What is Necrotizing Enterocolitis?

Necrotizing enterocolitis is essentially an inflammation of the intestines. Necrotizing means tissue death; the disease can result in holes in the intestine that must be surgically repaired by cutting out the dead portions and either performing an ostomy or surgically reattaching the two pieces of the intestine. Necrotizing enterocolitis can affect part or all of the intestines and can be mild or potentially life-threatening. Milder cases may be treated medically, by using antibiotics, ceasing oral feedings, implementation of an IV that delivers nutrients and liquids, and through the use of a nasogastric tube. More severe cases may require surgery to remove the damaged part of the intestines. In the most severe cases, intestinal failure may occur, or the infection may overwhelm the baby’s body.

NEC most often affects premature babies—those born before 37 weeks, and especially, those born before 32 weeks. NEC often occurs after a premature baby has been fed a bovine-based formula. The two largest manufacturers of these cow’s milk-based formulas are Abbott Laboratories and Mead Johnson, which make Enfamil and Similac. Enfamil and Similac formulas are those most likely to be given to babies in the hospital and even to be sent home with parents to feed their babies once they are released from the hospital. The manufacturers of Enfamil and Similac have been aware, possibly since the 90s, that feeding bovine-based formula to premature infants can result in a diagnosis of necrotizing enterocolitis.

Full-term babies with no health problems rarely develop NEC, while premature infants, especially those with other health problems, are much more likely to develop NEC. When you add in being fed Enfamil or Similac which is bovine-based, the risks of NEC increase exponentially. A premature baby may have an underdeveloped or immature digestive system. While the goal is always to treat NEC medically rather than surgically, this may not be possible when the intestine is perforated. Surgery is more likely to result in long-term effects from NEC. The formulas made by Mead Johnson and Abbott Laboratories that are bovine-based and typically used in hospitals include:

Enfamil: DHA-In-Sol, Human Milk Fortifier in liquid and powder, Enspire, 24-Calorie Formula, Nutramigen, NeuroPro Enfacare, NeuroPro Gentlease, Premature Infant Iron Formula 24 Cal and 30 Cal, and Premature 30 and 24 Cal

Similac: 360 Total Care, Special Care 20/24/24 High Protein/30, Special Care, NeoSure, Expert Care Alimentum, Alimentum, Human Milk Fortifier Hydrolyzed Protein Concentrated Liquid, Human Milk Fortifier Powder and Concentrated Liquid, and Liquid Protein Fortifier

What Are the Signs and Symptoms of Necrotizing Enterocolitis?

Necrotizing enterocolitis is usually diagnosed through a complete physical exam, bloodwork, and an X-ray of your baby’s digestive system. In some cases, the X-ray will reveal “bubbles,” around the intestine or abdominal cavity which may indicate a damaged bowel or perforation. Parents may be the first to notice that their infant has significant stomach distress, even before NEC is diagnosed. The baby’s tummy may be discolored, tender, or swollen. Other common signs and symptoms of necrotizing enterocolitis include:

• Rapid or unusual changes in body temperature
• Changes in heart rate
• Vomit that is green or yellow
• Lethargy
• Refusing to eat
• Lack of weight gain
• Diarrhea with bloody stool
• Metabolic acidosis
• Jaundiced appearance
• Low blood pressure
• Abnormal breathing patterns
• Lack of appetite
• Sleep apnea

Can There Be Long-Term Effects of Necrotizing Enterocolitis?

While some babies may recover well from necrotizing enterocolitis, others may suffer long-term effects from the disease. Long-term effects are most likely to affect babies who required surgery for their necrotizing enterocolitis. It is estimated that more than 50 percent of NEC infants who underwent surgery will have a neurodevelopmental delay, including vision and hearing problems and cerebral palsy. Children who suffered from NEC as an infant can suffer from poor educational, motor, and behavioral outcomes during their childhood years, and poor memory performance in adulthood. Other long-term effects of NEC include:

