The causes of Erb’s palsy often stem from the result of a difficult birth or medical negligence. Learning the exact cause of your child’s Erb’s palsy may require you to obtain copies of their medical records or take other steps to find out what happened during their birth. Your medical malpractice birth injury attorney can help you navigate this process and build a case for compensation. Learn about Erb’s Palsy symptoms.
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Failure to Take Action to Aid in a Difficult Birth
Brachial plexus injuries like Erb’s palsy are rare outside of difficult deliveries. When the second stage of labor (active labor) lasts longer than normal, the risk of Erb’s palsy greatly increases. A large baby, breech presentation, or abnormalities in the mother’s birth canal can all trigger circumstances where the baby’s neck is twisted or stretched too far, and they suffer this type of nerve damage.
In most of these cases, the doctor monitoring the pregnancy and delivering the baby can predict these complications and take steps to prevent injury. For example, if the baby appears too large to deliver vaginally, it may be necessary to perform a cesarean (C-section) delivery.
Inappropriate Force During Delivery
Another common cause of Erb’s palsy and other brachial plexus nerve injuries is when someone helping to delivery the baby uses too much force or inappropriate force. This can stretch the baby’s neck, damaging the brachial plexus nerves. This may occur when a doctor tugs on the baby’s head or arm, or when using forceps or a vacuum extractor.
While sometimes applying some force is necessary to deliver the baby quickly, there are techniques that should be used to prevent injuries.
Diagnosing Erb’s Palsy in a Newborn
Because nerve damage at the brachial plexus occurs during birth and causes immediate paralysis of the affected area and other symptoms, it is often diagnosed at birth. Doctors, nurses, and others tasked with evaluating the health of the newborn may notice weak movements or a lack of movement in the affected arm. When the shoulder and bicep are affected, an Erb’s palsy diagnosis will likely follow.
If a nurse or other care provider notice these symptoms, they will bring it to the attention of a doctor. Alternatively, a baby’s pediatrician may notice symptoms. This prompts a physical examination of the baby. While a physical exam is generally thorough enough for an accurate Erb’s palsy diagnosis, the doctor may refer the baby for additional testing to rule out additional concerns. This may include:
- Other medical imaging
In some cases, the doctor will prescribe conservative treatment, at-home physical therapy exercises, and monitor the injury closely. If healing does not begin within a few weeks, they may then order medical imaging or additional testing.
Sometimes, doctors may want to send the baby for an electromyogram (EMG) or a nerve conduction study (NCS). These tests can help them understand the best course of action if the nerve does not appear to be healing on its own. Surgery may be necessary to get a more favorable outcome.
Erb’s Palsy Is a Preventable Birth Injury in Many Cases
Many causes of Erb’s palsy are avoidable and may support a medical malpractice birth injury case. Many children born with brachial plexus injuries never fully recover. They may face weakness and complications in their affected arm for years to come. In some other cases, additional surgeries may be necessary to improve motor function or treat complications.
If your child received an Erb’s palsy diagnosis, your family may be eligible to take legal action and hold the doctor or hospital liable. To learn more, schedule a time to discuss your case with a birth injury lawyer. They can help you understand your options, build a case, and understand the time limits that may apply in your case. You could pursue damages that include:
- Medical care costs related to the injury
- Future medical care related to the injury
- Out-of-pocket expenses
- Pain and suffering
Most medical malpractice birth injury attorneys offer free case reviews and take on these cases based on contingency. This means your family will pay nothing out of pocket for their services.
Erb’s palsy most commonly occurs as a result of a preventable birth injury. When a doctor or other medical care provider pulls on the baby with excessive force or using an improper technique while the baby is in the birth canal, it can cause injury to the nerves of the brachial plexus.
The brachial plexus is a network of nerves that connect the hands, arms, and shoulders with the spinal cord. The nerves affected in the brachial plexus injury, known as Erb’s palsy, control movement and sensation in the shoulder and upper arm.
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How Are Head-first Deliveries Related to Erb’s Palsy?
While breech presentations can increase the risk for Erb’s palsy, it also occurs in head-first deliveries. Head-first presentation, also known as cephalic presentation, is the “normal” way a baby enters the birth canal.
When the baby presents face-first without tucking its chin or when it faces the mother’s abdomen, it can increase the difficulty and length of delivery as well as the risk of Erb’s palsy and other birth injuries. It may also increase the need for the doctor to employ forceps or a vacuum-assisted extraction device.
Birth Injuries From Excessive Pulling on the Shoulders Can Occur During Head-First Deliveries
In a cephalic presentation, especially when the baby presents face-first, the doctor may pull and tug at the child’s shoulders to try to get the newborn to move down the birth canal. Even in a normal head-first delivery, delivering the shoulders can be a problem. Shoulder dystocia, when both shoulders get stuck in the birth canal, is a leading risk factor for Erb’s palsy.
