Avoiding Medical Errors: Effectively Treating Kernicterus in Newborns

January 09, 2013

Avoiding Medical Errors: Effectively Treating Kernicterus in Newborns

Jaundice is a common condition among newborns whose livers are not yet mature enough to keep up with the body's production of bilirubin, a natural but potentially toxic chemical compound produced by the red blood cells. While jaundice often goes away on its own with little or no medical intervention, in severe cases it can lead to a devastating condition called kernicterus.

Kernicterus occurs when severe jaundice is left untreated and excess bilirubin is deposited in the brain. Because bilirubin is toxic to brain cells, this can result in severe, permanent brain damage and even death. Treatment of severe jaundice and kernicterus focuses on preventing bilirubin from reaching the brain, where it can cause permanent harm.

In many cases, jaundice and the early stages of kernicterus can be treated with phototherapy, a non-invasive technique that uses light to break down bilirubin and allow it to be removed from the bloodstream. With early detection and intervention, phototherapy can be effective at preventing jaundice from progressing into kernicterus, as well as preventing the early stages of kernicterus from worsening.

Blood Transfusion May Prevent Kernicterus from Progressing

When phototherapy cannot adequately reduce the bilirubin levels in an infant's bloodstream, an exchange transfusion may be necessary. An exchange transfusion removes bilirubin from the body by gradually replacing the baby's own blood with bilirubin-free blood from a donor.

During an exchange transfusion, doctors place one or more catheters, or thin tubes, into the baby's blood vessels. In several cycles lasting a few minutes each, doctors use the catheters to withdraw the infant's blood and replace it with an equal amount of fresh blood that has been pre-warmed to body temperature.

Depending on the baby's size and the severity of his or her condition, doctors typically replace between 5 and 15 mL per cycle, repeating the transfusion process over a period of several hours until the appropriate amount of blood has been exchanged. If bilirubin levels continue to rise after completion of the exchange transfusion, the procedure may need to be repeated one or more times.

Health Risks of Exchange Transfusions

While exchange transfusion can be highly effective at lowering toxic bilirubin levels and preventing kernicterus from becoming more severe, there are risks involved in the procedure.

For instance, while intensive screening of banked blood makes the risk of infection from known pathogens very small, there is some risk of infection from previously unknown pathogens that are not tested for in the screening process. Infection at the catheterization site is also a possibility, as are negative reactions to the donor blood, which may range from mild to severe and potentially fatal. In addition, as with any medical procedure, there is a risk of human error associated with the use of exchange transfusions to treat kernicterus.

Legal Help for Families Affected by Kernicterus

Kernicterus is a potentially devastating condition that is almost always preventable. If your child suffers from kernicterus as a result of a medical provider's failure to diagnose and treat severe jaundice, contact an attorney experienced in representing families of children affected by kernicterus to learn more about your legal options.

Article provided by Todd & Weld LLP
Visit us at http://www.kernicterus.com