Articles Posted in Brachial Plexus Injury

During the delivery of Baby Doe, a shoulder dystocia was encountered. That is the medical condition in which a fetus in labor and delivery has a shoulder caught on the pelvis of the mother. An obstetrician in this case performed maneuvers to try to resolve the dystocia.

However, Doe suffered a severe brachial plexus injury that necessitated surgery to repair the nerve avulsion. Brachial plexus injury to the child is the result of the push and tug that often takes place in a should dystocia situation during delivery. The baby’s shoulder and arm nerves are stretched such that permanent damage often occurs to the child’s arm.

Unfortunately, the surgery in this case was unsuccessful. Doe now has partially lost the use of his right arm and hand.
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The Supreme Court of Iowa affirmed the judgment of the district court dismissing the plaintiff’s medical malpractice claims against the medical provider defendants, holding that there was no reversible error.

The child involved in this case is identified as T.D., who was born Aug. 31, 2007 at the Henry County Health Center. Dr. James Widner, employed by Family Medicine of Mt. Pleasant P.C., was the physician in charge of T.D.’s prenatal care and delivery.

During labor and delivery, the child’s shoulder became stuck on his mother’s pelvis. The defendant physicians and nurses performed maneuvers to resolve the stuck shoulder. However, the plaintiff child T.D. was born with a permanent nerve injury, brachial plexus, preventing the normal use and function of the child’s left arm. Shoulder dystocia is a birth injury that occurs in cases just like this, when the baby’s shoulder gets stuck inside the mother’s pelvis. This condition is a medical emergency because the infant’s delay in birth may cause severe brain damage or death if not resolved in six minutes or less. Dr. Widner and the nurses performed maneuvers that resolved the shoulder dystocia in one minute and ten seconds. However, T.D. was born with a permanent injury to his left shoulder and arm, a nerve injury referred to as a brachial plexus that prevents normal use and function of his arm. T.D.’s delivery was captured on a 21-minute birth video recorded by T.D.’s aunt.
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Zoila Fuentes Medina was admitted to the Brooklyn Hospital Center to deliver her baby. During her prenatal treatment at the hospital’s high-risk clinic, concerns were raised about possible macrosomia. Macrosomia is a condition in which a fetus has a predicted birth weight of more than 8 lbs. 13 oz. Suspected fetal macrosomia is not an indication for induction of labor. Induction in a macrosomia condition does not improve maternal or fetal outcomes.

A sonogram taken before her admission revealed that her baby was above the 90th percentile in size. First-year resident Dr. Patrick Ellis attended to the delivery under the supervision of on-call physician Dr. Yves Richard Jean-Gills.

Medina’s baby became caught on her pubic bone when delivery was attempted. Dr. Ellis applied extreme force to the baby’s head and neck. As a result, the baby suffered a brachial plexus injury that resulted in permanent Erb’s palsy.
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On July 8, 2003, Madison Drake was delivered by obstetrician Dr. Timothy Durkee at Swedish American Hospital in Rockford, Ill. During the vaginal delivery of this newborn, a shoulder dystocia was encountered. Essentially that means that the baby’s shoulder was caught or stuck on the mother’s pubic bone. Dr. Durkee used the McRoberts maneuver with suprapubic pressure to finish the delivery of the baby.

Madison’s mother, Nicole Drake, consented to vaginal delivery, but claimed that she requested a C-section several times during her labor.

Madison suffered a left humerus fracture, brachial plexus injury, and a mild hypoxic brain injury that left baby Madison with cognitive deficits and executive function impairment. The brachial plexus injury would most likely have been caused by the effort to dislodge the baby’s shoulder that was stuck on the mother’s pubic bone.
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In this case, it was alleged by the mother of a baby, now 3 years old, that the child’s shoulder dystocia occurred during labor and delivery, which caused an unnecessary and avoidable injury to her child. According to the lawsuit brought on behalf of Baby Doe, the obstetrician allegedly applied traction to release the baby’s shoulders. As a result, however, Doe suffered a brachial plexus injury. Baby Doe has been diagnosed as having Erb’s Palsy, which has led to a disfigurement.

The Doe family sued the hospital maintaining that it was liable for the negligence of the obstetrician who mishandled the shoulder dystocia by applying excessive traction.

The defendant hospital reportedly argued that Baby Doe’s injuries were from maternal forces of labor rather than excessive traction. That is a common defense in shoulder dystocia cases. Before trial, the parties settled for $375,000.
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Wendy Castro developed gestational diabetes during her pregnancy. She underwent an induction of labor at a federally supported health care facility. The attending certified nurse midwife Barbara Carroll encountered shoulder dystocia during the delivery and allegedly responded by applying suprapubic pressure. A shoulder dystocia is an event during labor and delivery in which the newborn’s head is delivered but the anterior shoulder of the baby gets stuck on the mother’s public bone. In that case, the shoulders fail to deliver after the baby’s head.

