Hawaii Injury Lawyer Blog

Some physicians are unaware of pre-surgical "bridging" protocols for patients who are chronically anticoagulated with coumadin. The bridging standard in some cases calls for physicians to administer lovenox in place of coumadin during surgery to prevent thromboembolism. Patients who are "at risk" (prior history of stroke, hypertensive, or other cardiac history) may be candidates for bridging therapy. Failing to bridge at-risk patients can result in stroke, and those patients may have a meritorious medical malpractice claim.

Plaintiff’s contended that nurses and physicians failed to appreciate non-reassuring indications during the labor process and that an expedited c-section would have prevented the child’s injuries. The fetal heart tracing revealed persistent variable decelerations followed by severe and prolonged decelerations and bradycardia thirty seven minutes prior to delivery. The child was transferred to a tertiary hospital where she responded remarkably well to a cooling protocol for hypoxic-ischemic encephalopathy. The child’s neurologic examinations were near normal and there was scant, if any, evidence of a cognitive injury. She was walking at ten months, communicating well at eighteen months and expected to be mainstreamed in the public school system. She was diagnosed with a mild left hemiparesis and gastrointestinal disorder; neither condition requiring attendant care.

This case involved neonatal injuries to premature triplets. One child was seriously injured and the other two were significantly less involved. The injuries were caused by a condition which can be treated if timely diagnosed. It is a common problem in premature infants. We contended that the hospital, neonatologist, and pediatricians failed to properly follow up and screen these children and failed to diagnose the condition in a timely manner. The defendants contended that the mother had been properly warned about the condition and failed to obtain exams in a timely fashion after the triplets were discharged from the hospital. This confidential settlement was believed to be the largest of its type in the history of the state at the time.

Psychological testing is commonly used in Hawai'i to establish the scope of a brain injury. The testing is performed by a licensed psychologist who administers numerous psychometric tests that assess a plaintiff’s ability to recall, recollect and process and information. The testing ordinarily lasts all day and can cause significant fatigue. Psychological testing is particularly important in cases involving a subtle brain injury. Often these plaintiffs will report complaints of short-term memory loss, impairment of executive function, and exhaustion from overworking the brain to process information that was formerly processed without difficulty. The “neuropsychometric tests” can elicit quantifiable information that supports the plaintiff’s contention of a brain injury. The testing is important in cases involving plaintiffs who, on the outside, appear to be fine; they walk, talk and otherwise seem to be cognitively intact to the casual observer. Often these types of plaintiffs are asked in litigation why they can’t return to work, or why they require attendant care. Neuropsychometric testing can identify specific processing problems and is a critical tool in proving the extent of any brain injury.

Birth injured children in Hawai'i who have sued their physician, nurse or midwife for negligently causing their birth injuries will need a life care plan to establish the extent of their future needs. The life care plan specifically identifies everything that the injured child will ever require in terms of hardware, therapies and attendant care. The life care plan is prepared by a rehabilitation physician often in coordination with a nurse. The physician and nurse will visit the child’s home, interview the parents and examine the child. They will prepare a written report detailing their findings that your attorney will use to prove your child’s damages.

Children may sustain brain injuries in the birthing process due to the negligence of their physician, nurse or midwife. If you, or someone you know, has a child with a brain injury from the birthing process, you should seek to have the records reviewed by an attorney who represents children in birth injury cases.