Plain-English steps to protect your baby’s health, preserve important records, and understand what information may matter if you later have questions about the care your family received.
Updated August 2026
When a newborn needs emergency resuscitation, NICU care, seizure monitoring, treatment for severe jaundice, therapeutic hypothermia, or transfer to a higher-level hospital, parents can be overwhelmed with information.
Your baby’s immediate medical care comes first. At the same time, writing down what happened and preserving records can make it much easier to understand the birth and newborn course later.
An unexpected complication or poor outcome does not automatically mean medical negligence occurred. Determining whether care was appropriate requires the complete medical record, the specific circumstances, and—when a legal claim is being evaluated—appropriate medical expert review.
If your baby is experiencing an urgent medical problem now, contact the treating medical team or seek emergency medical care.
Quick-Glance Birth Injury Checklist
In the Hospital: Day 0–1
- Ask the care team to explain the working diagnosis and what they are watching for. Terms you may hear include neonatal encephalopathy, hypoxic-ischemic encephalopathy (HIE), seizures, respiratory distress, infection, hypoglycemia, or hyperbilirubinemia.
- Write down the names and roles of the doctors, nurses, specialists, and transport personnel you speak with, along with the approximate time of important conversations.
- Ask for the results that are currently available, including Apgar scores, umbilical cord blood gases, early blood gases, laboratory testing, bilirubin results, EEG findings, and imaging reports when applicable.
- If HIE or neonatal encephalopathy is being considered, ask whether your baby was evaluated for therapeutic hypothermia (“cooling”), whether cooling was recommended, and the time it was started. The AAP’s 2026 clinical report states that therapeutic hypothermia for eligible newborns with moderate-to-severe HIE is ideally initiated within the first six hours after birth and generally continued for 72 hours. Eligibility depends on factors including gestational age, examination findings, laboratory results, and the individual clinical situation.
- If seizures are suspected, ask whether continuous EEG monitoring is being used and record its start and stop times. Continuous EEG is an important tool for evaluating suspected or confirmed neonatal seizures, but the appropriate duration depends on the baby’s circumstances.
- If jaundice is an issue, write down each bilirubin value and the time it was drawn. Ask what phototherapy threshold is being used. Under the AAP guideline for newborns at least 35 weeks’ gestation, treatment thresholds depend on factors including the baby’s gestational age, age in hours, bilirubin level, and neurotoxicity risk factors.
- If your baby is being transferred to another hospital, record when the transfer was requested, when the transport team arrived, when your baby departed, and when your baby reached the receiving hospital. Kentucky families may encounter teams such as UK HealthCare’s Kentucky Kids Crew or Norton Children’s “Just for Kids” Transport Team.
Within 24–72 Hours
- Ask whether your baby’s Kentucky newborn screening has been completed. Kentucky’s program includes a heel-stick blood specimen, pulse-oximetry screening for critical congenital heart disease (CCHD), and newborn hearing screening. Kentucky CHFS states that newborn screening should generally occur about 24 hours after birth or before hospital discharge.
- Start a timeline notebook or phone note. Record important events by exact time whenever possible, rather than only by date.
- If labor involved fetal-heart-rate concerns, oxytocin, an emergency cesarean delivery, shoulder dystocia, a difficult assisted delivery, or another complication, write down what staff told you in their own words. You can compare those explanations with the medical record later.
- Keep copies or screenshots of information released through the patient portal, including labs, imaging reports, after-visit summaries, messages, medication lists, and discharge instructions.
- Ask what specialists will follow your baby after discharge and whether appointments are being made with neurology, developmental pediatrics, audiology, ophthalmology, a high-risk infant clinic, physical therapy, occupational therapy, or speech/feeding therapy, as applicable.
During the First Two Weeks
- Send written medical-record requests for the mother’s labor-and-delivery record and the baby’s newborn/NICU record. These are usually separate medical records and may have different medical-record numbers.
- Ask for the complete fetal-monitoring record, not only selected screenshots or portions of the tracing. Request the exported tracing/images, annotations and event markers, and any separately archived waveform data that remains available.
- Request the complete medication administration record, including oxytocin administration and dose changes if oxytocin was used. You may also request any separately retained infusion-pump information, but pump logs are not necessarily part of the ordinary patient medical record or retained in every case.
- If your baby was transported, request records from the sending hospital, transport service, and receiving hospital.
- Keep all discharge paperwork, referrals, therapy evaluations, and follow-up records.
