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A brachial plexus injury can affect a newborn’s ability to move the shoulder, arm, wrist, or hand. Some children recover function as the affected nerves heal. Others experience lasting weakness, limited range of motion, or permanent impairment that may require therapy, monitoring, or surgical treatment.
For parents, a serious brachial plexus injury can raise important questions about what happened during labor and delivery. The delivery records may reveal whether healthcare providers recognized potential complications, responded appropriately, used appropriate delivery techniques, and took steps to protect the child from preventable nerve damage.
Snyder & Wenner, P.C. has represented Arizona patients and families in serious medical malpractice matters for more than 40 years. Our attorneys focus on complex cases involving catastrophic harm, permanent disability, and wrongful death. When a newborn suffers a significant brachial plexus injury, we examine the medical records, delivery circumstances, and available medical evidence to determine whether the care provided met the applicable standard and whether the child’s injury may have resulted from negligent conduct.
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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 control movement and sensation in parts of the shoulder, arm, forearm, and hand.
During childbirth, these nerves can sometimes be stretched or otherwise injured. The severity of the injury depends on which nerves are affected and the extent of the damage.
The injury may involve one or more nerve roots.
Some brachial plexus injuries affect the upper portion of the nerve network. Others involve a broader portion of the plexus and can cause more extensive weakness.
One well-known type of brachial plexus birth injury is Erb’s palsy, which commonly involves the upper nerves of the brachial plexus. Because Erb’s palsy has its own medical and legal issues, Snyder & Wenner also addresses that condition separately rather than treating every brachial plexus injury as the same diagnosis.
Several circumstances may be associated with neonatal brachial plexus injury, including shoulder dystocia, larger birth weight, breech presentation, prolonged labor, and certain assisted deliveries. These circumstances can make the medical records and delivery documentation particularly important when evaluating how the injury occurred and whether healthcare providers responded appropriately to the risks present during labor and delivery.
A large U.S. study reviewing more than 11 million births identified 17,334 documented cases of neonatal brachial plexus palsy, corresponding to an incidence of at least 1.51 cases per 1,000 live births. The study also examined risk factors such as shoulder dystocia, larger birth weight, breech presentation, and instrument-assisted delivery.
One of the circumstances frequently associated with a brachial plexus birth injury is shoulder dystocia.
Shoulder dystocia occurs when, after the baby’s head is delivered, one of the shoulders becomes positioned behind the mother’s pelvic bone and does not deliver normally. Healthcare providers may need to use specific maneuvers to complete the delivery.
When a serious brachial plexus injury follows a delivery involving shoulder dystocia, however, the medical records may be reviewed to understand:
When a serious brachial plexus injury follows a delivery involving shoulder dystocia, the medical records may provide important evidence about how providers responded to the complication. The review may examine when the condition was recognized, which maneuvers were used, the sequence of those interventions, whether excessive traction was applied, and whether the delivery was managed appropriately under the circumstances.
Brachial plexus injuries can also occur in deliveries without documented shoulder dystocia. Research has identified several delivery circumstances associated with these injuries, including larger birth weight, instrument-assisted delivery, breech presentation, and other labor-related factors.
A complete investigation may examine the prenatal and labor information available to providers, the circumstances surrounding the delivery, the techniques used by the medical team, and the child’s resulting nerve injury. These details can help establish whether the care provided met the applicable standard and whether negligent conduct contributed to the child’s harm.
A brachial plexus injury case often begins with the delivery records.
Parents may remember that the delivery became difficult, that additional healthcare providers entered the room, that the baby’s shoulder became lodged, or that the medical team performed several maneuvers before birth was completed. In other cases, parents may not have realized anything unusual occurred until they noticed that the newborn was not moving one arm normally.
Both the medical records and the child’s subsequent evaluations may be important.
Records reviewed in a potential claim may include:
The legal review may also examine the severity and location of the nerve injury.
Brachial plexus injuries can range from stretching of the nerves to more significant damage. The extent of recovery over time may help medical professionals assess the severity of the injury and its likely long-term consequences.
Snyder & Wenner approaches these cases by reconstructing the treatment timeline and examining what the medical evidence shows about the delivery, the actions taken by healthcare providers, and the child’s resulting injury.
When appropriate, our attorneys work with qualified medical professionals to evaluate the delivery, the applicable standard of care, causation, and the child’s prognosis. The firm deliberately focuses on serious matters where the consequences justify substantial investigation and preparation.
The outlook for a child with a brachial plexus injury depends on the nerves involved and the severity of the damage.
Some children recover substantial function during infancy.
