Brain Injury in Newborns (HIE) – Legal Pathways for Families

If you are reading this in the hours or days after your baby received a diagnosis of hypoxic-ischemic encephalopathy — HIE — you are probably running on little sleep, a lot of fear, and more questions than anyone has answered. What happened? Could it have been prevented? What does this mean for your child’s future?

Those questions deserve real answers. And one of them — whether a medical provider’s negligence caused or contributed to your baby’s brain injury — may have significant legal consequences for your family.

This guide walks you through what HIE is, how obstetric mistakes cause it, and what your legal options look like. If something feels wrong about how your labor and delivery was handled, trust that instinct enough to make a phone call. Our experienced HIE birth injury lawyers can offer a free, confidential consultation, and there is no cost or obligation to reach out.

What Is HIE? Understanding Newborn Brain Injury

Hypoxic-ischemic encephalopathy — HIE — is a type of brain injury caused by oxygen deprivation during or around the time of birth. The name breaks down plainly: hypoxic means not enough oxygen; ischemic means reduced blood flow; encephalopathy means injury to the brain.

When a baby’s brain goes without adequate oxygen, even for a short period, brain cells start to die. The extent of damage depends on how long the deprivation lasted and how quickly the medical team responded once it was detected.

Research published in Obstetrics & Gynecology confirms that HIE is a leading cause of death and lasting disability in newborns — including cognitive impairment, cerebral palsy, seizures, and hearing or vision loss. That same research highlights that cooling therapy (therapeutic hypothermia), when started within six hours of birth, can meaningfully limit the extent of the injury. That window matters, which is one reason the response time of the delivery team is so critical.

Signs that your newborn may have HIE include low Apgar scores at birth, seizures in the first hours of life, difficulty breathing or the need for resuscitation, limpness, feeding problems, and abnormal or absent reflexes. If your baby was placed in the NICU, underwent cooling therapy, or had a brain MRI shortly after delivery, these may be indicators that something went wrong during or around birth.

How Obstetric Negligence Causes HIE

HIE is not always inevitable. It is, in fact, one of the most litigated conditions in birth injury law — largely because it is frequently preventable when medical teams follow established standards of care. That does not mean every case of HIE involves negligence. But it does mean that when warning signs were ignored or protocols were not followed, there may be accountability.

Here are the most common ways that obstetric negligence leads to oxygen deprivation and HIE:

Failure to respond to fetal distress. Electronic fetal monitoring is specifically designed to catch signs of oxygen deprivation before they become catastrophic. A Category II or Category III fetal heart rate pattern is a recognized warning. When nurses or physicians fail to act on those signals — or fail to escalate appropriately — the consequences can be permanent.

Delayed or failed emergency C-section. When fetal distress is identified, the standard of care often requires an immediate cesarean delivery. Delays caused by poor communication, understaffing, or a failure to appreciate the urgency of the situation are among the most common preventable causes of HIE.

Misuse of forceps or vacuum extractors. These instruments can be appropriate tools in the right circumstances, but their misuse can compress a baby’s skull, disrupt circulation, or cause injuries that contribute directly to oxygen deprivation.

Failure to manage maternal emergencies. Conditions like preeclampsia, placental abruption, umbilical cord prolapse, and uterine rupture are well-known obstetric emergencies with established treatment protocols. When they are missed, undertreated, or responded to too slowly, a baby’s oxygen supply can be cut off rapidly.

Pitocin misuse. Oxytocin (Pitocin) is commonly used to induce or speed up labor. When administered improperly, it can cause contractions that are too strong, too long, or too frequent — a condition called uterine tachysystole — which starves the baby of oxygen between contractions.

Failure to intervene in prolonged labor. A stalled or dangerously slow labor without timely intervention places a baby at serious risk. The longer the delay, the greater the potential for harm.

If any of these situations occurred during your delivery, your family may have grounds for an HIE birth injury claim.

Legal Pathways for HIE Families: What a Birth Injury Claim Looks Like

You do not need a legal background to understand this. Here is what a birth injury lawsuit actually requires.

What Has to Be Proven

A medical malpractice claim comes down to four things. First, that the hospital or medical staff owed your family a duty of care — in the context of labor and delivery, that is rarely in question. Second, that they breached that duty by falling below the accepted standard of care. Third, that the breach caused or contributed to your baby’s HIE. Fourth, that your family suffered real harm as a result.

