Hypoxic-Ischemic Encephalopathy | Birth Injury Law Firm

What is Hypoxic Ischemic Encephalopathy (HIE)?

Brain Damages Caused by Conditions During Labor and Delivery

Hypoxic Ischemic Encephalopathy is a brain injury caused by reduced oxygen in the blood and decreased blood flow to the brain. This usually occurs around the time a baby is born. But HIE can occur at any time during a woman’s pregnancy, labor and delivery, or after the baby is born.

Caring for a Child with Brain Damage

Anterior Cerebral Artery (ACA)
The anterior cerebral artery (ACA) is one of a pair of cerebral arteries that supplies oxygenated blood to most midline portions of the frontal lobes and superior medial parietal lobes of the brain.

Middle Cerebral Artery (MCA)
The MCA supplies many deep brain structures, the majority of the lateral surface of the cerebral hemispheres, and the temporal pole of the brain.

Posterior Cerebral Artery (PCA)
The posterior cerebral artery (PCA) is one of a pair of cerebral arteries that supply oxygenated blood to the occipital lobe, part of the back of the human brain.

When brain cells are deprived of adequate oxygen and blood, they die. Irreversible brain damage is the result.

“Hypoxic Ischemic Encephalopathy due to fetal or neonatal asphyxia is a leading cause of death or severe impairment among infants.” - Cerebralpalsy.org

Babies with HIE usually have cognitive deficits, developmental delays, and serious disabilities like cerebral palsy. Their families face long-term and even lifetime consequences, including costly medical treatments, therapies, assistive devices and technology, and caregivers.

HIE is sometimes preventable. Doctors, nurses, midwives, and other medical staff should be aware of risk factors. Careful fetal monitoring and timely intervention could prevent or minimize brain damage for some infants. Failing to do so is medical malpractice.

And families of children harmed by medical malpractice often seek compensation for their child’s injuries from the parties that caused those injuries.

What Is Hypoxic-Ischemic Encephalopathy?

Hypoxic-ischemic encephalopathy (HIE) is a severe birth complication involving severe, permanent brain damage. It’s a complicated injury caused by a series of events. To understand what this condition is, we can start by knowing what each term means:

Hypoxic – means there’s a shortage of oxygen in the blood
Ischemic - means the blood flow is reduced
Encephalopathy – means disease, damage, or malfunction of the brain

Medical professionals may use other terms related to HIE, including:

Neonatal encephalopathy: Some medical professionals and researchers use this term in place of hypoxic-ischemic encephalopathy.
Intrapartum asphyxia: This term means oxygen deprivation that occurs during labor. Evidence of intrapartum asphyxia is seen in fetal umbilical arterial blood, fetal bradycardia (low heart rate), lack of fetal heart rate variability with Category III tracings, and low Apgar scores.
Birth asphyxia (also known as perinatal asphyxia and neonatal asphyxia): This term means the baby experienced breathing difficulties due to a lack of oxygen before, during, and after childbirth.

HIE begins when the baby suffers oxygen deprivation (hypoxia). The hypoxia starts a chain of events that can lead to fetal distress and brain damage. When the baby’s oxygen is low, the body tries to give all the available oxygen to the baby’s heart. But the baby still doesn’t have enough oxygen to support itself.

The baby’s heart then begins to show signs of fetal distress due to a lack of oxygen.

With less oxygen circulating in the baby’s blood, its brain and other organs begin to sustain damage. The baby’s liver, kidneys, and lungs may recover fully. And babies with mild brain damage due to HIE may recover somewhat with therapy. However, severe damage to the brain is usually irreversible.

And all this is happening while the mother is focused on delivering the baby. That’s why it’s so critical for medical professionals caring for mom and baby to watch closing for signs and symptoms of oxygen deprivation. They should have the knowledge and experience to properly monitor and treat complications as they arise. In many cases, HIE is preventable when babies and mothers receive proper care.

Symptoms of Hypoxic-Ischemic Encephalopathy

The signs and symptoms of hypoxic-ischemic encephalopathy (HIE) vary from mild to severe and can occur before, during, or after a baby is born. The severity of the brain injury depends in part on the type of injury and its timing.

During childbirth, the mother’s medical team should understand risk factors based on her medical history. For example, complications are more likely when mothers have underlying medical conditions like diabetes and high blood pressure. Doctors and nurses always monitor mothers and babies during childbirth, but at-risk pregnancies need a higher level of monitoring.

Signs that a baby’s oxygen supply is compromised during labor and delivery include an abnormal fetal heart rate. Certain types of fetal heart tracings indicate oxygen deprivation, shock, or infection:

Too fast (tachycardia)
Too slow (bradycardia)
Poor or missing variability (how the baby’s heart reacts to the mother’s contractions)

After the baby is born, other signs indicate that the newborn has suffered or is continuing to suffer hypoxia (oxygen deprivation):

