Everything You Need To Know About HIE

Childbirth is often regarded as one of the happiest moments of a parent’s life; unfortunately, many complications can arise when an attending physician or medical professional is negligent. Among the maladies an infant may suffer from is a serious brain disorder (encephalopathy) called hypoxic-ischemic encephalopathy (HIE), which often has fatal or lifelong effects on an infant. If your child developed HIE due to an attending medical professional’s negligence, it is likely that you are eligible to file a legal claim.


According to research, up to 60% of infants with HIE will suffer a tragic death or develop severe disabilities by the time they turn 2 years old (for many, this occurs by the baby’s 18-month checkup). While there are no concrete statistics for the state of Maryland alone, it has been found that HIE occurs in 2 to 3 out of every 1,000 live births in developing countries, meaning that thousands of infants are affected annually.

Common Causes

The primary cause of HIE is a lack of oxygen (hypoxic) in the blood, which leads to a shortage of blood flow to the brain (ischemic). Therefore, the development of HIE is a two-stage process: Once oxygen deprivation is addressed, normal blood flow returns to the brain, and toxins are released from damaged brain cells. This second stage of brain cell damage is medically referred to as “reperfusion injury,” and it is concerning because brain cell death and any related issues will develop over the hours and days after the initial injury occurred. In other words, many parents may not know their child has HIE until after irreversible damage has been done, with many discovering its existence long after birth when their child misses important developmental milestones.

Since the root cause of HIE is oxygen deprivation, a wide array of malpractices committed by a medical professional could lead to its development. A few causes include the following:

  • Mismanaged prolonged labor
  • Mismanaged high-risk pregnancy
  • Placental, uterine, and/or umbilical cord complications
  • Unaddressed/untreated infections
  • Poorly monitored fetus
  • Failure to properly address/prevent a premature birth

Please note: While many people think that injury can only happen to the infant when they are in the birth canal, HIE can also develop prior to birth and during the postpartum period.

Symptoms and Diagnosis

When HIE is suspected, ultrasounds and MRIs are used to confirm whether brain damage occurred. In addition, blood gas tests may be administered to determine an infant’s blood oxygen level.

The most common symptoms include:

  • Slow, irregular, or absent breathing
  • Acidosis
  • Seizures
  • Low or “floppy” muscle tone
  • Depressed or absent reflexes
  • Blue or very pale skin
  • Apgar score of 3 or less

If an infant is diagnosed with HIE, the severity of the condition will be determined via Sarnat staging, which considers alertness, seizures, respiration, muscle tone, and illness duration, among other factors. Final HIE diagnosis will fall somewhere on a three-grade scale, with Grade I being a mild form, Grade II a moderate form, and Grade III a severe form. Grade I is likely to resolve in 24 hours, while Grade II may lead to the development of mild disabilities. Grade III often leads to severe, lifelong disabilities.

Routes of Treatment

There is no cure for HIE. However, if detected in time, HIE may be managed using therapeutic hypothermia, a treatment in which an infant’s brain and/or body is cooled down below room temperature to avoid the progression of brain damage. To be effective, this treatment must be delivered for a duration of 72 hours, beginning within 6 to 24 hours after the injury occurred. In addition, an infant may be given medication to address seizures or any other therapies to help them manage their blood pressure, liver function, or the like. For instance, they may require a breathing tube to assist with breathing.

After therapeutic hypothermia, treatment will focus more on helping a parent and their child adapt to any remaining symptoms and/or conditions, such as cerebral palsy.

Fighting for Infants Harmed by Negligence

With more than 75 years of combined legal experience, Brown & Barron has fought for many children and parents harmed by negligent medical professionals. If your infant developed HIE, you may be able to file a legal claim to recover compensation and hold the at-fault party accountable for the harm they have done to your family. Moreover, bringing these parties to justice can prevent them from harming families for years to come.

Call (410) 698-1717 or fill out an online form today to speak to a Brown & Barron attorney.

Woman holding a baby
Related Posts
  • What Are Birth Injuries? Read More
  • The Cost of Raising a Child with Cerebral Palsy Read More
  • Cooling Therapy for Hypoxic Ischemic Encephalopathy (HIE) Treatments Read More