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In obstetrics negligence cases, a frequent claim is that an obstetrician negligently delivered an infant causing brachial plexus injury or Erb's Palsy. During a vaginal delivery after the infant's head delivers, the anterior shoulder can get stuck behind the mother's pelvic bone. This stuck shoulder syndrome is called shoulder dystocia.

There are numerous maneuvers to free the shoulder; none of these maneuvers involve touching the baby's head. When an obstetrician applies excessive force to the neck--Erb's palsy usually occurs.

Counsel may encounter the following defenses:

Even if the doctor applied undue force - this was after all - an emergency. Attempts at lateral traction are never acceptable for two reasons. 1--the procedure cannot free the anterior shoulder and 2--lateral traction is the only known cause for Erb's palsy.

The obstetrician didn't know the baby weighed 8 pounds 14 oz or more. This is bad practice as there are numerous tools to determine the baby's fetal weight.

Shoulder dystocia was not predicted because the infant was not about average weight. Should dystocia is still predictable if there's disproportion between the size of the fetus and size of the pelvis.

Delivery was normal and easy; Erb's palsy must've happened in utero. Excessive lateral traction is the only known cause for Erb's palsy in a head first vaginal delivery.

The obstetrician applied gentle lateral traction. Once shoulder dystocia happens, no lateral traction should be administered.

By understanding the birth injury mechanisms, counsel can effectively respond to the defense's contentions and demonstrate that the injury was both predictable and preventable.

Source: Based on an article written by Stephen H. Mackauf for the , , and The Problems With Shoulder Dystocia by Anapol Schwartz Philadelphia Lawyers. fosamax femur

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