- Start a simple development and therapy journal documenting feeding, movement, tone, seizures or seizure-like events reported to physicians, sleep concerns, therapies, specialist visits, hospital returns, diagnoses, and developmental milestones.
- If developmental concerns arise, ask your pediatrician about Kentucky’s Early Intervention System (KEIS), formerly known as First Steps. Kentucky’s program serves eligible children from birth to age three who have developmental delays or certain conditions associated with developmental delay.
Medical Records That Can Help Reconstruct What Happened
No single lab result, monitor strip, Apgar score, or imaging study proves that malpractice occurred. Birth-injury evaluations generally require looking at the entire sequence of events.
Electronic Fetal Monitoring Records
Electronic fetal monitoring can show how the fetal heart rate and uterine activity changed during labor and what interventions occurred around those changes.
ACOG’s current Intrapartum Fetal Heart Rate Monitoring: Interpretation and Management Clinical Practice Guideline, published in October 2025, uses the familiar Category I, II, and III classification system and provides an evidence-based framework for evaluating and managing fetal-heart-rate patterns.
Useful records may include:
- Complete fetal-heart-rate and uterine-contraction tracings
- Nursing annotations and event markers
- Documentation of Category I, II, or III assessments
- Maternal-position changes and other interventions
- Oxytocin changes
- Provider notifications and bedside evaluations
- Documentation surrounding any decision to proceed with operative delivery
The tracing should be evaluated as part of the entire clinical record—not in isolation.
Oxytocin and Medication Records
When oxytocin was used to induce or augment labor, the timing and dose history can be important.
AHRQ identifies oxytocin as a high-alert medication and addresses monitoring for uterine tachysystole, fetal-heart-rate changes, provider notification, and circumstances in which oxytocin may need to be reduced or discontinued.
Records to look for include:
- Medication administration record
- Oxytocin start time
- Dose increases and decreases
- Stop and restart times
- Maternal and fetal monitoring around dose changes
- Nursing and physician documentation
- Infusion-pump information, if separately retained and available
A hospital’s actual policies and the patient’s clinical circumstances also matter.
Cesarean and Operating-Room Timeline
If an urgent or emergency cesarean delivery occurred, gather records showing the sequence of events, such as:
- Time the concern was recognized
- Time the obstetric provider was notified
- Decision for cesarean delivery
- Anesthesia notification and evaluation
- Transfer to the operating room
- Anesthesia start
- Incision
- Delivery
These times help reconstruct what happened. They should not be interpreted as though one fixed decision-to-delivery deadline applies to every case. ACOG’s 2025 fetal-monitoring guidance recognizes that the timing and mode of delivery depend on the maternal-fetal condition and what is clinically feasible.
Delivery-Room and Newborn Records
Important newborn information can include:
- Apgar scores
- Umbilical cord arterial and venous blood gases
- Early newborn blood gases
- Delivery-room resuscitation record
- Heart-rate and oxygenation documentation
- Intubation or ventilation records
- Chest compressions or medications, if required
- NICU admission documentation
- Neurologic examinations
- Seizure documentation and EEG
- Therapeutic-hypothermia records
- Brain ultrasound or MRI reports
- Infection evaluations and cultures
- Glucose results
- Bilirubin levels and phototherapy records
The 2025 AHA/AAP neonatal resuscitation guidelines superseded the prior 2020 recommendations and provide the current framework for neonatal resuscitation at birth.
Apgar scores, cord gases, the need for resuscitation, or even treatment with therapeutic hypothermia should not be treated as standalone proof of the cause of a baby’s condition. The AAP’s 2026 HIE report specifically notes that providing therapeutic hypothermia does not itself establish that hypoxia-ischemia caused the newborn’s encephalopathy.
Placental Records
If the placenta was sent to pathology, request the placental pathology report and any related pathology documentation.
Placental findings may provide additional information about infection, inflammation, bleeding, vascular problems, or other conditions relevant to understanding the pregnancy and delivery. Their significance depends on the rest of the medical evidence.
Transport Records
When a newborn is transferred to a higher-level NICU, transport documentation can help establish:
- When the transfer was requested
- When a receiving physician or service accepted the baby
- When the transport team was activated
- Team arrival time
- Baby’s condition before departure
- Treatments performed before and during transport
- Departure and arrival times
- Temperature and other monitoring during transport
- Bedside handoff at the receiving hospital
UK HealthCare’s Kentucky Kids Crew provides neonatal and pediatric interfacility critical-care transport, while Norton Children’s “Just for Kids” team provides neonatal and pediatric transport by ground and air.
