Shoulder Dystocia

For over three decades, Searcy Denney has represented the families of babies injured during birth. We hold obstetricians, nurses and hospitals liable for brain damage, brachial plexus injuries, facial paralysis, nerve damage and other serious harm caused by medical negligence.

Our Florida birth injury attorneys recognize the many challenges your child faces and aggressively pursue the means for you to deal effectively with medical treatments, assistance with daily living, lost wages, and other matters related to caring for your child. Our goal is to help you give your child the best medical care and quality of life possible.

Shoulder Dystocia

Shoulder dystocia occurs when a baby’s shoulders get stuck in the birth canal. The delivery complication puts both mother and child at risk of serious injuries. But, with adequate monitoring and safe delivery techniques, shoulder dystocia is preventable.

Risks to the Baby

During a difficult delivery, your otherwise healthy baby may suffer debilitating shoulder dystocia injuries, including:

• Klumpke’s paralysis. The stretching of the brachial plexus nerves in the shoulder can result in paralysis of the forearm, hand, wrist and fingers of the affected arm. This rare condition often causes permanent disabilities.
• Erb’s palsy. Damage to the brachial plexus nerves may also result in Erb’s palsy, in which the child has no control over the arm or the arm remains stiff and deformed. This type of palsy may cause paralysis, weakness, shaking and pain to the affected arm.
• Hypoxia. Lack of oxygen to the baby’s brain during labor can result in brain damage, cerebral palsy or death.

Risks to the Mother

In addition to putting your newborn’s health at risk, your baby’s shoulder dystocia may also injure you. You may face such debilitating, painful complications as:

• Postpartum hemorrhage. Excessive blood loss can result in maternal shock and death if not immediately treated.
• 3^rd and 4^th degree vaginal laceration. Severe perineal tears might damage the vagina, perineal muscles, anal sphincter and anus, requiring surgery and leading to long-term incontinence, infertility, pain and sexual dysfunction.
• Uterine rupture. A uterine rupture is a potentially life threatening event in which the wall of the uterine completely fissures.

Why Shoulder Dystocia Happens

Your doctor should carefully monitor your health during your pregnancy and take special precautions if you have these risk factors for shoulder dystocia:

• Larger than normal fetus
• Multiple babies
• Diabetes
• Obesity
• Late delivery
• Induced labor
• History of dystocia
• Operative vaginal birth

If appropriate, your doctor should recommend a C-section or other actions to reduce the risk associated with a difficult labor.

Oxygen Asphyxia

During pregnancy, the placenta transfers oxygen-rich blood into the uterus and to the fetus. Immediately upon birth, the baby begins to breathe oxygen into his or her lungs. Complications that interrupt oxygen flow at any stage of pregnancy and delivery may result in brain damage. Life-threatening fetal distress occurs if the baby does not get enough oxygen.

Oxygen asphyxia may occur while in-utero because of low oxygen in the mother’s blood if she has anemia, low blood pressure or another medical condition. An interruption in blood flow, because the placenta was pinched or entrapped during a difficult labor, may also deprive the newborn of sufficient oxygen.

The baby suffocates if the placental oxygen supply is cut off before the newborn is able to draw a breath — for example, if the umbilical cord was delivered before the infant or the placenta separated from the uterus too early.

The stress of delivery may cause the baby to defecate (meconium) into the amniotic fluid, which the baby then breathes in, a condition called meconium aspiration syndrome (MAS). Even a very short period of oxygen asphyxia can cause serious, permanent brain damage.

Signs and Risks of Oxygen Asphyxia During Pregnancy

Your doctor is responsible for monitoring your health and the health of your baby during pregnancy. This important medical duty includes recognizing and reacting to risk factors associated with maternal medical conditions, such as low blood pressure, anemia, iron deficiency or infection, that may restrict the flow of oxygen. Signs that a fetus is receiving insufficient oxygen include abnormal heart rate and increased blood acid levels.

Signs and Risks of Oxygen Asphyxia During Delivery

During delivery, doctors can detect fetal distress through the baby’s decreased movement, increased heart rate and meconium in the amniotic fluid.

