after birth. When medical professionals fail to recognize warning signs or respond appropriately to fetal distress, the consequences can be catastrophic and permanent. If your child suffered HIE due to medical negligence in Illinois, you have legal rights.
What Is Hypoxic-Ischemic Encephalopathy (HIE)?
HIE occurs when a baby’s brain doesn’t receive enough oxygen (hypoxia) and blood flow (ischemia) during the critical period around birth. The term “encephalopathy” refers to brain dysfunction or damage. This oxygen deprivation can cause brain cells to die within minutes, leading to permanent neurological damage.
HIE affects approximately 1.5 to 2.5 per 1,000 live births in the United States, making it one of the most common causes of preventable brain damage in newborns. The severity ranges from mild cases with full recovery to severe cases resulting in lifelong disabilities or death.
Severity Classifications of HIE
Mild HIE (Stage 1): Symptoms include muscle tone changes, irritability, and feeding difficulties. Most infants with mild HIE recover fully within a few days without permanent damage.
Moderate HIE (Stage 2): Symptoms include lethargy, significant hypotonia (decreased muscle tone), diminished reflexes, and seizures. Without proper treatment, moderate HIE can result in permanent disabilities.
Severe HIE (Stage 3): Symptoms include stupor or coma, no response to stimuli, absent reflexes, irregular breathing, and prolonged seizures. Severe HIE often results in death or profound permanent disabilities including cerebral palsy, intellectual disabilities, and epilepsy.
What Causes HIE During Birth?
Several events during pregnancy, labor, and delivery can deprive a baby’s brain of oxygen:
Umbilical Cord Problems
- Umbilical cord prolapse: When the cord slips through the cervix before the baby, it can become compressed
- Nuchal cord: The cord wrapped around the baby’s neck
- True knots: Knots in the umbilical cord that tighten during delivery
- Cord compression: Pressure on the cord reducing blood flow to the baby
Placental Complications
- Placental abruption: The placenta separates from the uterine wall before delivery
- Placenta previa: The placenta covers the cervix and can cause bleeding
- Placental insufficiency: The placenta fails to deliver adequate oxygen and nutrients
Labor and Delivery Complications
- Prolonged labor: Extended labor puts stress on the baby
- Uterine rupture: A tear in the uterus during labor
- Failed vacuum or forceps delivery: Traumatic assisted delivery
- Delayed emergency cesarean section: Failing to perform a C-section when medically necessary
- Shoulder dystocia: When the baby’s shoulder becomes stuck during delivery
Maternal Factors
- Maternal hypotension: Dangerously low blood pressure in the mother
- Maternal cardiac arrest: Heart stoppage during delivery
- Severe preeclampsia or eclampsia: Pregnancy-induced hypertension complications
- Maternal infection: Infections that spread to the baby
Medical Negligence That Leads to HIE
While some cases of HIE occur despite proper medical care, many are preventable. Medical negligence that commonly leads to HIE includes:
Failure to Monitor Fetal Heart Rate
Electronic fetal monitoring (EFM) tracks the baby’s heart rate patterns throughout labor. Abnormal patterns—such as late decelerations, variable decelerations, or decreased variability—can signal fetal distress. When medical staff fail to properly interpret these warning signs or don’t monitor continuously during high-risk labor, they may miss critical opportunities to intervene.
Delayed Response to Fetal Distress
Once fetal distress is identified, rapid response is essential. Medical standards require immediate action when monitoring shows signs of oxygen deprivation. Delays in calling for emergency cesarean section, bringing in necessary specialists, or taking other intervention measures can be the difference between a healthy baby and permanent brain damage.
Improper Use of Labor-Inducing Drugs
Pitocin (oxytocin) and other labor-inducing medications can cause dangerously strong contractions that reduce blood flow to the baby. When these drugs are administered improperly, at excessive doses, or without adequate monitoring, they can cause uterine hyperstimulation leading to fetal oxygen deprivation.
Failure to Perform Timely Cesarean Section
The standard of care requires that hospitals be capable of performing an emergency C-section within 30 minutes of the decision. When fetal distress indicates the need for immediate delivery, delays due to unavailable operating rooms, absent surgeons, or poor communication can cause devastating brain injuries.
Mismanagement of High-Risk Pregnancies
Certain conditions—including gestational diabetes, preeclampsia, multiple births, and post-term pregnancy—require heightened monitoring and often earlier delivery. Failing to identify these risk factors or manage them appropriately increases the risk of oxygen deprivation during delivery.
Inadequate Neonatal Resuscitation
When a baby is born not breathing or in distress, immediate and proper resuscitation is critical. Medical staff must be trained in neonatal resuscitation protocols and have proper equipment available. Delays or improper technique can extend the period of oxygen deprivation, worsening brain damage.
Therapeutic Hypothermia: The Critical 6-Hour Window
One of the most important advances in treating HIE is therapeutic hypothermia, also called cooling therapy. This treatment involves lowering the baby’s body temperature to 33.5°C (92.3°F) for 72 hours to slow brain cell death and reduce the extent of permanent damage.
The critical factor: Cooling therapy must begin within 6 hours of birth to be effective. When medical staff fail to recognize HIE symptoms promptly or delay transfer to a facility equipped for cooling therapy, they may miss this narrow window, allowing preventable brain damage to become permanent.
Studies show that therapeutic hypothermia can significantly improve outcomes for babies with moderate to severe HIE, reducing the risk of death or major disability by approximately 25%. Failure to offer or timely initiate this treatment when indicated may constitute medical negligence.
