BIRTH INJURY Medical Malpractice Lawsuit: Excessive Traction Results in Permanent Brachial Plexus Injury.
The mother was a thirty-two-year-old, gravida III, para II who presented to labor and delivery in active labor.
The pre-natal record for the delivery of the baby indicates an ultrasound was done with an estimated fetal weight at the time of 4039 grams +/-609 grams also listed on the pre-natal record as 9+/- lbs. The fetal age by ultrasound was listed as 20 weeks 6 days.
The delivering doctor did recognize the turtle sign, and indication of shoulder dystocia. The delivery note states that following the recognition of shoulder dystocia the McRoberts maneuver was utilized with suprapubic pressure applied. These maneuvers were not successful. An attempt was made to rotate anterior shoulder (right) counter clockwise also unsuccessful. An attempt was made to deliver posterior shoulder again unsuccessful. The delivering was then able to follow the arm down to the elbow but was unable to slip the arm anteriorly across the body. Further McRoberts and suprapubic pressure were done and finally the delivering doctor was able to push the infants shoulder up and rotate the anterior shoulder clockwise and underneath the pubic symphysis and deliver the baby.
It was later found during surgery that the child suffered a very severe brachial plexus injury at birth. The small C5 nerve root was ruptured, the C6 was avulsed with empty dural sheath, C7 was completely ruptured, C8 and T1 were encased in scar tissue.
The delivering doctor fell below the standard of care in his care and treatment in several areas.
- Failure to properly assess the estimated fetal weight prior. By failing to order any subsequent ultrasound evaluations after the 20th
- Failure to order a full three-hour glucose tolerance test to determine if the mother was a gestational diabetic. This is particularly in light of her history of gestational diabetes.
- Failure to perform and document appropriate should dystocia release techniques in the face of a recognized shoulder dystocia.
- Application of excessive lateral traction to the baby’s head and neck in the presence of a shoulder dystocia resulting in an avulsion injury to the right upper extremity of the baby.
If the doctor had applied the appropriate shoulder dystocia release maneuvers, and not used excessive lateral traction in the fact of shoulder dystocia the baby would not have sustained the upper right arm injuries and would not have pain, suffering and permanent disability consequences of an Erbs Palsy injury.
The brachial plexus injury suffered is the result of excessive traction placed upon baby’s head during the time of delivery with a recognized shoulder dystocia. The permanent neurologic injury to the brachial plexus was caused by excessive traction to the fetal head and neck applied by the medical resident while attempting to deliver the macrosomic baby.