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Brachial Plexus Injury & Erb’s Palsy

Medical malpractice lawyers in Maine serving Portland, Lewiston, Bangor and Auburn.

baby getting examined by doctorChildbirth can be fraught with complications and in some cases can result in serious injuries to a baby. One of these is known as brachial plexus injury, or Erb’s palsy, caused by paralysis of the arm due to harm caused to the network of nerves connecting the spinal cord to the muscles of the shoulder, elbow and arm. This network of nerves is known as the “brachial plexus.”

If you or a family member has experienced the heartbreaking effects of a botched childbirth resulting in brachial plexus injuries or Erb’s palsy, the Portland, Maine-based personal injury lawyers of Hardy, Wolf & Downing want to hear from you.

For more than a quarter century, our birth injury attorneys have fought to protect the rights of victims of negligence and malpractice on the part of medical practitioners who should know better—and we want to help you recover the compensation you deserve, too.

Types of brachial plexus injury and required treatments

About two babies in 1,000 experience brachial plexus injuries at birth. About one in 10 of those infants will demand surgical treatment while others will recover full nerve function without surgery—albeit through sometimes extensive physical and/or occupational therapies.  In cases where surgical repair is required, an orthopedic surgeon may need to correct bone, joint or muscle deformities and graft nerves or tendons onto areas where tissue damage has occurred.

There are several types of brachial plexus injuries, which can lead to Erb’s palsy:

  • “Neurapraxia”occurs when the nerves inside the spinal cord are stretched but not broken, causing a temporary loss of motor and sensory function. Within around three months, affected infants should recover.Neurapraxia is the most common form of brachial plexus injury.
  • “Rupture” is another common brachial plexus injury, signified by the tearing of nerves in the neck, shoulder or arm.
  • “Neuroma” involves the forming of scar tissue around nerves, causing pain and reduced functioning that requires surgery. Surgery in such cases will attempt to repair and reconstruct the nerve and/or perform secondary tendon transfers.
  • “Avulsion” is the tearing of nerve roots from the spinal cord and represents anywhere between 10 to 20% of brachial plexus injuries. In such cases, damaged tissue necessitates a nerve transplant. In instances where avulsion has hurt the nerve to the diaphragm, an infant will experience respiratory problems. “Horner’s syndrome,” signaled by a drooping eyelid on the affected side of the infant’s body, is a particularly extreme manifestation of avulsion.

Common symptoms of brachial plexus injury and Erb’s Palsy

Your infant may be suffering from brachial plexus injuries if they are experiencing one or more of the following symptoms:

  • Pain
  • Bruising in areas of shoulders and/or upper arms
  • Loss of sensation
  • Muscle weakness
  • Paralysis or poor range of movement in some or all of the muscles of the shoulders and/or upper limbs

Possible causes of Erb’s palsy and brachial plexus injuries

The majority of Erb’s palsy or brachial plexus injuries happen as a result of a complicated childbirth that involves “shoulder dystocia.”

Dystocia happens when a baby’s shoulders become wedged in the birth canal as the baby passes through. A great percentage of dystocia-related injuries are preventable, brought on only by the negligence of attending medical professionals who fail to take appropriate safety precautions required by prevailing obstetric standards.

In the state of Maine, certain medical standards govern situations in which shoulder dystocia and other birth complications may cause risks to the baby and/or mother in labor and delivery. Doctors are required to have a birth plan in place should such issues occur—for example, in the case of dystocia, gentle efforts to extricate the baby via forceps or a suction cup, or, alternatively, an episiotomy or C-section.

If a doctor instead applies excessive force to a baby’s head, neck, arms or shoulders, with pressing, pulling or twisting motions, that doctor may be held liable for resulting brachial plexus or Erb’s palsy injuries.

There are also certain risk factors that attending doctors and medical teams should look for in delivering a baby more prone to dystocia.

Medical professionals should look for the following warning signs:

  • Disproportionate relative size of the baby and mother
  • Gestational diabetes
  • Previous brachial plexus injuries
  • Slow descent or dilation

When attending medical professionals fail to act responsibly in situations where the above warning signs are present and may indicate complications to come— including the possibility of harm to the brachial plexus nerves— these professionals may be acting negligently and can be held responsible with a medical malpractice claim.

The job of our birth injury lawyers will be to get clear answers to the following questions: Why did brachial plexus injuries or Erb’s palsy occur?  What, in other words, caused your baby’s injuries? Did the doctor do everything possible to facilitate a health birth? Were the nurses attentive to the mother’s needs and abide by legally required standards of care?  Was the hospital fully equipped to deal with a complicated birth situation?

Portland, Maine birth injury attorneys

In the aftermath of a difficult delivery resulting in sometimes permanent and severe brachial plexus injuries or Erb’s palsy, there is little consolation to be found. For parents and families whose children will face the costly lifelong consequences of a difficult delivery, often the only recourse that will offer any sort of comfort is to find a trustworthy lawyer who can advocate on your behalf.

We at the law offices of Hardy, Wolf & Downing understand. We know the pain you will suffer in the form of expensive reparative surgeries, unending medical bills and often enduring pain and suffering. Our team of Maine medical malpractice attorneys and heath care experts can help you get to the bottom of what went wrong and help you chart a path towards restoration. Call our offices today for a free case evaluation today.

  1. Mayo Clinic, “Brachial plexus injury,”
  2. Ortho Info“Erb’s Palsy(Brachial Plexus Birth Palsy),”