Meconium is a baby’s first stool. About 10% of babies are born through meconium stained amniotic fluid. In and of itself, meconium stained fluid is not harmful to the baby. However, if meconium is ingested into a baby’s lungs, such as when a baby attempts to take their first breath after birth, this is called meconium aspiration and this can obstruct a baby’s airway. This obstruction can prevent a baby’s ability to breath which, if not timely corrected, can lead to serious complications include brain damage. When a newborn baby’s airway is obstructed from meconium, doctors and other medical providers are trained to perform neonatal resuscitation in an effort to clear the airway and help baby begin breathing. However, improperly performed neonatal resuscitation in the presence of meconium stained fluid can form the basis for a medical malpractice case if it leads to serious injury or death.Neonatal Resuscitation for Meconium Airway Obstruction
If a baby is born in a hospital in the US, the hospital must supply at least one medical professional knowledgeable and skilled in neonatal resuscitation for every delivery. This includes knowing how to manage a baby born through meconium stained fluid. Simply because a doctor has a certificate in neonatal resuscitation is not sufficient. The resuscitator must understand that neonatal resuscitation follows certain steps. These steps follow the ABCs of resuscitation. A stands for airway. B stands for breathing. And C stands for circulation. (There is often a third letter, D, which stands for drugs which may be necessary in certain instances.) Each step of neonatal resuscitation must be performed correctly before moving on to the next step. For example, a baby cannot Breath if their Airway is obstructed with meconium stained fluid.
If a baby is not breathing because of meconium obstruction, the medical provider will nearly always attempt to clear the airway. To do this, a doctor will insert an airway tube or endotracheal tube into the baby’s trachea. With the ET tube properly in place, the baby’s airway will be suctioned through the tube. In the very rare event the baby is still not breathing after suctioning, the doctor will move on to B or breathing. Often referred to as positive pressure ventilation, the doctor effectively pushes air through the ET tube and into the baby. In the most highly unusual cases where the baby is still not breathing, the doctor will often move to Circulation and, if necessary, Drugs. However, as soon as ventilation is established, nearly all newborns will begin breathing and show a rapid improvement in their overall condition. This is particular true of meconium babies. Failing to carefully perform the steps of neonatal resuscitation can cause serious harm or even death, constituting medical malpractice.
In addition to providing competent medical staff, a hospital must have a system in place to ensure all neonatal resuscitation equipment is readily available at every delivery. The equipment required for every delivery is outlined in a book called the Neonatal Resuscitation Program textbook. The NRP textbook also outlines the steps for performing neonatal resuscitation. The equipment need at delivery includes many items, including a laryngoscope, endotracheal tubing, and a meconium aspirator. Backup equipment should also be available. Failing to provide the necessary equipment for neonatal resuscitation can form the basis for medical malpractice lawsuit.Most Meconium Babies Suffer No Permanent Harm
Most babies born through meconium stained fluid experience no permanent harm. This of course assumes the medical provider complied with the standard of care using the necessary supplied equipment. Even babies who go on to develop meconium aspiration syndrome, where the meconium enters the lungs and causes respiratory problems, suffer no lasting effects from this condition. However, in severe cases of meconium aspiration syndrome or MAS, meconium aspiration babies may require Extracorporeal Membrane Oxygen Treatment or ECMO. With ECMO, a machine that works like an artificial lung and circulates blood through the machine and back then back into the baby’s blood stream. Although this advanced life support treatment saves lives, the treatment itself carries its own risks including the risk of brain damage. Effective neonatal resuscitation can reduce the likelihood of needing ECMO treatment from meconium aspiration.
If a baby has suffered serious injury or death from meconium aspiration, a competent medical malpractice lawyer can investigate the case and help determine what may have gone wrong. For further information, contact Jason Kroot of Kroot Law, LLC for a free and confidential evaluation.