Respiratory Difficulties: Neonatal resuscitation may become necessary for babies who have trouble breathing because of HIE.
APGAR Scores: APGAR scores indicate a newborn’s overall health and wellbeing in the first moments of life. Babies with scores at or below five likely have suffered HIE at birth.
Umbilical cord tests: Umbilical artery blood samples showing the baby’s blood is acidic (indicating metabolic issues or acidemia) increase the chance the baby has experienced HIE or is currently doing so.
Meconium-stained fluid: Babies sometimes expel meconium (a waste product) from their intestines into the amniotic fluid. The baby then can breathe in the meconium, aspirate it into their lungs, and become very ill.
Organ Dysfunction: Oxygen deprivation can damage multiple organs, including the heart, lungs, and liver.
Mouth and Throat Weakness: A newborn’s inability to latch, suck, swallow or other feeding problems could be caused by weak throat and mouth muscles. They may also use a feeble cry. Such weakness can be the result of a birth injury like HIE.
Seizures: Seizures that occur shortly after a baby is born are particularly concerning. They can be a sign that the newborn has a brain disorder that could have been hypoxic-ischemic in nature.
Abnormal newborn reflexes: Newborns with brain damage may be unable to grasp objects and make abnormal movements. They also may fail to react to loud sounds and movements around them.
Muscle Tone: Low muscle tone or floppiness (hypotonia) often indicates brain damage. Likewise, babies with tighter muscles than average (hypertonia) may have suffered hypoxic-ischemic encephalopathy.

Signs of Possible Oxygen Deprivation

Respiratory Difficulties
Apgar Scores
Umbilical Cord Tests
Meconium-Stained fluid
Organ Dysfunction
Mouth and Throat Weakness
Seizures
Abnormal Newborn Reflexes
Muscle Tone

Some of these symptoms can indicate problems other than hypoxic-ischemic encephalopathy (HIE). However, medical professionals have a duty to test newborns who are at risk or exhibiting signs of HIE to determine how to proceed.

Diagnosing Hypoxic-Ischemic Encephalopathy

Obstetricians, nurses, and other medical staff should be aware of a baby’s risk factors. Fetal heart monitoring during labor and delivery gives important clues that a newborn suffered oxygen deprivation (hypoxia). A baby’s insufficient oxygen supplies may have caused reduced blood flow to the brain (ischemia) that in turn caused encephalopathy (brain injury).

Just suspecting that a baby might have had HIE based on obvious symptoms is not enough. Brain injuries are subtle and sometimes difficult to diagnose. Doctors presume a newborn has HIE should immediately start protective therapies until they perform more tests.

The baby’s doctor may call in a pediatric neurologist to examine the baby. Usually, the doctor or neurologist will review the infant’s medical records paying close attention to lab tests, fetal heart tracings, and other reports. Then, they might use neuroimaging to take a closer look at the baby’s brain:

HIE Brain Imaging

Magnetic Resonance Imaging (MRI): This test can show whether brain damage occurred or not.
Cranial ultrasonography: Doctors use this test almost exclusively on babies. It produces pictures of the brain and cerebrospinal fluid and evaluates blood flow.
Computed Tomography (CT) scan: Although this test is used less often than MRIs, it can be useful when doctors suspect an acute hypoxic or ischemic event.
Proton Magnetic Resonance Spectroscopy (MRS) – A noninvasive way to get information about metabolic activity in the baby’s brain.
Electroencephalogram (EEG): A neonatal EEG can help evaluate a baby’s seizure disorder and encephalopathy.

Neuroimaging test results help physicians diagnose HIE and start early intervention to minimize brain damage.

The baby’s prognosis may become more apparent when results are combined with other information about the birth injury, including:

Medical professionals also evaluate potential HIE-related brain injury using the Sarnat staging criteria (or a similar staging method). Babies with suspected hypoxic-ischemic encephalopathy are categorized as:

Stages of Hypoxic Ischemic Encephalopathy

Stage 1: Baby exhibits hyper alertness, hyperreflexia (spasticity) and has a normal EEG.
Stage 2: The baby may react slowly to its environment, have hypotonia (low muscle tone), and seizures. This stage sometimes follows Stage 1 but can also appear from birth.
Stage 3: The baby is flaccid, stuporous (unconscious or unresponsive, and abnormal EEGs.

Babies in Stage 3 or Stage 2 that lasts more than five days have a worse prognosis than those in Stage 1.

This type of staging is often used to determine whether a baby should receive hypothermia cooling therapy. This treatment involves lowering the baby’s body temperature for several days to give cells time to recover from HIE.

Diagnosing a newborn with hypoxic-ischemic encephalopathy (HIE) and learning the extent of brain injury is the first step toward treatment.

Treating Newborns with Hypoxic-Ischemic Encephalopathy

When HIE is known or suspected, doctors may take the following action:

Hypothermia Therapy

Hypothermia therapy can reduce brain injury and may improve the baby’s neurological outcome. The therapy involves cooling the baby for 72 hours, and it must start within 6 hours of birth. Doctors use a cooling blanket and medication for hypothermia therapy.

The baby’s medical providers must closely monitor the baby during hypothermia therapy. Specifically, they must watch the infant’s heart rate, breathing, and temperature. Electroencephalograms (EEGs) and cerebral function monitors are also used.

The baby is slowly rewarmed when the therapy ends.

ECMO

Extracorporeal membrane oxygenation (ECMO) therapy might be used for severely injured newborns. Specifically, it can be used for babies in cardiac and respiratory failure.

The machine used is similar to the heart-lung machine used during some surgeries. Tubes move blood from the baby to a part of the machine that functions like an artificial lung (membrane). The membrane adds oxygen to the baby’s blood and removes toxins like carbon dioxide before returning the blood to the infant.

Supportive HIE Treatments

Treatment may be limited to supportive treatments that can address damage to the baby’s:

Heart and healthy blood pressure
Kidney and liver function
Respiration using mechanical ventilation

Some babies may also need medication for seizures caused by their HIE-related brain injury.

