Page 10 - Dallas Vol 5 No 1

Medical Malpractice
Neonatal Abstinence Syndrome
By Kay Van Wey
Every 25 minutes, a baby is born addicted to opioids in the United States. is condition, known as Neonatal Abstinence Syndrome
(NAS), occurs when a baby is exposed to opioid drugs while still in the womb, caus- ing the baby to become addicted prior to birth and to experience drug withdrawal just as an addicted adult would.
To get an idea of what NAS really looks like, picture this: nurses report high- pitched wails as the baby goes through the pain of opioid withdrawals just minutes a er entering the world. ey describe it as unlike any average newborn cries ... as something you could not forget. ese wailing babies are further triggered by en- vironmental stimuli connected to the cen- tral nervous system, setting o tremors and seizures. One of the most jolting stim- uli to a NAS baby is their mother’s smile because it is so emotional ... being with their mother physically causes them pain. So rather than carefully handing this wail- ing newborn to its mother to be swaddled and soothed, nurses rush these babies to the neonatal intensive care unit (NICU)
where they are treated for vomiting, diar- rhea, fevers, seizures and extremely low birth weight.
Currently, many of these infants are treated with tapering doses of morphine, or alternatively buprenorphine, to man- age extreme withdrawal symptoms. With treatment babies typically get better in five to 30 days, however, the long-term effects of NAS remain relatively un- known. Researchers are studying the lasting impact on babies born with NAS as they develop, particularly paying at- tention to potential cognitive disabilities, psychological traumas, and predisposi- tions to addiction.
Beyond the staggering health impacts on these babies, families a ected by NAS also accumulate a much longer hospital stay and a much higher bill. In 2016, the average newborn stayed in the hospital for two days, with an average charge of $3,500. However, NAS babies stayed an average of nearly 17 days and racked up about $67,000 in hospital bills. Taxpay- ers are also a ected, as Medicaid funds around 80 percent of costs associated with NAS births/treatment.
Neonatal Abstinence Syndrome is most commonly caused by the mother taking some type of opioid during the pregnan- cy. is includes prescription painkillers (such as codeine, hydrocodone, morphine and oxycodone) as well as heroin. Even if the drug was prescribed by a doctor and is taken according to the health care pro- vider’s instructions, the baby is still at risk for NAS. Any use of opioids during preg- nancy can pass through the placenta and umbilical cord to the baby.
Between 2000-2012, babies born with NAS increased five-fold. Since then, the number of babies born addicted to opioids continues to rise, mirroring the steady increase in opioid use and abuse in society in general. NAS affects mothers/infants across all demograph- ics. From upper-middle class mothers with prescription painkiller addictions, to low-income, heroin-addicted women who cannot quit using during their preg-
nancies – NAS does not discriminate in its victimology. Current data shows NAS is especially on the rise in white, rural communities.
Babies a ected by NAS are quite literal- ly innocent, voiceless victims to the opioid drug epidemic and its path of destruction. But, babies are not the only ones a ected.
For the past several decades, opioid liti- gation has primarily centered on individ- ual patients versus the prescribing doctor and sometimes the pharmacist or phar- macy who lled the prescriptions. Re- cently, the litigation has begun to focus on the manufacturers of these highly addic- tive drugs. Late last year, 66 lawsuits were merged into one national prescription opiate multidistrict litigation suit. Cities, hospitals and Native American tribes are standing up to Big Pharma directly for their enormous nancial losses incurred treating the victims of opioid addiction, including babies a ected by NAS.
In sum, while it is easy to vilify the mothers who used opioids during their pregnancies as well as others who have become addicted to opioids, in reality, the blame runs much deeper. We have studies now that show addiction is a brain disease, and more and more information is com- ing out showing how Big Pharma has mar- keted opioid drugs as safe for moderate pain while concealing their highly addic- tive nature. ese new cases against large pharmaceutical companies will be ones to watch, and hopefully bring much-needed attention to the legal battles on behalf of the innocent infant victims of the opioid epidemic.
I have personally been involved in liti- gating these cases for the past several de- cades and will continue ghting on behalf of the victims. It is disheartening to see that not only do we have an entire genera- tion of addicts now due in large part to the greed of large pharmaceutical companies, but we may also have future generations of addicts if NAS babies themselves have a proclivity to addiction. Sadly, I feel our society will su er the consequences for many years to come.
Kay Van Wey is a medical malpractice attor- ney and patient safety advocate. She is board certi ed in Personal Injury Trial Law by the Tex- as Board of Legal Specialization. Kay has been voted Texas Super Lawyer for 15 consecutive years as well as “D Best” in Tort, Product & Medical Liability Litigation. Kay serves as Ad- junct Professor of Law at SMU teaching the medical malpractice course. Kay has also at- tained membership in the Million and Multi-Mil- lion Dollar Advocates Forum. You may reach Kay directly at [email protected].
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