Boyes Turner’s medical negligence solicitors are specialists in cerebral palsy, birth injury and neonatal care negligence claims, which means that most of our severely disabled child clients, and their families, will have spent time in the hospital’s SCBU, NNU or NICU. What are SCBU, NNU and NICU? SCBU (often pronounced scaboo) is the abbreviated name for the ‘special care baby unit’. In some hospitals the specialist care unit for newborn babies is called the neonatal unit (NNU). Newborn babies who are very seriously unwell and need intensive care levels of monitoring, treatment and breathing support may be admitted to the neonatal intensive care unit (NICU). Why has my newborn baby been admitted to the neonatal unit? One of the first things that happens when a newborn baby is found to be seriously unwell at birth is that they are transferred to SCBU, NNU or NICU. This can be worrying for a mother who has just given birth to be separated from her newborn baby so soon, but it may be necessary if the baby needs very close monitoring and observation or treatment from the specialist neonatal team, such as respiratory support or therapeutic cooling. The midwife or another clinician from the maternity team should tell the parents why their baby is being transferred to the neonatal unit. The neonatal team should keep parents informed about their baby’s condition and obtain their consent where it is necessary for certain treatments, such as cooling. They should also support parents in spending time and, where possible, enjoying contact with their baby on the neonatal unit. Does a newborn baby’s admission to SCBU or NICU mean that they have suffered a serious birth injury? Hospitals and other maternity units generally prefer a healthy newborn baby to remain with their mother, to experience the benefits of early skin-to-skin contact and bonding, and to establish a healthy, regular pattern of feeding. Newborn babies can require a short period of specialist neonatal care for many reasons, such as being born prematurely or small for dates, or because they need additional help with breathing, or treatment for hypoglycaemia or infection. In some cases, however, the baby’s admission to SCBU or NICU may be because they have suffered a birth injury or a neonatal injury. Certain types of birth or neonatal brain injury must also be reported by the hospital or maternity unit to NHS Resolution and, with parents’ consent, to MNSI for investigation. What are common reasons for a baby with birth injury to need care on SCBU, NNU or NICU? Some of the most common reasons that we encounter where a baby who has been injured as a result of negligent maternity or neonatal care has needed specialist neonatal care on NNU, NICU or SCBU include: HIE birth injury HIE (hypoxic ischaemic encephalopathy) is a condition suffered by babies whose brains have been damaged by lack of oxygen during labour or around the time of birth. HIE birth injury can be negligently caused by various circumstances in which the blood and oxygen supply to the baby’s brain is compromised, such as by hyperstimulation of the mother’s uterus with the uterine stimulant Syntocinon in labour, compression of the umbilical cord, delays in delivery of a baby suffering from fetal distress, and delays in resuscitation or clearing the baby’s airway of meconium immediately after birth. The fetal heart rate should be monitored regularly during labour, and if the baby is showing worrying signs, steps should be taken to deliver the baby quickly to restore the baby’s circulation and oxygen supply before the hypoxic injury to their brain causes permanent disability. A baby who has suffered distress before birth may struggle to breathe after delivery. Neonatal staff should be warned that a compromised baby is about to be born, and must attend the birth ready and equipped to clear the baby’s airway and resuscitate them immediately to restore their oxygen supply and prevent further hypoxic brain injury. Babies with moderate (grade 2) or severe (grade 3) HIE are usually recommended to commence therapeutic cooling within six hours after birth in a specialist neonatal intensive care unit (NICU). Kernicterus Kernicterus is a specific type of damage to a newborn baby’s brain that is caused by severe, untreated jaundice. Most people are familiar with the term ‘jaundice’ which is the name for the yellow discolouration of the skin and the whites of eyes that is caused by a build-up of a yellow substance called bilirubin in the blood. Jaundice is common in newborn babies and is often harmless, resolving naturally over a short period of time. However, if the baby’s bilirubin exceeds a safe level, it can cause kernicterus brain injury and lifelong disability. Signs of jaundice in a newborn baby must be recognised and