Frequently Asked Questions – Erb’s Palsy

It’s difficult to ignore the tragedy of a newborn infant suffering an injury during delivery. Erb’s palsy, a fairly common birth injury, is nearly always preventable. However, due to medical negligence, many newborns and older babies end up with the medical condition, creating an even more heartbreaking situation for parents.

What Is Erb’s Palsy?

Erb’s palsy, also called brachial plexus palsy, is a medical condition that causes paralysis or weakness of the arm. It’s commonly found in newborns who suffered a difficult or abnormal delivery. The condition involves the nerves in the neck that control arm motion, turning the affected muscles inward, disrupting the infant’s mobility. This type of birth injury occurs when a baby’s neck is stretched during delivery as its head and shoulders travel through the birth canal. There are times that Erb’s palsy occurs due to challenging deliveries, but many cases happen as a result of medical negligence. 

How Common Is Erb’s Palsy?

According to the American Association of Neuromuscular and Electrodiagnostic Medicine, obstetric brachial plexus injuries, or Erb’s palsy, occurs in as many as 2.6 per 1,000 full-term live births. It’s impossible to say how many of these cases occur due to medical negligence, as each case is unique.

What Are The Symptoms of Erb’s Palsy?

Typically, the symptoms of Erb’s palsy are immediately evident after childbirth, although there are times that symptoms are not detected until days or weeks following delivery. Babies who are suffering from Erb’s palsy are usually seen with the affected arm lying by their side with an elbow that lacks movement.

Some of the other symptoms, which can range from mild to severe, you may see in babies with Erb’s palsy include:

• use or movement of hands, but not the elbow or shoulder
• minimal control of arm movement
• no muscle control in the arm
• paralysis of the whole arm, with the fingers and hand hanging limp
• paralyzed face on the affected side
• in older babies, the inability to sit up unassisted or to crawl unaided

What Are The Types of Erb’s Palsy?

There are different types of Erb’s palsy, categorized based on the type of nerve damage that’s occurred. These types include:

• Avulsion: this occurs when the nerve is torn from the spine
• Neuroma: this occurs when the nerve has attempted to heal, but there is scar tissue that has developed around the injury placing pressure on the damaged nerve praxis
• Rupture: this is when the nerve is torn, but not from where it’s attached to the spine
• Neuropraxia: this is the mildest type of injury, involving a physiologic block of nerve conduction within an axon without any anatomical interruption

How Does Erb’s Palsy Happen?

Erb’s palsy commonly occurs when there is a difficult labor and delivery. It happens when doctors or other medical staff have to tug or pull the baby in positions that aren’t normal. If a baby is lodged in the birth canal, it may become necessary to dislodge it quickly to avoid oxygen deprivation, which can cause brain damage. There are times when a doctor will make a judgment call to risk Erb’s palsy rather than delay the delivery and risk brain damage.

There are different types of pulling that can lead to Erb’s palsy, including:

• When a baby is positioned feet first, Erb’s palsy can result from pulling the legs and feet, which causes the arms to go over the head, putting unnatural stress on shoulder joints.
• When a baby is positioned face first, Erb’s palsy can result from pulling by the face and neck.
• When the baby is too large to move through the birth canal, it can be squeezed and pushed, resulting in unnecessary stress on the neck, shoulders, and arms. In some cases, one of the baby’s shoulders may get caught on the mother’s pubic bone.
• Erb’s palsy can happen after birth when the medical staff lift the baby from its arms instead of supporting the baby’s back and neck.
• Erb’s palsy can also occur with the improper use of tools that assist in delivery, such as a vacuum extraction tool or forceps.

How Is Erb’s Palsy Treated And Can It Be Cured?

There are various types of treatments used for Erb’s palsy, depending upon the severity of the condition in the baby. Some of these brachial plexus injuries heal on their own within a short amount of time. In other cases, treatment may include physical therapy and daily exercises to improve functionality. In still other cases, it may be necessary for babies to have surgery to repair injuries. Typically, surgery is beneficial when it’s done between the ages of five months and one year. There are some cases where it’s necessary to have more than one procedure done over time.

While Erb’s palsy is often treatable, it isn’t always curable. There are cases in which the injuries from Erb’s palsy are not completely resolvable, and the child will have life-long problems.

Is Erb’s Palsy Preventable?

Many cases of Erb’s palsy could’ve been prevented had physicians or other medical professionals acted differently. While it isn’t always possible for a doctor to anticipate the angle that a baby will come out, the doctor is responsible for making sure the baby and mother are safe throughout labor and delivery.

Doctors can prevent cases of Erb’s palsy in multiple ways. They are responsible for having various tests run that determines the size, health, and position of the baby before labor and delivery. That allows them to estimate how the delivery will progress and to determine the likelihood that complications will occur. Monitoring the size of the baby throughout pregnancy is a key responsibility that helps prevent Erb’s palsy from occurring, because it shows if the baby is too large to fit through the birth canal. If it’s determined that the baby is too big, then the doctor should schedule a C-section for delivery.

What Should You Do If Your Baby Has Erb’s Palsy?

Babies who suffer birth injuries like Erb’s palsy can require extensive medical care. For parents, the injuries suffered by their child are often devastating, emotionally and financially. When Erb’s palsy is caused by the negligence or error of a medical professional, the baby and the baby’s parents may be entitled to compensation in a medical malpractice claim against the responsible party.

At Ross Feller Casey, we have a team of Ivy League educated doctors who are available to consult on these types of birth injury cases. They can thoroughly review medical records and identify when medical negligence happened. We also have expert birth injury attorneys with long track records of winning major Erb’s palsy cases, resulting in financial recoveries for families that have suffered the negative impact of a birth injury.

Let Ross Feller Casey help with your Erb’s palsy claim. Contact our offices today to schedule a free case evaluation. All birth injury cases are handled on a contingency basis, so there is no charge to you until your case is won or settled.