Brachial Plexus Injuries During Birth: Causes and Legal Actions

Brachial plexus birth injuries are a complex medical condition that can have lifelong effects on children and their families. These injuries, caused by damage to the nerves responsible for controlling arm movement, can occur during challenging deliveries. As parents navigate this emotional and physical journey, understanding the causes, diagnosis, treatment, and legal recourse becomes essential.

This guide provides an in-depth look at brachial plexus birth injuries, equipping families with the knowledge needed to make informed decisions and explore their options for medical and legal assistance.

What Are Brachial Plexus Birth Injuries?

The brachial plexus is a network of nerves that originate in the spinal cord and travel through the neck, shoulder, and arm. These nerves control movement and sensation in the upper limbs. When these nerves are stretched, compressed, or torn during childbirth, the result is a brachial plexus injury.

Types of Brachial Plexus Injuries

Brachial plexus injuries during childbirth typically fall into one of the following categories:

1. Erb’s Palsy
   • This is the most common type of brachial plexus injury.
   • It affects the upper portion of the brachial plexus, causing weakness or paralysis in the shoulder and upper arm.
   • Children with Erb’s palsy may have limited ability to lift their arm or rotate their shoulder.
2. Total Brachial Plexus Palsy
   • This occurs when the entire network of nerves is damaged.
   • It results in complete loss of movement and sensation in the affected arm.
   • Recovery from total palsy is more challenging and often requires surgical intervention.
3. Klumpke’s Palsy
   • A rare form of injury that affects the lower portion of the brachial plexus.
   • This can lead to weakness or paralysis in the forearm, hand, and fingers.
   • In severe cases, it can cause a claw-like deformity of the hand.

Prevalence and Risk Factors

While relatively rare, brachial plexus injuries affect 1-2 in every 1,000 live births. The condition is more likely to occur in cases of difficult or prolonged labor, larger babies, or deliveries involving complications such as shoulder dystocia.

Understanding the Causes of Brachial Plexus Birth Injuries

Brachial plexus injuries often occur due to complications during the delivery process. These complications can arise from natural challenges, but they are sometimes exacerbated by medical errors.

Shoulder Dystocia

Shoulder dystocia is one of the most common causes of brachial plexus injuries. It occurs when the baby’s shoulder becomes lodged behind the mother’s pelvic bone during delivery. This can create significant tension on the baby’s brachial plexus nerves, especially if excessive force is applied to free the shoulder.

Excessive Traction or Improper Delivery Techniques

• Improper use of delivery tools like vacuum extractors or forceps can result in excessive pulling on the baby’s head, stretching the brachial plexus nerves.
• Manual pulling or twisting of the baby’s head during delivery can also lead to nerve damage.

Other Contributing Factors

1. Macrosomia: Babies weighing more than 8.8 pounds at birth are at higher risk of shoulder dystocia and associated injuries.
2. Prolonged Labor: Extended or difficult labor increases the likelihood of complications requiring intervention.
3. Breech Position: Babies delivered feet or buttocks first are more susceptible to nerve injuries due to the abnormal positioning of the shoulders during delivery.
4. Maternal Diabetes: This condition can contribute to larger birth weights and increase the likelihood of delivery complications.

 

Diagnosing Brachial Plexus Injuries in Newborns

Identifying brachial plexus injuries as early as possible is critical for ensuring the best outcomes. Diagnosis typically involves a combination of physical examinations and advanced diagnostic tools.

Signs and Symptoms

Newborns with a brachial plexus injury may exhibit the following symptoms:

1. Limpness or weakness in one arm.
2. Inability to move the arm, shoulder, or hand.
3. Abnormal posture of the affected arm, such as it hanging by the side or bent at the elbow.
4. Lack of reflexes in the arm or hand.

Diagnostic Tools

1. Physical Examination
   • Doctors assess muscle tone, reflexes, and range of motion to evaluate the extent of the injury.
2. Imaging Studies
   • X-rays: Used to check for fractures or bone abnormalities that may accompany nerve injuries.
   • MRI Scans: Provide detailed images of soft tissue, including nerves and muscles, to pinpoint the exact location and severity of the damage.
3. Nerve Conduction Studies and Electromyography (EMG)
   • These tests evaluate the electrical activity of muscles and nerves to assess whether the nerves are functioning properly.

