Brachial Plexus Injuries – Erb’s Palsy/ Shoulder Dystocia

Each year there are millions of children born in the United States. While many of these births are uncomplicated, there are a number of infants that are injured each year during the birthing process. One type of injury that can occur is Erb’s Palsy, also known as shoulder dystocia.

Shoulder Dystocia / Erb’s Palsy

According to the American Academy of Orthopedic Surgeons (AAOS), Erb’s Palsy is a condition that occurs in “[o]ne or two of every 1,000 babies.” It is a type of brachial plexus palsy and is usually caused “when an infant’s neck is stretched to the side during a difficult delivery.” The brachial plexus is a nerve network that is near the neck and “provide[s] movement and feeling to the shoulder, arm, hand, and fingers.” The term ‘palsy’ means weakness so a palsy in the arm means a weakness in the area. Thus, a child who has a brachial plexus birth palsy can have weakness as well as loss of motion in his or her arm.

Erb’s Palsy is specifically when the child has an injury to the upper nerves of the arm. If this occurs, the child may be able to move his or her fingers, but not the shoulder. Other times the arm may be totally paralyzed.

Types of Nerve Injury

There are four types of nerve injuries that a child with Erb’s Palsy could have. The symptoms of these injuries are all the same and include loss of feeling as well as partial paralysis or complete paralysis. The different types of nerve injuries can occur separately or at the same time. These nerve injuries are as follows:

• Neurapraxia: This injury is a stretch injury that does not tear the nerve, but rather “shocks” it. It is the most common type of nerve injury that occurs and can usually heal on its own.
• Neuroma: A neuroma is a condition that occurs when a “stretch injury damages some of the nerve fibers and it results in scar tissue that presses down on what remains of the healthy nerve. Unlike with neurapraxia, total recovery may not occur, though some healing may take place.
• Rupture: This type of stretch injury causes the nerve to tear and will not heal on its own. It is one of the most serious types of nerve injury. One possible way to repair a rupture is by “’splicing’ a donor nerve graft from another nerve of the child.”
• Avulsion: This kind of nerve injury occurs when “the nerve is torn from the spinal cord.” According to AAOS, “it is not possible to repair avulsion from the spinal cord.” However, “[i]n some cases, it may be possible to restore some function in the arm by using a nerve from another muscle as a donor.

Medical Errors Leading to Erb’s Palsy

A brachial plexus stretch injury, which leads to Erb’s Palsy, typically occurs during a difficult delivery. It can occur during a vaginal delivery or during a cesarean section. However, there is much less risk of this occurring during the latter.

When medical professionals attempt to dislodge an infant from the birth canal, methods used to pull the baby that put undue stress on the shoulder joint can result in Erb’s palsy. In addition, certain medical tools such as vacuum extraction tool or forceps may be used improperly during delivery and can result in shoulder dystocia.

Contact A Philadelphia Birth Injury Attorney

If your child has Erb’s Palsy and you believe it was the result of a health care provider’s negligence during your child’s birth, contact the law firm of Gilman & Bedigian today. Our attorneys have extensive experience fighting for children who have been hurt due to the negligence of a medical professional such as a doctor or nurse. You can reach us today by calling 1.800.529.6162, or by filling out our online contact form.