Others may continue to experience limitations affecting shoulder movement, elbow flexion, wrist function, grip strength, or overall use of the affected arm.
A review of neonatal brachial plexus palsy literature reports that many infants experience spontaneous recovery during the first months of life, while a portion continue to experience significant functional deficits.
Children with continuing impairment may need:
The condition can also affect the development of the shoulder and arm over time.
When one arm is substantially weaker or less mobile, differences in muscle strength and joint development may become more noticeable as the child grows.
For families pursuing a medical malpractice claim, the legal evaluation may therefore extend beyond the original delivery injury.
The child’s expected future needs may be relevant when assessing damages. Depending on the severity of the condition, those needs can include medical treatment, rehabilitation, surgical care, therapy, equipment, and assistance with activities affected by reduced upper-extremity function.
A permanent impairment may also affect future education, employment, independence, and earning capacity.
The goal is to understand the practical effect of the injury over the child’s lifetime rather than focus only on medical expenses already incurred.
A brachial plexus injury may support a medical malpractice claim when the evidence shows that healthcare providers failed to meet the applicable standard of care and that the failure contributed to the child’s nerve damage.
A legal and medical review may examine whether providers:
The medical evidence can be particularly important in determining how the injury occurred and whether the actions taken during labor and delivery contributed to the resulting nerve damage.
The investigation may compare the treatment timeline, provider decisions, delivery documentation, and the child’s medical findings with the applicable standard of care. When appropriate, qualified medical professionals may review the records and provide insight into the delivery, the cause of the injury, and the child’s long-term prognosis.
Arizona law places time limits on medical malpractice claims.
Under A.R.S. § 12-542, medical malpractice actions generally must be filed within two years after the cause of action accrues.
Claims involving children require additional consideration because Arizona law contains provisions addressing the effect of minority on certain filing periods.
Parents may also have separate claims arising from the same birth, and those claims may be subject to different deadlines.
Families should therefore obtain legal guidance based on their specific circumstances rather than assume one filing period applies to every claim.
Earlier review can also help preserve important information. Delivery records can be obtained, details of the birth can be documented, and the child’s medical progress can be evaluated as treatment continues.
If your child suffered a serious brachial plexus injury during birth in Phoenix, Snyder & Wenner can review the delivery records and explain whether the available evidence supports further investigation.
The brachial plexus is a network of nerves that begins near the spinal cord and extends through the neck and shoulder into the arm. These nerves help control movement and sensation in the shoulder, arm, forearm, and hand.
Possible signs include weakness or limited movement in one arm, reduced shoulder or elbow motion, an absent or reduced reflex, weak grip, or an arm that remains positioned close to the body. The exact symptoms depend on which nerves were affected.
Erb’s palsy is a type of brachial plexus injury that commonly affects the upper portion of the nerve network. Not every brachial plexus injury is Erb’s palsy because different nerves and levels of the plexus can be affected.
Shoulder dystocia occurs when a baby’s shoulder becomes lodged behind the mother’s pelvic bone after the head has been delivered. Healthcare providers may need to use specific maneuvers to complete the delivery. When a brachial plexus injury follows shoulder dystocia, the delivery records can help show when the condition was recognized, which interventions were performed, and how the medical team responded.
A difficult delivery can place significant demands on the baby’s shoulders, neck, and nerves. When a brachial plexus injury occurs, the delivery records may show how the complication developed, which maneuvers were used, whether excessive traction was applied, and how healthcare providers responded. Reviewing these details can help determine whether the medical care contributed to the child’s nerve damage.
Important evidence may include prenatal records, fetal-size estimates, labor and delivery documentation, fetal monitoring, records describing shoulder dystocia, descriptions of delivery maneuvers, physician and nursing notes, newborn examinations, neurological evaluations, imaging, and therapy documentation. The medical evidence can help determine whether providers recognized relevant risks, responded appropriately during delivery, and whether their conduct contributed to the child’s nerve injury.
Relevant evidence may include prenatal records, fetal-size estimates, labor and delivery documentation, shoulder dystocia records, descriptions of delivery maneuvers, physician and nursing notes, newborn examinations, neurological records, imaging, and therapy documentation.
Some children regain substantial function as the nerves recover. Others experience persistent weakness or limited movement. The prognosis depends on which nerves were affected and the severity of the injury.
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 begin by reviewing the pregnancy and delivery circumstances and identifying the medical records needed to reconstruct what happened. When appropriate, we work with qualified medical professionals to evaluate the delivery, standard of care, cause of the nerve injury, and the child’s long-term needs. We then explain what the medical evidence may show and whether the circumstances support further legal action.
