Improper NICU Care and Cerebral Palsy

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Babies sent to a hospital’s neonatal intensive care unit (NICU) are already at risk, but when they don’t get the proper care, the risk increases, which can potentially lead to cerebral palsy. There are various reasons improper NICU care happens, such as administering the wrong medication to improperly maintaining breathing machines. NICU errors can lead to medical malpractice if healthcare professionals fail to provide a professional standard of healthcare.

Reasons for NICU Care

A NICU, according to Stanford Children’s Hospital, is a special area in hospitals where “advanced technology and trained healthcare professionals give special care for the tiniest patients.” [1]

When babies are born with high-risk medical issues, there is a good chance they’ll be sent to the NICU for evaluation and treatment. Healthcare professionals who work in NICU typically specialize in dealing with babies born with complications.

The NICU team includes medical experts, which can include nurses, a neonatologist and fellows, respiratory therapists, pediatric residents, dieticians, pharmacists, and more. Which team of healthcare professionals a baby will need depends on the reason they’re in the NICU.

An infant can end up in NICU care for many reasons. For instance, if babies can’t breathe on their own, they could need medical assistance and monitoring until their lungs are strong enough. This is known medically as respiratory distress syndrome (RDS).

Another example is when a baby is deprived of oxygen due to prolonged labor or any medical issue that leads to fetal distress. Babies that are deprived of oxygen have a heightened chance of developing brain damage, cerebral palsy, and associated conditions.

The most common reason for infants to end up in a NICU is premature birth, meaning a baby born before 37 weeks gestation. These babies are at risk of infections, compromised immune systems, failure to control body temperature, and unstable vital signs.

Other reasons for NICU care include:

• Jaundice
• Infant hypoglycemia
• Seizures
• Anemia
• High blood pressure in the lungs
• Heart defects
• Bleeding in the brain
• Macrosomia

A controlled, well-monitored NICU aims to ensure that babies are cared for until they can safely go home. Medical care, depending on the baby’s needs, could include an incubator, a breathing machine, medications, intravenous feeding, breathing tubes, and if needed, surgery.

NICU Errors

Keep in mind that a newborn in NICU must be closely monitored. Any slight misstep by a healthcare professional could potentially to a lifetime of medical disorders for a vulnerable infant.

The most common NICU errors that can result in cerebral palsy and other medical conditions include:

Medication Errors

According to a study published in BMJ Journals, medication errors are one of the main reasons for NICU mistakes.

“Medical errors are a common occurrence in the neonatal intensive care unit (NICU). Although this high risk, fragile patient population is prone to a wide array of errors, medication errors are particularly common,” the study reads. [2]

Further, pharmacists may have to dilute medications to “that are extremely minute compared with adult standards,” [3] which can lead to additional errors.

Breathing Tube Errors

As mentioned earlier, one of the reasons newborns are admitted to a NICU is the failure to breathe on their own. Medical staff in NICU must do many things to ensure the infant’s safety, including, in some cases, inserting a breathing tube to allow the baby to get oxygen.

Inserting a breathing tube requires a highly-qualified healthcare professional who can successfully insert the breathing tube in the correct places. Errors occur when a healthcare professional inserts the tube down only one airway or into the baby’s esophagus.

Ventilator Errors

Ventilator errors occur when breaths are administered too fast for the baby, which can result in blood vessel constriction in the brain.

Respiratory therapists generally maintain and adjust the ventilators so that infants can receive oxygen at the same rate as if they were breathing on their own. [4]

However, if the ventilator supplies too much oxygen and the infant breathes too fast, they are at risk of developing hypocarbia, meaning reduced carbon dioxide in the blood. [5] Further, breathing machine errors can result in an infant developing a collapsed lung, known as pneumothorax.

Other reason NICU errors occur include:

• Delays in diagnosis
• Misdiagnosis
• Delays and/or errors for operation procedures
• System failures

Improper NICU Care and Medical Malpractice

According to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), fatigue and sleep deprivation are among the many reasons that improper NICU care happens. [6] It can also happen because there is usually a team of experts who care for each infant, and when one person makes an error, it affects the entire team.

According to the study, patient safety in large hospitals tend to focus more on adult patients, which can also lead to NICU errors when healthcare professionals don’t dedicate enough time to these fragile infants.

Because of their unique vulnerability, even minor errors can lead to devastating short and long-term consequences. In large general hospitals, patient safety efforts are likely to be targeted toward adult patients or treatment units, with little appreciation for the unique needs of the NICUs and their patients,” the study read.

Regardless, healthcare professionals are obligated to uphold a professional standard of healthcare for all patients, regardless of age.

The U.S. National Institutes of Health (NIH) reports that although the standard of care for medical professionals doesn’t mean being perfect at their duties, it does mean they must provide the quality of care that’s upheld by law. [7]

For example, if a healthcare professional falls asleep and fails to monitor an infant’s stress level and it results in injuries, it could potentially lead to medical malpractice.

Another example of not fulfilling the standard of care is giving the baby the wrong medication. Regardless of the situation, medication errors are preventable yet continue to be one of the primary reasons for NICU injuries.

If your baby developed cerebral palsy and you think NICU errors caused it, you may have a medical malpractice case. Contact us at 866-579-8495 for questions or additional assistance.