Newborn Nerve Injury

Bell's Palsy | Brachial Plexus | Spinal Cord Injury

The labor and delivery process is often an exhausting and traumatic experience for a baby. Fortunately, most deliveries in the United States in the 21^st century result in happy and healthy boys and girls. Unfortunately, sometimes babies can suffer serious and permanent nerve injuries as a result.

Facial Nerve Paralysis and Bell’s Palsy Medical Malpractice

What are facial nerve paralysis and Bell’s Palsy?

Facial nerve palsy refers to a condition in which the seventh cranial nerve (“facial nerve”) is damaged and causes weakness or paralysis of the face. Idiopathic facial paralysis, commonly known as Bell’s Palsy, is when the cause of the facial muscle weakness is unknown. Even though in many of the cases the cause of facial nerve paralysis is unknown, there are several described causes, including congenital (e.g. due to delivery traumas or genetic diseases) and acquired (e.g. infective, inflammatory, neoplastic, traumatic or iatrogenic) causes.

One of the more common known causes of congenital facial nerve paralysis is birth trauma related to a difficult delivery. In some cases, the injury could have been avoided with the exercise of reasonable care.

What are the symptoms of facial nerve palsy?

The facial nerve controls the muscles used in facial expression. The nerve extends out from the brainstem and divides into smaller branches, which are located throughout the face.

There are varying degrees of facial nerve palsy depending on which part and how severely the facial nerve was injured. A facial nerve injury due to a birth trauma usually affects only one part of the facial nerve and the infant will have diminished movement on the affected side of the face. One of the most common symptoms of facial nerve palsy due to birth trauma is muscle weakness around the lips that is most noticeable when the infant cries.

Other symptoms of facial nerve palsy due to birth trauma include:

asymmetrical facial movement
drooping on one side of the face
an inability to close the eye completely
difficulty blinking
drooling
difficulties feeding
no movement on the affected side of the face

Usually the condition is diagnosed while the infant is in the hospital, however in some mild cases the problem may not be recognized until a later time.

How can Bell’s Palsy be caused by medical malpractice?

There are a few ways that cerebral palsy could be caused by the negligence of a health care provider. For example:

Improper delivery technique: one of the risk factors associated with traumatic facial nerve palsy is the use of forceps during delivery. A doctor may be negligent in applying too much pressure on the facial nerve when using forceps, resulting in a facial nerve injury.
Failure to recognize risk factors that predispose the baby to a facial nerve injury during delivery. There are risk factors that increase the risk of the infant suffering an injury to the facial nerve, including birth weight greater than 3500 grams and prolonged second stage labor. A doctor may be negligent in failing to perform an emergency delivery, such as a Cesarean section, in a timely manner.
Viral infections: there is research indicating that newborns can contract viral infections, such as Herpes Simplex Virus (HSV), from their mothers during delivery. Although the cause of Bell’s palsy is unknown, it has been linked to HSV, as well as other viruses. So doctors must be reasonably prudent to reduce the risk of transmission to the baby.

There are many different ways a facial nerve palsy injury can occur due to medical malpractice, so it is best to have our experienced medical malpractice lawyers review your potential case.

What are the treatments for a facial nerve injury?

Most cases of facial nerve palsy due to birth trauma or Bell’s Palsy have a favorable prognosis, with a majority resolving on their own. However, the severity of the lesion can influence the degree of recovery. Patients with partial paralysis have a better prognosis with none or moderate residual dysfunction. Those with severe paralysis have a poor possibility of a full recovery.

There are several options for parents to help their children with facial nerve palsy, but the severity of the injury will determine much of the extent of recovery. Some potential treatment options include:

Eye patches and eye drops: if the eye is affected by a facial nerve injury, immediate and constant medical treatment is required to protect the eye, including artificial tears and ointment, eye patches, and frequent ophthalmologic evaluations.
Medications: In some cases, steroids are considered or recommended to treat traumatic facial paralysis in a newborn, however it is unclear if they are effective in treating a newborn with facial paralysis due to birth trauma. In infants with difficulty feeding due to weak mouth muscles, it is essential to provide nutritional support.
Surgery: in most cases of traumatic facial nerve palsy, surgery is not necessary. Surgery may be considered, however, in infants with poor prognostic factors, such as unilateral complete paralysis present at birth, evidence of temporal bone trauma, complete loss of function of the facial nerve at 3-5 days, and no improvement by 5 weeks of age. Doctors may consider different surgical options depending on the type of injury, including surgery to repair the nerve and plastic surgical procedures.

