The brachial plexus is a network of nerves that transmits signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries birth injuries cause damages - sometimes, but not always permanent - damage to those nerves.
Brachial plexus injuries often occur from excessive lateral traction on the infant's head during birth. Excessive traction to free the shoulder pulls the child's delicate head and can cause injuries to nerve roots, commonly the C5, C6 and C7 nerve roots of the brachial plexus. Infants delivered with excessive traction can suffer rupture or avulsion injuries. These are the most troubling; there little hope for a recovery from an avulsion or rupture without immediate surgery to reconnect the nerve network and the spine.
Is the cause of the brachial plexus injuries medical malpractice? According to the medical literature, most obstetric brachial plexus birth injuries are related to traction applied by OB/GYN or midwife during the birthing process.
The defenses in cases involving brachial plexus injuries from excessive traction are largely the same. First, the brachial plexus injury occurred in utero. Second, the doctor made only "gentle tugs" in the child's delivery. If does not work, the doctors either blame the mother ("natural expulsive forces") or that the lateral traction was necessary for delivery.
Certainly, these are sometimes valid defenses. Not every brachial plexus injury is medical negligence. But brachial plexus injuries are a leading cause of medical malpractice lawsuits for a reason: doctors often use excessive traction in a panic when the child's anterior shoulder initially became impacted on the pelvic bone. In many cases, the OB/GYN delivering the baby often uses excessive lateral traction, pulling on the head using the corkscrew maneuver rather than placing his hand inside the mother's vagina and onto the baby's shoulder and rotating.
How to Spot Medical Malpractice
Brachial plexus injuries usually occur from mechanical force during delivery when the shoulder becomes wedged underneath the pelvic bone. When this happens, the doctor may see the baby's head come out and then retract (much like a turtle). This is a clear sign that something is stuck. At this point, it is incumbent upon the doctor to try and maneuver the baby to get it out. This takes time (usually 3 to 5 minutes). A clear indication of malpractice is if the doctor proceeded to deliver the baby in a relatively short period (30 seconds to 1 minute).
Another sign of medical malpractice is if the doctor used forceps or suction once the baby was stuck. The excessive force from the forceps or suction could damage the nerves. In their defense, the doctors may try to argue that the brachial plexus injury could occur in utero. However, brachial plexus injuries in utero rarely occur because there is not enough force to damage the nerves. In utero, there simply is nothing for the baby to be wedged against to cause that harm. Also, in utero infections can be ruled out by testing the baby once it is born.Brachial Plexus Birth Injuries Verdicts
This is a sampling of brachial plexus palsy birth injury jury verdicts around the country in recent years:
- Florida, 2012: $780,000 (brachial plexus palsy to left arm during childbirth)
- Virginia, 2010: $2,230,000 (verdict against midwife for brachial plexus injuries suffered by child during labor and delivery leading to permanent right arm injury. Boy was required to undergo to nerve transfer surgeries)
- California, 2010: $932,250 (shoulder dystocia injury leading to brachial plexus paralysis/ doctor did not attempt McRoberts or Woods maneuver to dislodge the child's left shoulder. Child needed tendon transfer surgery when he was six months old.)
- Texas, 2010: $1,799,600 (plaintiff claimed doctor pulled down too hard on child's head when while trying to free the shoulder and the nurses applied fundal pressure to the mother, which is exactly what they should not do during a potential shoulder dystocia)
- New York, 2009: $ 60,939,847 (excessive traction to the child's head during delivery resulting in brachial plexus injury. The child also suffered lateral medullary syndrome, a condition that causes impairment of speech and the ability to swallow).
If you believe that you or your child suffered a brachial plexus injury as the result of medical malpractice, call a malpractice lawyer at 800-553-8082 or get a free online consultation.