Erb’s Palsy and Klumpke’s Palsy Attorneys in Denver
We know being born involves physical trauma. However, with prenatal monitoring, modern hospital care, and the wide availability of cesarean sections, there’s less excuse than ever for babies being born with lifelong injuries. Medical negligence at any stage of the prenatal, labor and delivery, or postnatal period is inexcusable, and if your baby has weakness, loss of sensation, or paralysis in one or both arms, chances are good he suffered a brachial plexus injury.
What can you do? Call Leventhal Puga Braley P.C. at (877) 433-3906. Our nationally acclaimed lawyers are active member of the American Association of Justice’s Birth Trauma Litigation Group and handle these cases. We offer a no-cost initial consultation to review your medical records and find out if you have a valid medical malpractice claim against your child’s doctor. We are parents ourselves, and we take care of our clients. Contact us today.
The brachial plexus is a nerve cluster located underneath the collarbone, connecting the arm and shoulder with the spinal cord. During birth, when a child’s head is kinked inside the womb, or twisted and pulled to exit the birth canal, this vital cluster of nerves can be damaged for life. Which is why doctors shouldn’t twist or yank on babies’ heads – not with forceps, not with vacuum extraction, and not with their hands. "Too much traction" is the cause of almost all of these obstetric brachial plexus injuries in the United States – and that can be medical negligence. Stretching or tearing these nerves will lead to paralysis of part or all of the baby’s affected arm. There are two general diagnoses related to OBPIs: Klumpke’s palsy and Erb’s palsy.
Erb-Duchenne palsy or Erb’s palsy, described by Dr. William Erb in 1874, comes from damage to the upper trunk C5–C6 nerves. These nerves affect the deltoid, biceps, and brachialis muscles – meaning the shoulder and upper arm. Erb’s palsy often appears in the form of the arm being permanently "crooked" or unable to straighten, bent at the elbow and held against the body. The child will have difficulty using the arm and grasping objects or making a fist on the affected side. However, the arm could also appear loose or "floppy."
Klumpke’s palsy, also known as Klumpke's paralysis or Dejerine-Klumpke palsy, affects the lower nerve roots of the brachial plexus: C8-T1. It will impact the muscles of the hand, as well as the flexors of the wrists and fingers. The forearm may also suffer weakness and loss of sensation along with the hand. Klumpke’s palsy is usually seen in the form of a "claw hand."
Depending on the degree of injury, the child will have some level of pain, cramping, and discomfort. The earlier these OBPIs are given medical intervention, the better for the child’s development and long-term use of the arm, wrist, and hand.
Brachial plexus palsy occurs whenever one nerve or more from the cluster is:
- Avulsed: Avulsion occurs when the "root" of the nerve is torn out from the spinal cord. If avulsion is the cause of your child’s Erb’s palsy or Klumpke’s palsy, the condition is permanent. Reattachment is not an option at this time, though some patients may have motion returned through grafting surgery. It is more likely that part or all of the arm will be rendered completely paralyzed, without any sensation at all.
- Ruptured: Any tear along the length of the nerve is called a rupture, and it requires surgery and grafting to give the child back some strength, feeling, and range of motion in the arm. But there will be pain, and the child will have to receive ongoing physical therapy and other intervention to restore as much use as possible.
- Stretched: There are two degrees of stretching injuries in nerves: neurapraxia and neuroma. Neurapraxia is the stretching itself – the child will feel the burning pain, tingling, and extreme discomfort of a nerve injury, but the injury should heal on its own in a few months. However, if the stretching is serious enough to cause scar tissue to build up, it is a neuroma, and in addition to suffering the pain, the child will have a less stable nerve from the extra weight of the scar tissue. Physical therapy or surgery may help, but the damage is likely permanent and will affect the strength of the arm and range of motion, as well as create an increased likelihood of future injury.
In addition, any loss of function in the arm can lead to problems with the circulatory, nervous, and muscular systems. Visit your doctor right away if you suspect your child has suffered nerve damage during birth.
Obstetrician-gynecologists, neonatal nurses, and every medical professional involved in the birthing process should be aware of conditions that put a child at risk of a brachial plexus injury. For example, if the mother has a small pelvis and the child a large head, it’s a case of cephalopelvic disproportion, which is much more likely to cause the baby to get "stuck" and require mechanical force to remove. The same is true of a baby in breech position, in a head-first position, or a baby that is larger than average. An early water break and prolonged labor can also be a problem due to the lack of amniotic fluid cushioning the child in the womb. The use of forceps to pull a child out is risky, and should only be done in specific situations by an experienced practitioner.
The greatest danger of OBPI is shoulder dystocia, a complication where the child’s head exits the birth canal but the shoulder remains lodged on the mother’s pelvic bone. When doctors try to pull the head from side to side, back and forth, it can easily stretch or tear the nerves. Also, any breaks to collarbone during birth (which is sometimes done to deliver a child with shoulder dystocia) can also cause damage to the brachial plexus beneath it.
However it happens, brachial plexus palsy is almost 100% avoidable, and Leventhal Puga Braley P.C. has taken on many negligent medical providers on behalf of injured children and their parents. Call (877) 433-3906 to speak to a top Denver birth injury lawyer about your situation. Remember, we handle cases from around the United States and do not charge you any fees until we win you a satisfactory settlement or jury verdict.
- What Is Erb’s Palsy And How Can It Affect Your Newborn?
- Erb-Duchenne and Dejerine-Klumpke Palsies Information Page
- Klumpke Paralysis - NIH