Many newborns (neonates) experience mild jaundice as fetal hemoglobin is rapidly replaced with mature hemoglobin. Since unconsolidated pathways within the neonate liver cannot process bilirubin as effectively as a mature liver, the neonate liver excretes bilirubin too quickly for the newborn’s bloodstream to assimilate it properly. Excess blood bilirubin produces a condition called hyperbilirubinemia, or jaundice.
Once jaundice is indicated in a newborn, the attending birth doctor should order a physical examination of the infant and blood tests to determine serum bilirubin level. Some infants may be more at risk for suffering hyperbilirubinemia than others. These risk factors include:
- Premature birth (neonates born prior to 38 weeks)
- Neonates born with a viral or bacterial infection
- Problems with feeding and/or digestion
- Neonates who experience significant bruising during the birth process (increased breakdown of red blood cells produces more bilirubin)
- Neonates who have different blood type from the mother (placental antibodies delivered to the neonate can cause rapid breakdown of red blood cells and excess blood bilirubin)
Breast-fed babies who do not receive enough nutrition through breast milk may also suffer from high bilirubin levels several weeks after birth, even if they were not jaundiced at birth.
Signs of High Bilirubin Levels in Infants
Visible signs that a neonate may be suffering hyperbilirubinemia include a yellowish hue to the facial skin and yellowing of the whites of eyes. High bilirubin levels will discolor the infant’s chest and stomach as well and also make him extremely sleepy. Babies diagnosed with hyperbilirubinemia may be so lethargic that nurses have difficulty rousing the infant to feed.
How are Doctors Supposed to Treat Jaundice?
Infants with jaundice are usually given phototherapy to reduce blood bilirubin levels. However, phototherapy will not work on infants suffering an underlying disease or disorder that prevents the liver from functioning properly. Doctors failing to recognize a pediatric liver disease or ignoring prolonged infant jaundice are putting the child’s life at risk by allowing a potentially fatal condition called kernicterus to permanently damage the infant’s nervous system.
What is Kernicterus?
Also called bilirubin encephalopathy, kernicterus occurs when untreated or misdiagnosed hyperbilirubinemia allows toxic bilirubin to accumulate in the infant’s brain, specifically the gray matter containing neurons that communicate with the central nervous system. Newborns diagnosed with even mild jaundice are vulnerable to kernicterus and should be carefully monitored so that any change to blood bilirubin levels is detected immediately.
Infants suffering acute bilirubin encephalopathy will exhibit the following symptoms:
- Extreme lethargy
- Emitting high-pitched cries
Long-term consequences of kernicterus as a result of medical malpractice involve numerous deficits to the central nervous. Neurological lesions will permanently damage the brain’s gray matter when excessive bilirubin levels reach the infant’s brain. Consequently, children diagnosed later in life with acute bilirubin encephalopathy present these developmental issues:
- Movement/motor disorders (dystonia and/or athetoid cerebral palsy)
- Hearing loss (auditory neuropathy)
- Eye/vision deficits ( strabismus, nystagmus, cortical visual impairment)
- Dental enamel hypoplasia
- Disorders of the GI tract
Neurological impairments caused by acute bilirubin encephalopathy are associated with lesions on the basal ganglia and on the visual/auditory parts of the brain stem. Currently, no effective treatments exists for reversing kernicterus as a result of medical malpractice.
Medical Malpractice and Acute Bilirubin Encephalopathy
Doctors sued for medical malpractice involving infants with ABE are guilty of doing the following:
- Delaying or interrupting phototherapy treatments to assess the risk of giving a blood transfusion to the infant. Tests done prior to a transfusion CAN be performed on the infant during phototherapy
- Neglecting to properly examine an infant for signs of high bilirubin levels and kernicterus
- Discounting or disregarding bilirubin test results. Levels of blood bilirubin are specific to the infant’s age–not in days but in hours. For example, an 8.5 bilirubin level is high risk for a neonate less than 24 hours old. However, the same level is considered low risk for infants at least 48 hours old. Doctors interpreting tests that should be reason for alarm but fail to act on such tests may be found guilty of medical malpractice.
Contact a Medical Malpractice Attorney for Bilirubin Encephalopathy Birth Injury Compensation
You may be eligible for medical malpractice compensation If your child suffers kernicterus. Our law firm has successfully handled many medical malpractice cases involving birth injuries and can help you get the compensation you deserve for you pain, suffering and medical bills. Call us today for an immediate consultation.