Brachial Plexus | Birth Injury | Medical Negligence
What is the Brachial Plexus
The brachial plexus is a nerve network that operates in the neck region and its purpose is to control the movement and sensation in the upper body limbs, namely the shoulders, arms and hands.
What is a Brachial Plexus Birth Injury
A brachial plexus birth injury is an injury sustained by a baby and this can be caused for a number of reasons, some traumatic, some not traumatic, but one of the main reasons this injury occurs is because of shoulder dystocia.
What is Shoulder Dystocia
Shoulder dystocia is a medical term which involves a situation where the baby’s head has been born during labour but the baby’s shoulders get stuck behind the mother’s pelvic bone. In this situation obviously something needs to be done to dislodge the baby’s shoulders in order for the birth of the child’s body to occur.
If a shoulder dystocia occurs during labour, medical manoeuvres must be implemented by the medical team to manipulate the safe delivery of the baby. Careful management of the labour must occur and excessive force should not be used to aid the birth. The medical professional at this stage will also be concerned of another possibility, asphyxia, which is a condition involving deficiency of oxygen.
A variety of different actions and manoeuvres may be implemented by the medical team depending on the circumstances which present themselves.
For example, and this will vary and depend on the circumstances, but subrapubic pressure may be implemented, or the baby’s posterior arm will be removed, or fundal pressure will be applied, or the Mcrobert’s manoeuvre will be applied.
Some of these medically termed actions should be taken by the medical team when shoulder dystocia occurs to prevent injury and the guidelines should be followed.
Essentially, if a shoulder dystocia medical emergency arises, it must be managed properly. Medical procedures and actions must take place so the baby can be delivered safely.
Symptoms of Brachial Plexus Birth Injury
- A weak arm, wrist, hand
- Limp arm, wrist, hand
- Upper limbs mobility difficulty
- Pain in the upper limbs
In the event a brachial plexus injury occurs a CT ( computer tomography ) test and/or MRI ( magnetic resonance imaging ) test or nerve tests will have to be undertaken.
The severity of a brachial plexus injury will depend on the circumstances, but more often than not this injury in children does heal.
Investigation of Medical Negligence
If you are pursuing a case for medical negligence relating to brachial plexus injury, it is very important the exact cause of the injury is established.
A medical professional will not be negligent because shoulder dystocia has occurred. The onus on the medical professional is how they handle this event by minimising risk and preventing injury once shoulder dystocia occurs. It can be a pressurised environment because shoulder dystocia is a medical emergency and things can go wrong sometimes.
If a shoulder dystocia occurs, a midwife or obstetrician should be availing of what is termed the HELPERR protocol. This involves a seven step system which should be followed to reduce the risk of injury in this medical emergency.
In order to establish the existence of negligence, the parent or your solicitor must take the necessary steps to investigate the events. This begins necessarily with a meeting with the parents. Consent for the release of medical records will have to be sought. Subsequently, examination of the medical records will have to be undertaken and then the appropriate medical expert will then have to be engaged to begin with.
Once this medical professional has provided his diagnosis and prognosis, the solicitor can examine the negligence issues and possibility of liability.
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