Therapy: Therapy may be considered as the child ages. For example, speech therapy should be considered if the paralysis affects the child’s ability to speak. If the infant has permanent paralysis, special therapy options are available to help support the child through challenges they may face. Other members of the multidisciplinary team may include pediatricians, neurologists, ophthalmologists, physical therapists and plastic surgeons.

What is the statute of limitations for a birth injury from medical malpractice?

Washington law that most medical malpractice lawsuits be filed within three years of the date of alleged negligence. Exceptions do apply, so that time limit may be longer or shorter, depending on the specific circumstance of each case. It is best to not wait until most of this time has passed; if you suspect medical malpractice, get in touch with us.

Bell’s Palsy Case Review

We are available to review your potential case without cost or obligation. We will talk with you regarding what happened and then if it seems like there may have been medical malpractice, we will help get all the medical records and review those as well. Feel free to reach out to us by phone or e-mail.

Erb’s Palsy or Brachial Plexus Palsy Medical Malpractice

What is a Brachial Plexus Palsy injury?

Neonatal brachial plexus palsy (NBPP), also known as obstetric brachial plexus palsy and birth-related brachial plexus palsy, is an injury that a newborn can sustain during the delivery process. The brachial plexus is a network of nerves that sends signals responsible for movement and sensation from the spinal cord in your neck to the muscles of your shoulders, arms, hands, and fingers. When one or more of the nerves have been damaged, the injury may result in arm weakness and loss of motion, usually on one side.

There are several different types of brachial plexus palsy:

Erb’s palsy, named after one of the doctors who first described the injury, is the most common form of birth-related brachial plexus injury, accounting for almost 80% of these injuries. In Erb’s palsy, the upper arm is affected.
Klumpke palsy affects the lower arm and hand and is the most infrequent pattern of injury.
“Global” or “Total” brachial plexus birth palsy is when all of the upper and lower nerve roots are affected. The infant may present with arm paralysis.

There are a several different ways in which the brachial plexus can be injured:

Neurapraxia: a stretch injury, the most common type of brachial plexus injury, occurs when the nerve is mildly stretched but does not tear. These injuries usually heal on their own or with simple non-surgical treatment methods within a few months.
Neuroma: scar tissue may result from a stretch injury and can press on the remaining healthy nerve causing a neuroma. This type of injury usually results in some, but not total, recovery.
Rupture: a stretch injury in which the nerve is more forcefully stretched, causing the nerve itself to tear (rupture) partially or fully. These types of injuries can sometimes be repaired with surgery if done in a timely manner.
Avulsion: when the nerve is torn from the spinal cord. This is the most severe type of injury and may not be repairable even if surgery is done in a timely manner.

What are the symptoms of brachial plexus injury?

The symptoms of a brachial plexus nerve injury are the same regardless of the type of injury. The symptoms can vary greatly, however, depending on the location and severity of the injury. Several different nerve injuries can occur in the same infant, with varying degrees of severity. Signs and symptoms of brachial plexus palsy include:

Weakness in the baby’s hand, arm or shoulder
Inability to use certain muscles in the hand, arm and shoulder
Complete lack of movement in the arm, shoulder and hand
Abnormal position of the arm, wrist or hand
Decreased or no sensation in the arm, shoulder and hand
Tingling in the arm
Pain in the arm or hand

How can brachial plexus be caused by medical malpractice?

Stretching is considered the most common mechanism of brachial plexus palsy at birth. The injury is often caused when an infant’s neck is stretched to one side during a difficult delivery.

There are several ways that brachial plexus palsy could be caused by the negligence of a health care provider. For example:

Improper delivery technique: Shoulder dystocia is a risk factor for neonatal brachial plexus injury. Sometimes a child’s shoulder gets wedged in the mother’s pelvis, impeding delivery. This can occur in the absence of risk factors, so clinicians should be prepared for this possible complication in all vaginal deliveries and knowledgeable about the procedures that have been shown to be effective for delivering the impacted shoulders. A doctor may be negligent in managing the shoulder dystocia, such as applying too much force, in performing certain twisting and extension maneuvers, or in the use of forceps, which can cause the brachial plexus nerves to be stretched and injured as a result.
Complications due to baby size, abnormal fetal position, and maternal factors: Possible risk factors for a brachial plexus injury include a large birth weight, breech presentation, and maternal diabetes. These risk factors should be considered when deciding on the mode of delivery, such as recommending a Cesarean section when there are concerns about a difficult delivery or in recognizing and managing complications, such as shoulder dystocia, during the delivery process.