The second and third elements — the breach and the causation — are where these cases are won or lost, and they require qualified medical experts to establish. Our medical malpractice FAQ addresses many of the questions families have about this process.

What Compensation May Be Available

Families who succeed in HIE claims may be compensated for a range of losses. Medical costs — from NICU care through a lifetime of treatment and management — are typically the largest component, and they can be staggering. A child with moderate to severe HIE may require decades of physical therapy, occupational therapy, speech therapy, specialized educational support, adaptive equipment, and in some cases, residential care.

Beyond those direct costs, families may also recover for the child’s pain and suffering, the parents’ emotional trauma, and the child’s lost earning capacity if the injury prevents them from working as an adult. These cases can involve millions of dollars, not as a windfall, but as a realistic accounting of what it costs to care for a seriously injured child over a lifetime. 

Common Questions Families Ask

How long do I have to file a claim in Ohio?

Ans – Under Ohio Revised Code § 2305.113, the general rule for medical malpractice claims is one year from when the injury occurred or was discovered. But for minors, Ohio Revised Code § 2305.16 changes the picture significantly. Both the one-year statute of limitations and the four-year statute of repose are tolled — paused — while your child is a minor. In plain terms, neither deadline begins running until your child turns 18, giving them until their 19th birthday to file.

That said, waiting is rarely in your family’s interest. Fetal monitoring strips, nursing notes, operative reports, and internal hospital communications can disappear. Witnesses move on. Memories fade. The sooner an attorney can secure and preserve the evidence, the stronger the case.

Do I have to pay anything upfront?

Ans – No. The birth injury attorneys at Clark Perdue work on a contingency fee basis. That means no fees unless and until your case results in a recovery. There is no financial risk to consulting with an attorney or pursuing a claim.

How hard is it to prove one of these cases?

Ans –  Honestly — these are among the most demanding cases in civil litigation. They require a granular review of obstetric records, fetal monitoring data, nursing documentation, and delivery room communications, along with expert testimony from board-certified specialists in obstetrics and neonatology. The hospitals and their insurers will have experienced defense teams. You need attorneys who have handled birth injury cases before and know how to build them. Our brain injury FAQ and medical malpractice FAQ cover more of the questions families commonly have at this stage.

How Does an Experienced HIE Birth Injury Lawyer Fight for Your Family?

When you contact our team, here is what happens:

Your attorney starts by securing and analyzing the full record — fetal monitoring strips, nursing notes, operative and anesthesia reports, NICU documentation, everything. That review typically reveals the specific moments where the standard of care broke down.

From there, the team works with qualified medical experts — obstetricians, neonatologists, pediatric neurologists — who can explain what the providers knew, what they should have done, and what the consequences of their failures were. This is not a matter of hindsight. There are clear standards in obstetric medicine, and deviations from them are documentable.

Your attorney will also work with life care planners and economic experts to calculate your child’s full lifetime needs — making sure that any resolution fully accounts for the reality ahead. Too many families accept settlements that look large but fall short of what decades of care will actually cost.

Most birth injury cases settle without going to trial. But the reason families receive serious settlement offers is that the other side knows the case is prepared and ready. Clark Perdue builds every case with trial in mind, because that preparation is what produces results.

Throughout this process, you are kept informed and treated with the respect your family deserves. You will not feel like a case number here.

Your Child’s Future Deserves a Fight — Contact Our Team Today

An HIE diagnosis is not a verdict on your child’s potential. Many children with HIE make meaningful progress with the right therapies and support. What a legal claim can do is make sure your family has the financial resources to give your child every possible opportunity — the therapies, the equipment, the specialists, the care.

If you have questions about what happened during your baby’s delivery, or if something about the way your birth was managed has stayed with you, please reach out. You may not know yet whether you have a case. That is exactly what a consultation is for.

Clark Perdue offers free, confidential consultations for families dealing with HIE and newborn brain injury. There is no obligation. We will listen carefully, review what you share with us, and give you an honest answer about your legal options.

Your family has already been through enough. Let us take it from here.

Contact Clark Perdue today →  You can also reach us by phone: Local (614) 469-1400 | Toll Free (800) 647-7003