New York shoulder birth injury claims must generally be filed before the child's 10th birthday under CPLR §214-a and CPLR §208. Public-hospital cases require a 90-day Notice of Claim deadline under GML §50-e, and every settlement requires judicial approval at an infant compromise hearing under CPLR §1207 and §1208, with attorney fees following the Judiciary Law §474-a sliding scale.
Shoulder birth injuries cover a range of conditions — clavicle fracture (the most common orthopedic birth injury), humerus fracture, brachial plexus injury, and soft tissue injury — produced during labor by mechanical forces on the fetal shoulder during passage through the maternal pelvis. Per a 2024 peer-reviewed ScienceDirect review, clavicle fracture incidence in the literature varies from 0.05% to 3.2% of births, while humerus fracture incidence varies from 0.01% to 0.37%. Per a 2018-2022 peer-reviewed Portuguese cohort study (PMC12671675, n=8,132 births), shoulder dystocia was associated with a substantially elevated risk of clavicle fracture (odds ratio 35.71; 95% CI 17.86–71.43).
Porter Law Group represents New York families whose newborns suffered preventable shoulder birth injuries.
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Shoulder birth injuries occupy a distinctive analytical space in birth injury litigation. Most clavicle fractures resolve spontaneously and are not actionable on their own — per peer-reviewed obstetric literature, "clavicle fracture is generally considered an unpredictable and unavoidable complication of normal birth." However, certain patterns establish liability: clavicle or humerus fracture combined with brachial plexus injury, fractures associated with documented shoulder dystocia where excessive lateral traction was applied, and shoulder injuries where the obstetric maneuvers documented in the chart departed from ACOG Practice Bulletin No. 178: Shoulder Dystocia standards.
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 birth-related disabilities. 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 orthopedic surgeons, pediatric neurologists, and life care planners on every case. Seven of eight partner-level attorneys are recognized by Super Lawyers, a distinction earned by fewer than 5% of New York attorneys.
"Most clavicle fractures resolve in three weeks and produce no lasting disability — those cases are not malpractice. The cases that do produce substantial recoveries involve clavicle or humerus fractures combined with brachial plexus injury, or shoulder dystocia where the documented maneuvers and forces went beyond what ACOG Practice Bulletin No. 178 supports. The chart almost always shows what happened."
— Michael S. Porter, J.D., Porter Law Group

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A shoulder birth injury is any injury to the fetal shoulder region — bones, nerves, or soft tissue — produced during labor and delivery by mechanical forces on the shoulder during passage through the maternal pelvis. The four major categories are:
| Injury Type | What It Is | Reported Incidence | Typical Prognosis |
| Clavicle fracture | Break in the collarbone, typically a greenstick (incomplete) fracture | 0.05%–3.2% of births per 2024 ScienceDirect review; decreased from 17.6/1000 to 6.2/1000 over 2004–2017 in Finnish national cohort (n=629,457) | Universally excellent with full remodeling; no functional deficits expected |
| Humerus fracture | Break in the upper arm bone | 0.01%–0.37% of births per 2024 ScienceDirect review | Generally good with conservative treatment; functional recovery typical |
| Brachial plexus injury | Damage to the network of nerves running from the spine through the shoulder to the arm and hand | National incidence ~1.5/1,000 per 2014 ACOG/AAP NBPP Task Force | Variable — most resolve in months; a substantial minority have permanent deficits per peer-reviewed literature; covered in detail in our Brachial Plexus practice page |
| Soft tissue injury | Bruising, hematoma, or other non-bone, non-nerve injury to the shoulder region | Common; specific incidence varies by definition | Generally resolves spontaneously without sequelae |
The injury types frequently coexist — particularly when shoulder dystocia is present. A 2018-2022 Portuguese cohort study (PMC12671675, n=8,132 births) found that 15.4% of clavicle fractures involved shoulder dystocia, and shoulder dystocia substantially elevated the risk of clavicle fracture (odds ratio 35.71; 95% CI 17.86–71.43). However, an isolated clavicle fracture without other injury is generally NOT considered evidence of malpractice on its own.
Clavicle fracture is the most common orthopedic birth injury. Per a 2024 peer-reviewed ScienceDirect review summarizing the literature, "Clavicle fractures are the most common type of birth fracture. Their incidence in the literature varies widely from around 0.05% to 3.2%."
The clavicle (collarbone) typically fractures during delivery when the fetal shoulder impacts against the maternal pubic symphysis or sacral promontory, or when lateral traction is applied to deliver an impacted shoulder. Per the 2018-2022 Portuguese cohort study (PMC12671675), the recognized risk factors are:
Clavicle fracture treatment is conservative — gentle mobilization, pain management when needed, and protective swathing of the affected arm. Per the same 2024 ScienceDirect review, "the prognosis after these injuries is universally excellent, with full remodeling and no functional deficits expected." Most heal completely in 3 to 6 weeks.