• Intestinal strictures develop in about 6-33 percent of infants who have previously had NEC. A stricture is a narrowing of the intestine that makes it difficult for food to pass through the intestines as it should The strictures may be the result of damage to the intestines during NEC that resulted in scarring. Strictures can require more invasive treatments, including additional surgical procedures.
• Cholestasis is a liver disease characterized by reduced or blocked bile flow and can be a by-product of NEC.
• Failure to thrive and grow. This is essentially inadequate physical growth because the body is unable to get the nutrients it needs to thrive. The combined effects of NEC in the gastrointestinal system of an infant along with the necessary withholding of feeding may contribute to slower-than-normal physical development.
• Short bowel syndrome can be caused when NEC destroys a section of the small intestine and the damaged portion is removed. When there is a substantial loss of the intestine the infant may develop short bowel syndrome, sometimes referred to as short gut syndrome. Short bowel syndrome currently has no cure and can prevent babies from absorbing the nutrition they need to grow and thrive.

About 4-6 percent of babies may have a recurrence of necrotizing enterocolitis that requires surgical intervention.

Could Your Necrotizing Enterocolitis Lawsuit Be Affected by the Idaho Statutes of Limitations?

Statutes of limitations can restrict the amount of time you have to file a lawsuit against a negligent party for injuries or harm you received as a result of the other party’s negligent behavior. Each state sets its own statutes of limitations. While some states have the same statute of limitations for personal injury, wrongful death, product liability, and medical malpractice claims, others differentiate between these different types of claims.

Certain states allow for what is known as the Discovery Rule, which allows extra time for injuries or harm that might not reasonably be discovered immediately. The Discovery Rule can extend your time based on when the injury was actually discovered—or should have been discovered.

Regarding product liability claims, some states add a statute of repose, which extends the window of time based on when the product was manufactured, distributed, purchased, or sold in conjunction with when the injury was discovered or should reasonably have been discovered. In the state of Idaho, the following statutes of limitations apply:

• Personal injury claims in the state have a two-year statute of limitations in the state of Idaho with no exception for the Discovery Rule.
• Wrongful death claims in the state of Idaho are bound by a two-year statute of limitations and Idaho does not accept the Discovery Rule. This means that personal injury claims and wrongful death claims in the state of Idaho generally strictly adhere to the amount of time stated in the statute.
• Medical malpractice claims in the state of Idaho usually fall under a two-year statute of limitations, with two exceptions. The first exception involves the placement and accidental or unintentional leaving of any foreign object in the body of the patient. The second exception involves a defendant’s fraudulent, knowing concealment of a patient’s injury for the sole purpose of escaping responsibility. In each of these scenarios, the time does not begin to run until the injured party knows or should have known he or she was injured as a result of medical malpractice. Once that discovery has been made—or reasonably should have been made—the patient has one year or the standard two years to file the lawsuit, whichever is later.
• A product liability claim has a statute of limitations of two years in the state of Idaho, although the negligence claim does not begin to accrue until some damage has occurred. Idaho has a statute of repose that states that an action may not be commenced after the expiration of the useful safe life of the product in question, with an outside time limit of ten years.

Because these statutes can be extremely complex, it is crucial that you speak to a knowledgeable NEC baby formula lawsuit attorney who can help you apply your state’s statutes to your NEC baby formula lawsuit.

How Can You Benefit from Speaking to an NEC Baby Formula Lawsuit Attorney?

If your baby developed necrotizing enterocolitis after being fed a cow’s milk-based formula, you were likely not told of the potential risks of the formula. Premature babies are often fed these formulas, either as the sole source of nutrition or in conjunction with breast milk, to help the infant put on weight, but the adverse effects can be devastating. It can be extremely beneficial for you to speak to an experienced NEC baby formula lawsuit attorney from Sullo & Sullo who can help you determine whether an Enfamil lawsuit is right for you, and the best way to proceed. If you are a resident of any of the following Idaho locales, contact Sullo & Sullo today:

Boise, Idaho

Nampa, Idaho

Meridian, Idaho

Idaho Falls, Idaho

Pocatello, Idaho

Caldwell, Idaho

Coeur d’Alene, Idaho

Twin Falls, Idaho