klumpke's Palsy lawyer

Dejerine-Klumpke palsy (also known as Klumpke's Palsy or Klumpke's paralysis) is the paralysis of the upper brachial plexus.  Paralysis of the lower brachial plexus is known as Erb-Duchenne palsy.  Klumpke's palsy usually coincides with Erb's palsy and is referred to as global brachial plexus palsy.  The brachial plexus is a network of nerves which allows the transfer of signals from the spine to the shoulder, arm, and hand. Damage to those nerves result in brachial plexus injuries.

Medical experts disagree on the extent to which Klumpke's palsy is preventable. Some doctors say that Klumpke's palsy is usually preventable. Other doctors disagree. But no one can serious argue that Klumpke's palsy cannot be caused by medical malpractice. In too many tragic cases, Klumpke's palsy causes lifelong injuries to children because of a simple mistake made by a doctor at the time of your life when you need the best possible medical care.

Types of Brachial Plexus Injuries

There are four types of brachial plexus injuries:

  • Avulsion
  • Rupture              
  • Neuroma
  • Neuropraxia

The most severe avulsion, which occurs when the nerve is torn from the spine.  Rupture and refers to a torn nerve, but not at the spinal attachment.  Neuroma occurs when the scar tissue from healed torn nerve exerts pressure on the injured nerve preventing it from transferring signals to the muscles.   Neuropraxia is the most common injury, is a nerve that has been damaged but not torn, it is also referred to as "stretch". 

Causes of Brachial Plexus Injuries

Brachial plexus injuries may occur from injuries sustained during difficult child birth or from other trauma.  During difficult childbirths, a baby's shoulders may become impacted (shoulder dystocia) and the brachial plexus nerves stretch or tear, especially if the physician pulls on the baby's head.   Though obstetric brachial plexus injuries usually occur from vaginal child birth, injuries can also occur during Cesarean section.  It is estimated that the prevalence of  brachial plexus palsy is three in every one thousand births.   In older children, adolescents and adults, iinjuries can occur from sports injuries, gunshot wounds, animal bites, viruses, high velocity accidents such as motorcycle or ATV accidents or poorly positioned arms during medical procedures.  In cases of injury during child birth, attending Physician's may be aware of complications but may or may not document them or steps taken to resolve this issue.  This often makes it difficult to determine the specific cause or liable party of the injury in newborns.

Risk Factors for Klumpke's palsy

Risk factors for Klumpke's palsy include:

  • Macrosomia (a large baby)
  • Pelvic size or shape (e.g. a small pelvis)
  • Excessive weight gain by the mother
  •  Gestational diabetes
  •  Short maternal stature
  •  A shoulder dystocia or a brachial plexus injury at a prior birth
  • Slow dilation/descent
  • Use of forceps or vacuum extractor as an aid in childbirth
Symptoms

Symptoms of brachial plexus injury include lack of muscle control, lack of feeling or sensation or paralysis of the arm, hand or wrist.  Electromyography may be used to diagnose brachial plexus injuries.  In a study reported in the American Journal of Obstetrics and Gynecology, researchers reviewed children suffering brachial plexus palsy after vaginal delivery at John Hopkins between 1993 to 2004 and data representing litigated permanent brachial plexus palsy reported between 1986 and 2003 was reviewed from multiple institutions.  The study reported that non-shoulder dystocia brachial plexus palsy is rare and distinct from shoulder dystocia brachial plexus palsy and can be distinguished by risk factors including birth weight, posterior arm involvement, injury severity and fetal acidosis.

Treatment and Outcome

Brachial injuries will sometime heal on their own, others may require occupational or physiotherapy, electrostimulation, botox injections, water therapy or surgery to correct the damage.  Prognosis is dependent on the injured site and type of brachial plexus injury.  Children generally recover within 3 to 4 months of the injury caused during childbirth however some may suffer long term complications.  Chronic complications can include an inability to supply nerves to the affected area, decreased strength and stamina, altered movements and biomechanics, muscle atrophy, impaired bone growth, joint dysfunction, osteoarthritis, difference in limb length, scapular winging, glenohumeral dysplasia, scoliosis, balance and coordination problems, decreased dexterity, psychological problems, partial paralysis of the diaphragm and Horner's Syndrome (drooping eyelid).

Brachial plexus injury is a leading causes of serious injury medical malpractice lawsuits by children against medical doctors in Maryland.   If you believe that you or your child has been injured by medical malpractice of a doctor in Maryland, call us at 800-553-8082 or click here for a free online, no obligation consultation.