Clinical Negligence: Erb’s Palsy and Shoulder Dystocia

Erb’s Palsy, often caused by shoulder dystocia, is a nerve condition that can be caused by clinical negligence. Can you claim compensation?

Erb’s Palsy, often known as brachial plexus paralysis, is normally caused by shoulder dystocia and results in damage to the nerves in the brachial plexus. Compensation may be awarded if a birth injury to either the mother or child is found to be caused by clinical negligence.

Not all birth injuries cause long-term damage, but in some cases, they may be permanent. There are also other risks associated with shoulder dystocia and Erb’s Palsy. The effects can be life-changing and in the most severe cases, the child will be paralysed for life.

But what can you do if your baby is injured during birth and how can you prove clinical negligence?

What is Erb’s Palsy?

The network of nerves around the neck that facilitate the movement of the arm is called the brachial plexus. These allow functionality and feeling in the shoulder, arm and hand. If inappropriate or excessive force is applied to the baby’s head, neck, or shoulders during birth, damaging these vital nerves the effects can be life changing.

One or two out of every 1,000 babies will be born with this condition. It can affect one or all five primary nerves within this nerve network. For that reason, the severity of each baby’s injury will be individual. Some will have complete paralysis, while others will experience temporary reduced movement.

How is it caused?

Erb’s Palsy is most associated with shoulder dystocia, and this is often how the nerves become overstretched. Shoulder dystocia is when a baby’s shoulder becomes impacted behind the mother’s pelvic bone. This can affect the way the baby grows, and it can also make for a difficult birth.

Clinical negligence can often be the cause of Erb’s Palsy where shoulder dystocia is apparent. During the pregnancy, there are certain situations which can increase the risk of shoulder dystocia and Erb’s Palsy, including gestational diabetes, pelvic abnormalities, use of forceps or vacuum, excessive maternal weight gain, babies in the breech position and large babies are often likely to experience shoulder dystocia. If medical staff fail to monitor the size of the baby or its positioning, they cannot arrange a caesarean section in advance.

If the mother has a small pelvis or has experienced shoulder dystocia in a previous birth, this needs to be monitored and preparations for safe delivery should be made. Failure to prepare in this way could either lead to excessive force being used to deliver the baby or fetal distress.

If the delivery is delayed because the shoulder is stuck, lack of oxygen to the brain can cause brain damage. Twisting and tugging, forceps or other birth assistance tools can all put a strain on the baby’s brachial plexus nerves.

The medical professionals should recognise and monitor closely if you are likely to have increased risks during the birth and may recommend a caesarean section or advise on other ways to prevent or reduce the likelihood of injury.

The brachial plexus can be damaged in four ways:

1. Avulsion – When a nerve completely separates from the spinal cord this is called avulsion. An avulsion is the most severe injury and form of Erb’s Palsy.

1. Rupture – A rupture is the nerve tearing either partially or completely.
2. Neuroma – When nerves heal, they create scar tissue. This scar tissue can put pressure on healthy nerves, and this is known as neuroma.
3. Neuropraxia – The most common type of Erb’s Palsy is known as neuropraxia which is when nerves are overstretched during birth.

Other Injuries can also be caused because of shoulder dystocia including fractures, cervical subluxation, facial palsy, and shoulder dislocations.

Recovery rate

Fortunately, permanent damage is rare. Most babies born with Erb’s Palsy will regain motion and feeling within a few months with physical therapy to help heal the damage. The earlier this is taken up; the less damage is likely to be done.

More severe cases often require extensive surgery to repair nerves or muscles however the surgery also carries the risk of permanent paralysis, so it is vital that medical professionals are cautious when treating the condition.

Unfortunately, children with more severe cases of Erb’s Palsy are likely to suffer with lasting effects.

Children whose movement is still restricted after a year will rarely gain full function again. They may also experience shortness in the affected arm or weakness. More rarely, children can face complications such as shoulder dislocation or scoliosis in the spine.

Where brain damage occurred due to a delayed birth, the child will face some form of life-long disability.

Your child may be entitled to compensation if the Erb’s Palsy is because of clinical negligence. The level of compensation awarded will reflect the needs of the child.

How Coodes can help

At Coodes, we have helped many people receive compensation for birth injuries. Erb’s Palsy claims can be made for poor decisions made during pregnancy or birth. Whether this is the use of excessive force or the incorrect tools during the birth, or lack of monitoring or advice about the potential risks of injuries, referring you for a caesarean section or take steps to move your baby out of a trapped position.

The time limits around clinical negligence claims can vary depending on age and who is affected. More information on these limits can be found here.

Coodes is one of the only law firms in Cornwall able to represent clients with Legal Aid, which may be available for clinical negligence claims concerning birth injuries. Very few firms can represent clients with Legal Aid, which helps families to cover the costs of pursuing their case. Find out more here.

Next steps

If you are concerned about the health of yourself or your child then, firstly, please seek medical advice.

Secondly, get in touch with our experienced accredited birth injury solicitors at Coodes. We can help you with birth injury claims, including muscular and physical injuries and injuries during delivery.

If you or your child has experienced Erb’s Palsy or lasting complications because of clinical negligence, get in touch. We can guide you through the process and have successfully helped several clients claim compensation for an avoidable birth injury.