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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Motorbike Accident | Brachial Plexus Injury
Description
A brachial plexus injury which can arise from motorbike accidents is an injury to the nerves located in the brachial plexus. The word brachial refers to the arm and the word plexus refers to the nerve network. This network of nerves originates in the spinal cord and then travels up to the shoulder region and on to the neck. It involves what’s termed the three trunks, upper, middle and lower, which essentially are nerve fibres. The brachial plexus is comprised of five parts, the trunks, roots, division, cords and branches.
The brachial plexus is a human nerve transport mechanism which controls the muscles to the fingers, hands, arms and shoulders.
Essentially, this is a human information system enabling us feel and move our hands, arms and shoulders.
Causes of Brachial Plexus Injury
Nerves are vulnerable areas to the body or parts of our anatomy in the event of accidents. They are essential though. Every movement of the brachial (arms) needs these nerves fully functioning. Motorbike accidents and car accidents can cause a brachial plexus injury. In motorbike accidents in particular, as a person may be thrown from the bike and the shoulder and or neck region may be impacted, a brachial plexus injury can result.
Brachial plexus injuries can also occur during childbirth.
Symptoms of Brachial Plexus Injury
- Loss of muscle control in the shoulder
- Loss of muscle control in the hand, wrist or arm
- Lack of feeling sensation in the arm or hand
- Swelling around the shoulder
- Neck pain
- Shoulder pain
- Weakness in the arm/shoulder/wrist
- Broken clavicle
- No feeling in the arm or hand
- Shoulder pain or numbness
- There may be other individual symptoms
Nerve injuries can inhibit signals to the brain and/or from the brain. The effect of this is to reduce or prevent normal functioning of the arm, shoulder hand which we all generally have without this injury. The effect of this injury is to put the human electrical wiring out of kilter.
Treatment Options
There are many treatment options which can be made available to a person with a brachial plexus injury. Every treatment will depend on an individual assessment. The area of injury may differ in the trunk region in the brachial plexus, from person to person, and so the treatment will vary. The treatment option will also vary on assessment depending on the degree of the injury from mild to severe.
Possible Treatment Options :
- Physiotherapy
- Chiropractic help
- Massage Therapy
- Drug Therapy
- Pain Management Therapy
- Physical Therapy
- Occupational Therapy
- Surgical Therapy
Motorbike Accidents
An injury to the brachial plexus arising from motorbike accidents can be more common than from car accidents. In a nutshell, a motorbike doesn’t have the same protection as a car does in the event of an accident. The same back and neck protection which can reduce or prevent the possibility of a brachial plexus injury is considerably less so for a driver of a motorbike. Consequently, as road users, motorbike drivers are more vulnerable to this type of injury.
Personal Injury Claim
Motorbike accidents can be caused by many things, some being, our driving, other car drivers, other motorbike drivers, defective road surfaces, spills, junction errors, undertakings, right of way errors and so on.
We all, as road users, are bound to take reasonable care to avoid an act or omission that could cause injury to another road user.
If you have been injured due to the fault of another, you are entitled to make a personal injury claim detailing the impact of the accident to one’s life.
Sometimes, the non-injured motorbike driver will argue the accident was not their fault and the accident was instead the fault of the injured motorbike driver who has this injury, brachial plexus.
Any questions in relation to this, we can help. There are certain steps one must take when pursuing a personal injury claim and certain statutory requirements.
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Truth & Justice | Symphysiotomy | Medical Negligence
It is roughly fourteen years on since a report which exposed the practice of symphysiotomy procedures in Ireland. More often than not these surgical procedures were performed on people who were unaware the procedure had taken place. Within these fourteen years, alot of debate has occurred, an inquiry sought, a report commissioned, a petition signed by doctors and the mobilisation of survivor groups.
Now, the government has asked a Judge to examine the possibility of a compensation redress scheme. The Judge is tasked with trying to find a solution after meeting survivor representatives, the State Claims Agency, insurers and indemnifiers. It is believed that this process will be concluded by February, 2014 and the government will have the report by then.
Initially, the government showed encouraging signs of supporting a Statute of Limitations Bill which would ensure that the normal statutory time limit would not apply to a woman who has had symphysiotomy carried out. They have subsequently rowed back from this.
