Articles Posted in Erbs Palsy

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A woman gave birth sometime on October 7, 2005 at a college hospital. An obstetrician attended the birth but an obstetrical resident was the doctor who personally delivered the baby.

The woman’s delivery progressed well but her pushing had to be temporarily stopped because when the baby girl’s head was delivered, it was seen that the umbilical cord was wrapped around the baby’s head. The resident clamped the umbilical cord and cut it and then delivered the rest of the baby. The child’s head presented itself with the back of her head facing the right side of her mother’s body. The mother suffered a vaginal laceration with the birth because no episiotomy (surgical cut in the vagina to allow easier delivery of the baby) was made by the resident. They then repaired the vaginal laceration.

After the birth, the pediatrician noted a weakness in the right arm of the baby. The diagnosis was Erb’s palsy as a consequence of the baby’s shoulder getting caught in the mother’s pubic bone. With the mother’s uterus pushing the baby out and the resident pulling the baby out, the baby’s right shoulder was stretched and suffered a fracture and the nerves were pulled and injured resulting in muscle weakness in the right shoulder and right arm.

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The complainants seek damages for the infant’s right arm paralysis injury (Erbs palsy brachial plexus). The accused parties are the hospital, the obstetrical resident who delivered the infant and the attending physician who was present at the delivery.

The complainants allege that the doctors failed to properly manage and perform the delivery of the infant, failed to properly detect and manage shoulder dystocia, failed to perform rotational maneuvers to deliver the infant, failed to properly position the mother for delivery, improperly performed delivery by applying excessive traction to the infant’s head, failed to perform an episiotomy in the presence of a shoulder dystocia, failed to place the mother in the necessary birth position and failed to perform the necessary birth maneuver, and improperly performed maneuvers at delivery which resulted in injury to the brachial plexus nerve. The doctors on the other hand, claim that the birth injury sustained by the infant is inconsistent with the records of the labor and delivery. It was not caused by a medical malpractice and instead, was the result of maternal fetal forces.

In support of their motion for summary judgment, the doctors submit the affirmation of obstetrics and gynecology physician board certified who reviewed the pertinent medical records, pleadings and deposition transcripts. The board certified physician observes that the mother’s pre-natal history was benign and she had no maternal risk factors for shoulder dystocia. She also observes that the mother did not have an abnormal pelvic anatomy, gestational diabetes, was not post-date. The records revealed that the mother had no previous shoulder dystocia delivery and was not extremely short of stature. The board certified physician also pronounces that there was no assisted vaginal delivery or protracted active phase of first stage labor or second stage labor. The delivery note also indicated that the child was delivered with a non-reducible nuchal cord wrapped once around the neck and was clamped and cut upon the head’s delivery. The nuchal cord is significant because in its presence, the mother was directed to stop pushing after delivery of the head in order to have the cord cut prior to the delivery of the child’s body. Based upon the charting, a shoulder dystocia was not encountered. Had there been any complications or the need for maneuvers to be undertaken because shoulder dystocia was encountered, or for any other reason, it would have been documented in the physician’s notes, nursing notes, or pediatric notes. The board certified physician strongly claims that absence of any of such documentation is clear and convincing evidence that maneuvers and/or excessive traction were not used and shoulder dystocia not encountered. The work-up from admission to delivery was well within the standards of care, and there were no departures from the standard of care from the time of delivery through the delivery itself, based upon the records. Following the delivery, the mother had a first-degree vaginal laceration and was repaired with 3.0 chromic sutures, which indicates that it was a superficial laceration without muscle involvement and it was not, as indicated in the complaint that a trapped shoulder had to be delivered.

