Shoulder Dystocia and Brachial Plexus Injuries in Philadelphia

Shoulder Dystocia and Brachial Plexus Injuries in Philadelphia

When a baby's shoulder becomes stuck behind the mother's pelvic bone during delivery, doctors face a critical decision. The way they respond in those moments can mean the difference between a healthy birth and a lifelong injury.

Shoulder dystocia is a known delivery complication, and medical professionals are trained to handle it safely. But when a doctor uses excessive force to free a stuck shoulder, the result can be a brachial plexus injury that affects a child's arm, hand, and mobility for years or even permanently.

If your child was hurt during delivery in Philadelphia, understanding how these injuries happen and when they cross the line into medical malpractice is an important first step toward holding the responsible parties accountable.

SCHEDULE A CONSULTATION

Key Takeaways for Shoulder Dystocia and Brachial Plexus Injuries

• Shoulder dystocia occurs when a baby's shoulder gets lodged behind the mother's pelvic bone during delivery, and it requires specific medical maneuvers to resolve safely.
• Brachial plexus injuries happen when the nerves running from the neck to the arm are stretched, compressed, or torn, often due to excessive pulling or force during delivery.
• Medical professionals are trained in recognized techniques to address shoulder dystocia without applying dangerous traction to the baby's head and neck.
• Pennsylvania law allows families to pursue malpractice claims when a healthcare provider's negligence during delivery causes preventable harm to a newborn.
• A birth injury malpractice case requires proof that the medical provider deviated from the accepted standard of care and that this deviation directly caused the injury.
• Families may be entitled to compensation covering medical treatment, therapy, future care needs, and other related losses.

What Is Shoulder Dystocia?

Shoulder dystocia is a delivery emergency that happens when a baby's head passes through the birth canal, but one or both shoulders become trapped behind the mother's pubic bone. It typically occurs during the second stage of labor, after the baby's head has already been delivered. The condition requires immediate intervention because the baby's body cannot be delivered with normal pushing alone, and delays can lead to oxygen deprivation.

Several risk factors can increase the likelihood of shoulder dystocia, including:

• A higher-than-average birth weight (macrosomia), often defined as over 8 pounds, 13 ounces
• Maternal gestational diabetes
• A history of shoulder dystocia in previous deliveries
• Prolonged labor or a slow second stage
• Assisted delivery using vacuum extraction or forceps

While not every case of shoulder dystocia can be predicted, medical providers are expected to recognize risk factors during prenatal care and plan accordingly.

The American College of Obstetricians and Gynecologists (ACOG) provides clinical guidelines on identifying and managing this complication. When providers fail to assess these risks or prepare for a complicated delivery, the consequences can be serious.

Understanding Brachial Plexus Injuries in Newborns

The brachial plexus is a network of nerves that runs from the spinal cord in the neck, through the shoulder, and down into the arm and hand. These nerves control movement and sensation in the entire upper limb. During a difficult delivery involving shoulder dystocia, excessive pulling or twisting of the baby's head and neck can stretch or tear these delicate nerves.

Brachial plexus injuries in newborns range in severity:

• Neuropraxia (stretching): The mildest form, where nerves are stretched but not torn. Many babies recover within a few months with physical therapy.
• Neuroma: Nerve fibers are damaged and scar tissue forms during healing, which can press on surrounding healthy nerves and limit recovery.
• Rupture: The nerve is torn but not at the point where it attaches to the spinal cord. Surgical repair may be needed.
• Avulsion: The most severe type, where the nerve root is torn away from the spinal cord entirely. This often results in permanent loss of function.

The most well-known condition associated with these injuries is Erb's palsy, which affects the upper nerves of the brachial plexus and can leave a child with a limp or paralyzed arm. Children with more severe injuries may face a lifetime of surgeries, physical therapy, and adaptive challenges.

SCHEDULE A CONSULTATION

How Excessive Force During Delivery Leads to Injury

Doctors and delivery teams are trained to use specific, well-established maneuvers when shoulder dystocia occurs. These techniques are designed to free the baby's shoulder without putting dangerous pressure on the neck and brachial plexus nerves. Recognized safe maneuvers include:

• McRoberts maneuver: Flexing the mother's legs sharply toward her abdomen to widen the pelvic opening
• Suprapubic pressure: Applying targeted pressure just above the mother's pubic bone to dislodge the baby's shoulder
• Woods' screw maneuver: Gently rotating the baby's posterior shoulder to free the anterior shoulder
• Delivery of the posterior arm: Carefully sweeping the baby's back arm across the chest to reduce shoulder width

These techniques work with the baby's body rather than against it. The critical error that leads to brachial plexus injuries is applying excessive lateral traction, which means pulling the baby's head forcefully to one side or downward while the shoulder remains stuck. This stretches the brachial plexus nerves beyond their limit.

