What Is a NICU (Neonatal Intensive Care Unit)?

Neonatal intensive care units (NICUs) play a vital role in caring for infants facing critical health challenges immediately after birth. This specialized medical facility can address various medical conditions that can arise during childbirth, demanding prompt and precise interventions to ensure the newborn’s well-being.

Despite notable advancements in neonatal care, the issue of medical malpractice remains a concern. This article delves into a comprehensive exploration of NICUs, identifying babies in need, investigating high-risk factors, highlighting the importance of specialized equipment, and recognizing the neonatal multidisciplinary team.

It also addresses the critical aspect of navigating challenges in the NICU, emphasizing the importance of understanding and preventing medical errors and seeking legal recourse when necessary.

Neonatal Intensive Care Unit (NICU): A Sanctuary for Vulnerable Newborns

Before birth, the baby relies on essential functions provided by the mother, including breathing, nutrition, waste elimination, and immune protection. Upon leaving the womb, a series of transformative changes must occur in the baby’s body systems, including the following:

• The lungs need to adapt to breathing air;
• There are alterations in cardiac and pulmonary circulation;
• The digestive system must initiate the processing of food and the elimination of waste;
• The kidneys need to commence their function of balancing fluids and chemicals while excreting waste;
• The liver and immune systems must begin independent functioning.

The baby’s body systems must seamlessly collaborate in this new postnatal phase. Challenges in making this transition can arise, particularly in cases of preterm birth, difficult deliveries or birth defects, amplifying the complexity of these changes.

Fortunately, specialized care is readily available to help newborns navigate these vital transitions. The Neonatal Intensive Care Unit, also known as the intensive care nursery or newborn intensive care unit, is a hospital facility designed to meet the needs of premature and critically ill infants.

Identifying Babies in Need

The NICU provides care for a wide range of needs, including premature births (before 37 weeks), low birth weight infants (less than 5.5 pounds), and those with specific health conditions. Twins, triplets, and other multiples, born smaller and earlier than their single counterparts, are frequently admitted to the NICU for close monitoring.

High-Risk Factors

Assessment for NICU admission involves evaluating numerous factors:

Maternal Factors

• Age extremes (below 16 or above 40)
• Substance use (drugs or alcohol)
• Diabetes
• Hypertension
• Bleeding
• Sexually transmitted diseases
• Multiple pregnancies
• Amniotic fluid abnormalities
• Premature rupture of membranes

Delivery Factors

• Oxygen deprivation-related organ system changes
• Abnormal birth positions
• Meconium passage during pregnancy
• Nuchal cord (umbilical cord wrapped around the neck)
• Instrument-assisted deliveries

Baby Factors

• Gestational age extremes
• Low or high birth weight
• Small for gestational age
• Respiratory distress, infections, birth defects, seizures
• Hypoglycemia
• Need for medical interventions or treatments

Medical Equipment in the NICU

At the heart of the NICU is advanced medical technology designed to provide precise care to newborns. It includes:

• Ventilators: Essential for assisting newborns with respiratory challenges by delivering controlled breaths.
• Incubators: Provide a controlled environment mimicking the womb for premature or unwell newborns.
• Monitors: Track vital signs in real-time, such as heart rate, blood pressure, and oxygen levels.
  • Vital signs monitor: Detect heart rate and breathing changes with chest pads.
  • Oxygen saturation monitors: Measure blood oxygen levels with sensors on the baby’s foot or hand.
  • Apnea monitors: Track breathing using a pad under the baby’s body.
• Phototherapy units: Phototherapy units treat conditions like jaundice by exposing infants to controlled light, aiding in the breakdown of bilirubin.

NICU Levels

NICUs have different levels, each tailored to address the specific needs of infants. The NICU levels are structured as follows:

• Level I: This level is for healthy full-term babies with no special needs or specific requirements.
• Level II: Reserved for newborns born near full-term, typically around 32 weeks, who may have additional health needs.
• Level III: Designed for at-risk babies born early, at less than 32 weeks, who may also face critical health issues.
• Level IV: Intended for newborns with diverse, complex health needs, requiring continuous, around-the-clock care.

The Neonatal Multidisciplinary Team

A team of specialized professionals provides care to infants in the Neonatal Intensive Care Unit (NICU). These professionals include the following:

• Neonatologists
• Respiratory Therapists
• Neonatal Fellows
• Neonatal Physician Assistants
• Neonatal Nurse Practitioners
• Neonatal Nurses
• Lactation Specialists
• Other Medical Personnel

Navigating Challenges in the NICU: Understanding and Preventing Medical Errors

In any medical setting, errors pose significant dangers, and the NICU presents unique risks to its vulnerable population. Challenges in NICU care for premature infants include potential consequences for routine actions, such as administering the wrong baby formula and the impact of mechanical ventilation on lung disorders.

Inadequate monitoring and delayed responses to breathing issues can lead to organ damage affecting cardiac and brain function.

Types of Mistakes That Qualify as NICU Medical Malpractice and Negligence

NICU medical malpractice and negligence encompasses a range of failures that can occur in any hospital setting. These may include:

• Neglecting visible signs of jaundice on the first day of life.
• Failing to assess bilirubin levels promptly.
• Neglecting the implementation of intensive phototherapy when necessary.
• Omitting jaundice screening evaluations.
• Neglecting proper documentation and charting of jaundice results.
• Overlooking hyperbilirubinemia.
• Failing to follow up with a jaundiced neonate.
• Inadequate resuscitation efforts at birth.
• Insufficient resuscitation while in the NICU.
• Neglecting proper monitoring of the infant.
• Failing to notify specialists about the baby’s condition.
• Delaying necessary treatment.
• Disregarding established procedures.
• Inadequate use of proper equipment.
• Incorrect utilization of medical equipment.
• Insufficient documentation and charting.
• Overlooking the treatment of group B strep infection.
• Failing to address infections or sepsis promptly.
• Providing incorrect drug dosages.
• Neglecting to keep necessary medical equipment readily available and operational.
• Failing to maintain equipment, machines, and medical devices leads to malfunctions.
• Mishandling or dropping the baby and unsafe infant handling practices.
• Errors in medication and prescription drug administration.
• Failure to diagnose medical conditions accurately.
• Neglecting the administration of surfactant to premature babies or those with respiratory stress disorder (RSD).
• Failing to transfer the baby to an appropriate NICU after delivery.
• Inadequate maintenance of NICU sterility and infection control.
• Delays in providing necessary treatments.

Seeking Legal Recourse for NICU Errors

The impact of NICU injuries resulting from medical malpractice is devastating for families. Specific errors in the NICU can increase the likelihood of a child developing Cerebral Palsy, a serious neurological condition. Additionally, the improper management of assisted breathing can contribute to or exacerbate respiratory issues in newborns.

Seeking legal recourse for errors occurring in a NICU is a complex process that requires a thorough understanding of medical malpractice law. A birth trauma lawyer can assist you in navigating the complexities of seeking compensation for these life-altering circumstances.

Successful legal actions can help ensure your child receives the necessary medical care and support for their ongoing needs.

Contact a Birth Trauma Lawyer at Sommers Roth & Elmaleh

If you believe that your child suffered harm due to negligence or errors in the Neonatal Intensive Care Unit, seek legal guidance. The legal professionals at Sommers Roth & Elmaleh specialize in medical malpractice cases, including those related to obstetric malpractice.

Our team of birth trauma lawyers is committed to standing by your side and providing the guidance needed to pursue fair compensation for the harm your child has endured. To schedule a free consultation and explore your legal rights, call 1-844-777-7372 or contact us here.