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Case #1075: Brachial Plexus


On March 23, the Plaintiff presented to a local hospital for childbirth. She was 39 weeks pregnant and was admitted at approximately 1:00 a.m. At that time, she was 4 centimeters dilated, 100% effaced, and the fetus in utero was at -1 station. By 5:00 a.m., the Plaintiff was 9 centimeters dilated, 100% effaced, and the fetus had descended to a +2 station. Within 9 minutes, she was fully dilated and pushing. However, after only approximately 5 minutes into the second stage of labor (which usually lasts up to two hours), when it is critical to permit the unborn baby to spontaneously and naturally descend, the Defendant utilized a vacuum extractor to hasten the delivery of the baby when he was still only at +2 station. Use of the vacuum extractor when the baby was still in that position violated the standards of care as the baby needed to descend for vaginal childbirth unassisted, thus allowing the baby’s shoulders to naturally conform to the mother’s bony pelvis.

As the direct and proximate result of the Defendant’s contraindicated and inappropriate use of the vacuum extractor, the Infant Plaintiff suffered a severe shoulder and brachial plexus injury. The wrongful use of the vacuum extractor before natural molding of the baby’s shoulders to the contours of the birth canal created a shoulder dystocia. Moreover, the Defendant used excessive traction on the baby’s head while attempting to relieve the shoulder dystocia and complete the delivery. When the baby was finally pulled from his mother, it was obvious that the Defendant had inflicted a severe brachial plexus injury as the infant had no movement of his right arm. Subsequently, MRI disclosed an avulsion injury whereby some of the nerve roots to the brachial plexus were actually torn from the spinal cord.

As a result of the negligence of the Defendant, the Infant Plaintiff suffered a permanent Erb’s palsy and disability. He will not be able to utilize his right arm in a normal fashion, and will proceed through life essentially as a one-armed person in a two-armed world.

The Defendant asserted that her use of the vacuum extractor was safe and indicated given the infant’s position and due to non-reassuring fetal heart tracings. Specifically, the Defendant claimed that, at the time of delivery, the baby was at the pelvic outlet and that she lost the fetal heartbeat, thus mandating a vacuum extraction. However, the Defendant did not produce any witness or medical record entry to support her claim of loss of the fetal heart.

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