A brachial plexus birth injury is a nerve injury that occurs during childbirth when excessive traction on the fetal head damages the network of nerves (C5 through T1) controlling movement and sensation in the shoulder, arm, and hand. The two most recognized sub-conditions are Erb’s palsy, which affects the upper nerve roots (C5–C6) and causes weakness or paralysis of the upper arm, and Klumpke’s palsy, which affects the lower nerve roots (C8–T1) and causes hand and forearm weakness. According to the ACOG Task Force on Neonatal Brachial Plexus Palsy, these injuries occur in approximately 1.5 per 1,000 births, and a peer-reviewed study in PubMed Central found that 10–30% of affected children have permanent neurologic deficits. When a brachial plexus injury results from excessive traction during delivery, it may be grounds for a medical malpractice claim in New York. Under CPLR §214-a and CPLR §208, most New York brachial plexus birth injury claims must be filed before the child’s 10th birthday. Porter Law Group represents New York families in these cases on a contingency-fee basis.
Settlement
Jury Verdict
Settlement
Settlement
Brachial plexus birth cases turn on contested obstetric medicine, the defense will argue the injury was caused by natural forces of labor rather than excessive lateral traction, and winning requires experts who can interpret delivery notes, shoulder-dystocia documentation, and the precise sequence of maneuvers performed. Porter Law Group has recovered more than $500 million for seriously injured clients since 2009, including multiple pediatric recoveries exceeding $8 million for children with permanent delivery-related disabilities. The firm's birth injury practice handles the full spectrum of labor-and-delivery malpractice, from brachial plexus injuries to hypoxic-ischemic encephalopathy, and every case is built with the same forensic obstetric rigor.
Led by Harvard-educated attorney Michael S. Porter, a former U.S. Army JAG Corps Captain with over 20 years of trial experience, the firm retains maternal-fetal medicine specialists, pediatric neurologists, pediatric orthopedic and neurosurgeons, and life care planners to document the mechanism of injury and the cost of a lifetime of therapy, orthotics, and reconstructive surgery. Seven of eight partner-level attorneys are recognized by Super Lawyers, a distinction earned by fewer than 5% of New York attorneys.
"Brachial plexus cases are won or lost on the delivery-room documentation. What maneuvers were performed, in what order, how long each took, how much traction was applied, whether fundal pressure was used — the chart tells the story of whether the standard of care was followed or whether a physician panicked and pulled too hard. ACOG Practice Bulletin No. 178 is explicit that aggressive lateral traction on the fetal head is associated with brachial plexus injuries, and when a chart shows that practice, the case is very strong."
— Michael S. Porter, J.D., Porter Law Group
REQUEST A NO-OBLIGATION CASE REVIEW
A brachial plexus birth injury (also called neonatal brachial plexus palsy (NBPP) or obstetric brachial plexus palsy) is a stretch, tear, or rupture of the network of nerves (C5 through T1) that runs from the spinal cord through the neck into the shoulder, arm, and hand. The injury typically occurs during delivery when excessive lateral traction is applied to the fetal head while the shoulder remains impacted behind the mother’s pubic bone. According to the 2014 ACOG NBPP Task Force Report, the overall incidence is approximately 1.5 per 1,000 total births, with a higher rate after vaginal delivery than cesarean.
The three clinical patterns differ by which nerve roots are damaged:
| Injury Pattern | Nerve Roots Involved | Incidence per 1,000 Births (2014 ACOG Task Force) | Clinical Presentation |
| Erb's palsy | C5–C6 (upper plexus) | 1.2 | "Waiter's tip" — arm hangs at side, rotated inward, wrist flexed |
| Klumpke palsy | C8–T1 (lower plexus) | 0.05 | "Claw hand" — hand and forearm weakness, possible Horner syndrome |
| Total plexus palsy | C5–T1 (entire plexus) | Balance of the 1.5/1,000 overall rate | Complete arm paralysis, often with sensory loss; most severe prognosis |
Injury severity also varies by the biology of the nerve damage.
The PubMed Central review indicates that 10–30% of affected infants have permanent neurologic deficits, which may include limb-length discrepancy, glenohumeral joint dysplasia, and lifelong weakness.
The overwhelming majority of brachial plexus birth injuries occur when excessive downward or lateral traction is applied to the fetal head during a shoulder dystocia, an obstetric emergency in which the anterior shoulder becomes impacted behind the mother's pubic symphysis. Under ACOG Practice Bulletin No. 178, the recognized management sequence is:
Recognized risk factors include fetal macrosomia (birth weight over 4,500 g), maternal diabetes, prior shoulder dystocia, operative vaginal delivery (vacuum or forceps), prolonged second stage, and fetal malposition. When these risk factors are present and the obstetrician either fails to offer a cesarean or fails to respond to the emergency with the recommended sequence, the resulting brachial plexus injury is generally actionable as medical malpractice.
