Articles Posted in Shoulder Dystocia

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In 1980, a son was born to a couple in Clinton County, New York. The baby boy was born with a port wine stain on his face. A port wine stain is a reddish colored birthmark they are natural, and can occur anywhere on a child’s body. They are most often at the back of the neck or upper shoulders of babies. When they occur on the back of the neck or upper shoulders, they are often referred to as stork bites. These birth marks usually include an increase in vascular supply to that area.

In 1993, the parents of the child took him to see a plastic surgeon to inquire about the possibility of removing the birthmark. The doctor advised that he could remove the birthmark from the boy’s face with an instrument called an argon laser. The doctor did not tell the parents that there was the possibility of scarring from using the laser to remove the mark. The doctor was aware that children in the boy’s age group frequently experienced hypertrophic scarring as a side effect of argon laser removal of port wine stain birthmarks. The company that manufactured the machine placed a warning in their 1992 user’s manual about the risk of scarring. However, the hospital where the machine was located had not updated their manual for the machine. They still had a 1987 manual, which did not contain the warning about scarring children with port wine stains.

The doctor who performed the procedure stated that he was familiar with the risk and chose not to tell the parents. The court determined that the hospital and the company that manufactured the machine were both free from liability in this case. The hospital was relieved of liability because the plastic surgeon who performed the procedure had hospital privileges, but was not on staff at the hospital. The manufacturer of the machine was relieved of liability based on the fact that the updated user’s manual contained the warning about scarring.

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In ninety percent of birth injuries involving the brachial plexus, the injury will heal within a few days to six months. The rest do not ever heal.

A concerned mother of an injured baby reports their frustration and desperation. “We were willing to go anywhere, to do anything. But, we didn’t know what to do” following the birth of her son David. Their quest eventually led them to a pediatric physical therapist familiar with the Children’s Hospital Brachial Plexus Clinic, which had opened about five years previously. The clinic is one of a handful of treatment centers in the United States that treats 100 to 125 patients a year with this particular injury.

The chief doctor and clinic founder reports that “Although brachial plexus injuries can occur in accidents or from a breech birth, most are due to shoulder dystocia delivery.” At this particular facility, doctors perform brachial plexus surgery on children as young as 6 to 9 months. They are able to remove scars and add nerve grafts.

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