Newborn Facial Nerve Palsy

Facial nerve palsy is one of the most common and emotionally difficult birth injuries, affecting around 1.8 out of every 1,000 live births. It occurs when the seventh cranial nerve, which controls facial movement, is damaged during childbirth. This can lead to uneven facial expressions and difficulties with feeding. While many cases are temporary and resolve within weeks, up to 10% result in permanent paralysis—often due to preventable trauma linked to medical negligence.

In most cases, facial nerve injuries are caused by mechanical trauma during birth. Instrument-assisted deliveries, such as those using forceps or vacuum extractors, can apply damaging pressure to a newborn’s fragile facial nerve. Because infants’ bones have not fully developed to protect this nerve until about age two, they are especially vulnerable to injury during delivery. When healthcare providers apply too much force, use instruments improperly, or fail to perform a cesarean section when necessary, the consequences can be life-altering.

If your baby developed facial nerve palsy due to medical negligence during delivery, the experienced New York birth injury attorneys at the Porter Law Group are here to help you pursue justice and compensation for your child's injuries and your family's emotional distress.

Experienced Newborn Facial Nerve Palsy Lawyers Throughout New York State

If you suspect your child’s facial nerve injury was caused by excessive force during delivery, improper use of forceps or vacuum extractors, or a delayed cesarean section, contact the Porter Law Group right away. Our knowledgeable birth injury lawyers have extensive experience advocating for families affected by preventable facial nerve injuries throughout New York State, from New York City and Long Island to Albany, Syracuse, Buffalo, Rochester, and every community across the state.

We understand the complex medical and legal issues surrounding birth-related facial nerve injuries and work with leading neurologists, plastic surgeons, obstetricians, and other medical experts to thoroughly investigate each case. Our team will examine whether healthcare providers used appropriate delivery techniques, recognized risk factors requiring alternative delivery methods, and provided adequate informed consent about the risks associated with instrumental deliveries.

Call us at 833-PORTER9 or email info@porterlawteam.com to discuss your legal options in a free, comprehensive consultation. We're committed to helping families understand their rights and pursue compensation for both the immediate and long-term consequences of preventable facial nerve injuries.

Understanding Facial Nerve Injury in Newborns

The facial nerve, or seventh cranial nerve, controls all facial movements including eye closure, facial expressions, and mouth movements crucial for feeding and communication. In newborns, this nerve's path through the skull makes it particularly vulnerable to injury during the birth process.

Anatomical Vulnerabilities During Birth

The facial nerve passes through several narrow areas in the skull, including the stylomastoid foramen and the parotid gland, making it especially vulnerable during childbirth. In vertex (head-first) deliveries, the baby’s facial nerve can be compressed between the mother’s pelvic bones or by obstetrical instruments. Because newborns lack the bony protection that develops by age two, the nerve is more exposed to pressure and injury.

When this nerve is compressed, it can stop functioning properly. In severe cases, it may undergo Wallerian degeneration, where the nerve fibers break down and need to regrow. Most injuries affect the lower branch of the facial nerve, weakening muscles around the mouth (orbicularis oris and mentalis). This results in the classic sign of facial nerve palsy in newborns—an uneven facial expression when crying.

Classification and Types of Facial Nerve Palsy

Doctors use the House-Brackmann scale to classify facial nerve palsy, with birth-related injuries usually rated as Grade II or III (mild to moderate dysfunction). It’s important to distinguish injuries caused by birth trauma from conditions present at birth, such as Möbius syndrome or other developmental disorders.

Traumatic Birth-Related Palsy typically shows:

• Clear temporal relationship to difficult delivery or instrument use
• Associated injuries like bruising around the ear or blood in the ear canal
• Presence of other birth trauma such as cephalohematomas or brachial plexus injuries
• Evidence of compression near the stylomastoid foramen

Key Clinical Features include:

• Uneven facial movement, especially when crying
• Incomplete eyelid closure (lagophthalmos) that can risk corneal damage
• Flattened nasolabial fold and mouth deviation toward the unaffected side
• Absent forehead wrinkling in severe cases involving the nerve's upper branch

Common Causes and Risk Factors for Facial Nerve Injury

Understanding the risk factors and causes of facial nerve injury helps identify when medical negligence may have contributed to preventable trauma.

Obstetrical Instrumentation and Delivery Trauma

Forceps-Assisted Deliveries: Studies show that forceps-assisted deliveries account for 74 to 91.9% of traumatic facial nerve injuries. Using forceps increases the risk of nerve compression by more than eight times compared to natural vaginal births. When forceps are placed incorrectly or too much pressure is used, the metal blades can press directly against the facial nerve as it exits the skull.

