A birth injury involving brain damage is among the most devastating outcomes a family can face. When a newborn is deprived of oxygen during labor or delivery, the resulting brain injury can alter the trajectory of an entire life — shaping what a child can learn, how they move, and what they are capable of as they grow. What makes these cases particularly urgent is that many of these injuries are preventable. When physicians and delivery teams monitor properly, recognize distress signals, and respond in time, the brain is protected. When they do not, families are left to navigate the consequences of someone else’s failure.
Davis & Davis’s trial tested legal team, led by Steven R. Davis and John A. Davis, Jr., has spent nearly 70 years of combined experience representing Texas families in birth injury cases. We understand the medical and legal complexity these cases demand, and we bring both to bear for every client we serve.
What Is Hypoxic-Ischemic Encephalopathy?
Hypoxic-ischemic encephalopathy, or HIE, is a type of brain injury that occurs when a baby’s brain is deprived of adequate oxygen and blood flow around the time of birth. “Hypoxic” refers to insufficient oxygen; “ischemic” refers to reduced blood flow; and “encephalopathy” describes the resulting brain dysfunction. Research published in peer-reviewed medical literature estimates HIE affects approximately 1.7 in every 1,000 live births in the United States — and among those cases, many involve delivery room failures that competent, attentive medical care could have prevented.
The condition resulting from asphyxia can range from mild to severe depending on how long the brain was deprived of oxygen and how quickly treatment was initiated after birth. In severe cases, HIE causes permanent neurological damage with lifelong implications.
How HIE Occurs During Labor and Delivery
HIE most commonly develops when a complication during labor or delivery cuts off the baby’s oxygen supply. The delivery team is trained and expected to recognize these complications and respond promptly. Conditions that can trigger an HIE event include:
Umbilical cord complications — including prolapse, compression, or a nuchal cord wrapped around the baby’s neck — can abruptly restrict oxygenated blood flow. Placental abruption, in which the placenta separates from the uterine wall before delivery, causes sudden and severe oxygen deprivation. Uterine rupture, prolonged or obstructed labor, and maternal blood pressure crises each present warning signals that a monitoring team must detect and act on. When the fetal heart rate monitor shows patterns consistent with distress and the delivery team fails to escalate to an emergency cesarean section in time, the consequences can be permanent.
Physicians and nursing staff in the delivery room are responsible for continuously reading fetal heart rate tracings and identifying abnormal patterns. Failure to recognize those patterns, failure to notify the attending physician, and failure to perform a timely emergency delivery are among the most common negligent acts that lead to HIE birth injury lawsuits in Texas.
Warning Signs and Diagnosis of HIE in Newborns
Signs of HIE may be present at birth or emerge in the hours that follow. A newborn who required resuscitation at delivery, who has low APGAR scores at five minutes, who presents with seizures, poor muscle tone, or difficulty breathing should be evaluated for HIE without delay. Diagnostic tools used to confirm the injury and assess its extent include brain MRI, electroencephalogram (EEG) monitoring, and umbilical cord blood gas analysis.
Treatment for HIE must begin quickly. Therapeutic hypothermia — a cooling therapy that reduces the brain’s core temperature for 72 hours — has been shown to reduce the extent of neurological damage when initiated within six hours of birth. If this treatment window is missed, or if the indication for cooling therapy is not recognized by the care team, additional preventable harm can result.
The Long-Term Effects of Neonatal Brain Injury
HIE can carry lifelong consequences. Children who suffered moderate to severe oxygen deprivation at birth may develop cerebral palsy, epilepsy and seizure disorders, developmental delays, cognitive impairment, and difficulties with motor control, speech, and vision. The severity of these outcomes depends on the extent and duration of the oxygen deprivation and on how quickly appropriate treatment was initiated.
For families, the financial reality of these conditions is substantial. Ongoing medical care, physical therapy, occupational therapy, speech therapy, specialized educational services, adaptive equipment, and long-term care needs can accumulate into costs that span decades. A family facing these circumstances deserves legal representation that understands both the medical picture and the full scope of what those costs represent.
What Must Be Proven in a Texas Birth Injury Malpractice Case
A successful birth injury malpractice claim in Texas requires the same four elements as any medical malpractice case: duty, breach, causation, and damages. The duty and breach analysis focuses on whether the delivery team met the standard of care — what competent obstetricians, nurses, and hospital staff would have done under the same clinical circumstances. Expert testimony from board-certified obstetricians and neonatologists is required to establish these elements, and Texas law requires a written expert opinion within 120 days of filing suit.
Causation in HIE cases often turns on fetal heart rate monitoring data and delivery room records. If the records show that abnormal heart rate patterns were present for a period of time before an emergency cesarean section was performed, and an expert can testify that an earlier intervention would have prevented or reduced the brain injury, the causation element can be established. This is why preserving and obtaining complete delivery records — including all fetal monitoring strips — is critical from the earliest stages of an investigation.
Texas Law and What Compensation May Be Available
Texas law places a cap on noneconomic damages — compensation for pain, suffering, mental anguish, and related losses — in health care liability claims. Under Texas Civil Practice and Remedies Code Section 74.301, noneconomic damages against physicians and other healthcare providers are limited to $250,000 per claimant. Noneconomic damages against health care institutions are capped separately at $250,000, for a potential combined cap of $500,000 against institutional defendants.
Critically, Texas does not cap economic damages in medical malpractice cases. Compensation for medical expenses — both past and future — lost earning capacity, costs of long-term care and rehabilitation, and other financial losses is recoverable without limit. For children with severe HIE, the economic damages picture is often substantial, and pursuing the full recovery available under Texas law requires attorneys with the skill and determination to document and demand it.
Davis & Davis Fights for Texas Families Affected by Birth Injuries
When a newborn’s brain injury could have been prevented by attentive, competent medical care, the family left to cope with the consequences deserves full legal accountability. Davis & Davis’s trial tested legal team has the resources, the medical knowledge, and the litigation record to pursue these cases effectively on behalf of Texas families. We work on no upfront fees, and we do not collect unless we recover for you. To speak with our team about your family’s situation, please complete our contact form for a free case evaluation.
