The day your child is born should be the happiest of your life. When that joy is replaced by the sudden discovery of a severe injury, such as paralysis, weakness, or limited movement in your baby’s arm or shoulder, it is devastating.
This type of injury, often identified as Erb’s Palsy or a Brachial Plexus injury, is usually a direct result of excessive force, negligent maneuvers, or poor decision-making by doctors and nurses during a difficult delivery.
While some doctors may dismiss the injury as an unavoidable complication, the reality is that the vast majority of Brachial Plexus injuries that occur during birth are preventable. They happen when medical staff fail to properly manage a delivery complication known as shoulder dystocia, or when they ignore warning signs that necessitated a Cesarean section.
If your child in Baltimore or anywhere in Maryland has suffered Erb’s Palsy, Klumpke’s Palsy, or any degree of Brachial Plexus damage due to medical negligence, the Law Office of David Ellin is here to stand with you.
David Ellin has many years of experience fighting complex medical malpractice cases and has recovered millions of dollars for victims. We have the resources and medical knowledge to prove that the trauma to your child’s nerves was not an accident but a failure of the standard of care.
Call (410) 833-0044 to discuss your case with an experienced Baltimore Erb’s Palsy & Brachial Plexus Injury Lawyer.
Key Takeaways
- Preventable Injury: Most severe Erb’s Palsy cases are preventable and are caused by a doctor’s use of excessive lateral traction (forceful pulling) during a difficult delivery.
- Shoulder Dystocia Mismanagement: The key failure is often the incorrect handling of shoulder dystocia, where safe maneuvers (like the HELPERR sequence) are bypassed for traumatic force.
- Failure to Plan: Negligence can also occur before delivery if the medical team fails to recommend a C-section when high-risk factors were present.
- Evidence is in the Records: Successfully proving negligence relies on analyzing delivery room notes and fetal monitor strips for evidence of unwarranted force or distress.
- Statute of Limitations: A child’s right to sue for their injury is preserved in Maryland. However, it is vital to act quickly to seek consultation immediately to protect the claim.
- Required Expert Testimony: Maryland law mandates a Certificate of Qualified Expert to confirm the injury resulted from a breach of the medical standard of care.
Baltimore Erb’s Palsy & Brachial Plexus Injury Guide
- Understanding the Brachial Plexus and Erb’s Palsy
- The Root Cause: Negligence During Shoulder Dystocia
- Proving an Erb’s Palsy Lawsuit in Baltimore
- The Lifetime Costs of Erb’s Palsy and Brachial Plexus Injuries
- The Legal Process in Maryland
- Why Choose Us for Your Birth Injury Case?
- Take Action to Protect Your Child’s Future
Understanding the Brachial Plexus and Erb’s Palsy
David Ellin, Baltimore Erb’s Palsy & Brachial Plexus Injury Lawyer
To successfully litigate an Erb’s Palsy case, an attorney must understand the intricate anatomy of the injury, the surgical options, and the lifetime implications for the child.
The Brachial Plexus
The Brachial Plexus is a network of five groups of nerves (C5 through T1) that originate in the spinal cord in the neck. These nerves control the movement, sensation, and strength in the shoulder, arm, hand, and fingers.
What is Erb’s Palsy?
Erb’s Palsy (or Erb-Duchenne palsy) is the most common form of Brachial Plexus birth injury. It typically affects the upper nerves (C5 and C6). The injury occurs when the baby’s head and neck are pulled forcefully in one direction while the shoulder is pushed in the opposite direction during delivery, stretching or tearing these nerve roots.
The classic symptoms of Erb’s Palsy include:
- The arm hangs limply from the shoulder.
- Inability to rotate the arm outward (pronation).
- Lack of grip in the hand (depending on the severity).
- The “waiter’s tip” position, where the arm is held straight, rotated inward, and the wrist is bent.