Unfortunately, supportive treatment usually does not prevent any ongoing brain injury that occurs in newborns.

Early intervention gives children with very mild HIE a better outcome. Treatments for HIE can prevent or minimize further brain damage. Failing to provide these proper treatments can be medical negligence or malpractice.

Causes and Risk Factors for HIE

With hypoxic-ischemic encephalopathy, brain damage occurs due to low oxygen and poor blood flow to the brain.

But what causes the lack of oxygen (hypoxia)? The exact cause is not always known. However, there are risk factors and conditions that make hypoxia likely. During a woman’s pregnancy, the fetus can be deprived of oxygen because of:

Placental insufficiency, which can reduce the flow of nutrients and oxygen to the baby
Preeclampsia, when the mother has high blood pressure and other signs of organ damage
Existing maternal medical conditions, like diabetes, heart disease, or anemia
Congenital infections, including viruses
Drug or alcohol abuse
Severe fetal anemia, when the baby does not have enough red blood cells to carry oxygen to the rest of the baby’s body
Fetal lung conditions, like congenital pulmonary airway malformation

As childbirth begins, the baby can experience problems that cause intrapartum asphyxia (oxygen deprivation) and hypoxic-ischemic encephalopathy (HIE):

Umbilical cord prolapse, compression, or wrapped around the baby’s neck
Placental abruption, where the placenta pulls away from the uterus before birth
Placenta previa that can cause severe bleeding during pregnancy or labor
Uterine rupture that causes excessive bleeding
Maternal low blood pressure
Prolonged labor or arrested labor
Fetal heart monitoring mistakes that miss signs of fetal distress
Abnormal fetal presentation, like a breech position, that delays birth
Cephalopelvic disproportion, where the baby is too big for the mother’s pelvis and may get stuck
Shoulder dystocia, which happens when at least one of the baby’s shoulders is unable to make it through the birth canal
Delayed C-section that prolongs a difficult birth or a baby’s fetal distress
Anesthesia errors during childbirth or a C-section
Assisted delivery when the doctor uses forceps or a vacuum extractor to deliver the baby
Fetal stroke due to blood flow being blocked, sometimes by blood clots

Finally, newborn infants can be at risk for brain damage caused by HIE if they:

Were premature
Have heart or lung disease that limits blood circulation
Have developed serious infections
Sustained brain or skull trauma during birth, possibly because of medical negligence or errors
Have very low blood pressure

Oxygen deprivation (hypoxia) leads to poor blood flow (ischemia), which can cause brain damage (HIE).

“Regardless of the specific cause of injury, the common underlying physiologic processes that result in HIE are diminished cerebral blood flow (ischemia) and reduced blood oxygenation (hypoxemia).”
- Radiological Society of North America

The severity of the hypoxia, how long it lasted, and which part of the brain was affected directly affect the baby’s future.

Can Hypoxic-Ischemic Encephalopathy (HIE) Be Prevented?

The best way to prevent hypoxic-ischemic encephalopathy (HIE) is by preventing asphyxia from occurring. It’s not always possible to do that, but medical professionals might minimize the damage by:

Prenatal care and testing: The mother’s physician should be aware of high-risk pregnancies and the complications that could occur during labor and delivery. It’s important to get a complete medical history for the mom and conduct tests that pinpoint potentially serious conditions. Doctors can be ready for trouble if they know that it’s likely to occur
Trying to stop premature births: Obstetricians can give medications like tocolytics and magnesium sulfate that might slow or stop contractions. Delaying delivery gives the baby time to mature. Doctors also administer corticosteroids to the mother to help strengthen the baby’s lungs
Watch for signs of fetal distress: Closely monitor the baby’s heartbeat and react immediately to changes that indicate oxygen deprivation. Failing to monitor the heart rate or analyze the results is medical negligence and malpractice
React quickly when fetal distress is suspected: Doctors might first try interventions like changing the mother’s position. Sometimes this helps stop what is harming the baby, like a compressed umbilical cord. If intervention fails, the baby must be delivered as quickly as possible.Delaying the C-section could worsen the baby’s hypoxia and lead to further brain damage
Properly diagnosing and treating newborns with neonatal encephalopathy: Treatment for newborns suffering from hypoxic-ischemic encephalopathy (HIE) must start within a few hours after birth. Neonatal resuscitation is a first step, but babies with severe HIE might need additional treatment, including hypothermia therapy, to minimize brain damage

Sometimes brain damage from HIE is preventable. However, careful monitoring, close communication among medical professionals, and swift action are necessary. When medical staff fails to meet their standard of care for patients, they can be held accountable for medical negligence and malpractice.

Long-Term Consequences of HIE

Some babies with HIE recover fully. Organs like the heart, liver, and kidneys might recover from mild damage. However, children may not recover from the brain injuries caused by HIE. With early HIE diagnosis and intervention, children may advance as far as possible.