Importance of Early Diagnosis

Early detection allows healthcare providers to begin appropriate treatments, such as physical therapy or surgery, which can significantly improve long-term outcomes.

 

Treatment Options for Brachial Plexus Injuries

The course of treatment depends on the severity of the injury. While some cases resolve with minimal intervention, others require intensive therapy or surgical procedures.

Non-Surgical Treatments

For mild injuries, non-surgical approaches are often effective:

• Physical Therapy: Gentle stretching and strengthening exercises help maintain joint mobility and encourage nerve recovery.
• Occupational Therapy: Focuses on developing fine motor skills and functional use of the affected arm and hand.
• Supportive Devices: Splints or braces may be used to prevent contractures and maintain proper joint alignment.

Surgical Interventions

In cases where the injury does not improve after 3-6 months, surgery may be necessary. Common procedures include:

• Nerve Grafts: Damaged nerves are replaced with healthy tissue from another part of the body.
• Nerve Transfers: Nearby nerves are rerouted to restore function to the affected area.
• Tendon Transfers: Tendons from functional muscles are repositioned to compensate for paralyzed muscles.

Prognosis

The prognosis varies widely depending on the extent of the injury. While many children recover fully within the first year, severe cases may result in lifelong physical limitations. Long-term therapy and adaptive equipment can help improve mobility and independence.

 

Legal Implications: Understanding Your Rights

When brachial plexus injuries result from medical negligence, families have the right to seek legal recourse. Filing a medical malpractice claim can provide the financial support needed to cover medical expenses, therapy, and other costs.

What Is Medical Negligence?

Medical negligence occurs when healthcare providers fail to meet the standard of care, resulting in preventable injuries. Examples include:

• Failing to recognize risk factors like shoulder dystocia.
• Using excessive force or inappropriate delivery techniques.
• Delaying or improperly addressing labor complications.

Steps to Filing a Claim

1. Consult a Birth Injury Attorney
   Seek a lawyer experienced in handling medical malpractice cases to evaluate your claim.
2. Gather Evidence
   Collect medical records, expert opinions, and any documentation related to the injury and treatment.
3. File a Lawsuit
   Work with your attorney to file a claim seeking compensation for damages, including medical costs and emotional distress.

Potential Compensation

Compensation can cover:

• Immediate and long-term medical expenses.
• Costs of physical and occupational therapy.
• Emotional pain and suffering for the family.
• Financial support for the child’s future needs.

 

The Long-Term Impact of Brachial Plexus Injuries

For families, the effects of brachial plexus injuries extend far beyond the initial diagnosis. These injuries can have lasting physical, emotional, and financial consequences.

Physical and Functional Challenges

Children with severe injuries may face lifelong limitations in arm movement and strength. Assistive devices, therapy, and adaptive techniques can help improve their independence and quality of life.

Emotional and Psychological Effects

Living with a disability can affect a child’s self-esteem and social interactions. Parents may also experience emotional strain as they navigate the challenges of caregiving.

Support Resources

• Support Groups: Connecting with other families can provide emotional support and practical advice.
• Counseling Services: Therapy can help both children and parents cope with the emotional impact of the injury.

Frequently Asked Questions About Brachial Plexus Injuries

What are the common causes of brachial plexus injuries?
The most common causes include shoulder dystocia, excessive force during delivery, and improper use of delivery tools.

Can these injuries be prevented?
Yes, with proper prenatal care and skilled handling during delivery, many injuries can be avoided.

What should I do if my baby is diagnosed with a brachial plexus injury?
Seek immediate medical attention, follow up with specialists, and consider consulting a birth injury attorney to explore your legal options.

 

Contact Matzus Law, LLC Today

If your child has suffered a brachial plexus birth injury, you don’t have to navigate this journey alone. Medical and legal professionals can help you secure the care and support your child needs.

Contact Matzus Law, LLC today for a free consultation and take the first step toward ensuring your child’s future health and well-being.