A brachial plexus injury affects the nerves located in the baby’s neck. The injury can develop if a child’s shoulder becomes stuck in its mother’s pubic bone during natural birth. This condition is commonly known as shoulder dystocia. It is considered an obstetrical emergency.
Because of the baby’s position in the birth canal during delivery, the umbilical cord is pinched closed. This means that there is limited blood flow to the baby. The baby must be delivered within 5 or 6 minutes of the shoulder dystocia. Any delay poses a risk of neurological impairment as a result of the cessation of blood flow via the umbilical cord to the infant.
As the medical professional employs downward traction on the baby’s head to free the shoulder, a child’s brachial plexus injury can occur. The downward traction can stretch the nerves in the baby’s neck. In extreme cases, the traction can cause an avulsion of the nerve, where the nerves are dragged away from the cervical spine.
Brachial plexus injuries are often short-term but can also be permanent. The damage to the brachial plexus nerves can have a direct impact on how the arm functions on the side of the injury.
Brachial Plexus is a Common Injury
The upper brachial plexus nerves can be damaged if they are stretched, ripped, cut, or entirely removed from the spinal cord. Less severe injuries, such as stretches, can recover on their own. More serious injuries will call for additional therapies that include occupational or physical therapy, assistive devices, medications, or surgery. If your child sustains a brachial plexus birth injury, you should contact a birth injury lawyer to help you prove medical malpractice. Medical malpractice cases are complicated since the liable parties deny liability.
The Risk of Brachial Plexus Injury
Brachial plexus injuries are a fairly common birth injury. Usually, the risk is particularly high for larger babies, difficult vaginal births, and newborns in the breech position. Infants born to diabetic moms and babies born after extremely long labour are also at risk.
These injuries occur if medical professionals breach the standard of care through negligence or omission. A few examples of decisions made by the medical team that can result in medical negligence are:
- Failure to predict a difficult delivery due to the baby’s position, size and other risk factors
- Failure to realize that the baby is wedged beneath the mother’s pelvic bone
- Failure to check for fetal discomfort
- Failure to execute a C-section when needed
- Using excessive force to remove the infant from the mother’s birth canal
- Applying excessive pressure to the baby’s head or neck during delivery
- Use of instruments like vacuums and forceps
- Failure to offer adequate care after birth
Types of Brachial Plexus Birth Injuries
There are two primary kinds of birth injuries to the baby’s shoulder.
Erb’s palsy is the most prevalent of the two. This injury causes nerve damage in the baby’s upper brachial plexus. It produces numbness and paralysis in the shoulders, arms, and elbows, as well as a tingling sensation in the hand.
Klumpke’s palsy is a less prevalent injury involving the lower brachial plexus. It can cause impairment in the wrist and hand, such as loss of motion, feeling, and being unable to move fingers.
If any of these injuries occur, they can result in avulsion. This is a condition whereby the nerve is ripped from the spine. Other potential complications include neuroma (tear scar tissue), nerve rupture (a tear), or neurapraxia (stretched nerves).
Early Diagnosis of Brachial Plexus Birth Injury is Crucial
If a brachial plexus injury occurs, it is critical to seek immediate medical attention. Some of such injuries will heal on their own without requiring medical intervention. However, for others, treatment must begin as soon as possible so that neurologists or neurosurgeons can assess the infant’s progress.
Functional improvement in newborns should be noticed within three months of receiving occupational and physical therapy. Approximately one out of every ten newborns who sustain injuries to the brachial plexus will require surgery.
Surgery is best done between four and nine months following birth. Surgeries conducted more than twelve months after brachial plexus birth damage are typically less effective in restoring function.
Diagnosis of Brachial Plexus
An initial checkup of both arms and hands to assess feeling and function can aid in determining whether an injury occurred. Additional tests to diagnose or substantiate a diagnosis include:
- X-rays of the shoulders and neck
- MRIs and CT scans, which can include dye tests
- Nerve conduction tests and electromyograms
- Sometimes physicians repeat these tests to monitor treatment progress
The Signs of a Brachial Plexus Birth Injury
The symptoms of brachial plexus injuries vary depending on the severity of the birth injury and its location. The most severe damage and symptoms are caused by rupturing or tearing the affected nerves, particularly if they are entirely separated from the baby’s spinal cord.
