Neonatology Expert Witness

Neonatology expert witnesses evaluate the care newborns receive in the delivery room, the newborn nursery, and the neonatal intensive care unit. They review delivery records, resuscitation documentation, Apgar scores, cord blood gases, NICU flowsheets, lab trends, and neuroimaging to assess whether the newborn was stabilized properly, whether problems were recognized and treated in time, and what role the care after birth played in the child’s outcome.

Cases commonly involving neonatologists include delayed or inadequate resuscitation at delivery, failure to start therapeutic hypothermia in an eligible infant, untreated or undertreated hypoglycemia, severe jaundice that progressed to brain injury, delayed diagnosis of neonatal sepsis, and medication or feeding errors in the NICU. Many of these cases involve permanent neurological injury, which makes both liability and damages highly contested.

Timing is often the central question in birth injury litigation. When a child has brain injury, the parties will dispute whether it happened before labor, during labor and delivery, or after birth. A neonatologist can address the postnatal piece, including whether the newborn’s condition at birth, blood gas results, and early course point toward an acute injury around delivery, and whether delays in resuscitation, cooling, or treatment of complications made the injury worse. These opinions usually work alongside those of an obstetrician and a pediatric neuroradiologist, and the experts need to tell a consistent story.

Therapeutic hypothermia has become a frequent issue because it is time-sensitive. Cooling is generally most effective when started within the first six hours after birth, so experts look at when the infant was identified as a candidate, whether the hospital could provide cooling or needed to transfer, and how long the process took. Hospitals without a NICU face questions about their transfer protocols and whether the newborn was stabilized before transport.

The strongest neonatology experts are board certified in neonatal-perinatal medicine through the American Board of Pediatrics and actively practice in a NICU. Experience at both large academic centers and community hospitals helps an expert speak to the standard in the setting where the care took place. Attorneys should also consider whether the expert has published or taught on the specific condition at issue, such as hypoxic-ischemic encephalopathy or neonatal hypoglycemia, since causation opinions in these cases draw close scrutiny.