Hypoxic-Ischemic Encephalopathy (HIE) Birth Injury Lawsuit

Hypoxic-ischemic encephalopathy (HIE) is one of the most serious birth injuries a child can suffer… and it is usually preventable. When oxygen deprivation during labor or delivery causes permanent brain damage, families deserve answers.

An HIE lawsuit can provide those answers. It can also provide the financial resources your child will need for a lifetime of therapy, medical equipment, special education, and around-the-clock support.

Our hypoxic-ischemic encephalopathy lawyers have secured tens of millions of dollars in settlements and verdicts for families affected by birth injury malpractice. Our lawyers take cases nationwide and work with leading medical experts to determine exactly what went wrong and who is responsible.

Was your child’s brain injury caused by:

• Delayed C-section?
• Ignored fetal heart rate abnormalities?
• Mismanaged labor or improper use of Pitocin?
• Failure to respond to umbilical cord complications?

If so, you may have a case. Call our HIE lawyers at 800-553-8082 for a free consultation or reach out online.

What is Hypoxic-Ischemic Encephalopathy (HIE)?

Neonatal encephalopathy is a broad term for abnormal brain and nervous system function in a newborn after birth, and it can have many different causes. Even brief interruptions in oxygen supply can damage delicate brain tissue, leading to developmental delays, cognitive impairment, cerebral palsy, seizures, or death.

HIE affects roughly 1-8 out of every 1,000 live births in developed countries. Common causes include umbilical cord complications, placental abruption, uterine rupture, and prolonged or obstructed labor.

The only proven treatment is therapeutic hypothermia. This is controlled cooling of the infant’s body temperature within six hours of birth to slow brain cell death and reduce inflammation. This has shown some promise in recent years, and some of our clients have appears to have a better outcome with cooling.  Studies confirm that cooling therapy significantly reduces death and major disability in affected newborns.

The full extent of an HIE injury often is not apparent at birth. Research shows that children diagnosed with neonatal encephalopathy—including those initially classified as mild—may develop cognitive and motor difficulties that only emerge at school age. There is no cure for HIE, but early intervention, including physical therapy, occupational therapy, and speech therapy, can meaningfully improve outcomes.

How Severe Is Your Child’s HIE? Understanding Sarnat Staging

There’s no single test for HIE. Doctors diagnose it based on clinical signs, MRI imaging, and blood gas results. To classify severity, most hospitals use Sarnat staging—a three-tier system that predicts outcomes and guides treatment.

Understanding your child’s Sarnat grade matters for two reasons: it shapes their medical prognosis, and it directly affects the value of a potential HIE lawsuit.

Why this matters for your case:

• Grade I cases are harder to pursue because long-term harm may be limited.  That said, there is emerging research that shows even “mild” HIE can cause learning difficulties that appear years later.
• Grade II and III cases often involve substantial damages: lifetime care costs, lost earning capacity, and pain and suffering. These are the cases where medical negligence is most likely to have made a decisive difference.

If your child was diagnosed with moderate or severe HIE after a delayed C-section, ignored fetal distress, or other delivery complications, the Sarnat grade is a key piece of evidence. Our HIE lawyers can help you understand what it means for your claim.

Organs Impacted by HIE

Hypoxic-ischemic encephalopathy (HIE) primarily affects the brain, but it can also lead to multiorgan failure due to the systemic nature of oxygen deprivation and reduced blood flow. When the brain is deprived of oxygen, the body may prioritize preserving brain function by diverting blood flow from other organs to the brain. This redirection can have detrimental consequences on various organs, leading to multiorgan failure.

Paradoxically, with acute profound HIE, there is less risk to other organs. Multiorgan failure is less likely to occur due to the limited time frame for the body to compromise other organs in an attempt to protect the brain. Conversely, in a partial-prolonged HIE scenario, the brain has redirected blood and oxygen flow from other organs to itself over an extended period, resulting in the potential for multiorgan failure.

Seizures and HIE

HIE, or hypoxic-ischemic encephalopathy, can indeed lead to seizures. Typically, the seizures experienced by children with HIE are relatively manageable and can be brought under control with appropriate treatment. However, there are cases where children with severe HIE may develop a more challenging condition called status epilepticus.

Status epilepticus refers to a prolonged seizure or a series of seizures without a complete recovery of consciousness between episodes. This condition is more commonly found in children with severe HIE and is not typically observed in cases with less severe, or refractory, HIE. Seizures in HIE can be caused by the brain’s increased irritability due to the release of neurotransmitters and the disruption of normal brain function. Uncontrolled seizures are a serious issue in newborns with HIE and they have been linked to brain damage and poor developmental outcomes.

