Articles Posted in Brachial Plexus Injury

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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Beatriz Escobar received prenatal care from the defendant obstetrician, Dr. Daniel Rostein. She was admitted to MacNeal Hospital for induction of labor at 38 weeks gestation on the afternoon of Oct. 3, 2005.

On admission, she was given Pitocin at progressively increased dosages throughout the evening. After fetal monitor strips indicated possible fetal complications around midnight, Dr. Rostein, who was not at the hospital, ordered preparations for a Cesarean section delivery.

Once Dr. Rostein arrived at the hospital and evaluated Escobar, he found no fetal concerns and decided to proceed with the original plan for a vaginal delivery.

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During the delivery of Gwendolyn E., her shoulder became stuck or she encountered shoulder dystocia. Shoulder dystocia is a term used when the baby’s shoulder gets stuck behind the pelvic bone of the mother during delivery. Because of the shoulder dystocia involving Gwendolyn’s delivery, the attending obstetrician, Dr. Miguel Carbonell, applied traction.

As a result of the traction, Gwendolyn suffered a brachial plexus injury, which required many surgeries. She is now 6 years old but has limited use of her left hand because of the nerve injuries to the brachial plexus. The brachial plexus is a network of nerves that runs from the spine to the neck to the shoulders. During a shoulder dystocia delivery, the baby can have those nerves stretched or torn, which results in very serious mobility injuries to the shoulder, arms and hands.

Gwendolyn’s mother filed a lawsuit against Dr. Carbonell and the employer, Associates for Women’s Health of Southern Oregon, alleging use of excessive traction.

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During the birth of Jasmyn Finch, the obstetrician, Dr. Claire Bernardin encountered Jasmyne’s shoulder stuck behind her mother’s pelvic bone or sacral promontory. When a shoulder dystocia does occur during the delivery phase, it is considered an emergency. It is a dangerous occurrence that can be overcome with the use of maneuvers, such as the McRoberts maneuver. Jasmyne suffered shoulder dystocia, but with the help of an assistant, Dr. Bernardin delivered Jasmyne. Unfortunately, Jasmyne was born with left brachial plexus injury.

As a result of the brachial plexus injury, Jasmyne, who is now 19, cannot lift her left arm above her shoulder. In addition, her left shoulder is 8 centimeters shorter than her right arm.

The brachial plexus is a network of nerves that runs from the spine, neck and through the shoulders. In childbirth, when the shoulder gets stuck as in Jasmyne’s situation, the nerves can be stretched or torn and permanently disrupted. Some brachial plexus injuries heal without the need of surgery. But in this case, the injury to the right shoulder was permanent and devastating.

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In 2008 a study was published that focused on uncomplicated pregnancies. The question was whether to induce labor in women whose gestation had reached 41 to 42 weeks. It was revealed that inducing labor in women who have reached 41 weeks of pregnancy and who were otherwise low-risk showed the condition of the baby at birth to be favorable. The goal of obstetricians was to ensure the successful delivery of the baby before 42 weeks of gestation — for the benefit of the baby and mother.

The study suggested that there was an improvement in prenatal outcomes as a result of a more proactive post-term (more than 39 weeks) labor induction practice.

This guideline has shown that there was a significant reduction in the number of stillborn infants at term, 39 weeks of gestation. In addition to this conclusion, it was found or suggested that maternal deaths were also improved with proactive labor induction.

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On March 1, 2011, Jamie Rae was in induced for labor at 39 weeks gestation due to the large size of her baby. The defendant obstetrician, Dr. James Riva, did a vaginal delivery of the baby, Bailei Rae, at a hospital in Maryville, Ill.

During the course of the delivery of Bailei, a shoulder dystocia occurred involving the anterior presenting shoulder. That means that the baby’s shoulder was stuck on the pelvic bone of her mother, Jamie Rae. While performing maneuvers to relieve the shoulder dystocia, Dr. Riva allegedly exerted excessive traction on the baby’s head, causing a 5-level cervical nerve root injury including a complete avulsion at C-8.

As a result, the 9 lbs 2 oz newborn baby, Bailei Rae, sustained a brachial plexus injury to the posterior shoulder with permanent nerve root damage and Erb’s palsy in the left arm.

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