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Q&A: Erb’s palsy

My daughter has severe Erb’s palsy. I’ve read that Erb’s palsy is often the result of medical malpractice, but someone told me that it is not the result of malpractice if the delivery did not include shoulder dystocia. The medical records of my daughter’s birth do not mention shoulder dystocia. Do I not have a case?

A: The simple fact that shoulder dystocia is not mentioned in the records does not mean you do not have a valid case. It is true that Erb’s palsy is much more likely to be the result of negligence if the birth involves shoulder dystocia. However, there are methods to prove shoulder dystocia when the condition is unrecorded.

Many other descriptions in the medical records can indicate a shoulder dystocia delivery. For example, “slow body delivery” or “difficult delivery” both indicate that the baby’s shoulder was stuck behind the mother’s pubic bone.

In Erb’s palsy cases, the presence of shoulder dystocia can indicate a higher likelihood of medical negligence because doctors sometimes pull on the baby’s head to deliver the baby. If the baby is stuck and the doctor pulls too strongly, permanent injury can be caused to the nerves running to the arm.
Gentle pulling will not cause permanent brachial plexus injury, but anything more can cause significant injury to those nerves. The only situation when anything more than gentle pulling on the baby’s head combined with shoulder dystocia is not negligent is when the baby is in imminent danger of suffocating and must be delivered immediately.

If your daughter had normal Apgar scores and no acidosis, then she was not in danger of suffocating and therefore, anything more than gentle pulling on her would be negligence. If the delivery involved shoulder dystocia and anything more than gentle pulling on her head, there is a strong chance that her Erb’s palsy was caused by medical negligence.


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