Dallas Kernicterus Lawyer
When Severe Newborn Jaundice Leads to Permanent Neurologic Injury
Kernicterus is a permanent neurologic injury caused by bilirubin toxicity. When severe newborn hyperbilirubinemia was not appropriately identified, monitored, followed, or treated, the medical record may raise serious questions about whether preventable errors contributed to a child's injury.
At Law Office of Kelly Liebbe, families work directly with Kelly Liebbe from the first conversation through the resolution of an accepted case. Kelly personally reviews the medical records and limits the number of birth injury matters she accepts so she can remain directly involved in the medical and legal analysis.
Kelly has represented families in Texas birth injury, medical malpractice, and hospital malpractice matters since 2007.
Call (855) 650-3359 or contact us online to discuss your child’s jaundice diagnosis and possible kernicterus claim directly with our office.
How Severe Hyperbilirubinemia Can Cause Kernicterus
Jaundice occurs when bilirubin accumulates in a newborn's blood.
Some degree of jaundice is common in newborns. The medical concern is whether bilirubin rises to a level that creates a risk of neurologic injury and whether the infant receives appropriate assessment, monitoring, follow-up, and treatment.
When unconjugated bilirubin reaches neurotoxic levels, bilirubin can enter brain tissue and cause acute bilirubin encephalopathy. Severe bilirubin neurotoxicity can result in permanent kernicterus.
Kernicterus can be associated with serious neurologic effects, including hearing loss or auditory neuropathy and choreoathetoid cerebral palsy, a movement disorder that can involve involuntary or poorly controlled movements.
The child's own medical providers must evaluate the diagnosis, neurologic effects, treatment needs, and prognosis.
Our broader birth injury practice addresses medical negligence allegations involving labor, delivery, and newborn care.
Bilirubin Monitoring Is More Than Looking for Visible Jaundice
Visual jaundice is only part of newborn assessment.
Transcutaneous bilirubin, or TcB, devices estimate bilirubin through the skin and can be used as a screening tool. Total serum bilirubin, or TSB, measures bilirubin through a blood sample and is the definitive measurement used for treatment and escalation decisions when indicated.
The significance of a bilirubin result depends on more than the number alone.
Relevant clinical considerations can include:
- The baby's age in hours
- Gestational age
- The bilirubin level and how quickly it is rising
- Hemolysis or risk of hemolysis
- Sepsis or clinical instability
- Other bilirubin neurotoxicity risk factors
- Prior testing and treatment
- The timing and adequacy of post-discharge follow-up
A legal review asks whether the monitoring and treatment decisions reflected the information that was available at the time.
Potential Failures in Jaundice Monitoring & Treatment
A kernicterus diagnosis does not automatically establish malpractice.
The legal question is whether a physician, hospital, nurse, or other health care provider departed from the applicable standard of care and whether that departure caused or contributed to the bilirubin-related injury.
Depending on the medical record, review may focus on whether providers:
- Recognized significant jaundice or other clinical warning signs
- Obtained appropriate TcB or TSB measurements
- Correctly interpreted bilirubin results in light of the baby's age and clinical risk factors
- Recognized hemolysis or other conditions that increased risk
- Monitored a rising bilirubin level appropriately
- Provided appropriate phototherapy when indicated
- Escalated care when bilirubin reached dangerous levels
- Considered exchange transfusion when clinically required
- Provided appropriate discharge instructions and follow-up
- Responded appropriately when jaundice worsened after discharge
No individual item proves negligence on its own.
The timing, laboratory results, treatment thresholds, clinical condition, and qualified medical interpretation must be considered together.
How Kelly Liebbe Evaluates a Kernicterus Claim
The review begins with a direct conversation about the pregnancy, birth, hospital stay, discharge, jaundice, testing, treatment, and any later neurological diagnosis.
You work directly with Kelly.
After the firm is retained, Kelly personally reviews the medical records rather than passing that responsibility to an associate or case manager.
Depending on the case, relevant records may include:
- Delivery and newborn records
- Nursing assessments
- Bilirubin laboratory results
- TcB screening records
- Phototherapy documentation
- Blood typing and hemolysis-related testing
- Discharge instructions
- Pediatric follow-up records
- Emergency-department or readmission records
- Neurology, audiology, imaging, and rehabilitation records
Kelly also works with qualified physicians and other medical professionals who can evaluate the standard of care, causation, and the child's medical needs.
A poor outcome alone is not enough. The medical evidence must support both a departure from accepted care and a connection between that departure and the injury being claimed.
Families in Dallas and throughout Texas can call (855) 650-3359 or contact our office through the form to discuss a possible kernicterus claim with Kelly Liebbe.
Potential Compensation for a Kernicterus Injury
Compensation depends on the child's injuries, future needs, defendants, and losses supported by medical and financial evidence.
Economic damages may include:
- Past and future medical care
- Rehabilitation and therapy
- Audiology or hearing-related care
- Assistive technology and equipment
- Long-term attendant or custodial care
- Home or vehicle modifications
- Lost future earning capacity when supported by the evidence
Texas medical liability law treats noneconomic damages differently.
Pain, suffering, mental anguish, and similar noneconomic damages are subject to statutory caps under Texas Civil Practice and Remedies Code Chapter 74. Different limits can apply depending on whether the defendants are physicians, other health care providers, one institution, or multiple health care institutions.
Those noneconomic caps do not operate as a general cap on properly supported economic damages such as necessary future medical and custodial care.
No specific recovery can be predicted before liability, causation, future needs, and applicable damages law have been evaluated.
Texas Filing Deadlines Require Individual Review
Texas health care liability deadlines are not safely calculated from a child's age alone.
Texas Civil Practice and Remedies Code § 74.251 generally establishes a two-year limitations period and contains a special statutory provision for children under age 12. The statute also establishes a 10-year statute of repose.
Texas courts have addressed constitutional issues involving the application of limitations rules to a minor's own medical malpractice claim, which makes the analysis more complicated than simply selecting one date from the statute.
Additional procedural requirements also matter.
Before filing a Texas health care liability lawsuit, a claimant generally must provide statutory written notice to each physician or health care provider at least 60 days in advance, along with the required medical authorization. Proper notice can also affect the limitations calculation.
Because the child's age, treatment dates, defendants, notice, and other facts can change the analysis, families should not assume they have until a particular birthday or until the end of the 10-year period.
