Boyes Turner 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. What is SCBU? SCBU (often pronounced scaboo) is the abbreviated name for the ‘special care baby unit’. In some hospitals the specialist care unit for babies may be called the neonatal intensive care unit (NICU) or neonatal unit (NNU), depending on the level of monitoring, treatment and breathing support that it provides for the baby. Common reasons for admission to SBCU Our clients have come to us because they have a serious injury which was caused by maternity or neonatal mistakes. Most have been, or should have been, admitted to SCBU because their condition required specialist care, observation and treatment. The most common reasons we see for an injured baby needing special care include: 1. Hypoxic-ischaemic encephalopathy (‘HIE’) HIE is damage to a newborn baby’s brain caused by a lack of oxygen. This may occur during labour and around the time of birth if the unborn baby is not getting enough oxygen. An unborn baby or fetus who is struggling to take in oxygen may show signs of fetal distress. The fetal heart rate should be monitored regularly during labour and if baby is showing worrying signs, steps should be taken to deliver the baby quickly. A baby who has suffered distress before birth may still struggle to breathe after delivery. Neonatal staff must be ready to resuscitate babies immediately after birth to avoid further brain injury. Babies with HIE from lack of oxygen around the time of birth have suffered severe, permanent injury. They need therapeutic cooling and specialist care on SCBU or NNU. 2. Kernicterus Kernicterus is a specific pattern of brain damage caused to a newborn baby as the result of severe, untreated jaundice. Kernicterus is avoidable with correct neonatal care. Jaundice is the name given to the yellow discolouration of the skin and the whites of eyes and is caused by a build-up of a yellow substance caused bilirubin in the blood. Jaundice is common in newborn babies and is often harmless, resolving itself over a short period of time. However, if the level of bilirubin is allowed to get too high it can cause permanent brain damage. Signs of jaundice in a newborn baby must be noted and bilirubin levels must be checked regularly. If treatment is needed, the baby must have phototherapy or exchange transfusion treatment. Treatment must take place before bilirubin levels get dangerously high to prevent kernicterus brain damage. Babies who have suffered kernicterus brain damage from untreated jaundice should be cared for on NNU or SCBU. 3. Hypoglycaemia Hypoglycaemia is the medical term for low blood sugar (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 with no long-term implications, but if the baby’s blood sugar level is allowed to drop too low this can cause seizures and long-term brain damage. 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 damage from hypoglycaemia might not be obvious immediately but can become seriously disabling to the child at school and in later life. 4. 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, or permanent disability from septicaemia or amputation. 5. 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 (sometime called haemorrhagic disease of the newborn) 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 on SCBU. How can Boyes Turner help? Each of the conditions discussed above can cause severe injury and lifelong disability. In each type of case, we have specialist experience which enables us to establish quickly whether the injury was caused by medical negligence. In many such cases, such as where a baby suffers brain damage from kernicterus, it is highly likely to have been caused by errors of care. Where this has happened, we help the family cope with the costs and impact of their child’s injury and provide for their lifelong needs through their entitlement to compensation. 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, and behavioural problems. Whilst it is best to seek legal advice as soon as possible after negligent care has caused injury, many of these difficulties are not always noticeable straight away. We are also highly skilled at bringing claims for teenagers and young adults whose increasing awareness of their difficulties causes them to investigate a negligent birth or neonatal injury. These cases are complex. They must be handled by specialist solicitors with a proven track record of recovering full compensation to provide for the child’s immediate and life-long needs. We are proud to have recovered millions in compensation for clients who have experienced cerebral palsy and severe neonatal neurological injury. We also have a special educational needs team who can help children affected by neonatal brain injury secure appropriate educational support for their child within the school that is right for them. Legal aid is available for cerebral palsy and neonatal neurological injury claims caused during pregnancy, birth or the first eight weeks of the baby’s life. Where our specialists believe the injured child is eligible for Legal Aid and has a viable claim, we apply for Legal Aid on the child’s behalf. If you have suffered severe injury from medical negligence and would like to find out more about making a claim, contact by email at mednegclaims@boyesturner.com