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On 23 January 1985, plaintiff was born by caesarean section at North Central Bronx Hospital, an affiliate hospital of defendant HHC. The infant plaintiff’s parents are citizens of Guyana and the mother has had intermittent residence in the Bronx. Apparently, the caesarean section was necessitated by fetal distress arising from the umbilical cord being wrapped around his neck. Upon delivery, there was evidence of meconium and he received low Apgar scores. Hospital records indicate that he had suffered birth injuries such as birth asphyxia, meconium respiration and additional ailments (birth injury accidents). Plaintiff was discharged on 28 January 1985. Discharge memoranda indicate follow-up appointments and a referral to the Visiting Nursing Services. There is some evidence that the mother was provided with a set of appointment papers for a follow-up clinic appointment, but the mother states that she received no instructions after discharge. She recalls that a nurse visited once a week for six weeks, but she is not sure what the visits were for. Apparently she was given an appointment for a follow-up examination at the Kennedy Center, but she did not keep her appointment. The mother returned to Guyana with plaintiff in March 1985. There, she took him to a clinic for a six-week checkup, but otherwise sought no medical examinations.

At some point, she received a letter from North Central Bronx Hospital advising her that plaintiff should have a blood test. As a result, she returned with plaintiff to a Bronx clinic in September 1985. She did not recall the reason for the blood test, but recalled that the outcome was “OK.” Plaintiff notes that the clinic’s lab slip referencing the18 September 1985 blood test identified North Central Bronx as his hospital. Defendant argues that the clinic was not at North Central Bronx, though plaintiff tries to connect the two entities by noting that the clinic identified plaintiff by use of plaintiff’s North Central Bronx chart number. In any event, the mother subsequently took plaintiff back to Guyana. While in Guyana, the mother took him to a clinic to get vaccinations, and occasionally for colds, and at one point a doctor there indicated that plaintiff had a damaged hand, but no further treatment was ever given, and no further references were made.

Around 1986, plaintiff’s mother began to notice that plaintiff had difficulties with his left hand and arm, that he could not hold things and had general clumsiness when trying to hold things. She also observed at some point that he had difficulty with his left leg. She did not have this treated in Guyana; instead, she returned to the United States. Upon her request, she was scheduled for an appointment at North Central Bronx Hospital’s Well Baby Clinic on 12 August 1987. This was some 2½ years after plaintiff was discharged following his birth. In the interim, the mother had had no interaction with defendant hospital as to the medical conditions relating to the child’s birth. During that appointment, several diagnostic evaluations were made in connection with probable cerebral palsy, and a pediatric rehabilitation consultation was requested. The mother was scheduled for a 13 November 1987 appointment, and then a 29 January 1988 appointment, but she failed to appear at either appointment. She and plaintiff also failed to appear for a scheduled 7 October 1987 appointment for a rehabilitation and speech language pathology consultation. On 10 November 1987, she and plaintiff also failed to appear for a clinic appointment. She subsequently explained that during this time period, she had returned to Guyana where plaintiff was seen by a doctor who indicated that plaintiff had a damaged hand.

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A suit filed by the family and legal counsel of a four-year-old boy was settled last week for €800,000. The boy’s right arm was paralyzed because of injuries incurred during his birth.

The Justice who approved the boy’s settlement said, “it was a perfectly fair and reasonable settlement.”

The boy, suing through his mother, filed against those who were found responsible for causing a severe birth injury that resulted in five spinal nerves being damaged. The consultant obstetrician based at Mount Carmel Hospital, on Braemor Rd, in Church town, Co Dublin, was found reasonably responsible.

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In 2007, an Evesham family that previously won a landmark court ruling in favor of their son lost their specially adapted home to floodwaters. The ruined home was bought by the family with proceeds from their son’s malpractice suit. The boy was left severely disabled after complications incurred during his birth.

The boy was awarded almost £5 million after a judge agreed that he had been let down by medical professionals who failed to diagnose his mother with gestational diabetes during her pregnancy. Mothers with this condition typically deliver larger babies.

A nurse remembers the case. He says that the mother was given permission to deliver the child at home instead of in a hospital via an early C-section. Because of this, there were complications during the birth, and the child was left with cerebral palsy and Erb’s palsy which has completely confined him to a wheelchair. He is also unable to speak.

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An 8-month-old Iraqi infant, who had suffered nerve damage during birth, is expected to recover some kind of movement in his right hand after a successful surgery in Houston last week. The surgery lasted two hours and according to the doctor, “It went really well.”