the baby’s bilirubin levels must be checked regularly. If the bilirubin level fails to resolve or there is a risk of it becoming dangerously high, the baby will need treatment with phototherapy or an exchange transfusion to prevent permanent disability from kernicterus brain injury. Treatment for babies with worrying bilirubin levels or kernicterus brain injury will usually take place on the SCBU, NNU or NICU. Kernicterus is avoidable with correct neonatal care. If a baby’s kernicterus brain injury occurred whilst they were in hospital or receiving community midwife care, it is likely to have been caused by medical negligence. Hypoglycaemia Hypoglycaemia is the medical term for low blood sugar (low glucose). This can occur in newborn babies for a variety of reasons, including premature babies who struggle to feed during their first few days of life. Neonatal hypoglycaemia is often treatable simply by feeding, with no long-term consequences, but if the baby’s blood sugar level is allowed to drop too low this can cause seizures and permanent damage to the baby’s brain. It is important that babies’ blood glucose levels are monitored correctly, that feeding difficulties are addressed and that timely treatment is given where necessary. For this reason, babies with hypoglycaemia should be cared for on SCBU/NNU. The effects of brain injury from hypoglycaemia might not be obvious immediately but can result in serious physical, behavioural and learning disability which only becomes evident during the child’s school years and adult life. Early onset meningitis Meningitis is a life-threatening infection resulting in inflammation of the protective membranes which cover the brain and spinal cord. Babies with meningitis need urgent treatment with intravenous antibiotics. They are seriously ill and should be treated on SCBU, NNU or NICU. Delays in recognising the symptoms of meningitis, delays in diagnosis, referral or urgent admission to hospital for urgent antibiotics can lead to death, brain injury, septicaemia or sepsis, and permanent disability. Vitamin K deficiency bleeding (‘VKDB’) VKDB is a rare blood clotting disorder caused by a shortage of Vitamin K. Newborn babies are unable to make their own Vitamin K and are at risk of serious brain injury from bleeding into their brain. To avoid vitamin K deficiency bleeding (sometimes called haemorrhagic disease of the newborn or HDN) it is standard practice for all newborn babies to be given vitamin K, either by injection or orally, immediately after birth to avoid brain injury and serious disability. Babies who have suffered VKDB in the neonatal period should be cared for in a specialist neonatal unit, such as NICU. Specialist solicitors for birth injury and neonatal brain injury claims Each of the conditions discussed above can cause severe injury and lifelong disability. Just as severe illness in the neonatal period must be treated in a specialist neonatal unit, claims involving birth injury and neonatal brain injury should be handled by specialist solicitors. Boyes Turner’s birth injury and neonatal brain injury solicitors have specialist skills and experience which enable us to establish quickly whether the child’s injury was caused by medical negligence. We have helped severely injured children with a wide range of impairments and long-term difficulties. These include cerebral palsy, spasticity, athetosis, severe cognitive damage, learning disability, delayed development, impaired control of movement, damage to senses, difficulty with feeding, impaired speech and communication, behavioural problems and autism/ADHD. Whilst we recommend seeking legal advice as soon as possible after negligent care has caused injury, the full impact of the child’s disability may not be noticeable straight away. We are also highly skilled at securing compensation in claims for teenagers and young adults whose increasing awareness of their difficulties causes them to investigate (or reinvestigate) a negligent birth or neonatal injury. Our specialist solicitors have a proven track record of recovering maximum-level interim payments and final compensation settlements which provide for the child’s immediate and life-long needs. We work closely with our special educational needs (SEN) team to ensure that our brain-injured client children secure the educational support that they need within the school that is right for them, and our Court of Protection deputyship team to support our clients in managing and protecting their compensation whilst ensuring that funds are accessible to meet their needs. If your child has cerebral palsy or neurodevelopmental disability as a result of medical negligence, or you have been contacted by HSSIB/MNSI or NHS Resolution, you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.