Long-Term Effects of HIE
The consequences of HIE depend on the severity of oxygen deprivation and the areas of the brain affected. Children who survive moderate to severe HIE often face lifelong challenges:
Cerebral Palsy
HIE is one of the leading causes of cerebral palsy. The brain damage affects movement, muscle coordination, and posture. Children may require mobility devices, ongoing physical therapy, and adaptive equipment throughout their lives.
Intellectual and Developmental Disabilities
Oxygen deprivation can damage areas of the brain responsible for learning, memory, and cognitive function. Children with HIE may experience developmental delays, learning disabilities, and intellectual impairments ranging from mild to severe.
Epilepsy and Seizure Disorders
Brain damage from HIE frequently leads to seizure disorders that may be difficult to control with medication. Seizures can further damage the developing brain and significantly impact quality of life.
Vision and Hearing Impairments
HIE can affect sensory processing areas of the brain, leading to cortical visual impairment, blindness, or hearing loss.
Behavioral and Emotional Challenges
Children with HIE-related brain damage may struggle with attention, impulse control, emotional regulation, and social interactions.
Proving Medical Negligence in HIE Cases
Birth injury cases involving HIE are among the most complex medical malpractice claims. To succeed, you must prove four elements:
1. Duty of Care
The medical providers (doctors, nurses, hospital) had a duty to provide care meeting accepted medical standards. This is established by the patient-provider relationship.
2. Breach of Standard of Care
The medical providers failed to meet the accepted standard of care. This might include failing to monitor properly, not responding to warning signs, delaying necessary interventions, or improperly using medications or instruments.
3. Causation
The breach of care directly caused or contributed to the baby’s HIE. This often requires detailed analysis of fetal monitoring strips, medical records, and the timeline of events to show that proper care would have prevented the injury.
4. Damages
The HIE resulted in actual harm requiring compensation. In HIE cases, damages typically include extensive medical expenses, ongoing care costs, and non-economic damages for pain and suffering.
Illinois Statute of Limitations for HIE Cases
Under 735 ILCS 5/13-212 (the Illinois medical malpractice statute of limitations), special rules apply to birth injury cases involving minors:
- For children: A medical malpractice lawsuit must be filed within 8 years of the date of the negligent act, but no later than the child’s 22nd birthday
- For parents’ claims: Parents’ individual claims (such as emotional distress or loss of consortium) must be filed within 2 years of when they knew or should have known about the injury
Illinois also follows a modified comparative negligence standard under 735 ILCS 5/2-1116. You can recover damages as long as you are less than 50% at fault for the injury.
While these timelines may seem generous, building a strong HIE case takes significant time. Medical expert witnesses must be retained, extensive records must be gathered and analyzed, and proper causation must be established. Starting the legal process early preserves evidence and allows for thorough case preparation.
Compensation in HIE Birth Injury Cases
HIE cases often involve the largest verdicts and settlements in birth injury law because the damages are so extensive. Compensation may include:
Lifetime Medical Care
Children with HIE often require ongoing medical treatment including neurology appointments, medications, surgeries, hospitalizations, and specialized therapies throughout their lives. These costs can reach millions of dollars.
Therapies and Rehabilitation
Physical therapy, occupational therapy, speech therapy, and behavioral therapy are often needed continuously from infancy through adulthood.
Adaptive Equipment and Home Modifications
Wheelchairs, communication devices, specialized beds, and home accessibility modifications may be necessary, with equipment needing replacement as the child grows.
Special Education and Support Services
Many children with HIE require special education programs, tutoring, and support services throughout their schooling.
Home Health Aides and Nursing Care
Children with severe HIE may need around-the-clock care from trained professionals, representing one of the largest components of lifetime damages.
Lost Future Earnings
If HIE prevents a child from working as an adult, compensation includes the income they would have earned over their lifetime.
Pain and Suffering
Compensation for the physical pain, emotional distress, and diminished quality of life experienced by the child.
Why Chicago Families Choose Phillips Law Offices
HIE cases require attorneys with specific expertise in birth injury litigation. Phillips Law Offices brings:
- Decades of birth injury experience: We understand the complex medical and legal issues in HIE cases
- Access to leading medical experts: We work with top obstetricians, neonatologists, pediatric neurologists, and life care planners
- Resources for complex litigation: HIE cases require substantial investment in expert witnesses, medical record analysis, and case development
- Proven results: Our track record includes significant verdicts and settlements for families of children with HIE
- Compassionate advocacy: We understand the emotional toll on families and provide supportive guidance throughout the legal process
Related Birth Injury Resources
Learn more about related birth injuries and your legal options:
What to Do If You Suspect Your Child’s HIE Was Preventable
If your child was diagnosed with HIE and you believe medical negligence may have played a role, take these steps:
- Request complete medical records: Obtain all records from prenatal care, labor and delivery, and neonatal treatment, including fetal monitoring strips
- Document everything: Keep detailed records of your child’s diagnoses, treatments, therapies, and developmental progress
- Consult a birth injury attorney: Have experienced lawyers review your case with medical experts to determine if negligence occurred
- Act promptly: While the statute of limitations extends to your child’s 22nd birthday, evidence preservation and case building should begin as soon as possible
Free HIE Case Evaluation
Phillips Law Offices offers free, confidential consultations for families of children with HIE. We’ll review your medical records, consult with experts, and provide an honest assessment of whether you have a viable case—all at no cost and no obligation.
If we take your case, you pay nothing unless we recover compensation for you. Our contingency fee arrangement means we share your stake in the outcome and fight for maximum recovery.
Contact Phillips Law Offices today at (312) 346-4262 to discuss your child’s HIE diagnosis and learn about your legal options.