NEC and Malpractice Lawsuits

October 27, 2021 | Attorney, Matthew Dolman
NEC and Malpractice Lawsuits Few times in our lives are more exciting and joyful than the birth of a child. Babies follow their own schedule, and sometimes that means they are born prematurely. A preemie is any child born before 37 weeks of gestation or a child born weighing less than five and a half pounds.

Premature Birth Statistics

It is surprising how many births end prematurely. According to Brave Beginnings, there are approximately 500,000 premature births on an annual basis. It is not surprising that most multiple births (twins, triplets, etc.) come prematurely. At one time, blindness was common with premature births because doctors placed these infants in incubators. More than 2,500 premature births resulted in blind babies. Fortunately, doctors have nearly eradicated this phenomenon today. However, this does not minimize the other risks associated with premature birth, and everyone on the medical team should take every precaution and monitor infants for these issues.

Risks Associated with Premature Births

Premature birth creates numerous risks, some preventable and caused by inadequate care. Some of the common issues a premature baby may face include
  • Anemia - Preemies are often subjected to multiple blood tests to check for signs of infection or other problems. Because of this, they cannot often regenerate the red blood cells, which can lead to anemia.
  • Breathing problems - According to the March of Dimes, numerous breathing issues are associated with premature birth. Premature birth can result in apnea or other more serious lung issues.
  • Jaundice - When an infant's liver has not fully developed, it is common for a child to have a buildup of bilirubin, which can result in the child requiring treatment for jaundice. This can also occur in children who are born at term.
  • Patent ductus arteriosus (PDA) - When the valves on the infant's ductus arteriosus fail to close properly after birth, the resulting condition can cause heart and breathing problems.
  • Susceptibility to infection - An infant who is born prematurely has a lower ability to fight off infection. This could lead to any number of problems, including sepsis. This is why everyone must take proper care when handling the infant.
  • Retinopathy of prematurity (ROP) - In most cases, ROP is mild, and an infant will not suffer any permanent vision loss. Approximately 500 premature babies will lose their sight from ROP.
  • Necrotizing enterocolitis (NEC) - The result of a breakdown of the tissue in the intestine that damages or kills intestinal tissue.
Many premature babies develop normally once they have been cared for in a neonatal unit. However, in some cases, the medical team overlooks symptoms of problems. One of the more overlooked serious problems is NEC.

Understanding Necrotizing Enterocolitis (NEC)

NEC is an intestinal illness that occurs in newborns. This illness develops in the lower intestine of premature or low birth weight newborns. When manifesting, the cells in the intestine become damaged, or the cells themselves die, causing other problems. This problem can develop as soon as three days after birth. Upwards of 10 percent of premature infants will contract NEC. In most cases, NEC can be diagnosed early and treated, resulting in good outcomes. However, when your medical team fails to properly identify this infection, producing devastating outcomes. Medical malpractice attorneys can help families recover financially from the neglect of their medical team.

Challenges of Diagnosing NEC

While NEC is complicated and rare, it presents symptoms that should result in the infant's medical team looking for causes. Some of these symptoms include:
  • Blood in the stool
  • Fever and lethargic behavior
  • Abdominal discoloration, swelling, or bloating
  • Green fluid found in stomach contents
  • Diarrhea and vomiting
  • Poor feeding
  • Apnea and other breathing issues
As you can see, some of these symptoms are similar to other conditions that may occur in premature infants. This makes diagnosing the cause of these symptoms critical to a better outcome for the infant. Once the symptoms of NEC appear, the diagnosis can be confirmed by checking the gas pattern in the intestines using x-ray technology. An X-ray may show a streaky or bubbly appearance in the walls of the intestine. In advanced cases of NEC, air may escape and manifest in the large veins in the abdomen or liver, which may require drawing fluid from the infant's belly to determine if the intestine has a hole.

Treatment and Follow-Up Medical Care of NEC

Doctors must monitor infants' stools for blood and regularly check stomach sizes. Swelling in the stomach can create additional issues including difficulty breathing. Any breathing issues may require regular oxygen. If this is insufficient, they may require intubation with a ventilator. Regular blood tests must monitor the infant for bacterial accumulation and check for anemia. Typically, the treatment for NEC includes:
  • Suspend Feedings - In most cases, there will be a need to stop providing regular feeding to the infant.
  • Begin Drainage - Using a drainage tube inserted either nasally, or through the mouth is used to remove air and fluid from the intestine and stomach.
  • IV Treatments - To ensure the infant is hydrated and getting nutrients, infants may receive intravenous fluids and nutrients.
  • Infection Prevention - Infants may receive antibiotics even with no sign of infection as a preventative. If there are already signs of infection, there is also a need for antibiotics.
  • Examinations and X-Rays - Any infant treated for NEC will require frequent abdominal X-rays and exams to monitor their progress.
  • Surgical Options - The medical team should consult with a pediatric surgeon upon diagnosis if the case becomes severe and surgery becomes the only option.
After the treatment regimen, most often the infant should only receive breast milk or specialized formula.

