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Brachial Plexus Injury Overview

When dealing with brachial plexus injury and other types of birth injuries, it is important to remember that they often result from avoidable trauma. The process of labor and delivery can be a stressful one for mother and child. Complications during birth such as a long or difficult labor, a breech birth or the baby’s shoulder being lodged against the mother’s pelvis can create a tense situation in which the delivery team may have to take prompt measures to avoid injury or harm to the baby.

A brachial plexus injury is one type of birth injury, which can permanently affect mobility and sensation on the shoulder, arm and hand of the child. It is said to occur in about one to three out of 1,000 live births in the United States. Consequences of a brachial plexus injury may include lifelong disability and ongoing medical and rehabilitation costs. Brachial plexus injuries tend to occur due to medical errors and/or medical negligence. If your child has 1suffered Erb’s palsy, Klumpke’s paralysis or any other type of brachial plexus injury at birth, you should immediately discuss your case with an experienced New York City birth injury lawyer.

What is a Brachial Plexus Injury?

The brachial plexus is an intricate network of nerves located between the neck and the shoulders, which control muscle function in the chest, shoulder, arms and hands, as well as sensation or feeling in the upper limbs. Brachial plexus birth palsy is an injury to the brachial plexus nerves. During a difficult birth, these nerves may stretch, compress or tear causing loss of muscle function or even paralysis of the upper arm. These injuries may affect all or only a part of the brachial plexus. Injuries to the upper brachial plexus (C5, C6) affect the muscles of the shoulder and elbow while injuries to the lower brachial plexus (C7, C8 and T1) may affect muscles of the forearm and the hand.

What Causes Brachial Plexus Injuries?

When a brachial plexus injury happens during birth, it may affect any part of the nerve fibers and it may range in severity depending on where the injury is located and how it occurred. One of the most common causes of brachial plexus injury is excessive stretching and force that is applied during labor and delivery. In most of these instances, the labor and delivery is typically difficult and stressful. Often, the delivery involves the use of birth-assistance tools such as forceps or a vacuum extractor.

Some of the other common causes of brachial plexus injuries at birth include:

  • A breech delivery, which occurs when a baby is born feet-first instead of head-first. Around 3 to 5 percent of pregnant women will have a breech baby. Most babies in breech position are born by caesarean section because it is viewed as safer than being born vaginally.
  • Large infant weight and size. Also known as “macrosomia,” this is when a newborn is larger than average. The average newborn weighs about 7 pounds. Babies with macrosomia weigh more than 8 pounds and 13 ounces. Macrosomic babies are more likely to have a difficult delivery. The risk of complications is significantly greater when a baby is born weighing more than 9 pounds and 15 ounces.
  • The mother has diabetes or is obese. Infants that are born to diabetic or obese mothers have a greater risk for complications including respiratory distress, growth abnormalities and congenital malformations.
  • When baby gets lodged in the mother’s pelvic area. This occurs because a woman’s pelvis isn’t big enough to let the baby through. Some women have pelvises that may have less room in certain parts causing the baby to become stuck. This situation is usually diagnosed when labor is not progressing. Care providers need to remain vigilant and make attempts to strengthen contractions or speed up labor by artificial means. If the baby is in distress, an emergency C-section is often required.

Even when birth-assisting tools are not used, brachial plexus injuries may occur if a doctor applies improper pressure and force on the infant during delivery. For example, infant shoulder dystocia occurs when the baby’s head is delivered, but the shoulders get stuck in the mother’s pelvic region. When a complication such as asphyxia occurs, the doctor may pull the baby’s shoulders with excessive force, which may lead to damage of the brachial plexus nerves.

Types of Brachial Plexus Injuries

There are several different types of brachial plexus injuries. Brachial plexus birth palsies are often categorized by the type of nerve injury and the pattern of nerves involved. Generally speaking, there are four types of brachial plexus nerve injuries.


This is the most common type of brachial plexus injury and involves the stretching and tearing of the nerves in the brachial plexus. This type of injury typically occurs outside the spinal cord. Neurapraxia injuries essentially affect the protecting lining and covering of the nerve. Still, this type of injury can be painful and cause difficulties. Common symptoms of neurapraxia include muscle weakness; burning, tingling or numbness in the affected area; extreme sensitivity; and sensation issues.

Erb’s Palsy

Erb’s palsy is simply another name for Brachial Plexus Palsy. It occurs when the brachial plexus nerves in the upper arm are damaged. In such cases, the nerve is torn, but not at the location where it attaches to the spine. The injury occurs outside the spinal cord. Erb’s palsy usually ranges in severity depending on how the injury occurred. The consequences of Erb’s palsy may be long-term or even permanent. The child may suffer full or partial paralysis in the affected arm. The infant may lose sensation or motor function in the arm that has been affected. The child may suffer decreased grip and arm numbness and the affected arm may be bent toward the body or hang limp. Treatment options for Erb’s palsy may range from medications and surgery to physical therapy and massage.

