Guide to Hypoxic-Ischemic Encephalopathy (HIE) Lawsuits

Gregg Hollander | November 4, 2026 | Medical Malpractice

Your newborn may have needed resuscitation, intensive care, or cooling therapy shortly after delivery. Yet even after doctors explain the brain injury, questions about what happened during labor may remain unanswered.

An HIE lawsuit may be possible when medical mistakes caused or worsened the injury, but the diagnosis alone does not establish malpractice. The central question is whether timely, appropriate care would probably have changed your child’s outcome.

Founded in 1996 by Attorney Gregg Hollander, Hollander Law Firm represents Florida families affected by significant medical errors. In HIE cases, the difference between an unavoidable complication and malpractice hinges on critical decisions made during labor, delivery, or newborn care. We understand how to evaluate those decisions and determine whether a provider’s failure likely changed a child’s outcome.

Contact us online or call (561) 347-7770 for a free consultation. We can investigate the circumstances surrounding your child’s injury, explain your legal options, and help you determine the next steps.

What Is Hypoxic-Ischemic Encephalopathy (HIE)?

Hypoxic-ischemic encephalopathy is a type of brain injury caused by insufficient oxygen (hypoxia) and blood flow (ischemia). In newborns, the disruption may happen before birth, during labor or delivery, or shortly afterward. Deprived of what they need to function, brain cells can become damaged.

Signs may include:

  • Unusually weak muscle tone,
  • Poor responsiveness,
  • Irregular or slow heart rate,
  • Breathing problems,
  • Fatigue,
  • Difficulty feeding, or
  • Seizures.

These symptoms warrant urgent clinical assessment, but they can also occur with infections, metabolic disorders, and other conditions.

An HIE brain injury can have lasting effects, including movement disorders, epilepsy, or developmental disabilities.

What Are Common Hypoxic-Ischemic Encephalopathy Causes?

Common causes of HIE include a sudden or prolonged disruption of the baby’s oxygen supply or circulation.

Several obstetric emergencies can create that danger:

  • Placental abruption. The placenta separates from the uterine wall before delivery, potentially interrupting oxygen transfer to the baby.
  • Umbilical cord problems. Cord prolapse or significant compression can reduce circulation and may require rapid intervention.
  • Uterine rupture or major maternal bleeding. These emergencies can sharply reduce blood flow and endanger both parent and child.
  • Breathing or circulation failure after birth. A newborn who cannot establish adequate breathing or circulation may sustain further oxygen-related harm.

Maternal infection, placental disease, and conditions developing before labor can also contribute.

However, a difficult delivery does not, by itself, show that anyone was negligent. What matters legally is whether clinicians recognized the warning signs and responded reasonably.

What Does an HIE Diagnosis Mean?

A diagnosis of HIE indicates that the medical team believes a newborn’s neurological problems resulted from insufficient oxygen and blood flow.

Clinicians consider the neurological examination alongside several forms of evidence:

  • Blood gas tests. Doctors test blood from the umbilical cord or newborn shortly after birth to measure oxygen, carbon dioxide, and acidity levels. Excess acid in the blood may indicate that the baby experienced inadequate oxygen supply around delivery, although the test alone cannot establish the cause.
  • EEG monitoring. Recording brain activity helps detect seizures, including those without obvious movements.
  • MRI imaging. Brain scans can show patterns and the extent of injury, although they usually cannot pinpoint the exact moment damage occurred.

Doctors also assess alertness, reflexes, muscle tone, breathing, and feeding to classify the condition as mild, moderate, or severe. Mild cases may resolve with limited impairment. Moderate cases carry greater risks of lasting problems. Severe cases can involve profound neurological dysfunction and require extensive support.

What Is Common HIE Treatment?

Doctors first make sure the newborn can breathe and has stable blood circulation. For babies with moderate or severe HIE who were born at 36 weeks of pregnancy or later, the main treatment is therapeutic hypothermia, also called cooling therapy.

During cooling therapy, doctors use special equipment to lower the baby’s body temperature to approximately 92–94°F. This helps protect brain cells and limit further damage after oxygen deprivation. According to the American Academy of Pediatrics, cooling should begin within six hours of birth and continue for 72 hours. The baby is then gradually warmed to a normal body temperature.

Cooling therapy can help reduce the risk of disabilities, although it cannot reverse damage that has already occurred.

Other treatments may include:

  • EEG monitoring. Doctors place small sensors on the baby’s scalp to measure brain activity and detect seizures, including those that cause no visible movements.
  • Seizure medications. Babies who experience seizures may receive medication to control them and reduce further stress on the brain.
  • Breathing support. Some newborns need additional oxygen or a ventilator, a machine that helps them breathe, until they can breathe adequately on their own.

After leaving the hospital, children may need regular developmental evaluations to monitor their movement, learning, and communication skills. Physical, occupational, or speech therapy may also help address developmental difficulties as they grow.