Symphysiotomy Procedure
Symphysiotomy is a surgical procedure which severs a woman’s pelvis to allow childbirth.
Sometimes, this procedure was performed before a mother went into labour. Some women received the surgery days or weeks before their due date. Sometimes, the surgery was performed during the day of the labour. Sometimes, it was performed during labour.
On other occasions, this procedure was performed after a baby had been delivered by caesarean section.
The myriad of forms of physical and psychological damage as a result of this procedure was and is colossal.
Pre & or Post Surgery
One of the greatest difficulties in relation to the administration of the symphysiotomy procedure was the fact that it was performed more often than not without the knowledge and/or consent of the birthing mother. A lack of information, knowledge and consent seems common place. Many women didn’t know what procedure was being undertaken at the time or even afterwards. Sometimes, decades elapsed before the women even knew their pelvises were broken. The media has undoubtedly played a role in piecing the jigsaw together for many women who had no idea what had happened to them.
Symphysiotomy was performed on 1,500 women in Ireland during the 1940s right up until 1992. This procedure had almost been completely abandoned in other countries. In Ireland, a resurgence of this procedure occurred.
During this time, it seems clear, hospitals and medical professionals did not have any guidelines or protocols to follow in relation to obtaining consent for symphysiotomy. It would appear that the patients’ consent operated on the basis of being implied when they crossed the threshold into the hospital.
Lots of women then in turn, were completely unaware of any post-symphysiotomy care. There were protocols to help and advise the mothers how to heal from the operation but as seems evident, these were not consistently followed.
Case before the Courts
In one notable case which came before the courts, the court stated the surgery was ‘’deeply flawed’’ and it was ‘’entirely unjustified’’.
In this case the symphysiotomy was performed after the mother had safely given birth.
The Time is Now
The government has now appointed Judge Murphy to engage with representatives of the survivors, the State Claims Agency, insurers, indemnifiers and parties involved. The aim is to seek to establish a compensation redress scheme. The Judge is tasked with formulating a report which is due by February, 2014. If the insurance companies agree to a compensation fund, the government may also contribute to the fund.
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Transparency Decade | Duty of Candour | Medical Negligence.
Recently, a conference took place where it was proposed, a ‘Duty of Candour’ should exist in Ireland in relation to health care provision. This duty, if implemented, would benefit patients, doctors, health care professionals by creating a more open, transparent system which means, in practice, if an accident happened while under medical care, this accident would create a legal obligation on the healthcare professional to reveal at an early stage when the medical accident occurs. There is an obligation on the healthcare professional already to do just that, report an accident, however there is no legislation in Ireland to back this up to create a legal duty of candour. Would the introduction of this duty aid patients’ prior to any medical negligence action or even during it, we believe so.
Deny & Defend
Under our current system a medical accident may be admitted or denied, defended or not revealed as our system operates mostly on a ‘Deny & Defend’ policy. It has been suggested there should be a new health care culture in relation to medical mishaps, one where transparency, openness and trust are all fostered. A new system whereby medical staff would admit mistakes and victims could obtain answers early rather than later.
Duty of Candour
A duty of candour, if introduced by legislation would impose an obligation on all health care professionals and administrators to reveal at the earliest possible opportunity when a medical accident takes place. Patients who suffer a preventable injury in a hospital or other medical setting have a right to know what has happened.
Internationally, there has been a growing implementation of a duty of candour, sometimes called ‘open disclosure’ into the delivery of health care.
USA
In America, a legal obligation for healthcare professionals operates in seven states to disclose serious unanticipated outcomes to patients. In Michigan it has been reported the move away from a policy of ‘deny & defend’ towards a more open system has resulted in medical negligence litigation costs being halved, claims speed has increased and insurance reserves have reduced by two-thirds. In Illinois after the new system was introduced it has been reported medical negligence claims fell by 50%.
New Zealand
In New Zealand, health care institutions have a legal duty to ensure systems are in place, whereby open disclosure, as it’s called there, is practiced by health care professionals. A patient must be informed about an adverse event, being unintended harm caused during health care delivery. It is thought open disclosure improves patient’s rights, fosters open and honest professional relationships and enables a system to change to improve service quality and safety.
