Articles Posted in Brachial Plexus

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Birth Injuries Can Cause Shoulder, Arm, and Hand Paralysis in Newborn

The brachial plexus is a bundle of nerves located in an infant’s body’s upper shoulder and neck area. The nerves can be damaged when the site is pulled or pinched during labor and delivery. Brachial plexus injury (BPBI) remains the leading cause of infants’ upper extremity paralysis that can significantly impact arm and hand mobility and leave up to 30% of those affected with residual neurologic deficits.

When the damage happens, it may be relatively minor, and some children will be lucky enough to make a full recovery eventually. But at other times, for example, in a case of a forced breech delivery or improper use of an instrumented delivery, the damage may be so extensive that a permanent disability is the only outcome. The child could have restricted movement of the shoulder, arm, and hand and possible nerve injuries that affect facial muscles. These problems are associated with the side of the body where the immediate damage happened.

delayed c section injuries

6 Birth Injuries to Baby That Can Happen Due to Delayed C-Section

Healthcare professionals are trained to detect when an emergency C-section is needed. Still, if a doctor delays action to deliver a baby or the health system is not prepared to act quickly, severe consequences to both baby and mom can lead to a myriad of injuries related to lack of oxygen and organ failure, infant brain damage, and developmental disabilities. In the most severe cases, infant or maternal death may occur due to medical errors and negligence. Unfortunately, physicians can fail to schedule a C-section or delay intervening even though the warning signs related to fetal or maternal distress were present.

  1. Fetal Lacerations

Brain Injuries to Children
A birth injury is defined as the structural destruction or functional deterioration of an infant’s body due to a traumatic event at birth. According to the American Academy of Pediatrics, “Some of these injuries are avoidable when appropriate care is available, and others are part of the delivery process that can occur even when clinicians practice extreme caution.” And most of the time, birth injuries are typically indicative of a medical mistake that was likely the cause of a traumatic experience to the fetus or newborn. Here is a deeper look and explanation of the top ten most common birth injuries in the U.S.

  1. Cerebral Palsy: Centers for Disease Control and Prevention data shows the average prevalence of cerebral palsy is 3.3 children per 1,000 live births. It is the most common motor and movement disability of childhood and could cause serious, long-term injuries.
  2. Facial Paralysis: Facial nerve palsy is the loss of voluntary muscle control of the face. While it can be serious, the condition often goes away over time. The injury is caused by the pressure put on the baby’s seventh cranial nerve during birth.

The parents of a baby girl have brought a lawsuit against the doctors and the hospital alleging medical malpractice. The suit states that the infant was severely injured during birth as a result of the use of excessive traction. The baby suffered injuries to spinal nerves in her neck and shoulder areas. The child sustained brachial plexus palsy which caused paralysis of the right arm. Injuries of this type are recognized immediately; however, sometimes the extent of damage and disability may take some time to determine. This lawsuit names the University of Chicago Medical Center and two doctors.

Brachial Plexus Injuries
The brachial plexus is a group of nerves in the shoulder area. Brachial plexus injuries in newborns occur when these nerves are damaged. This can be caused by pulling on the shoulders during delivery, putting too much pressure on the baby’s raised arms, or the baby’s head and neck pulling towards the shoulders during birth. There are several types of brachial plexus injuries that may occur including:
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In an Oregon courtroom, the family of a child injured at birth successfully proved their case against an obstetrician and won damages in excess of $1 million. The child, who is now six-years-old, suffers from a brachial plexus injury. The compensation that she receives from her injuries will assist with medical fees, as well as non-financial challenges she will face for the remainder of her life.

According to reports, the events unfolded as follows:

The expectant mother was admitted to a regional medical center, with normal signs of labor.
The labor progressed without issue until the baby began descending deeper into the birth canal Medical staff diagnosed the baby with shoulder dystocia.
According to the plaintiffs, despite the early diagnosis, the medical staff used traction to complete the delivery process The baby was born with a brachial plexus injury.
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The maternal forces defense is a common defense used by doctors and hospitals in medical malpractice lawsuits involving Erb’s Palsy. According to the maternal forces defense, injury that results in loss of development of a limb is caused by natural forces that occur as a part of labor, not due to negligence of medical staff.

Erb’s Palsy

Erb’s Palsy is a brachial plexus injury. The brachial plexus nerves are located at the upper part of the arm near the shoulder. Brachial plexus injuries are incredibly common during vaginal birth when the shoulder of the infant is unable to pass and must be manipulated by the obstetrician. Likelihood of verdicts for the plaintiffs in these cases are extremely high as plaintiffs’ attorneys argue that the only way in which the injury could have occurred was the obstetrician or other medical professional applying too much downward traction to the arm during manipulation. Plaintiff’s attorneys couple this argument with also alleging that medical professionals were aware of this complication yet took no actions to avoid it or fix the underlying issue.

It is easy to develop the assumption that all birth injury cases result in a settlement or judgement for the plaintiff. But that is not true. News stories and blog posts are simply far more likely to discuss cases that result in liability as illustrative of the ways in which the legal system works and preventable injuries can affect the birthing process. But just because you hear more about the cases where plaintiffs are successful does not mean that doctors are almost always found liable.

