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Every second matters when a baby doesn’t get enough oxygen during birth. Hypoxic-ischemic encephalopathy, commonly known as HIE, is a serious birth injury that requires immediate medical intervention and often results in lifelong disabilities. While not all HIE cases are preventable, many result from medical negligence—when doctors fail to recognize warning signs, delay necessary interventions, or make critical errors during delivery.
If your child is affected by HIE, the medical malpractice attorneys at Regan Zambri Long are here to help. Our team includes partner Jacqueline Colclough, who worked as an obstetrical and neonatal nurse caring for women during labor and critically ill newborns before attending law school. We have the experience to investigate your case, determine whether medical negligence played a role, and guide you through this emotionally trying time. Your child will have special needs. We will make sure you get all the financial compensation you deserve to take care of them.
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Hypoxic-ischemic encephalopathy occurs when a newborn’s brain doesn’t receive sufficient oxygen and blood flow during the period from 20 weeks of gestation to 28 days after birth. The newborn brain requires constant oxygen and nutrients delivered through blood flow to function properly and continue developing. Brain cells are extremely sensitive to oxygen deprivation and start becoming damaged when the oxygen supply is interrupted for more than a few minutes. Any longer and the damage risks becoming permanent.
Many infants with HIE also experience perinatal stroke during the same oxygen-deprivation event, as the conditions share the same underlying mechanism and frequently occur together
Several pregnancy and childbirth conditions can interrupt normal blood flow and lead to HIE. Placental complications include placental abruption (premature separation from the uterine wall), placental insufficiency, and placental rupture. Umbilical cord emergencies, such as nuchal cord (cord wrapped around baby’s neck), cord prolapse, and cord compression, can also deprive a baby of oxygen. Labor and delivery complications like uterine rupture, shoulder dystocia, prolonged or obstructed labor, maternal hemorrhage, and abnormal fetal positioning all present serious HIE risks.
Medical professionals must recognize potential risk factors and respond appropriately to mitigate HIE risks. Recognizing and responding to these risk factors requires vigilant monitoring and swift action from labor and delivery teams. Partner Jacqueline Colclough worked as an obstetrical nurse before law school and understands the protocols medical staff must follow to prevent oxygen deprivation injuries. When these standards aren’t met, the results can be devastating.
If your child experienced oxygen deprivation during birth and you have concerns about the medical care provided, contact us for a free case review. Partner Jacqueline Colclough’s obstetrical and neonatal nursing background allows us to identify whether preventable errors occurred. There is no cost for this consultation and no obligation to pursue legal action.
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If HIE is detected during birth in full-term babies, therapeutic hypothermia (also known as brain cooling therapy) may be administered within a six-hour window. This treatment works by cooling the baby’s body temperature to slow the cascade of cellular damage that follows oxygen deprivation.
However, therapeutic hypothermia has important limitations that families should understand.
Research from the National Institute of Child Health and Human Development shows that while cooling therapy can reduce the risk of death or disability for some full-term infants with moderate HIE, outcomes remain concerning—nearly half of cooled babies still experience death or significant disability. The treatment reduced poor outcomes by approximately 25%, improving them from about 60% to 45% in moderate HIE cases, but this means cooling is helpful rather than curative.
Critically, therapeutic hypothermia does not benefit babies born prematurely. Preterm infants with HIE face unique challenges, and cooling therapy has not proven effective for this population. Additionally, babies with severe HIE show less benefit from cooling therapy than those with moderate injuries.
The six-hour window for therapeutic hypothermia makes immediate recognition and response critical for eligible babies. Our partner Jacqueline Colclough cared for critically ill and high-risk newborns as a neonatal nurse, giving her firsthand knowledge of how these treatments should be administered, which babies are candidates for cooling therapy, and when delays in care or failure to properly assess eligibility constitute negligence.
Long-term HIE outcomes vary significantly depending on the severity of the initial brain injury, whether the baby was full-term or preterm, the timing and effectiveness of early treatment, and the individual baby’s response to therapeutic interventions.
Even with the best available medical care, including therapeutic hypothermia when appropriate, many babies with HIE experience significant long-term disabilities. The recovery spectrum ranges from complete recovery with no lasting effects in mild HIE cases to severe disabilities requiring lifelong care and support in the most serious cases. Most families find themselves somewhere in the middle of this spectrum, with children who have some disabilities but retain many abilities and continue to learn and develop throughout their lives.
For preterm babies with HIE, outcomes can be particularly challenging because they lack access to proven treatment options like therapeutic hypothermia and face additional complications related to prematurity itself. This reality underscores why proper prenatal care, appropriate management of preterm labor, and prevention of premature birth are so critical.
Cerebral palsy affects movement and posture and may range from mild coordination difficulties to severe physical disabilities requiring wheelchairs and extensive support. The severity depends on which areas of the brain were affected by oxygen deprivation, how quickly treatment was initiated (when applicable), and the baby’s gestational age at birth.
Many children with HIE experience developmental delays that may affect speech, motor skills, social interaction, and cognitive milestones. Early intervention services can help children reach their maximum potential despite these challenges, though the extent of developmental progress varies significantly among individual children.
Children with HIE typically require comprehensive, coordinated medical care throughout their lives. Pediatric neurologists specialize in brain injuries and developmental disorders, monitoring neurological development, adjusting seizure medications as needed, and coordinating with other specialists. Developmental pediatricians focus specifically on children with disabilities and help create comprehensive care plans that address medical, educational, and social needs. Physical, speech, and occupational therapists work together to support a child’s maximum functional abilities and independence.