UK
In the UK there have been a number of calls to introduce a Duty of Candour into healthcare provision over the years. Cover-ups and scandals have moved the impetus to put this duty on a statutory basis. This is now looking likely for introduction in 2014.
Ireland
In Ireland predominately we don’t have this policy as adopted in other countries. However, things may be changing. Currently, this duty of candour or open disclosure is being tried and tested in a couple of hospitals. It is estimated that 50% of Irish Hospitals haven’t any open disclosure guidelines, policies etc. This could be about to change. Advocates for change suggest a culture of open disclosure would greatly benefit the patient and reduce medical negligence litigation across the board. If a person was informed of what happened, provided with an acknowledgement of events, an explanation etc. this could benefit the person in question.
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*Injuries Compensation – Crime*
If you been a victim of violence in a crime be that an assault, mugging or any type of criminal act culminating in a person being injured, you are entitled to seek compensation for your injuries from the Criminal Injuries Compensation Tribunal.
Our constitution dictates, the state guarantees in the law, to respect, and, as far as practicable, by its laws to defend and vindicate the personal rights of the citizen. It also states that our laws should protect people from unjust attack.
A Criminal Injuries Compensation tribunal was set up in 1974 to compensate victims of crime for loss from personal injuries.
3 Month Rule!
An application for compensation should be made pretty quickly after the crime. A victim has a 3 month time frame to complete and register their application with the criminal injuries tribunal.
This 3 month rule does Not apply where a fatality has occurred.
Application Forms for victims of crimes can be found here Justice.ie website.
There are two Application Forms:
- Non-fatal Injury Application Form; and
- Fatal Injury Application Form.
Reporting the Incident to the Gardai
To qualify for compensation it will be necessary to inform the Criminal Injuries Compensation Tribunal that the offence giving rise to the injury is/has been subject to criminal proceedings, or that it was reported to the Gardai. The Tribunal use the report from the Gardai in assessing the application for compensation for the criminally inflicted injury.
Persons who can claim compensation before the Criminal Injuries Compensation Tribunal
- A person who sustained and injury ( victim );
- Any person responsible for the maintenance of the victim who has suffered pecuniary loss or incurred any expenses as a result of the victims injuries;
- Where the victim has died as a result of the injury, and dependent of the victim or, if he has no dependent, any person who incurred expenses as a result of the death;
- Where the victim has died otherwise than as a result of the injury, any dependent of the victim.
Will the person making the application need to attend the Criminal Injuries Tribunal
This is unlikely.
The Tribunal will mostly make their decision on any award of compensation without the need of the applicant. If there is an oral hearing, then yes, an applicant should most definitely attend the hearing. Your application will benefit from your attendance.
Will the Criminal Injuries Tribunal oral hearing (if required) take place in private.
Yes.
Will I need legal representation at the Criminal Injuries Tribunal
This is entirely up to yourself.
Will the perpetrator of the crime in question be at the Injuries Tribunal
No, not under any circumstance.
If you have any questions about injuries compensation we can help.
Make a Personal Injury Enquiry !
If you have been in an accident, make a Free Enquiry now by contacting us in one of the following ways to find out what options are open to you. We have a Free Enquiry, No obligations policy.
Contact Us:
1. Call us on 052 61 21999 between the hours of 9am to 5pm – Monday to Friday.
2. Email us – info@clearysolicitors.com – with a contact number and we will call you back.
3. Fill out our online Enquiry Form.
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DISCLAIMER
Please be advised that the above-mentioned material is intended as an overview and as a broad out-line of the topic discussed. It should not be considered as complete and comprehensive legal advice, nor act as an appropriate substitute.
Due care has been taken in the publication of this article and we do not accept legal liability as a result of reliance on any material covered in the above article.
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Truth or Dare | Personal Injury Claims.
Crime of omission, this is not normally what an injured person thinks is applicable to them ( the injured party ), when they are going about their business and an accident happens due to the fault of another’s negligence and they decide to pursue a course of action. However, this is what was argued recently towards a personal injury claimant who the court concluded gave false information in relation to their personal injury claim.