Severity and Classifications of Injury
The prognosis for the child depends entirely on the type and extent of nerve damage:
| Classification | Description of Injury | Prognosis |
| Neurapraxia | The nerve is stretched but not torn. Most common and mildest. | Good. Function usually returns within 3 months as the nerve heals. |
| Neuroma | Scar tissue forms around the nerve, placing pressure on the fibers. | Partial recovery. May require surgical intervention to remove scar tissue. |
| Rupture | The nerve is torn but not at the spinal attachment. | Does not heal naturally and requires immediate surgery (nerve grafting). |
| Avulsion | The nerve root is completely torn from the spinal cord. Most severe injury. | Very poor. Surgical repair is necessary but recovery is often incomplete. |
The Root Cause: Negligence During Shoulder Dystocia
The overwhelming majority of severe Erb’s Palsy injuries occur when a physician or midwife mismanages shoulder dystocia.
What is Shoulder Dystocia?
Shoulder dystocia occurs after the baby’s head has been delivered, but the anterior shoulder becomes lodged behind the mother’s pubic bone. This complication is a true obstetrical emergency because the baby’s chest is compressed, cutting off the oxygen supply. The medical team has mere minutes to deliver the baby safely before brain damage occurs.
Negligent Intervention is the Key to Malpractice
When faced with shoulder dystocia, the standard of care mandates a strict progression of non-traumatic maneuvers, known as the HELPERR sequence (Hyperflexion, Episiotomy, Leg-flexion, Pressure, Enter the vagina, Rotate the shoulder, Remove the posterior arm).
Malpractice occurs when the doctor panics, bypasses these safe techniques, and resorts to excessive lateral traction (pulling too hard on the baby’s head and neck) in an attempt to dislodge the shoulder. This forceful pulling is what stretches or tears the Brachial Plexus nerves.
Failure to Predict and Prepare
Furthermore, negligence can occur even before the dystocia happens. Competent medical staff are expected to predict and prepare for a high-risk delivery. Predictable risk factors for shoulder dystocia include:
- Maternal Diabetes: Leads to larger babies (macrosomia).
- Maternal Obesity: Increases difficulty in maneuvering the baby.
- Fetal Macrosomia: A baby weighing over 8 pounds, 13 ounces.
- Prolonged Second Stage of Labor: Indicates difficulty progressing.
- Instrumental Delivery: Use of forceps or vacuum extraction.
When these risk factors are present, the medical team has a duty to prepare for potential dystocia or, in cases of extreme macrosomia, recommend a scheduled C-section to avoid the risk entirely. A failure to perform a timely C-section when shoulder dystocia was highly likely is often a key component of a malpractice claim.
Proving an Erb’s Palsy Lawsuit in Baltimore
Successfully litigating an Erb’s Palsy case requires reconstructing the chaotic final moments of delivery to prove that the doctor’s actions were negligent.
1. The Medical Records: Delivery Notes and Fetal Monitoring
We conduct a forensic analysis of the delivery room records, looking for evidence of excessive traction:
- The “Time Out” of the Dystocia: How long did the dystocia last? If it was less than two minutes, the use of excessive traction is highly likely, as the safe maneuvers take time.
- Doctor/Nurse Notes: We look for descriptions of “hard pull,” “stuck shoulder,” or “significant traction” in the handwritten notes, which can be direct evidence of negligence.
- Fetal Monitor Strips: Did the baby show signs of distress before the pulling started? If so, the defense may try to argue that the doctor pulled hard to save the baby from oxygen deprivation. However, if the baby was not in distress, there was no justifiable reason to resort to traumatic force.
2. Expert Testimony on Biomechanics
We have access to biomechanical experts and pediatric neurologists who can testify that the type of injury sustained requires a magnitude of force that could not have occurred naturally during labor and was only possible through excessive lateral traction exerted by the delivery team.
3. Causation: Linking Force to Damage
We must prove that the nerve damage was caused by the doctor’s negligence, not by any other factor (e.g., in-utero positioning). The immediate appearance of the limp arm at the time of birth is powerful evidence linking the injury directly to the maneuvers used during the delivery.
The Lifetime Costs of Erb’s Palsy and Brachial Plexus Injuries
While mild Erb’s Palsy (Neurapraxia) often resolves completely, severe, permanent injuries condemn a child to a life of limited function, requiring extensive medical interventions and therapeutic support. The goal of an Erb’s Palsy lawsuit is to secure the financial resources necessary to maximize the child’s recovery and independence.
