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Erb’s palsy is a type of brachial plexus injury that can affect movement and strength in a newborn’s shoulder and arm. Some children regain substantial function as the affected nerves recover. Others experience persistent weakness, limited range of motion, or permanent impairment that may require ongoing therapy or additional medical care.
Parents may first notice that their newborn does not move one arm normally or holds the arm in an unusual position. They may also remember a difficult delivery, shoulder dystocia, several delivery maneuvers, or other complications.
Snyder & Wenner, P.C. has represented Arizona patients and families in serious medical malpractice cases for more than 40 years. Our attorneys focus on complex matters involving significant and lasting harm. When a child develops Erb’s palsy after birth, we can review the pregnancy, labor and delivery records, newborn examinations, and subsequent treatment to determine whether the care provided met the applicable standard of care.
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Erb’s palsy is an injury involving the upper portion of the brachial plexus, the network of nerves that runs from the spinal cord through the neck and shoulder into the arm.
The brachial plexus controls movement and sensation throughout portions of the shoulder, arm, wrist, and hand. When the upper nerves are stretched or otherwise damaged around birth, a child may develop weakness or paralysis affecting the shoulder and upper arm.
Possible signs include:
The severity varies.
Some nerve injuries are relatively mild and improve with time. More significant damage may result in persistent functional limitations.
Erb’s palsy is part of the broader category of neonatal brachial plexus palsy, but not every brachial plexus injury is Erb’s palsy. Injuries involving different portions of the nerve network may affect other parts of the arm or hand.
The condition is recognized in obstetric and pediatric literature. An American College of Obstetricians and Gynecologists task force reported an overall incidence of neonatal brachial plexus palsy, including temporary and persistent cases, of approximately 1.5 per 1,000 births.
The incidence data illustrates that neonatal brachial plexus injuries are a recognized complication of childbirth. For an individual child, however, the delivery records and medical evidence are important in determining how the nerve injury occurred and what factors contributed to it.
A large U.S. study involving more than 11 million births similarly identified an incidence of at least 1.51 neonatal brachial plexus palsy cases per 1,000 live births.
Erb’s palsy can develop when nerves in the upper brachial plexus are stretched or damaged around the time of delivery.
One circumstance frequently associated with these injuries is shoulder dystocia.
Shoulder dystocia occurs when the baby’s head is delivered but one of the shoulders becomes positioned behind the mother’s pelvic bone, preventing the remainder of the body from delivering normally.
Healthcare providers may need to use specific maneuvers to resolve the obstruction and complete delivery.
When a child develops Erb’s palsy after a delivery involving shoulder dystocia, the medical records can provide important evidence about how the complication was recognized and managed. The review may examine:
Medical literature also recognizes other factors associated with neonatal brachial plexus palsy.
A nationwide U.S. study found that shoulder dystocia was strongly associated with neonatal brachial plexus palsy. It also identified larger birth weight and forceps delivery among significant risk factors.
Erb’s palsy usually refers to damage affecting the upper nerves of the brachial plexus.
Because those nerves help control shoulder and elbow movement, children with Erb’s palsy may experience difficulty lifting the arm away from the body, rotating the shoulder, or bending the elbow.
Other brachial plexus injuries may affect different nerve roots and produce different symptoms.
A more extensive injury can involve much of the nerve network, resulting in weakness or paralysis throughout the arm and hand.
The specific diagnosis matters because the location and severity of the nerve injury can affect:
Medical evaluation may involve physical examinations, imaging, nerve testing, and monitoring over time.
For legal purposes, the distinction also helps clarify what part of the brachial plexus was damaged and how the injury may have occurred.
Recovery varies.
Some children experience substantial improvement as stretched nerves heal. Others continue to have weakness or restricted movement.
A review of 63 publications involving more than 17 million births found that neonatal brachial plexus palsy lasting at least 12 months occurred in approximately 10% to 18% of affected children in U.S.-based reports.
The child’s prognosis depends on factors such as:
Children may initially be treated with careful range-of-motion exercises and physical or occupational therapy.
Some may require evaluation by physicians who manage peripheral nerve or upper-extremity conditions. More significant injuries may require additional diagnostic testing or surgical evaluation.
