IV Infiltration Injuries in Florida Newborns and NICU Babies: What Parents Need to Know

When your newborn is in the Neonatal Intensive Care Unit (NICU), you trust the medical team completely. For many Florida families, that trust is shaken when a routine IV line leads to severe swelling, blistering, skin breakdown, or even permanent damage.

IV infiltration injuries in newborns and NICU babies are more common than many parents realize — and in some cases, they may be preventable medical malpractice.

What Is IV Infiltration in a Newborn?

IV infiltration occurs when IV fluids leak out of a vein and into surrounding tissue. In newborns — especially premature infants — veins are extremely fragile and delicate.

In more serious cases, the injury is called extravasation, which involves leakage of medications or solutions that can damage tissue, including:

• Total parenteral nutrition (TPN)

• Calcium solutions

• Dextrose

• Antibiotics

• Vasopressors

• Certain IV medications used in NICU care

Because newborn skin is thin and underdeveloped, even small amounts of leaked fluid can cause serious harm.

Newborns — particularly premature babies — are uniquely vulnerable:

• Tiny, fragile veins

• Underdeveloped skin and tissue

• Limited ability to express pain

• Frequent need for IV medications and nutrition

Many infiltrations are first noticed when a nurse sees swelling, blanching, redness, or coolness around the IV site. But in some cases, the leak goes unnoticed for hours.

Delays in detection can lead to:

• Severe swelling

• Skin necrosis (tissue death)

• Compartment syndrome

• Nerve damage

• Permanent scarring

• Need for surgical intervention or skin grafting

What Should NICU Staff Be Doing?

Hospitals throughout Florida — including facilities such as Nicklaus Children's Hospital, Jackson Memorial Hospital, and Baptist Hospital of Miami — are expected to follow strict protocols when caring for newborns with IV lines.

The standard of care generally requires:

• Frequent monitoring and documentation of IV sites

• Use of appropriate catheter size

• Securing IV lines properly

• Immediate response to swelling or discoloration

• Escalation to physicians when infiltration is suspected

• Use of antidotes (when appropriate) for certain medications

If a nurse fails to check an IV site for extended periods, ignores signs of swelling, or delays intervention, that may fall below the acceptable standard of care.

Warning Signs Parents May Notice

Parents are often the first to notice something is wrong.

You may observe:

• Sudden swelling of the hand, arm, foot, or scalp (common IV sites in newborns)

• Shiny or tight-looking skin

• Blisters

• Color changes (white, purple, red, or blue)

• Your baby crying when the area is touched

• The limb appearing cold

Never hesitate to speak up if something looks unusual. Prompt action can significantly reduce damage.

How Serious Can These Injuries Be?

While some infiltrations resolve with minimal harm, severe cases can result in:

• Full-thickness skin loss

• Permanent scarring

• Disfigurement

• Restricted movement of fingers or limbs

• Chronic pain or nerve damage

• Need for reconstructive surgery

In extreme cases, compartment syndrome can develop, cutting off blood flow and causing lasting functional impairment.

For a newborn who is just beginning life, these injuries can have lifelong consequences.

When Does an IV Infiltration Become Medical Malpractice in Florida?

Not every infiltration is malpractice. IVs can fail even with proper care.

However, a medical malpractice claim may exist if:

• The IV site was not properly monitored

• Nurses failed to respond to obvious warning signs

• Documentation is inconsistent or missing

• There was an unreasonable delay in treatment

• Hospital policies were not followed

• Staff were improperly trained

Florida law requires proof that the healthcare provider breached the prevailing professional standard of care and that the breach caused harm.