However, other newborns may suffer permanent, severe disabilities, including:

Developmental delays: The baby will miss important development milestones that relate to average physical, social, language, and cognitive skills
Cognitive impairment: Children who had HIE may have trouble with cognitive skills like learning, thinking, and problem-solving
Cerebral Palsy: HIE can lead to cerebral palsy, a complicated condition that can include physical and cognitive disabilities
Seizure Disorders: Brain damage can cause babies to have seizures

Families of children with hypoxic-ischemic encephalopathy (HIE) can face a lifetime of intense care. Depending on the severity of their child’s brain injury, they might need some or all of the following:

Surgery
Medication
Therapy
Assistive devices
Special education and training
Trained caregivers

Caring for a Child with Brain Damage

Surgery
Medication
Therapy
Assistive Devices
Special education and training
Trained caregivers

Such care is physically, emotionally, and financially draining on families. Families may seek compensation through a birth injury lawsuit when medical professionals failed to provide the care needed to prevent HIE. The compensation a family receives from a birth injury lawsuit can pay for care and other expenses.

Is Your Child’s Brain Injury the Result of Medical Malpractice?

The parents of children who suffered birth injuries from hypoxic-ischemic encephalopathy (HIE) want answers. They want to know what happened to harm their child’s brain. Were there signs of fetal distress that the doctors and nurses failed to recognize and/or failed to respond to in a timely manner? Should their newborn have received treatments immediately after being born?

Our dedicated birth injury lawyers want to help you find those answers.

We diligently investigate the facts and hold responsible parties accountable by pursuing medical malpractice claims against them. We are trained to review the fetal heart monitor strips with a fine-tooth comb—just like the medical providers should have been doing during your delivery. We have a team of nurses experienced in birth injury that assists us in not only reviewing the fetal monitor strips but the entire labor and delivery and newborn medical record chart.

When we find the necessary evidence, we pursue every means possible to obtain you and your child appropriate compensation. The compensation our clients receive helps them pay for their child’s current and future medical treatment, assistive technology and equipment, and the other expenses associated with caring for a child with brain injuries, seizure disorders, and cerebral palsy.

Sometimes families are nervous to talk to lawyers about their child’s case. Others may simply feel consumed by their circumstances and unable to participate in a lawsuit involving their child’s birth injury. We are here to take a large part of that burden off of you and your family.

Why Should You Talk with the Knowledgeable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to an attorney who understands birth injury.

At Miller Weisbrod Olesky, a team of committed professionals uses our detailed case review process to assess your potential claim. They start by learning more about you and your child. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.

If we feel medical malpractice was present, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.

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Our Birth Injury Attorneys

Les Weisbrod

Les Weisbrod has been on the cutting edge of the national birth injury litigation scene for almost 40 years.

As a national birth injury attorney, Les has settled over 204 medical negligence cases for more than $1,000,000. He also obtained settlements in 75 birth injury cases for over $1,000,000 each.

His $31 million verdict against Baylor University Medical Center in Dallas was one of the top 100 verdicts in the United States that given year.

Les is recognized nationally and internationally as one of the top plaintiff’s medical malpractice trial lawyers in the United States. But the recoveries for the clients and the differences made in the lives of the children and families Les has represented tell only part of the story.

Les has worked with his law partner Clay Miller for years to build a one-of-a-kind law firm.

Miller Weisbrod provides unique and unparalleled services to families of birth-injured and brain-injured children from the moment the firm decides to take the case.

The registered nurses and registered nurse-attorneys on staff are valuable team members who assist Miller Weisbrod birth-injury clients. Les has designed a system where each birth injured child is assigned a nurse-attorney liaison to guide them through the process of medical treatment/evaluation, therapies, home assistance, and quality of life improvement.

Miller Weisbrod’s unmatched service allows families to better cope with the immediate challenges facing our young clients.

Birth-injured children and their families are Les and Miller Weisbrod’s priority.

Les and the attorneys at Miller Weisbrod fight for the justice their clients are entitled to under our nation’s system of justice.

This fighting spirit has taken Les across the United States to represent clients in birth injury and medical negligence cases. In fact, he has personally handled cases not only in Texas but also in Arkansas, Arizona, Colorado, Oklahoma, Louisiana, Utah, Iowa, Ohio, Oregon, Montana, Alabama, Georgia, Florida, and New York.

Les and Miller Weisbrod continue to expand their reach of helping brain-injured children to new states each year as we strive to bring a sense of justice to each affected family. And Les is not the only one who notices he fights for his clients.

Michael Rustad, a Professor of Law at Suffolk University Law School in Boston who has done extensive research on punitive damage awards, says,

“Les Weisbrod has obtained more medical malpractice punitive damage jury verdicts for his clients than any other attorney in the United States.”

Also, a well-known defense medical malpractice attorney dubbed Les Weisbrod the “pitbull” of the Texas medical malpractice bar in a media profile of Les published by a major newspaper.

Les shares his experience and knowledge to improve the representation of all birth-injured children and their families.

In the early 1990s, Les recognized that a more focused effort needed to be made to educate attorneys who handle birth injury cases. As a result, Les was the founding Co-Chair of the American Association for Justice (AAJ) Birth Trauma Litigation Group in 1991. He also was a founding Co-Chair of AAJ’s Medical Negligence Litigation Group in 1999 and served as Chair of AAJ’s Professional Negligence Section in 1996.

Combined, these groups have put on more than a hundred continuing education seminars across the United States. helping to educate other attorneys by bringing in world-renowned experts in the fields of:

labor and delivery
neonatal care
the care and treatment of birth-injured children, including those suffering from cerebral palsy and hypoxic-ischemic encephalopathy (HIE)

Education and professional experiences back up his dedication to helping children and families harmed by medical malpractice.