The operating surgeon specializes in treating children with brachial-plexus injuries like this baby. Brachial-plexus injuries, also known as Erb’s Palsy, commonly happen during birth and are referred to as shoulder dystocia.

After discovering that the child’s nerves had been pulled out of the spinal cord, a nerve bypass operation was performed. Hospitals in Queens and Staten Island deal with these problems all the time.

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A birth injury condition known as Erb’s Palsy occurs in about two out of every one thousand births, and it is typically the result of inadequate treatment by a physician or obstetrician.

A study done in Manhattan and Long Island, presented a public announcement identifying recognizable markers of the condition. In most deliveries when the baby was affected, doctor and nursing staff failed to recognize that a C-section should have been performed. Most C-sections in this case would have been based on the baby’s size. Another factor in the development of Erb’s Palsy is inadequate care and delivery situations that result in “shoulder dystocia”. The use of excessive pressure on the baby’s head, neck, or shoulder during delivery can cause several types of pressure-related nerve damages.

In malpractice or negligence cases, families have the right to seek compensation from those who are responsible. It is possibly for the plaintiffs to come to an out-of-court agreement, or settlement that is compensation received when injuries are the result of medical negligence or malpractice. Such settlements are a major boon for families having to deal with the additional costs of therapies and surgeries.

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Recently, the High Court of London approved a settlement for almost €1M in an medical malpractice action filed by the parents of a nine-year-old boy who suffered shoulder and hand injuries at the time of his birth.

The boy’s 45-year-old mother has filed a separate suit concerning the trauma. She claims she underwent a ‘horrific childbirth’ which tragically left her son John physically disabled.

A reporter found that the court was told the case brought on behalf of the boy had been settled for €900,000. Senior counsel for the child said, “Liability had been admitted by the obstetrician and the Southern Health Board.” They also supplied a substantial apology.  

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Over half a million pounds in compensation was just awarded to a North London teenager. Complications at her delivery years ago left her partially disabled as she enters adulthood.

The sixteen-year-old from Barnet suffered serious complications during her birth at London’s Barnet and Chase Farm Hospital, and she now suffers with Erb’s Palsy.

Erb’s Palys is a condition that causes paralysis of the arm. More specifically, the upper group of the arm’s primary nerves are severed during severe trauma. Depending on the nature of the trauma, the paralysis can either resolve on its own over a period of months, necessitate rehabilitative therapy, or require surgery. It was caused when her shoulder became stuck during delivery, which caused the extensive damage to the nerves in her shoulder. A study reveals that complications such as this happen more often than the public realizes.

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Having a baby can be one of a family’s most joyous occasions, and with more than 4 million babies born each year there are many happy people with healthy new additions to their families. However, the New York Birth Injury Attorney claims, there are also other babies that are born with a variety of health problems, including those deemed as being debilitating like Erbs Palsy. While any child that is born with medical problems is both sad and tragic, many parents have been utilizing a method known as cord blood storage as a means of providing for their children should a condition or illness manifest itself as they grow and develop.

An questioner was told that cord blood contains stem cells and other genetic information about the baby. The method of delivery of the baby is irrelevant as the cord blood can be harvested whether the baby is born vaginally or by C-section. The cord blood is collected before the umbilical cord is cut and is then sent to either a private or public storage facility to which the parents will pay a monthly fee to store their child’s cord blood for future use, if needed. The one distinction between the public and private storage is that the parents’ monthly fee assures that their child’s blood will be available to them if needed, and a public storage is more like a cord blood bank where the cord blood is made available to anyone who needs it. Either storage method would only be good until the child reaches about 18-years of age since it is at that point that there would be insufficient stem cells within the cord blood to treat the person.

While storing cord blood may be considered by many to be a controversial approach to a potential medical problem that may never materialize, there are many who store the cord blood in case their child develops a blood type disease such as leukemia. To a parent who has a child who has been diagnosed with such a disease, cord blood storage could be considered a godsend.

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