Is Neonatal Cooling Potential Evidence of Medical Malpractice?

by John McKiggan

How many children suffer brain injury during labour and delivery each year?

There are between 330,000 to 390,000 babies born in Canada each year.

Neonatal encephalopathy is a neurological (brain) injury that happens in approximately 1 out of 1000 to 6 out of 1000 births. So, approximately 330 to 1980 babies are born in Canada each year will suffer some form of neonatal encephalopathy.

Hypoxic ischemic encephalopathy (HIE) accounts for a significant proportion of babies who suffered neonatal encephalopathy. In fact, hypoxic ischemic encephalopathy (HIE) is the most common cause of acquired brain injury in full term infants.

HIE is known to cause cerebral palsy. So if your baby has suffered HIE, your child is also at risk of developing cerebral palsy. The reverse is also true, if your child has been diagnosed with cerebral palsy, there is a good chance that your baby suffered HIE during labour and delivery.

HIE is a preventable injury

What parents need to know is that HIE and the resulting cerebral palsy is an entirely preventable injury.

The most important tool medical professionals have to prevent children from suffering a brain injury during labour and delivery is the Electronic Fetal Monitor (EFM). This machine monitors the fetal heart rate during delivery. Medical professionals are trained to read the EFM tracing and to understand when the baby is suffering from oxygen deprivation that may put the child at risk of brain injury.

If the medical professionals (doctors and nurses) do not pay attention to the EFM or fail to interpret the EFM tracing properly, babies can suffer asphyxiation leading to brain injury caused by Hypoxic Ischemic Encephalopathy.

Most birth injury lawsuits involve allegations that the doctors and nurses failed to act promptly when the EFM tracing showed the baby was in distress.

If your baby suffered Hypoxic Ischemic Encephalopathy you need to investigate whether there was any negligence during labour and delivery.

For more information about how the EFM works you can read my article: Electronic Fetal Monitoring: What is it and Why is it Important to the Safety of Your Baby?

Neonatal Cooling

Neonatal cooling is a treatment that is used to reduce or eliminate brain injury caused by Hypoxic Ischemic Encephalopathy. Since 2007 it has been standard practice in hospitals across Canada to “Cool” infants who are born with signs of moderate to severe HIE. Cooling has been scientifically proven to reduce the negative impact (morbidity and mortality) of HIE.

Cooling is the only available treatment for babies who have suffered brain injury caused by asphyxiation.

However, what parents are not being told is that the reason their baby is being cooled is because there may have been negligence during their delivery.

How many victims of cerebral palsy were caused by negligence during labour and delivery?

The potential numbers are staggering.

Every single child in Canada that has received neonatal cooling treatment in the last ten (10) years is (by definition) a victim of HIE.

Since we know that HIE is a preventable injury, every single child that has received neonatal cooling is a potential victim of medical malpractice.

We know that only a small handful of birth injury claims (less than a dozen) are filed across Canada every year.

But there are thousands of infants across Canada every year who are cooled because they suffered HIE during delivery. One study by the Canadian Neonatal Network followed just 31 hospitals across Canada with neonatal intensive care units for a period of two years. That study found that over 200 children were treated with neonatal cooling between 2010 to 2012.

Every single one of these babies had a potentially preventable injury. Every single one of these babies is a potential victim of medical malpractice.

However, there is no doubt that the vast majority of parents of these infants have no idea their child’s injuries could have been prevented.

What parents need to know

• Hypoxic ischemic encephalopathy (HIE) is a preventable injury;
• Neonatal Cooling is used to treat HIE;
• If your baby underwent neonatal cooling because of HIE it means your child suffered a potentially preventable birth injury;
• If your baby was diagnosed with HIE and/or underwent neonatal cooling you need to speak to a birth injury lawyer about your options.

Want more information?

If your child has suffered an injury that you think may have been caused by medical malpractice you can get a free copy of Birth Injury Lawsuits: A Parent’s Guide by contacting me through this blog. You can also download a copy here. Or you can call us toll free at 1-877-423-2050 and we will send you a print copy.

I co-authored Birth Injury Lawsuits: A Parent’s Guide with the other members of the Birth Injury Lawyers Alliance, a group I helped found that is dedicated to advocating for the effective representation of children with preventable birth injuries.

Photo via University College London (UCL) –

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