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Neonatal Jaundice, Hyperbilirubinemia and Kernicterus

Most newborn infants develop a total serum or plasma bilirubin (TB) level of greater than 1 mg/dL.  As the bilirubin level increases, it can produce neonatal jaundice.  Jaundice is the yellowish discoloration of the skin and/or whites of the eyes caused by bilirubin deposition in the tissues.

Neonatal hyperbilirubinemia in newborn infants born at greater than or at 35 weeks gestational age is defined as a total serum or plasma bilirubin (TB) greater than the 95th percentile on the hour specific Bhutani nomogram (Figure1).

Hyperbilirubinemia can be caused by certain conditions or amplification of the processes responsible for neonatal jaundice.  The most common cause of hyperbilirubinemia is increased production of bilirubin due to hemolytic diseases that include the following:

  1. Isoimmune – mediated hemolysis (e.g. ABO or Rh(D) incompatibility).
  2. Inherited red blood cell membrane defects.
  3. Erythrocyle enzymatic defects like glucose-6-erythropoietic dehydrogenase (G6PD) deficiency.
  4. Sepsis, and
  5. Breast feeding failure.

Severe neonatal hyperbilirubinemia is defined as a TB greater than 25 mg/dL.  It is associated with an increased risk for the development of Bilirubin-Induced Neurologic Dysfunction (BIND) which happens when bilirubin crosses the blood-brain barrier and binds to brain tissue.

Acute Bilirubin Encephalopathy (ABE) is a term used to describe the acute manifestations of BIND which include:  Sleepiness, lethargy, hypotonia, high-pitched cry, poor suck, irritability, arching of the back or trunk. Kernicterus is a term used to describe the chronic and permanent sequelae of brain damage caused by bilirubin toxicity.

Infants with kernicterus have movement disorders known as “dystonic” or “athetoid” cerebral palsy.  The athetoid form of cerebral palsy refers to slow, writhing movements.  Dystonia refers to abnormal muscle tone.  Some children with kernicterus are deaf.  Most infants and children with kernicterus are profoundly impaired and require lifelong care. Kernicterus is almost always preventable.  The major risk factors for developing kernicterus are:

  • Predischarge total serum or plasma bilirubin in the high-risk zone defined as greater than the 95th percentile for age.
  • Jaundice within the first 24 hours of life.
  • G6PD deficiency.
  • Gestational age 35 to 36 weeks.
  • Failure to recognize risk factors for developing hyperbilirubinemia.
  • Failure to timely test bilirubin levels.
  • Failure to treat hyperbilirubinemia.

We Define Success By Getting You The Compensation You Need

The attorneys at The Lancione Law Firm are among the most prominent and respected medical malpractice and birth injury firms in Ohio, successfully handling Kernicterus cases for infants and their families. The firm has obtained multi-million dollar settlements of Kernicterus claims on behalf of their clients. Due to the mobility challenges faced by most children and their families, The Lancione Law Firm will visit clients wherever it is convenient. The firm prides itself on strong, effective and sensitive representation and focuses on obtaining the maximum compensation for each claim. When The Lancione Law Firm accepts a case, you can be confident that they will successfully pursue every reasonable lead to ensure your future is protected.

Call Us To Learn More About How We Can Help You

When your child is injured due to the negligence of a medical professional in the hospital, you should contact an attorney who is experienced in birth injury claims to evaluate your legal options. For a free initial consultation, we welcome you to contact us online or call 440-331-6100. The Lancione Law Firm accepts most medical malpractice cases on a contingency basis, meaning fees are not received until the claim is successful.

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$22 Million Dollar Settlement

A child who suffered severe brain damage resulting in Kernicterus, caused by the hospital’s failure to properly interpret bilirubin levels.

$15.5 Million Dollar Settlement

A baby boy who suffered brain damage and cerebral palsy due to nurses failing to notify obstetrician that the baby was experiencing fetal distress.

$14.2 Million Dollar Settlement

A baby girl who suffered brain damage and cerebral palsy due to nurse failing to follow hospital policy.

$12.6 Million Dollar Settlement

A baby girl diagnosed with cerebral palsy after obstetrician failed to respond to signs of fetal distress.

$9 Million Dollar Settlement

A child who suffered severe brain damage resulting in cerebral palsy. The child was delivered by emergency cesarean section following uterine rupture.

What Our Clients Say

I have so much heartfelt gratitude for Lancione & Lancione. John Lancione is nothing short of knowledgeable, readily accessible, and honest. Not only was his team professional and capable, but they were also genuine and compassionate. It was difficult reliving the facts of my daughter’s case, but I was able to see how diligently John worked on her behalf. His experience was invaluable at the critical moments, and we were fortunate to have this team representing us. While the circumstances of our case will always be hapless and emotionally tragic, John skillfully guided us through the process and led us to a satisfying outcome which affords my daughter with the on-going care she needs and me with the peace that I was seeking. Crystal Rinker

What Our Clients Say

John Lancione is an upstanding person. He has incredible passion for what he does and infinite knowledge of law. John and his team are personable and professional. My daughter was born with severe medical complications due to negligence, and the first time I contacted John’s law firm, I spoke directly with him. Within the next few days, John traveled to my home where we went over the details of my case. He was forthright and reviewed my case diligently. John and his firm were always reachable and got back to me quickly with any information. Although, this was a difficult time for my family, John made it positive. Whenever we would speak of my daughter, or when he would call just to see how she was doing, he always used her name. As small as that sounds, it is true to the type of person that he is. He always made me feel as though my daughter were more than just another case number; and that she is a human being. Incredible person!! I highly recommend him to anyone!!!!!!!! Amanda Green

Representing Families Affected By Birth Injuries

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