In fact, the opposite may be true. When a case goes to trial, the burden is still on the plaintiff (injured child and family) to produce sufficient evidence to prove negligence. Sometimes that burden is hard to meet, and judges and juries routinely find for doctors. This basic concept is important to reiterate whenever faced with arguments from those seeking to change legal rules as a result of “runaway verdicts” or excessive lawsuits.”

For example, just this month the Press Herald reported on a case in which a birth injury lawsuit verdict went against the plaintiff. According to the report, the case was filed by a mother who essential claimed that excessive force was used during delivery. That force apparently led the child to suffer a brachial plexus injury–the nerve bundle near the shoulder that control’s ones’ arm, hand, and finger.

A letter to the editor published in Tauton Gazette recently reminded local readers that October was the annual Brachial Plexus Injury Awareness month. While we are a few days late on the official month, it is still a good time to remind community members of the risk of damage to the brachial plexus during a child’s delivery. Tens of thousands of children continue to be affected by this serious birth injury, and, unfortunately, most are not aware that it even exists until it affects someone that they know and love.

As the story reminds, the brachial plexus is a bundle of nerves that control a wide range of motor skills. The nerve bundle being in the spinal cord and then forms in “trunks” near the top of the shoulder. When this bundle is damaged in any way, usually during a child’s delivery, then it is referred to as a brachial plexus injury. Considering that the nerves control movement in the shoulder, arm, hand and fingers, children who experience this damage often have mobility issues in that part of their body.

These injuries come in different forms. Some are quite severe with complete removal of the bundle from the spine, and other involve severe stretching or partial tears. As you’d expect, the severity of the damage to the nerve bundle affects the overall scope of the consequences for the child. The most severe damage leads to permanant, irreversible paralysis. Less damaging injuries can sometimes heal or be fixed with surgical intervention.

Shoulder dystocia is a serious situation that often results in birth injuries that affect thousands of infants each year. Our Chicago birth injury lawyers know that while so many infants are hurt in this way each year, many in the community remain completely unaware of the injury, its causes, and how it can be prevented. Unfortunately, this is one of those injuries that are rooted closely with inadequate medical care being provided during a delivery. If excessive force or inadequate maneuvers are used in certain situations, harm can occur with a lifetime of repercussions for the child.

A recent Digital Journal story touched on the injuries and how they can often be prevented by careful conduct by involved medical staff during certain deliveries. The article explains how the injury involves a child’s shoulder getting stuck on a mother’s pelvic bone. This usually occurs after the baby’s head has emerged but while the shoulder is still inside the mother’s body. While undoubtedly stressful, when this situation occurs it is vital that careful maneuvers be used to extricate the child from the body safety. In this tense time it is vital that medical staff not give in to the tendency to use excessive force in order to get the child out of the body.

The recent story on the situation explained that an infant’s shoulder’s normally rotate during a delivery to pass through the pelvic bones at the appropriate angle. Yet, sometimes this doesn’t happen. Our Illinois birth injury attorneys know that there are situations where a child’s shoulders may be too big or a mother’s pelvic bone too narrow, leading to the risky situation of the shoulder’s getting stuck. However, just because the shoulders get stuck does not mean that an injury is guaranteed to occur. Steps can be taken to get the baby out without causing damage.

As we discussed earlier this week the most common Illinois birth injuries are those that involve brain damage and those caused by the application of excessive force during delivery. In many ways brain injuries are perhaps the most severe type of birth injury, because they ultimately limit the mental development of a child indefinitely. Excessive force often causes nerve damage that may result in children not be able to use limbs properly or at all. However, brain injuries often deprive children of their ability to create memories, learn properly, communicate, and otherwise become fully integrated into society. Of course that is not to say that injuries like shoulder dytocia and brachial plexus injuries are not severe or necessary of full redress. They are always incredibly tragic and our Chicago birth injury lawyers have worked with many families whose children have developed these injuries because of the negligence of others. But at the end of the day there are certain physical injuries that are more easily compensated for than mental injuries.

However debating distinctions between brain injuries and other physical birth injuries is often academic, because in many cases children actually suffer both problems. For example, when the baby’s shoulder gets caught behind the mother’s pelvis (shoulder dystocia), if not attended to, the child can suffer oxygen deprivation to the brain. Missteps by the doctor often means that the child both suffers brain damage as well as experiences nerve damage which may results in Erb’s or Klempke’s Palsy. Erb’s and Klumpke Palsy are conditions related to the weakness or paralysis of the arm. When the brachial plexus nerve bundle is damaged then the child may lose feeling or movement in their arm. The nerve bundle is located near the neck and upper arm.

While these physical injuries are tough for families to deal with, the situation is made much worse when combined with a brain injury. Newborn brain injuries often result from too much shifting of the skull while in the birth canal. Excessive movement results in pressure being applied to the sensitive tissues of the child’s brain, causing trauma and potential lifelong injury.

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