A brachial plexus injury occurs most commonly in newborns during delivery. It is an injury that results from damage to the nerves running along the side of the neck. Stretching of these nerves can cause mild to serious damage, resulting in temporary or permanent injury. The consequences of brachial plexus damage are reduction or loss of sensation or control of movement in the arm.
Too often these injuries are preventable, and the cause can be pinpointed as a medical mistake, such as poor judgement or too much force. When this happens parents often choose to file a medical malpractice suit against the responsible individual or medical team. If you have a child born with a brachial plexus injury, you may be able to follow the advice of an experienced malpractice lawyer to get compensation.
The Brachial Plexus Nerves
The brachial plexus is a group of five nerves, arranged in a bundle that runs from the spinal cord, along the neck, across the upper part of the chest, and into the armpit. The nerves affect sensation and movement in the shoulder, the upper and lower arm, and the wrist, hand, and fingers. Different nerves in this bundle are responsible for the different parts of the arm. There are two bundles of brachial plexus nerves, one on each side of the neck and leading to each arm.
Damage and Injury to the Brachial Plexus
When the nerves of the brachial plexus are damaged, it affects feeling, movement, and muscle control in the shoulder, arm, or hand, depending on which nerves and where along the nerves the damage occurs. Injuries to the brachial plexus nerves may occur at any stage of life. Any time the head and shoulder are pulled apart from each other with adequate force, the nerves may be damaged. A car accident and a sporting injury are examples of events that may cause such an injury in a person of any age.
The most common way in which these nerves are damaged is during childbirth. When the baby emerges from the birth canal, the head and shoulder or arm may get pulled forcefully apart, causing the nerves to be stretched and potentially damaged. The severity of the damage determines who severe the resulting injury is. The injury may be mild and temporary, or it may be severe and permanent. Babies with mild injuries usually recover within a few months with some massage and physical therapy. More severe cases may require surgery, but in many cases the child will always have a disability causing weakness, lack of sensation, or even paralysis.
There are three main types of injury caused by brachial plexus damage. An avulsion is most severe and occurs when the root of a nerve is torn from the spinal cord. This can usually not be repaired. A rupture occurs when the nerves are stretched enough to tear them, and surgery may be able to repair the damage. Stretching is the mildest type of injury, and in these cases the nerves often heal, with restoration of function occurring within a few months.
How Medical Mistakes Cause Injury
There may be instances in which the nerves get damaged during childbirth as a pure accident. There may have been no way for the physician, midwife, or nurse to have prevented the nerve injury. However, there are also too many situations in which the damage was preventable and the baby should not have had to suffer the injury.
The ultimate, underlying cause of brachial plexus injury is the stretching of the nerves, when the head and shoulder are pulled apart. This happens when part of the baby is in the birth canal, and the other is being pulled out. There are several mistakes that may be made resulting in this situation:
- Using too much force when delivering the baby
- Failing to notice that a baby is in the breech position
- Failing to identify a high birth weight, which can make delivery more difficult
- Failing to order a cesarean section when there are complications
- Detecting complications, but acting too late
- Failing to diagnose shoulder dystocia, when the baby’s shoulder is stuck in the birth canal
- Using tools that put too much force on the baby, such as forceps or a vacuum extractor
Brachial Plexus Injuries and Malpractice
According to research, birth injuries that cause permanent weakness or disability often lead to monetary damages and successful malpractice cases. One study found that for a 16-year period, between 1985 and 2001, 60 percent of cases related to brachial plexus injuries led to monetary awards for the plaintiff. The median amount paid out was $301,000, which is much higher than the median for all types of malpractice cases. Payouts were higher in teaching hospitals.
To demonstrate that a brachial plexus injury was the result of negligence and malpractice, there are four elements that must be proven: that there was a duty by the medical team to provide care for the mother and baby, that the duty was breached by a mistake, that the mistake caused harm, and that the harm resulted in damages. A common way to prove that there was a breach in care is to show that a similar medical professional, if put in the same situation, would have done something differently that would have prevented the injury.
Consequences of Brachial Plexus Injuries
Parents often choose to file malpractice lawsuits after brachial plexus damage because these injuries can lead to lasting consequences for the child for the rest of his or her life. When the injury is mild there may be some additional medical expenses to help speed and ensure the healing process. With moderate to severe injuries, though, there can be lifelong disability, including paralysis of the arm in the worst cases.
A child born with a moderate to severe brachial plexus injury will likely face long-term medical bills, surgeries and physical therapy, use of assistive devices, educational interventions, physical pain, emotional suffering, and a limited ability to do certain things that other children are able to do. For parents, there may also be emotional suffering and the loss of wages because it may be necessary to stay home with the child for a period of time.
Examples of Malpractice Cases
There are many examples of cases in which brachial plexus damage during delivery led to successful malpractice cases brought by the parents. In one extreme example, parents of a girl with brachial plexus damage won $20 million during a jury trial. The baby was in the breech position, but the doctor failed to order a cesarean section. As a result, excessive force was used to deliver her and she ended up with serious damage. The case also proved that the doctors failed to order follow up ultrasounds leading up to the birth that could have detected potential complications.
In another big case, a Delaware jury awarded parents $4.5 million after the doctor was found to be liable for brachial plexus damage. The baby suffered serious injuries that resulted in permanent disability in his arm. The jury awarded the parents $3 million for damages and the additional $1.5 million for prejudgment interest because it took nine years for them to get justice for their baby.
Brachial plexus injuries can have serious and lasting consequences for an individual and a family. In many instances the damage could have been prevented and parents often seek damages as a result. If you have a child that is suffering because of brachial plexus nerve injuries, let a malpractice lawyer help you determine if you have a successful case.