Erb’s Palsy – Shoulder Dystocia
4. Is it always the doctors’ and nurses’ fault if a brachial plexus injury occurs?
5. How are nurses to blame when a brachial plexus injury occurs?
A: In laymen’s terms, shoulder dystocia means that your child got stuck in the birth canal after his or her head appeared. By definition, shoulder dystocia is relieved by nurses or doctors performing one or more maneuvers to safely get the baby out of the birth canal.
Q: Is shoulder dystocia a rare occurrence and are doctors and nurses expected to be able to treat it when it occurs?
A: It is not that rare. Depending upon which study you review, shoulder dystocia occurs in one to ten percent of all births. Certain risk factors increase the likelihood that your baby will get stuck in the birth canal after his or her head appears. Excessive maternal weight gain during your pregnancy, gestational diabetes, and an estimated fetal weight above nine pounds are all risk factors. As mother and baby get bigger, the chances of shoulder dystocia occurring also statistically increase.
Q: My daughter has been diagnosed with a brachial plexus injury, also called Erb’s Palsy. Could her injury have been the medical staff’s fault?
A: Brachial plexus injury, also called Erb’s Palsy, is caused by excessive traction forces being placed upon the baby’s head during the delivery process. It results in torn or stretched nerve roots that come off the baby’s cervical spine. Most often these injuries subside and go away. Sometimes, however, they can be very serious and permanent. Doctors and nurses are trained how to treat shoulder dystocia so that babies don’t get a brachial plexus injury. When doctors or nurses fail to use appropriate and accepted maneuvers to get the baby out, brachial plexus injury can occur.
Q: Is it always the doctors’ and nurses’ fault if a brachial plexus injury occurs?
A: Not always, but often. Doctors are trained not to panic after shoulder dystocia is recognized. They are also trained not to pull too hard because of the known correlation between pulling too hard and brachial plexus injuries. If doctors pull too hard or do not use accepted proven methods to get the baby out, injury can occur.
Q: How are nurses to blame when a brachial plexus injury occurs?
A: Nurses are trained to follow the instructions of the doctors when shoulder dystocia is recognized. They are trained never to place their hands on the top of the mother’s abdomen and push down. This is known as fundal pressure. Using fundal pressure can further impact the baby’s shoulders against the mother’s pubic bone and make it more difficult for the baby to be delivered. It can also cause injury to the baby’s shoulder and arm when the doctor is trying to deliver from below. Nurses who don’t follow the doctor’s instructions or use fundal pressure (pressure on top of the uterus) can cause brachial plexus injury.
Q: My one-year old baby has limited mobility in his arm. Our pediatrician says it appears to be a case of Erb’s Palsy. Is it too late to go back and review my child’s delivery records to see if medical malpractice was the cause?
A: No. Medical malpractice claims, like most personal injury claims, are governed by a statute of limitations. The timeframe to pursue a child’s claim is longer than the timeframe to pursue an adult’s claim. Typically, it is at least eight (8) years. You should contact an attorney right away to discuss your options and review your child’s medical records to determine whether or not a viable claim exists.
