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Our Medical Negligence team at Kingsley Napley has recently been supporting pioneering charity Peeps HIE as a Corporate Friend. Globally, hypoxic-ischaemic encephalopathy (HIE) is a leading cause of disability, affecting around three million babies each year. This fantastic charity – the only one in the UK dedicated to supporting those affected by HIE – provides essential help to parents, families and friends.
Peeps also strives to increase awareness of HIE, about which many people have little or no prior knowledge. HIE can occur if a baby’s brain does not receive enough oxygen and/or blood flow around the time of birth. In some cases it can result in permanent brain damage and conditions such as cerebral palsy. We have previously recorded a podcast with Penny Harger, relationship manager at Peeps, herself the mother of an affected child. Our chat with Penny provides a lot of information about HIE and the work of the charity and can be found here.
Our Clinical Negligence department regularly acts for clients whose babies have suffered harm due to poor care which in turn has led to an HIE event, or alternatively where there have been failures around the diagnosis or treatment of the condition. You can read more about HIE and legal claims here.
In this blog, I recap on some of the key causes and symptoms of HIE, the circumstances in which legal claims may be possible, and also highlight some emerging research around the diagnosis and treatment of HIE.
HIE may be caused by complications during pregnancy, including pre-eclampsia or issues with blood flow to the placenta such as a maternal blood-clotting disorder. Other causes can include situations where the labour is traumatic or where a placental abruption or uterine rupture has occurred. There may have been a cord compression or entanglement or issues with the delivery of a large for dates baby.
When complications have not been identified or a condition has not been diagnosed in a timely fashion, or there have been negligent failures in the management of a birth leading to an HIE event, it is possible that a claim for compensation may be pursued on behalf of the injured child.
HIE Diagnosis
Signs of HIE can include a low heart rate, breathing difficulties, the passing of meconium, poor reflexes and low muscle tone at birth, irritability and having seizures, or having a weak cry. Various tests may be arranged to enable a diagnosis to be made. These include an MRI scan, which can detect brain injury, a cranial ultrasound, which can reveal bleeding or swelling, and the checking of cord blood gas levels. A build-up of acid in the umbilical cord – acidosis – can increase the risk of developing HIE.
When the condition is diagnosed Sarnat Staging can be used which classifies HIE as Grade 1, 2 or 3 – mild, moderate or severe.
Treatment can vary depending on severity. Most babies with mild HIE recover quickly. The risk of permanent brain damage is greater where HIE is moderate to severe. To reduce the risk in those cases babies may receive therapeutic hypothermia (cooling treatment). This involves a baby’s temperature being lowered for 72 hours, sometimes using a cooling mattress. The therapy should be started as soon as possible and usually within the first six hours after birth. Legal claims can arise if there was a negligent delay in diagnosis and if appropriate treatment did not swiftly take place.
New research
According to a recent study by researchers at Imperial College London, where a baby has a hypoxic brain injury, a blood test may pinpoint the underlying cause of that injury and whether or not the baby is likely to respond to cooling treatment. It is considered that the findings could eventually lead to a test which promptly diagnoses brain injury in new-borns and assists with making the right treatment decisions. From my perspective as a medical negligence lawyer, any developments to help inform treatment decisions and to improve accuracy of diagnosis are vitally important.
Please contact our team for a free no obligation discussion if you have any concerns about medical treatment related to a birth.
Further information
If you have any questions regarding this blog, please contact Sharon Burkill in our Medical Negligence and Personal Injury team.
About the author
Sharon Burkill joined the Clinical Negligence and Personal Injury team as a Legal Director, in 2024, having previously been a Senior Associate at the firm between 2005 and 2016. Sharon re-joins Kingsley Napley following a five-year period in the medical negligence team at Irwin Mitchell.
We welcome views and opinions about the issues raised in this blog. Should you require specific advice in relation to personal circumstances, please use the form on the contact page.
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