Oxygen may be cut off during a long, difficult birth because of:

• Poor maternal oxygen delivery due to low blood pressure or anemia
• Pinched umbilical cord
• Prolapsed umbilical cord that is delivered before the baby
• Early separation of the placenta from the uterus
• Premature baby with poorly formed airway or lungs
• Meconium aspiration syndrome (MAS), if the infant defecates into the amniotic fluid and breathes it in

Once the child is born, doctors have a duty to act emergently if the baby shows signs of oxygen deprivation, such as pale skin color, weak breathing, low heart rate, poor reflexes, acidosis, seizures or meconium-stained amniotic fluid.

Oxygen Deprivation Results in Brain Damage

Brain cells begin to die after only a short period of oxygen deprivation. Therefore, doctors and hospital staff have a duty to act quickly to restore the oxygen. Children who stopped breathing have a high risk for brain damage, which may result in physical disabilities, intellectual disabilities, developmental impairment, cerebral palsy or death.

Erb’s Palsy

One in every 1,000 babies is born with Erb’s palsy, a condition that affects arm movement, strength and sensation. Although some children overcome the condition through physical therapy, passive range of motion exercises and surgery, many children endure a lifetime of challenges.

Doctor’s Delivery Mistakes Can Cause Erb’s Palsy

Brachial plexus injuries generally occur during birth when the obstetrician:

• Allows the baby’s head and neck to twist to the side in the birth canal
• Stretches or tugs on the newborn’s shoulder as the baby passes through the birth canal head first
• Places pressure on the infant’s raised arm in a feet-first breech delivery

Disabilities Associated With Erb’s Palsy

Erb’s palsy can result in health issues and disabilities that may be temporary or permanent, including:

• Paralysis in the child’s upper arm, forearm or hand
• Weakness in the affected arm
• Loss of sensation and numbness in the arm
• No motor reflex, which is the involuntary response system
• Inability to fully grip with the hand and fingers
• Permanently flexed position of the arm

Brachial Plexus Injuries

During delivery, the newborn’s fragile shoulder is vulnerable to injuries. In particular, the brachial plexus network of nerves, which transmits signals from the brain to the fingers, hands, forearm and upper arm.

This sensitive neural network can become damaged if the doctor tugs, pulls or presses on the infant’s shoulder during a vaginal birth. The resulting brachial plexus palsy causes pain, paralysis, numbness, weakness and disability to an otherwise healthy baby’s affected arm. Damage to this intricate nerve system may result in Erb’s palsy or Klumpke’s paralysis, paralysis of the lower brachial plexus nerves..

These conditions manifest as paralysis, weakness, numbness, pain and disfigurement to the affected arm. Rupture of the brachial plexus typically requires substantial medical care and may never fully heal. Avulsion, when the brachial plexus rips off the spinal cord, usually results in a permanent disability.

Types and Causes of Brachial Plexus Injuries

The brachial plexus is the complex group of nerves that come together at the neck and shoulder and control movement and feeling in the arms, hands and fingers. Injury to the brachial plexus typically occurs during delivery and may include:

• Neurapraxia. The doctor overstretches the brachial plexus nerves during delivery. The mildest of the types of brachial plexus injuries, this condition may heal within three months with medical therapy.
• Neuroma. Scar tissue may form on the overstretched brachial plexus nerve fibers and press on healthy nerves. With treatment, the baby may partially recover, but may still have a partial disability.
• Rupture. An overstretched nerve that is torn will not heal without substantial medical care that may include surgery. Even with treatment or surgery, the child may suffer a permanent disability.
• Avulsion. Treatment cannot fully repair an avulsion in which the nerve is ripped from the spinal cord. In some cases, doctors might be able to splice a donor nerve graft removed from another child’s muscle. However, even after this major surgery, the child may only regain some function and feeling in the affected arm, but rarely all.

Symptoms of Brachial Plexus Palsy

Depending upon the level of damage to the nerves, the symptoms of brachial plexus injuries range from uncomfortable and temporarily debilitating to extremely painful and severely, permanently debilitating. Generally, brachial plexus injuries cause these symptoms in the affected arm:

• Severe pain
• Paralysis of arm, hand or fingers
• Inability to grip or close hands
• Numbness or total loss of feeling
• Muscle weakness
• Joint stiffness
• Permanently, inwardly bent arm

Some children also develop Horner’s syndrome, in which the eyelids droop.

