Monday, November 16th, 2020
Birth trauma refers to damage of the tissues and organs of a newborn baby. Although many newborns might have minor injuries during birth, sometimes the injuries are more severe and include serious nerve damage. Brachial plexus birth injuries refers to damage to the brachial plexus nerves that occurs at birth, and may be related to a difficult labor and delivery.
The brachial plexus is a network of nerves that begins at the spinal cord in the neck and delivers messages from the brain to the shoulder, arm and hand. These nerves control muscle function in the chest, shoulders, arms and hands, as well as sensation in the upper limbs. A brachial plexus birth injury occurs when the baby’s neck is stretched, compressed, or awkwardly twisted. A quick or emergency delivery resulting in the baby being forcibly pulled out can result in a brachial plexus injury. The nerves may stretch or tear during a traumatic delivery. Although nerves have some ability to heal on their own, it depends on the severity of the damage.
The most common type of brachial plexus injury is called Erb’s palsy. Babies with a brachial plexus injury may have difficulty moving their arm or lack feeling in their arm. Damaged nerves may result in symptoms from minor weakness to partial or complete paralysis depending on the severity of the injury. A less common injury that affects the lower brachial plexus is called Klumpke’s palsy. This typically affects only the muscles in the hand and is not common in babies.
Four types of brachial plexus nerve injuries
- Neuropraxia – This is a stretch injury and is the most common. The nerve is stretched but not torn. These injuries will typically heal on their own in time.
- Neuroma – This is a more serious stretch injury that damages nerve fibers and results in scar tissue. The scar tissue may press on the healthy nerve and create discomfort. Long-term recovery is typically only partial, not complete.
- Rupture – This a stretch injury that tears or ruptures the nerve. This type of injury will not heal on its own. Surgery is required to re-attach the nerves.
- Avulsion – This type of injury is the most severe type of nerve damage and occurs when the nerve fiber is torn from the spinal cord.
For severe brachial plexus injuries, prompt surgical treatment might be needed to attempt to regain function. Without it, permanent disability may occur. In the most severe cases, the damage may be permanent. Chronic pain can also be a long-term result of a brachial plexus injury.
Erb’s Palsy birth injury
Erb’s palsy may occur during delivery when excessive pressure is put on the baby’s head, neck or shoulder because of difficulty delivering. The symptoms of brachial plexus injury can vary based on severity and extent of damage. Erb’s palsy is the result of the upper brachial plexus being paralyzed. The risk of a baby developing Erb’s palsy is greatly increased if they develop shoulder dystocia during delivery. Shoulder dystocia is a condition where the baby comes through the birth canal at an awkward angle and a shoulder becomes stuck on the mother’s pelvis. Erb’s palsy can include paralysis or limpness in a baby’s arm, limited or no movement in hands and fingers, and loss of sensation in hands and fingers.
Symptoms of Erb’s Palsy
- Weakness or numbness in arm.
- Limited motion in the shoulder, arm, wrist or hand.
- Arm hanging by side and rotated inward.
- Partial or total paralysis of the arm.
Potential Causes of Erb’s Palsy / Brachial Plexus Injuries
As we mentioned above, brachial plexus nerve injuries typically occur with traumatic or difficult deliveries. This may include a large baby, a breech birth or prolonged labor. A doctor delivering quickly may use excessive force to pull the baby from the birth canal resulting in a stretching of the baby’s neck. This can also result from excessive pulling on the shoulders during a head-first delivery, or by pressure on the infant’s raised arms during a feet-first delivery. Risk factors associated with brachial plexus injuries include improper use of birthing or extraction tools, prolonged labor, breech delivery, large baby, small or abnormal maternal pelvis shape or excessive maternal weight gain.
A baby’s arm that is limp can usually indicate a brachial plexus injury. Proper diagnosis requires a complete neurological exam to determine which nerves have been impacted and the severity of the injury. Treatment may include anything from physical therapy to improve movement in the muscles and nerves or occupational therapy to improve joint function and muscle tone to surgery in the most severe cases.
Brachial Plexus injuries during childbirth
The main cause of Erb’s palsy is damage to the nerves during childbirth. Brachial plexus injuries are avoidable. An obstetrician must proceed with extreme caution when risk factors are present during delivery. For instance, failure to recognize that a caesarean section should have been performed due to the baby’s size, use of excessive force or pressure on the baby’s head, neck, or shoulder during delivery, or improper use of delivery instruments, such as forceps or vacuum extractors, may indicate an error on the part of the doctor.
Often, Erb’s Palsy injuries are the result of preventable medical errors during delivery. Medical professionals have a duty to ensure you and your baby are provided a certain standard of care. Birth injuries may come with lifelong limitations for your child, crippling medical costs, and lasting emotional stress. If your infant has suffered a brachial plexus injury or has been diagnosed with Erb’s Palsy that you believe may have been caused by medical negligence, you should consult with an experienced birth injury attorney to explore your options and help recover compensation for your child’s injuries. The Distasio & Kowalski birth injury attorneys have seen the toll birth injuries can take on a family and we are here to help.
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Tuesday, March 5th, 2019
Cerebral palsy is a lifelong and serious neurological disorder that is often caused by a lack of enough oxygen reaching an infant’s brain during labor or delivery. Head trauma before, during or shortly after birth can be a cause. While not all cases of cerebral palsy are caused by medical error, some certainly are. Medical errors or medical malpractice during labor or delivery can sometimes result in hypoxia, or insufficient oxygen to the brain, or asphyxia, which is insufficient oxygen to the body. The Centers for Disease Control and Prevention suggest that 85 to 90 percent of cerebral palsy cases are congenital, or occur before or during the birth.
