Lawsuits for Medical Malpractice During DeliveryDelivery Medical Malpractice Lawsuits
This page focuses on newborn medical malpractice for problems during delivery specifically during child birth shoulder nerve conduction injuries and joint contracture from avulsion, rupture, neuroma, and stretch injuries. Beware of newborn injuries involving damage to bones, joints, neck, and shoulder. Do you have a medical malpractice lawsuit?
Erb’s Palsy: What are the different types of injuries to shoulder and neck? What is joint contracture?
A study was done in an obstetrical brachial plexus clinic in the Middle East. The author designed a study in which the indication for brachial plexus surgery in infants with Erb's palsy was the lack of active elbow flexion against gravity at 4 months old.
Forty-three infants were included in the study and were distributed among four groups: Group A included infants who had active elbow flexion at the initial assessment or at 2 months old; group B included infants who had active elbow flexion at 3 months old; group C included infants who had active elbow flexion at 4 months old; and group D included infants who did not have active elbow flexion at 4 months of age.
At the final follow-up, all infants in group A demonstrated complete spontaneous recovery of the limb. All in group B also had satisfactory spontaneous recoveries and none required secondary corrective procedures. Five of the 11 patients in group C had satisfactory spontaneous recoveries. The remaining six children in group C had good recovery of elbow flexion but a poor recovery of shoulder function. Finally, all three patients who did not have elbow flexion at 4 months of age (group D) underwent surgical exploration and reconstruction of the brachial plexus using nerve grafts.
Brachial plexus injuries range from mild neuropraxia with early recovery to complete disruption with no potential for recovery. Fortunately, 80 to 90 percent of children with such brachial plexus injuries will attain normal or near normal functionality.
The examination to determine the extent of brachial plexus injury starts by trying to raise the arm which becomes impossible when the deltoid nerve and suprascapular muscles are paralyzed. Elbow flexion (the ability to extend at the elbow) is weakened because of weakness in biceps and brachial nerve. If roots are damaged above their junction, paralysis happens, producing weakness in retraction and protraction of scapula. After the age of 6 months, contractures begin to develop causing further deformity of the forearm. (A contracture is the chronic loss of joint motion due to structural changes in non-bony tissue.)
Radiographs look for presence of a cervical rib. A cervical rib is an extra rib which arises from the seventh cervical vertebra. It’s a congenital abnormality located above the normal first rib. A cervical rib is present in only about 1 in 200 percent of people. Of 42 infants found to have a cervical rib, 28 newborns had an Erb's Palsy which leads to a conclusion that a cervical rib is a risk factor for an Erb's Palsy.
Management of brachial plexus injury is crucial especially during the first six months. Gentle range of motion exercises is necessary to retain external rotation and abduction at the shoulder. An electromyogram (EMG) will help distinguish reversible vs. not reversible nerve damage.
The controversy lies at what age (before 6 months or after 6 months) should corrective grafting surgery be done in attempt to improve function.
Does your child suffer from brachial plexus injury? Are you burdened by doctors’ appointments and loss of income from caring for your child? Is your child’s suffering too painful to bear? If you answered – yes – to any of the above questions, then it’s time to seek counsel from medical malpractice law firm who help you.
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