When a provider panics, lacks proper training, or simply pulls too hard instead of using the correct maneuvers, the result is often a preventable nerve injury. In busy delivery rooms across Philadelphia, from hospitals near the University of Pennsylvania campus to medical centers throughout the greater metro area, the same standard of care applies. Every delivering physician is expected to know and use these techniques.

When Does a Birth Injury Become Medical Malpractice?

Not every shoulder dystocia injury is the result of malpractice. The complication itself is not always preventable, and some degree of risk exists in every delivery. However, a delivery injury crosses into malpractice territory when a healthcare provider fails to meet the accepted standard of care and that failure directly causes harm.

Under Pennsylvania law (40 P.S. § 1303.504), medical malpractice claims require a Certificate of Merit from a qualified medical professional confirming that the care provided fell below accepted standards. To build a successful birth injury malpractice case, families generally need to establish four elements:

• Duty of care: The doctor, nurse, or hospital had a professional obligation to provide competent medical care during delivery.
• Breach of duty: The provider deviated from the accepted standard of care. This could include using excessive force, failing to perform recognized maneuvers, ignoring known risk factors, or not calling for additional help.
• Causation: The provider's actions (or lack of action) directly caused the brachial plexus injury. This is often the most contested element and typically requires testimony from medical professionals.
• Damages: The child suffered actual harm, whether physical, financial, or both.

It is important to understand that the standard of care is not perfection. It is what a reasonably competent medical professional would have done under the same circumstances. When the evidence shows that a provider pulled too hard, skipped safer techniques, or ignored warning signs, that is a breach families have the right to pursue.

What Compensation Can Families Seek?

A birth injury affects not just the child but the entire family. When malpractice is established, Pennsylvania law allows families to seek compensation for the full scope of harm caused. Depending on the severity of the brachial plexus injury, recoverable damages may include:

• Past and future medical expenses, including surgeries, nerve grafts, and hospital stays
• Physical therapy, occupational therapy, and rehabilitation costs
• Adaptive equipment and home modifications
• Pain and suffering experienced by the child
• Emotional distress endured by parents and family members
• Loss of future earning capacity if the injury results in permanent disability
• Cost of ongoing supportive care throughout the child's life

Severe brachial plexus injuries can require decades of treatment. Children with Erb's palsy or total plexus involvement may need multiple surgeries during their growing years, along with consistent therapy to maintain whatever function is possible. The financial burden on families can be significant, and a malpractice claim aims to shift that burden to the parties responsible for the injury.

SCHEDULE A CONSULTATION

Steps to Take If You Suspect a Birth Injury

If you believe your child's brachial plexus injury was caused by excessive force during delivery, there are several steps that can help protect your family's rights:

• Request your complete medical records. This includes prenatal records, labor and delivery notes, fetal monitoring strips, and any operative reports. These documents form the foundation of any potential claim.
• Document your child's condition. Keep a record of all diagnoses, treatments, therapies, and medical visits related to the injury. Note any developmental milestones that are delayed or affected.
• Be mindful of time limits. Pennsylvania generally has a two-year statute of limitations for medical malpractice claims, though special rules may apply when the injured party is a minor. Acting promptly helps preserve important evidence.
• Consult with a birth injury attorney. An experienced legal team can review your case, work with medical professionals to evaluate whether the standard of care was met, and advise you on your options.

Taking these steps early gives your family the strongest possible position if you decide to move forward with a claim.

FAQs for Shoulder Dystocia and Brachial Plexus Birth Injuries

Here are answers to some common questions families have about these injuries and the legal process.

Talk to Our Philadelphia Birth Injury Team Today

No family should have to watch their child struggle with a preventable injury. If your baby suffered a brachial plexus injury during delivery in Philadelphia or anywhere in Pennsylvania, the team at Wapner Newman is here to help you understand your options and fight for the compensation your family deserves.

At Wapner Newman, we understand how deeply a birth injury can affect a family. Our team has recovered millions for clients throughout Philadelphia and Pennsylvania, and we approach every case with the dedication and compassion that families in these situations deserve.

We have spent decades standing up for families just like yours, and we are ready to put that experience to work for you. Call us today at (215) 555-1234 for a free consultation. Your fight is our fight.

SCHEDULE A CONSULTATION