Failure to Identify Neonatal Jaundice or Infection: How Missed Diagnoses Lead to Catastrophic Birth Injury Claims

Newborns are uniquely vulnerable in the hours and days following delivery. Among the most critical early threats are neonatal jaundice and neonatal sepsis (infection). Both conditions are highly treatable if detected early — yet when healthcare providers fail to recognize or act on warning signs, the outcome can be devastating. For attorneys handling birth injury and wrongful death litigation, these cases often reveal clear failures in monitoring, documentation, and escalation of care.

Neonatal Jaundice and the Risk of Kernicterus

What is neonatal jaundice?
Jaundice occurs in more than 50% of newborns, caused by elevated bilirubin levels. Normally, bilirubin is processed by the liver, but in newborns, immature liver function can lead to dangerous buildup.

Progression to kernicterus:
If untreated, bilirubin crosses the blood-brain barrier and causes kernicterus, a form of permanent brain damage. This condition is preventable, yet it remains a common cause of malpractice litigation.

Signs often overlooked:

• Yellowing of the skin or eyes (especially in the first 24 hours).

• Lethargy, excessive sleepiness, or poor feeding.

• High-pitched crying, irritability, or arching of the body.

Treatment protocols:

• Bilirubin testing: Required when jaundice is suspected.

• Phototherapy: Standard treatment to lower bilirubin levels.

• Exchange transfusion: For severe cases to rapidly reduce levels.

Legal implications:
Failure to order bilirubin testing, delayed phototherapy, or discharging the baby too soon without follow-up often forms the basis for malpractice claims. Attorneys should scrutinize:

• Hospital discharge instructions and whether bilirubin re-checks were ordered.

• Pediatric follow-up documentation within the first 48 hours.

• Whether treatment thresholds were consistent with American Academy of Pediatrics (AAP) guidelines.

Neonatal Sepsis: Rapidly Fatal if Missed

What is neonatal sepsis?
Sepsis is a life-threatening infection in newborns caused by bacteria entering the bloodstream. It can develop within hours and requires immediate treatment with intravenous antibiotics.

Why it’s missed:
Symptoms are often subtle and nonspecific, leading to delay in recognition.

Warning signs that should not be ignored:

• Temperature instability (fever or hypothermia).

• Poor feeding, vomiting, or refusal to nurse.

• Breathing difficulties, rapid breathing, or apnea.

• Irritability, seizures, or altered responsiveness.

Consequences of delay:

• Shock, multi-organ failure, and death within hours.

• Long-term brain injury for survivors.

Legal implications:
Missed or delayed sepsis diagnoses often involve:

• Failure to order blood cultures, CBC, or lumbar puncture when infection was suspected.

• Delay in starting broad-spectrum IV antibiotics.

• Inadequate maternal risk assessment (e.g., maternal fever, prolonged rupture of membranes, Group B Strep status).

• Lack of NICU transfer when red flags were present.

Attorneys should pay close attention to timeline reconstruction — identifying when early symptoms first appeared and whether immediate action was taken.

Litigation Focus: Proving Negligence in Missed Neonatal Diagnoses

Cases involving kernicterus or neonatal sepsis often hinge on whether providers adhered to established standards of care:

• Monitoring & screening protocols

  • Was bilirubin screening performed before hospital discharge?

  • Were sepsis risk factors documented and acted upon?

• Escalation of care

  • Was the infant referred to NICU or higher-level care when symptoms persisted?

  • Were specialists consulted in a timely manner?

• Documentation gaps

  • Missing or incomplete progress notes, discharge instructions, and lab results can show a lack of diligence.

• Timeliness of intervention

  • Attorneys often find that the difference between survival and death was only a matter of hours.

How Lexcura Summit Supports Attorneys in Neonatal Cases

At Lexcura Summit Medical-Legal Consulting, our team of over 200 board-certified clinicians provides in-depth medical review to strengthen birth injury and wrongful death cases. We deliver:

• Medical Chronologies – Clear, organized timelines highlighting missed red flags.

• Narrative Summaries – Easy-to-understand case overviews for judges and juries.

• Life Care Plans – Comprehensive projections for infants with permanent disabilities due to kernicterus or sepsis.

• Expert Witness Preparation – Ensuring attorneys have the clinical insight needed for strong depositions and courtroom strategy.

Our reports are litigation-ready and delivered within 7 days (rush service in 2–3 days).

Key Takeaways for Attorneys

• Neonatal jaundice and sepsis are common, treatable, but potentially fatal if ignored.

• Failure to diagnose or treat can lead to catastrophic, lifelong consequences including brain damage, cerebral palsy, or death.

• Litigation success often depends on reconstructing the timeline and proving that providers failed to act on early warning signs.

With Lexcura Summit, you gain speed, precision, and trusted medical insight to secure the best outcomes for your clients.

Partner With Lexcura Summit

Contact us today to discuss how we can support your next neonatal injury case.

📞 (352) 703-0703
🌐 www.lexcura-summit.com