One of the most serious birth injuries that can occur during laborand delivery is brachial plexus palsy or Erb’s palsy — a type of brachial plexus injury that affects a baby’s shoulder, arm and hand, etc. The brachial plexus is a network of nerves near the neck that controls movement and sensation in the upper limbs. When these delicate nerves are stretched, compressed or torn during childbirth, a newborn may suffer weakness, paralysis or loss of feeling in one arm.
Many brachial plexus injuries are linked to avoidable medical errors. Here are the four most common causes of brachial plexus palsy or Erb’s palsy due to medical negligence.
This obstetric emergency occurs when a baby’s head delivers, but one or both shoulders become lodged behind the mother’s pelvic bone. The condition requires immediate and careful maneuvering to safely complete the delivery. When excessive force is used to pull the baby’s head or neck, the brachial plexus nerves can stretch beyond their normal range. Even a few seconds of improper traction can result in nerve damage.
Healthcare providers are trained in specific techniques such as repositioning the mother or using controlled maneuvers to relieve shoulder dystocia safely. If a doctor pulls forcefully on the baby’s head instead of following accepted protocols, the risk of permanent injury increases. Failure to properly manage shoulder dystocia is one of the most common grounds for a birth injury claim.
Improper handling during labor can cause Erb’s palsy. Excessive lateral traction (side-to-side pulling) on a baby’s head, especially when the shoulders have not fully cleared the birth canal, can stretch or tear the nerves in the neck and shoulder area. Medical professionals must carefully guide the baby through the birth canal. If a physician fails to follow standard obstetric guidelines, the use of unnecessary force may cross the line into negligence (carelessness).
In some cases, the injury may have been avoided altogether with a planned cesarean section (C-section). When risk factors such as fetal macrosomia (a large baby), maternal diabetes or a history of difficult deliveries are present, providers should evaluate whether a C-section would be safer. Ignoring known risk factors can expose both mother and baby to preventable harm.
Assisted vaginal deliveries sometimes require medical instruments such as forceps or vacuum extractors. When used correctly, these tools can help safely guide a baby out of the birth canal. However, improper placement or excessive pulling with these instruments can cause significant trauma. Forceps are metal instruments placed around the baby’s head to assist with delivery. If positioned incorrectly or applied with too much pressure, they can stretch the brachial plexus nerves. Similarly, a vacuum extractor that is used with too much traction or repeated attempts can increase the risk of nerve damage.
Medical providers must follow strict guidelines regarding when and how these tools are used. If an assisted delivery is attempted despite clear contraindications, or if repeated unsuccessful attempts are made, the risk of injury rises dramatically. In these situations, switching to an emergency C-section may have been the safer option.
Certain pregnancies carry a higher risk for brachial plexus injury. These include:
• Large birth weight (over 8 pounds, 13 ounces)
• Maternal diabetes
• Prolonged labor
• Breech presentation
• Prior history of shoulder dystocia
• Maternal obesity
A critical part of prenatal and delivery care is identifying these risk factors and creating an appropriate birth plan. If a physician fails to monitor fetal size, ignores warning signs during labor, or does not prepare for potential complications, preventable injuries can occur.
For example, if ultrasound estimates indicate a significantly large baby and the physician proceeds with a vaginal delivery without discussing the risks, this decision may fall below the accepted standard of care. Similarly, if warning signs of fetal distress appear and are not addressed promptly, the baby may be subjected to unnecessary trauma during a rushed or complicated delivery.
In the context of a birth injury such as brachial plexus palsy (Erb’s palsy), medical negligence is said to have occurred if:
• The healthcare provider failed to follow accepted medical standards.
• Excessive force was used during delivery.
• Risk factors were ignored or not properly managed.
• A safer alternative, such as a C-section, was not offered when appropriate.
Medical malpractice claims require a thorough investigation of prenatal records, labor and delivery notes and expert medical opinions. The family of a victim should immediately contact a birth injury lawyer who will work with field experts and investigators and can determine whether the injury should have been prevented.
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. It is in the best interest of injured victims and their families in such cases to contact an experienced personal injury lawyer before contacting the people responsible for the injuries, and definitely before contacting or communicating with any insurance company, or their lawyers, investigators, or adjusters.
One of our clients secured a $2,850,000 verdict in an Erb’s palsy (brachial plexus palsy) case that was reduced by the appeals court to $1,846,000 because the verdict was so large. This was the highest amount upheld by the appellate (appeals) courts for many, many years. In addition, we recovered $1,400,000 for a newborn who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head. Also, one of our clients obtained a verdict for $43,940,000 and another of our clients got a verdict for $23,500,000, both in medical malpractice cases.
We have seen cases where New York City Health and Hospital Corporation facilities deliver babies who are born with brachial plexus palsy (Erb’s palsy) or cerebral palsy, stemming from negligence (carelessness), and/or medical malpractice in the labor and delivery etc. of the children, such as cerebral palsy or brain damage etc.
The following list identifies some of these hospitals (operated by New York City Health and Hospitals Corporation):
• Jacobi Hospital aka Bronx Municipal 1400 Pelham Parkway South Bronx, New York 10461 718-918-5000
• Lincoln Hospital 234 East 149th Street Bronx, New York 10451 718-579-5000
• North Central Bronx Hospital 3424 Kossuth Avenue Bronx, New York 10467 718-519-5000
• Coney Island Hospital 2601 Ocean Parkway Brooklyn, New York 11235 718-616-3000
• Kings County Hospital 451 Clarkson Avenue Brooklyn, New York 11203 718-245-3131
• Woodhull Hospital 760 Broadway Brooklyn, New York 11206 718-963-8000
• Bellevue Hospital 462 First Avenue New York, New York 10016 212-562-5555
• Harlem Hospital 506 Lenox Avenue New York, New York 10037 212-939-1000
• Metropolitan Hospital 1901 First Avenue New York, New York 10029 212-423-6262
• Elmhurst Hospital 79-01 Broadway Elmhurst, New York 11373 718-334-4000
• Queens Hospital Center 82-68 164th Street Jamaica, New York 11432 718-883-3000
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