Vacuum Extraction: Although vacuum use is less commonly involved, it still accounts for 8% to 40% of facial nerve injuries. The suction and pulling forces used during vacuum deliveries can stretch the nerve beyond its normal range, causing damage.

Sequential Instrument Use: Using both vacuum and forceps during the same delivery dramatically increases trauma risk. A notable Connecticut case involved five forceps pulls that caused both permanent facial palsy and Erb's palsy, demonstrating the serious danger of repeated instrumental attempts.

Maternal and Fetal Risk Factors

• Fetal Macrosomia: Babies weighing more than 3,500 grams (around 7.7 pounds) increase the risk of cephalopelvic disproportion, which may require more force during delivery and increase the chance of nerve damage.
• Maternal Factors: First-time mothers (primiparity) often have narrower birth canals which can lead to prolonged labor and more pressure on the baby’s head and face.
• Prolonged Labor: When the second stage of labor lasts more than four hours in a first-time birth, the risk of nerve injury triples. Longer labors often result in more instrumental interventions.
• Epidural Anesthesia: While epidurals ease pain, they can also reduce a mother’s ability to push effectively, increasing the need for vacuum or forceps delivery—which in turn increases the risk of nerve injury.

Medical Negligence Contributing to Facial Nerve Injury

Healthcare provider errors that can cause or contribute to facial nerve injuries include:

• Improper instrument application: Using mid-cavity forceps despite unfavorable fetal positioning
• Excessive force during extraction: Applying more pressure than safe protocols recommend
• Delayed cesarean section: Continuing instrumental delivery attempts despite non-reassuring fetal status or poor progress
• Inadequate risk assessment: Failing to recognize situations where cesarean delivery would be safer than instrumental attempts
• Insufficient informed consent: Not properly warning patients about the risks of facial nerve injury associated with instrumental deliveries (5-7.5 per 1,000 births)

When Facial Nerve Palsy Cases Constitute Medical Malpractice

While some facial nerve injuries may occur despite appropriate care, medical malpractice claims arise when healthcare providers fail to meet established standards of care and this failure contributes to preventable nerve damage.

Common Patterns of Medical Negligence

• Improper Instrument Technique: Using forceps or vacuum extractors when contraindicated, applying excessive force beyond safe parameters, or making multiple unsuccessful attempts without considering cesarean delivery as an alternative.
• Failure to Recognize High-Risk Situations: Not appropriately assessing factors such as fetal macrosomia, cephalopelvic disproportion, or prolonged labor that increase the risk of traumatic delivery and associated nerve injuries.
• Delayed Decision-Making: Continuing instrumental delivery attempts despite poor progress, fetal distress, or other complications that indicate the need for immediate cesarean section.
• Inadequate Informed Consent: Failing to properly inform patients about the risks of facial nerve injury associated with instrumental deliveries, which affects between 5 and 7.5 out of every 1,000 such deliveries.

Establishing Legal Liability

Successful medical malpractice claims involving facial nerve palsy must establish:

• Standard of Care Violations: Demonstrating that healthcare providers failed to follow established protocols for instrumental delivery, risk assessment, or emergency intervention.
• Causation: Proving a clear temporal relationship between the negligent care and the development of facial nerve injury. The proximity between forceps use and palsy onset strongly supports causation in traumatic cases.
• Preventability: Showing that proper medical care, such as timely cesarean section or appropriate instrument technique, would have prevented the nerve injury.
• Damages: Establishing both economic losses (medical expenses, therapy costs) and non-economic damages (pain and suffering, disfigurement, emotional distress) resulting from the injury.

Compensation Available in Facial Nerve Injury Cases

Families affected by facial nerve injuries due to medical negligence may be entitled to significant compensation, particularly when the condition results in permanent paralysis requiring lifelong treatment and accommodation.

Economic Damages

These are measurable financial losses related to the injury:

• Medical Expenses: All past and future medical costs related to treating the facial nerve injury, including specialist consultations, surgical interventions, physical therapy, and ongoing monitoring for complications.
• Reconstructive Surgery Costs: Multiple surgical procedures may be needed throughout the child's life to improve function and appearance, including nerve grafts, muscle transfers, and cosmetic procedures.
• Therapy and Rehabilitation: Extensive physical therapy, speech therapy, and occupational therapy may be needed to address feeding difficulties, speech development issues, and facial muscle function.
• Special Equipment and Aids: Costs for eye protection devices, feeding assistance tools, and other specialized equipment needed to manage the condition's effects.
• Educational Support: Special services that may be needed if the injury affects speech development or social interaction in school settings.
• Lost Earning Capacity: Compensation for potential impact on the child's future employment opportunities, particularly in fields where facial appearance or expression is important.

