Canadians who seek medical care during childbirth expect a reasonable degree of care and skill from their doctors and birth attendants. When doctors make mistakes during delivery, their actions may potentially cause life-long complications for babies before they are even born.
While injuries to the brachial plexus can occur at any age and stage of life, medical malpractice litigation deals with brachial plexus injuries that are sustained at birth as a result of medical or obstetrical negligence. Not every brachial plexus birth injury is the result of medical negligence, however, brachial plexus birth injuries can be caused by negligence in deliveries that are complicated by a condition known as shoulder dystocia.
What is Shoulder Dystocia?
Medical malpractice cases brought because of brachial plexus birth injuries often involve deliveries that were complicated by shoulder dystocia. Shoulder dystocia is a complication of childbirth that occurs when one or both of the baby’s shoulders become stuck in the birth canal during delivery. In cases of shoulder dystocia, it is most common for the baby’s shoulder to become stuck behind the maternal pubic bone after the baby’s head has been delivered. Shoulder dystocia is an obstetrical emergency and usually requires medical intervention to carefully dislodge the baby’s shoulder from where it is trapped behind the pubic bone.
Shoulder dystocia is unpredictable and unpreventable. Proper management of shoulder dystocia is essential to prevent brachial plexus birth injuries. Doctors and birth attendants are trained to manage shoulder dystocia through a variety of methods to free the trapped shoulder without causing injury to the baby. Unfortunately, mistakes in the management of shoulder dystocia can result in damage to the baby’s brachial plexus. The improper use of forceps, lateral traction, or a kiwi vacuum are examples of interventions that can result in damage to the brachial plexus when a delivery is complicated by shoulder dystocia.
What is the Brachial Plexus?
The brachial plexus is a network of nerves that originate from the C5, C6, C7, C8 and T1 vertebrae in the upper spine and extend through the shoulder, arm, and hand. These nerves carry signals from the spinal cord to control mobility, function, and feeling. Injury to the brachial plexus can interrupt these nerve signals and may result in a loss of muscle function and sensation in the affected arm.
Injuries to the brachial plexus can be classified based on which nerves are damaged. Injuries to the upper brachial plexus that affect the C5 and C6 nerve roots are known as Erb’s palsy. Erb’s palsy is the most common brachial plexus birth injury, and often arises in cases of deliveries complicated by shoulder dystocia. Injuries to the lower brachial plexus that affect the C8 and T1 nerve roots are known as Klumpke’s palsy. In some cases, all the nerves in the brachial plexus will be affected at the same time, which is known as a total brachial plexus injury.
Brachial plexus injuries happen when the nerves are either stretched or compressed, causing damage to the nerve fibers. Injuries can range in severity from minor nerve strain to serious nerve damage, rupture, and tearing. The most severe brachial plexus injuries occur when the nerve root is torn out of the spinal cord, known as “avulsion”. Brachial plexus avulsions are serious injuries caused by significant traction, or pulling, on the affected arm which causes the roots of the nerve to tear free of the spinal column.
In deliveries complicated by shoulder dystocia, the improper application of traction and force on the baby’s head can cause stretching of the brachial plexus in the trapped shoulder. In some cases, the injury to the brachial plexus will be minor and temporary. In other cases, however, excessive traction before the baby’s shoulder has been dislodged from where it is trapped can cause tearing of the nerves and result in permanent injury to the baby’s shoulder, arm, and hand.
Why Consult a Medical Malpractice Lawyer?
To be successful in a medical malpractice case, a claimant must prove that the doctor/birth attendant’s actions caused the injury. This is a legal issue known as “causation”. Not every brachial plexus injury is caused by a doctor’s mistake, and it is important to consult with an experienced medical malpractice lawyer when considering legal action.
The medical malpractice lawyers and staff at BIMMA have experience evaluating brachial plexus birth injury claims to determine whether it is likely that causation can be proven. Experienced lawyers will be happy to review your case and provide a no obligation opinion on whether you may be able to bring a successful claim in medical malpractice.
In many cases, a serious brachial plexus injury will result in lifelong complications and possible future care costs. If your child sustained a brachial plexus injury at birth, it is important to schedule a free consultation to speak with a medical malpractice lawyer and determine whether a legal claim may be in your child’s best interest.