Klumpke’s Palsy

Klumpke’s palsy is a type of brachial plexus injury that affects the lower part of the brachial plexus nerves resulting in numbness, loss of feeling and a claw-like appearance in the hand of the affected arm. Klumpke’s palsy is caused by difficulties in childbirth including complications in vaginal deliveries, particularly in situations where the mother is small and the baby has a large birth weight and gets stuck in the birth canal.

Klumpke’s palsy affects the hand, wrist, and arm and is typically caused by shoulder dystocia, which occurs when the infant gets lodged in the mother’s pelvis. When a doctor pulls and uses excessive force in an attempt to get the baby out, it may result in this type of a brachial plexus injury. In severe cases where children suffer partial or complete paralysis, medication, surgery and rehabilitation may be needed.

Horner’s Syndrome

This represents roughly 10 to 20 percent of brachial plexus injuries and it is usually associated with an avulsion or the action of a pulling and/or tearing. In these cases, a chain of nerves has been injured, usually in the T2 to T4 region. The child may have myosis (drooping eyelid) and anhydrosis (diminished sweat in part of the face). In addition, the child may have a more severe injury of the brachial plexus where the nerve roots are torn from the spinal cord. This type of injury typically occurs in the spinal cord. It cannot be surgically repaired. Instead, the damaged tissue must be surgically replaced through nerve transfers. An avulsion may also injure the nerve connected to the diaphragm, causing breathing difficulties.


This type of injury occurs when scar tissue grows around and over the affected area putting excessive pressure on the injured nerve. This may make it difficult for the affected nerve to send signals to the muscles. Neuroma may resolve on its own if the scar tissue is smaller. However, if it is too large, surgery may be required to remove the scar tissue. Neurolysis is another type of treatment that is routinely used for children with neuroma. It involves applying hot and cold packs or chemicals such as alcohol.

Compensation for Brachial Plexus Injuries

The cost of raising a child who has suffered a brachial plexus injury will depend on the severity of the injuries that have been suffered. Parents with children who have mild to moderate limitation in their range of motion will spend less on treatment and rehabilitation costs compared to those whose child has suffered partial or complete paralysis. If your child’s birth injuries were caused by medical negligence on the part of the obstetrician, nurse or other hospital staff members you may be able to seek the following damages:

  • Medical Expenses: Ongoing medical expenses, which typically include physical and occupational therapy costs and expenses relating to surgeries, hospitalizations, medications and medical equipment.
  • Lost income: This includes future loss of wages, which the patient will suffer as a result of his or her permanent injuries or disabilities. This also includes the loss of income parents sustain as a result of caring for a child with brachial plexus injuries or other birth injuries.
  • Physical and occupational therapy: Children who experience the symptoms of a birth injury will require ongoing and possibly, lifelong occupational and physical therapy services. These can prove expensive.
  • Psychological services: Brachial plexus injuries may result in a number of psychological issues that may need to be treated over the course of a lifetime. These types of services may also be costly.

The consequences of a brachial plexus injury may be temporary or lifelong. This varies depending on the nature and extent of the injuries the child has sustained. Depending on the type of brachial plexus injury the child has suffered, some may recover quickly. However, other children with severe damage to the brachial plexus nerves may only recover with surgical intervention or not at all. It may take months or even years after the injury, if at all.

If your child suffered a brachial plexus injury because your doctor failed to anticipate reasonable risks or complications, or because your doctor performed dangerous actions during delivery such as using excessive force, you may be able to seek compensation by filing a medical malpractice lawsuit against the doctor and/or the hospital. Such a lawsuit can help compensate you and your child for damages and costs associated with the injuries.

Our Results

  • $1,400,000: We recovered this amount for a newborn, who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head. As a result, the child now suffers from a brachial plexus injury.
  • $1,175,000: Settlement in a brachial plexus palsy case.
  • $1,000,000: We recovered this amount for a baby who suffered from Erb’s palsy after doctors were negligent during the delivery. The child for whom we recovered this money is now a fully functional teenager.
  • $850,000: Settlement reached in Erb’s palsy case.
  • $2,850,000: Verdict for one of our Erb’s palsy clients that was reduced by the appeals court to $1,850,000 because the verdict was so large. This was the highest amount upheld by the appellate courts for many, many years.

Contacting an Experienced Lawyer

If your child has suffered a birth injury or has been diagnosed with a brachial plexus injury as a result of medical negligence, you may be able to file a lawsuit seeking compensation for damages including, but not limited to, medical expenses, lost income and benefits, loss of livelihood, hospital and rehabilitation costs, permanent injuries, disabilities, past and future pain and suffering, etc. The experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you.

Please contact us TOLL FREE 24 hours a day, 7 days a week at 1-800-WORK-4-YOU (1-800-967-5496). WE CAN EVEN COME TO YOU. There is no attorneys’ fee unless we recover money for you. We can also help with personal injury cases in New York, New Jersey, Connecticut, Pennsylvania, or Florida. If you have been seriously injured in any of the 50 U.S. states, please call us and we will try to help you with your case.

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