Brachial plexus palsy (Erb’s palsy) is a condition that often arises from complications during childbirth, particularly when shoulder dystocia occurs. The connection between these two conditions stems typically from negligent (careless) obstetric maneuvers that injure the brachial plexus nerves. Understanding this relationship is critical in birth injury cases as it involves a complex interplay between anatomy, delivery techniques and risk management.
What Is Brachial Plexus Palsy?
The brachial plexus is a network of nerves that originates in the spinal cord at the neck and controls the muscles and sensation in the shoulder, arm and hand. These nerves are vulnerable to injury during birth, particularly when excessive force is applied or when the baby’s position during delivery causes stretching or tearing of the nerve fibers.
Brachial plexus (Erb’s) palsy occurs when these nerves are damaged. The most common form in newborns is brachial plexus palsy (Erb’s palsy), which affects the upper nerves of the brachial plexus. This results in weakness or paralysis in the upper arm and shoulder. It could result in in permanent disability.
What Is Shoulder Dystocia?
Shoulder dystocia is an obstetric emergency in which, after the delivery of the baby’s head, the anterior shoulder becomes lodged behind the mother’s pubic bone. This impedes the delivery of the rest of the baby’s body and requires immediate and careful intervention to avoid serious complications.
When this happens, it poses significant risks to both the infant and the mother. For the baby, these risks include hypoxia (lack of oxygen), fractures and nerve injuries such as Erb’s palsy/brachial plexus palsy. For the mother, it can result in hemorrhage, tearing, and other complications.
How Shoulder Dystocia Causes Erb’s Palsy
When shoulder dystocia occurs, medical professionals must act quickly to resolve the situation. Various maneuvers are employed to dislodge the shoulder, including the McRoberts maneuver, suprapubic pressure and more invasive procedures such as rotational maneuvers or delivering the posterior arm first.
These maneuvers can sometimes exert excessive traction or lateral pressure on the infant’s head, neck and shoulders. When the baby’s head is pulled while the shoulder remains stuck, the brachial plexus nerves can stretch or tear, leading to Erb’s palsy.
Risk Factors for Shoulder Dystocia and Associated Nerve Injuries
Several factors increase the risk of shoulder dystocia and, consequently, the risk of brachial plexus injuries:
Fetal macrosomia: Babies weighing more than 4,000 grams (about 8 lbs 13 oz) are more likely to experience shoulder dystocia.
Maternal diabetes: This condition increases the likelihood of fetal overgrowth.
Prolonged second stage of labor: This could lead to longer labor and more stressful deliveries.
Instrumental delivery: Use of vacuum or forceps can increase the risk of traction injuries.
Previous shoulder dystocia: History of shoulder dystocia in prior deliveries raises the risk in subsequent births.
There are preventive strategies and clinical practices that can reduce the incidence or severity of injury in such cases:
• Prenatal identification of risk: Ultrasound to monitor fetal size, managing maternal diabetes, and assessing labor progression.
• Elective Cesarean delivery: This is considered in cases of suspected macrosomia or previous shoulder dystocia.
• Proper training in maneuvers: Medical providers must be well-versed in managing shoulder dystocia with minimal traction to reduce nerve injury.
Contacting an Experienced Lawyer
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 cases where New York City Health and Hospital Corporation facilities deliver babies who are born with 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 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
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, lead poisoning and medical malpractice cases including, brachial plexus palsy (Erb’s palsy) and cerebral palsy 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.
Other TOLL FREE phone numbers for us are:
1-800-RADIO-LAW, 1-888-WYPADEK, OR 1-800-LAS-LEYES
Please visit us at: www.WORK4YOULAW.com