Importantly, the 2014 ACOG Task Force confirms that neonatal brachial plexus palsy can occur without clinically recognizable shoulder dystocia — which defeats the common defense argument that "no dystocia = no negligence."
New York places no statutory cap on damages in medical malpractice or birth injury cases. A brachial plexus case with a permanent deficit can involve seven or eight figures in recoverable damages across four categories.
Future medical and surgical care. The treatment pathway frequently includes physical and occupational therapy from infancy through adolescence, primary nerve surgery (typically at 6–12 months when spontaneous recovery is not occurring), secondary reconstructive procedures such as tendon transfers or humeral osteotomy, and lifelong orthotic and therapeutic maintenance. Life care plans routinely project millions of dollars in medical costs.
Lost future earning capacity. A child with permanent dominant-arm weakness loses access to a substantial range of manual trades and professions. Economists project earning-capacity loss based on the child's family educational background, U.S. Census demographic earnings data, and vocational analysis of the child's specific limitations.
Pain and suffering. Non-economic damages in New York are not capped. Juries consider the permanence of the injury, the child's life expectancy, and the loss of normal bimanual function in every activity of daily living.
Parents' derivative claim. Parents can recover the medical expenses they paid on the child's behalf and damages for loss of the child's services — but under their own 2.5-year CPLR §214-a medical malpractice statute, which is not tolled by the child's infancy.
FIND OUT WHAT YOUR CHILD'S BRACHIAL PLEXUS CASE IS WORTH →
Porter Law Group's published results include 53 cases at or above $1 million, with multiple pediatric recoveries exceeding $8 million. View all case results →
$8,300,000 Settlement: A premature infant suffered profound permanent disabilities, including cerebral palsy, after physicians failed to properly manage the mother’s pre-gestational diabetes, the same metabolic condition that is a leading risk factor for macrosomia and shoulder dystocia. The structured settlement provides lifetime care and therapy funding.
$8,250,000 Settlement: An infant sustained permanent physical and cognitive disabilities after delayed response to fetal distress during labor. Proceeds covered lifetime medical and educational needs.
$8,120,000 Settlement: An infant suffered permanent delivery room-related injuries caused by mismanaged labor and delivery. The recovery funded a life-care plan built with the family’s physicians and therapists.
Every case is different. Past results do not guarantee future outcomes.
Brachial plexus claims are medical malpractice cases, so the deadline is shorter than a general child injury claim and is subject to a hard 10-year cap that ordinary personal injury cases do not face. The deadline also depends on where the delivery occurred, private hospital, municipal or county hospital, or state-operated (SUNY) facility. Each category has its own procedural track, and the distinction catches many families by surprise.
| Category of Defendant | Statute of Limitations | Infancy Toll | Effective Deadline | Primary Statute |
| Private hospital / private physician | 2.5 years | Yes — but capped at 10 years from malpractice | Child's 10th birthday (in most cases) | CPLR §214-a +CPLR §208 |
| Municipal / county hospital (NYC Health + Hospitals, county hospitals) | 1 year and 90 days after Notice of Claim | No — the 90-day Notice of Claim deadline is NOT tolled by infancy | 90 days from injury to file Notice of Claim; 1 year + 90 days to sue | GML §50-e |
| State facility (SUNY Upstate, SUNY Downstate, Stony Brook University Hospital, other state-operated hospitals) | 2 years and 6 months after timely Notice of Intention | No — the 90-day Notice of Intention deadline is NOT tolled by infancy | Notice of Intention within 90 days; claim filed in the Court of Claims within 2 years and 6 months | Court of Claims Act §10; CPLR §214-a |
| Wrongful death of infant | 2 years from date of death | N/A | 2 years from death | EPTL §5-4.1 |
| Parents' derivative claim | 2.5 years | No not tolled by child's infancy | 2.5 years from malpractice | CPLR §214-a |
Was Your Baby Diagnosed with a Brachial Plexus Injury?
Let us help. Our clients don't have to pay anything unless we win.
1. Request the complete labor-and-delivery record. Under New York Public Health Law §18, you are entitled to your and your child's complete medical records within a reasonable time of a written request. The critical documents are the full labor-and-delivery note, the shoulder-dystocia documentation (if any), the nursing notes tracking maneuvers and elapsed time, the neonatal examination, and any imaging or nerve conduction studies.
2. Document every pediatric and therapy visit. Keep a dated log of physical therapy, occupational therapy, and every specialist appointment with pediatric neurology, pediatric orthopedics, or hand surgery. The child's recovery trajectory over the first year is central to both the prognosis and the damages calculation.
3. Photograph the affected arm regularly. Resting position, range of motion, and limb-length comparisons are critical evidence. Begin photographing the arm's position shortly after birth and continue monthly.