Les received his B.A. magna cum laude in 1975 from Claremont Men’s College and his J.D. in 1978 from Southern Methodist University Law School.

He is Board Certified by the Texas Board of Legal Specialization in Personal Injury Trial Law and Civil Trial Law.

Les was a past president of the Dallas Trial Lawyers Association in 1993. He has been a member of the Texas Trial Lawyers Association Board of Directors since 1990.

His work with the American Association for Justice (AAJ) (formerly ATLA) includes serving as President, President-Elect, Vice President, Secretary, Treasurer, and Parliamentarian. Mr. Weisbrod has also served on the AAJ Board of Governors since 1998 and the 17-member Executive Committee of AAJ since 2001. In 1990, he was chosen as a Rising Star of the ATLA and presented a paper entitled “Dirt and Greed: A New Look at Medical Malpractice Cases.”

Les has written and lectured extensively on birth injury litigation, medical malpractice, and medical product topics.

Les is a contributing author to the 1996 text Operative Obstetrics published by Williams & Wilkins. He also co-authored the “Drugs & Medical Devices” chapter in AAJ’s Litigating Tort Cases.

He also has lectured to lawyer groups across the U.S., Canada, England, and Australia.

Education

Southern Methodist University - School of Law, J.D. - Dallas, Texas, 1978
Claremont Men's College - B.A. - Claremont, California, 1975

Bar Admissions

Texas
Arkansas

Areas of Practice

Medical Malpractice
Birth Injury/Birth Trauma
Products Liability
Personal Injury

Associations & Memberships

State Bar of Texas
National Association Of Distinguished Counsel
Million Dollar Advocates Forum
Multi-Million Dollar Advocates Forum
American Association for Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association
Pan-European Organization of Personal Injury Lawyers
American Society of Law and Medicine
Consumer Attorneys of California
Arkansas Trial Lawyers Association
Louisiana Trial Lawyers Association
Dallas and American Bar Associations
ABOTA (American Board of Trial Advocates)

Clay Miller

Clay is Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization. Clay has practiced solely in the field of catastrophic injury and wrongful death since graduating from law school. His practice has been limited to the representation of victims. Over the past twenty-four years, Clay has successfully settled or tried to verdict cases in the areas of vehicular negligence, medical malpractice, construction site accidents, workplace injury, premises liability, and commercial trucking and a nationwide business loss case (suits filed in a dozen different states) involving defective truck engines sold to trucking companies.

Clay represented dozens of trucking companies in lost profit and diminished value claims against Caterpillar in 2010 through 2012. These cases were filed in over a dozen states with the bellwhether trial set in Federal Court in Davenport, Iowa. After intense litigation and trial preparation, a global confidential settlement was reached for all the clients.

Clay's most recent 2017 victories are a $30,800,000 jury verdict in Tennessee arising from fraud claims in the sale of heavy-duty truck engines and a $26,500,000 jury verdict in a construction accident, obtained within 60 days of each other.

Clay was raised in Lewisville, Texas and completed his undergraduate degree in Finance at
Texas A & M University. Following graduation from Southern Methodist University School of law, Clay worked for two Dallas firms representing victims. In 1998, Clay began his own practice before forming his current partnership. In addition to his law practice, Clay has lectured at seminars and published in the areas of construction accidents, jury selection techniques, medical negligence, trucking accidents and settlement tactics.

He is active in local and statewide trial lawyers' associations including serving as the Chair of the Advocates for the Texas Trial Lawyers' Association in 2002 and remains on the Board of Directors. Clay served as President of the Dallas Trial Lawyers Association from 2008-2009. He has also been a member of the American Board of Trial Advocates (ABOTA) since 2014.

Education

Southern Methodist University School of Law - Dallas, Texas
Texas A&M University - Finance - College Station, Texas

Bar Admissions

Texas
New Mexico
Colorado

Areas of Practice

Associations & Memberships

State Bar of Texas
State Bar of New Mexico
State Bar of Colorado
American Board of Trial Advocates (ABOTA)
Texas Trial Lawyers Association
Dallas Trial Lawyers’ Association
American Association of Justice

David Olesky

David Olesky is Vice Chair of the Health Care Professional Liability practice. David is a trial lawyer focusing his practice on complex litigation matters that involve defending and protecting clients in all types of cases related to catastrophic injuries or death, but with a special focus on birth injury cases. David regularly advises his health care clients on the issues and challenges that they face on a daily basis. Clients repeatedly look to him for guidance to handle such high stakes cases and matters in Texas and jurisdictions outside of Texas.

David has earned the trust and reliance of clients he has worked with by consistently getting the results that matter most to them, whether that is a win at trial or a favorable outcome through alternative dispute resolution outside the courthouse. Through his representation, David demonstrates a true loyalty and hardworking commitment to the clients that he serves.

David believes the foundation of any client relationship is to act as a trusted advisor instead of simply as a litigator. Clients value his earnest representation of their business interests, accompanied by a devotion to understanding their businesses, prompt attention to their immediate needs and the challenges they face in their individual roles.

Education

Southern Methodist University Dedman School of Law, J.D., 1992 - Dallas, Texas
University of Texas, B.B.A, 1989 - Austin, Texas

Bar Admissions

Texas

Areas of Practice

Associations & Memberships

American Bar Association
Dallas Bar Association
Dallas Bar Foundation Fellow
Texas Bar Association

Alexandra V. Boone

Alexandra Boone is a partner in Miller Weisbrod. She concentrates her legal practice in the area of birth injury, medical malpractice and mass tort products liability. Alex currently works directly with firm partner Les Weisbrod in managing the birth injury docket and working with the firm’s highly qualified expert witnesses in the review of potential cases. Alex also litigates her own docket of medical negligence cases.