Educational planning becomes critical as children with HIE approach school age. Many children need specialized educational support, including Individualized Education Programs (IEPs), classroom accommodations, assistive technology for learning, modified curriculum when necessary, and sometimes one-on-one aide support.
The District of Columbia Public Schools system and surrounding jurisdictions provide extensive services for children with disabilities, though families often benefit from advocacy support to ensure their children receive all appropriate services and accommodations. Federal law guarantees disabled children access to appropriate education services, but families sometimes need help understanding these rights and ensuring school compliance.
The Children’s Health Insurance Program (CHIP) provides coverage for families who don’t qualify for Medicaid but struggle with insurance costs. Specialized Medicaid waiver programs provide services for children with significant disabilities regardless of family income, offering crucial support that supplements private insurance.
Supplemental Security Income (SSI) provides ongoing financial assistance from Social Security for children with disabilities. Social Security Disability Insurance (SSDI) is available for families impacted by caregiving responsibilities. These programs have complex application processes and ongoing requirements that often benefit from professional guidance.
Many families find that connecting with others who have navigated similar challenges provides hope, practical advice, and lasting friendships that enrich their lives significantly. The HIE community provides emotional support, practical guidance, and advocacy opportunities that prove invaluable for managing the challenges and celebrating the successes that come with raising a child with HIE.
Mental health support becomes very important for many families as they process the trauma of their child’s birth injury, adjust their expectations and dreams for their family’s future, and develop new coping strategies for managing ongoing challenges. Family counseling, individual therapy, support groups, and peer mentorship programs can all provide valuable emotional support and practical guidance for families at different stages of their HIE journey.
Many HIE cases result from unavoidable medical complications. However, many cases result from preventable medical errors. Determining whether medical negligence contributed to HIE requires understanding complex obstetrical and neonatal care standards.
Partner Jacqueline Colclough’s background as an obstetrical and neonatal nurse—caring for women during labor and high-risk infants—gives our firm unique insight into where preventable errors occur. She can review medical records, identify deviations from proper protocols, and work with medical experts to build your case.
Common indicators of medical negligence include failure to monitor fetal distress, delayed response to complications, delayed emergency cesarean section, improper management of preterm labor risks, improper use of delivery instruments, medication errors, or communication breakdowns between medical team members.
The key question is often whether the oxygen deprivation could have been prevented through proper monitoring, earlier intervention, or different management decisions. A free consultation can provide clarity about your case.
Medical errors during delivery can also cause HIE. Improper use of forceps or vacuum extractors, medication errors affecting mother or baby, and anesthesia complications can all contribute to oxygen deprivation. Communication breakdowns between medical team members, failure to escalate concerns to attending physicians, and inadequate handoff communication between shifts create dangerous gaps in care that can result in preventable injuries.
Multiple healthcare providers may bear responsibility when medical negligence contributes to HIE:
Many families don’t realize that their child’s HIE was preventable. Failures in fetal monitoring, delayed delivery decisions, or improper instrument use can all constitute medical negligence. We offer free case evaluations to help you understand whether the medical care met appropriate standards. Contact us today, Washington. DC’s three-year statute of limitations means time is limited.
Washington, DC, includes both economic and non-economic damages, with no statutory caps on pain and suffering awards in medical malpractice cases involving children. This means that juries can award full compensation that truly reflects the impact of the injury on the child and family, without artificial limits on non-economic damages.
Compensation in HIE cases addresses both immediate and long-term financial impacts that families face when caring for children with HIE-related disabilities.
Educational costs include private therapy services, specialized educational programs, tutoring, and assistive technology for learning and communication. Many children with HIE need services beyond what public schools provide, creating significant out-of-pocket expenses for families.
Lost earning capacity represents a significant component of HIE damages. Children with HIE-related disabilities may have reduced ability to earn income as adults compared to what they would have earned without injury. Economic experts work with medical professionals to assess the likely impact of specific disabilities on future earning potential and calculate appropriate compensation.
We handle catastrophic injury and medical malpractice cases, giving us experience with both the medical aspects of HIE and its devastating impact on families. We work with leading medical experts in obstetrics and neonatology who can testify about what should have happened during your child’s delivery.
Our familiarity with Washington, DC area hospitals and their standards of care helps us understand the institutional context of your case. Throughout the legal process, we provide compassionate representation that acknowledges the emotional toll these cases take on families while fighting for the compensation your child deserves.
If you have questions about whether medical negligence may have contributed to your child’s HIE, we encourage you to seek legal consultation. We offer free case evaluations that provide families with risk-free opportunities to have experienced birth injury attorneys review their situations, explain relevant legal concepts, and provide honest assessments of whether pursuing legal action might be appropriate.
Children with HIE require extensive medical care, therapy services, specialized equipment, educational support, and often lifelong assistance with daily activities. The compensation available through a successful legal case can mean the difference between struggling to afford basic care and providing your child with every opportunity to reach their maximum potential. Holding negligent healthcare providers accountable also helps prevent future injuries by encouraging better practices and protocols. Let us review your case—no cost, no obligation. Call today.
Have you or your loved one sustained injuries in Washington DC, Maryland or Virginia? Regan Zambri Long PLLC has the best lawyers in the country to analyze your case and answer the questions you may have.