Articles Posted in Brachial Plexus Injury

This Supreme Court case comes from an appeal twice to the appellate court and originally from the Circuit Court of Adams County, Ill. The issue was “whether the ruling of the appellate court, 2016 IL App (4th) 150843, reversing the judgment and remanding this case for a new trial requires a trial de novo on all claims.” The first appellate court decision answered this question in the affirmative. The Illinois Supreme Court granted motions by the Illinois Association of Defense Trial Counsel to file an amicus curiae brief in support of defendant and the Illinois Trial Lawyers’ Association (ITLA) to file an amicus curiae brief in support of plaintiff’s position.

Because the resolution of the appeal concerned a narrow-certified question, the Illinois Supreme Court summarized the facts pertinent to making its decision.

In August 2015, plaintiffs Kristopher Crim and Teri Crim, acting on behalf of their biological son, Collin Crim, who was born on June 17, 2005, filed a fourth amended medical malpractice claim against the defendant, Gina Dietrich, D.O., alleging two claims: (1) Defendant failed to obtain Teri’s informed consent to perform a natural birth despite possible risks associated with Collin’s large size, and (2) defendant negligently delivered Collin, causing him injuries. The allegations supporting the informed consent claim are found in paragraph (a) through (j) of plaintiffs’ fourth amended complaint, while sub-paragraphs (k) and (l) concern the allegations related to professional negligence during the delivery of the child.
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The U.S. Court of Appeals for the Fourth Circuit has affirmed a federal court’s exclusion of evidence regarding the defendant physician’s general reputation on internet websites.

In this case, Sheena Dorman, Dillon Ming and their minor child sued obstetrician Dr. Richard G. Welch and his medical practice, Annapolis OB-Gyn Associates P.A., alleging that the defendant physician’s negligence in applying lateral force during the child’s birth led to the development of Erb’s palsy.

The jury returned a verdict in favor of the defendants. The plaintiffs appealed, challenging several of the trial court’s evidentiary rulings.
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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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