Klumpke’s palsy occurs when the nerves running down the side of the neck are damaged, affecting the function of the forearm, hand, and wrist. The injury may be mild to severe, causing sensation loss, loss of control over movement, muscle weakness, and paralysis. This type of palsy most often occurs in newborns due to damage during labor and delivery.
In some cases the damage that a baby suffers to the brachial plexus nerves during delivery is not preventable. But most of the time it is preventable and some error or poor judgment on the part of a doctor or midwife led to the damage. Klumpke’s palsy may cause permanent disability and if your child was born with this condition you may be facing lifelong medical costs. Let a malpractice lawyer help guide you as you decide whether or not to file a medical malpractice suit.
Brachial Plexus Nerves and Klumpke’s Palsy
The brachial plexus nerves are several nerves that run from the spinal cord down each side of the neck to the two arms. They are responsible for sensation and control of movement in the arms. When those nerves are damaged, which may occur when the head and shoulder are forced apart, stretching or even tearing the nerves, it can result in palsy. This is when the damage causes loss of sensation, muscle weakness, or lack of control in any part of the arm.
When the nerve damage results in palsy in the wrist or hands or in the forearm, as opposed to the upper arm or shoulder, it is called Klumpke’s palsy. This type of palsy is rare, and occurs in just one percent of cases of damage to the brachial plexus nerves. If the damage is mild, the resulting palsy is also mild and usually temporary. The baby will have function restored within a few months. If the damage is severe, such as if the nerves are torn or completely sundered from the spinal cord, the disability may be severe, causing paralysis even, and likely permanent.
Causes of Klumpke’s Palsy
In nearly half of all instances in which a child suffers brachial plexus injuries, the cause is shoulder dystocia. This occurs when the baby’s shoulder gets stuck in the birth canal as the head emerges. The person delivering the baby may have to use a lot of force to dislodge it, and this can stretch out the nerves causing damage that may result in Klumpke’s palsy. Shoulder dystocia is the most common cause of brachial plexus damage, but there are other ways in which it may occur. All of these causes ultimately result in the nerves being stretched and damaged.
Medical Errors Leading to Klumpke’s Palsy
Shoulder dystocia is a major cause of Klumpke’s palsy, and in many cases a situation that could have bene prevented. While in some cases there is little to nothing the doctor or other professional could have done differently, in many the accident was preventable. For instance, the doctor may have failed to detect that the baby was unusually large, which increases the risk of shoulder dystocia. There may be other complications that should have been detected, or it may be clear that a cesarean section could have prevented the damage but that the doctor failed to order it.
Other ways in which a medical error can cause Klumpke’s palsy include:
- Excessive force in delivering a baby.
- Not detecting early enough that the baby is in the breech position.
- Not identifying other potential complications or the need for a cesarean section.
- Identifying the complications but acting too late to avoid damage.
- Misuse of instruments such as a vacuum extractor or forceps, resulting in too much force on the baby’s head or neck.
To prove that medical errors that led to Klumpke’s palsy were negligent and constitute medical malpractice, a legal team must prove that the medical professional had a duty to provide care, breached that duty, and because of the breach caused harm and damages to the baby and his or her family. Proving a breach in duty to care, or standard of care, requires showing that the medical professional who made the mistake could have done something differently, and that a similar professional would have avoided the mistake and the resulting damage.
Consequences of Klumpke’s Palsy
The consequences of being born with Klumpke’s palsy vary depending on the individual injury. The prognosis is generally poorer than for the more common Erb’s palsy, which affects the upper part of the arm. In some cases the injury may be mild and a baby will recover hand and arm function within a few months, requiring some therapy or massage.
In cases that are more moderate or severe, a child may end up with a permanent disability that could be as debilitating as complete paralysis. The child may then face a need for lifelong care or treatment; and there may be surgeries and ongoing expensive therapies, medications, and other types of medical treatment. The parents may need to stop working and earning to care for the child and there is the possibility that the child and family will suffer emotionally as well as physically.
Examples of Malpractice Cases
Cases in which families file lawsuits over brachial plexus injuries are not uncommon, although those citing Klumpke’s palsy are less common as the condition is rare. One case is ongoing and involves a young girl whose hand and lower arm were partially paralyzed by a birth injury. The family says that the doctor who delivered the baby used unnecessary force in pulling her out of the birth canal and caused nerve damage as a result. Whether they will win compensation for their daughter remains to be seen.
In another case a jury awarded a young girl $2 million for the brachial plexus injury she suffered at birth. The family accused the doctor delivering the baby of failing to identify shoulder dystocia. As a result the doctor pulled very forcefully on the baby, using a vacuum extractor, causing the nerve damage. The family also said that the doctor failed to detect complications leading up to the delivery that increased the risk of shoulder dystocia.
Klumpke’s palsy is not a very common condition caused by birth injury, but when it does occur it can have devastating consequences and is often found to have been preventable. Compensation from a lawsuit or settlement can help the family provide the best care and future for a child with this condition, but it is important to rely on the expertise of a medical malpractice lawyer before proceeding with legal action.