How a Medical Professional Can Prevent NEC

Because NEC typically attacks premature infants, an expectant mother's medical team can prevent NEC by avoiding premature birth. However, when these steps fail and an infant is born prematurely, then the infant's medical team must ensure the mother knows the dangers of NEC and advise her of ways to prevent it. This includes encouraging the mother to nurse, use sterilized milk bank breast milk, or feed the infant a special formula. When a medical team fails to take this preventative action, their actions can be considered negligent, and the resulting illness can result in significant additional hospitalization and medical costs, illness, and unfortunately, in some cases, death. A parent should never have to worry about mounting medical bills when their child requires care that a medical professional could have avoided by properly monitoring their child for NEC. A medical malpractice lawyer can help hold the responsible parties accountable for their negligent handling of your infant's care.

Baby Formula and NEC

One reason why doctors should inform a mother about NEC after giving birth to a premature baby: A growing number of cases of NEC are linked to baby formula. Often, to boost the infant's weight, neonatal intensive care units (NICU) turn to high-calorie cow-milk-based formulas like Similac or Enfamil. A growing number of studies indicate feeding these formulas to an infant can also increase their risk of NEC. Whether your infant developed NEC because your medical team failed to prevent premature birth, failed to identify the potential symptoms, or failed to advise you of the higher risk of NEC associated with infant formulas, you should seek assistance from an attorney to determine if you should file a claim against those medical professional(s).

Medical Malpractice Legal Challenges Are Difficult

You must take several procedural steps to hold a medical professional accountable for their mistakes. First, your lawyer may perform a thorough investigation to identify the party or parties you can hold accountable. Then another medical professional with the same or similar knowledge to the liable party must agree there is sufficient reason to believe proper precautions could have prevented the injury to your child. These steps require someone who has experience dealing with these types of cases. Chances are, you do not have the resources to help you identify them on your own. Once this process is complete, you must notify the liable party of your intention to file a lawsuit 90 days before said filing. Within 90 days, you can expect to hear one of three results from the liable party's insurance company:
  • They admit liability.
  • They offer to settle.
  • They reject your claim.
If the insurer admits liability and includes an offer to settle, you have only 50 days to accept their offer. However, this will start negotiations, not the end of the case. First offers are seldom the final word because insurance companies make them to just settle the suit and avoid paying anything more than necessary.

Ongoing Health Concerns Complicate NEC Malpractice Lawsuits

While many infants recover from NEC without many complications, in some cases, there are conditions parents should carefully monitor their child for in later years. Nearly upwards of one-half of all infants develop long-term complications despite treatment. The two primary issues include:
  • Intestinal stricture - The intestine narrows, making it difficult for food to pass through. Pain, bloating, constipation, and fatigue can result—similar to the challenges facing adults with Crohn's disease.
  • Short-bowel syndrome - The infant may have had a portion of their intestine damaged so severely they had to have it removed or the infection damaged the intestine so seriously it is shorter.
  • Other complications - While rare, some children experience recurring NEC, cholestatic liver disease, or other metabolic complications.
When evaluating a settlement offer, you must know what the child's care may cost going forward and what other health issues they may face as they grow up. Remember, once a settlement offer is officially accepted, the insurance company bears no liability for future costs of care.

Advocates for Parents and Infants

When an infant suffers preventable NEC, they deserve an advocate. As new parents, you have your hands full caring for your child, and you must focus on making sure they are as healthy and well-cared for as possible. The additional stress of dealing with insurance company adjusters will only take away the time you have to care for your child. That is why you need a strong advocate on your side. Parents who believe their child is suffering because of medical mistakes resulted in NEC need a birth injury lawyer with medical malpractice experience. These experienced professionals will serve as an advocate for both the parent and child. A new parent should never have to worry about the high cost associated with the treatment of NEC when the medical team could have prevented it. The Dolman Law Group works with local counsel in any jurisdiction outside Florida for the purpose of filing lawsuits in jurisdictions wherein we are not licensed. Thus, we will follow each State's ethical rules to ensure a local attorney is involved.


Matthew Dolman

Personal Injury Lawyer

This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has successfully fought for more than 11,000 injured clients and acted as lead counsel in more than 1,000 lawsuits. Always on the cutting edge of personal injury law, Matt is actively engaged in complex legal matters, including Suboxone, AFFF, and Ozempic lawsuits.  Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess of $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.

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