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Shoulder Dystocia/Erb’s Palsy/Brachial Plexus Injury

Erb’s Palsy/Shoulder Dystocia/ BPI: A Lifelong and Often Avoidable Birth Injury

DeliveryThe brachial plexus is a group of nerves that control the muscles of the shoulder and arm. When excessive force during a child’s birth causes injury to the nerves, the resulting condition is called Erb’s Palsy, Brachial Plexus Palsy, or Erb-Duchenne Paralysis. When the damage also affects the arm and hand, the condition is called Klumpke Paralysis.

This type of injury to a child is often medical negligence due to substandard care during the birth process. Oftentimes there was a failure to diagnosis a large baby that cannot fit through the birth canal, which led to the baby’s shoulders getting stuck. The medical providers then fail to follow proper procedures to safely deliver the baby. They apply excessive force by pulling and/or twisting, resulting in the ripping or tearing of nerves from the spine.

Baby with Erb's PalsyWeakness of the arm is often seen in the delivery room. With physical therapy, some babies recover in the first two years of life, but are not often fully functional. Others require potential nerve grafts and nerve transfer surgeries, which may or may not be successful. Those that do not recover can have a life-long disability including a separation of the nerve root from the spinal cord.

If you suspect that your child’s physical problems or learning disabilities are related to something that happened at birth, please don’t delay in contacting us so that we can appropriately investigate your case. There are time limitations for filing such cases.

Child injury

If you want information about Brachial Plexus injury in adults click to our page here

If you are reading this information regarding your child’s health, two important things to know are:

  1. Babies who’s Moms’ have had prenatal care in the seventh through ninth month of pregnancy should not experience this injury. With regular prenatal care health care professionals should never be surprised about your baby’s size and/or in comparison to your birth canal size, when labor occurs. That is regardless of a planned C-Section, naturally occurring labor or induced labor.
  2. No matter the mildness or severity of the child’s nerve injury, medical treatment will be needed, and usually for a considerable time period.

Other associated terms and conditions of Brachial Plexus Injury are Shoulder Dystocia, Erb’s Palsy, Horner’s Eye, Kulmpke’s Palsy, and Waiter’s Tip.

Obstetric Brachial Plexus Injury (OBPI) is a nerve injury occurring during a baby’s birth. If your baby is diagnosed with this, an investigation by an experienced birth injury attorney is warranted. This life-long injury is most commonly caused by medical negligence. If a Mom or Dad is told that it was a difficult delivery and that their baby’s or Mother’s size was the reason for the nerve injury that is not accurate. The size of the baby or Mom may be a risk factor associated with shoulder dystocia which should be recognized by the health care providers so that steps can be taken to safely deliver the baby free from any injury.

Just because a baby is big, a Mom has a smaller birth canal than baby’s width, or has any other medical conditions; an injury should not happen to the baby. The medical standard of care requires doctors and hospitals to plan for the proper delivery of a baby when they know a baby will be large, a mother is small, and when a mother has other certain medical conditions. Babies whose mothers’ have had regular prenatal care should not experience this injury.

Babies whose mothers’ have regular prenatal care have the right to expect their baby will be born safely. Parents always have the legal right to question any concerns about their child’s birth and resulting conditions. With regular prenatal care there should be no surprises when labor occurs as to a baby’s size in comparison to Mom.

The brachial plexus are the nerves that control the hand, arm, and shoulder. A birth injury may happen when a baby is too large for the birth canal and a medically negligent delivery technique is used, such as pulling or twisting the baby’s head and shoulders, or using a vacuum extraction incorrectly. These methods can cause the brachial plexus nerves to stretch or tear.

Erb’s Palsy (or Erb-Duchenne Palsy) refers to upper nerve damage. A different but related injury is Total Brachial Plexus Palsy also known as Klumpke’s Palsy which refers to the lower and upper nerves being injured. Other associated terms are:
Waiter’s Tip which is when the arm hangs down and the hand is turned backward.
Horner’s Syndrome which can affect the nerves leading to the face and eye.

Do you see these symptoms?
Your child has a lack of movement in the shoulder, arm, hand or fingers
Your child has a weak hand grip
Your child does not have the normal Moro Reflex, meaning she does NOT fully extend arms out and/or raise her arms when she feels a falling sensation or hears a sudden noise

An associated condition called Horner’s Syndrome which affects the eye and/or face may have occurred. It could have been due to damage to the sympathetic nerves of the face, as a result of pulling too hard during delivery. You may notice that your baby has:

A smaller pupil size in one eye
A drooping eyelid in one eye
Your baby has decreased sweating on the affected side of the face.

You owe it to your family to have Pegalis Law Group, LLC investigate what happened to cause the Erb’s Palsy Birth Injury. The costs over a lifetime of with treatment and therapy can be considerable. Treatment options vary and at the least will include occupational and/or physical therapy to increase function. Healing for a more minimal injury may take from three months to two years. A more severe injury may require multiple surgeries. Unfortunately there is also the possibility of paralysis, with its associated high cost of care and the need for a lifetime of costs for household help and sometimes loss of income.

Call us for a no-fee consultation directly with our senior partners at 516 684-2900 or email us here.

Child injury

Types of obstetrical injuries of the brachial plexus that can happen during the birth of a baby

The Neurapraxia injury can have occurred in your baby during delivery when a nerve was stretched or compressed such as in a difficult delivery when proper precautions were not taken. The baby’s affected nerves may recover with treatment.

A Rupture injury occurs when the baby’s nerve is torn, but not where it attaches to the spine. This can happen during delivery yet should never happen! This type of OBPI may require multiple surgical repairs.

An Avulsion injury of the brachial plexus nerves occurs when the nerve roots are torn away and separated from the spinal cord. This brachial plexus injury requires multiple treatments and often replacement of the damaged tissue.

A Neuroma injury may occur when a young child’s nerve tried to heal itself, causing scar tissue to form, which puts pressure on the injured nerve. This can severely interfere with functioning. This brachial plexus injury may require long-term therapies as well as surgical treatments, such as nerve reconstruction or secondary tendon transfers.


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