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Erb's Palsy

Erb’s Palsy is a condition cause by an injury to a child’s brachial plexus–the large system of nerves that runs down the spinal column to muscles in the shoulders and arms.

During the labor and delivery process, an infant is especially vulnerable to brachial plexus injuries. This is why physicians are obligated to utilize well-known and accepted techniques that protect newborns from these types of injuries.

A provider who injures a newborn by failing to use these techniques has committed medical malpractice and can be held responsible for the resulting injury which can cause total or partial paralysis of a child’s shoulder and arm, other profound physical consequences, and financial loss.

The Four Types of Erb’s Palsy:

  • Neurapraxia: caused by stretching of the nerve without tearing
  • Rupture: caused by tearing of the nerve, without separation from the spine
  • Avulsion: caused by the nerve tearing away from the spine
  • Neuroma: caused by growth of scar tissue around the injury causing pressure on the injured nerve, and preventing the nerve from sending signals to the muscles.

What Causes Erb's Palsy?

During delivery of a newborn, the baby’s shoulder can get stuck in the birth canal or on the mother’s pelvis. When this occurs, the baby’s natural progression through the birth canal, and the delivery process, are delayed.

Physicians and midwifes have at their disposal many medical tools that will signal when delivery is being compromised by “shoulder dystocia.” These medical professionals are expected to be aware of these tools to identify these complications and use them in a timely fashion.

They are also obligated to take advantage of time-tested and standard delivery protocols to remedy dystocia which may be causing a delay in the delivery process.

It is imperative to identify this complication and take steps to alleviate it in a timely manner because the failure to do so can cause permanent and profound injury to the unborn baby – including physical injury to the nerves that control spinal and upper extremity function, and other neurologic injuries resulting from a lack of oxygen to the brain. Physicians must work quickly and safely to ensure the baby does not suffer from oxygen deprivation, nerve-stretch injuries, and the like.

Erb’s Palsy – Risk Factors of Shoulder Dystocia

Before the labor-and-delivery process even begins, competent medical providers can identify certain risk factors (for both mother and baby) that can signal an increased risk for shoulder dystocia. These known risk factors include: an unusually large baby (as diagnosed by ultrasound), gestational diabetes, a “breech” presentation (i.e., baby exits the pelvis with the buttocks or feet first as opposed to the normal head-first position), the mother has an unusually small pelvic structure, prior deliveries with complications, unusual large weight gain during the pregnancy, etc.

Applicable standards of medical care require a treating physician and/or midwife to identify these risk factors, and prepare in advance of the labor-and-delivery process for complications that might occur.

Erb’s Palsy – Available Delivery Techniques to Avoid Injury

When shoulder dystocia occurs, physicians and midwives can and should employ delivery techniques to alleviate the dystocia to avoid permanent injury to the newborn baby. These techniques are designed to essentially “unstick” the shoulder, thereby permitting the baby to be delivered without suffering the devastating consequences of oxygen deprivation and/or prolonged trauma to the nerves in the shoulder.

Commonly, physicians and/or midwives will change the position of the mother’s legs in an effort to widen the birth canal. Also, gentle pressure can be applied to the mother to free the baby’s shoulder. A physician will often physically rotate the baby while in the birth canal in order to free the shoulder. If these maneuvers are unsuccessful, a physician and/or midwife may intentionally break the baby’s collar bone or order an emergency C-section to promote delivery.

A physician or midwife’s failure to employ these techniques in a timely fashion can result in profound and devastating injury to the newborn. Klumpke’s palsy will cause paralysis of the fingers and hands. Horner’s Syndrome can cause the eyelid to droop and result in an uneven pupil size. Erb’s palsy causes the arm to stay close to the body, with the palm facing backwards and no movement of the arm from below the elbow.

A Complete Brachial Plexus Injury is the most severe form of injury, and causes total paralysis of the affected arm. Each of these injuries can happen due to rupture of the nerves, stretch injury of the nerves, crush injury to the nerves, neuroma or scar tissue development, or an avulsion injury where the nerve is no longer attached to the spine.

While some brachial plexus injuries may improve over time, most result in severe permanent disabilities that will negatively impact the child over the course of his or her entire life. If your child has suffered such an injury, the stakes couldn’t be higher.

The medical costs alone can be overwhelming. These types of injuries can also directly impact an individual’s ability to work in certain occupations when they reach adulthood, and often result in chronic pain, lifelong medical care including multiple surgeries, and other emotional injuries due to their physical limitations.

With stakes this high for you and your child, you can turn to the experienced legal team at the Porter Law Group for answers to your questions. We will work hard for the compensation you and your child deserve. We will investigate the complex aspects of your case, rely on the very best experts to build your case, and maximize the likelihood that you win.

Children who suffer birth injuries face serious challenges, including the need for lifelong medical interventions, surgeries, home health care, physical and occupational therapy, etc. The costs associated with this medical care can be daunting.

If your child has suffered a birth injury, or if you have a question that has not been answered appropriately by your medical providers, fill out the form below or call the Porter Law Group now at 833-99BIRTH.

Last Updated on November 20, 2023 by Michael S. Porter
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