Erb’s Palsy Birth Injury

Erb’s Palsy is a paralysis of the arm caused by injury to the upper group of the arm’s main nerves (specifically, spinal roots C5-C7) in the brachial plexus. It is almost always a birth injury, which results from an abnormal or difficult childbirth or labor. It can be a result of medical malpractice, such as excessive pulling on the shoulders during delivery, or if the infant’s head and neck are pulled toward the side at the same time as the shoulders pass through the birth canal.

Erb’s Palsy is the name for damage that is caused to the nerves. These nerves extend bilaterally from the neck and shoulder area to the upper extremities and are responsible for controlling the muscles in the arms, hands, and fingers. Erb’s Palsy is most often the result of shoulder dystocia, which occurs when a baby’s shoulders get stuck on a mother’s pelvic bone. This can result in damage to the nerves of the brachial plexus including stretching, tears, rupture or avulsion of the affected nerves. The trauma causes limpness, reduced sensation, paralysis, or lack of muscle control in the upper limbs.

Medical malpractice may also take place when a doctor, justifiably anxious about the possibility of the baby suffocating, uses excessive or misdirected force to reposition the baby, tearing nerves and causing Erb’s Palsy or another brachial plexus palsy. If these medical errors lead to a birth injury such as Erb’s Palsy, you have the legal right to sue for compensation for the medical bills, your child’s pain and permanent disability.

While most cases of Erb’s Palsy are healed within six to 24 months, according to the American Academy of Family Physicians, about 10 percent become a lifelong disability.

Children with Erb’s Palsy are all affected in different ways; depending on the type of nerve damage, and the symptoms can range from mild to severe. With Erb’s Palsy, there are four different types of nerve injuries, including:

1. an avulsion, meaning the nerve is torn from the spine,
2. a rupture, meaning the nerve is torn but not where it attaches to the spine,
3. a neuroma, meaning the nerve has tried to heal but scar tissue has grown around the injury placing pressure on the injured nerve praxis. While the nerve has been damaged, it has not been torn and improvement should be seen within 3 months.
4. Neuropraxia is the mildest form of a nerve injury. Neuropraxia, the most common form of Erb’s Palsy, is limited to the specific place where the injury occurs. It is a physiologic block of nerve conduction within an axon without any anatomical interruption. Many infants born with brachial plexus palsy have neuropraxia and sometimes recover within 4-6 weeks.

Symptoms of Erb’s Palsy are usually very obvious. A baby suffering from Erb’s Palsy can be seen with the affected arm laying by their side and an extended elbow devoid of movement. The injuries associated to Erb’s palsy are the neck, clavicle, shoulder, and arm. Precautions should be used with children suffering with brachial plexus injuries to prevent shoulder or elbow dislocation, a frozen shoulder, and soft tissue or joint contractures. Lifting a child with Erb’s Palsy from under the armpits should always be avoided.

Examples of different symptoms of Erb’s Palsy:

• no muscle control and no feeling in the arm or hand,
• little control of arm movements,
• the use of hands but not of the shoulder or elbow,
• the entire arm may be paralyzed with the hand and fingers hanging limp,
• facial paralysis on the affected side,
• not able to sit up without assistance,
• the inability to crawl without the use of therapeutic devices.

Treatment for Erb’s Palsy generally consists of daily exercise and physical therapy to improve functionality of joints and muscles. In about 20 percent of the cases, babies born with Erb’s Palsy will greatly benefit from surgery between the ages of 5 and 12 months. Infants with brachial plexus palsy can benefit from surgical procedures to increase their arm functions. Since most children with Erb’s Palsy have damage to multiple nerves of the brachial plexus, more than one procedure, performed by a pediatric neurosurgeon, may be necessary.

If you or a loved one has suffered from Erb’s Palsy, The Schupak Law Firm has the experience and skill necessary to provide you with sound advice on how to protect your legal rights and obtain the maximum compensation allowable under the law. Call us at (703) 491-7070 for a free consultation.