Treatment can continue as the child grows because persistent weakness may affect the development and use of the shoulder and arm.
A child with lasting Erb’s palsy may have difficulty with movements that require full strength or range of motion in the affected arm.
Depending on the severity, long-term concerns can include:
The effects can change as a child grows.
A limitation that appears relatively minor during infancy may become more noticeable when the child begins dressing independently, participating in school activities, playing sports, or performing tasks requiring coordinated use of both arms.
A serious medical malpractice case may therefore require evaluation of future needs rather than focusing only on initial treatment.
Potential future costs may involve:
When permanent functional loss is present, the analysis may also consider how the injury could affect future employment and independence.
A medical malpractice claim generally requires evidence that a healthcare provider failed to meet the accepted standard of care and that the failure caused or contributed to the child’s injury.
Potential questions may include whether providers:
Causation must also be established.
Causation is an important part of evaluating an Erb’s palsy medical malpractice claim. Medical evidence may help establish how the brachial plexus was injured, when the injury occurred, and whether provider conduct during the delivery contributed to the nerve damage.
The review may consider the sequence of delivery events, shoulder dystocia documentation, delivery maneuvers, traction applied during delivery, the newborn’s condition immediately after birth, neurological findings, and the child’s subsequent medical evaluations.
Arizona law imposes filing deadlines on medical malpractice actions.
Under A.R.S. § 12-542, medical malpractice actions generally must be commenced within two years after the cause of action accrues.
Claims involving children can require additional analysis because Arizona law contains provisions addressing minority and certain limitation periods. Parents may also have separate claims arising from the same delivery.
As a result, families should not assume that every legal claim related to a child’s birth follows the same deadline.
An earlier review can also make it easier to collect delivery records, document what parents remember, and follow the child’s medical progress.
If your child developed Erb’s palsy after a difficult delivery in Phoenix, Snyder & Wenner can review the pregnancy and delivery records, examine the circumstances surrounding the nerve injury, and explain the legal options supported by the evidence.
Erb’s palsy is a type of brachial plexus injury affecting nerves that help control the shoulder and upper arm. A newborn may have weakness, reduced movement, or paralysis in the affected arm.
Erb’s palsy is one form of brachial plexus injury. It generally affects the upper portion of the nerve network. Other brachial plexus injuries may involve different nerves and affect more of the arm or hand.
Possible signs include limited movement of one arm, weakness in the shoulder, difficulty bending the elbow, reduced reflexes, or an arm that remains positioned close to the body.
Medical records may include documentation of when shoulder dystocia was recognized, the maneuvers used to resolve the delivery, the sequence of interventions, any traction applied, fetal monitoring, maternal and fetal conditions, and the newborn’s condition immediately after birth. These records can help reconstruct the delivery and determine how the nerve injury occurred.
Evidence may include delivery records, fetal monitoring, documentation of shoulder dystocia, descriptions of delivery maneuvers, evidence concerning traction, newborn examinations, and subsequent neurological and therapy records. The medical evidence can help determine whether providers recognized and responded appropriately to complications and whether their conduct contributed to the child’s nerve injury.
Relevant records may include prenatal documentation, fetal size estimates, labor and delivery notes, shoulder dystocia records, descriptions of delivery maneuvers, physician and nursing documentation, newborn examinations, neurological evaluations, and therapy records.
Some children regain substantial or full function, particularly when the nerve injury is less severe. Others experience lasting weakness or restricted movement. Recovery depends on the nerves affected and the extent of the damage.
Treatment may include physical therapy, occupational therapy, range-of-motion exercises, neurological or orthopedic monitoring, nerve studies, imaging, and surgical evaluation when significant impairment persists.
When medical negligence is established, qualifying damages may address treatment, therapy, rehabilitation, surgical care, future medical needs, and other consequences of permanent functional impairment. The specific losses depend on the evidence.
Our attorneys review the pregnancy and delivery records, the circumstances surrounding shoulder dystocia or other delivery complications, and the child’s subsequent medical evaluations. When appropriate, we work with qualified medical professionals to evaluate the standard of care, causation, and long-term consequences and explain the legal options supported by the evidence.