The term given to the nerves running between the spine and shoulders is called the brachial plexus. These nerves control the movement of muscles in the human shoulders, hands, and arms. Damages to the brachial plexus, however, can occur when a physician behaves negligently by not providing the proper obstetrical care.

A brachial plexus injury can occur to an infant during natural child birth. If an infant is too big and cannot drop through the mother's pelvis, the baby's shoulder may get stuck behind the pelvic bone even though its head has already passed through the area. A doctor may try to complete the natural delivery instead of performing a C-section. This can stretch the infant's neck to the point of damaging the nerves in the brachial plexus.

Three Kinds of Brachial Plexus Injuries:

1. Rupture: Surgery is required because the nerves in the plexus have been torn in one or more places.
   
   
2. Stretch: Bruising or swelling that occurs during birth because the baby's shoulder has gotten stuck in the pelvic bone, compressing the nerves in the plexus to the point of damage—although the degree of damage may vary in severity. Although stretch injuries can heal spontaneously within two years and possibly full restore complete functionality, neuroma—the scar tissue that presses down on the nerves—may develop and have to be removed with surgery.
   
   
3. Avulsion: This is the most severe type of plexus injury. Surgery and muscle transfer may be necessary for the infant to regain function. Avulsion occurs when nerves are pulled away from the spine resulting in a completely flaccid extremity. Avulsion may also lead to Horner's syndrome.

Klumpke's Palsy and Erb's Palsy

This injury affects the nerves in babies. Klumpke's Palsy refers to damage in the lower plexus, while Erb's Palsy refers to nerve damage in the upper plexus. Klumpke's and Erb's can both lead to paralysis or weakness that comes from stretching the nerves during delivery. Children who have Klumpke's Palsy do not have full range of movement in their hands and wrists, while children with Erb's Palsy are not able to fully move their shoulder and arms.

If a doctor doesn't notice that the baby is too large for natural delivery, does not perform a caesarean birth instead, or uses the wrong delivery method once baby's shoulder becomes stuck (known as shoulder dystocia), then the physician may have behaved negligently.

Signs a Doctor Should Look For To Indicate That A Baby May Be Too Large For Natural Delivery:

1. Obesity: If the mother is obese, chances are she may deliver a large baby.
   
   
2. Gestational diabetes: A doctor should always test the fetus for this type of diabetes. Larger babies are often associated with gestational diabetes.
   
   
3. The McDonald measurement or fundal height: A physician records the measurements from the top of the uterus to the top of the pubis during prenatal visits. If measurements are too big, the doctor should be able to observe the size of the baby.
   
   
4. Excessive weight gain during pregnancy: If a mother is 30 years of age or older and she gains a lot of weight during her pregnancy, there is a chance she will deliver a big baby.
   
   
5. Maternal history: If the last baby that a mother delivered was large in size, there is a good probability that her next infant will be large also.

If a doctor believes that the baby about to be delivered may be large, he or she should use an ultrasound to confirm this observation. If the doctor does not use the correct method for delivery, he or she may be liable for malpractice.

Correct Delivery Techniques for a Large Baby May Include:

• Caesarean section.
• Suprapubic pressure.
• McRoberts maneuver.
• Wood's corkscrew maneuver.

For more information, or to speak with one of our medical malpractice attorneys, contact us online or call Rosenbaum & Associates at 1-800-7-LEGAL-7 today. You can also request a Free Case Evaluation online. Our law offices are located in Philadelphia, and our medical malpractice attorneys are proud to represent medical malpractice victims throughout New Jersey and Pennsylvania.