What Is a Brachial Plexus Injury and How Does It Happen During Birth?
The brachial plexus is a bundle of nerves that originates in the neck and travels through the shoulder into the arm. These nerves control movement and sensation in the shoulder, elbow, wrist, and hand. When a delivering physician applies excessive lateral traction to the baby’s head and neck during a difficult delivery, those nerves may stretch, compress, or tear.
How Shoulder Dystocia Leads to Nerve Damage
Shoulder dystocia occurs when the baby’s head delivers but one or both shoulders become lodged behind the mother’s pubic bone. This is a recognized obstetric emergency, and the American College of Obstetricians and Gynecologists (ACOG) publishes protocols for managing it safely. The delivering physician’s response during shoulder dystocia directly determines whether the baby sustains a brachial plexus injury.
When the physician pulls downward on the baby’s head with excessive force rather than following established relief maneuvers, the stretch on the brachial plexus nerves may cause damage ranging from mild neuropraxia (a temporary nerve stretch) to avulsion (the nerve root tearing away from the spinal cord). The severity of the injury depends on the amount of force applied and how long the compression lasted.
Types of Brachial Plexus Injuries in Newborns
Not all brachial plexus injuries present the same way, and the type of nerve damage your child sustained affects both the prognosis and the legal case. Brooklyn families frequently encounter the following diagnoses after a difficult delivery.
- Erb’s palsy (upper brachial plexus injury), affecting the shoulder and upper arm, resulting in the arm hanging at the side with limited movement
- Klumpke’s palsy (lower brachial plexus injury), affecting the forearm, wrist, and hand, which is less common but may cause significant loss of grip and fine motor control
- Total plexus involvement, affecting the entire arm from shoulder to hand, often associated with more severe traction injuries
- Neuropraxia, a stretch injury where the nerve remains intact but function is temporarily reduced, with most cases resolving within weeks to months
- Neuroma or avulsion injuries, where the nerve is partially or completely torn, potentially requiring surgical intervention and carrying a higher risk of permanent impairment
Even injuries that appear mild in the first weeks of life may reveal lasting functional limitations as the child grows and begins reaching developmental milestones. An early medical and legal evaluation gives your family the clearest picture of your child’s prognosis and the strength of a potential claim.
What Delivery Room Errors Lead to Brachial Plexus Injuries in Brooklyn?
Brachial plexus injuries during delivery are closely linked to how the medical team manages labor, anticipates complications, and responds to shoulder dystocia. Brooklyn hospitals deliver thousands of babies each year at facilities including Maimonides Medical Center, NYU Langone Hospital Brooklyn, and NYC Health + Hospitals/Kings County, and the standard of care at each of these institutions requires physicians to follow established protocols for difficult deliveries.
Specific Obstetric Failures That Cause Nerve Damage
The following delivery room errors appear frequently in Brooklyn brachial plexus injury cases reviewed by birth injury attorneys.
- Applying excessive downward traction on the baby’s head when the shoulder is stuck, rather than using recognized maneuvers to free the shoulder without pulling on the neck
- Failing to perform the McRoberts maneuver (repositioning the mother’s legs to widen the pelvic opening) or suprapubic pressure as a first response to shoulder dystocia
- Using forceps or vacuum extraction improperly, adding lateral force to the baby’s head and neck during an already complicated delivery
- Failing to anticipate shoulder dystocia in high-risk deliveries, such as when the baby is estimated to be large for gestational age or the mother has gestational diabetes
- Delaying a cesarean section when prenatal indicators suggest a vaginal delivery carries a heightened risk of shoulder dystocia
Obstetric protocols exist precisely to prevent brachial plexus injuries during complicated deliveries. When a physician skips those protocols or applies force that exceeds what the clinical situation permits, the resulting nerve damage may form the basis of a malpractice claim.
How Do You Prove a Brachial Plexus Birth Injury Case in Brooklyn?
A brachial plexus birth injury case requires your legal team to prove the same four elements that apply to all New York medical malpractice claims, with a specific focus on what happened during the delivery itself. The evidence centers on the delivery record and the testimony of retained obstetric and neurological physicians.
- Duty of care: The obstetrician, midwife, and hospital owed your baby a duty to provide competent care during labor and delivery.
- Breach of the standard of care: The delivering physician or team failed to follow accepted obstetric protocols for managing the delivery, including the response to shoulder dystocia.
- Causation: The breach directly caused the brachial plexus injury, meaning the nerve damage resulted from the physician’s actions rather than an unavoidable complication.
- Damages: Your child suffered measurable harm, including nerve damage, loss of arm function, need for medical treatment or surgery, and the impact on the child’s development and quality of life.
Hospitals frequently argue that brachial plexus injuries occur naturally during difficult deliveries and that the physician followed proper technique.
A Brooklyn brachial plexus injury attorney at Finz & Finz counters that defense by presenting retained physicians who analyze the delivery record, the documented maneuvers, and the clinical evidence of the type and severity of force applied.
What Filing Deadlines Apply to Brooklyn Brachial Plexus Injury Cases?
New York’s medical malpractice statute of limitations under CPLR § 214-a provides additional time for claims involving minors. A birth injury lawsuit generally must be filed within 10 years of the date of the malpractice, and no later than the child’s twentieth birthday.
The 90-Day Notice of Claim for Brooklyn Public Hospitals
If your child was born at a public hospital in Brooklyn, such as Kings County Hospital or Woodhull Medical Center, a Notice of Claim must be filed within 90 days of the delivery. This deadline applies regardless of the extended statute of limitations for minors, and missing it typically bars the family from pursuing the case at all. The 90-day window passes quickly, which is why seeking legal guidance soon after your child’s diagnosis matters.
Why Timing Affects the Strength of Your Case
Beyond the legal deadlines, the practical strength of a brachial plexus case depends on the preservation of key evidence. Delivery records, fetal monitoring strips, and staff recollections are most reliable and accessible in the months and years immediately following the birth. The longer a family waits, the more difficult it becomes to reconstruct the full picture of what happened in the delivery room.
What Compensation May Be Available in a Brooklyn Brachial Plexus Case?
The financial and personal impact of a brachial plexus birth injury depends on the severity of the nerve damage, whether surgery is required, and how the injury affects your child’s development over time. New York law allows families to seek damages that account for both the immediate medical costs and the long-term consequences of the injury.
Categories of Damages in Brachial Plexus Birth Injury Claims
Brooklyn families pursuing a brachial plexus malpractice claim may seek the following types of compensation.
- Past and future medical expenses, including surgery (such as nerve grafting or tendon transfer), physical therapy, occupational therapy, and ongoing specialist appointments
- Costs of adaptive equipment and modifications needed to accommodate limited arm or hand function as the child grows
- The child’s pain and suffering, covering both the physical discomfort from the injury and the emotional impact of growing up with a functional limitation
- Loss of future earning capacity if the injury permanently limits the child’s ability to perform certain types of work as an adult
New York does not impose a cap on non-economic damages in medical malpractice cases, and juries in birth injury cases consider the full trajectory of the child’s life when assessing the harm.
A brachial plexus injury that appears minor at birth may carry significant long-term consequences that only become apparent as the child develops, making thorough medical documentation and early legal evaluation particularly important.