Personal Injury Lawyer

A birth injury lawyer typically has experience with a subset of birth injury lawsuits coming from a brachial plexus injury. Brachial plexus injuries, or Erb’s palsy, typically occurs as a result of excessive traction by the obstetrician during labor and delivery after encountering a shoulder dystocia. “Shoulder dystocia” simply means that the newborn’s shoulder became stuck in the birth canal.  

What Is A Brachial Plexus Injury?

When a delivering physician encounters a shoulder dystocia, several maneuvers are required to avoid overstretching the nerves that run through the child’s neck. If the central path of these nerves — called the brachial plexus — is injured, the child’s arm and hand can be rendered effectively useless. This is obviously a catastrophic birth injury that is the subject of many medical malpractice lawsuits.  

The American College of Obstetricians and Gynecologists (ACOG) describes shoulder dystocia as “a delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders.” This description was designed to offer obstetricians a defense in obstetrical malpractice cases. Since the definition includes a subjective element, the defendant obstetrician can argue that the additional maneuvers were not necessary.

Evidence of Injury

Medical studies show that obstetricians routinely fail to record the occurrence of a shoulder dystocia in the medical record. One study found that 40% of medical charts failed to properly chart the occurrence of this obstetrical complication. In the absence of accurate charting, often the only evidence of a shoulder dystocia is a resulting injury to the child’s brachial plexus. 

The ACOG definition actually encourages physicians to fail to chart when a shoulder dystocia is encountered. It is important to carefully interview the mother and others present during the delivery process. In addition, nurses’ notes can be an invaluable source of information. Even in the absence of charting, a brachial plexus injury case is winnable.

Defense of Shoulder Dystocia

Defense attorneys typically defend shoulder dystocia lawsuits by arguing that the injury occurred as a result of “maternal forces of labor.” This defense has been severely criticized by both obstetricians and biomedical engineers. Indeed, even the proponents of this defense concede that it cannot be proven.  

Due to the nature of this injury, it is important to be sure a child who has weakness or atrophy in their arm or hand is evaluated by a pediatric neurologist.  

Medical Literature

The prevailing medical literature in the field of pediatric neurology directly relates a brachial plexus injury or Erb’s palsy to excessive traction during the delivery process. In this regard, a leading pediatric neurologist wrote: “Brachial plexus injury is thought to result from stretching of the brachial plexus, with its roots anchored to the cervical cord, by extreme lateral traction.  The traction is exerted via the shoulder in the process of delivering the head with breech deliveries, and by the head, in the process of delivering the shoulder… The relatively rare occurrence of intrauterine injury to the brachial plexus has been secondary to abnormalities of fetal position or uterine structure.”  

Contact a Birth Injury Lawyer

An experienced birth injury lawyer, like a birth injury lawyer in Cleveland, OH, will advise his or her client that these cases are vigorously defended by well-prepared medical malpractice defense attorneys and well-compensated medical experts. Children suffering a brachial plexus injury or Erb’s palsy must live with permanent deformity and weakness as a result of obstetrical malpractice. 

Thanks to Mishkind Kulwicki Law for their insight into brachial plexus injury lawsuits.