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A brachial plexus injury can affect a newborn’s ability to move the shoulder, arm, wrist, or hand. Some children regain substantial function as the affected nerves recover. Others may experience persistent weakness, limited range of motion, or permanent impairment requiring therapy, medical monitoring, or surgical care.
Parents may first notice that their baby is not moving one arm normally. In other cases, families remember a difficult delivery, shoulder dystocia, several delivery maneuvers, or an assisted birth. Those circumstances can point to problems with how the delivery was managed, and the delivery records can show what the healthcare team did and when.
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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 throughout the shoulder, arm, forearm, wrist, and hand.
During childbirth, excessive pulling or pressure on a baby’s head, neck, or shoulder can stretch or tear these nerves.
The symptoms depend on which nerves were affected and how severe the damage was.
Some injuries involve the upper portion of the brachial plexus. Erb’s palsy is one form of upper brachial plexus injury. Other injuries may involve a larger portion of the nerve network and affect the forearm, wrist, or hand.
National research helps show how often neonatal brachial plexus palsy has been identified. A U.S. study examining more than 11 million births found 17,334 documented cases, for an incidence of at least 1.51 cases per 1,000 live births.
Mesa-specific public-health data also provide local context. According to the Arizona Department of Health Services, Mesa’s six community statistical areas recorded a combined 6,224 births in 2023. The same table reported 450 low-birthweight newborns across Central, East, Gateway, North, Southwest, and West Mesa. These numbers illustrate the volume of maternal and newborn care provided to Mesa families each year.
Several circumstances may be associated with neonatal brachial plexus injury.
One of the best-known is shoulder dystocia, which occurs when the baby’s head has been delivered but one shoulder becomes positioned behind the mother’s pelvic bone. The healthcare team may need to use specific maneuvers to release the shoulder and complete delivery.
Shoulder dystocia is a recognized obstetric emergency. Providers are trained to watch for risk factors such as a large estimated fetal weight, maternal diabetes, or a prior shoulder dystocia, and to respond with established maneuvers. When a child has significant brachial plexus damage, the delivery records may be reviewed to determine:
Medical research has found a strong association between shoulder dystocia and neonatal brachial plexus palsy. The nationwide study of more than 11 million births found shoulder dystocia to be a major risk factor, while higher birth weight and forceps delivery were also associated with increased risk.
When these risk factors are present, providers are expected to take them into account when planning and managing the delivery.
Brachial plexus injuries can also occur during other difficult deliveries, including those involving forceps, vacuum extraction, or excessive traction on the baby’s head. The delivery records can show what force was applied and how the team managed the birth.
For that reason, each case requires individual analysis rather than assumptions based on one feature of the delivery.
Recovery varies according to the location and severity of the nerve injury.
Some children regain substantial movement during infancy. Others continue to experience weakness or reduced range of motion.
Factors affecting recovery may include:
Treatment may include physical therapy, occupational therapy, range-of-motion exercises, neurological monitoring, orthopedic care, imaging, nerve studies, or surgical evaluation.
The child’s medical team may monitor progress over time before determining the likely extent of permanent impairment.
A lasting nerve injury can affect more than arm movement during infancy.
As a child grows, reduced strength or restricted range of motion may affect tasks requiring coordinated use of both arms.
Possible long-term concerns include:
A child’s needs may also evolve over time.
Therapy that begins in infancy may continue into childhood. Additional assessments may be needed as the shoulder and arm develop. Some children require surgical procedures or long-term rehabilitation.
When medical negligence causes a permanent nerve injury, evaluating damages involves more than the expenses already incurred.
The analysis may consider future treatment, rehabilitation, assistive equipment, functional limitations, and the effect of permanent impairment on future education, independence, or earning capacity.
This approach reflects Snyder & Wenner’s focus on the long-term human consequences of serious injuries rather than reducing a case to immediate medical costs.
A brachial plexus injury can support a medical malpractice claim when the evidence shows that a healthcare provider failed to meet the accepted standard of care and that this failure caused or contributed to the child’s injury.
Potential questions may include whether providers:
Causation connects the provider’s conduct to the child’s nerve injury. Descriptions of the maneuvers used, the duration of the shoulder dystocia, the amount of traction applied, and the location and severity of the nerve damage can help show how the force used during delivery caused the injury.
Arizona law places time limits on medical malpractice claims.
Under A.R.S. § 12-542, actions involving injuries to another person, including medical malpractice claims, generally must be commenced within two years after the cause of action accrues.
Claims involving children may require additional analysis under other Arizona provisions, and claims belonging to parents may be legally distinct from claims belonging to the child.
Families should therefore obtain guidance based on their specific circumstances rather than assume every claim arising from the same delivery follows one deadline.
Earlier review can also help preserve delivery records, document parents’ recollections, and track the child’s treatment and recovery.
If your child suffered a serious brachial plexus injury during birth in Mesa, Snyder & Wenner can review the delivery records and explain whether the available evidence supports further investigation.
A brachial plexus birth injury involves damage to nerves extending from the neck and shoulder into the arm. Depending on the nerves affected, a newborn may have weakness, reduced movement, loss of sensation, or paralysis in part of the arm.
Possible signs include limited movement of one arm, shoulder weakness, difficulty bending the elbow, reduced grip, diminished reflexes, or a noticeable difference in movement between the arms.
Yes. Erb’s palsy generally involves the upper portion of the brachial plexus. Other brachial plexus injuries can involve different nerve roots and may affect a larger portion of the arm or hand.
Shoulder dystocia occurs when the baby’s head is delivered but one shoulder becomes lodged behind the mother’s pelvic bone. Healthcare providers may need to use specific maneuvers to complete delivery. Providers are expected to anticipate known risk factors and respond promptly with recognized maneuvers that protect the baby’s nerves.
NShoulder dystocia is one of the strongest risk factors for a brachial plexus birth injury. When a baby’s shoulder is stuck, pulling on the baby’s head or improperly performing delivery maneuvers can stretch or tear the nerves. These injuries can also occur during other difficult deliveries, such as those involving forceps.
A brachial plexus injury can involve medical negligence when a provider fails to meet the applicable standard of care and that failure causes or contributes to the nerve injury. Examples can include applying excessive traction to the baby’s head, failing to use recognized shoulder dystocia maneuvers, or failing to account for known risk factors when planning the delivery.
Relevant evidence may include prenatal records, fetal-size estimates, labor and delivery notes, shoulder dystocia documentation, descriptions of delivery maneuvers, newborn examinations, neurological assessments, imaging, nerve studies, and therapy records.
Some children regain substantial or full function as the affected nerves recover. Others continue to experience weakness or restricted movement. The prognosis depends on the location and severity of the damage.
Treatment may include physical therapy, occupational therapy, neurological or orthopedic evaluation, range-of-motion exercises, imaging, nerve studies, or surgical evaluation in more serious cases.
Our attorneys review the pregnancy and delivery records, including the circumstances surrounding any difficult birth or shoulder dystocia. When appropriate, we work with qualified medical professionals to evaluate the standard of care, causation, and long-term consequences before determining whether additional legal investigation may be appropriate.