The signs of brachial plexus injuries in babies can include:
- Being unable to move the arm, hand, or shoulder
- A feeling of numbness or burning sensations in the affected area
- Weakness in baby’s arms, shoulders, or hands
- Persistent pain in serious cases
Brachial Plexus Birth Palsy and Erb’s Palsy
Brachial plexus palsy develops when the baby’s brachial plexus nerves are injured. This makes the brain unable to deliver signals to the arm muscles, thus limiting the baby’s ability to use a portion or the entire arm.
As outlined by the Seattle Children’s Hospital, Erb’s palsy develops when the top nerves of a baby’s brachial plexus are stretched. This affects the baby’s elbow and shoulder muscles. Infants with Erb’s palsy can sometimes flex their fingers but cannot move their shoulders.
Additional symptoms of Erb’s palsy include:
- Partial or total paralysis of one arm
- Numbness or weakness in the affected part of the arm
- The affected arm has a restricted range of motion
- Total plexus palsy – refers to a more severe form of brachial plexus palsy. It affects both the baby’s upper and lower brachial plexus nerves.
Treatment Options for Brachial Plexus Injury
Depending on the extent of the injury, your baby could recover from brachial plexus birth injuries. Even if your baby needs to undergo brachial plexus surgery, the surgery has a high success rate of 95%. However, in extreme cases, a brachial plexus injury can lead to complete paralysis, making your baby permanently disabled.
Even severe brachial plexus injury can improve with these treatments:
- Physical therapy helps the injured limbs function better by a range of motion and flexibility.
- Occupational therapy may benefit a baby with muscle weakness in doing daily chores such as getting dressed.
- Nerve or orthopedic surgery could be required for serious brachial plexus birth injuries.
Surgical Treatment Options for Brachial Plexus Birth Injuries
The popular surgical techniques to treat serious brachial plexus birth injuries are:
Muscle & tendon transfers
Muscles and tendons are moved from another area of the body to help an infant recover arm function.
Neurolysis
This involves removing the scar tissue from a nerve to enable it to function properly.
Nerve grafts
A surgeon uses nerve fibres obtained from another part of the body to resolve nerve injuries.
How an Erb’s Palsy Lawyer Can Help
An Erb’s palsy lawyer is a subcategory of medical malpractice lawyers. Brachial plexus injury lawyers assist families impacted by the disorder to file birth injury lawsuits to seek monetary damages for their baby’s injuries.
The vast majority of Erb’s palsy cases are moderate and can be resolved on their own. However, serious cases call for surgery and lead to hefty medical bills. An experienced birth injury lawyer who specializes in Erb’s palsy knows the financial and emotional challenges that brachial plexus injury cases pose.
Erb’s palsy lawyers will do everything possible to prove that your child’s injury was avoidable. An experienced lawyer will help you take legal action to obtain the compensation you deserve. Settlement figures vary greatly depending on multiple factors; however, some claimants have received even more than $1 million.
Brachial Plexus Injury And Medical Malpractice
Erb’s palsy is a type of brachial plexus injury that occurs when a baby’s shoulder is pulled. This causes damage to the spinal cord or brain. Shoulder dystocia, or when the baby’s arms get lodged in the birth canal, can result in a brachial plexus injury.
The condition results from medical negligence or misconduct by an obstetrician or medical practitioner during the childbirth process.
Erb’s palsy can be caused by various types of medical malpractice, including:
- Pulling the infant’s head or neck too hard as the shoulders go through the birth canal
- Exerting too much pressure on the baby’s shoulders in a head-first birth
- Pulling on a baby’s feet in a feet-first (breech) birth
Experienced medical experts are trained to handle the birthing process without injuring the child’s neck or head. However, medical negligence or misconduct can cause the development of Erb’s palsy. An experienced birth injury lawyer will try to demonstrate that the birth injury was preventable.
A Brachial Plexus Injury Lawyer Will Help You File a Lawsuit
A brachial plexus injury lawyer can assist you in pursuing an Erb’s palsy case against the medical providers who caused your child’s injury. Birth injury lawyers work hard to bring justice to families who have suffered from brachial plexus injuries.
A birth injury lawyer will help you navigate the legal procedure far more easily than if you were to file a case on your own and represent yourself. Experienced Erb’s palsy lawyers understand how you can maximize your compensation.
You need an aggressive birth injury lawyer to collect and present relevant evidence to prove medical mistakes.
