Shoulder Dystocia
[
Shoulder dystocia] is an obstetric emergency with the potential to severely injure both
mother and child. A shoulder dystocia happens when the baby's shoulder becomes stuck behind the mother's pubic bone during delivery; most shoulder dystocia situations are diagnosed when the baby's head delivers but the shoulders do not follow. If shoulder dystocia occurs,
any amount of traction placed on the baby's head can cause severe nerve injury. Shoulder
dystocia is one of the most difficult complications that can occur during delivery, because
a shoulder dystocia situation carries such high risk for complications.
Erb's Palsy is one of the most common (and serious) shoulder dystocia injuries. Erb's Palsy results when a shoulder dystocia condition is mishandled, resulting in damage to the nerves connecting the neck and arm. Shoulder dystocia can stretch the nerve tissue and cause damage resulting in permanent paralysis of the arm.
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Risks During Delivery
A properly trained obstetrician will identify any shoulder dystocia risks and take steps to avoid injury during the delivery. Increased risks of shoulder dystocia are linked to high birth-weight babies, overweight or obese mothers, and a long second stage of labor. Shoulder dystocia can be prevented by scheduling a caesarean section (c-section) for high-risk mothers. If shoulder dystocia occurs during the birthing process, there are 16 different techniques to free the trapped shoulder and ensure safe delivery. Shoulder
dystocia is a serious situation, but does not have to result in injury.
About 1 or 2 babies in 1,000 suffer brachial plexus injuries at birth, and about 1 in 10 of these babies need treatment. Unfortunately, medical mistakes do occur and in the case of shoulder dystocia, the mistakes can be lasting with conditions such as Erbs Palsy.
Brachial Plexus Palsy
Brachial Plexus Palsy occurs when the brachial plexus, a network of nerves, is damaged.
Since the brachial plexus conducts signals from the spine to the arm and hand when it is
damaged a limp arm can result. The brachial plexus is a network of nerves formed by fibers, which are located between the shoulder and the neck. Most often brachial plexus injuries
happen during birth when excessive lateral traction is applied to the fetal neck region. In
cases of brachial plexus palsy the upper part of the brachial plexus is involved. The
brachial plexus palsy injuries are 90% of the time caused by traumatic stretching of the
plexus during birth. Many babies with brachial plexus injuries are larger than average at
birth.
Types of Erb's Palsy
There are different types of brachial plexus injuries. Children with Erb's Palsy are all
affected in different ways; depending on the type of nerve damage in Erb's Palsy children the symptoms can range from mild to severe. With Erb's palsy there are four different types of nerve injuries, including:
- an avulsion meaning the nerve is torn from the spine
- a rupture meaning the nerve is torn but not where it attaches to the spine
- a neuroma meaning the nerve has tried to heal but scar tissue has grown around the injury
placing pressure on the injured nerve praxis. While the nerve has been damaged, it has not
been torn and improvement should be seen within 3 months.
- Neuropraxia is the mildest form of a nerve injury. Neuropraxia, the most common form of
Erb's palsy is localized to the specific place where the injury occurs. It is a physiologic
block of nerve conduction within an axon without any anatomical interruption. Many infants
born with brachial plexus palsy have neuropraxia and sometimes recover within 4-6 weeks.
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Symptoms of Erb's Palsy
Symptoms of Erb's Palsy are usually very obvious. A baby suffering from Erb's Palsy can be seen with the affected arm laying by their side and an extended elbow devoid of movement. The injuries that are associated to Erb's palsy are the neck, clavicle, shoulder, and arm. Some precautions should be used with children with brachial plexus injuries are shoulder or elbow dislocation, a frozen shoulder, soft tissue or joint contractures.
Lifting a child with Erb's Palsy from under the armpits should always be avoided.
Examples of different symptoms of Erb's Palsy:
- no muscle control and no feeling in the arm or hand
- little control of arm movements
- the use of hands but not of the shoulder or elbow
- the entire arm may be paralyzed with the hand and fingers hanging limp
- facial paralysis on the affected side
- not able to sit up without assistance
- the inability to crawl without the use of therapeutic devices.
Treatment for Erb's Palsy
Treatment for Erb's Palsy generally consists of daily exercise and physical therapy to improve functionality of joints and muscles. In about 20% of the cases, babies born with Erb's Palsy will greatly benefit from surgery between the ages of 5 and 12 months. Infants with brachial plexus palsy can benefit from surgical procedures to increase their arm functions. Since most children with Erb's Palsy have damage to multiple nerves of the brachial plexus, more than one procedure, preformed by a pediatric neurosurgeon, may be necessary.
Erb's Palsy Birth Injuries Settlements and Verdicts
$10.5 million settlement for a child who suffered severe brain damage as a result of medical malpractice which occurred during prenatal care.
$5 million settlement for a newborn child who suffered brain damage during delivery resulting in severe cerebral palsy.
$2.6 million settlement for a child who's fetal distress was ingnored by the obstetrition, resulting in a severely brain damaged baby with cerebral palsy.
$1.1 million settlement for a baby that suffered a brachial plexus injury during birth, resulting in Erb's Palsy.
$13.3 million verdict for a child damaged at birth due to a mistake during delivery, causing Erb's Palsy.
$1 million verdict for a baby who suffered Erb's Palsy and Klumpke Palsy due to the doctor's negligent management of a shoulder dystocia.
$500,000 settlement for child with brachial palsy after shoulder dystocia during delivery.
Register your Erb's Palsy Case
If your child has suffered from Erb's Palsy as a result of a birth injury, you may qualify for damages or remedies that may be awarded in a possible Erb's Palsy lawsuit. Please click on the link below to submit your Erb's Palsy complaint to a lawyer for a free case evaluation.
