Klumpke’s Palsy Lawyer

Dejerine-Klumpke palsy (also known as Klumpke’s Palsy or Klumpke’s paralysis) is a rare but serious birth injury that affects the lower part of the brachial plexus. This nerve network controls movement and sensation in the arm and hand. When these nerves are damaged during delivery, the result can be permanent paralysis or lasting weakness in a newborn’s wrist, hand, or fingers. These injuries often occur because of medical mistakes that were entirely preventable.

To understand how these injuries occur and how doctors sometimes fail to prevent them, it is helpful to understand the anatomy. The brachial plexus is the bundle of nerves that runs from the spinal cord through the neck and into the shoulder, arm, and hand. When the upper nerves are damaged, it results in Erb’s palsy. When the lower nerves are involved, it is referred to as Klumpke’s palsy. If both regions are affected, the condition is often referred to as a global brachial plexus injury.

Doctors may debate whether Klumpke’s palsy is always preventable, but there is little dispute that it can be caused by negligence. In many cases, a baby suffers a life-altering injury because a physician pulled too hard, failed to follow protocol, or made the wrong call under pressure. These are not rare flukes. They are avoidable injuries with devastating consequences.

What Causes a Brachial Plexus Injury

What happens when these injuries are caused by a medical mistake? Often what happens is there is a problem getting the baby to deliver. Some doctors simply panic before good medical practice says they should, and they apply excessive traction to get the baby out. There are lots of different things doctors should try first. Attentive doctors who are on top of the problem should try first.

The reality is that in the vast majority of these excessive traction cases, the child could have been successively delivered using mild traction or other less drastic measures. Admittedly, it is a fine line to walk for these doctors – excessive traction is called for if there is an imminent risk of asphyxia injury. But these doctors are paid a lot of money to make the right call and not panic at the first sign of a problem.

There is also no question that when it comes to who panics most quickly in these situations, it is physicians who lack experience (or skill) delivering children.

Types of Brachial Plexus Injuries

Brachial plexus injuries are classified based on the nature and severity of the nerve damage. Understanding these distinctions is critical not only for medical prognosis but also for evaluating the long-term impact on the child and the strength of a malpractice claim. There are four primary types of brachial plexus injuries:

Avulsion

Avulsion is the most devastating type of brachial plexus injury. It gets our lawyers’ attention because it is almost always a red flag for serious medical negligence.

Avulsion happens when the nerve root is violently torn away from the spinal cord. There is no chance of natural recovery. The damage is permanent. These children are often left with complete paralysis in the affected arm, facing a lifetime of physical limitations, surgeries, and therapy. Medically, avulsions are unmistakable. Legally, they often tell a clear story: a doctor applied far too much traction during delivery, and a preventable injury became a lifelong disability. When we encounter avulsion in a birth record, our attorneys dig deep to scrutinize the decisions made in that delivery room.

Rupture

A rupture happens when the nerve is torn, but unlike an avulsion, the tear occurs outside the spinal cord. The nerve remains partially intact, and surgical repair may be possible in some cases. Ruptures can still result in lasting weakness or paralysis if not promptly diagnosed and treated. In malpractice cases, the key issue is whether excessive traction or improper delivery technique caused the rupture.

Neuroma

A neuroma forms when a damaged nerve heals with scar tissue that interferes with nerve signal transmission. This scar tissue can compress the nerve and limit recovery. Neuromas may require surgical intervention to remove the scar tissue and restore partial function. Neuromas are often the result of a healing process that has gone awry. In the context of litigation, they raise questions about both the initial injury and the quality of follow-up care.

Injury Type	Nerve Damage	Recovery Potential	Medical Red Flags
Avulsion	Nerve root torn from spinal cord	No natural recovery; permanent	Often indicates excessive force during delivery
Rupture	Torn nerve, not at the root	Possible surgical repair	May reflect preventable traction injury
Neuroma	Scar tissue on damaged nerve	Partial recovery possible	Can suggest delay or lack of follow-up care
Neuropraxia	Stretch or compression, no tear	High recovery potential	Still requires careful diagnosis and monitoring

Neuropraxia

Formerly referred to in some contexts as “neurotropic,” neuropraxia is the mildest and most common form of brachial plexus injury. It involves a stretching or temporary compression of the nerve, rather than a tear. In most cases, the nerve remains structurally intact and function returns within weeks or months without surgical intervention. However, even neuropraxia can lead to long-term complications if misdiagnosed or improperly managed.

Each of these injuries reflects a different mechanism and level of trauma. In birth injury litigation, identifying the specific type of nerve damage helps clarify causation and guides expert testimony on whether the injury was preventable.

Causes of Brachial Plexus Injuries

Brachial plexus injuries may occur from injuries sustained during difficult childbirth 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 childbirth, 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 and adults, injuries can occur from sports injuries, gunshot wounds, animal bites, viruses, high-velocity accidents such as a motorcycle or ATV accidents or poorly positioned arms during medical procedures.

In cases of injury during childbirth, attending physicians 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 particular 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

The symptoms of a brachial plexus injury in a newborn can range from subtle weakness to complete paralysis in the shoulder, arm, or hand. Often, the first sign is that the baby is not moving one arm normally—or not at all. The affected limb may appear limp, and the infant may show little or no response to touch or pain on that side. In more severe cases, there may be an obvious lack of muscle control in the wrist or hand, or a visible difference in posture, such as the arm hanging by the side with the forearm turned inward. Over time, untreated or severe injuries can lead to muscle atrophy, limited range of motion, and long-term functional impairment.