If a person who brings a personal injury claim is found by the court to give false, dishonest, misleading information relating to their claim they can receive a sentence of ten years and or a fine of €100,000.
The law in Ireland on this is outlined in the Civil Liability Act 2004.
S. 25 of that Act, state’s, a person gives or dishonestly causes to be given, or adduces or dishonestly causes to be adduced, evidence in a personal injuries action that— is false or misleading in any material respect, and that he she knows to be false or misleading, he/she will be guilty of an offence.
person gives, or dishonestly causes to be given, an instruction or information, in relation to a personal injuries action, to a solicitor, or person acting on behalf of a solicitor, or an expert, that— is false or misleading in any material respect, and that he she knows to be false or misleading, he/she will be guilty of an offence
A dishonest act is simply defined an act that was intended to mislead the court.
So the law is clear then, if anyone pursuing a personal injury claim gives false information to the court, to their solicitor, to a doctor, orthopaedic surgeon etc. or any expert involved in or hired by the injured person then that person if the lie is proved in court can be sentenced to jail and or fined. This is a mighty consequence for being found to bring a fraudulent claim. A person could go to jail, incur a fine of €100,000, lose their freedom, lose the personal injury case they had, and may have to pay the costs of bringing the case in the first place to the defendant.
S.26 of the Civil Liability Act state’s that the court will dismiss a claim where the person who brought the claim is found to have given false or misleading evidence.
Sometimes there is a view in Ireland there is a claims culture. What a claims culture means to one man, another may have a different interpretation of what exactly a claims culture is. All I know is if one was to bring an unmeritorious claim based on deceit and lies; there can be a very heavy price to pay in Ireland to take this route in the form of prison and or a huge fine.
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*Personal Injury Claim*
If you have been injured in a car accident or injured at work or for example injured in a public place etc. and you seek a civil remedy in the form of damages, you must amongst other things, submit an application to the Personal Injuries Board for assessment.
The Personal Injuries Assessment Board established the Personal Injuries Board as an alternative dispute resolution mechanism with the aim of increasing litigation speed and reducing costs.
If you have been injured and seek compensation for the pain, suffering and loss then certain procedures must be followed.
Time Limits
If you have been injured due to the negligence of another and wish to pursue an action to recover damages, you must begin this action within 2 years of the accident in question. This is a strict legislative rule which has some exceptions in exceptional circumstances.
Letter before Action
Under S.8 of the Civil Liability Act 2004 this is called a ‘Letter of Claim’. A person pursuing an action should serve notice in writing to the other person within two months of the date of the accident of their intention to pursue this course of action.
If it’s possible in the circumstances do obtain the details of the other driver in relation to a car accident or a cycling accident and take note of the registration of the car. It’s more difficult for the Gardai to investigate this if there is no registration or no witnesses for example.
If this letter does not go to the other person a court can draw inferences from the injured party’s failure to do so.
Preservation of Evidence
Depending on the nature of the accident and the factual situation a Court Order may be required to preserve and maintain evidence in a situation where the other party will not undertake to preserve it.
Form A
If the matter is not resolved at this stage and the alleged wrongdoer is on notice of it now, then an application to the Injuries Board should be made by completing and submitting Form A with the application fee €45 and a medical report.
The medical report will be completed by your doctor and will include information regarding accident details, injuries sustained, medical history, complaints, clinical findings and prognosis.
When you receive the medical report you should go through its content and make sure everything is accurate and your happy with it basicly.
Insurance Company Correspondence
It’s possible or even likely after the application to the Injuries Board is submitted, you will receive a holding letter from the Insurance Company explaining that liability is being investigated and asking a series of questions.
Sometimes liability will be conceded immediately and the Insurance Company will seek settlement negotiations. Sometimes this may happen further down the line or not at all.
Registration
Once the Injuries Board have received the application they will send the s.50 confirmation letter which is very important as it acknowledges registration of the civil action and that the injured party’s application will be assessed by the Injuries Board.
Section 13 Notice
The Injuries Board will then send this notice of the application to the alleged wrongdoer and he/she has 90 days to consent/reject or do nothing. The Injuries Board will send a copy of the injured person’s application with this notice and or any other accompanying documents.