If the baby is much larger than the birth canal, a Cesarean section (C-section) may have been a better delivery route. Failure to order a C-section when necessary could be grounds for a medical malpractice birth injury lawsuit.
Understanding Erb’s Palsy and Why Brachial Plexus Injuries Occur
Erb’s palsy results from damage to the nerves that supply movement and sensation to the baby’s upper arm.
These injuries often occur because of forceful pulling, putting excessive lateral traction on the baby’s head and neck in an effort to move it down the birth canal. Shoulder dystocia causes a significant increase in risk for this type of injury and Erb’s palsy. Other risk factors for developing this type of nerve injury in a head-first delivery include:
- The use of forceps or a vacuum extraction tool during delivery
- Large infant size, high birth weight
- Mother with gestational diabetes resulting in a large baby
- An especially petite mother
- Excessive maternal weight gain during pregnancy
- Extended and difficult labor, especially the second stage
If the mother and baby face these risk factors, the doctor should recognize them and consider if a C-section is a better option than a vaginal delivery. If delivery is already in progress, there are techniques the doctor can use to properly turn the child or deliver without excessive pulling.
Knowing which birth technique to use and how to use it is paramount. Choosing the wrong option or applying it incorrectly may be grounds for a medical malpractice case if the child develops Erb’s palsy or suffers another birth injury.
Identifying and Treating Erb’s Palsy
If a newborn does suffer a brachial plexus injury during birth, the symptoms are usually apparent immediately. Hospital staff often recognize the symptoms, and many newborns receive a diagnosis in the first hours or days after birth. Signs and symptoms of this type of injury include:
- Paralysis or weakness in one arm
- Weakened grip in the hand of the affected arm
- Lack of sensation in the affected arm
- Holding the arm in a “waiter’s tip” position, with the arm extended and held close to the body, and the wrist flexed
- Absent Moro (startle) reflexes in the affected arm
The most common treatment for a child with Erb’s palsy is a conservative approach that includes close monitoring of their progress and physical therapy to help them maintain and build muscle mass and range of motion. This is effective in the vast majority of children with Erb’s palsy. It rarely causes lasting damage.
Occasionally, surgical repair is necessary. In rare cases, a child could have a lasting disability related to a birth injury and Erb’s palsy.
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How Can Forceful Arm Pulling During Birth Lead to Erb’s Palsy?
If a doctor or other medical care provider tugs or pulls on a baby’s arm with too much force during delivery, it can damage the nerves that connect the upper arm to the spinal cord, causing Erb’s palsy. This type of birth injury almost always resolves with treatment, but some children require surgery. Rarely, children have lasting disabilities as a result of this type of nerve damage.
Erb’s palsy is the most common type of brachial plexus injury, and generally the least severe. Other types of brachial plexus birth injuries can also occur as a result of forceful pulling on one of the baby’s arms during childbirth. A birth injury lawyer can fight for the justice you and your child deserve after diagnosis of a condition like Erb’s palsy. Call the Birth Injury Lawyers Group at 1-800-222-9529.
Improper Techniques When Delivering a Baby Can Lead to Birth Injury
Erb’s palsy occurs because of damage—ranging from bruising to complete tears—of the nerves that connect the upper arm with the spinal cord. Most commonly, this damage occurs at Erb’s point, at the top of the brachial plexus where the fifth and sixth cranial nerves meet.
If the baby enters the birth canal at an awkward angle, it is possible for the head to turn one direction while the doctor forcefully pulls on the arm in the other direction. This puts undue stress on the baby’s arm, shoulder, and neck, and injuries. This kind of forceful arm pulling during birth can lead to Erb’s Palsy. Stress of this nature is sometimes called “excessive lateral traction.”
Risk Factors for Erb’s Palsy
Erb’s palsy is common when the baby presents with an unusual delivery, or there is cephalo-pelvic disproportion (CPD). CPD is a preventable complication that occurs when the newborn is much larger than the birth canal. Doctors who monitor patients and their babies closely should be able to predict CPD and order a Caesarean section (C-section).
Babies whose shoulders get stuck during birth, called shoulder dystocia, is the most common risk factor for Erb’s palsy. Other risk factors that may contribute to this type of injury include:
- Improper use of forceps or vacuum extraction tools during delivery
- Large infant size, sometimes because of maternal gestational diabetes
- Small maternal size
- Long, difficult labor and delivery
Any time there are factors that make it more difficult for the infant to pass through the birth canal, the chances for improper or forceful arm pulling increase.