Medical providers often use tools like electromyography (EMG) or nerve conduction studies to assess the extent of the nerve damage. Early intervention is critical. The sooner the injury is diagnosed, the better the chances for partial or full recovery—particularly in cases where surgery or intensive therapy is needed to restore function.

Clinically, one of the most important distinctions is whether the injury resulted from a difficult delivery, and specifically, whether shoulder dystocia was present. That question carries enormous legal weight. The defense often argues that brachial plexus injuries happen even in textbook deliveries. They always push the narrative that these injuries are simply an unfortunate, natural risk of childbirth.

But the data tells a different story. A study published in the American Journal of Obstetrics and Gynecology examined cases of brachial plexus palsy following vaginal deliveries, including data from Johns Hopkins and multiple litigated claims. The study found that permanent injuries in the absence of shoulder dystocia are not only rare—they are medically and legally distinct. These cases often involve lower birth weights, injuries to the posterior arm, and less severe patterns of damage. In other words, when there is no shoulder dystocia and the injury is permanent, it raises serious questions about whether the delivery was mishandled.

For plaintiffs’ lawyers, this distinction is crucial. It undermines the defense narrative of inevitability and supports a central truth in many of these cases: brachial plexus injuries are not always the result of difficult births. Sometimes, they are the result of poor decisions made in the delivery room—and the medical record, combined with peer-reviewed literature, often proves it.

Treatment and Outcome

Thankfully, brachial injuries will sometimes heal on their own. Others may require occupational or physiotherapy, electrostimulation, botox injections, water therapy, or surgery to correct the damage. Prognosis depends on the location of the injury and the type of brachial plexus injury. Children often recover within 3 to 4 months of the injury caused during childbirth. But some may suffer long-term complications.

Then there are chronic complications. They can include an inability to supply nerves to the affected area, decreased strength and stamina, altered movements and biomechanics,  and muscle atrophy.

They can also include 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).

Proving Medical Negligence in a Klumpke’s Palsy Case

Not every brachial plexus injury is caused by malpractice. Our malpractice lawyers do not take every case we see, and the reason is often that we do not think medical malpractice caused the child’s injuries.  But many are. Proving it requires a focused investigation into how the delivery was managed. These cases often hinge on whether the physician used excessive traction during shoulder dystocia, whether safer alternatives were available, and whether appropriate precautions were taken based on risk factors known before delivery.

Medical records rarely admit to pulling too hard. That is why these cases often rely on expert testimony and a detailed review of delivery notes, fetal monitoring strips, and neonatal assessments. An experienced Klumpke’s palsy malpractice lawyer will work with obstetric experts and pediatric neurologists to identify whether the standard of care was breached. In cases involving Klumpke’s palsy, certain facts raise immediate red flags, especially when the injury occurs in the absence of documented shoulder dystocia or when a doctor fails to attempt well-established maneuvers before applying traction.

The legal test is not whether the outcome was unfortunate. It is whether the doctor did what a reasonably careful physician would have done under the same circumstances. If that answer is no, and the child is left with a permanent injury, then the family may be entitled to settlement compensation (or a jury award) for medical bills, future care, lost earning potential, and pain and suffering.

Brachial Plexus Injury Settlement Amounts and Jury Payouts

Jury verdicts and settlement amounts in brachial plexus and Klumpke’s palsy cases vary widely depending on the severity of the injury, the clarity of negligence, and the long-term impact on the child’s life. These cases often involve significant damages, but outcomes can differ dramatically based on venue, expert testimony, and how the medical records document the delivery.

Below are examples of recent jury payouts and settlements in birth injury cases involving brachial plexus damage. Why so few cases? There are not that many claims and there are even less reported settlement amounts.

Please keep in mind that these example settlements and verdicts are certainly not predictive of any one case. But they help illustrate how these claims are often valued when the injury is permanent and preventable.

• 2025 Connecticut – $5,000,000 Settlement: A newborn suffered lasting arm and hand dysfunction following shoulder dystocia and excessive traction during delivery. The obstetrician admitted using force instead of employing accepted maneuvers. Although surgery improved function, permanent deformity remained. The case settled confidentially for $5 million.
• 2025 Maryland – $1,500,000 Settlement: A Maryland family received $1.5 million after their child sustained a permanent brachial plexus injury at birth. The claim alleged improper delivery technique and failure to manage shoulder dystocia properly.
• 2024 New Jersey – $975,000 Settlement: A six-year-old boy diagnosed with Erb’s or Klumpke’s palsy following a difficult delivery was awarded $975,000. The lawsuit focused on excessive traction and lack of early intervention to minimize nerve damage.
• 2022 New Jersey – $950,000 Settlement: In a case involving either Erb’s or Klumpke’s palsy, the plaintiff argued that the obstetrician applied excessive force instead of using recognized shoulder dystocia techniques. A permanent injury resulted and the case resolved for $950,000.

Getting a Lawyer to Figure Out Your Child’s Claim

Brachial plexus injury is a leading cause of serious injury doctor error lawsuits.  Our attorneys handle complex and high-value brachial plexus injury cases in Maryland and nationwide. If your child suffered a preventable nerve injury at birth, we will investigate the delivery, consult top medical experts, and fight for the full compensation your family deserves. If you believe that you or your child has been injured by a mistake of a doctor in Maryland, call us at 800-553-8082 or click here for a free online, no obligation consultation.

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