Erb’s Palsy is characterized by weakness or paralysis of the arm due to injury to the network of nerves that supply the arm and hand. This condition often results from complications during childbirth, particularly when excessive traction is applied to the baby’s head during a difficult delivery. 

 

While not all cases of Erb’s Palsy are due to medical negligence, there are several instances where improper medical practices may cause the condition. In these instances, the victims of medical malpractice can take legal action against healthcare providers. This article explores the causes of Erb’s Palsy, how medical malpractice is identified in these cases, and the implications for affected families.

What is Erb’s Palsy?

 

Erb’s Palsy occurs when there is damage to a group of nerves called the brachial plexus, which is comprised of nerves stemming from the spine that help control the trunk and the upper limbs of the body. Approximately fifty percent of injuries in this region are to the C5, C6, and C7 nerve roots. The injury typically leads to symptoms that can include weakness, limited movement, and muscle atrophy in the affected arm. The severity of the injury can vary significantly—from minor weakness that may resolve on its own to complete paralysis that necessitates surgical intervention.

 

The majority of cases are associated with birth injuries, particularly in infants delivered using forceps or during shoulder dystocia, where the baby’s shoulder gets stuck during delivery.

Causes of Erb’s Palsy

 

While Erb’s Palsy can occur due to natural birth complications, certain factors increase the risk of the injury, particularly when medical interventions are involved:

 

1. Shoulder Dystocia: This is a situation where the baby’s shoulder becomes lodged behind the mother’s pelvic bone during delivery. If not handled correctly, using excessive force to deliver the baby can injure the nerves in the shoulder region.
2. Forceps Delivery: The use of forceps can lead to an increased risk of brachial plexus injury. If the healthcare provider applies too much force or does it incorrectly, significant damage can result.
3. Vacuum Extraction: Similar to forceps, vacuum extraction involves pulling on the baby’s head to aid in delivery. If used improperly, it can also lead to nerve injury.
4. Large Baby (Macrosomia): Babies with a high birth weight face an increased risk of shoulder dystocia, requiring careful handling during delivery.
5. Maternal Factors: Conditions such as gestational diabetes may increase the likelihood of having a larger baby, contributing to the risk of Erb’s Palsy.

Identifying Medical Malpractice in Erb’s Palsy Cases

 

Medical malpractice occurs when a healthcare provider fails to meet the standard of care that a reasonable provider would have delivered in a similar situation, resulting in injury to the patient. 

 

Several criteria can help determine if medical malpractice contributed to the development of Erb’s Palsy:

 

1. Established Standard of Care: It must be demonstrated what the standard practices are during labor and delivery. This includes the appropriate use of forceps, vacuum extraction, and management of shoulder dystocia.
2. Deviation from Standard: Evidence must show that the healthcare provider deviated from this established standard. For example, using excessive force when pulling on the head during shoulder dystocia could be considered a deviation.
3. Causation: It is essential to prove a direct link between the provider’s actions and the resulting injury. Experts often need to testify that the actions taken by the medical staff led directly to the development of Erb’s Palsy.
4. Injury: Finally, there must be demonstrable harm to the patient, including medical records substantiating the diagnosis of Erb’s Palsy and any subsequent treatment.

 

Common Scenarios of Medical Malpractice Leading to Erb’s Palsy

 

Some typical scenarios of injuries resulting from medical malpractice are as follows:

 

1. Inadequate Preparation for Delivery: If a healthcare provider fails to assess the size of the baby accurately or does not properly prepare for potential complications during delivery, their negligence may constitute malpractice.
2. Failure to Identify Risk Factors: If a provider does not recognize the risk factors associated with shoulder dystocia (like maternal diabetes or a history of large babies) and fails to take preventative measures, that can be grounds for malpractice.
3. Improper Use of Delivery Tools: Misuse of forceps or vacuum devices, particularly when there is clear evidence suggesting an urgent need to avoid such tools, can point to negligence.
4. Lack of Prompt Intervention: Failing to respond promptly and appropriately when encountering shoulder dystocia can result in injury; healthcare providers should properly train in maneuvering techniques designed to relieve shoulder dystocia.

Impact of Erb’s Palsy on Families

 

The aftermath of a diagnosis of Erb’s Palsy can be devastating for families. The emotional, physical, and financial burdens often extend far beyond the injury itself. 

