Information About Erb’s Palsy & Brachial Plexus Injuries
What is Erb’s Palsy?
Erbs Palsy is a medical condition in which the brachial plexus nerve is injured. The brachial plexus is a bundle of nerves between the neck and shoulder. Injury to the brachial plexus can cause varying degrees of paralysis of the shoulder, arm, and hand. With a few very rare exceptions, all permanent Erbs Palsy birth injuries which are discovered at or shortly after birth should be considered medically preventable.
What is Shoulder Dystocia?
Shoulder Dystocia occurs when the baby’s shoulder becomes stuck beneath the mother’s pubic bone after the head comes out, making delivery difficult. This is in contrast to a normal delivery, in which the baby’s shoulder typically follows fairly quickly and easily after delivery of the head.
Shoulder Dystocia requires a rapid response because the baby can be deprived of oxygen while the delivery is delayed. Fortunately, there are several methods which when correctly applied will safely deliver a baby whose shoulders are stuck, and the standard of care requires that one or more of these methods be attempted. Some of the most commonly used methods are:
- The McRoberts maneuver, which involves the flexing of each of the mother’s legs so that her thighs are pulled towards her abdomen.
- Wood’s Corkscrew maneuver, which involves the obstetrician reaching into the birth canal and rotating the baby’s shoulders to free the arm.
- Suprapubic pressure, which involves pressing down on the mother’s lower abdomen to help get the shoulder out from underneath the mother’s pubic bone.
- Delivering the posterior arm (ie., the arm that is not lodged under the pubic bone) from the birth canal.
One action that is not acceptable is for the obstetrician to pull or exert force on the baby’s head to try to free up and deliver the shoulders. Pulling on the baby’s head is unsafe and a deviation from proper practice while the shoulders are stuck because it can cause permanent damage to the brachial plexus nerves.
Risk Factors for Shoulder Dystocia
During pregnancy, a doctor should be watching for Shoulder Dystocia risk factors, which include:
- Maternal obesity
- Maternal diabetes
- Advanced age of mother
- Short or small mother
- Flat, contracted or exceptionally small pelvis
- Above-normal weight gain during pregnancy
- High pre-birth weight of the baby
- Abnormally long gestation period
- Prolonged labor
- Breech position
In some cases, the presence of risk factors requires an obstetrician to discuss or recommend the performance of a Caesarean Section delivery in order to avoid the risk of Shoulder Dystocia occurring. However, Shoulder Dystocia can occur even in women who do not possess any of the above risk factors, and for that reason obstetricians are taught that they must always be prepared with a “drill” or game plan to address Shoulder Dystocia should it occur.
Symptoms and Effects of Erb’s Palsy
Any of the following symptoms can mean that your baby is suffering from Erbs Palsy:
- Paralysis of the shoulder, arm and/or hand
- Loss of feeling in the shoulder, arm and/or hand
- Hand which does not function properly
- Limp hand or fingers
- Shorter than normal arm
- Rotated arm
- Winged shoulder blade
- Downward sloped shoulder
- Flexed elbow
- Atrophy of the deltoid, biceps, and brachialis muscles
Treatment for Erb’s Palsy
Early detection of Erbs Palsy will increase a baby’s chance of achieving a better recovery. Treatment always includes physical therapy and may require surgery to attempt to repair or replace damaged nerve fibers. Fortunately, many babies recover spontaneously during the first three months after injury, and some degree of improvement can be seen up to the age of two. Unfortunately, damage still present by a baby’s second birthday is generally considered to be permanent. The severity of the injury typically determines the likelihood and extent of any recovery seen.
What to Do if Your Child Suffered an Erb’s Palsy Injury
If you suspect that your child may have suffered an Erbs Palsy injury, it is important to consult as soon as possible with a physician who is qualified to address and treat Erbs Palsy injuries. Proper and timely treatment will maximize the chances that your child will survive with as little damage as possible under the circumstances. Unfortunately, even with the best of care, some children with Erbs Palsy injuries are left with some degree of paralysis of the shoulder, arm, and hand. This creates challenges to everyday functioning, cosmetic issues involving the appearance of the affected shoulder and arm, and potential psychological or emotional issues.
It is in your child’s interest to be in a position to benefit from the very best and most advanced treatment available. There may be a significant difference in the treatment and services that private medical insurance or such programs as Medicaid will cover, and the most desirable state of the art treatment. If your child has suffered an Erbs Palsy injury, obtaining compensation may be the only way to provide the care and services needed to maximize your child’s recovery and potential.
Collectively, New Jersey medical malpractice lawyers Michael L. Weiss, Esq. and Robert E. Paarz, Esq. have presented over 25 Erbs Palsy injury cases to juries and have helped many children achieve substantial financial recoveries. They are committed to using their knowledge and experience to help any child with Erbs Palsy obtain fair compensation.
If you believe your child may have experienced such an injury, please contact Weiss & Paarz, P.C., today.
*The firm handles cases in New Jersey and Pennsylvania. For cases outside those states, Weiss & Paarz works with local attorneys in the state where the medical care took place, at no additional cost to the client.