Kentucky Medical Records Request Template
You can copy, edit, and send the following to the hospital’s Health Information Management (HIM) or Medical Records Department.
To: Health Information Management / Medical Records
Hospital: [Hospital Name]
Re: [Mother’s Full Name], DOB [MM/DD/YYYY], MRN [if known]
**and/or Baby [Baby’s Full Name], DOB [MM/DD/YYYY], MRN [if known]I am requesting a copy of the complete medical record under applicable Kentucky and federal law, including KRS 422.317 and, for my minor child’s records, KRS 422.355, subject to any applicable legal exceptions.
Please provide the records electronically through a secure portal or other available electronic format.
For the maternal labor-and-delivery record, please include:
- Triage and admission records
- Labor-and-delivery flowsheets
- Nursing, physician, midwife, resident, and consultant notes
- Orders
- Complete medication administration record
- Induction or augmentation documentation
- Oxytocin administration, including documented start, stop, restart, and rate changes
- Any separately retained infusion-pump data that is available
- Complete fetal-monitoring tracings from admission through delivery, including annotations and event markers
- Any archived fetal-monitor waveform/data exports that remain available
- Uterine-monitoring/IUPC records, if used
- Laboratory results
- Anesthesia evaluation and record
- Operating-room record and timestamps
- Delivery note and operative report
- Placental pathology report, if performed
- Postpartum and discharge records
For the baby’s newborn/NICU record, please include:
- Delivery-room/newborn resuscitation record
- Apgar scores
- Umbilical cord blood-gas results
- Early newborn blood gases
- Newborn and NICU nursing and physician records
- Medication administration records
- Respiratory-support and ventilator documentation
- Neurologic examinations
- Therapeutic-hypothermia/cooling documentation, if applicable
- EEG reports and monitoring dates/times
- Imaging reports, including head ultrasound and MRI
- Laboratory results
- Bilirubin results with collection times
- Phototherapy documentation
- Infection workup, cultures, and antibiotic records
- Consultation notes
- Newborn-screening documentation
- Discharge records and follow-up referrals
If a requested item is maintained in a separate system, archive, department, or transport service and is not included in the ordinary medical-record release, please identify where I should direct a separate request.
Requested delivery: Secure electronic copy
Name: [Name]
Address: [Address]
Phone: [Phone]
Email: [Email]
Signature: __________________________
Date: ______________________________
Kentucky’s KRS 422.317 states that, upon a patient’s written request, a covered hospital or health care provider must provide the patient a copy of the medical record without charge. The statute permits a copying fee of up to $1 per page for a second copy. Kentucky also enacted KRS 422.355, effective in 2024, expressly providing parents and other qualifying personal representatives access to a minor patient’s health information, subject to federal and state-law exceptions.
What About EHR Audit Trails and Hospital Policies?
You may hear attorneys or experts discuss an EHR audit trail, metadata, hospital policies, protocols, staffing information, or device logs.
Those materials are not necessarily part of the ordinary patient medical record, and a routine request under KRS 422.317 should not be assumed to require their production.
If a potential legal claim is being investigated, an attorney can determine whether additional records should be requested informally, preserved, obtained through authorization, or later sought through formal legal process.
Build a Minute-by-Minute Birth Timeline
Print this page or recreate it in a notebook.
Labor and Delivery
Hospital arrival/admission: __________________________
Labor began / induction began: _______________________
Fetal monitoring started: ____________________________
First fetal-heart-rate concern you were told about: __________________________
Provider notified: __________________________
Provider arrived/evaluated: __________________________
Maternal repositioning or other interventions:
IV fluids or medications:
Oxytocin started: __________________________
Oxytocin increased/decreased/stopped:
Amnioinfusion, if performed: __________________________
Decision for operative delivery, if any: __________________________
Anesthesia notified/evaluated: __________________________
Entered operating room: __________________________
Incision: __________________________
Delivery: __________________________
Newborn and NICU
Time of birth: __________________________
Apgar scores: 1 minute ______ / 5 minutes ______ / other ______
Cord arterial pH: __________________________
Cord arterial base deficit/excess: __________________________
Cord venous results: __________________________
Resuscitation performed:
NICU admission: __________________________
First neurologic concern documented or discussed:
HIE/encephalopathy evaluation: __________________________
Therapeutic hypothermia considered: Yes / No / Unknown
Cooling started: __________________________
Cooling ended / rewarming began: __________________________
Suspected or confirmed seizures: __________________________
EEG started: __________________________
EEG stopped: __________________________
Head ultrasound: __________________________
MRI: __________________________
Highest/important bilirubin values and times:
Phototherapy started: __________________________
Phototherapy stopped: __________________________
Cultures/infection workup: __________________________
Antibiotics started: __________________________
Transport
Transfer requested: __________________________
Receiving hospital/service: __________________________
Transfer accepted: __________________________
Transport team activated: __________________________
Transport team arrived: __________________________
Baby departed sending hospital: __________________________
Baby arrived at receiving hospital: __________________________
Important treatment during transport:
Kentucky Birth Injury Deadlines: Do Not Guess
Kentucky limitation rules are especially important because different claims arising from the same birth can have different deadlines.
