Erb’s Palsy Lawsuits

In 2008, a Michigan woman gave birth to her child. During that birth, the child got stuck in the birth canal. The medical staff should have delivered the baby via Caesarian section, or taken other precautions to ensure the infant’s safety, but instead, according to the mother, the medical staff continued with vaginal delivery, and pulled down too hard on the baby’s head. As a result, the nerves in the baby’s right arm were severed, which left her with Erb’s palsy, a medical condition which results in paralysis of the arm.

The mother sued the hospital and in 2013, a Michigan jury awarded the mother $12.9 million in her Erb’s palsy lawsuit. This is just one example of many similar lawsuits that have been filed by parents of children who were wrongly injured in the delivery room.

The medical malpractice lawyers at Chaffin Luhana are currently investigating cases in which doctors failed to take the proper safety precautions during a baby’s birth, resulting in injury to the baby. If you have a baby that suffers from Erb’s palsy that you believe was caused during the birthing process, you may be eligible to file an Erb’s palsy lawsuit.

What is Erb’s Palsy?

Erb’s palsy (also called Erb-Duchenne palsy or Erb-Duchenne paralysis) is a condition in which the arm is weak or paralyzed because of an injury to the brachial plexus. The injury typically occurs during an abnormal or difficult childbirth.

The brachial plexus is a network of nerves that extends from the spinal cord in the neck and down the arm and into the shoulder and chest. Erb’s palsy or Erb’s paralysis is a form of brachial plexus injury that occurs when the nerves in the baby’s upper arm are damaged.

Estimates are that about one-to-two of every 1,000 newborns will suffer from an injury during the birthing process that results in Erb’s palsy. The disorder is named after the “Erb’s point,” which is an area on the neck where the injury occurs that was named after “Wilhelm Erb,” the doctor who first described the condition. A brachial plexus injury can occur anywhere along the network of brachial plexus nerves. Erb’s palsy, however, is an injury that occurs due to nerve damage in this one particular location which provide movement to the shoulder and arm.

Symptoms of Erb’s palsy include:

The infant’s arm hangs limply from the shoulder
The infant can’t move the shoulder, but may be able to move the fingers
The infant can’t move his arm over his head
The arm is partially or completely paralyzed
The arm feels painful or numb
The infant has trouble gripping with the hand on the affected side

What Are the Complications of Erb’s Palsy?

Mild Erb’s palsy may improve over time. More severe Erb’s palsy involves more severe nerve damage, and may result in permanent paralysis and disability.

When diagnosing Erb’s palsy, a doctor will look at the extent of nerve damage, and determine which of the following four categories applies:

Neuropraxia: This is the most common type of nerve injury, and occurs when the nerve is stretched, but not torn. This type of injury usually heals on its own within a few months.
Neuroma: This also involves nerve stretching, but is a more serious stretch injury. The nerves are damaged and are likely to form scar tissue as they heal. The weight of the scar tissue may pressure the nearby nerves, so the recovery is only partial.
Ruptures: This means that the nerve was torn. This type of Erb’s palsy requires medical treatment, usually surgery to help repair the nerves.
Avulsions: This is the most serious type of nerve injury, and occurs when the nerve is completely torn away from the spinal cord. The affected nerves can’t be reattached, but some function may be restored with surgical nerve grafts.

Long-term complications depend on the severity of the injury. Mild cases will usually clear up on their own, though physical therapy is typically needed. Most cases of Erb’s palsy will heal within a year with proper and consistent care.

In some cases, however, children with Erb’s palsy develop lifelong problems because of the injury. They may have permanent dysfunction or long-term paralysis of the arm. They may also have uncontrollable muscle contractions.

A child with one arm shorter than the other often has that condition because of Erb’s palsy. The nerves in the brachial plexus affect growth. If they are severed or severely damaged, the affected arm will grow more slowly than the child’s other arm. As the child gets older, the size difference will become more noticeable.