Over the course of her 17 years with the firm, Alex has focused on the administration and prosecution of mass tort litigation, originally focusing on occupational toxins, but more recently in the area of pharmaceuticals and medical devices. In the past, she has actively pursed cases involving hormone therapy. Alex was also instrumental in our firm successfully resolving thousands of cases transvaginal mesh, hip prosthetics, and blood thinner lawsuits. She is actively prosecuting over 1,000 cases.

In addition to being a member of the Texas bar, she is also licensed in Oklahoma and is a member of the American Association of Justice, Texas Trial Lawyers Association, Oklahoma Association of Justice and the Dallas Trial Lawyers Association.

Education

Baylor University - School of Law, 1996, J.D. - Waco, Texas

Bar Admissions

Texas - 1996
Oklahoma - 2006

Areas of Practice

Products Liability
Mass Tort

Associations & Memberships

State Bar of Texas
American Association of Justice
Texas Trial Lawyers Association
Oklahoma Association of Justice
Dallas Trial Lawyers Association

Pro Bono Activities

East Texas Legal Services/Nix Law Firm Pro Bono Project, 1996 - 1997

Robert Wolf

Robert E. Wolf was born in Dallas, Texas and graduated Magna Cum Laude as a proud horned frog from Texas Christian University in 1997, with Bachelor of Science degree in Political Science and was inducted into Phi Beta Kappa and Mortar Board. He obtained his law degree from Southern Methodist University in 2000 while serving as an Articles Editor for the International Law Review and winning awards at Mock Trial and Appellate competitions.

Robert has been named a Thomson Reuters | Texas Super Lawyers Rising Star (less than 2.5% of attorneys in Texas receive this distinction) in 2011, 2012, 2013, 2014, and 2015. Further, Robert was recognized as a National Trial Lawyers Top 40 Under 40 attorney for Texas in 2012 (no more than 40 attorneys in Texas are eligible for this award annually).

Robert brought his passion for and over 14 years of experience of representing seriously injured individuals and their families to Miller Weisbrod in January 2015, and has concentrated his legal practice in the area of medical malpractice, products liability, and pharmaceutical/mass tort litigation. He is a member of the State Bar of Texas, American Association for Justice, Texas Trial Lawyers Association, and Dallas Trial Lawyers Association.

In addition to many successful jury verdicts and settlements across Texas, Oklahoma, Iowa, Wisconsin, and Idaho, Robert’s role as an attorney representing victims and their families has led to numerous changes to key safety practices and policies and procedures at corporations and medical facilities.

Robert and his wife Suzy also get plenty of exercise trying to keep up with their precious and very active daughter.

Education

Southern Methodist University - Dedman School of Law, J.D. - 2000 - Dallas, Texas
Texas Christian University - B.S. Political Science - 1997 - Fort Worth, Texas

Bar Admissions

Texas - 2000

Areas of Practice

Medical Malpractice
Personal Injury
Products Liability

Associations & Memberships

State Bar of Texas
American Association of Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association

Carrie Vine

Carrie Lynn Vine has over 15 years of experience in medical malpractice litigation, with a particular focus in representing children and families who have suffered birth injuries as a result of the negligence of either doctors, nurses or hospitals.

She is a passionate advocate for her clients and has handled hundreds of birth injury and birth trauma cases throughout the United States. As part of Carrie’s national birth injury legal practice, she has handled cases in Texas, Arkansas, California, Nevada, Kentucky, Georgia, Illinois, Wisconsin, Ohio, Pennsylvania, North Carolina, South Carolina, Florida, and North Dakota. She is determined to seek justice and works to obtain fair compensation for the children and families she represents.

Carrie earned her law degree from Northern Illinois University where she tutored other law students. Prior to law school, she received her undergraduate degree from the University of Notre Dame in Biomedical and Biological Science, and earned both a Master’s Degree and a Ph.D. from The Pennsylvania State University in Anthropological Genetics. She then conducted post-doctoral research at the University of Michigan Medical School before deciding to attend law school. She applies an academic mindset and love of science and medicine to mastering the medical principles and literature relevant to the cases she pursues.

Carrie is an active member of the American Association of Justice as well as the Birth Trauma Litigation Group (BLTG).

Education

Northern Illinois University:

Law School
University of Notre Dame:

Biomedical Science
Pennsylvania State University:

Anthropological Genetics

Bar Admissions

Texas

Areas of Practice

Birth Injury/Birth Trauma
Medical Malpractice

Associations & Memberships

American Association of Justice:

Member
Birth Trauma Litigation Group:

Member

Larry Lassiter

Lawrence R. Lassiter is an AV-rated attorney with more than twenty years of experience in appellate and trial advocacy. He has been consulted by attorneys across the country to conduct research, evaluate cases, prepare appellate and trial briefs, and formulate litigation strategy. He has prepared hundreds of appellate briefs in federal and state appellate courts, including the highest courts of Texas, West Virginia, Georgia, Oklahoma, Ohio, Nebraska and Tennessee, and he is member of the Bar of the United States Supreme Court. Larry has a national appellate and legal briefing practice. Larry has filed extensive briefs and/or argued before either state or federal courts in 30 out of 50 states in his career.

