A brachial plexus birth injury, also known as Erb’s palsy, is an injury to the nerves of the brachial plexus. The brachial plexus is a complex network of nerves between the neck and shoulders, which control muscle function in the chest, shoulder, arms and hands as well as sensation or feeling in the upper limbs.
During a difficult birth, the nerves of the brachial plexus may be stretched, compressed or torn. This may result in loss of muscle function or even paralysis of the upper arm. Injuries may affect all or only a part of the brachial plexus. Injuries to the upper brachial plexus affect muscles of the shoulder and the elbow. Injuries to the lower brachial plexus can affect muscles of the hand and the forearm.
Types of Brachial Plexus Injuries
According to Johns Hopkins Medicine, brachial plexus birth injuries (Erb’s palsy) are often categorized depending on the type of nerve injury and the pattern of nerves that are involved. There are four types of nerve injuries:
Stretching or Neurapraxia: This is when the nerves of the brachial plexus have been stretched, but not torn. This type of injury is the most common when it comes to brachial plexus birth injuries (Erb’s palsy) and typically occurs outside the spinal cord.
Rupture: In such cases, the nerves of the brachial plexus may be torn, but not where they attach to the spine. This injury also occurs outside the spinal cord and often requires surgery in order to be repaired.
Avulsion: In these types of injuries, the nerve roots are torn from the spinal cord and therefore, the injury does occur at the spinal cord. This type of brachial plexus palsy (Erb’s palsy) occurs in up to 20% of cases and cannot be surgically repaired. The damaged tissue must be replaced via nerve transfers. An avulsion may also result in injuries to the nerves of the diaphragm, causing breathing difficulties. A droopy eyelid on the affected side may be an indication of a more severe injury such as Horner’s syndrome.
Neuroma: In this type of injury, the nerve has tried to heal, but scar tissue forms and presses against the injured nerve thereby interfering with nerve function. This type of injury may require surgical treatment with nerve reconstruction and/or secondary tendon transfers.
Forms of Brachial Plexus Injuries
Brachial plexus injuries (Erb’s palsy injuries) can manifest in different forms:
Erb’s palsy: This involves the upper portion of the brachial plexus. With this type of injury, the child usually experiences weakness involving the muscles of the shoulder and the biceps. Physical therapy at home for Erb’s palsy typically begins when the baby is 3 weeks old to prevent stiffness, atrophy and shoulder dislocation.
Total plexus involvement: This accounts for about 20 to 30% of brachial plexus injuries. All five nerves of the brachial plexus are involved in such cases. Children who are affected by such injuries may not be able to move the shoulder, arm or hand.
Horner’s syndrome: This represents roughly 10 to 20% of brachial plexus injuries. It is usually associated with avulsion. The child may experience symptoms such as droopy eyelid, miosis (smaller pupil of the eye) and a condition known as anhydrosis, which refers to diminished sweat production in part of the face.
Klumpke’s palsy: It involves the lower roots of the brachial plexus and typically affects the muscles of the hand.
Contacting an Experienced Lawyer
If your child has brachial plexus palsy (Erb’s palsy), he or she may be able to receive compensation that may help pay for medical expenses, lost income, cost of therapy, future treatments, 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. One of our clients secured a $2,850,000 verdict 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 many cases where New York City Health and Hospital Corporation facilities deliver babies who are born with cerebral palsy or Brachial plexus palsy (Erb’s palsy) stemming from negligence (carelessness), and/or medical malpractice in the labor and delivery etc. of the children.
The following list identifies some of these hospitals (operated by New York City Health and Hospital 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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