What Erb’s Palsy Is and What It Can Actually Mean Long-Term
Erb’s palsy is an injury to the brachial plexus, the network of nerves that runs from the spinal cord through the neck and into the arm. When those nerves are stretched, compressed, or torn during delivery, the result is weakness or paralysis in the affected arm. The severity depends on which nerves were injured and how severely.
The Spectrum of Injury Is Wide, and the Prognosis Is Not Always “Wait and See”
Mild cases involving nerve stretching, called neuropraxia, sometimes resolve with physical therapy over the first year of life. That is the best outcome, and it does happen. But a significant portion of Erb’s palsy cases do not resolve on their own. Injuries involving nerve rupture or avulsion, where the nerve root is torn from the spinal cord entirely, do not heal without surgical intervention. Cases involving neuroma formation, where scar tissue replaces healthy nerve tissue, require surgical excision and nerve grafting to restore meaningful function.
The “wait and see” approach that many families are initially given is appropriate for monitoring early recovery. It becomes a problem when it delays surgical evaluation past the window where intervention produces the best results, typically within the first six to nine months of life.
What Partial Recovery Looks Like
Children with moderate to severe Erb’s palsy who do not achieve full recovery may develop muscle atrophy in the affected arm, limited range of motion, weakness in grip and elbow flexion, and, in some cases, a shortened arm relative to the unaffected side. These are not temporary inconveniences. They shape a child’s physical development, school experience, and long-term quality of life in ways that a damages analysis must account for across decades, not just the first few years.
How Delivery Negligence Causes Erb’s Palsy
Erb’s palsy caused by medical negligence typically traces back to one of two failure points: mismanagement of shoulder dystocia in the delivery room, or failure to anticipate and plan for a high-risk delivery before labor began.
Shoulder Dystocia and What the Delivery Team Is Trained to Do
Shoulder dystocia occurs when the baby’s anterior shoulder becomes impacted behind the mother’s pubic bone after the head has delivered. It is an obstetric emergency, but it is not an unmanageable one. Hospitals train delivering physicians and nursing staff in a specific sequence of maneuvers designed to free the impacted shoulder without applying lateral traction to the baby’s head and neck.
That lateral traction is what injures the brachial plexus. The maneuvers, including the McRoberts maneuver, suprapubic pressure, and rotational techniques, exist precisely because pulling on the baby’s head is the wrong response. When a physician applies excessive downward or lateral force in a moment of urgency, they have departed from what the standard of care requires, and the resulting nerve injury is the consequence of that departure.
When the Warning Signs Were There Before Labor Began
Not all shoulder dystocia negligence happens in the delivery room. Several risk factors for shoulder dystocia are identifiable during prenatal care and at the time of hospital admission. A large estimated fetal weight, a prior delivery involving shoulder dystocia, maternal diabetes or gestational diabetes, a prolonged second stage of labor, and certain maternal pelvic measurements all increase the statistical likelihood of shoulder dystocia occurring.
When those risk factors were documented, and a vaginal delivery was proceeded with anyway, without a documented conversation about elective C-section or a modified delivery plan, the negligence may have begun before the mother ever pushed. That pre-delivery theory is one of the most consequential aspects of Erb’s palsy litigation and requires careful review of the full prenatal and labor records.
Call (718) 946-2273 to have our team review your delivery records.
Brooklyn’s Delivery Landscape and Why It Matters to These Cases
Maimonides and the Reality of High-Volume Delivery Pressure
Maimonides Medical Center in Borough Park is one of the highest-volume maternity programs in New York State, delivering thousands of babies each year. That volume is a point of institutional pride, and it reflects a genuine service to Brooklyn’s diverse communities.
It also creates real delivery room conditions, including staffing ratios, shift transitions, documentation practices under pressure, and attending physician workloads, which are relevant when evaluating whether the standard of care was met in a specific delivery.
A delivery room where shoulder dystocia was managed incorrectly is not automatically a high-volume problem. But the records of how decisions were made, who was present, how quickly additional support arrived, and what was documented in the moment all become part of the factual picture.