Managing seizures is crucial for children with HIE, as uncontrolled seizures can worsen the brain injury and lead to further complications. Treatment options for seizures in HIE may include anti-seizure medications, such as benzodiazepines or antiepileptic drugs. But drugs are tricky with HIE-related seizures.  Current medications for treating seizures, such as phenobarbital and phenytoin, aren’t always effective and may even have harmful effects on a developing brain. A newer medication called levetiracetam might have fewer risks, but its effectiveness is still being evaluated.

Causes of HIE

Hypoxic-ischemic encephalopathy (HIE) is a condition that occurs when the brain doesn’t receive enough oxygen and blood flow, which can lead to brain damage. There are various causes of HIE, including:

1. Complications during childbirth: HIE can occur when there are complications during labor and delivery, such as a prolapsed umbilical cord or problems with the placenta. One reoccurring problem is the umbilical cord becoming compressed, knotted, or wrapped around the baby’s neck, restricting blood flow and oxygen supply.
2. Maternal health problems: Health problems affecting the mother during pregnancy, such as hypertension or placental insufficiency, can also lead to HIE. This is why high-risk pregnancies must be treated differently.
3. Trauma: Trauma to the head or oxygen deprivation due to drowning, suffocation, or strangulation can cause HIE.
4. Infections: Infections such as meningitis, sepsis, and encephalitis can also lead to HIE.
5. Inadequate fetal monitoring: Failure to accurately monitor the baby’s heart rate and other vital signs during labor, leading to delayed intervention in the case of complications.
6. Delayed C-section: A delayed decision to perform a cesarean section when it becomes clear that a vaginal birth is not possible or safe for the baby.
7. Uterine rupture: A tear in the uterine wall that can lead to severe bleeding and reduced oxygen delivery to the baby.

The severity of HIE can vary depending on the cause and the extent of the brain damage. It’s important to identify and address the underlying cause of HIE as soon as possible to prevent further damage and minimize long-term effects. Some HIE malpractice lawsuits are more about reacting to a known problem than filing to diagnose complications.

When Medical Negligence Leads to HIE

In some cases, HIE is unavoidable, but in many others, it results from medical negligence. Healthcare providers have a duty to adhere to the standard of care during pregnancy, labor, and delivery. If they fail to do so and their negligence leads to an HIE birth injury, they may be held liable for the damages incurred.

Examples of medical negligence that can cause HIE include:

1. Misinterpretation of fetal monitoring: A failure to recognize signs of fetal distress and take appropriate action.
2. Inadequate or delayed intervention: A healthcare provider’s failure to respond to complications promptly and effectively.
3. Improper use of labor-inducing drugs: Overuse or misuse of drugs like Pitocin, which can lead to dangerous contractions and oxygen deprivation.
4. Inappropriate use of delivery tools: Forceps or vacuum extractors can cause injury if used incorrectly or in situations where their use is not warranted.
5. Failure to diagnose and treat maternal infections: Infections can be passed on to the baby, leading to oxygen deprivation and HIE.

HIE Malpractice Settlements and Verdicts

Below are settlements and verdicts from recent birth injury malpractice cases involving HIE. Keep in mind these are not meant to be representative of the average HIE settlement value, but rather just a tool for comparative analysis.

$2,500,000 Settlement (Pennsylvania 2025): The mother went to the hospital at 42 weeks of gestation, and the baby allegedly began to show signs of fetal distress during the delivery, but was delivered via spontaneous vaginal delivery, and soon after began exhibiting seizure activity. The infant suffered hypoxic ischemic encephalopathy, resulting in global developmental delays, neurologic injuries, cognitive injuries and disabilities, and respiratory distress. The plaintiff contended that the defendants failed to meet the standard of care, resulting in a delay in delivery and oxygen deprivation with serious complications.

$4,077,003 Settlement (New York 2024): The mother presented to the defendant hospital two days past her due date, was in a non-progressing labor for three hours with fetal heart monitoring displaying non-reassuring vitals until a c-section was performed, and she was born limp with poor respiratory effort and was dusky and pale in color. The baby sustained hypoxic–ischemic encephalopathy, leaving her unable to walk, crawl, sit, or feed herself, and she will require assistance with all activities of daily living. The lawsuit claimed that the defendants failed to properly and timely assess the mother and fetus and delayed the performance of an emergent C-section, departing from the standard of care and causing significant and permanent brain damage to the infant.

$1,300,000 Settlement (Indiana 2024): The infant was delivered blue, without movement or respiratory effort or heart rate, and diagnosed with birth depression, respiratory failure, and hypoxic ischemic encephalopathy. He initially was started on hypothermia cooling blankets for three days in an effort to reduce brain swelling and encephalopathy caused by the traumatic birth, but soon thereafter his condition was deemed irreversible. The infant died 2 weeks later, and his parent brought a wrongful death lawsuit against the OB/GYN.

