The most common error we see by nurses during labor and delivery that can lead to a baby suffering a Hypoxic-Ischemic Encephalopathy (HIE) brain injury at birth is the failure to adequately monitor and respond to a baby in distress. For our talk today a baby in distress often manifests as abnormal fetal heart rate patterns, which can indicate that the baby is not receiving sufficient oxygen. Below we will drill down further into how the failure to adequately monitor and respond to a baby in distress can manifest in real life.


Key errors include:


1. **Failure to Monitor Fetal Heart Rate (FHR) Properly**: Inadequate or incorrect use of fetal heart rate monitors, not recognizing or ignoring signs of distress.
2. **Delayed Response to Abnormal FHR**: Slow or inappropriate response to signs of fetal distress, such as delayed decision to perform an emergency C-section.
3. **Poor Communication**: Inefficient communication among the medical team, leading to delays in intervention.
4. **Inadequate Documentation**: Incomplete or inaccurate recording of the mother’s and baby’s vital signs and conditions, which can delay or misinform necessary medical decisions.

Proper training and adherence to monitoring protocols are critical to prevent these types of errors and ensure timely interventions that can prevent HIE. A parent of a baby diagnosed with Hypoxic-Ischemic Encephalopathy (HIE) can determine if the errors mentioned occurred by taking the following steps:

1. **Obtain Medical Records**: Request and review the complete medical records from the hospital, including prenatal, labor, delivery, and neonatal care documents. These records should include fetal heart rate monitoring strips, nurses’ notes, and doctors’ notes.

2. **Look for Signs of Fetal Distress**: Review the fetal heart rate monitoring strips for any signs of abnormal patterns indicating fetal distress. Look for documentation of decelerations, tachycardia, or bradycardia during labor.

3. **Check Response Times**: Evaluate the time intervals between the recognition of fetal distress and the interventions taken (e.g., administration of oxygen, changes in maternal position, amnioinfusion, or decision for an emergency C-section). Delays in response may indicate negligence.

4. **Assess Communication and Documentation**: Review the medical records for thoroughness and accuracy. Look for notes on communication among the healthcare team members. Poor or missing documentation can be a red flag for inadequate care.

5. **Consult with a Medical Expert**: Have the medical records reviewed by a medical expert, such as a neonatologist or an obstetrician, who can interpret the data and provide an opinion on whether the standard of care was met and if any errors contributed to the HIE.

6. **Legal Consultation**: Consider consulting with a birth injury attorney who specializes in birth injuries. They can help interpret medical records, gather expert testimony, and determine if there is a viable case for medical negligence.


By systematically reviewing these aspects, parents can better understand if the failure to monitor and respond to fetal distress contributed to their baby’s HIE diagnosis. As was mentioned above, failure to adequately monitor and respond to a baby in distress can be devastating to a baby in some cases and is the most common error we see by nurses during labor and delivery.


To speak with me further as to my firm helping you find out how this happened to your baby, I invite you to reach out to me at my contact info below so we can perform a birth injury investigation for you and your family. Remember, it does not cost you any money to talk with me initially about your baby’s story.


Marcus B. Boston, Esq.

Boston Law Group, LLC

9701 Apollo Dr. Suite 100

Largo, Maryland 20774


1-833-4 BABY HELP



Marcus Boston is a Maryland medical malpractice attorney who helps people navigate the Maryland childbirth injury and medical malpractice process to get money for their injuries caused by the carelessness of doctors and hospitals. BLG handles cases in Prince George’s County, Baltimore City, Montgomery County, Howard County, Anne Arundel County, and all other Maryland Counties. blgesq Maryland birth injury attorneys