Brachial Plexus



The brachial plexus is a bundle of nerves running from the shoulder and through the arm to the hand. Injuries to the brachial plexus can result in shoulder dystocia, Erb’s palsy, and Klumpke’s palsy. These are all conditions that affect movement and sensation in the shoulders, arms, and hands.




There are several reasons why brachial plexus injuries occur throughout delivery. It is the doctor’s responsibility to properly monitor both mother and child, as well as to use appropriate practices to ensure safe delivery.

These including:

High birth weight baby: Whether the child is too large, or the mother’s birth canal is too small, it is the doctor’s responsibility to properly monitor if it will be safe to deliver vaginally. If it is deemed high risk due to either of these factors, it is the doctor’s responsibility to suggest cesarean delivery.

Breech delivery: A breech position means that the baby is being delivered bottom-first. This position can be dangerous for both mother and child. In this position, there is too much pressure being placed on the baby’s arms and shoulders, which could result in a brachial plexus injury. It is the doctor’s responsibility to take the proper measures to ensure safe delivery.

Improper use of tools: During the birthing process, a doctor may use tools such as forceps or a vacuum extractor. If these tools are used improperly, or if the doctor uses excessive force while pulling on the baby’s head or neck, it may result in a brachial plexus injury.


Shoulder dystocia: This occurs when a baby’s shoulder gets lodged in the mother’s pelvis during labor. Shoulder dystocia happens for several reasons including fetal macrosomia, the mother is delivering multiple children, the mother is obese, labor and delivery are late, labor is induced, the mother receives an epidural. This injury can result in paralysis of the upper arm, Erb’s palsy, broken bones, and facial injuries.

Erb’s palsy: A movement disorder characterized by nerve damage because of shoulder dystocia, resulting in pain or paralysis in the shoulder, arm, and neck.

Klumpke’s palsy: A movement disorder characterized by nerve damage because of shoulder dystocia, resulting in difficulty using specific muscles, paralyzed arm, stiff joints, muscle atrophy in the shoulder, and lack of sensation in the arm or hand.


Although not all brachial plexus injuries are a direct result of medical malpractice, there are instances in which it could be considered as such.

These include:

  • Failure to properly monitor mother and child
  • Failure to suggest cesarean delivery
  • Excessive force used during the delivery process
  • Improper use of birth tools
  • Failure to properly execute medical maneuvers
FAQs About Your

Medical Malpractice Case

How do I know if I have a medical malpractice case?
Medical Malpractice is a form of professional negligence that can be committed by any medical professional who is involved in giving care to a patient. To prove medical malpractice, a claimant must show that a doctor-patient relationship existed, that the professional violated the standard of care, and an injury resulted from that violation.    
What is “informed consent” and how does this relate to malpractice?
In Rhode Island, informed consent refers to the conversation a medical professional has with their patient when they explain the proposed course of treatment and its risks. The physician must also offer information for alternative treatments and/or the option of not treating a specific illness. Rhode Island requires a five-part test to decide if there is validity in a medical malpractice case surrounding a lack of informed consent. This test includes: the physician’s explanation of risk was inadequate, the risk was known and withheld by the physician, the risk was a valid concern, and the injury in question was caused by this undisclosed risk.
How can a jury determine if a physician’s actions were negligent?
All medical professionals are expected to abide by a standard of care. A judge is responsible for questions of law. A juror is a trier of fact. While a jury listens to an entire trial, their job is to take the law as described to them by the judge and apply all of the facts and information that were relayed to them through testimony throughout the trial. A jury is then responsible for rendering a verdict based on the law given to them during jury instructions by the judge and their opinion a to whether or not the case presented by the plaintiff meets or exceeds the standard of law as defined by the judge of negligence by the medical professional.
What are examples of medical malpractice?
A licensed medical professional's actions that fall below the standard of care include failure to diagnose/misdiagnosis, failure to order proper testing, failure to recognize symptoms, misreading/ignoring laboratory results, surgical errors or wrong-site surgery, improper medication/dosages, unnecessary surgery, poor follow-up or aftercare, premature discharge, or disregarding or not taking an appropriate patient history.  
How much time do I have to start my case?
The statute of limitations for medical malpractice cases in Rhode Island is up to three years after the discovery of their medical condition. In Massachusetts, patients are given up to three years from the discovery date if they would not have reasonably known of the malpractice. In Connecticut, patients are given up to two years to file their case.
Do I have any medical rights?
You have the right to:
  • Access information regarding your case that is accurate, easy to understand, and in your language.
  • Access any assistance you may need to understand your medical information.
  • Be involved in decisions regarding your medical treatment.
  • Receive respectful care from any medical professional.
  • Confidentiality regarding your medical care and treatments.
  • Read and copy your medical records to ensure accuracy.
  • File a complaint against any medical staff who treats you.

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