Treatments and Prognoses

Medical treatment may partially or totally correct the brachial plexus injury in some cases. Physical therapy and passive mobility exercise can often improve functionality in children with moderate brachial plexus palsy. Until full use has been recovered, however, the child may lose valuable developmental time and may never fully recover.

Serious brachial plexus injuries often require surgery. Doctors may splice fibers from the child’s healthy muscle into the affected arm muscles to improve strength and movement. They may also splice nerve fibers from another child to repair nerves that were completely severed from the spinal cord. Even after these complicated surgeries, the child will likely have a serious, lifetime disability.

Facial Paralysis

Damage to the seventh cranial nerve may occur if undue pressure is placed on the infant’s face during passage through the birth canal. Causes of facial nerve palsy include:

• Improper use of instruments, such as forceps, during the delivery
• Very large baby, increasing risk of vaginal birth
• Long, difficult delivery
• Improper use of epidural anesthesia during C-section or vaginal delivery
• Negligent use of certain drugs that induce labor and intensify contractions

Facial nerve palsy usually affects one side or part of the face. A baby’s paralyzed or weakened facial muscles often appear most obvious while crying — the eyelid may not fully close, the lower face may look uneven and his or her mouth may not move normally. In severe cases, the entire side of the face is paralyzed.

Cerebral Palsy

Cerebral palsy occurs in 1.5 to four children out of every 1,000 live births. Symptoms of the neurological condition manifest in early childhood and the condition never improves. However, with the right care and tools, the condition can often be managed so children with cerebral palsy can live as normal of a life as possible.

Signs of Cerebral Palsy

This permanent condition affects every aspect of a child’s life, including movement, eating, language, and sometimes learning and behavior, depending upon the severity of the condition.

Cerebral palsy is divided into three main types, but generally these symptoms overlap:

• Spastic cerebral palsy results in increased muscle tone, which manifests in joint and muscle stiffness and restricted, jerky movements.
• Athetoid cerebral palsy results in decreased muscle tone and, hence, floppy, involuntary, uncontrolled movements.
• Ataxic cerebral palsy causes lack of balance, stability and depth perception.

Usually doctors diagnose cerebral palsy by the child’s 18^th month based partly upon signs of delayed cognitive, physical, social and emotional development, as well as the telltale rigidity and/or floppiness of muscle tone.

Causes of Cerebral Palsy

Brain damage is the root cause of cerebral palsy. A number of prenatal and delivery errors may injure the brain, including:

• Premature birth and low birth weight associated with negligent prenatal advice and failure to diagnose risk factors
• Undiagnosed thrombophilia, which is a blood clot that restricts flow of oxygen to the baby’s brain
• Undetected and untreated bacterial or viral infections that attack the fetus’s nervous system
• Prolonged oxygen asphyxia during a long, difficult delivery
• Multiple births, particularly if doctors fail to take necessary precautions

Caring for a Child With Cerebral Palsy

Generally, a child with cerebral palsy requires constant lifetime care.  Since there is no cure, medical providers primarily focus on management, including:

• Physical therapy to promote muscle tone, improve overall physical health and increase mobility
• Speech therapy that also assists the child in breathing, eating and swallowing by maintaining the health of the mouth, throat and jaw
• Occupational therapy to help children adapt to the world around them and gain some level of independence and autonomy
• Orthotics that can correct or prevent bone and joint deformities
• Surgeries might include cutting nerves to prevent spasms or straightening twisted bones
• Medications, such as pain relievers, muscle relaxants and digestive aids

Our medical malpractice attorneys calculate the long-term costs of caring for a child with cerebral palsy and seek compensation that covers these extraordinary expenses over the full course of your child’s life.

Injuries to Mothers

Pregnancy and childbirth are traumatic for a woman’s body. But, with modern medicine, permanent injuries are rare. Unfortunately, a doctor’s negligence during delivery may cause the mother severe nerve damage with devastating results. There are also times when an obstetric mistake during labor may also cause irreversible harm to the mother.

Instead of enjoying your child’s first few days of life, you may experience excruciating pain and disability. Your injuries may keep you from caring for your newborn and may force you to undergo surgery. At its worst, you may never recover your full health.

