What are Hypoxic and Anoxic Brian Injuries?
Hypoxic and anoxic brain injuries may occur whenever oxygen supply and delivery to the brain is compromised. Hypoxia results when the brain is partially deprived of oxygen, leading to permanent brain damage. Anoxia is the result of the brain completely and totally losing its oxygen supply, thereby leading to severe permanent brain damage.
Hypoxic Brain Injury: Partial Oxygen Deprivation
While hypoxic brain injury results where there is a partial supply of oxygen to the brain, that supply is nevertheless inadequate to maintain normal brain function.
Oxygen delivery to the brain may be partially restricted for a wide variety of reasons. Hypoxic brain injury commonly arises due to interruptions of blood flow to the brain, typically resulting from cardiac or respiratory arrest, strangulation, suffocation, choking, and severe asthma. Broader systemic health issues which affect the oxygen content of the blood may also cause hypoxic brain injury, such as severe anemia and hypotension. Other causes of hypoxic brain injury include traumatic vascular injuries, near-drowning, smoke inhalation, exposure to carbon monoxide poisoning, hemorrhagic and septic shock, drug overdoses, electric shock, and acute lung injury.
The symptoms and side-effects of hypoxic brain injury can range from mild to severe. Mild symptoms include lack of concentration, reduced attention, poor coordination, memory issues, slurred speech, difficulty moving one’s body, dizziness, and headaches. By contrast, the more severe symptoms of hypoxic brain injury include seizures, loss of consciousness, coma, hallucinations, and death.
Anoxic Brain Injury: Complete Oxygen Deprivation
The causes of anoxic brain injury are quite similar to the factors causing hypoxia, as described above. The only difference is that such causes result in a complete deprivation of oxygen where the individual experiences anoxia. Causes of anoxic brain injury include stroke, cardiac arrest, low blood pressure, near drowning, carbon monoxide poisoning, choking, and drug overdose.
In terms of symptomatology, similar to hypoxic brain injury, anoxia can also present as mild or severe. Where anoxic brain injury is severe, it will result in loss of consciousness and coma. Depending on whether the individual emerges from a coma, they will likely experience significant cognitive, physical, and emotional changes. For example, a patient with anoxic brain injury may have memory loss, deficits with executive functioning and processing, balance and motor deficits such as ataxia, fatigue and weakness, and a host of behavioural and psychological changes.
How Can a Lawyer Help With Your Hypoxic or Anoxic Brain Injury Claim?
It is widely accepted medical knowledge that injury to the brain cells can begin within minutes, and therefore must be treated in a timely manner in order to prevent permanent brain injury. The responsibility of involved health care professionals, therefore, is to ensure prompt diagnosis and intervention.
Where brain injury results from hypoxia and anoxia which is not treated in a timely and appropriate manner, it can have severely damaging effects on an individual and will forever change their lives. The role of the legal professional in such a case is to investigate whether the quality of medical care and treatment provided to the patient was within the accepted standard of care, and, if not, to advocate on behalf of the client with respect to compensating for the life-altering effects of their hypoxic and/or anoxic brain injury.
A Primer on Hypoxic and Anoxic Brain Injury Cases in Canada
The body of case law in Canada dealing with issues of hypoxic and anoxic brain injuries are largely in the nature of birth injury cases. Such cases usually involve delayed delivery of a child, which results in hypoxic ischemic encephalopathy to the newborn.
In Gutbir v. University Health Network, 2012 ONCA 66, the Plaintiff mother went into labour and was admitted to the defendant hospital between 7 and 8 a.m. The Plaintiff minor was born at 3:45 p.m. She was blue, silent, and permanently brain damaged. At trial, the jury found the defendant obstetrician and hospital liable. The jury found that the defendants breached the requisite standard of care based on the manner in which they monitored the fetal heart rate of the baby prior to delivery; there were clear fetal heartbeat abnormalities which ought to have been detected, but were not, and which would have required earlier intervention by emergent delivery of the baby had they been detected. Instead, due to the negligence of the defendants in failing to monitor the fetal heart rate, the Plaintiff minor was deprived of oxygen to her brain for nearly three hours in utero. She was born with permanent brain damage and lives with cerebral palsy as a result. The Court of Appeal upheld the jury’s finding of negligence and the award of damages in the amount of $5,500,000 to the Plaintiff minor.
In Butler v. Royal Victoria Hospital, 2017 ONSC 2792, the Plaintiff attended the defendant hospital for delivery of her twin babies. The defendant nurses artificially ruptured the membranes of one of the Plaintiff’s twins, Sarah, which resulted in a compression of the umbilical cord for approximately 25 minutes. About thirty minutes after rupturing the membranes, the Plaintiff infant was delivered by emergency Caesarean section. Upon birth, she suffered a hypoxic ischemic event and required resuscitation with intubation. She lives today with cerebral palsy and numerous other cognitive and behavioural impairments. The defendants conceded a breach of the standard of care. The only issue at trial was whether artificially rupturing the membranes caused the newborn’s hypoxic ischemic encephalopathy, and whether that is the etiological cause of her cerebral palsy and other impairments. The court found that the test for causation was met by the plaintiffs.
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