Brachial Plexus & Erb's Palsy Birth Injuries - Medical Malpractice Law Firm

Brachial Plexus

Brachial plexus is a weakening or paralysis of the arm caused by injury to the arm’s upper group of main nerves that form part of the brachial plexus. The brachial plexus is a highway of nerves near the neck that influence all of the nerves of the arm providing movement and feeling to the arm, hand, and fingers. Erb’s palsy is when the weakening or paralysis is the result of damage or injury to the brachial plexus nerves affecting the movement of the upper arm and rotating of the lower arm.

The term “plexus” refers to this “highway,” “network,” or “group” of nerves. The nerves pass from the spinal cord through the vertebrae of the neck and into the arm. The nerves come together near the side of the neck and then spread out into the arm after passing through the collarbone (clavicle).

The brachial plexus nerves that influence the arm and shoulder lie higher in the neck than those that control the hands and fingers. As such, it is more common for Erb's Palsy to affect the motion of the arm and shoulder than hand and fingers. It is more severe when the lower brachial plexus nerves that control the hand and fingers are injured. This condition is referred to as total or global brachial plexus palsy. When the hand is affected by the paralysis, a condition known as Klumpke paralysis can also occur causing the eyelid on the opposite side of the affected hand to droop.

Shoulder Dystocia

Infant brachial plexus is most commonly caused by shoulder dystocia. Dystocia is an abnormal or difficult childbirth or labor. Shoulder dystocia is a case of abnormal or difficult delivery of the shoulders after the infant’s head is manifest. The shoulders have difficulty passing below the mother’s pubic symphysis. The doctors will try to maneuver the shoulders as shoulder dystocia is an obstetrical emergency potentially leading to fetal demise within 5 minutes (due to compression of the umbilical cord within the birth canal) if the baby is not delivered.

Types of Brachial Plexus Nerve Injuries

Generally, four types of brachial plexus nerve injuries can occur:

A brachial plexus injury can be classified as neurapraxia. Neurapraxia is the most common injury that shocks the nerve but does not tear it. This injury usually heals within three months.

A brachial plexus injury can be classified as neuroma. Neuroma injuries are those involving damage to the nerve fibers resulting in scar tissue that presses on a surrounding healthy nerve. Some recovery is obtained.

Some brachial plexus nerve injuries involve a tear (or rupture) of the nerve. A tear or rupture will require medical assistance. Most likely, physicians will splice a donor nerve graft. Such grafts vary in results, leave some scarring, take much time to heal, and are not helpful to older infants.

The most serious brachial plexus injury involves an avulsion. An avulsion occurs when the nerve is torn from the spinal cord and cannot be repaired.

Brachial Plexus Long Term

Brachial plexus is a condition that can also be obtained in adulthood as the result of injury to the shoulder, but it is most commonly caused by dystocia. While most labor related brachial plexus birth injuries do heal on their own, the infant will require frequent re-examination to confirm the nerves are recovering. Depending on the injury, recovery can last for an extended period of time. Starting at about three weeks of age, parents may need to perform rehabilitating exercises with the child to prevent the joints of the shoulder, elbow, wrist and hand from becoming permanently stiff (i.e., joint contracture). Full range of motion is most often received within one year of age, but after this point, full function is rarely obtained.

Long term, some children may experience abnormal growth as a result of brachial plexus in everything from shoulder to fingertips. The shorter growth generally results from comparative lack of use of these body parts and the influence of nerves (unaffected vs. affected) on growth. The lack of muscular development in areas affected by the brachial plexus may inherit long term weakness or lack of movement. Similarly, these areas may experience abnormal circulatory development resulting in an inadequate ability to regulate temperature in these areas as compared to the rest of the body. Lack of circulatory development can also reduce the healing ability of the skin. Skin may take greater periods of time to heal and infections may easily manifest if open cuts or injuries are not sterilized immediately. Arthritis is another potential long term affect of brachial plexus.

Brachial Plexus and Medical Malpractice

Brachial plexus birth injuries significantly impact both parent and child. Parents will need to bring their child to frequent medical examinations to monitor the child’s recovery. Parents will also need to set aside time for the child’s rehabilitative motion therapy. Medical and rehabilitative treatments will result in greater health care costs. The child will potentially experience a variety of long term life limiting effects, depending on the severity of the birth injuries, and if not resolved early in the infant’s life. The negative results are compounded when the infant’s birth injuries are the result of medical malpractice because the physicians involved deviated from acceptable standards of practice in providing health care resulting in damage to the brachial plexus.

The law firm at Seeger Weiss LLP specializes in assisting parents whose children have been negatively affected by brachial plexus as the result of medical malpractice. Children with such birth injuries deserve legal assistance from attorneys or lawyers experienced at such forms of complex litigation. Seeger Weiss offers a free initial case evaluation. To learn more about how Seeger Weiss can assist you, please complete the contact form, or call toll free at 888-584-0411.