Searcy Denney understands the heartbreak of birth-related injuries to the mother, child and entire family. Our Florida medical malpractice attorneys work aggressively to hold health care providers responsible for nerve injuries and other birth-related injuries. We have the resources and knowledge to fight corporate hospitals that failed to facilitate a safe childbirth and work diligently to help injured mothers obtain just compensation.

Femoral Nerve Dysfunction

Debilitating nerve damage may result from prolonged pressure or entrapment on the femoral nerve during vaginal delivery. The femoral nerve signals the leg muscles to move the hips and legs. Injury to the nerve can hinder the ability to walk and cause numbness in the leg and foot. Some women may require a wheelchair or walker for weeks or months after labor.

Lumbosacral Plexus Injury

An improperly placed epidural during a C-section or vaginal birth can cause injury to the lumbosacral plexus, which is the network of nerves that control movement and sensation in the legs. Damage to these nerves can cause weakness, numbness, tingling and burning as well as shooting or stabbing pain.

Pelvic Floor Damage

If the mother is particularly small or the baby too big, excessive pressure can overstretch the genital tract and the pelvic floor muscles. As a result, women may suffer urinary incontinence and genital prolapse, a condition in which the vaginal canal protrudes from the vaginal opening.

Perineal Tear

A negligently performed episiotomy may fail to protect the mother from serious perineal injury. Superficial tearing of the vagina is common during delivery and may cause only minor, temporary problems. Third and fourth-degree perineal tears, however, can result in devastating nerve and muscle damage. In the most severe cases, the tears penetrate the anal sphincter, causing incontinence, sexual dysfunction, numbness and pain.

Wrongful Birth

The happy experience of having a baby can soon turn to heartbreak if you learn your baby is severely disabled. Your first question is likely whether medical care can improve your baby’s condition. If you find that nothing can be done, the next question is whether the tragic situation could have been prevented.

Searcy Denney holds doctors to their duty of providing accurate, thorough information to patients. Your doctor had the duty to advise you of potential birth defect risks associated with your age, health and medical history. In addition, your doctor had the duty to recommend appropriate tests for congenital birth defects. Finally, you have the right to make an informed decision about whether to terminate a pregnancy that is consistent with your own spiritual, family, medical and financial circumstances.

Risks in Pregnancy

Fetal abnormalities can be detected using standard medical diagnostics. These tests should be made available to every pregnant woman, especially if she has risk factors that might increase her chances of having a baby with a birth defect. Ultrasound, blood tests, chorionic villus sampling, amniocentesis and DNA sampling can expose severe chromosomal, physical and genetic medical conditions, such as:

• Anencephaly
• Brain damage
• Cystic fibrosis
• Down syndrome
• Malformed limbs and organs
• Muscular dystrophy
• Neural tube defects
• Spina bifida
• Zika-related microcephaly

These conditions have no treatments available and may leave the child permanently dependent upon his or her parents to survive. The child may not be able to walk, talk, bathe, use the toilet or eat, and so caregivers must constantly perform these tasks. In some cases, the child will die within days or years of birth.

Damages for Wrongful Birth

Caring for a child who has a severe disability requires a lifelong, constant commitment. Often, one parent has to quit his or her job to remain with the child 24-7. The caregiver may feel isolated by the grueling, lonely task of caring for a child who will never get better. The financial, emotional and physical losses can be extensive.

To alleviate some of the stress on your family, our attorneys pursue damages that may include:

• Lost wages as a result of childcare duties
• Costs of medical treatments and palliative care
• Costs of special medical and assisted living equipment
• Costs of hired nurses and nursing aids
• Costs of adapting home and vehicle for special needs
• Daily costs of raising a child, such as food, clothing and shelter
• Mental anguish, depression and anxiety of the caregivers
• Pain and suffering of the child

Our lawyers and staff recognize the challenges and heartache that parents of severely disabled children face and we treat your family with respect, compassion and confidentiality.

Find Out If You Are Eligible to File a Medical Negligence Claim for Your Child’s Birth Injuries

If your baby was injured because of medical negligence, you may have the right to compensation. We believe that your child should have every opportunity to recover functionality, independence, health and quality of life. To help make this possible, we pursue legal action against the doctors and hospital responsible for your newborn’s injuries.

Contact Searcy Denney to schedule a free consultation with our medical malpractice lawyers. Because we take your claim on contingency, you owe us no attorneys’ fees or costs until we recover damages for your baby’s injuries.