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Minneapolis Hypoxic-Ischemic Encephalopathy (HIE) Lawyer

Hypoxic-ischemic birth injuries are all too common. Worldwide, hypoxic-ischemic encephalopathy (HIE) is the fifth leading cause of death in children under age five. The majority of babies who do survive a birth injury caused by oxygen deprivation — many of whom will not be diagnosed until weeks or even months after the injury occurred — will need lifelong care and accommodation.

Tragically, HIE is often the result of medical malpractice. As the parent of an HIE child, you have a long emotionally and physically challenging road ahead of you. Seeking legal advice from a Minnesota Birth Injury Attorney to learn how you can hold the doctor and others who caused your child’s HIE financially responsible is the right thing to do for your child and for your entire family.

Hypoxic-ischemic encephalopathy (HIE) — also referred to as birth asphyxia, perinatal asphyxia and neonatal encephalopathy — is a type of brain damage. It is the result of a birth injury that causes oxygen deprivation and reduced blood flow immediately before or during the birth process.

There are a variety of birth complications that can cause HIE, and many are the result of medical malpractice. Examples of the types of negligent actions that can be the cause of your child’s HIE include:

Improperly Managed High-Risk Pregnancy

Expectant mothers with certain medical conditions, such as gestational diabetes and preeclampsia, are at increased risk for complications. If you had these conditions during your pregnancy, there is a chance that your health care providers did not provide you with the level of monitoring and treatment your condition required.

Umbilical Cord, Placental or Uterine Complications

Complications involving the umbilical cord, placenta or uterus, when not properly identified and treated, can interfere with the baby receiving enough oxygenated blood, resulting in HIE. Examples include:

  • Any type of umbilical cord compression before or during birth;
  • Placental abruption, where the placenta separates from the uterus before the baby is born;
  • Placenta previa, caused by the placenta attaching too closely to the cervix;
  • Placental insufficiency, which means the placenta is unable to deliver adequate amounts of blood to the baby; and
  • Uterine rupture, where the uterus partially or completely tears.
Infections During Labor and Delivery

If the mother has an infection, it can spread to the baby during labor and delivery if the doctor does not take appropriate measures. If you had an infection when you had your baby, it was your doctor’s responsibility to conduct an infection screening and prescribe antibiotics if indicated. The failure to do so could have resulted in a birth injury.

Failure to Properly Monitor the Fetal Heart Rate

If a mother and baby are being properly monitored, any signs of fetal distress can almost always be addressed before any permanent injury from oxygen deprivation occurs. This may result in an emergency cesarean section, but the baby will be spared a birth injury. If monitoring is neglected or sporadic, the chances increase that the danger signs of oxygen deprivation and other issues will be missed.

Prolonged Labor

Prolonged uterine contractions during a labor that is not progressing fast enough can harm your baby. It is your doctor’s responsibility to know when labor is going on too long. If this happened to you, your doctor should have offered you a medically sound intervention, such as an emergency C-section, before your baby could develop HIE from oxygen deprivation.

Premature Birth

If you delivered your baby prematurely and the result was a baby with HIE or another birth injury, you are within your rights to question whether your caregivers did everything possible to prevent the premature birth. There are interventions available — such as progesterone treatment or cervical cerclage — that are often successful at stopping early delivery. If your doctor failed to address your risk of premature birth, you could have a malpractice claim against them.

Improperly Inducing Labor

If your doctor gave you medication to induce or hurry up your labor, this could have contributed to your baby’s HIE. Medicines such as Cytotec and Pitocin can make your uterine contractions so strong that they actually deprive the baby of oxygen.

Post-Birth Conditions

If your baby developed a neonatal condition — such as hypoglycemia, respiratory distress or jaundice —that was not properly managed, hypoxic-ischemic injury could have been the result. In other words, your baby might have developed HIE as a result of neglect during the first month following birth.

Some babies manifest signs of hypoxic-ischemic injury right away. They have breathing or feeding problems and have low Apgar scores, all tell-tale signs of HIE. You might notice shortly after birth that your baby does not respond to loud noises or just does not seem alert. These signs might have been severe enough that you took your baby to the doctor and received the HIE diagnosis.