How to Know If Your Child Has Erb’s Palsy or Another Brachial Plexus Injury
You may not know immediately if your doctor used an improper technique or force during your child’s delivery, but symptoms of brachial plexus injuries, including Erb’s palsy, are usually immediately evident. This may include:
- Full paralysis or weakness in the affected arm
- Lack of sensation in the upper arm
- A weakened grip in the hand
- The arm extended or bent and held close to the body
While the symptoms may be visible immediately after birth, diagnosis can be difficult in some cases. This is because symptoms are similar to other conditions, including collarbone fractures that can occur in the same way.
To diagnose the newborn, the doctor will perform a physical exam. This exam will look at:
- Muscle control and movement in the affected arm
- Sensation in the affected arm
- Grip strength in the hand of the affected arm
- Moro reflex (startle response) as it affects the arm
The doctor may also want to conduct medical imaging scans and other testing to get a better understanding of the injury. This could include:
- An X-ray to rule out collarbone fracture
- Nerve conduction study (NCS)
- Electromyogram (EMG)
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
Once they have an accurate diagnosis, they can recommend a treatment plan that fits the severity of your infant’s injury. In most cases, conservative treatment is effective. This focuses on splinting and physical therapy to help the baby maintain and build strength and range of motion while the nerves have time to heal.
Severe injuries may require surgery and cause lifelong impairment in rare cases.
Erb’s Palsy Is the Most Common Type of Brachial Plexus Injury
Erb’s palsy affects the upper nerves of the brachial plexus and is the most common type of brachial plexus injury. Most brachial plexus injuries will heal on their own within a few months, although doctors generally prescribe in-home physical therapy to help the baby retain strength and range of motion until they heal.
Between 80 to 96 percent of babies who receive an Erb’s palsy diagnosis have a complete recovery. They generally exhibit some recovery within a few weeks of birth. The remaining babies may recover only partial feeling or movement. Some may not recover at all on their own and may need surgery to allow them any movement or sensation in the affected shoulder and upper arm.
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Medical Care Providers Could Prevent Many Causes of Erb’s Palsy
Erb’s palsy is frequently a preventable birth injury. Doctors or other medical care providers must use careful, skilled techniques to guide the baby through the birth canal if the delivery stalls or the baby becomes stuck. Using too much force, tugging improperly, or failing to use approved techniques can cause Erb’s palsy, other brachial plexus injuries, and more serious birth injuries.
In addition to improper technique or force, there are other ways a doctor or other medical professional can cause brachial plexus injuries, including Erb’s palsy. In some cases, doctors try to deliver a baby vaginally who is too large for the mother’s build, or there are other indications that a cesarean section (c-section) would be more appropriate.
In other cases, doctors opt to use forceps or a vacuum extractor device to help deliver the baby, which can cause Erb’s palsy or other birth injuries.
Erb’s Palsy May Support a Valid Medical Malpractice Birth Injury Case
If you and your attorney can uncover evidence to prove that a doctor or other medical care provider caused your child’s Erb’s palsy–or failed to prevent the injury–you may be eligible to pursue compensation for the injuries your child suffered, as well as the expenses you incurred as a result.
Your lawyer will help you build your case based on your state’s rules for pursuing damages through a medical malpractice lawsuit. Often this requires calling in a medical expert witness who can:
- Verify that medical negligence occurred
- Explain what most medical care professionals would have done
- Discuss how your doctor’s actions caused your child’s injuries
Along with other evidence such as your child’s medical records and proof of your losses, the expert’s opinion will help prove your case to the doctor or hospital’s insurer or the judge and jury during trial.
Your attorney will present the evidence to prove medical malpractice in addition to the evidence that proves your child’s injuries, expenses, and losses. They will represent your family’s best interests throughout the claims process and can take legal action on your behalf when necessary.
There are time limits on filing a lawsuit in this type of case. Each state has its own statute of limitations and its own rules for tolling the statute of limitations when the victim is an infant. Your attorney will be familiar with the laws in your state and can help you meet this deadline when possible.
Talk to a Birth Injury Attorney Today
If your child suffered a birth injury and received an Erb’s palsy diagnosis, you may be able to pursue compensation for your child’s medical care, physical and occupational therapy, out-of-pocket expenses, pain and suffering, and more. Call the Birth Injury Lawyers Group to get help today.
We will discuss your case with you and help you understand your options for taking the next step to build a case and pursue the payout your family deserves. Compensation may help you recoup your losses or pay for your child’s ongoing and future care if they suffered lasting damage because of their birth injury.
Call (800) 222-9529 now to talk to a member of our team about your child’s Erb’s palsy.