Larry assists the Birth Injury team in all aspects of legal briefing. Unlike many other birth injury firms across the United States, Miller Weisbrod has an attorney dedicated to handling legal briefing on behalf of our clients across the country. Larry has handled extensive briefing in birth injury and other medical malpractice cases in Texas, New Mexico, Arkansas, Oklahoma, Iowa, Ohio, Alabama, Georgia, New York, Utah, Arizona, Louisiana and West Virginia.

Since joining Miller Weisbrod in 2010, Larry has won a number of important victories vindicating the rights of our clients in both state and federal appellate courts, including Vitacost.com, Inc. v. McCants, 210 So.3d 761 (Fla. Ct. App. 2017); TTHR Ltd. Partnership v. Moreno, 401 S.W.3d 41 (Tex. 2013); In re E.B., 729 S.E.2d 271 (W. Va. 2012); Mid-Continent Cas. Co. v. Davis, 683 F.3d 651 (5th Cir. 2012); Rouhani v. Morgan, 2017 WL 3526719 (Tex. App. – Houston [1st Dist.] 2017, no pet.); Mid-Continent Cas. Co. v. Andregg Contracting, Inc., 391 S.W.3d 573 (Tex. App. – Dallas 2012).

He was as a judicial clerk for the Honorable Harlington Wood Jr., Circuit Judge, United States Court of Appeals for the Seventh Circuit. Larry was a University of Iowa Presidential Scholar and served as Editor in Chief of the Iowa Law Review.

Larry is an active member of the American Association for Justice. He is a member of AAJ’s Birth Injury Litigation Group and Medical Negligence Sections.

Education

University of Iowa - Political Science & History - B.A. - Iowa City, Iowa
University of Iowa - School of Law - J.D. - Iowa City, Iowa

Bar Admissions

Texas - 1996
Kansas
Missouri

Areas of Practice

Appellate Advocacy
Medical Malpractice
Pharmaceuticals & Medical Devices
Products Liability
Personal Injury

Associations & Memberships

State Bar of Texas
American Association of Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association

Laurie Pierce

Laurie draws upon extensive experience in state and federal courts with a focus on complex claims involving medical malpractice cases. After many years of defending health care providers and hospital systems in medical malpractice cases, Laurie joined David Olesky in the national birth injury and medical negligence practice at Miller Weisbrod Olesky.

Laurie’s focus is to understand not only the facts and circumstances of the matter at hand, but to understand the specific needs and goals of the client and their unique business considerations. Her extensive background in commercial litigation provides a foundation that enhances her health care litigation practice. She works with clients that require more than a strong trial lawyer; they expect an attorney who understands the relationship between law and their specific business and who will work tirelessly to protect their rights, interests and bottom line.

Education

Southern Methodist University:

Dedman School of Law - 1992
Order of the Coif:

Journal of Air Law and Commerce, J.D. - 1992
Miami University-Oxford, Ohio

B.S. Education - 1982

Bar Admissions

Texas - 1992

Areas of Practice

Birth Injury/Birth Trauma
Health Care Industry
Health Care Litigation
Litigation and Dispute Resolution
Medical Malpractice

Associations & Memberships

American Association for Justice
American Bar Association
Dallas Bar Association
Dallas Bar Foundation Fellow
Texas Bar Association

Distinctions

Admitted to Pro Bono College of State Bar of Texas in 2019 for outstanding delivery of legal services to low-income Texans

Court Admissions

United States Supreme Court
U.S. District Court, Eastern District of Texas
U.S. District Court, Northern District of Texas
U.S. District Court, Southern District of Texas
U.S. District Court, Western District of Texas

Linda Cuaderes

Linda Cuaderes is both a registered nurse and a licensed lawyer. Linda works exclusively in Miller Weisbrod’s Birth Injury and Medical Malpractice section. Linda acts as the firm’s patient advocate and liaison with our young clients and their parents.

Linda combines her legal and nursing experience along with her exceptional organizational talent and attention to detail to make sure each child we represent is provided the highest level of medical care and attendant care during the pendency of their case. Linda communicates with our parent clients regularly to monitor their birth injured child’s treatment, provide guidance as to additional care and therapies and when necessary assist them in obtaining specialized medical providers.

Linda was raised in Bartlesville, Oklahoma and completed her Bachelor of Science in Nursing with Honors at the University of Oklahoma. She started as an Oncology Nurse at Presbyterian Hospital in Oklahoma City, quickly becoming the Assistant Head Nurse of the Outpatient Endoscopy Unit. Linda then entered the University of Oklahoma College of Law.

Following graduation, Linda joined Les Weisbrod in the Medical Malpractice Section. After taking time off to raise her three lovely children, Linda returned to Miller Weisbrod and her passion of holding healthcare providers accountable for preventable errors. Linda is active in the American Association for Justice, Texas Trial Lawyers Association, Dallas Trial Lawyers Association, and the Texas Bar Association. Linda is an active member of the Birth Trauma Litigation Group and Medical Negligence Section of the American Association for Justice.

She is admitted to practice before the Texas Supreme Court and routinely works on cases pending throughout the United States. Linda has worked with child victims of birth injury, their parents and other victims of medical malpractice in Texas, New Mexico, Oklahoma, Arkansas, Louisiana, Iowa, Ohio, New York, Alabama, Georgia, Arizona, Utah and Missouri.