Kentucky’s Medical-Malpractice Statute
KRS 413.140 includes a one-year limitations period for negligence or malpractice actions against physicians, surgeons, dentists, and qualifying hospitals. For medical-malpractice claims, the statute ties accrual to when the injury was discovered or, through reasonable care, should have been discovered. The statute also contains a five-year provision concerning the alleged negligent act or omission.
Birth-injury cases involving children require additional analysis because Kentucky also has an infancy-tolling statute.
A Child’s Minority Can Affect the Deadline
KRS 413.170 provides that when a person entitled to bring an action covered by the statute was an infant when the cause of action accrued, the limitations period may be tolled until the disability of minority is removed.
Kentucky’s Supreme Court addressed this issue again in June 2026. In Mercy Regional Emergency Medical System, LLC v. Estate of Fuson, the Court held that KRS 413.170 protected the minor children’s claims from the ordinary limitations period and that a next friend could not waive that statutory tolling merely by previously pursuing related claims.
That does not mean every claim connected to an injured child can wait until the child becomes an adult.
A child’s own claim, a parent’s individual claim, and a claim belonging to an estate can involve different parties, different legal rights, and different deadline calculations.
For that reason, parents should not rely on a general statement that “the child is a minor, so there is plenty of time.”
Wrongful Death Claims Are Different
If a child dies because of an alleged wrongful act or negligence, Kentucky’s wrongful-death statute provides that the action is prosecuted by the deceased person’s personal representative. KRS 411.130 also governs how a recovery is distributed.
Do not assume that tolling applicable to a child’s personal claim necessarily extends a deadline belonging to an estate or another family member.
Because deadline questions are highly fact-specific, speak with a Kentucky attorney promptly if you are considering a potential birth-injury or wrongful-death claim.
What to Save in a Birth Injury File
Create one paper folder, digital folder, or both.
Save:
- Complete hospital discharge paperwork
- Patient-portal downloads and screenshots
- Maternal labor-and-delivery records
- Baby’s newborn and NICU records
- Fetal-monitoring records
- Medication administration records
- Cord-gas and early blood-gas results
- Resuscitation records
- Placental pathology report
- Imaging reports and imaging files when available
- EEG reports
- Therapeutic-hypothermia records
- Bilirubin results and phototherapy documentation
- Transport records
- Specialist referrals
- Neurology records
- High-risk infant clinic records
- Pediatric records
- Physical, occupational, speech, and feeding therapy records
- Early-intervention evaluations and plans
- Hospital bills and insurance explanations of benefits
- Your contemporaneous timeline
- Your child’s symptom, development, and therapy journal
Avoid changing or “cleaning up” your original notes later. If you remember something new, add a new dated entry rather than rewriting the earlier entry.
If Your Baby Was Transferred to Another Kentucky Hospital
A transfer can generate records in several places.
Ask for documents from:
- The sending hospital
- The transport provider
- The receiving hospital
UK HealthCare — Kentucky Kids Crew
Kentucky Kids Crew provides hospital-to-hospital critical-care transportation for neonatal and pediatric patients and operates through Golisano Children’s at UK. Its transport teams provide ground and air critical-care transport.
If your baby was transported by Kids Crew, ask for documentation reflecting the activation, stabilization, transport, monitoring, treatments, departure, arrival, and handoff.
Norton Children’s — “Just for Kids” Transport Team
Norton Children’s “Just for Kids” Transport Team provides specialized neonatal and pediatric transportation 24 hours a day by ground and air.