But often, you may not find out your baby has HIE for weeks or months. This is because HIE brain injuries worsen over time. In fact, there is a chain reaction of sorts that occurs when the brain is deprived of oxygen. The affected cells die, releasing toxic substances that, in turn, cause injury to other brain cells. For this reason, hypoxic-ischemic brain injuries may not – and often don’t – manifest immediately.

In fact, the symptoms that come from brain damage may not be noticed until the baby fails to meet certain developmental milestones such as crawling or walking. These child-development delays are the catalyst for further testing that can lead to the HIE brain damage diagnosis.

How HIE affects any particular child depends on what parts of the brain sustained injury and how extensive the damage was. Because of this, no two cases of HIE brain damage are ever exactly the same. A child with severe HIE might develop cerebral palsy or other types of motor disorders. He or she could also develop epilepsy, seizures, and seizure disorders. In fact, any child who is affected by an HIE-causing event could end up with one, several, or all of these afflictions, along with a myriad of additional health and developmental concerns, including:

  • Brain bleeds (intracranial hemorrhages);
  • Hearing issues;
  • Learning disabilities;
  • Neurological and mental health issues, including emotional/behavioral disorders;
  • Respiratory conditions;
  • Sensory processing issues;
  • Skin afflictions;
  • Speech delays and/or language disorders;
  • Orthopedic issues and pain; and
  • Vision issues.

Under Minnesota law, damages for medical malpractice are unlimited. In other words, you are entitled to seek amounts to cover all of the costs that will be incurred for your child’s entire lifetime. While it is impossible to know the exact needs of each child going forward, children with HIE that resulted from medical malpractice can typically recover the lifetime costs of:

  • Making the home handicap accessible
  • Adaptive equipment, such as wheelchairs, special beds, commode and bathing adaptations for accessibility
  • Assistive technology
  • Access to special education
  • Medical care and medication
  • Physical and occupational therapy
  • Lost earning capacity or lost wages of the parents
  • Pain and suffering and emotional distress

In certain cases, you can also recover additional damages that, rather than being linked to the actual cost of care, are intended to punish those who caused the harm.

We recommend meeting with one of our experienced Minnesota Medical Malpractice Attorneys to undergo a thorough case review as soon as possible after diagnosis, as there are time limits for bringing suit. A successful HIE lawsuit depends on collecting, preserving, and properly presenting all the evidence that will show how the medical personnel, the hospital, and/or any others contributed to your child’s birth injury.

Call our Minnesota Medical Birth Injury Lawyer today at 612.349.2729.


We have a process that works in getting exceptional results for our clients. 

We are trial lawyers who prepare every case for trial from Day 1. Investigation and legal research are the first things we do, and we spend a lot of time on them. Because we haven’t filed the case yet, we have complete control – the defendant has no say and we want to use this time wisely.  We interview witnesses that can help us prove the case.  We’ll ask you for all relevant documents in your possession and review those carefully as well.  We also will spend some time conducting legal research about unique issues in the case.  We pull the jury instructions that the judge will ultimately charge the jury with after closing arguments at trial. 

Our next step is typically to send a demand letter to the defendant. In the letter, we thoroughly lay out: the facts surrounding the defendant’s misconduct; the applicable law (including statutory and case citations) that make clear that the defendant broke the law; an analysis of your damages and the defendant’s monetary exposure; a demand for a monetary amount to settle the claim; and an instruction to preserve all relevant evidence, including electronic evidence. The point of this letter is to give the defendant a chance to do the right thing and pay a fair amount before litigation, and to give the defendant an opportunity to present any defenses or evidence it wants us to consider before moving forward.  Sometimes we skip the demand letter if there are strategic reasons to move straight to filing, but we typically give defendants a chance to do the right thing.

If early negotiations fail, great – we file a Complaint and serve the defendant with it. A Complaint is a legal document that states the facts of what happened and alleges how the defendant broke the law. It formally starts the lawsuit.  Many lawyers draft complaints in a general and relatively vague way, just to get it done and filed – because that’s all that’s really required.  We take a different view. We view the Complaint as our first chance to tell your story to the judge, and we take it seriously. So we draft detailed complaints and include legal citations to statutory and judicial authority on unique points.  Sometimes we’ll include a number of exhibits, diagrams, or other demonstrative aids to help the Court understand our claims.  A secondary benefit of this approach is that defense lawyers reading the Complaint can become educated on the problems of their case and the state of the law – sometimes this leads them to reach out to us shortly after service of the Complaint to re-initiate settlement negotiations.  Of course, by that time, the price for settlement has gone up.

