Erbs Palsy – Brachial Plexus Injury – Birth Injury – Medical Negligence

Obstetric Erbs palsy (meaning birth-related) occurs in about 1 out of every 2,000 births. The most tragic aspect of this condition is that it is an entirely preventable birth injury. Erbs palsy is an injury to the network of nerves that lie across the chest area. Damage to the nerves is most often caused during birth and may be associated with other conditions most notably Klumpkes palsy, brachial plexus palsy and Horner’s syndrome. Erbs palsy manifests its self as an injury to the nerves that control the arm, wrist and hand and may vary in severity. The classical injury is where the arm hangs limp with the hand pointing backwards in the ‘waiters tip’ configuration. Erbs palsy is usually caused by medical negligence during a difficult delivery where excessive force is applied to the infant’s head which stretches and damages the nerves that pass from the spinal cord, across the chest to the arms and onward to the tips of the fingers. Whilst there may be some early recovery, the injury is permanent with little possibility of recovery.


Symptoms of Erbs palsy may be apparent immediately following the birth. These symptoms include reduced sensitivity or numbness in the child’s wrist, hand or arm. Symptoms can also include a limp or paraylysed hand lacking in muscle control. Other signs of Erbs palsy include the child holding the affected arm down at their side. In addition, the affected arm will not respond as expected to the startle reflex.

Shoulder Dystocia

The most common scenario that causes Erbs palsy results from shoulder dystocia which occurs when the child’s shoulder becomes trapped behind the mother’s pubic bone. There are well established protocols to deal with this problem which is a life-threatening situation. If a midwife or doctor fails to properly follow the protocols which include the McRoberts manoeuvre and thereafter applies excessive force to facilitate delivery, damage to the brachial plexus network of nerves may result in Erbs palsy. In this situation the injury has been caused by medical negligence and the victim’s parents are well advised to see an Erbs palsy compensation claim solicitor as soon as possible.

Risk Factors

There are well known risk factors Erbs palsy and any doctor or midwife who ignores these matters and does not make alternative arrangements to a natural birth may be liable to pay damages in a subsequent medical negligence compensation claim, :-

    large foetus

    small maternal pelvis

    maternal obesity

    diabetes mellitus

    post maturity

    previous shoulder dystocia

    prolongation of the late first stage of labour

    prolonged second stage of labour

    assisted vaginal delivery

Types of Injury

There are four types of birth injuries that can result in Erbs palsy:

    Avulsion: The nerve is torn from the spinal cord and completely severed. Cases of avulsion cannot be corrected through surgical repair. Avulsion is the most severe of the four types of injuries.

    Rupture: The nerve is torn from the spinal cord, but it is not completely severed or separated. There is a chance of a successful surgical repair, but even successful surgeries may not result in the recovery of the full function of the affected body part.

    Stretching: Stretching can damage the nerves, but with this type of injury, there is a chance of spontaneous recovery and the child may heal on their own without surgery.

    Scarring: Known as a neuroma, scarring interferes with the body’s ability to send electrical signals along the damaged nerve. Surgical removal of the scar tissue may be possible and can result in improved or fully recovered motor function.

Erbs palsy leaves a child with a lifetime of difficulties. In addition to living with a disability, the child can also experience psychological trauma, physical pain and emotional suffering. As the child ages, the extent of the disability may increase due to the onset of arthritis and problems caused by overusing other body parts in order to compensate for the disabled body part or parts.

Time Limits

Time limitation is a difficult legal issue dependent on location and you should take advice from a Medical Negligence Lawyers as soon as possible after the negligent event. If the time limit expires, then the ability to claim compensation may have been lost forever.


To prove negligence, it is necessary to show that the conduct of a healthcare professional has fallen below a reasonable standard. The standard of care provided by a doctor is compared with other physicians in the same field of medicine. Just because one treatment fails whereas another alternative treatment may have succeeded does not necessarily prove negligence. If a body of physicians would have approved the failed treatment (provided it was logical) then that failed treatment will not be judged to be negligent.