Erb’s Palsy is the paralysis of one arm. It occurs during the final stages of labour where a baby’s shoulder becomes lodged behind the mother’s pelvis and their arm or shoulder is damaged, attempting to manoeuvre and dislodge the shoulder to deliver the baby. This can lead to the baby suffering injuries such as a fractured collarbone or humerus, nerve damage in their arm or shoulder and hypoxia (lack of oxygen to the brain).
Attempting delivery in this situation is a medical emergency and can also cause injury to the mother including bruising and lacerations.
Erbs palsy medical negligence claims
Not all brachial plexus injuries result from medical negligence, but on occasion this does happen, for instance where there were warning signs about the position or size of the baby which were not appropriately monitored.
Erbs palsy specialist solicitors
At Ince Metcalfes, our specialist medical negligence solicitors can help you establish what happened and whether Erbs Palsy injuries to you or your baby should have been avoided.
We will work with you and with a tried and tested set of medical experts to investigate the way in which your labour was managed and whether antenatal care failed to identify warning signs about the position or size of your baby.
Where medical mistakes are found to have happened, we will make sure that your child gets the right Erbs Palsy treatment and support, and that your family gets the compensation that enables you to move on, positively.
To find out more information, please contact us on 0117 239 8012, or email us using the online contact form.
Client story: Erbs Palsy claim
AW – v – NHS Trust
£400,000 awarded our client who sustained a brachial plexus injury at birth.
The injury had resulted in one arm being shorter than the other. Our client had significantly reduced movement and was unable to lift her arm above her head. She had to undergo several surgical procedures to improve the range of movement in her arm and shoulder. Our remained self-conscious about the scarring which this surgery had brought about. She was bullied at school as a result of her disability, resulting in low self esteem and poor educational attendance and achievement. It was accepted that our client's future employment choices would be limited because of her injury.
Our client was unable to carry out certain self-care functions, such as tying back her hair or doing up small fastenings, as she was restricted to using one arm and this was likely to remain the case. She would therefore require care and assistance throughout her life, as well as specialist aids and equipment to facilitate independence where possible.
How is Erb’s Palsy caused?
Erb’s Palsy is usually caused by shoulder dystocia during labour. Shoulder dystocia happens in around 0.6-1.4 per cent of vaginal births and is an obstetric emergency. It is where the baby's shoulder impacts against the mother's pubic bone during the final stage of labour. As the head is emerging, the shoulder becomes wedged in the birth canal, and the baby has to be manoeuvred out. If traction on the affected arm occurs, or if the baby's head is pulled away from the collarbone, a brachial plexus (nerve) injury can occur.
Can shoulder dystocia be predicted?
There are several known maternal risk factors for the condition. These include diabetes, obesity, high parity and a prior birth in which shoulder dystocia occurred. Any very large foetus ("macrosomia") will also be at risk of the condition.
There are independent risk factors associated with labour, and these include a prolonged first and/or second stage of labour, and instrumental delivery (forceps or ventouse).
Can shoulder dystocia be prevented?
There are ways of avoiding it. Some clinicians plan early induction of labour. Some schedule caesarean section delivery but this is relatively unusual and, in fact, brachial plexus injuries have been known to occur during caesarean deliveries.
What injuries are caused by shoulder dystocia?
Both mother and baby can be injured. There can be maternal bruising and lacerations. But injuries to baby are often more severe and include hypoxia (lack of oxygen), fractured clavicle (collar bone), fractured humerus and extensive, permanent nerve injury.
How do we investigate the claim?
To win an Erb's palsy claim, you need to prove that the relevant clinical guidelines were not followed. You also need to show that, if they had been followed, the condition would probably not have developed. As part of these investigations, we will establish what was most likely to have caused the condition.
These claims can raise a host of questions about the management of labour, but it would be usual to consider questions like:
- Was the mode of delivery appropriate?
- Could or should the birth have been expedited more quickly?
- Was too much pressure applied in any release manoeuvre attempted?
- Was the birthing process monitored appropriately?
- Did staff communicate properly?
We will most likely need to assess not only the management of the birth itself, but also the antenatal care and in particular the identification of warning signs. If, for example, ultrasound images of the foetus in the womb reveal that it could or should have been known that the child was likely to be unusually big, we would need to investigate the significance of this. Usually, the input of several medical experts will be needed, probably including a midwife and an obstetrician, a neurologist and an orthopaedic surgeon.