Erb’s Palsy and Shoulder Dystocia: Proving Negligence in Pennsylvania Birth Injury Cases
A difficult delivery can change within seconds when a baby’s head is born, but the shoulders do not follow. Shoulder dystocia places the baby in a vulnerable position because the nerves extending from the neck into the shoulder and arm can be stretched or damaged as the delivery continues. An injury to the upper part of this nerve network, known as the brachial plexus, can leave a newborn with weakness or paralysis associated with Erb’s palsy.
One of the first signs can be an arm that does not move normally after birth or a baby who cannot fully bend the elbow or lift the shoulder. Early weakness can lead to questions about how the delivery unfolded once the shoulder became lodged and what steps were taken to complete the birth. Working with an experienced Philadelphia Erb’s palsy lawyer can help clarify whether the response to shoulder dystocia fell below accepted obstetrical standards.
Shoulder Dystocia Changes a Delivery Quickly
Shoulder dystocia occurs when the baby’s head has emerged, but one or both shoulders remain trapped behind the mother’s pelvic bone. It can develop even after labor has progressed normally. Risk factors such as a larger baby or maternal diabetes can raise concern before delivery, but they do not reliably predict which births will involve the complication.
Once the shoulder becomes lodged, the obstetrical team has to change the way the delivery is managed. Recognizing the impaction quickly allows the physician and nursing staff to move into the specific maneuvers used to free the shoulder and complete the birth.
Little time separates recognition of the problem from the effort to resolve it. The baby remains partly delivered while the team works to release the shoulder, making an organized response particularly important during those urgent moments.
How Erb’s Palsy Affects the Brachial Plexus
The brachial plexus carries nerve signals from the spinal cord into the shoulder, arm, and hand. Damage to the upper nerves can interfere with movement and sensation, leaving the affected arm weak or partially paralyzed after birth. A newborn may hold the arm close to the body, have difficulty bending the elbow, or show less movement on one side.
Some stretched nerves recover over time, while more extensive damage can leave persistent weakness, limited range of motion, or loss of function in the shoulder and arm. Recovery depends in part on the severity and location of the injury, and specialist follow-up can track how much strength and movement return during the first months of life.
Erb’s palsy identifies the pattern of weakness seen after birth. Different forces during labor and delivery can injure the same group of nerves, so the diagnosis has to be considered alongside the circumstances surrounding the difficult shoulder delivery.
The Delivery Response Can Affect the Brachial Plexus
Obstetricians use established maneuvers designed to release an impacted shoulder by changing the position of the mother or baby. Repositioning can create additional room for the shoulder and reduce the need for traction on the baby’s head and neck.
Repeated or excessive traction places additional tension on the brachial plexus while the shoulder remains trapped. The sequence of maneuvers and the amount of force used during delivery provide important context for understanding how a nerve injury occurred.
Nurses and other staff assist with repositioning, bring additional personnel into the room, and support the physician as the delivery progresses. A coordinated response keeps the team moving through the necessary maneuvers during an emergency in which both technique and timing carry real consequences for the baby.
Proving Negligence in an Erb’s Palsy Claim
An Erb’s palsy diagnosis identifies the injury; proving negligence requires a separate medical assessment of the delivery. Pennsylvania’s Medical Care Availability and Reduction of Error Act, 40 P.S. § 1303.512, sets qualifications for physicians who provide expert testimony concerning standard of care and causation in medical professional liability claims.
What happened after the shoulder became lodged is central to that review. Qualified medical testimony can address the delivery technique used, compare the response with accepted obstetrical practice, and explain how the child’s pattern of nerve damage relates to the forces involved during birth.
Brachial plexus damage can arise through different mechanisms. A negligence claim therefore depends on medical testimony that connects an identified error during delivery with the lasting injury rather than treating the diagnosis itself as proof of malpractice.
Erb’s Palsy Can Look Different as a Child Grows
Recovery can remain uncertain during the first months after birth. Early therapy may begin while the nerves heal, but lasting limitations often become easier to see as the child starts reaching, crawling, dressing, playing, and using both arms together.
Persistent weakness can affect shoulder development, range of motion, coordination, and strength. More significant nerve damage can require physical or occupational therapy, specialist care, or surgery. School, sports, dressing, grooming, and other everyday activities can reveal limitations that were difficult to measure during infancy.
Treatment often evolves as the child grows and new movement limitations become easier to identify. Guidance from a knowledgeable Philadelphia Erb’s palsy lawyer can help address the legal impact of permanent weakness, limited motion, and ongoing treatment.
Contact The Villari Firm
If your child was diagnosed with Erb’s palsy after a delivery complicated by shoulder dystocia, questions often remain about how the shoulder was released and how the injury occurred. The Villari Firm represents children and parents throughout Pennsylvania in birth injury claims involving brachial plexus damage and preventable delivery errors.
Contact The Villari Firm today to speak with one of our trusted Philadelphia Erb’s palsy lawyers and learn what legal options may be available after a preventable brachial plexus injury.
Sources:
- Pennsylvania General Assembly — Medical Care Availability and Reduction of Error Act, 40 P.S. § 1303.512 Expert Qualifications
legis.state.pa.us/WU01/LI/LI/US/HTM/2002/0/0013..HTM - American College of Obstetricians and Gynecologists — Shoulder Dystocia
acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/05/shoulder-dystocia - National Institute of Neurological Disorders and Stroke — Brachial Plexus Injury
ninds.nih.gov/health-information/disorders/brachial-plexus-injury