Birth injury cerebral palsy HIE attorney

Hypoxic ischaemic encephalopathy is brain injury caused by a lack of oxygen and blood flow around the time of birth. Where it results in cerebral palsy, the child requires care for a lifetime. These are among the most demanding claims in medical malpractice, because causation is genuinely difficult — not every case of cerebral palsy arises from events during labour. Law Offices Of SRIS, P.C. handles medical malpractice claims in Virginia, Maryland, the District of Columbia, New Jersey and New York.

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What the records must show

The fetal monitoring strips are the central document, and they must be obtained in full rather than in summary — they record the fetal heart rate pattern continuously and show whether concerning patterns developed, when, and how long they persisted before delivery. Alongside them: the labour and delivery notes, the timing of decisions, cord blood gas results, Apgar scores, the neonatal course, and MRI of the infant brain, whose pattern and timing of injury help establish when the insult occurred.

The causation problem

Cerebral palsy has many causes, and a substantial proportion of cases do not arise from events during labour — genetic factors, infection, developmental abnormalities and antenatal events all contribute. Establishing that an intrapartum event caused this child’s injury requires the monitoring evidence, the cord gases, the neonatal presentation and the imaging pattern to align. Qualified opinion from obstetric and neonatal or paediatric neurology practitioners is required, and honest assessment at the outset matters.

What the child needs

Therapeutic cooling within a narrow window after birth is an established intervention where the diagnosis is made in time, which is itself sometimes an issue. Beyond that, care is lifelong and extensive: physical, occupational and speech therapy, orthopaedic management including surgery, spasticity management, seizure treatment, feeding support, communication technology, mobility equipment, housing adaptation and attendant care. The claim is built as a catastrophic claim with a life care plan spanning decades.

How these claims are contested

Vigorously and on causation. That the injury occurred before labour began. That the monitoring pattern did not require earlier intervention. That earlier delivery would not have changed the outcome. That an underlying genetic or developmental factor explains the presentation. Each is answered — or honestly conceded — through the alignment of monitoring, cord gases, neonatal course and imaging pattern.

Building the claim properly

Obtain the complete records including the raw monitoring strips, not a summary. Establish the timeline of the fetal heart rate pattern, the recognition of concern, the decision to deliver and the actual delivery. Obtain the cord gases and the neonatal record. Obtain the infant MRI together with qualified opinion on the injury pattern and its likely timing. Then build the life care plan once the child’s clinical picture is sufficiently established, which takes years rather than months.

Available insurance coverage

What can be recovered is limited by what coverage exists. The at-fault party’s policy is the starting point, but it is frequently not the only source: the injured person’s own uninsured and underinsured motorist coverage, household policies, employer coverage where a vehicle was used for work, umbrella and excess layers, and the coverage of any additional responsible party can all apply. Underinsured coverage typically requires notice and consent before any settlement with the at-fault party — settling first can forfeit it. Identifying every available layer is early work, not closing work.

How damages are categorised and proven

Damages are not a single number that gets negotiated. They are separate categories, each proven by different evidence. Past medical expense is proven by billing records and the reasonableness of the charges. Future medical expense requires a physician’s opinion that the care is reasonably certain to be needed. Lost income is proven by employment and tax records; lost earning capacity is a different and larger question requiring vocational and economic analysis. Non-economic loss — pain, limitation, and the effect on daily life — is proven through the medical record and through testimony from people who can describe specific changes rather than general decline. No one can responsibly tell you what a case is worth before that evidence exists, and any figure offered at the outset is a guess.

Filing deadlines in medical malpractice

Medical malpractice deadlines differ from general personal injury deadlines and differ sharply between states. Virginia: two years under Va. Code § 8.01-243(A), generally accruing at the date of the negligent act, with extensions under § 8.01-243(C) for a foreign object, fraud or concealment, and certain malignancies, subject to an outer limit. Maryland: the earlier of five years from when the injury was committed or three years from when it was discovered, under Md. Code, Cts. & Jud. Proc. § 5-109, with separate rules for minors, foreign objects and reproductive-organ injuries. The District of Columbia has no malpractice-specific statute; the three-year catch-all at D.C. Code § 12-301(8) applies, with a discovery rule. New Jersey: two years under N.J.S.A. 2A:14-2, with a discovery rule and an early affidavit-of-merit requirement. New York: two years and six months under N.Y. C.P.L.R. § 214-a, accruing at the act or omission complained of, with a foreign-object discovery rule and a continuous-treatment toll. These are general periods only; confirm the deadline on your own facts without delay.

Frequently Asked Questions

What is HIE?

Hypoxic ischaemic encephalopathy — brain injury caused by insufficient oxygen and blood flow around the time of birth. Depending on severity it may resolve, or it may cause lasting neurological injury including cerebral palsy, seizure disorders and cognitive impairment.

Does cerebral palsy always mean something went wrong at birth?

No, and this is the central difficulty in these claims. A substantial proportion of cases arise from genetic factors, infection, developmental abnormalities or antenatal events rather than from labour. Establishing an intrapartum cause requires the monitoring, cord gases, neonatal course and imaging to align, and it warrants honest assessment.

What are the monitoring strips and why do they matter?

Continuous records of the fetal heart rate during labour. They show whether concerning patterns developed, when, and how long they persisted before delivery. They are the central document in these cases and must be obtained in full — a summary is not sufficient.

What is cooling therapy?

Therapeutic hypothermia, in which the newborn’s body temperature is lowered for a period to limit ongoing brain injury. It must be started within a narrow window after birth to be effective, so whether the diagnosis was made in time to offer it is sometimes itself an issue in the case.

What do cord blood gases show?

The acid-base status of the baby at delivery, which helps establish whether an oxygen-deprivation event occurred around birth and something about its severity and timing. They are important corroboration alongside the monitoring record and the neonatal presentation.

How long do these claims take?

Longer than most, because the child’s needs cannot be projected until the clinical picture is sufficiently established, which takes years. That is appropriate rather than delay — a life care plan spanning decades cannot be built from an uncertain baseline, and a settlement is final.

What will my child need long term?

Typically physical, occupational and speech therapy, orthopaedic management including surgery, spasticity and seizure management, feeding support, communication technology, mobility equipment, housing adaptation and attendant care. All of it across a lifetime, projected in a life care plan built from treating-physician opinions.

How long do I have to bring a claim?

Malpractice deadlines apply — two years in Virginia and New Jersey, the earlier of five years from injury or three from discovery in Maryland, three years in the District, and two years six months in New York — with tolling provisions that may apply for minors and specific rules in several states. Have it assessed immediately.

About Mr. Sris

Mr. Sris is the owner and founder of Law Offices Of SRIS, P.C., which has practiced since 1997. He is a former prosecutor and is admitted in Virginia, Maryland, the District of Columbia, New Jersey and New York. Of Counsel attorneys contract directly with the firm and handle matters alongside him. In 2019 Mr. Sris testified before the Virginia House Courts of Justice Committee on House Bill 635.

Speak with Mr. Sris

Injury claims are governed by filing deadlines that vary by state and by claim type, and evidence degrades quickly. Request a consultation. Reach our location at (888) 437-7747. Consultations are by appointment.

Last reviewed: August 22, 2026.

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