The most important framing for malpractice analysis: per a 1998 peer-reviewed ScienceDirect study, "clavicular fracture is generally considered an unpredictable and unavoidable complication of normal birth." Isolated clavicle fracture without other injury, complications, or evidence of inappropriate obstetric maneuvers is generally not actionable as malpractice.
Most isolated clavicle fractures are not malpractice. The cases that do produce substantial recoveries involve specific patterns where the shoulder injury was caused by — or accompanied by — preventable obstetric error. Six recurring failure patterns establish liability:
Failure 1 — Excessive lateral traction during shoulder dystocia. Per ACOG Practice Bulletin No. 178: Shoulder Dystocia (May 2017), the recognized response to shoulder dystocia is a sequence of maneuvers — McRoberts maneuver, suprapubic pressure, internal rotational maneuvers (Rubin, Woods corkscrew), delivery of the posterior arm, and, in extreme circumstances, Zavanelli maneuver. Excessive lateral traction on the fetal head is not part of the recognized maneuver sequence and is associated with elevated risk of brachial plexus injury and clavicle fracture. When the chart shows excessive force applied without progression through the documented maneuver sequence, the case for malpractice may be strong.
Failure 2 — Failure to anticipate and prepare for shoulder dystocia in high-risk deliveries. Per ACOG PB 178, recognized risk factors for shoulder dystocia include macrosomia (birthweight ≥4,000 g), maternal diabetes, prior shoulder dystocia, instrumental vaginal delivery, and prolonged second stage. Failure to consider cesarean delivery when these risk factors are documented — and the resulting delivery produces shoulder dystocia with injury — can support malpractice liability.
Failure 3 — Inappropriate use of vacuum extraction or forceps producing shoulder injury. Per a 2018-2022 Portuguese cohort (PMC12671675), instrumental vaginal birth approximately doubled the odds of clavicle fracture (OR 2.072; 95% CI 1.365–3.145). When vacuum extraction or forceps is used outside ACOG Practice Bulletin No. 219 (April 2020, Reaffirmed 2022) prerequisites and shoulder injury results, the case for malpractice is generally strong.
Failure 4 — Sequential vacuum and forceps producing shoulder injury. Per ACOG PB 219, sequential vacuum-then-forceps use is associated with substantially elevated rates of neonatal complications and should not routinely be performed. When the chart documents both vacuum AND forceps in the same delivery and the result is a shoulder injury, the case for malpractice is generally strong.
Failure 5 — Failure to recognize and treat humerus fracture promptly. Humerus fractures sometimes go undiagnosed in the immediate postpartum period because the affected limb may not show obvious deformity. Per the 2024 ScienceDirect review, risk factors for humerus fracture include complicated labor, breech presentation, preterm infancy, multiple births, shoulder dystocia, macrosomia, and instrument-assisted delivery. Delayed diagnosis can lead to malunion, requiring more aggressive treatment.
Failure 6 — Shoulder injury combined with brachial plexus injury. When clavicle or humerus fracture coexists with brachial plexus injury — particularly in the setting of documented shoulder dystocia — the cumulative pattern frequently supports malpractice liability. See our Brachial Plexus practice page and Klumpke Palsy practice page for detail on the specific nerve injuries.
New York places no statutory cap on damages in medical malpractice or birth injury cases. Recoverable damages depend on the resulting injury — most isolated clavicle fractures resolve without lasting sequelae and produce no recoverable damages because they heal completely, but cases involving brachial plexus injury, permanent functional deficit, or surgical management of complications are among the larger pediatric malpractice recoveries.
Future medical and rehabilitation care when the shoulder injury produces lasting deficit. Children with permanent brachial plexus injury (Erb's palsy, Klumpke's palsy, or total plexus palsy) typically require physical therapy, occupational therapy, sometimes nerve repair surgery (typically performed at 3-9 months of age), tendon transfers, or other reconstructive procedures. Lifetime care plans for severe brachial plexus injury can run into seven figures.
Past medical expenses for any surgical management of complicated fractures, nerve repair surgery, or related care.
Lost future earning capacity when permanent functional impairment results — particularly for hand-dominant arm injuries that affect future occupational options.
Pain and suffering damages are not capped in New York. Juries consider the permanence of the injury, the child's life expectancy, and the loss of normal function in the affected arm.
Wrongful death. Catastrophic shoulder dystocia complications producing death are rare but not unknown — when this occurs, parents may pursue a wrongful death claim under EPTL §5-4.1 within two years of the death.
Parents' derivative claim. Parents can recover 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 statute, which is not tolled by the child's infancy.