4. Act quickly if your child was born at a public or state hospital. Births at municipal and county hospitals trigger the 90-day Notice of Claim deadline under GML §50-e. Births at SUNY or other state-operated hospitals trigger a 90-day Notice of Intention deadline under Court of Claims Act §10, with the claim itself filed in the Court of Claims. Missing either 90-day deadline can bar the claim entirely unless the court grants leave to file late.
5. Contact a brachial plexus birth injury attorney. Porter Law Group offers free consultations on a contingency-fee basis and handles every stage of the case, from record collection through expert review, litigation, infant compromise approval, and trial.
GET A FREE CASE REVIEW: CALL (833) PORTER-9 →
Porter Law Group represents families in brachial plexus and related birth injury malpractice cases throughout New York State, with a statewide practice reaching every county and jurisdiction. Our Syracuse headquarters serves Central and Upstate New York, while attorneys travel regularly to downstate courthouses for cases in the five boroughs, Westchester, and Long Island.
Serving Clients statewide , including Syracuse,New York City, Manhattan,Buffalo, Rochester, Albany, Yonkers, White Plains, Utica, Binghamton, Long Island (Nassau and Suffolk Counties), Saratoga Springs, Ithaca.
Wherever your child was injured in New York, call (833) PORTER-9 for a free consultation with an experienced brachial plexus birth injury attorney.
Not every brachial plexus birth injury is malpractice, but the majority of permanent cases are linked to avoidable clinical errors. Under ACOG Practice Bulletin No. 178, the standard response to shoulder dystocia requires a specific sequence: McRoberts maneuver, suprapubic pressure, and posterior arm delivery before any traction is applied. When a provider skips that sequence and instead pulls aggressively on the fetal head, or fails to offer a planned cesarean to a patient with known risk factors like fetal macrosomia or prior shoulder dystocia, that deviation can support a malpractice claim. The ACOG Task Force also confirmed that brachial plexus palsy can occur without a charted shoulder dystocia, which means the absence of documented dystocia does not automatically rule out negligence. The key question is always what the delivery room record shows: were the right maneuvers performed, in the right order, before traction was applied?
Erb's palsy involves damage to the upper brachial plexus nerve roots (C5 and C6) and is the most common pattern, occurring in approximately 1.2 per 1,000 births according to the 2014 ACOG NBPP Task Force. It produces the classic "waiter's tip" posture with the arm held at the side, rotated inward, and the wrist flexed. Klumpke palsy involves the lower plexus (C8 and T1) and is far rarer at approximately 0.05 per 1,000 births. It causes weakness in the forearm and hand, often with a "claw hand" appearance, and can include Horner syndrome (a drooping eyelid, constricted pupil, and reduced facial sweating on the affected side) when sympathetic nerve fibers are involved. Mixed or total-plexus injuries involving all nerve roots from C5 to T1 are the most severe.
Recovery depends almost entirely on the severity of the nerve damage. Most infants with brachial plexus birth injuries recover within the first three months of life, particularly those with neurapraxia, a temporary stretch that heals on its own with physical therapy. In one prospective study of 80 infants, complete recovery occurred in 66% of cases, while roughly 14% were left with severe permanent weakness. The critical window is the first six months: if antigravity biceps function has not returned by that point, the prognosis changes significantly and nerve reconstruction surgery is typically indicated. Across the published literature, approximately 8 to 36% of affected children do not fully recover and experience permanent functional impairments, which can include limb-length discrepancy, glenohumeral dysplasia, and lifelong weakness. A pediatric brachial plexus specialist should evaluate your child as early as possible, since outcomes for surgical repair are substantially better when performed before six months of age.
New York places no statutory cap on damages in medical malpractice cases, so settlement value is built from the specific facts of the injury across four main categories. Future medical and surgical care is typically the largest driver: life care planners project the cost of physical and occupational therapy from infancy through adulthood, primary nerve surgery (usually between six and twelve months), secondary reconstructive procedures such as tendon transfers or humeral osteotomy, and lifelong orthotic maintenance, often totaling several million dollars for severe permanent injuries. Lost future earning capacity is calculated by forensic economists using Census demographic data and vocational analysis of the child's specific functional limitations. Non-economic damages for pain and suffering over the child's full life expectancy carry no cap in New York. The average birth injury settlement is over $1 million according to The Doctors Company, a major medical malpractice insurer, though cases involving complete nerve avulsion or dominant-arm paralysis routinely settle for significantly more. Every settlement on behalf of a minor in New York also requires judicial approval at an infant compromise hearing under CPLR §1207 and §1208.