Public Hospitals and the 90-Day Notice of Claim Requirement
Several of Brooklyn’s hospitals with active labor and delivery units operate under public entity rules. SUNY Downstate Medical Center and Kings County Hospital Center in East Flatbush, and Coney Island Hospital in the southern part of the borough, are all connected to public systems. Coney Island Hospital operates under NYC Health + Hospitals.
Under New York General Municipal Law § 50-e, a notice of claim against a public entity must be filed within 90 days of the injury. For a birth injury that occurred at a public hospital, that 90-day window begins at the time of the delivery, not at the point of diagnosis or the point at which the family retains an attorney.
Families who spend the early months of their child’s life focused entirely on medical care and therapy, without realizing that a legal deadline is running, sometimes discover the 90-day window has closed before they ever consulted an attorney. If the delivery occurred at a public Brooklyn hospital, that question needs to be the first one answered.
What the Damages Timeline Looks Like in a Birth Injury Case
Physical Therapy, Surgery, and the Costs That Follow a Child Into Adulthood
An Erb’s palsy damages analysis is not a snapshot of current medical expenses. It is a projection across a child’s developmental arc. Physical and occupational therapy typically begins in the first weeks of life and continues for years. Cases requiring surgical intervention, including nerve grafting, neurolysis, or secondary orthopedic procedures to address muscle contracture and joint deformity, generate surgical costs that extend through childhood and sometimes into adolescence.
Assistive devices, accommodations, educational support, and the cost of future care into adulthood are all part of a comprehensive damages model. So is the wage-earning impact of a permanent physical limitation that affects a child’s eventual career options. These figures require expert life-care planning analysis, and they often exceed what families initially assume is possible to recover.
Damages Beyond Medical Costs
Pain and suffering from repeated surgical and therapeutic interventions across a child’s development, the emotional impact of growing up with a visible physical limitation, and loss of enjoyment of activities that require full bilateral arm function are all recognized categories of non-economic damages in New York birth injury cases. Parents may also have claims for the costs and disruption they have personally sustained managing a child’s ongoing care needs.
If you believe your child’s injury may have been caused by delivery negligence, call (718) 946-2273 to schedule a free consultation. There are no upfront fees.
Ask Finz & Finz
My child’s doctor says the Erb’s palsy will probably resolve on its own. Should I still consult an attorney?
Yes, and timing matters. Whether a legal claim is viable is a separate question from whether the injury will resolve. The delivery record review and the assessment of whether negligence occurred should happen now, while records are accessible and memories are intact. If the injury resolves fully, the legal analysis is complete, and nothing was lost. If it doesn’t resolve as expected, having started the legal review early puts the case in a significantly stronger position.
The hospital said shoulder dystocia is unpredictable and could not have been prevented. Is that accurate?
Shoulder dystocia as an event can be difficult to predict with certainty in every individual case. The response to shoulder dystocia is not unpredictable. It is trained, protocolized, and standardized. Whether the clinical team followed the accepted maneuver sequence, applied excessive traction, and whether known risk factors should have prompted a different delivery plan are all specific factual questions that the delivery record can answer. “Unpredictable” is not a defense to a departure from the standard of care in managing the event.
We were not given clear information about C-section as an option before labor. Is that relevant?
It can be. Informed consent in obstetric care requires that patients be given meaningful information about delivery options, including the risks associated with proceeding with vaginal delivery when risk factors for shoulder dystocia are present. If gestational diabetes, a large estimated fetal weight, or other documented risk factors were present and a C-section discussion was not had or not documented, that gap is part of the pre-delivery negligence analysis.
How do we pay for a birth injury case if we are already managing significant medical expenses?
Finz & Finz, P.C., handles birth injury cases on a contingency fee basis. There are no upfront legal fees. Our fee is a percentage of the recovery if the case resolves in our favor. Families dealing with the ongoing costs of a child’s care should not face an additional financial barrier to a legal consultation.
In the overwhelming majority of Erb’s palsy cases caused by delivery negligence, the decisions that determined the outcome were made by the clinical team, not the parents. The risk factors for shoulder dystocia, the condition that causes most brachial plexus birth injuries, are frequently identifiable before labor ever begins. The maneuvers for managing it are trained, practiced, and standardized. When a delivering physician applies excessive force to free a stuck shoulder, the standard of care that was violated is not the parents’ responsibility to have known.
