Introduction
Erb’s Palsy, a brachial plexus birth injury, results from the nerves controlling the arm and hand being injured during birth. Such injuries pose great disability and trauma for individuals as well as their families. For lawyers defending or prosecuting any case in which there is a claim of Erb’s Palsy the medical, social and legal reasons behind the claim need to be appreciated. This article presents a thorough description of Erb’s Palsy, its role in cases of medical negligence, and how medical records review companies can assist the lawyers in succeeding in their cases.
1. Overview of Erb’s Palsy
Definition and Types
Erb’s Palsy is a condition resulting from injury to the brachial plexus, a network of nerves that control movement and sensation in the arm. The injury typically occurs during delivery, particularly in cases of shoulder dystocia. There are several types of Erb’s Palsy, including:
- Erb’s Palsy (Upper Brachial Plexus Injury): Involves damage to the upper nerves (C5 – C6) and the symptoms observed include weakened shoulder and arm or in effect paralysis of these body parts.
- Klumpke’s Palsy (Lower Brachial Plexus Injury): refers to damage to the lower nerves (C8-T1) and resulting to weak hand and wrist.
- Total Brachial Plexus Palsy: Entails a complete loss of function of the affected arm, due to total involvement of all the nerves within the brachial plexus.
Causes and Risk Factors
Erb’s Palsy is primarily caused by excessive pulling on the infant’s head during delivery, particularly in cases of:
- Shoulder Dystocia: When the baby is born the shoulder gets stuck behind the pelvic bone of the mother.
- Large Birth Weight: Considered a risk factor as well.
- Maternal Diabetes: Causes larger infants and more difficulty during birth.
- Prolonged Labor: Increases potential damage to the nerves during birth.
2. Symptoms and Diagnosis
Common Symptoms
Symptoms of Erb’s Palsy can vary depending on the severity of the nerve injury. Common signs include:
• Weakened or loss of functional activity of the muscles in the affected arm
• Loss of functional movement in the affected arm or hand
• Loss of feeling towards the hand or arm
• Nonfunctional use of the arm where abnormal postures exist like the arm resting on the sides
Diagnostic Procedures
Diagnosis of Erb’s Palsy typically involves:
• Physical Examination: Physical movements of the arm and examination for weakened muscles around the arm.
• Imaging Tests: MRI or ultrasound may assist to visualise the injury involved to the nerves and any other lesions.
3. Treatment Options
Non-Surgical Treatments
For mild cases, non-surgical treatments may include:
• Arm Physical Therapy: Targets enhanced strength and motion on the affected arm.
• Occupational therapy: Helps a child learn daily activities.
Surgical Interventions
Severe cases may require surgical intervention, such as:
• Nerve Repair: Involves rearranging the nerves to connect with each other.
• Muscle Transfer: Improvement of already existing functions in the problematic arm by transferring other muscles.
4. Legal Implications of Erb’s Palsy
Medical Malpractice Claims
Medical malpractice claims related to Erb’s Palsy often arise from:
• Failure to Recognize Risk Factors: Healthcare practitioners may be careless and do not seek risk factors which may trigger shoulder dystocia.
• Inadequate Response to Complications: It may be that appropriate measures were not taken whilst delivering the baby and nerve was injured resulting.
Failure to Diagnose
There can be delays in the manifestation of Erb’s Palsy which can lead to progression of symptoms and complications and as such, legal proceedings may be commenced against the healthcare providers. Providers’ standard of care in diagnosing and managing the condition will need to be proved as breached by the attorneys.
Informed Consent Issues
Informed consent is crucial in Erb’s Palsy cases. Patients and their families must be fully informed of the risks associated with delivery methods, especially in high-risk situations. Failure to obtain informed consent can lead to legal repercussions for healthcare providers.
5. The Role of Medical Records Review in Legal Cases
Importance of Accurate Documentation
Overview of the Medical records in the history of Erb’s Palsy Surgery must be accurate as these documents serve as an account of significant events throughout the corresponding years. In the example of this document, inaccuracies or omissions in medical records can greatly impact the outcome of a case brought to the court.
How Medical Records Review Supports Attorneys
Medical records review companies assist attorneys by:
- Working with medical documentation to determine discrepancies.
- Compiling papers on the pertinent medical past and treatment.
- Providing expert opinions on the standard of care.
By leveraging these services, attorneys can build stronger cases and improve their chances of favorable outcomes.
6. Case Studies
Case Study 1
Overview: An infant developed Erb’s Palsy due to prolonged labor and failure of the healthcare team to manage shoulder dystocia. The condition grossly affected the infant’s arm and will require extensive physiotherapy management in the future.
Challenges: A central issue faced was difficulty with establishing that there was a failure to meet the standard of care during the delivery by the healthcare providers. Furthermore, the case was further complicated by difficulty in acquiring the entire set of medical records.
Solutions: The attorney hired a medical records review company and asked them to look at the delivery notes and find where care may have been lacking. This investigation indicated that standard procedures for the treatment of shoulder dystocia were not adhered to by the delivery team.
Case Study 2
Overview: Erb’s Palsy, caused by improper delivery technique, left a child with mobility challenges. This led the family to take the hospital to court alleging negligence on the part of the hospital.
Challenges: The attorney had the task to show that the actions of the particular hospital staff during the delivery were deficient in a manner that caused the injury.
Solutions: The attorney worked with a medical records review company to obtain all the relevant and available records including the delivery file and all medical expert opinions regarding the level of care provided. This evidence was essential in proving the case of negligence.
7. Conclusion
Both patients and attorneys face distinct issues with Erb’s Palsy. It is important for the lawyers representing this condition to appreciate its medical, legal as well as emotinal impact. Medical records review services where medical records of clients are evaluated can help the attorneys to improve their strategies when handling clients’ cases. It is equally important to familiarize oneself with new developments in the treatment and legal protection of Erb’s Palsy for success in this area.