Cerebral palsy impairs muscle coordination and body movement. Harmful side effects of cerebral palsy can include breathing problems, trouble swallowing, speech impediment, as well as vision and hearing problems. Other side effects include cognitive impairments, seizure disorder, learning disabilities, and inability to control the bladder or bowels and more. 1 in 323 babies in the U.S. is diagnosed with cerebral palsy. This is according to the Cerebral Palsy Alliance Research Foundation.
Types of cerebral palsy
- Spastic Cerebral Palsy – The most common form of CP, it accounts for for 70-80% of cases. Symptoms include stiff and tight muscles. Those suffering from spastic cerebral palsy may have difficulty moving from one position to another. They may have trouble controlling muscles that are needed to perform tasks such as holding an object or speaking. Spasticity is due to damage to the motor cortex of the brain before, during or after birth.
- Dyskinetic Cerebral Palsy – This form of CP is characterized by involuntary movements, such as twisting and repetitive movements, slow movements or unpredictable movements. It results from damage to the basal ganglia of the brain.
- Ataxic Cerebral Palsy – Ataxic is characterized by shaky movements that may appear disorganized or jerky, as well as a difficulty in maintaining balance. Ataxia causes an interruption of muscle control in the arms and legs, causing a lack of balance and coordination. It has an impact on the movements required for day-to-day activities. Ataxia results from damage to the cerebellum.
Medical errors that may result in cerebral palsy
- Failing to properly monitor the mother or infant before, during or after childbirth.
- Failure to identify fetal distress by not properly monitoring the fetal heart rate during labor and delivery.
- The medical mistake of failing to identify and properly treat infections in the mother during pregnancy.
- Delayed diagnosis and treatment of maternal medical conditions or infections.
- Failing to identify an umbilical cord prolapse, a birth complication that occurs prior to delivery. Prolapse is when the umbilical cord drops through the open cervix into the vagina ahead of the baby. It sometimes getting trapped against the baby’s body.
- Medical errors regarding cesarean sections. This can include delaying a cesarean section needed due to an emergency or failing to perform a cesarean section in a high-risk pregnancy. Failing to perform a C-section when the baby is too large to deliver vaginally may also cause an injury. Medical mistakes relating to C-sections can lead to serious birth injuries.
- Medical negligence in using medical instruments or equipment. This can include the improper use of forceps or vacuum during delivery.
- Medication errors or the uses of medication that was inappropriate or dangerous for the mother or baby.
- Inadequate monitoring of the mother and baby when anesthesia is used.
- Medical diagnostic errors, such as incorrect reading of test results.
Providing a child with cerebral palsy with the appropriate care can take a toll on a family, both financially and emotionally. Cerebral palsy often requires a lifetime of care. Costly rehab, therapy and home care, as well as other medical expenses can become burdensome to an already struggling family. If your child has been diagnosed with cerebral palsy or is exhibiting symptoms of cerebral palsy, and you suspect medical malpractice, contact an experienced birth injury attorney today for help.
The burden of proof in birth injury cases
It’s hard to imagine that with just a single medical error, an infant’s life can be permanently harmed. The plaintiff has the burden of proof in a birth injury case. Therefore, a plaintiff must do more than just prove that a child suffers from cerebral palsy. A medical expert is needed to testify as to the specific cause of the disability. The medical expert will also determine whether it is a result of medical error or medical negligence. A doctor or hospital failing to provide the accepted standard of care may be a factor in a cerebral palsy birth injury. Responsible medical parties in a cerebral palsy medical malpractice case can include an OB-GYN, surgeon, doctor, nurse, hospital or healthcare clinic or others.
Statute of limitations in Pennsylvania cerebral palsy cases
If you feel your child was the victim of medical negligence or has cerebral palsy as the result of a medical error you may be entitled to compensation for those injuries, as well as resulting medical treatment. It is not too late to hold the responsible medical providers accountable for their negligent actions. A statute of limitations establishes the deadline for filing a lawsuit. If the injured victim is a minor at the time the injury or accident occurred, such as in the event of a birth injury, the statute of limitations does not begin until the victim turns 18. An injured child or minor has 2 years to file a lawsuit after they turn 18.
If your baby has been diagnosed with cerebral palsy and you believe that medical error or hospital error could have been the cause, you need to contact a medical malpractice lawyer. An experienced cerebral palsy birth injury lawyer can review the details of the case and help determine if medical negligence did cause your child’s birth injury. Medical errors leading to cerebral palsy can occur during pregnancy, labor and birth. They may also occur immediately following the birth of your baby.
Distasio & Kowalski medical malpractice lawyers
The birth injury lawyers at Distasio & Kowalski in Wilkes-Barre can help you to obtain the compensation you deserve. It is our goal to help your family overcome the lifelong difficulties associated with cerebral palsy or other birth injuries. This can include compensation for past and future medical expenses and caretaking costs, as well as for pain and suffering. We are a personal injury firm dedicated to getting injury victims the best possible legal results and holding medical professionals accountable for the harm they cause.
Read more on birth injuries and medical malpractice compensation on our website. Learn more about the early signs of cerebral palsy and screening on the CDC website.
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