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Erb’s palsy is a type of brachial plexus injury that can affect a newborn’s shoulder and upper arm. Some children regain substantial movement as the affected nerves recover. Others may experience persistent weakness, restricted range of motion, differences in arm development, or permanent impairment requiring continued therapy or surgical care.
Parents may first notice that their baby is not moving one arm normally. In other cases, families remember a difficult delivery involving shoulder dystocia, several delivery maneuvers, or an assisted birth. These circumstances often point to how the birth was managed, and a review of the delivery records can show what went wrong.
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Erb’s palsy is an injury affecting nerves in the upper portion of the brachial plexus. The brachial plexus is a network of nerves extending from the spinal cord through the neck and shoulder into the arm.
These nerves help control movement and sensation. When excessive downward or sideways pulling on a baby’s head during delivery injures the upper brachial plexus nerves, a newborn may have difficulty moving the shoulder or upper arm.
Possible signs include:
The severity varies considerably.
Some injuries involve stretching that improves as the nerves recover. More substantial nerve damage can result in long-term weakness or loss of function.
Erb’s palsy falls within the broader category of neonatal brachial plexus palsy. According to an American College of Obstetricians and Gynecologists task force report indexed by the National Library of Medicine, neonatal brachial plexus palsy occurs in approximately 1.5 per 1,000 births.
Erb’s palsy commonly develops when too much force is applied to a baby’s head and neck during a difficult delivery.
One circumstance frequently associated with these injuries is shoulder dystocia.
Shoulder dystocia occurs when the baby’s head has been delivered but one shoulder becomes lodged behind the mother’s pelvic bone. Healthcare providers may need to perform specific maneuvers to release the shoulder and complete delivery.
Delivery teams are trained to anticipate shoulder dystocia and to resolve it with a recognized sequence of maneuvers that protect the baby’s nerves. When a child has Erb’s palsy, a legal investigation may examine:
Erb’s palsy can also result from other difficult deliveries, including those involving forceps or vacuum extraction. The delivery records show how the baby was delivered and what force was used.
Erb’s palsy generally affects the upper portion of the brachial plexus and is commonly associated with weakness involving the shoulder and upper arm.
Other brachial plexus injuries may involve additional nerve roots.
Depending on which nerves are affected, a child may have problems involving:
This distinction matters because the location and extent of nerve damage can influence treatment and prognosis.
A child with an injury limited to certain upper nerves may have different functional limitations from a child with more extensive damage affecting most of the arm.
Neurological examinations, physical assessments, imaging, nerve studies, and changes in movement over time may help establish the extent of injury.
When Erb’s palsy does not fully resolve, the effects may become more apparent as a child grows.
Possible long-term concerns include:
A child may require continued physical or occupational therapy to maintain movement and function.
Some children may need further neurological or orthopedic evaluation as the shoulder and arm develop.
Permanent impairment can also affect activities that require coordinated use of both arms, from dressing and schoolwork to recreation and eventually employment.
When medical negligence contributes to lasting nerve damage, evaluating a claim may therefore involve anticipated future treatment and functional limitations rather than only medical expenses already incurred.
Parents in this situation often want to know how their child’s injury could have been prevented, what future care may be needed, and what an independent review can reveal about what happened.
Yes. Some children regain substantial or full movement as the nerves recover.
Recovery depends on factors such as:
Treatment may include:
The long-term outcome may not be clear immediately after birth.
Some children show meaningful improvement during infancy. Others continue to have weakness or restricted movement as they grow.
A systematic review and meta-analysis reported an overall neonatal brachial plexus palsy incidence of 1.74 per 1,000 live births and identified shoulder dystocia, higher birth weight, maternal diabetes, instrument-assisted delivery, and breech delivery among associated risk factors.
When these risk factors are present, the healthcare team is expected to recognize them and prepare for a potentially difficult delivery.
Erb’s palsy supports a medical malpractice claim when the evidence shows that a healthcare provider failed to meet the accepted standard of care and that this conduct caused or contributed to the child’s nerve injury.
Depending on the circumstances, an investigation may examine whether providers:
Causation is shown through the delivery itself. The documented maneuvers, how long the shoulder remained impacted, the amount of traction used, and nerve studies after birth can connect the delivery team’s conduct directly to the child’s injury.
Arizona places time limits on medical malpractice actions.
Under A.R.S. § 12-542, medical malpractice actions are generally subject to a two-year limitations period after the cause of action accrues.
Claims involving children can require additional legal analysis under Arizona law. Claims belonging to parents may also be legally distinct from those belonging to the injured child.
Families should therefore obtain guidance based on their individual circumstances rather than assume that every claim arising from the same delivery follows one deadline.
Earlier investigation may also help preserve labor and delivery records, document what parents remember, and follow the child’s treatment and recovery as the extent of impairment becomes clearer.
If your child developed Erb’s palsy after a difficult delivery in Chandler, Snyder & Wenner can review the pregnancy, delivery, and treatment records and explain whether the available evidence supports further investigation.
Erb’s palsy is a form of brachial plexus injury affecting nerves that help control movement and sensation in the shoulder and upper arm. A newborn may experience weakness, reduced movement, or paralysis in the affected arm.
Erb’s palsy is one type of brachial plexus injury. It generally affects the upper portion of the nerve network, while other brachial plexus injuries can involve additional nerves and more extensive arm or hand impairment.
Possible signs include limited movement of one arm, shoulder weakness, difficulty bending the elbow, reduced reflexes, reduced sensation, or an arm held close to the body.
Shoulder dystocia occurs when the baby’s head has been delivered but one shoulder becomes lodged behind the mother’s pelvic bone. Healthcare providers may need to perform specific maneuvers to complete delivery.
During a shoulder dystocia, the baby’s upper brachial plexus nerves are vulnerable to stretching. If the delivery team pulls on the baby’s head instead of using recognized maneuvers to free the shoulder, those nerves can be damaged.
Erb’s palsy is caused by medical negligence when providers fail to meet the applicable standard of care and that conduct injures the baby’s nerves. Examples can include using excessive traction, failing to perform recognized maneuvers in the proper sequence, or failing to plan for a high-risk delivery when risk factors such as maternal diabetes were known.
Relevant records may include prenatal information, fetal-size estimates, labor and delivery documentation, shoulder dystocia records, descriptions of delivery maneuvers, newborn examinations, neurological and orthopedic evaluations, imaging, nerve studies, and therapy records.
Yes. Some children regain substantial or full movement as injured nerves recover. Others experience persistent weakness or reduced range of motion. Prognosis depends on the location and severity of the nerve damage.
Treatment may include physical therapy, occupational therapy, range-of-motion exercises, neurological or orthopedic monitoring, diagnostic testing, and surgical evaluation when substantial impairment persists.
Our attorneys review the pregnancy, labor, delivery, and subsequent medical records to determine what occurred and how the nerve injury may have developed. We evaluate the evidence, applicable standard of care, causation, and long-term consequences before determining whether further legal action may be appropriate.