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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.

News Chief reported late last month on a newly filed birth injury lawsuit filed by a family whose infant suffered a string of complications after an allegedly botched childbirth. The child victim was born over two years ago, and, according to court documents, the child suffered permanent injuries that could have been prevented had the care provided by doctors, nurses, and other caregivers been up to a reasonable standard.

The young boy suffered a severe brachial plexus injury. As our Chicago birth injury attorneys have often explained, brachial plexus continue to be one of the most common birth injuries, affecting two or three births out of every one thousand. The brachial plexus is a bundle of nerves in the shoulder controlling movement in one’s shoulder, wrist, hand and fingers. When these nerves are injured in birth, the child often suffers severe mobility problems in the affected arms.

Many brachial plexus injuries are preventable. Often they arise when a child’s shoulder becomes caught on the mother’s pubic bone. When that happens-a condition known as shoulder dystocia-a doctor or nurse must be very careful not to apply too much force to the child. Otherwise, the medical team risks stretching the sensitive brachial plexus nerves. In addition, brachial plexus injuries often arise when a baby is born in breech position. Breech deliveries occur when the child is exiting the mother’s body feet first. When that happens, the child is at risk of having arms or shoulders become lodged in unnatural positions. If a medical professional fails to act carefully when dislodging the infant’s limb, than a severe injury may arise.

Expectant mothers often can ensure that they receive the best care possible when they educate themselves on the potential risks facing their unborn child and the ways that those risks can be minimized. Fortunately, most mothers will receive top-notch care from educated professionals who are a testament to the medical community. However, there will always be some cases where the conduct of the professionals involved in a delivery is not up to par. Both the mother and her child may suffer serious consequences as a result. Our Chicago birth injury lawyer works with families in those situations.

In most cases it is only after a child is born with some particular defect or injury that the family first investigates the cause of the injury. At times, it becomes clear that the injury could in fact have been prevented. At other times, the family never learns about the potential prevention at all, and those negligent professionals are never held accountable for their misconduct. Getting parents to think about these issues before they strike-or at least be aware of them-is an important goal of many birth injury advocacy groups.

For example, that is part of the reason why last month advocates celebrated Brachial Plexus Awareness Week. As we have explained, brachial plexus is an often debilitating injury that is usually caused by a traumatic birth. In rare cases the injury can also be caused by certain trauma during a car or sports accident. When it occurs during birth, it is usually when the child is large and gets stuck in the mother’s birth canal. In the Holland Sentinel, one mother explains how she endured a very painful and damaging birth when delivering her nine pound six ounce son. Late into the night, near the end of the birth, she notes that her son was roughly pushed by a nurse and pulled by a doctor before finally emerging. Unfortunately, the doctor later came to inform the woman that her son suffered what is often referred to as Erb’s Palsy-severe nerve damage in the arm. As a result the arm hung lifeless at his side. It even had to be pinned to his shirt the first few months of his life so that the infant did not unknowingly cause even more damage. The mother reports that her son has been in therapy since he was a week old.

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