If your child suffers from Erb’s Palsy, you should consider the possibility that your doctor or medical care professional may not have done all that is possible to prevent Erb’s Palsy during childbirth. The experienced birth injury attorneys of Oshman & Mirisola, LLP are always available to speak with you, and if you are unable to come to our offices for an initial case sign-up, we will send someone to you whether at home or in the hospital.
What causes Erb’s Palsy?
Occasionally during labor and birth, a baby’s shoulder can get stuck on the mother’s pelvic bone. This birthing emergency is called Shoulder Dystocia. Accepted medical protocol exists to deal with this birthing emergency. Doctors may use many different procedures to dislodge the baby’s shoulder so that the baby can safely pass through the birthing canal. In some cases, the doctor can reposition the mother, or the doctor can use his or her hands to maneuver and change the position of the baby. In particularly dangerous and difficult births, the doctor can break the baby’s clavicle bone on purpose, break the mother’s pelvic bone or perform an emergency C-section. A doctor can cut a deep episiotomy, perform the McRobert’s maneuver, and exert suprapubic pressure. The doctor can also use gentle traction in a horizontal plane to avoid damaging the brachial plexus.
In the event of shoulder dystocia, the doctor can support the head of the baby and apply a small amount of traction during the dislodging maneuvers. When the doctor uses excessive traction on the head while the baby’s shoulder remains stuck, the brachial plexus nerves in the baby’s neck may suffer injury. Depending on its location, this injury then causes one of the four types of brachial plexus palsy.
Though doctors cannot predict shoulder dystocia and the danger of brachial plexus palsy, certain factors may suggest that certain births face a higher risk of shoulder dystocia. These risk factors include:
- Fetal macrosomia, which is a condition in which the pre-birth weight of the baby is over 8 lbs. 14 oz.
- Maternal diabetes
- Maternal obesity
- Short maternal stature
- Platypelliod, or contracted or flat pelvis
- Maternal weight gain of 35 lbs. or more
- Additionally, a protracted first stage of labor may suggest an increased risk for shoulder dystocia and consequently, increased risk for brachial plexus palsy. In addition, a breech birth or other abnormal presentation of a fetus, while not a risk for shoulder dystocia, can result in brachial plexus injury.
The use of tools, including forceps or vacuum, to help the baby descend, may increase the risk of shoulder dystocia as well. Studies also suggest an association between an increased risk for shoulder dystocia and the use of labor-inducing drugs.
Despite these risk factors, more women have uneventful birthing experiences than those whose labors are complicated by shoulder dystocia. In addition, shoulder dystocia can occur in the absence of these risk factors as well. A minority of obstetric brachial plexus impairments are not related to shoulder dystocia. Some other reasons for this disability include tumors in the baby’s neck or the mother’s uterus, viral disease or other abnormalities.
Most brachial plexus injuries are usually mild and most will recover in 3 to 4 months. The more severe injuries may take 18 to 24 months to recover. During this recovery time physical therapy may be necessary. Gentle range of motion exercises and electrical stimulation of muscles need to be performed regularly to keep the joints of the arm supple and prevent atrophy.
Because different injury types may cause the same symptoms, it is difficult to know what kind of injury has occurred. In addition, sometimes many nerves in the brachial plexus may be injured and the nerves may have different types of injuries.
When a child is born with complications, it is unfortunate and can be very distressing for the family. It is especially unfortunate when we learn that our physicians and other medical personnel may have been able to prevent the complication.
Erb’s Palsy is difficult to diagnose. However, certain factors can suggest a higher risk. If you feel your child suffers from a brachial plexus injury such as Erb’s Palsy due to the negligence of your doctor or medical professional, please contact the attorneys of Oshman & Mirisola, LLP. You deserver to be compensated for your child’s physical and emotional damages. Contact us today at 1-800-400-8182, or contact us online for a free case evaluation.