Again, request the transport record separately if it is not included in the hospital’s ordinary medical-record release.
Do Medical Guidelines Prove Medical Malpractice?
No.
Organizations such as ACOG, AAP, AHA, ACNS, and AHRQ publish important clinical guidelines and patient-safety resources. Those materials can help families understand medical terminology, recognized risks, monitoring, and common clinical decision points.
They should not be treated as automatic proof of the legal standard of care in an individual case.
For example:
- ACOG’s 2025 fetal-monitoring guideline provides a framework for interpreting and managing intrapartum fetal-heart-rate patterns.
- AHRQ publishes safety guidance for oxytocin administration and responses to tachysystole and fetal-heart-rate abnormalities.
- The AAP’s 2022 hyperbilirubinemia guideline sets risk-based treatment thresholds for eligible newborns.
- The AHA and AAP jointly published updated neonatal-resuscitation guidelines in 2025, superseding the 2020 recommendations.
- The AAP’s 2026 HIE report addresses therapeutic hypothermia, including the importance of early recognition and initiation of cooling for eligible infants.
- The American Clinical Neurophysiology Society has current guidance addressing continuous EEG monitoring in neonates with suspected, high-risk, or confirmed seizures.
Whether a particular doctor, nurse, hospital, or other provider met the applicable legal standard of care depends on the circumstances and generally requires case-specific evaluation.
When You Are Ready to Understand Your Legal Options
If your child experienced a serious complication during labor, delivery, or the newborn period and you have questions about whether the care should be investigated, you can speak with the Morrin Law Office about your situation.
A legal review can help determine what records should be obtained, how the labor and newborn timeline fits together, whether additional medical review may be appropriate, and what Kentucky deadlines may apply.
Call Morrin Law Office for a free consultation:
859-358-0300
214 W Main St., Richmond, KY 40475
The sooner records and timelines are preserved, the easier it may be to evaluate what happened.
Sources and Public Resources
- Kentucky Revised Statutes — KRS 422.317, medical-record copies: KRS 422.317 — Kentucky Legislature
- Kentucky Revised Statutes — KRS 422.355, parental access to a minor’s medical record: KRS 422.355 — Kentucky Legislature
- Kentucky Revised Statutes — KRS 413.140, limitations for medical-malpractice actions: KRS 413.140 — Kentucky Legislature
- Kentucky Revised Statutes — KRS 413.170, infancy tolling: KRS 413.170 — Kentucky Legislature
- Kentucky Revised Statutes — KRS 411.130, wrongful death: KRS 411.130 — Kentucky Legislature
- Kentucky Supreme Court — Mercy Regional Emergency Medical System, LLC v. Estate of Fuson (June 25, 2026): Published Kentucky Supreme Court opinion
- ACOG — Intrapartum Fetal Heart Rate Monitoring: Interpretation and Management, Clinical Practice Guideline No. 10 (October 2025): ACOG fetal-heart-rate monitoring guideline
- AHRQ — Safe Medication Administration: Oxytocin: AHRQ oxytocin safety guidance
- American Academy of Pediatrics — Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation (2022): AAP hyperbilirubinemia guideline
- American Heart Association/American Academy of Pediatrics — 2025 Neonatal Resuscitation Guidelines: 2025 AHA/AAP neonatal resuscitation guidelines
- American Academy of Pediatrics — Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy (2026): AAP 2026 therapeutic hypothermia clinical report
- American Clinical Neurophysiology Society — Continuous EEG Monitoring in Neonates: ACNS neonatal continuous EEG guideline
- Kentucky Cabinet for Health and Family Services — Newborn Screening Program: Kentucky Newborn Screening Program
- Kentucky Cabinet for Health and Family Services — Kentucky Early Intervention System: Kentucky Early Intervention information
- UK HealthCare — Kentucky Kids Crew: Kentucky Kids Crew neonatal and pediatric transport
- Norton Children’s — “Just for Kids” Transport Team: Norton Children’s transport services
Disclaimer
This page provides general educational information only. It is not medical advice and is not a substitute for advice from your child’s physicians or other qualified health care professionals. It is also not legal advice, and reading this page or contacting Morrin Law Office does not by itself create an attorney-client relationship.
Medical guidance and Kentucky law can change, and the significance of any medical record, event, diagnosis, or legal deadline depends on the specific facts. Families with questions about a child’s health should consult the child’s medical team. Families with questions about a potential legal claim should speak with a qualified attorney about their individual circumstances.
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