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Porter Law Group's published catastrophic case results include three pediatric birth injury settlements that demonstrate the firm's track record in complex delivery-related injury cases. 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 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-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.
| 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 |
| Public hospital (NYC Health + Hospitals, SUNY Upstate, SUNY Downstate, Stony Brook, county hospitals) | 1 year and 90 days after Notice of Claim | No — 90-day Notice of Claim NOT tolled by infancy | 90 days from injury to file Notice of Claim | GML §50-e |
| 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 |
Shoulder birth injury cases pose a particular timing risk when the relevant injury is brachial plexus injury — because brachial plexus injuries often appear to be resolving in the first weeks of life, only to produce lasting deficit that becomes apparent at 6 to 18 months. Public-hospital families whose infant initially appeared to be recovering — and is later diagnosed with permanent brachial plexus deficit — have almost certainly missed the 90-day Notice of Claim window and must seek leave to serve a late notice of claim under GML §50-e(5).
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Seeking Compensation for a Shoulder Birth Injury in New York?
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1. Request the complete labor-and-delivery and neonatal records. Under Public Health Law §18, you are entitled to your and your child's complete medical records within a reasonable time of a written request. Critical documents include the operative delivery note (especially documenting any shoulder dystocia, the maneuvers used, and the time elapsed during delivery), Apgar scores, the initial newborn examination, X-ray imaging of the affected limb, and any orthopedic or neurology consultations.
2. Document the infant's arm function and movement over time. Photograph and video the affected arm during normal activity. Track the development of arm movement — whether the infant moves both arms equally, whether the affected arm hangs limp, whether there is any grasp reflex on the affected side. Brachial plexus injuries are graded by the level of nerve injury and recovery trajectory.
3. Preserve all imaging. X-rays of any clavicle or humerus fracture, MRI of the brachial plexus if performed, and EMG studies if obtained. These are core evidence in any subsequent malpractice claim.
4. Document orthopedic and neurology evaluations. If the injury is a brachial plexus injury, evaluation by a pediatric brachial plexus specialist within 3-9 months of birth is critical — both for recovery prognosis and for documenting the severity of the injury.
5. Track milestones and recovery. Keep a dated log of every pediatric, orthopedic, neurology, and therapy visit. The trajectory of recovery is core evidence of injury severity.
6. Act immediately if your child was born at a public hospital. Births at NYC Health + Hospitals facilities, SUNY Upstate, SUNY Downstate, Stony Brook, or any county-run facility require a Notice of Claim within 90 days under GML §50-e. Missing this deadline can bar the claim entirely.
7. Consult a New York shoulder birth injury attorney. Porter Law Group offers free consultations on a contingency-fee basis and handles every stage of the case.
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Porter Law Group represents families in shoulder birth injury 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.
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Wherever your child was injured in New York, call (833) PORTER-9 for a free consultation with an experienced birth injury attorney.

A clavicle fracture is a break in the collarbone — a bone injury. A brachial plexus injury is damage to the network of nerves running from the spine through the shoulder and into the arm — a nerve injury. The two can occur together (particularly in shoulder dystocia) but they are clinically distinct conditions with different prognoses. Clavicle fractures typically heal completely in 3-6 weeks with conservative treatment and produce no lasting functional deficit per the 2024 peer-reviewed ScienceDirect review. Brachial plexus injuries range from mild (full recovery in months) to severe (permanent functional deficit; may require nerve repair or tendon transfer surgery). The U.S. national incidence of brachial plexus birth palsy is approximately 1.5 per 1,000 births per the 2014 ACOG/AAP NBPP Task Force. See our Brachial Plexus practice page for clinical detail on the nerve injuries specifically.
Clavicle fractures are the most common orthopedic birth injury. Per a 2024 peer-reviewed ScienceDirect review, the incidence in the literature varies widely from 0.05% to 3.2% of births. Per a 2018-2022 peer-reviewed Portuguese cohort study (PMC12671675, n=8,132 births), the incidence was 1.1% overall — 0.04% in cesarean sections and 1.7% in vaginal births. Per a 2004-2017 Finnish nationwide cohort (n=629,457), incidence decreased from 17.6 per 1,000 to 6.2 per 1,000 vaginal births over the study period, with shoulder dystocia, diabetes, and birthweight ≥4,000 g identified as the strongest predisposing factors. Most clavicle fractures heal completely with no lasting functional deficit; the prognosis is universally excellent with full remodeling expected.
No — most clavicle fractures during birth are not medical malpractice. Per a 1998 peer-reviewed ScienceDirect study, "clavicular fracture is generally considered an unpredictable and unavoidable complication of normal birth." Isolated clavicle fracture without other injury, complications, or evidence of inappropriate obstetric maneuvers is generally not actionable as malpractice. The cases that do produce substantial recoveries involve specific patterns: clavicle or humerus fracture combined with brachial plexus injury; fractures associated with documented shoulder dystocia where excessive lateral traction was applied; or shoulder injuries occurring during instrumental delivery performed outside ACOG Practice Bulletin No. 219 prerequisites. The chart documenting the maneuvers used and the forces applied is the key evidence.
