When you know or suspect your baby has Erb’s Palsy — one of the most devastating conditions stemming from birth trauma — you need to understand:
• What is Erb’s Palsy?
• How is Erb’s Palsy diagnosed?
• What causes Erb’s Palsy?
• What are the possible symptoms of Erb’s Palsy?
• What are the treatment options?
• What are the long-term implications of a baby born with Erb’s Palsy?
• How much will a diagnosis of Erb’s Palsy cost my family?
Erb’s Palsy is one of several brachial plexus injuries. “Brachial” means “of the arm” and “plexus” is a connected group of nerves. So, the brachial plexus is a network of nerves. This network communicates messages or signals from the spinal cord to the shoulder, arm and hand.
Erb’s palsy is the most common form of brachial plexus injuries, which become apparent at childbirth. A “palsy” is a weakness. Erb’s Palsy is a particular weakness affecting the region from the shoulder to the elbow. Sixty percent of brachial plexus injuries are Erb’s Palsy diagnoses.
A diagnosis of Erb’s Palsy is typically made by a pediatrician, an orthopedic surgeon, a pediatric neurosurgeon or a microsurgeon. The physician will examine the baby and order certain tests. These include imagery like an MRI or a CT scan in combination with an EMG (electromyogram, which tests the electrical activity of muscles). The EMG can detect abnormal electrical activity when there has been nerve damage, which is a component of Erb’s Palsy.
If you think your baby’s arm is showing signs of Erb’s Palsy, insist on having your child evaluated and that the proper clinical tests are ordered.
Parents should be aware that it can be somewhat difficult to detect Erb’s Palsy in infants, as they don’t move their arms and shoulders a great deal.
Not all Erb’s Palsy cases are a result of complications during childbirth.
The most typical situation is that the baby is delivered in such a way that too much pressure is placed on the baby’s neck, shoulder and arm. This causes damage to the arm, shoulder and hand, which creates the weakness known as Erb’s Palsy.
The brachial plexus can be stretched, ruptured, or even completely torn off the spinal cord, which is known as an avulsion. In addition, a neuroma can form. This occurs when there has been an injury and scar tissue has grown around the injury, preventing proper functioning of the nerve signal system.
In many cases, Erb’s Palsy could have been prevented by better management of a mother’s pregnancy and delivery. Babies with a weight over 9 pounds and babies of mothers with diabetes are at high risk of being delivered with Erb’s Palsy.
The major causes of Erb’s Palsy are:
• Large babies
• Prolonged or complicated labor
• Breech birth (baby is not coming out head first)
• Use of forceps
• Baby spends an extended amount of time in the birth canal
• Difficulty delivering the shoulder (after head has emerged)
These situations can be prevented by medical personnel. But medical personnel fail to protect babies and contribute to the incidence of Erb’s Palsy when they do the following:
• Fail to diagnose gestational diabetes in the mother
• Fail to predict the baby’s size accurately
• Fail to accurately predict the time of gestation, allowing the pregnancy to go beyond full-term status
• Fail to obtain a complete history of the mother, including prior history or symptoms of diabetes or delivery of large babies
• Fail to help birth mothers manage weight gain
• Fail to deliver the baby via Cesarean section, especially after the baby has been in the birth canal for an extended amount of time
• Exert pressure on the baby’s neck during and before delivery, causing stretching, tearing or avulsion
• Improperly use forceps
Depending on the severity of the injury, Erb’s Palsy can be pervasive or minor, long-lasting or temporary. These are some of the symptoms of Erb’s Palsy:
• Weakness in the arm or shoulder
• Reduced mobility of the arm and shoulder and reduced range of motion
• Inability to flex or rotate the shoulder or upper arm
• Loss of feelings in the arm, shoulder or fingers
• Bruising or swelling
• Permanent nerve damage
• Partial paralysis
Erb’s Palsy can be treated. Sometimes significant improvements occur, and there are surgical and non-surgical treatments.
In less severe cases, extensive physical therapy can improve movement, sensation and mobility. This may require visits with the therapist as well as training parents and caregivers so that continued progress can be made.
Some children may be candidates for nerve reconstruction surgery, which should occur before the child celebrates his or her 1st birthday. There are other surgeries like muscle transfers, which should occur during early childhood but later than the nerve reconstruction surgery. The muscle transfer is not always a complete cure, but it may return some mobility, sensation or range of motion.
Erb’s Palsy, when it cannot be resolved, is a permanent limitation of mobility in the upper arm and shoulder. This means a child may have issues learning to crawl; issues with balance and walking; and diminished strength, which could affect self-care issues such as getting dressed, playing with playmates and participating in sports. Erb’s Palsy may contribute to episodes of pain and numbness. It also may impair the child’s ability to write and participate in all aspects of school.
At Giroux Pappas Trial Attorneys, it’s our job to evaluate the severity of your child’s Erb’s Palsy and determine what current and future expenses you may incur. These can include:
• Medical expenses from diagnostic tests to surgery, including doctor visits and prescription medication
• Therapeutic intervention, specifically physical and occupational therapy
• Educational testing and accommodation, especially if fine and gross motor skills are impaired
• Rehabilitation expenses
• Loss of income for parents during medical treatment and therapy
• Diminished future earnings potential of the child
When your child has been diagnosed with Erb’s Palsy, there is much to be done. One of the most important things you need to do is protect your child and protect your family. Find out if this regrettable birth defect was caused by medical malpractice — the failure to properly deliver your baby. If a medical professional failed to provide reasonable care during the mother’s pregnancy and childbirth, you may be entitled to financial compensation — money that you will need to take care of the long-term needs of this child.
Call Giroux Pappas Trial Attorneys today to take care of your child and take care of your family.
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