Kernicterus from Hyperbilirubinemia

Treatable. Preventable. Irreparable. These are a series of words we often use when discussing kernicterus, a devastating brain injury caused by hyperbilirubinemia, more commonly known as jaundice.

More than half of full-term newborns and up to four out of five premature babies will experience jaundice, a condition where there is excess bilirubin (old red blood cells) in the blood. An infant may develop a build-up of these cells if its liver is unable to process and excrete them as quickly as it should.

In many cases, jaundice in newborns resolves on its own as the baby’s liver starts working efficiently and cleans out this waste. In other cases, an inexpensive and minimally invasive form of phototherapy (light therapy) is enough to help treat the baby’s condition until its liver develops. The most severe cases of jaundice will require an exchange transfusion procedure.

With appropriate observation and prompt treatment when necessary, jaundice should be a minor concern for new parents as the prognosis for a full recovery is excellent. But if medical professionals neglect to monitor this condition properly, it can deteriorate and eventually result in a severe irreversible form of brain damage known as kernicterus.

Kernicterus from untreated jaundice is one of the most common types of medical malpractice case we see and also one of the most bitterly frustrating ones a new parent can experience. Knowing that effective treatment to prevent irreparable damage was available but unused due to negligence, leads to painful questions about why your child did not receive the care he or she needed so early in their young lives.

A common condition after birth.

What causes jaundice?

As a body breaks down old red blood cells, it creates a yellow pigment called bilirubin that is processed by the liver prior to excretion. If there is a delay or disruption in this process, bilirubin that builds up in the body often causes skin or the whites of the eyes to develop a yellowish hue that is a tell-tale sign of jaundice.

Newborn infants generally have more bilirubin in their blood than adults and also have more difficulty processing it. As a result, up to three in five babies develop a form of jaundice shortly after their delivery.

Common causes of jaundice in newborns include:

• abnormal development or immaturity of the liver.
• premature births (prior to 37 weeks of gestation).
• trouble breastfeeding or breast milk with high levels of a bilirubin-causing substance.
• bruising (injuries resulting in bleeding under the skin that lead of an excess of red blood cells).

Less frequently, jaundice can also be caused by:

• infections and septicemia (an extreme immune reaction to infection).
• mismatched maternal-infant blood types.
• genetic problems with red blood cells or the liver.
• a blockage between the liver and intestine.
• hypothyroidism.

When is jaundice a concern?

In the vast majority of cases, jaundice symptoms appear within two to three days of birth and resolve on their own within two weeks. In other cases, certain red flags should prompt additional medical evaluation and possible treatment.

You should see a doctor if your baby:

• develops the yellow pigment within the first day after birth.
• continues to have jaundice beyond two weeks.
• is not eating well, is unusually fussy,has a fever and/or has breathing problems.

When in doubt, it is always best to seek medical care to rule out serious conditions.

How is jaundice diagnosed and treated?

Although observing a pronounced yellow tinge of the skin or the whites of the eyes is often enough for a doctor to diagnose jaundice, they may perform blood, urine or skin tests to confirm the diagnosis, determine the cause of the jaundice, or to monitor levels of bilirubin.

While mild jaundice generally does not require any treatment, doctors may ask that you increase your feeding schedule to help the baby excrete waste more frequently, or pump breast milk rather than breast feed if the baby has breast milk jaundice.

For cases that may not resolve quickly enough on their own, doctors often use phototherapy. A special bright blue light is focussed on the skin to assist the baby’s body in breaking down the bilirubin. Doctors should monitor bilirubin levels to ensure the therapy is working. If the levels in the blood remain abnormally high despite phototherapy treatment, the next option is for an exchange transfusion to remove a small amount of the baby’s blood and replace it with donor blood that has normal levels of bilirubin.

What can happen if severe jaundice is left untreated or treatment is delayed?

When bilirubin builds up in the bloodstream and cannot be cleared effectively, there is a risk it can begin to collect in brain tissue and affect brain function (bilirubin encephalopathy). If not treated in time, it can cause serious and permanent brain damage.

In the early stages of kernicterus, babies may present with extreme jaundice, the absence of a startle reflex, poor feeding, lethargy, and low muscle tone. As the condition worsens the baby may begin to exhibit irritability, a high-pitched cry, arched back, high muscle tone and continue to have poor feeding. In late-stage kernicterus, the baby may go into a coma or appear to have a stupor, stop feeding, seizure, muscle rigidity, and a shrill cry.

Although high levels of bilirubin in the blood will indicate kernicterus, there is no direct link between the level in the blood and the degree of injury a baby may sustain. Kernicterus can cause severe brain damage, deafness, and death.

Is it medical malpractice?

Although jaundice is a common condition after birth, the potential for severe outcomes means that doctors should monitor newborns for signs of a worsening condition and perform tests to indicate if these babies may be at risk. Moreover, as medical knowledge advances, the thresholds for applying life-saving treatments such as phototherapy also change. If medical professionals neglect to keep up-to-date with standards of care, babies who should have qualified for treatment or more frequent testing may miss out on important interventions.

If your child, or the child of a loved one, has developed complications from jaundice after birth, it is in your best interests to review what occurred to cause their disability or death, and whether negligent actions or inaction caused the injury.

We can help.

Welcoming a new life into the world should be a time for joy, not sorrow. If someone’s negligence has hurt your loved one, you may be able to recover expenses relating to their past, current and future cost of care, lost potential future income, and damages for your and their pain and suffering. Contacting an experienced, knowledgeable, and skilled kernicterus birth injury lawyer to learn about your rights and options is an important first step as you build a better future for your loved ones.

Gluckstein Personal Injury Lawyers have been leaders in the field of birth injury law for decades. Recognized as one of the country’s top personal injury firms by our legal peers, we have a track record of getting results for our clients.

When you contact one of our birth injury lawyers, we will listen empathetically as you tell us what has happened. Your initial consultation is always free and with no obligation. As we outline your various options, we will explain what we can do as your trusted legal representative and advocate.

By calling on our extensive network of medical experts, we can build a strong medical malpractice case to encourage the defendants to provide a fair settlement for your many losses. We also have no hesitation in bringing the matter to court if we believe you are not receiving what you deserve.

Gluckstein Personal Injury Lawyers believes everyone should have access to justice, regardless of their financial means. Therefore, if we take your case we will only get paid if we are successful in winning you a court award or negotiating a settlement.

Why choose our birth injury lawyers?

When deciding on a lawyer there are many factors you will be considering. We know our top rank, long history of advocacy, and excellent track record for results will be important to many clients. But we also know that our reputation for and commitment to full-circle client care sets us apart.

When you become a Gluckstein Personal Injury Lawyers client, we treat you as we would treat our own family. We will be here for you every step of the way during your lawsuit, but also afterwards as you help your loved one build their best life possible.

Members of our own staff have dealt with serious birth injuries in their own families. We have a special appreciation for the type of compassionate care, concern, and support people like you need and deserve in this difficult time. Trust our team to take on your case and see first-hand what the Gluckstein advantage means.

Contact Gluckstein Personal Injury Lawyers today to learn more about what we can do for you.