The Injuries Board will after this period begin their assessment if the alleged wrongdoer does not reject this outright. In that case court proceedings will begin in earnest.
9 Month Period
The Injuries Board must make their assessment within 9 months of receiving the alleged wrongdoers consent to assessment. Once the assessment decision is made the alleged wrongdoer is given 21 days to accept the award or there’s deemed acceptance. The claimant is given 28 days and if no response is received, is deemed to accept the award.
Award of Pay
If the injured person and the other person ( respondent ) BOTH accept the award then the Injuries Board will make an Order to Pay. If one party does not accept the award in question for whatever reason, then a Court will have to hear the matter and resolve it.
Personal Injury Negligence Questions & Answers
If you have been injured in an accident due to the fault of another you will have a lot of questions.
These can vary from –
‘Am I eligible to make a claim or take a case’;
‘Is the other driver possibly negligent and is it easy or hard to prove’;
‘What is my personal injury case worth’;
‘What do I do if the other party has no insurance’;
We will try to answer any questions you have and advise on the best course of action. Most importantly, if instructed we will act for you to seek the best possible outcome for you.
Kieran Cleary and Roger Cleary can help with any questions you have regarding negligence, liability and what can be done. If instructed we will act in your best interests to secure what’s agreed.
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Make a Personal Injury Enquiry !
If you have been in an accident, make a Free Enquiry now by contacting us in one of the following ways to find out what options are open to you. We have a Free Enquiry, No obligations policy.
Contact Us:
1. Call us on 052 61 21999 between the hours of 9am to 5pm – Monday to Friday.
2. Email us – info@clearysolicitors.com – with a contact number and we will call you back.3. Fill out our online Enquiry Form.
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Just Seek It: *Medical Care – After Car Accidents*
If you have been in a car accident there is every reason to seek medical attention, even as a preventative measure and there is no reason that I can think of to not seek medical care, although avoidance of post accident medical care is not uncommon.
A general dislike for attending doctors’ surgery’s and attendance at a hospital should in our opinion be sidelined when one’s body has to withstand the impact of a car accident. We have learned that sometimes people after an accident make the decision to not attend a doctor. Frankly, attending a hospital is not at the top of my priority list either but the impact of a car accident to body can have may various adverse consequences. The only way to get clear on what has happened to your body after a car accident is to be tested.
Here is a list of what injuries can arise due to an accident and some of the means for testing for these.
This is the opposite of an exhaustive list of injuries that can arise from car accidents.
Neck Injury.
Common whiplash can result in muscle strain, ligament sprain or a disc injury. Soft tissue, joints and neck bones all work together to provide neck movement and to hold up the head basicly.
The greater the impact of a crash can result in cervical dislocation and disc injury. A doctor can conduct a physical examination, listen to any indicators of symptoms you provide, may require an x-ray if he/she suspects a fracture or may require an MRI if there’s a concern about an injury to a disk or to the spine.
Spinal Cord Injury.
The spinal cord is the connective runway distributing messages between the brain and the spinal cord and controls everything we do basicly. The brain and the spinal cord make up the central nervous system. The impact of a car accident to this area can inhibit the travel of messages back and forth to the brain and affect the central nervous system.
A radiographic evaluation using an x-ray, a MRI scan or a CT scan can assess any damage caused.
Back Injuries.
This injury can involve a sprain or strain and onto a more severe herniated disc which can cause considerable nerve pain. A further back injury can be a fractured vertebrae.
If your job involves a lot of lifting and movement on your feet, nerve damage or disc damage can be unbearable without relief.
Internal Body Injury.
The impact of a car accident can result in internal injuries not easily visible. A thorough examination should ascertain any broken rib, internal bleeding, abdominal aorta aneurysm, organ injury or a collapsed lung.
Head Injury.
Head injuries after an accident can be acutely serious as obviously the brain controls everything. Great force in a collision and damage the brain with unforeseen consequences. Not least our personality and mental faculties can be affected, omitting any physical motor consequences.
A bang to the head should no matter what be tested with maybe an MRI or CT or any scan that can help detection of any problems.
We hope if you’re in a vehicle collision at any speed you will seek some medical attention.