September 29, 2011

Erb’s palsy, also known as brachial palsy, occurs when the collection of nerves around the shoulder that are known as the brachial plexus are damaged during birth. The result may be a permanent loss of movement or weakness in the affected arm, the degree of which varies from patient to patient.

Brachial plexus injuries most often affect the upper arm only whereas Erb’s palsy (or Erb’s paralysis ) affects the upper and lower arm. (A condition known as Klumpke paralysis affects the hand and may also result in droop of the eyelid on the opposite side).

During delivery of a newborn, the brachial plexus may be injured as a result of the baby’s head and neck being pulled toward the side as the baby’s shoulders pass through the birth canal. Pulling on the shoulders during a head-first delivery or pressure on the baby’s raised arms during a feet-first delivery (breech delivery) may also result in injury to the brachial plexus. The injury to the brachial plexus may occur during a difficult delivery and may be caused be the negligence of the person performing the delivery if proper technique is not used or mismanagement of the delivery occurs.

Symptoms of Erb’s palsy or brachial plexus injuries may be present if the newborn is not moving his/her upper or lower arm or hand after birth, if the arm is bent at the elbow and is held against the body, if there is decreased grip on the affected side, or if the Moro reflex is absent on the affected side. A physical examination of the newborn typically will show that the baby is not moving the affected upper arm, lower arm, or hand, and the affected arm may flop when the baby is rolled from side to side. A full recovery within six months occurs in most cases. However, if a baby with a brachial plexus injury does not fully recover within six months, the prognosis for full recovery is poor.


(The Moro reflex is a normal involuntary reflex in newborns that typically disappears within three to four months after birth. The Moro reflex is tested by placing the baby face up on a soft and padded surface. The baby’s head is then gently lifted with enough support to just begin to remove the baby’s weight from the padding. The baby’s head is then released suddenly and allowed to fall back just momentarily but then quickly supported again before it can bang on the padding. The baby may have a startled look with his arms flinging out sideways with his palms up and his thumbs flexed. As the reflex ends, the baby draws his arms back to his body with elbows flexed and then relaxes. Lack of the Moro reflex on both sides may indicate a brain or spinal cord injury. Absence of the Moro reflex on one side may indicate a broken shoulder or Erb’s palsy. Only a trained medical professional should perform testing for the Moro reflex.)


Not all cases of brachial plexus injury occurring at birth are caused by medical malpractice.  However, if the delivering medical provider failed to take appropriate measures to avoid a difficult delivery or failed to use appropriate delivery techniques, then there may be a claim for medical malpractice.

If your baby was born with Erb’s palsy or injury to the brachial plexus, you and your baby may have claims for medical malpractice that should be investigated. Visit our website to be connected with medical malpractice lawyers in your local area who may be able to assist you with your claim or call us toll free 800-295-3959 for help finding a medical malpractice attorney in your area.

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