A humerus fracture is a break in the upper arm bone. Per a 2024 peer-reviewed ScienceDirect review, humerus fracture incidence varies from 0.01% to 0.37% of births in the literature — making it substantially less common than clavicle fracture. Recognized risk factors include complicated labor, breech presentation, preterm infancy, multiple births, shoulder dystocia, macrosomia, and instrument-assisted delivery. Humerus fractures can occur in vaginal OR cesarean delivery. Treatment is generally conservative, with most healing completely with no lasting functional deficit. Humerus fractures sometimes go undiagnosed in the immediate postpartum period because the affected limb may not show obvious deformity — delayed diagnosis can lead to malunion requiring more aggressive treatment.
Shoulder dystocia is the obstetric emergency where the fetal anterior shoulder becomes impacted behind the maternal pubic symphysis after the head has delivered. The recognized response per ACOG Practice Bulletin No. 178: Shoulder Dystocia (May 2017) is a sequence of maneuvers — McRoberts maneuver, suprapubic pressure, internal rotational maneuvers (Rubin, Woods corkscrew), delivery of the posterior arm. When excessive lateral traction is applied to the fetal head instead of (or in addition to) the recognized maneuvers, the brachial plexus nerves can be stretched or torn — producing brachial plexus injury — and the clavicle or humerus can fracture. Per the 2018-2022 Portuguese cohort study (PMC12671675), shoulder dystocia substantially elevated the risk of clavicle fracture (odds ratio 35.71; 95% CI 17.86-71.43). The wide confidence interval reflects clinical variability, but the magnitude of association is consistent across peer-reviewed sources.
Shoulder birth injury claims are medical malpractice actions under CPLR §214-a, which imposes a 2.5-year statute of limitations.CPLR §208 tolls the deadline during the child's minority but caps the toll at 10 years from the malpractice — meaning most shoulder birth injury cases must be filed before the child's 10th birthday. Deliveries at public hospitals (NYC Health + Hospitals, SUNY Upstate, SUNY Downstate) require a Notice of Claim within 90 days of the injury under General Municipal Law §50-e, and the infancy toll does not extend the 90-day deadline. Brachial plexus injuries pose a particular timing risk because the lasting deficit may not be apparent until 6 to 18 months of age — by which time the public-hospital 90-day window has long since closed and a motion for leave to serve a late notice of claim under GML §50-e(5) may be required.
Shoulder birth injury settlement values vary enormously based on the resulting injury. Most isolated clavicle or humerus fractures resolve completely and produce no recoverable damages. Cases involving brachial plexus injury producing permanent functional deficit can settle in the high six to seven figures depending on severity — Erb's palsy or Klumpke palsy with permanent deficit, total plexus palsy, or cases requiring nerve repair surgery and tendon transfers. New York places no statutory cap on damages in medical malpractice cases. Every settlement of a minor's claim must be approved by a judge at an infant compromise hearing under CPLR §1207, and attorney fees follow the sliding scale in Judiciary Law §474-a: 30% of the first $250,000, 25% of the next $250,000, 20% of the next $500,000, 15% of the next $250,000, and 10% of any amount over $1,250,000.
Porter Law Group maintains separate practice pages for related but distinct shoulder-region birth injury topics. This page (Shoulder Birth Injury) is the umbrella practice covering all shoulder-region birth injuries — clavicle and humerus fractures, brachial plexus injuries broadly, and soft tissue injuries — and is the right starting point when the specific injury type is uncertain. Our Shoulder Dystocia practice page focuses specifically on the obstetric emergency where the fetal shoulder becomes impacted during delivery and the ACOG Practice Bulletin No. 178 maneuver sequence. Our Brachial Plexus practice page focuses specifically on nerve injuries to the brachial plexus — Erb's palsy, Klumpke's palsy, total plexus palsy. Our Klumpke Palsy practice page focuses specifically on the lower brachial plexus subtype affecting the lower arm and hand. The practice pages are designed to allow families to start with whichever framing best matches what they know about their child's injury, then navigate to the more specific page as the diagnosis clarifies.

Michael S. Porter is the founder and managing partner of Porter Law Group, representing New York families in periventricular leukomalacia, birth injury, 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 newborn suffered a shoulder birth injury in New York due to medical negligence, critical deadlines may run faster than you expect: public-hospital cases require a Notice of Claim within 90 days, 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 under Judiciary Law §474-a, so you pay nothing unless you win.
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