 

Families might experience:

 

• Emotional Trauma: Parents may experience guilt, grief, and concern for their child’s future, as they navigate the challenges of raising a child with a disability.
• Financial Burden: The costs associated with Erb’s Palsy can escalate quickly. Treatment may include physical therapy, occupational therapy, and possibly surgeries to address the injury. Long-term care needs can also include specialized equipment, ongoing medical visits, and sometimes home modifications, all of which can become significant financial strains, particularly if the affected child requires lifelong interventions.

• Impact on Quality of Life: The child may face challenges in achieving normal milestones, potentially affecting their ability to engage in everyday activities, sports, and social interactions. Parents may also need to adjust their work hours or responsibilities to care for their children, further impacting family dynamics and finances.

Legal Considerations for Families

 

Families affected by Erb’s Palsy due to suspected medical malpractice should seek legal recourse. Consulting with medical malpractice attorneys like The Oshman Firm who specializes in birth injuries is recommended to navigate the complexities of such cases. 

 

Here are some key legal considerations:

 

1. Statute of Limitations: There are specific time limits within which families must file a medical malpractice claim. This period can vary by state, so it is crucial to act promptly to preserve your right to legal action.
2. Gathering Evidence: A strong case relies on comprehensive medical records, expert testimonies, and documentation of the injury’s impact on the child’s life. Working with legal professionals experienced in medical malpractice can help ensure that evidence is meticulously gathered and presented.
3. Settlement vs. Trial: Many cases settle before going to trial. Legal representation can help families negotiate fair compensation that considers both immediate and long-term needs, but if a fair settlement cannot be reached, families should be prepared to pursue litigation.
4. Emotional Support: The process of seeking justice for medical malpractice can be daunting. Families are encouraged to seek emotional support, either through counseling or support groups, to cope with the stress that may accompany legal proceedings.

Prevention and Awareness

 

Preventing Erb’s Palsy starts with awareness. Parents can advocate for better communication with their healthcare providers and become informed about potential risks associated with delivery methods:

 

1. Prenatal Education: Families should educate themselves about prenatal care, recognizing risk factors that may contribute to difficult deliveries. Discussing these concerns with healthcare practitioners and understanding birth plans can be important steps.
2. Informed Consent: It is vital for expectant parents to have thorough discussions with their healthcare provider regarding delivery methods, potential risks, and alternative options. Being informed empowers parents to make decisions aligned with their values and preferences.
3. Quality of Care: Parents have the right to seek out healthcare providers known for their quality of care and expertise in managing high-risk deliveries. Researching the hospital’s policies on managing complications can also provide peace of mind.
4. Advocacy: In cases where families feel uncertain or anxious about the delivery process, having a trusted advocate, such as a family member or doula, present can help ensure that their concerns are voiced during labor and delivery.

 

Need a Medical Malpractice Attorney?

 

While Erb’s Palsy can occur due to unavoidable complications during childbirth, there are many instances where medical negligence is responsible. Understanding the potential causes, identifying the standards of care, and recognizing warning signs are essential steps for parents. If negligence is suspected, pursuing legal action with The Oshman Firm can help families secure compensation for the challenges they face.

 

Awareness and education play significant roles in both prevention and advocacy. With proper preparation and knowledge, families can take steps to minimize risks associated with childbirth and address any concerns with their healthcare providers. Ultimately, the goal is to ensure the best possible outcomes for every child, creating a supportive environment that prioritizes safety, awareness, and quality care. Let The Oshman Firm help advocate for you and your loved ones. 

 

Sources

 

1. American Academy of Orthopaedic Surgeons. “Erb’s Palsy (Brachial Plexus Birth Palsy).” OrthoInfo, 1 Aug. 2022, https://orthoinfo.aaos.org/en/diseases–conditions/erbs-palsy-brachial-plexus-birth-palsy/ 
2. Chater M, Camfield P, Camfield C. Erb’s palsy – Who is to blame and what will happen? Paediatr Child Health. 2004 Oct;9(8):556-560. doi: 10.1093/pch/9.8.556. PMID: 19680484; PMCID: PMC2724163.
3. National Institute of Neurological Disorders and Stroke. “Brachial Plexus Injuries Information Page.” National Institute of Neurological Disorders and Stroke, 14 Feb. 2023, https://www.ninds.nih.gov/health-information/disorders/brachial-plexus-injuries.
4. MedlinePlus. “Erb’s Palsy.” MedlinePlus, U.S. National Library of Medicine, 5 May 2023, https://medlineplus.gov/ency/article/001396.htm.