Causes of Erb’s Palsy in Newborns

Erb’s palsy may occur because of improper treatment during a difficult or prolonged birth. It can happen in the following ways:

Pulling at the wrong angle: As the baby is passing through the birth canal, she’s coming at an awkward angle, with the head turned one direction while medical staff pull the arm the opposite direction, straining and possible stretching or tearing the nerves.
Excessive pulling: The baby becomes stuck in the birth canal because of “shoulder dystocia,” causing the medical staff may pull too hard on the shoulders. If the baby is delivered face-first, the risk of excessive pulling increases.
Breech birth: The baby is moving through the birth canal backwards, and the nerves are stressed and injured if the baby’s arms are pulled back over the head as the physician pulls her through by the feet and legs.

Shoulder dystocia is a condition that occurs when the baby’s shoulder becomes stuck behind the mother’s pubic bone or sacrum. The medical staff may try to pull the baby through using forceps or a vacuum, which can result in traction injury to the nerves.

Certain factors can increase the risk that shoulder dystocia or Erb’s palsy will occur. These include:

Large infant weight and size (also called “fetal macrosomia)
Maternal diabetes
Breech delivery
Maternal obesity
Mother is over the age of 35
Use of instruments to extract the baby (like forceps or a vacuum)
Birthing twins or other multiple births
Induced labor

Medical professionals are well trained in all these conditions, however, and know that they increase the risk of Erb’s palsy. They have a responsibility to know the proper steps to take when shoulder dystocia occurs, and also know that large infant weight or maternal obesity can increase risks of Erb’s palsy. Responsible medical professionals follow standard protocols and take the proper steps to make sure the baby is delivered safely.

When Medical Staff May be to Blame

Sometimes Erb’s palsy is unavoidable and no one is to blame. This sometimes occurs when the birth is difficult or if the baby has to be delivered under emergency conditions. Other times, however, the injury is preventable, and occurs because of medical negligence. If your baby suffered an injury due to any of the following, you may be eligible to file an Erb’s palsy lawsuit:

The medical professional failed to identify risk factors for Erb’s palsy.
The doctor failed to take steps to avoid traction injury during the delivery.
The doctor noticed signs of shoulder dystocia or awkward positioning of the baby, but failed to address these issues.
The doctor failed to recognize signs of fetal distress.
The person assisting with the delivery exerted too much force to pull the infant out of the birth canal.
The doctor failed to schedule a cesarean section, which is sometimes needed to ensure a safe delivery.
The doctor was negligent in postnatal care of the newborn.

If you’re not sure if you have a medical malpractice case, your Erb’s palsy attorney can help investigate to determine the extent of possible negligence on the part of the medical staff.

How is Erb’s Palsy Treated?

In most cases, doctors will recommend watchful waiting during the first month of the baby’s life. Since most injuries heal on their own, this is usually the wise approach. If the problems persist or if initial X-rays show the damage is severe, other treatments may be necessary.

Daily physical therapy is the most common treatment for Erb’s palsy. Parents will be given an Erb’s palsy guide to certain exercises that they can then help the baby perform at home. The doctor teaches parents how to perform these exercises properly, and then advise them to stay consistent with the practice. The earlier therapy begins in the child’s life, the more successful it is. The exercises help maintain range of motion and prevent the joint from becoming stiff while the nerves heal.

If the baby’s condition doesn’t improve with time and physical therapy, or if the nerves were ruptured or separated, surgery may be necessary. The type of surgery varies depending on the injury itself. Sometimes doctors perform “nerve grafts,” which help repair ruptured nerves by splicing other nerves onto them. Other times, nerve transfers are required, in which the doctor moves a nerve from another muscle to the injured area.

Nerves take a long time to heal, so recovery from surgery can take several months or even years. During that time, as noted in most Erb’s palsy guides, the child will require daily physical therapy to help improve their strength and range of motion.

If the affected arm remains weak as the child grows, they may need additional surgeries later in life to help improve their function. Long-term effects of the disorder can have a powerful impact on the child and the family. Children with limited use of one arm may suffer from self-esteem issues, or be unable to participate in certain activities. Parents can help with a positive attitude and possibly with therapy, but such an injury can cause long-term damage.