Medical and Surgical Intervention
The cost of necessary medical intervention over a child’s lifetime is staggering:
- Nerve Grafting/Transfer: Complicated surgical procedures performed by specialists, often needed within the first 3-6 months of life.
- Tendon and Muscle Transfers: Subsequent surgeries performed later in childhood to restore balance to the joint and increase range of motion.
- Physical and Occupational Therapy: Years of therapy are required to maintain muscle tone and teach compensatory skills.
- Pain Management: Chronic pain resulting from nerve damage.
Non-Medical Damages
We also seek compensation for the non-monetary losses that profoundly impact the child and family:
- Loss of Earning Capacity: The diminished ability to pursue certain careers due to the physical limitations of the arm or hand.
- Emotional and Psychological Trauma: The distress, self-consciousness, and potential teasing the child endures due to the physical appearance or inability to participate in sports and activities.
- Pain and Suffering: The physical pain, loss of movement, and overall suffering caused by the injury and corrective procedures.
The Legal Process in Maryland
Erb’s Palsy cases are handled under the stringent rules of Maryland medical malpractice law, requiring specific experience to ensure deadlines and procedural requirements are met.
The Statute of Limitations for a Child’s Claim
In Maryland, the statute of limitations for a child’s claim is unique and favorable: the child has three years from the date they reach the age of 11 to file their lawsuit. This means the child’s right to sue is preserved until they turn 14.
However, the parents’ claim for medical expenses incurred before the child turns 18 must be filed within the earlier of 5 years from injury or 3 years from discovery. Because of this complexity, it is vital to contact an attorney immediately to protect all available claims.
The Certificate of Qualified Expert (Certificate of Merit)
As with all Maryland malpractice claims, a lawsuit must first be filed with the Health Care Alternative Dispute Resolution Office (HCADRO), and then, within 90 days, be accompanied by a Certificate of Qualified Expert. This document, signed by a peer physician, attests that the doctor breached the standard of care and that the breach caused the Erb’s Palsy.
The Law Office of David Ellin manages this entire process, securing the necessary expert testimony early in the case to prove the viability of your claim and allow us to proceed to litigation in the Baltimore courts.
Why Choose Us for Your Birth Injury Case?
Litigating a Brachial Plexus injury case is not a job for a general practice attorney. It requires deep knowledge of obstetrics, orthopedic surgery, neurology, and the local practices of Baltimore hospitals.
Experience Against Major Institutions
David Ellin has built a reputation for aggressively challenging large hospital systems and their insurance defense teams. We understand the specific defenses often raised in these cases, such as claiming the injury was caused by “natural forces of labor”, and we know how to dismantle them using authoritative expert testimony and forensic evidence.
Dedication to Birth Injury Victims
We recognize that the journey ahead for a child with permanent Erb’s Palsy is challenging. Our firm is committed to securing not just a financial recovery, but a comprehensive package that includes funding for necessary future care, therapy, and educational support.
No Recovery, No Fee
We handle all Erb’s Palsy and Brachial Plexus injury cases on a contingency fee basis. This means you pay absolutely no attorney fees or costs upfront. We advance all investigation, expert, and filing fees. Our firm only gets paid if we successfully secure a settlement or win a verdict for you and your child.
Take Action to Protect Your Child’s Future
The functional future of a child with Erb’s Palsy often depends on early diagnosis and timely surgical intervention. The legal future depends on immediate action to preserve the evidence and meet Maryland’s strict deadlines.
If your child suffered a Brachial Plexus injury during birth in Baltimore, you deserve answers about what went wrong and may be entitled to compensation to secure their future care. Do not let the negligent maneuvers of a delivery team define your child’s life.
Contact the Law Office of David Ellin today for a free, confidential case evaluation. We will review the medical records, assess the likelihood of negligence, and clearly explain your legal options.
Call (410) 833-0044 or contact us online to schedule your free consultation with a Baltimore medical malpractice lawyer.
Law Office of David Ellin
154 Westminster Pike
Reisterstown, MD 21136
Ph: (410) 833-0044
