What is Kernicterus?
Jaundice (yellowing of the skin) is common in both term and pre-term infants in the neonatal period. It is caused by bilirubin, which is produced during the normal breakdown of red blood cells in the body. Bilirubin is normally removed from the blood by the liver, but when an infant's liver is unable to remove enough bilirubin, the excess amount in the blood causes the skin to take on a yellowish color. Excess bilirubin in the blood is called hyperbilirubinemia, and is easily treated.
Kernicterus occurs when hyperbilirubinemia is left untreated and bilirubin reaches dangerously high levels in the blood. This can cause permanent brain damage and even lead to death. Many infants that do survive kernicterus experience avoidable impairments such as vision and hearing loss, mental retardation, developmental delays, and cerebral palsy. Permanent deficits caused by kernicterus are unnecessary and wholly preventable.
The most common sign of an infant at risk for kernicterus is the yellowing of the skin and/or sclera (whites of the eyes). It is essential that these infants have bilirubin levels closely monitored and treatment begun immediately to decrease the amount of bilirubin in the blood. Other signs in an infant that alert to dangerous levels of bilirubin in the blood include:
- A shrill, high-pitched cry
- Weakness or difficulty waking baby up
- Arching of the back
- Dramatic increases or deceases in muscle tone
- Poor feeding
Can Kernicterus be Prevented?
Kernicterus is prevented by closely monitoring an infant's bilirubin levels, and beginning treatment early to avoid unnecessary permanent brain damage and death. Once hyperbilirubinemia is suspected, bilirubin levels should be evaluated by your infant's physician. If hyperbilirubinemia is diagnosed, treatment should begin immediately so as to keep bilirubin from reaching dangerous levels.
Treatment for excessive jaundice is easily managed by hydration, increased feeds and phototherapy. In more severe cases of hyperbilirubinemia and with acute kernicterus, a blood transfusion may be recommended for your infant so as to prevent further brain damage and death.
Doctors and nurses are trained to identify the signs of hyperbilirubinemia, and treatment is easily implemented. Brain damage or death that is sustained as a result of kernicterus is avoidable, preventable, and unnecessary.
Was My Infant Treated In Time?
Medical negligence and mismanagement of hyperbilirubinemia leading to kernicterus can arise in many different manners:
- Delay in the treatment of excessive bilirubin by waiting for lab results and/or repeat lab results
- Negligent assessment of hyperbilirubinemia
- Negligent assessment for signs of acute kernicterus
- Failure to compare serial bilirubin levels with age-specific norms
- Delaying or interrupting phototherapy for diagnostic tests
- Allowing bilirubin to reach dangerously high levels before initiating treatment
The deficits an infant suffers caused by kernicterus are devastating, and are wholly avoidable when managed properly. The attorneys of The Becker Law Firm, L.P.A., in Cleveland, Ohio, represent children harmed by the mismanagement of hyperbilirubinemia and kernicterus by doctors and nurses.
