During labor, sometimes a baby can become lodged in the pelvis, a recognized obstetric emergency called shoulder dystocia. It is a situation every obstetrician is trained to handle, with a specific set of maneuvers designed to free the baby’s shoulder safely.
The brachial plexus is the network of nerves running from the spinal cord through the neck and shoulder and into the arm. It controls movement and sensation in the entire arm and hand. When excessive force is applied to a baby’s head and neck during delivery, these nerves can be injured, and the severity depends on how badly they are damaged.
The injuries fall along a spectrum. At the milder end, a nerve can be stretched, which may heal over time. More seriously, a nerve can be torn, which typically does not fully recover on its own. At the most severe end is avulsion, where the nerve root is pulled completely away from the spinal cord.
An avulsion is the worst-case scenario. Because the nerve is separated from the spinal cord itself, it cannot simply heal or be repaired by reconnecting the ends. This is the category of injury our client’s baby suffered. The nerves were separated from the spinal cord, which is why the resulting Erb’s palsy is permanent rather than something the child may outgrow.
The doctor did not follow that protocol. Instead, he pulled the baby’s head too hard and too fast.
The Townsley Law Firm represented the family and recovered a settlement of over $600,000 in 2021.
Not All Brachial Plexus Injuries Are the Same
Erb’s palsy is a form of arm paralysis caused by an injury to the upper group of brachial plexus nerves near the neck. There are levels of injury that can happen with brachial plexus nerves, some resulting in permanent disability that require multiple, painful surgeries to minimize damage.
Risk management for this type of injury outlines specific rules to lower the chance of injury to the mother and baby. None of these protocols involve excessive force during delivery. Physicians are trained to recognize the signs of shoulder dystocia and avoid excessive lateral traction on the head during birth.
In this case, however, the force the doctor used was severe enough to separate the baby’s brachial plexus nerves from the spinal cord, showing that the doctor did not act within the standard of care. That is the most catastrophic form this injury can take. The result was a permanent Erb’s palsy disability.
That distinction matters enormously for the child’s future and for the value of the case because it is the difference between an injury that may improve and one the child will live with for life.
Shoulder Dystocia Is an Emergency With a Known, Practiced Response
When a baby’s shoulder becomes lodged behind the mother’s pubic bone after the head has delivered, the clock starts and the correct response is well established. Obstetricians are trained in a specific sequence of maneuvers that reposition the mother and the baby to open space and free the shoulder without applying dangerous force to the baby’s head and neck.
What the standard of care specifically prohibits is exactly what happened here: pulling hard and fast on the baby’s head to force the delivery. That kind of traction is what stretches, tears, and in the most severe cases avulses the brachial plexus nerves. The maneuvers exist precisely so that this force is never necessary.
This is what makes a case like this one so clear. The emergency was foreseeable and the correct response was known and teachable. The injury did not result from an impossible situation. It resulted from the wrong response to a situation that had a right one.
What Permanent Erb’s Palsy Means for a Child
Erb’s palsy affects the nerves controlling the shoulder and arm. When the injury is a permanent avulsion, the child faces lasting impairment that can include weakness or partial paralysis of the affected arm, limited range of motion, impaired growth or development of the limb, and reduced function of the hand.
Treatment for severe brachial plexus injuries can involve specialized nerve surgery, tendon and muscle transfers, and years of physical and occupational therapy, and even with intervention, full function is often not recoverable when the nerves have been avulsed. The child adapts to a permanent limitation rather than recovering from a temporary one.
For a child at the very beginning of life, that means a lifetime of impact: on physical development, on daily activities, on the kinds of work and activity available to them, and on the ongoing medical care they will need. A properly valued claim has to account for all of it, across the child’s entire life.