$14,000,000 Verdict (Illinois 2024): A boy’s mother was admitted to the hospital with severe symptoms at 33 weeks pregnant. However, there was a significant delay in her evaluation and treatment. She was not immediately assessed by a doctor or labor and delivery staff, leading to a delayed discovery of her condition—placental abruption. By the time she was taken to the operating room for an emergency cesarean section, the baby had a drastically reduced heart rate and was quickly born with signs of severe distress. He was resuscitated and treated for HIE.  Unfortunately, the initial lack of oxygen led to a diagnosis of cerebral palsy, and, as we often see in these types of cases, he eventually died at age four from complications related to his brain injury. The family’s HIE lawsuit argued that the hospital’s delay in treatment – specifically, not giving a C-section immediately when the baby was in distress and failure to monitor the unborn baby – contributed to the tragic outcome.

$8,000,000 Settlement (Michigan 2024):  The plaintiff, a 29-year-old woman with well-managed gestational diabetes, delivered a healthy baby boy at nearly 39 weeks. The baby seemed fine.  During postnatal recovery, a nurse discovered that he had stopped breathing approximately an hour and a half after birth. The baby was diagnosed with HIE due to oxygen deprivation to the brain. The family filed an HIE birth injury lawsuit that argued that the critical period immediately after birth was not properly supervised by the attending nurse, leading to the newborn’s sudden respiratory arrest and subsequent HIE. As a result of the HIE, the baby was diagnosed with cerebral palsy and severe cognitive and developmental impairments, necessitating lifelong specialized care and a feeding tube for nourishment.  The lawsuit was settled when the doctors made an $8 million settlement offer.

$11,ooo,ooo Verdict (Illinois 2023):  A mother-to-be was struggling to bring her child into the world with a child whose fetal heart rate should have signaled the child needed to be delivered.  Despite these alarming signs, the obstetrician in charge decided to wait for a natural birth instead of performing a Cesarean section.  As the minutes ticked by, the baby boy endured a 30-minute delay in his delivery. This precious time loss exposed him to ongoing hypoxic-ischemic injuries, ultimately resulting in brain damage.

$35,182,818 Verdict (New York 2023): A mother who was 9 months pregnant fell on her abdomen and went to the hospital. She was told everything was fine and discharged. She saw her OB/GYN 2 more times over the following few days before she had to be rushed to the hospital for an emergency C-section delivery, at which time it was discovered that she had suffered a placental abruption from the fall. The baby suffered an HIE injury and was left blind and severely disabled for the rest of her life. The lawsuit accused the defendants of negligently failing to diagnose and treat the mother’s placental abruption. The verdict included $2.1 million in future economic damages and the rest for pain and suffering.

$500,000 Settlement (Kansas 2022): The defendant doctor attempted to use a vacuum extractor to assist with a difficult vaginal delivery. The effort was not successful and in the process, the vacuum device caused significant trauma to the baby’s head. The baby had to be resuscitated after delivery and was transported to a NICU, where he was diagnosed with a large subgaleal hemorrhage and hypoxic-ischemic encephalopathy. The baby died 3 days later. The mother’s lawsuit alleged that the doctor was negligent in his use of the vacuum extractor and that negligence was the cause of the baby’s death.

$1,000,000 Settlement (New York 2022): During labor and delivery at St. Luke’s Cornwall Hospital, shoulder dystocia was encountered, causing the baby to become stuck in the birth canal for an extended time period. The baby lost oxygen and suffered hypoxic-ischemic encephalopathy, resulting in gross and fine motor disabilities. The lawsuit alleged that the doctors were negligent in failing to recognize signs of fetal distress and execute a C-section in a timely manner.

$7,000,000 Settlement (Illinois 2021): Infant reportedly suffered permanent and disabling injuries, including hypoxic-ischemic encephalopathy, during his birth at VHS West Suburban Medical Center, where his mother presented for labor and delivery at 36.5 weeks of gestational age with a diagnosis of spontaneous rupture of membranes. The lawsuit alleged that the defendants were negligent in failing to properly monitor the mother and failing to determine that the baby had been expelled spontaneously without a healthcare professional in the room, and became trapped under the mother’s right thigh.

$6,000,000 Settlement (Michigan 2021): Infant was born with HIE leading to cerebral palsy and permanent cognitive impairment requiring lifelong assistance due to oxygen deprivation during childbirth. The lawsuit alleged that the defendant (a federally run hospital) was negligent in failing to order a C-section despite signs of uteroplacental insufficiency, maternal hypotension, and non-reassuring fetal status.

Contact Our Birth Injury Lawyers

If you want to investigate your potential child injury claim or if you are a lawyer looking for help evaluating your client’s claim, call our birth injury malpractice lawyers at 800-553-8082.