Under these circumstances, Carroll then performed the McRoberts and Woods’ screw maneuvers, which are two of the usual maneuvers when this complication arises. “Dystocia” means a slow or difficult labor or birth.

Castro’s son suffered a left brachial plexus injury, a nerve injury caused by the stretching or contusions to the brachial plexus nerves as a result of the shoulder dystocia. He is now 4 years old. He has undergone surgery and has limited range of motion in his left arm because of the nerve damage. In some cases of shoulder dystocia the baby could suffer a birth asphyxia, lack of oxygen to the brain, which may cause permanent brain damage.
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Keyanna Vaughn, the mother of Marcus Crawford Jr., was first admitted to the University of Illinois Hospital in Chicago for induction of labor on Aug. 11, 2009. This was done after test results were revealed during a prenatal visit.

On Aug. 12, 2009, a hospital intern and senior resident attempted vaginal delivery without success. Dr. Meredith Cruz was a maternal/fetal medicine fellow who took over at that time. Dr. Cruz had completed her OB/Gyn residency in June 2009 and had recently begun her maternal/fetal medicine program.

Dr. Cruz diagnosed that the fetus was experiencing shoulder dystocia. Shoulder dystocia is a specific situation arising in labor and delivery when the delivery of the baby’s head occurs, but the anterior shoulder of the baby cannot pass through the birth canal and requires the doctor’s or nurse midwife’s manipulation or maneuver to rotate the baby. In other words, a shoulder dystocia is diagnosed when the baby’s shoulders do not deliver right after the baby’s head is delivered. The baby gets stuck in the birth canal as a result, which can clearly be a very serious dilemma.
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In this confidential settlement, during the delivery of Baby Doe, a shoulder dystocia occurred. The attending physician, Dr. Roe, released the impacted shoulder and delivered Baby Doe, who suffered a right brachial plexus injury. The brachial plexus injury required nerve graft surgery.

In spite of the surgery to correct the brachial plexus injury, Baby Doe now has a paralyzed right arm, shoulder and hand. Baby Doe’s mother suffered vaginal injuries as well during the delivery.

Baby Doe and her parents filed a lawsuit against the obstetrician, Dr. Roe, and the hospital that delivered Baby Doe, alleging that they chose not to properly handle the shoulder dystocia and safely delivery the baby. The Doe family claimed that Dr. Roe had encountered shoulder dystocia during the delivery of Baby Doe’s older sibling, but chose not to alert the Doe parents about this or the need for a Cesarean section delivery for future pregnancies.
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In August 2015, the plaintiffs, Kristopher Crim and Teri Crim, acting on behalf of their biological son, Collin Crim, filed a medical malpractice lawsuit against the defendant physician, Dr. Gina Dietrich, claiming that she chose not to comply with the standard of care applicable to an obstetrician. The Crims claimed that Dr. Dietrich’s negligent failure to obtain Teri’s informed consent prior to Collin’s natural birth resulted in a fracture to Collin’s right clavicle and nerve damage that extended down his right side to his shoulder, wrist, hand and fingers.

Following the presentation of the Crims’ case to the jury, Dr. Dietrich moved for a partially directed verdict on the issue of informed consent, which was granted by the trial judge. After additional evidence and argument, the jury returned a verdict in Dr. Dietrich’s favor and against the Crims on their remaining claim.

The Crims had sought expenses under Section 15 of the Rights of Married Persons Act (750 ILCS 65/15 (2014)). The court later imposed costs on the Crims as permitted by Section 5-109 of the Code of Civil Procedure, 735 ILCS 5/5-109. The Crims appealed, arguing that the trial judge erred by (1) granting Dr. Dietrich a directed verdict on the issue of informed consent; and (2) barring certain medical testimony. As the appeals panel pointed out, because they agreed with the Crims’ first argument on the directed verdict on informed consent, the trial court’s decisions were reversed.
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A Wisconsin appellate court has ruled that a trial judge improperly excluded a defendant physician’s expert testimony. The expert wanted to testify about the maternal forces of labor being a cause of the plaintiff child’s brachial plexus injury.

In this case, Leah Bayer and her husband filed a lawsuit against her obstetrician, Dr. Brian Dobbins, claiming that he mishandled their infant’s shoulder dystocia, causing the baby girl to suffer a permanent brachial plexus injury.

The defendant doctor contended that the child’s injury came from maternal forces of labor. This is probably the most common and over-used defense in a birth trauma injury cases. The Bayer family then filed a motion in limine and requested that the judge exclude the defendant’s expert testimony related to the maternal forces of labor theory. The trial judge granted the motion.

However, the appellate court reversed. Whether expert testimony is admissible under the Daubert standard depends on whether an expert is qualified and uses a methodology that is scientifically reliable and whether the testimony will assist the trier of fact to determine a fact in issue.
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