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Monday, October 6, 2008


Erb's Palsy

New York Erb's Palsy Attorneys

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Types of Erb's Palsy

Symptoms of Erb's Palsy

Treatment for Erb's Palsy

During a difficult, prolonged labor involving a breeched or large baby, if a doctor exerts too much force in pulling the baby through the birth canal, nerve damage can occur as a result of stretching the baby's neck. Known as a "brachial plexus injury," Erb's Palsy involves nerve damage resulting in a baby's inability to move an arm. In cases involving large babies, doctors must determine when to use a C-section in order to protect both the mother and the baby from injury. Our birth injury lawyers at Oshman & Mirisola review the progression of a mother's labor, identifying recognized signs and indications that, according to standard treatment protocols, recommend a C-section in order to avoid Erb's Palsy. We subpoena medical records, delivery room video footage when available, and present evidence demonstrating negligence on the part of doctors.

We are experienced birth injury attorneys who know how to investigate cases of Erb's Palsy and hold doctors financially responsible for their negligence. In one case, we recovered $2,625,000 in a settlement for a client in an Erb's Palsy case. To schedule a free consultation and learn how we can help you, contact Oshman & Mirisola today.

Erb's Palsy and Medical Malpractice

Erb's Palsy is one of the most common and serious of all shoulder dystocia injuries. (Different types of brachial plexus injuries may be classified as either Erb's Palsy or Klumpke's Palsy.)

The injury typically results from the use of excessive force or torque by the obstetrician to release the newborn's stuck shoulder. It is one of the most difficult obstacles that can occur during delivery because of the potential for high-risk complications. At this point the physician must:

Order an emergency Caesarean operation (C-section) to free the baby

Or perform a particular delivery maneuver avoiding the placement of pressure on the shoulder. One of 16 different maneuvers taught to obstetricians to free the trapped shoulder can be utilized.

If this procedure is improperly performed, an Erb's Palsy can occur where the nerve tissue between the arm and shoulder is stretched, partially torn, or completely ruptured. The victim suffers a partial or complete paralysis of the arm. Although many birth injuries resolve on their own, there is also a significant chance the Erb's Palsy will remain as a permanent disability to the child.

A properly trained obstetrician will identify shoulder dystocia risks and take steps to avoid injury during delivery. Increased risk factors include:

  • High birth-weight babies (more than 8 lbs, 14 oz)
  • Maternal diabetes
  • Mothers who are overweight
  • Mothers of short stature
  • A contracted or flat pelvis
  • Pregnancy beyond 40 weeks
  • Protracted second stage of labor
  • Previous birth complications

Klumpke's Palsy is a lower plexus injury, frequently resulting in paralysis of the hand and wrist, which results from a situation similar to Erb's Palsy.

Contact the medical malpractice attorneys of Oshman & Mirisola, LLP, to speak to our experienced birth injury attorney about your baby's particular circumstances.

Types of Erb's Palsy

There are different types of brachial plexus injuries. Children with Erb's Palsy are all affected in different ways. The variations are that some children will not have any muscle control or feeling in the arm or hand while some children can move their arms but have little control over the wrist and hand, with yet other children able to use their hands well but not their shoulder or elbow muscles. Depending on the type of nerve damage in Erb's Palsy children, the symptoms can range from mild to severe. With Erb's Palsy, there are four different types of nerve injuries, including:

  1. an avulsion, meaning the nerve is torn from the spine.
  2. a rupture, meaning the nerve is torn but not where it attaches to the spine.
  3. a neuroma, meaning the nerve has tried to heal but scar tissue has grown around the injury placing pressure on the injured nerve praxis. While the nerve has been damaged, it has not been torn and improvement should be seen within three months.
  4. Neuropraxia is the mildest form of a nerve injury. Neuropraxia, the most common form of Erb's Palsy is localized to the specific place where the injury occurs. It is a physiologic block of nerve conduction within an axon without any anatomical interruption. Many infants born with brachial plexus palsy have neuropraxia and sometimes recover within 4-6 weeks.

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Symptoms of Erb's Palsy

Symptoms of Erb's Palsy are usually very obvious. A baby suffering from Erb's Palsy will be seen with the affected arm laying by his or her side and an extended elbow devoid of movement.

The injuries that are associated with Erb's Palsy are related to the neck, clavicle, shoulder, and arm. Some precautions or problems that should be evaluated for signs of brachial plexus injuries are shoulder or elbow dislocation, a frozen shoulder, soft tissue, or joint contractures. Lifting a child with Erb's Palsy from under the armpits should always be avoided.

Examples of different symptoms of Erb's Palsy can include:

  • No muscle control and no feeling in the arm or hand.
  • The ability to move but with little control.
  • The use of hands but not of the shoulder or elbow.
  • The entire arm may be paralyzed with the hand and fingers hanging limp.
  • Facial paralysis on the affected side.
  • Not able to sit up without assistance.
  • The inability to crawl without the use of therapeutic devices.

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Treatment for Erb's Palsy

Treatment for Erb's Palsy that does not spontaneously recover generally consists of exercise and physical therapy. In 80% of the babies born with Erb's Palsy, recovery will occur without a surgical intervention. Often times, though, a child with brachial plexus palsy can benefit from surgical procedures to increase his or her arm functions.

Surgery is found to be most effective in Erb's Palsy children that are between the ages of 5 and 12 months; beyond this age group, surgery will not be as effective. Whether or not surgery is performed is dependent upon the individual child's condition. Where surgery occurs, it is performed by a pediatric neurosurgeon. The Erb's Palsy surgical procedure requires special anesthesia, an operating microscope, monitoring equipment, and specialists to be able to expose and identify each of the nerves of the brachial plexus and surrounding structures. Most children with Erb's Palsy have damage to multiple nerves, so more than one procedure must be performed. Erb's Palsy may also be helped by performing daily exercises to keep muscles limber and to prevent the joints from freezing.

If you feel your child suffers from a brachial plexus injury such as Erb's Palsy and wish to bring legal action to compensate your child for his or her physical and emotional damages, contact Erb's Palsy and childbirth injury attorney Ted Oshman to arrange a free consultation. We represent birth injury claims on a contingency fee - you pay no attorneys' fees unless we recover damages through settlement or trial.

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