How Do I Know Whether the HIE Brain Injury Was the Result of Medical Malpractice?

An HIE lawsuit may be possible if a doctor, nurse, or hospital failed to provide appropriate medical care and that failure caused or worsened your child’s brain injury. Under Florida law, you must establish that the provider failed to meet accepted medical standards and that proper care would more likely than not have prevented or reduced the harm.

Proving Medical Negligence in an HIE Case

An HIE diagnosis alone is not enough to show that a healthcare provider was responsible for your child’s injury.

To establish medical malpractice in Florida, you must prove four elements of negligence:

  • Duty of care. The doctor, nurse, or hospital had a professional responsibility to provide your child with appropriate medical care.
  • Breach of duty. The provider failed to deliver the level of care, skill, and treatment that reasonably careful healthcare providers in the same field would consider appropriate under similar circumstances. Examples include failing to respond to signs of fetal distress, delaying a necessary cesarean section, or failing to diagnose and promptly treat HIE.
  • Causation. The provider’s negligence must have more likely than not caused or worsened your child’s brain injury. You must show that appropriate care probably would have prevented or reduced the harm.
  • Damages. Your child suffered actual harm, which may include permanent neurological disabilities, ongoing medical expenses, and the need for long-term care.

Some newborns develop HIE despite appropriate medical treatment. A successful hypoxic ischemic encephalopathy claim must establish that a preventable medical error contributed to the injury, rather than simply identifying a complication during birth.

Florida’s NICA Program and Lawsuit Eligibility

Florida’s Birth-Related Neurological Injury Compensation Plan provides financial benefits for certain birth-related brain and spinal cord injuries without requiring families to prove medical negligence.

Under Florida law, eligibility depends on several factors, including:

  • When the injury occurred. The oxygen deprivation or mechanical injury must have occurred during labor, delivery, or immediate resuscitation after birth in a hospital.
  • The child’s condition. The injury must cause permanent and substantial mental and physical impairments.
  • Birth weight. The baby must have weighed at least 2,500 grams (approximately 5.5 pounds), or 2,000 grams (approximately 4.4 pounds) in a multiple birth.
  • The medical provider involved. A participating obstetric physician must generally have provided services during the birth.

If NICA applies, it generally replaces the right to pursue a traditional medical malpractice lawsuit against providers directly involved in the birth, although limited exceptions exist.

Hospitals and participating physicians must inform expectant parents about NICA, except in certain circumstances, such as medical emergencies. Whether the required notice was provided can affect the family’s legal rights. An administrative law judge determines NICA eligibility and resolves disputes about notice.

Hollander Law Firm can examine the circumstances of your child’s birth, evaluate whether NICA applies, and explain whether you may pursue a medical malpractice lawsuit or file a NICA Petition for Benefits.

FAQs

Can Severe Hypoxic Ischemic Encephalopathy Cause Cerebral Palsy?

Yes. Severe HIE can cause cerebral palsy when oxygen deprivation damages areas of a newborn’s brain responsible for movement and muscle control. Cerebral palsy is a lifelong condition that can affect a child’s posture, coordination, balance, and ability to move.

Children with cerebral palsy may experience muscle stiffness or weakness, difficulty walking, and problems with swallowing or speaking. However, not every baby with HIE develops cerebral palsy. The condition may not become apparent until months or years later, when the child begins missing motor development milestones, such as sitting, crawling, or walking.

How Long Do I Have to File an HIE Birth Injury Lawsuit in Florida?

Florida medical malpractice actions generally must be brought within two years of the incident or when it was, or reasonably should have been, discovered. However, you generally cannot bring the claim more than four years after the date of the accident.

A NICA petition must generally be filed within five years of birth.

If you fail to file your claim by the deadline, you generally cannot recover any compensation.

Who Could Be Responsible for the Injury?

Depending on the evidence, responsibility may involve:

  • An obstetrician,
  • Delivery nurses,
  • A hospital, or
  • Other providers responsible for newborn resuscitation and intensive care.

Determining who may be liable requires examining each provider’s decisions, how the medical staff communicated, and whether failures in care contributed to the child’s brain injury.

Discuss Your Hypoxic Ischemic Encephalopathy Claim with Hollander Law Firm

Understanding an infant’s brain injury requires a careful reconstruction of the events surrounding birth and the HIE treatment that followed. A viable HIE injury claim turns on what providers should have done, whether it could have changed the outcome, and which Florida legal process applies.

Hollander Law Firm represents families throughout Florida from its offices in Boca Raton, Fort Lauderdale, and West Palm Beach. We can assess the medical evidence, identify the experts needed to evaluate causation, and explain how NICA or Florida malpractice law may affect your options.

Contact our firm online or call (561) 347-7770 for a free consultation to discuss what happened during your child’s delivery and what the available records may reveal.

Legal References Used to Inform This Page

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