Non-Economic Damages

These cover the emotional and personal impact of an injury:

• Pain and Suffering: Compensation for physical discomfort, emotional distress, and psychological impact of facial disfigurement on both the child and family members.
• Disfigurement and Scarring: Damages for permanent facial asymmetry, scarring from surgical procedures, and the psychological impact of altered appearance.
• Loss of Quality of Life: Compensation for limitations in social interaction, reduced self-esteem, and impact on personal relationships that may result from facial paralysis.
• Parental Emotional Distress: Recognition of the significant emotional trauma experienced by parents witnessing their child's preventable injury and ongoing challenges.

In New York, non-economic damages are typically limited to $2 million unless gross negligence is proven. However, there is no cap on economic damages such as medical bills and lost income.

The Critical Role of Expert Medical Testimony

Proving medical malpractice in facial nerve injury cases requires sophisticated medical knowledge and expert testimony to help judges and juries understand the complex issues involved.

Essential Functions of Medical Experts

Medical experts in facial nerve injury cases must:

• Review delivery records and identify deviations from standard obstetric practices
• Explain the anatomy and vulnerability of the facial nerve during birth
• Demonstrate how proper techniques could have prevented the injury
• Assess the adequacy of risk evaluation and delivery planning
• Evaluate the long-term prognosis and potential need for future treatments
• Calculate costs of ongoing medical care and surgical interventions

The Porter Law Group works with board-certified neurologists, plastic surgeons, obstetricians, and other medical experts who specialize in facial nerve injuries and can provide compelling testimony about the care your child should have received.

Frequently Asked Questions About Facial Nerve Palsy Birth Injuries

Q: Will my baby's facial nerve palsy resolve completely?

A:In most cases, yes. About 89% to 100% of facial nerve injuries heal on their own within 3 to 8 weeks. However, up to 10% may result in permanent paralysis requiring surgical intervention and long-term management.

Q: How can I tell if my baby's facial nerve injury was caused by medical negligence?

A: Signs of potential negligence include excessive forceps or vacuum attempts, failure to perform cesarean section despite complications, improper instrument placement, or lack of informed consent about delivery risks.

Q: What immediate care does my baby need for facial nerve palsy?

A: Eye protection is crucial to prevent corneal damage from incomplete eyelid closure. This includes artificial tears and nighttime patching. Feeding support may also be needed if mouth function is affected.

Q: Can facial nerve palsy affect my child's development?

A: While most cases resolve without long-term effects, permanent paralysis can impact feeding, speech development, social interaction, and self-esteem, potentially requiring ongoing therapy and support.

Q: How long do I have to file a legal claim for my baby's facial nerve injury?

A: New York's statute of limitations for medical malpractice is generally 2.5 years, though different rules may apply for children. It's crucial to consult with an attorney as soon as possible to protect your rights.

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Why Choose the Porter Law Group for Your Baby's Facial Nerve Injury Case

The lawyers at the Porter Law Group have decades of experience representing individuals and families whose lives have been devastated by catastrophic injuries. We have obtained some of the largest settlements and verdicts in courts throughout the State of New York. We are a state-wide firm that handles cases with a hometown feel.

Our clients come to us looking for guidance and answers. With seasoned trial lawyers, the Porter Law Group has the resources necessary to help you navigate the most complex cases, against goliath insurance companies that will stop at nothing to prevent you from receiving the compensation you deserve.  

You only get one chance to hire the best lawyer for you and your family.  Hire the lawyers most recommended by former clients and local attorneys, and the firm that obtains superior results. 

When you or a loved one’s life has been devastated by a serious personal injury in New York, don’t hire a lawyer without calling the Porter Law Group to learn why so many of our clients are thankful they trusted us with their case in their time of need.    

Contact Our New York Facial Nerve Palsy Lawyers Today

The Porter Law Group is committed to helping families throughout New York State whose babies have suffered preventable facial nerve injuries due to medical negligence during delivery. If your child developed facial palsy due to improper use of delivery instruments, excessive force during delivery, or failure to perform timely cesarean section, our skilled medical malpractice attorneys will fight for the compensation your family needs.

We understand that facial nerve injuries can affect not only your child's physical function but also their emotional well-being and social development. When these injuries result from preventable medical errors, families deserve accountability and the resources necessary to provide optimal care and support.

Schedule your free consultation today by calling 833-PORTER9 or emailing info@porterlawteam.com. Let us put our knowledge, experience, and resources to work for your family during this challenging time. Your child deserves the best possible outcome, and we're here to help you secure the compensation necessary to achieve it.

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