There are many different ways a brachial plexus injury can occur due to medical malpractice but the occurrence of NBPP following birth does not always indicate that a provider was negligent, so it is best to have an experienced medical malpractice lawyer review your potential case.

What are the treatments for a brachial plexus injury?

The majority of infants with Erb’s palsy will recover both movement and feeling in the affected arm completely. However, some cases result in permanent weakness and disability, such as incomplete range of motion, weak muscles, decreased sensation, and chronic pain.

There are some options for parents to help their children with brachial plexus, however the severity of the injury will affect treatment decisions and determine the extent of the possible recovery. Some potential treatment options include:

Physical therapy: ongoing daily physical therapy starting soon after birth can help the baby recover and maintain range of motion and strength in the shoulder, elbow, wrist, and hand and prevent the joints from becoming permanently stiff.

Surgery: If the injuries to the nerves are serious enough and in the absence of functional recovery over several months, some children may need surgery to try to restore some function in the arm. Doctors may consider a few different surgical procedures depending on the type and severity of the injury, such as, a nerve graft, nerve transfer, or tendon transfer. Nerve surgery does not typically restore full function, however. As the child grows, there may be additional surgical procedures that can be performed to try to further improve function.

Mental health support: Some children may have problems with anxiety/depression and social problems due to their injury, which can interfere with their quality of life. For example, some children develop a low self-esteem as a result of limited movement of certain muscles and the size difference between the affected arm and unaffected arm that becomes more noticeable as they get older.

What is the statute of limitations for an Erb’s palsy or brachial plexus injury from medical malpractice?

Brachial Plexus Case Review

Spinal Cord Birth Injury Medical Malpractice

What is a spinal cord injury?

The spinal cord consists of many nerves that carry messages from the brain to the rest of the body. It provides sensory information to the skin, bones, muscles, and organs. A spinal cord injury occurs when the spinal cord is damaged. A spinal cord can be damaged by a bruise (contusion), partial tear, or complete tear.

What are the symptoms of an infant spinal cord injury?

There are varying degrees of a spinal cord injury depending on what type of damage occurred. Symptoms can be devastating, including a loss or decrease in muscle movement, reflexes, and feeling. The symptoms of a spinal cord injury are generally felt depending on the point of the injury on the spinal cord. An injury to the upper spinal cord would affect everything below it, versus an injury to the lower spinal cord would affect everything below that. A complete spinal cord injury means there is no movement or feeling below the point of injury while an incomplete spinal cord injury means there is a little feeling or movement. The main symptoms include:

Muscle weakness
Loss of voluntary muscle movement in the chest, arms, or legs
Breathing problems
Loss of feeling in the chest, arms, legs, or buttocks
Loss of bowel and bladder function
Poor blood pressure control, sweating, shivering, and abnormal function of the stomach and intestines.

How can a spinal cord injury during childbirth be caused by medical malpractice?

There are a few ways that a spinal cord injury could be caused by the negligence of a health care provider. For example:

Improper delivery technique: when the medical professionals use too much force with their hands, forceps, or vacuum, the spinal cord can be damaged.
Failure to recognize conditions, like spina bifida, that could predispose the child to a spinal cord injury during delivery.
Failure to recognize potential birth complications due to the baby’s size.

There are many different ways a spinal cord injury can occur due to medical malpractice, so it is best to have our experienced medical malpractice lawyers review your potential case.

What are the treatments for a baby’s spinal cord injury?

There are some options for parents to help their children with a spinal cord injury but the severity of the injury will determine much of the functional outcome. Some potential treatment options include:

Medical management: A team of doctors, nurses, and other medical professions should help manage your child’s health.
Therapy: physical, occupational, speech, and rehab can all maximize your child’s recovery ability.
Surgery: doctors may perform different surgical options depending on the type of injury.

What is the statute of limitations for a spinal cord birth injury from medical malpractice?

Attorneys

Retired

Staff