Some lawyers view written discovery as a necessary evil – something to get done and out of the way before depositions.  Not us.  Written discovery is a gift and an opportunity.  We spend a great deal of time crafting requests for documents and interrogatories (questions for the defendant to answer in writing) that are specific, detailed, and tailored to get what we need to prove our case.  Many lawyers – even great ones – think written discovery is a waste of time because defense lawyers typically answer them on behalf of their clients and can try to stonewall with legalese and objections.  We view this as a wonderful opportunity.  In our experience, most defense lawyers can’t help themselves when answering discovery: they over-state their defenses and make assertions that their clients will not be able to support in testimony. So we get to commit the defendant to defenses that they can’t back up, leading to contradictions, confusion, and chaos in their depositions later on.  We also use Requests for Admission – which many lawyers don’t.  The Federal Rules and Minnesota Rules of Civil Procedure allow us to ask defendants to “admit” certain facts.  We send them RFAs that are very difficult for them to deny.  Of course, they do it anyway, but that sets them up later for cost and fee-shifting, which the Rules mandate for defendants that deny RFAs that are later proven true.  And usually, we can get the defendants’ own witnesses to admit facts that their defense lawyers denied in RFA.  That’s a great situation that leads to more chaos and confusion on the defense side.

One last point on written discovery – we send multiple waves of it throughout discovery.  We typically send 3 or 4 sets of written discovery requests to defendants throughout discovery.  This compounds the problems for them, because the defense lawyers continue to overstate their defenses, but now run into contradictions from not just the defendant witnesses’ deposition testimony, but also their own previous discovery responses.  This makes for a great record that we can present to the judge at dispositive motions, and use for impeachment at trial.

This is our chance to question relevant witnesses, on the record with a court reporter (we typically videotape important depositions as well). We get to confront the defense witnesses with all of the evidence we’ve developed through written discovery and document production. By this time, the defendant put its witnesses in an impossible position through its written defenses, which are often untrue and indefensible.  So the witness has to either lie to support the defense, or admit it’s not true.  That’s a dilemma that works for our clients either way, no matter which option the witness takes.  We use depositions to expose contradictions, create a record for dispositive motions, lock witnesses into their stories so that we can impeach them later at trial, and sometimes, to show defense lawyers how hopeless their case is.  We often calls from defense counsel shortly after depositions of their clients, seeking to re-start settlement negotiations.

The defendant will usually make a motion for summary judgment after discovery, asking the Court to throw out the case without having a jury trial. Because we’ve hit discovery so hard – both through written discovery and depositions – this is a tough motion for defense counsel to write in our cases.  We draft our response for the Court and now get to bring everything together: the admissions, contradictions, nonsense, and obvious fact disputes that we’ve uncovered through discovery.  We tell a compelling story that wraps everything together for the Court and makes clear that the defense motion has to be denied, and the defendant needs to face a jury for its conduct.

Sometimes, we’ll even make an affirmative motion for summary judgment, asking the Court to grant judgment in favor of our client without a trial. These motions are generally rare for plaintiffs to make, because the defendant can usually point to some fact dispute on its intent or some other factor that necessitates a trial. But we make affirmative summary judgment motions significantly more than is typical for plaintiffs, and that’s because the work we put in during discovery helps build a fantastic record to do so.

After the Court denies the defense motion for summary judgment, the defendant has only 2 options: 1) do the right thing and pay you a fair amount to our client to settle your claim (usually much, much more at this point than the defendant could have paid at the beginning of the case to settle); or 2) face a jury for its conduct and risk an enormous verdict. This is the dilemma that we have been creating and forcing the defendant into for the entire case. We’ll engage in settlement negotiations at this point from a position of extreme strength, mainly because most defendants are (rightly) terrified of facing a jury to defend their conduct.

This is, candidly, our favorite part of the case – why we went to law school: to hold the powerful accountable before juries.  We prepare heavily for trial, including: detailed witness preparation, focus groups, and mock trials.  At this point, the potential outcomes and consequences for the defendant are much more severe than if it simply did the right thing at the beginning of the case and paid a fair amount to compensate our client for its misconduct.  As we advocate to the jury for our client, we’re also mindful of protecting the record so that defendants will be unsuccessful in attacking the verdict in post-trial motions or appeal.

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