Pennsylvania Erbs Palsy and Brachial Plexus Lawyer
Erb's palsy is a condition that results from damage to the brachial plexus nerves. These are a series of nerves that travel from the spinal cord into the arm. The nerves running between the spine and shoulders are called the brachial plexus, which are essential to control the movement of muscles in the hands, arms and shoulders.
A brachial plexus injury can occur to an infant during natural child birth. If an infant is too large the baby's shoulder may get stuck behind the pelvic bone even though its head has already passed through the area. A doctor may continue with the natural delivery instead of performing a C-section. This can stretch the infant's neck to the point of damaging the nerves in the brachial plexus.
This injury may result in varying degrees of weakness or paralysis of the shoulder, arm, or hand. Which part of the arm is involved, depends on which nerves in the network are injured. A baby with this injury typically holds his limp arm down by his side with forearm turned inward and wrist bent.
Three Kinds of Brachial Plexus Injuries:
- Rupture: Surgery is required because the nerves in the plexus have been torn in one or more places.
- Stretch: Bruising or swelling that occurs during birth because the baby's shoulder has gotten stuck in the pelvic bone, compressing the nerves in the plexus to the point of damage-although the degree of damage may vary in severity. Although stretch injuries can heal spontaneously within two years and possibly full restore complete functionality, neuroma-the scar tissue that presses down on the nerves-may develop and have to be removed with surgery.
- Avulsion: This is the most severe type of plexus injury. Surgery and muscle transfer may be necessary for the infant to regain function. Avulsion occurs when nerves are pulled away from the spine resulting in a completely flaccid extremity. Avulsion may also lead to Horner's syndrome.
Two areas of nerves can be affected in the delivery process. Klumpke's Palsy refers to damage in the lower plexus, while Erb's Palsy refers to nerve damage in the upper plexus. Klumpke's and Erb's can both lead to paralysis or weakness. Children who have Klumpke's Palsy do not have full range of movement in their hands and wrists, while children with Erb's Palsy are not able to fully move their shoulder and arms.
If a doctor doesn't recognize that the baby is too large for natural delivery, and fails to perform a caesarean birth instead, or uses the wrong delivery method once baby's shoulder becomes stuck (known as shoulder dystocia), then the physician may have committed malpractice. The most common mechanism of injury to the brachial plexus during birth is traction of the head and neck in a direction away from the site of injury. The use of forceps or vacuum may contribute to excessive force and cause a nerve injury.
Signs a Doctor Should Look For To Indicate That A Baby May Be Too Large For Natural Delivery:
- Obesity: If the mother is obese, chances are she may deliver a large baby.
- Gestational diabetes: A doctor should always test the fetus for this type of diabetes. Larger babies are often associated with gestational diabetes.
- The McDonald measurement or fundal height: A physician records the measurements from the top of the uterus to the top of the pubis during prenatal visits. If measurements are too big, the doctor should be able to observe the size of the baby.
- Excessive weight gain during pregnancy: If a mother is 30 years of age or older and she gains a lot of weight during her pregnancy, there is a chance she will deliver a big baby.
- Maternal history: If the last baby that a mother delivered was large in size, there is a good probability that her next infant will be large also.
- Fetal malposition: The baby is not proceeding head first into the birth canal.
If a doctor believes that the baby about to be delivered may be large, he or she should use an ultrasound to confirm this observation. If the doctor does not use the correct method for delivery, he or she may be liable for malpractice.
Correct Delivery Techniques for a Large Baby May Include:
- Caesarean section.
- Suprapubic pressure.
- McRoberts maneuver.
- Wood's corkscrew maneuver.
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