Improper NICU Care and Cerebral Palsy

Fact Checked

Improper NICU care can lead to cerebral palsy in babies. Improper care can include administering the wrong medication or failing to maintain breathing machines, among many other mistakes. NICU errors can lead to medical malpractice when babies suffer the serious consequences of poor care.

What Is the NICU?

NICU stands for neonatal intensive care unit. It is a special nursery in hospitals that provides 24-hour care for the most vulnerable babies. Babies in the NICU are either dangerously preterm or very sick.

Physicians and nurses provide intensive care in the NICU and round-the-clock monitoring.

When Does a Baby Need Care in the NICU?

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 in the NICU specialize in dealing with babies born with complications.

The NICU team includes medical experts, nurses, neonatologists and fellows, respiratory therapists, pediatric residents, dieticians, pharmacists, and more.[1] Which team of healthcare professionals a baby will need depends on why they’re in the NICU.

An infant can end up in NICU care for many reasons. For instance, babies who can’t breathe independently 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 deprived of oxygen have a heightened chance of developing brain damage, cerebral palsy, and associated conditions.

The most common reason infants end up in the 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 ensures that babies are cared for until they can safely go home. Depending on the baby’s needs, medical care could include an incubator, a breathing machine, medications, intravenous feeding, breathing tubes, and surgery if needed.

What Kinds of Mistakes Are Made in the NICU?

Keep in mind that a newborn in the NICU must be closely monitored. A healthcare professional’s slight misstep could potentially lead 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 common 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]

Medication errors in the NICU can include ordering the wrong drug or using the wrong dose. Preterm babies are particularly vulnerable to mistakes made with medications because their bodies are so small and cannot buffer the errors.

Another issue is the small doses used with perterm babies. Pharmacists dilute medications to such minute degrees that a mistake is easy to make and can lead to even tenfold dose increases.[3]

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 the 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 independently.

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 alveoli of the lungs.[4] Further, breathing machine errors can result in an infant developing a collapsed lung, known as pneumothorax.

Other reasons NICU errors occur include:

• Delays in diagnosis
• Misdiagnosis
• Delays or mistakes during surgical procedures
• System failures

Is Improper NICU Care 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 for improper NICU care.[5]

It can also occur because a team of experts usually cares for each infant. When one person makes an error, it affects the entire team.

According to the study, patient safety in large hospitals tends 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.

Although the standard of care for medical professionals doesn’t mean being perfect at their duties, they must provide the quality of care upheld by law.[6]

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 complications due to NICU errors, talk to an experienced birth injury lawyer. They can help you take action over medical malpractice.