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A brachial plexus injury can affect a newborn’s shoulder, arm, wrist, or hand. Some children regain substantial function as the nerves recover. Others experience lasting weakness, limited range of motion, or permanent impairment that may require ongoing therapy or surgical care.
Parents may first notice that their baby does not move one arm normally. Others may remember a difficult delivery, shoulder dystocia, several delivery maneuvers, or an assisted birth. These circumstances can raise important questions about the delivery process, provider decisions, and whether appropriate care was provided when complications developed.
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 and permanent disability. For Scottsdale families, we can review the pregnancy, labor and delivery records, newborn examinations, and later medical evaluations to determine whether the care provided met the applicable standard of care.
Use this form to get the fastest review by an attorney and the fastest response from our office.
The brachial plexus is a group of nerves that extends from the spinal cord through the neck and shoulder into the arm. These nerves help control movement and sensation in the shoulder, arm, forearm, wrist, and hand.
During childbirth, the brachial plexus can sometimes be stretched or otherwise injured. The resulting condition is often called neonatal brachial plexus palsy.
The severity depends on which nerves are involved and how extensively they were damaged.
Some injuries involve only 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 more extensively.
Brachial plexus birth injuries are uncommon but well recognized. A 2022 review indexed by the National Library of Medicine reported that the U.S. incidence declined from approximately 1.5 to around 0.9 cases per 1,000 live births over the prior two decades.
Another review of 63 publications covering more than 17 million births found an overall U.S. rate of approximately 1.5 cases per 1,000 births. It also reported that some injuries persisted for at least 12 months.
A brachial plexus injury may develop when forces around delivery place stress on the nerves between the neck and arm.
One circumstance associated with these injuries is shoulder dystocia. Shoulder dystocia occurs when the baby’s head has been delivered but one shoulder becomes positioned behind the mother’s pelvic bone, making delivery of the body more difficult.
Healthcare providers may need to use specific maneuvers to complete the delivery safely.
When shoulder dystocia occurs, the actions taken by healthcare providers, including recognition of the complication and delivery maneuvers performed, may become important parts of the medical review.
If a child develops a serious brachial plexus injury after shoulder dystocia, however, the delivery may be reviewed to determine:
Other factors associated with neonatal brachial plexus palsy may include higher birth weight, breech presentation, instrument-assisted delivery, or other labor circumstances. These factors may require additional evaluation of the prenatal and delivery records to understand how they affected the course of care.
A potential brachial plexus claim often begins with the delivery record.
Parents may remember that the birth became unexpectedly difficult or that additional healthcare providers entered the room. They may remember specific maneuvers being performed or a sudden change in the delivery plan.
In other cases, nothing seemed unusual to the family until the newborn examination showed that the baby was not moving one arm normally.
A legal review may involve records such as:
The records are examined as a complete timeline rather than as isolated entries.
If shoulder dystocia occurred, the medical documentation may show when it was recognized and which maneuvers were attempted. The legal review may compare that information with the child’s immediate condition and later neurological findings.
The investigation may also examine information available before delivery.
Shoulder dystocia is one of the delivery complications most commonly discussed in connection with brachial plexus injury.
When the baby’s shoulder becomes lodged, healthcare providers typically use established maneuvers intended to relieve the obstruction and complete delivery.
The medical record may document:
When shoulder dystocia occurs, reviewing the timing of recognition, delivery maneuvers, and provider responses can help determine how the injury developed.
The American College of Obstetricians and Gynecologists’ task force has described neonatal brachial plexus palsy as presenting with weakness or paralysis of an upper extremity and reported an overall incidence of approximately 1.5 per 1,000 births.
The evidence generally must show 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 involve whether providers:
Causation is especially important.
Medical records, delivery documentation, and medical review can help identify the factors involved in the child’s nerve injury and whether provider actions contributed to the outcome.
The medical evidence must therefore establish how the child’s nerves were injured and whether provider conduct probably contributed to that damage.
Arizona law places time limits 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.
Cases involving children can require additional analysis because Arizona law contains provisions addressing minority and certain limitation periods. Parents may also have separate claims related to the same delivery.
Because deadlines can vary depending on the circumstances of the claim, families should seek legal guidance promptly to protect their rights.
Earlier review can also help preserve delivery records, document what occurred, and track the child’s medical progress while treatment continues.
If your child suffered a serious brachial plexus injury during birth in Scottsdale, Snyder & Wenner can review the delivery records and review the delivery records, evaluate the medical evidence, and help families understand their legal options.
A brachial plexus birth injury involves damage to nerves running from the spinal cord through the neck and shoulder into the arm. It can cause weakness, reduced movement, loss of sensation, or paralysis in part of the affected 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 is one type of brachial plexus injury that generally affects the upper portion of the nerve network. Other brachial plexus injuries can affect different nerves and produce different patterns of weakness.
When shoulder dystocia occurs, medical records can help show how the complication was recognized, what delivery maneuvers were used, how providers responded, and whether those actions contributed to the child’s nerve injury.
A review may include prenatal records, labor and delivery documentation, fetal monitoring, delivery notes, shoulder dystocia records, newborn examinations, and later medical evaluations. These records help reconstruct the events surrounding the injury.
Relevant records may include prenatal documentation, fetal-size estimates, labor and delivery notes, shoulder dystocia documentation, descriptions of delivery maneuvers, newborn examinations, neurological evaluations, imaging, nerve testing, and therapy records.
Yes. Some children regain substantial function during infancy. Others continue to experience weakness or limited movement. Recovery depends on the location and severity of the nerve injury.
Treatment can include range-of-motion exercises, physical therapy, occupational therapy, neurological or orthopedic monitoring, imaging, nerve studies, and surgical evaluation when significant impairment persists.
Persistent symptoms may indicate a more significant nerve injury. Medical evaluation can help determine the extent of permanent impairment and whether additional treatment or rehabilitation is appropriate.
Our attorneys review the pregnancy and delivery records, including the circumstances surrounding any difficult delivery or shoulder dystocia. When appropriate, we work with qualified medical professionals to assess the standard of care, mechanism of injury, causation, and long-term consequences to evaluate the medical evidence and help families understand the legal options available.
