Houston NICU Malpractice Lawyer

Why Newborns End Up in the NICU

Babies are admitted to the NICU for many reasons. Prematurity and low birth weight are among the most common, along with respiratory distress, infections, severe jaundice, low blood sugar, and complications during labor and delivery.

Some NICU admissions are unavoidable, while others are the direct result of negligence that happened before the baby ever reached the unit. When the labor and delivery team fails to respond to problems during the delivery process, a baby may arrive in the NICU already carrying a serious injury.

Fetal Distress During Labor and Delivery

Fetal distress means the baby is not tolerating labor well, often because of reduced blood flow or oxygen. Problems with the umbilical cord, such as cord compression or prolapse, placental abruption, uterine rupture, and a prolonged or obstructed labor can all cut off a baby’s oxygen supply.

When fetal distress is recognized and managed quickly, usually through an expedited delivery, many babies are born without lasting harm. When it is missed or mismanaged, however, prolonged oxygen deprivation can cause a permanent brain injury before the baby is even born. Difficult deliveries complicated by shoulder dystocia or improper use of instruments can also cause physical trauma, including a head injury, broken bone, nerve damage, or, in rare cases, spinal cord injuries. In any case, a fetal distress injury lawyer in Houston can help determine whether the delivery team responded appropriately.

Fetal Monitoring Failures That Lead to NICU Admission

During labor, electronic fetal monitoring tracks the baby’s heart rate and the mother’s contractions. Labor and delivery nurses and physicians are trained to read these tracings and spot warning signs, such as late decelerations, reduced variability, or a persistently high or low baseline heart rate.

Misreading the tracings, ignoring concerning patterns, or failing to notify the physician can leave a struggling baby in distress for far too long. Even when the problem is recognized, a delay in moving to an emergency C-section can make the difference between a healthy baby and a severe injury. In many cases, the HIE, seizures, or brain damage treated in the NICU can be traced directly to a delay caused by these failures before birth.

Failure to Recognize and Respond to Abnormal Findings

A NICU baby’s condition can change in minutes, and the team is responsible for catching those changes early. Negligence often involves missing shifts in vital signs, drops in oxygen saturation, rising bilirubin levels, or dangerously low blood glucose. It can also involve lab results or imaging, such as a head ultrasound showing an intracranial hemorrhage, that are not reviewed or acted on in time. When abnormal findings sit unaddressed, a treatable problem can quickly become a severe injury.

Delayed Intervention for Infection, Jaundice, and Respiratory Problems

Newborns can become critically ill from infection with very little warning. Delayed diagnosis of sepsis, meningitis, or necrotizing enterocolitis (NEC) can allow the illness to spread, damaging organs and the brain. Early signs, such as temperature instability, feeding intolerance, lethargy, or a swollen abdomen, must be taken seriously.

Jaundice is common in newborns and usually harmless, but when bilirubin levels climb too high and go untreated, the result can be kernicterus, a permanent form of brain damage. Phototherapy and, when needed, exchange transfusions are effective treatments, which is why failing to monitor and treat jaundice is so serious. Likewise, a slow response to breathing problems, such as apnea episodes or worsening respiratory distress, can lead to oxygen deprivation and neurological injury.

Medication and Dosage Errors

Newborns receive tiny, weight-based doses of medication, often measured in fractions of a milliliter. That leaves almost no margin for error. One of the most dangerous mistakes in the NICU is a tenfold error, such as a misplaced decimal point, that gives a baby ten times the intended dose. Other errors include giving the wrong drug, giving a medication to the wrong patient, or giving it by the wrong route, such as into a vein instead of a feeding tube. Medication records are often key evidence in proving that one of these errors occurred.

Oxygen and Ventilator Errors

Oxygen therapy requires a careful balance. Too little oxygen can starve the brain and lead to hypoxic brain injury. Too much oxygen, particularly in premature infants, can damage the developing blood vessels of the eye and cause retinopathy of prematurity (ROP), which can lead to vision loss or blindness.

Babies on ventilators face additional risks. A breathing tube that slips out of place and isn’t noticed quickly can cut off a baby’s air supply. Incorrect ventilator settings, failure to adjust them as the baby’s lungs change, and slow responses to alarms can all cause lasting harm.

IV, Feeding Tube, and Line Errors

NICU babies often depend on IVs, feeding tubes, and central lines. When an IV slips out of the vein, fluid or medication can leak into the surrounding tissue. This is known as IV infiltration, and with certain fluids, it can cause severe burns, tissue death, and scarring. Similarly, a misplaced feeding tube can deliver nutrition into the lungs instead of the stomach. Central lines, which are threaded into large veins, must be inserted and maintained under strict sterile conditions, because central line infections can be life-threatening for a newborn.

Understaffing and Communication Breakdowns

Safe NICU care depends on having enough trained nurses for the number and severity of babies in the unit. When nurse-to-patient ratios are too high, alarms go unanswered, assessments are rushed, and subtle warning signs are missed. 

Handoff errors during shift changes can cause critical information about a baby’s condition to be lost. Nurses or residents may also fail to call the attending neonatologist when a baby is deteriorating. These system-level failures often point to hospital liability.