The absence of a documented shoulder dystocia does not foreclose a brachial plexus malpractice claim and is one of the most common defenses families encounter. The 2014 ACOG Task Force on Neonatal Brachial Plexus Palsy expressly acknowledged that brachial plexus palsy can occur without a clinically recognizable shoulder dystocia during either vaginal or cesarean delivery, which directly undermines the "no dystocia, no negligence" argument. In practice, cases without a charted dystocia often involve other actionable deviations: failure to offer a planned cesarean when macrosomia or prior dystocia was documented prenatally, use of vacuum or forceps against clinical indications, excessive traction during what was recorded as an uncomplicated delivery, or under-documentation of an emergency that actually did occur in the room. An obstetric expert reviewing the full labor-and-delivery record, nursing notes, shoulder-dystocia documentation, and fetal monitoring strips can often reconstruct what happened and identify the departure from the standard of care regardless of what the summary narrative says.
Michael S. Porter is the founder and managing partner of Porter Law Group, representing New York families in birth injury, brachial plexus, medical malpractice, and catastrophic injury cases. A graduate of Harvard University (B.A., 1994) and Syracuse University College of Law (J.D., 1997), Porter served four years as a Captain in the U.S. Army Judge Advocate General's Corps. Selected to Super Lawyers for 14 consecutive years (2012–2025), he holds a 10.0 Superb rating on Avvo and a Distinguished rating from Martindale-Hubbell.
Bar Admissions: New York State Bar | U.S. District Court, Northern and Western Districts of New York
Memberships: New York State Bar Association, Onondaga County Bar Association, New York State Academy of Trial Lawyers, Multi-Million Dollar Advocates Forum
If your child suffered a brachial plexus injury during a New York delivery, critical deadlines may run faster than you expect: municipal-hospital cases require a Notice of Claim within 90 days under GML §50-e, SUNY and other state-facility cases require a Notice of Intention within 90 days under the Court of Claims Act, parents' derivative claims are not tolled by the child's infancy, and the 10-year cap under CPLR §208 closes most birth injury windows before a child's 10th birthday.
Contact Porter Law Group today at (833) PORTER-9 for a free, no-obligation consultation. We operate on a contingency-fee basis, so you pay nothing unless you win.
Phone: +1 833-767-8379
Email: info@porterlawteam.com
Monday to Friday: 8 AM to 5 PM | Saturday and Sunday: Closed
Avoid sharing confidential information via contact form, text, or voicemail as they are not secure. Please be aware that using any of these communication methods does not establish an attorney-client relationship. *By appointment only.
The information contained on this site is proprietary and protected. Any unauthorized or illegal use, copying, or dissemination will be prosecuted to the fullest extent of the law. All content on this site is provided for informational purposes only. It is not, nor should it be taken as medical or legal advice. None of the content on this site is intended to substitute for medical advice, diagnosis, or treatment. Attorney Advertising.
We serve clients in every city and county in New York State. These include places like: The Adirondacks, Albany, Alexandria Bay, Amsterdam, Astoria, Auburn, Ballston Spa, Batavia, Beacon, Binghamton, Brooklyn, Buffalo, Canandaigua, Carthage, Cattaraugus, Catskill, Cayuga Lake, Cazenovia, Chelsea, Clayton, Clifton Park, Cobleskill, Colonie, Cooperstown, Corning, Cortland, Delhi, Delmar, Dunkirk, East Aurora, East Hampton, Elmira, Fayetteville, Finger Lakes, Flushing, Fredonia, Fulton, Garden City, Geneva, Glen Cove, Glens Falls, Gloversville, Gouverneur, Great Neck, Greenwich Village, Hamilton, Hammondsport, Harlem, Haverstraw, Hempstead, Herkimer, Hornell, Hudson, Huntington, Ilion, Ithaca, Jamaica, Jamestown, Johnstown, Kingston, Lake George, Lake Placid, Lewiston, Little Falls, Liverpool, Lockport, Long Island City, Lowville, Malone, Manhattan, Manlius, Massena, Medina, Middletown, Monticello, Montauk, Mount Vernon, New Paltz, New Rochelle, Newburgh, Niagara Falls, North Tonawanda, Norwich, Nyack, Ogdensburg, Old Forge, Olean, Oneida, Oneonta, Ossining, Oswego, Penn Yan, Peekskill, Plattsburgh, Port Chester, Potsdam, Poughkeepsie, Queens, Rhinebeck, Riverhead, Rochester, Rome, Rye, Sag Harbor, Saranac Lake, Saratoga Springs, Schenectady, Seneca Falls, Seneca Lake, Skaneateles, SoHo, Southampton, Spring Valley, Staten Island, Stony Brook, Suffern, Syracuse, Tarrytown, The Bronx, Thousand Islands, Ticonderoga, Troy, Tupper Lake, Utica, Warsaw, Waterloo, Watertown, Watkins Glen, Wellsville, White Plains, Williamsburg, Woodstock, Yonkers, and many more communities throughout New York State.
Copyright © 2026, Porter Law Group. Personal Injury Lawyers
Made with 💛 by Gold Penguin