Education

University of Oklahoma - School of Law, 1990, J.D. - Norman, Oklahoma
University of Oklahoma - School of Nursing, 1985 - Norman, Oklahoma

Bar Admissions

Texas - 1996

Areas of Practice

Medical Malpractice
Birth Injury/Birth Trauma

Associations & Memberships

Texas Bar Association
American Association of Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association

Kristin Jones

Kristin combines her medical and legal training to provide invaluable, passionate service to parents struggling to care for their birth-injured children. Families often have questions as they go through the birth injury lawsuit process. Kristin diligently identifies and investigates all medical issues so the birth injury attorneys at Miller Weisbrod can answer those questions. Kristin ensures that our birth injured children’s medical records are thoroughly reviewed and organized. Miller Weisbrod’s birth trauma litigation attorneys and medical experts retained by the firm need her services while pursuing justice for our clients.

Education

SMU Dedman School of Law - Dallas, Texas
University of Texas at Arlington - Arlington, Texas

Bar Admissions

Texas - 1996

Areas of Practice

Medical Malpractice
Birth Injury/Birth Trauma

Associations & Memberships

State Bar of Texas
American Association of Justice
Texas Trial Lawyers Association

Matt Adair

Matt Adair is an attorney specializing in medical malpractice, products liability, and pharmaceutical litigation. He received his bachelor’s degree in Philosophy from the University of Notre Dame. During his time there, he studied abroad at the New College at Oxford University in Oxford, England.

Matt is a member of the State Bar of Texas, American Association for Justice, Texas Trial Lawyers Association, and Dallas Trial Lawyers Association.

Education

University of Notre Dame - Philosophy, B.A. 2012 - Notre Dame, Indiana
Baylor University - School of Law J.D. 2015 - Waco, Texas

Bar Admissions

Texas - 2015

Areas of Practice

Medical Malpractice
Products Liability
Pharmaceutical Litigation

Associations & Memberships

State Bar of Texas
American Association of Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association

Garrett Stanford

Garrett Stanford was born in Dallas, Texas and graduated from Southern Methodist University in 2017 with a B.A. in Political Science. After graduation, he attended Baylor University School of Law. During his time at Baylor, he was a member of the Order of the Barristers and he won the Judge W.C. Davis Endowed Criminal Practice Professional Track Award. He obtained his law degree and license to practice law in 2020.

Garrett joined Miller Weisbrod in August 2021. His legal practice is concentrated in the area of birth injury and medical malpractice. Garret is actively involved in handling birth injury and medical malpractice cases in Texas, Ohio, Utah, Arkansas and Oklahoma.

Education

Southern Methodist University - Political Science, B.S. - Dallas, Texas
University of Baylor - School of Law, J.D. - Waco, Texas

Bar Admissions

Texas - 2020

Areas of Practice

Medical Malpractice
Birth Injury/Birth Trauma

Associations & Memberships

State Bar of Texas

Meet our Legal Nursing Team

Linda Chalk

As a registered nurse, Linda practiced ICU nursing for 44 years while caring for a wide range of patient conditions. She has worked closely with founding partner Les Weisbrod for over 30 years, investigating and pursuing birth injury cases.

Along with DJ Weisbrod, Linda heads up the firm’s birth injury intake, screening, and medical literature research team. She personally screens all potential cases to ensure that medical issues have been addressed before we file lawsuits on behalf of birth-injured children and their families.

DJ Weisbrod

Before joining Miller Weisbrod, DJ practiced as a surgical nurse in various hospital and operative settings. She has been with the firm over 30 years.

DJ directs Miller Weisbrod’s birth injury intake and medical screening team. She has also served as firm founder Les Weisbrod’s trial nurse for all cases involving medical negligence and birth injury.

Linda Cuaderes

Education

University of Oklahoma - School of Law, 1990, J.D. - Norman, Oklahoma
University of Oklahoma - School of Nursing, 1985 - Norman, Oklahoma

Bar Admissions

Texas - 1990

Areas of Practice

Birth Injury/Birth Trauma
Medical Malpractice

Associations & Memberships

Texas Bar Association
American Association of Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association

Kristin Jones

Kristin combines her medical and legal training to provide invaluable, passionate service to parents struggling to care for their birth-injured children.

Families often have questions as they go through the birth injury lawsuit process. Kristin diligently identifies and investigates all medical issues so the birth injury attorneys at Miller Weisbrod can answer those questions Kristin ensures that our birth injured children’s medical records are thoroughly reviewed and organized. Miller Weisbrod’s birth trauma litigation attorneys and medical experts retained by the firm need her services while pursuing justice for our clients.

Kelly Kunkel

Kelly Kunkel was born and raised in Dallas, Texas. She has 15 years’ experience in hospital based High Risk Obstetrics and Labor and Delivery bedside nursing care. Kelly graduated with an Associate’s Degree in Nursing from El Centro College in December of 1990 and received her Bachelor’s Degree in Nursing from West Texas A&M University in 2008; graduating with honors.

In addition, Kelly has over 25 years’ experience in medical malpractice case management and litigation and has worked with David Olesky for over 22 years. After many years of assisting in defending healthcare providers and hospital systems in medical malpractice cases involving complex litigation matters related to birth injury, catastrophic injury and death, Kelly has proudly joined David Olesky in the national birth injury and medical negligence practice at Miller Weisbrod Olesky.