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Brachial Plexus Injuries: Everything You Need to Know

Written by Berkowitz

Newborn and Mother

Connecticut Malpractice Lawyers Serving Victims of BRAchial Plexus Injuries

Brachial plexus injuries are more common than people realize. In fact, it is estimated that one to two infants born per 1,000 may have suffered from this injury. This injury is more common with long, difficult labors, and it is often the result of negligence on the part of a doctor or other healthcare provider.

What is a Brachial Plexus Injury?

A brachial plexus neuropathy (BPN) happens when the nerves in the upper shoulder area are damaged and lead to severe pain in the arms or shoulders. A BPN could dramatically reduce or eliminate the possibility of movement, and can decrease sensation in those affected areas.

The pain with a BPN is sudden and severe. While uncommon in adults, BPNs can show misleading presence in infants, which is why they are often not diagnosed right away. Sometimes, these conditions can even be misdiagnosed in infants or adults, which leads to further complications.

Common Causes of a BPN

A BPN is a peripheral neuropathy, which constitutes the damage done to a single nerve or set of nerves in the shoulder and arm. When an infant suffers from a BPN, the brachial plexus region is damaged. This means that the region coming from the brain and spinal cord into the arms is damaged, since the brachial plexus nerves are what run through the lower neck and upper shoulders.

Damage typically occurs due to a direct injury, such as:

  • Trauma during birth,
  • Stretching injury,
  • Pressure from growing tumors, or
  • Damage done during radiation therapy.

Brachial plexus injuries can also be associated with medical conditions; when those conditions are not diagnosed and treated, they can lead to a BPN. These conditions include birth defects, exposure to toxins, conditions that are inflammatory, and immune system diseases. Infants are at highest risk for a BPN, especially after a long and difficult labor. Among adults, young men are more likely than women to develop a BPN.

Symptoms Associated with a BPN

There are several symptoms associated with BPNs. Healthcare providers should look for these symptoms in an infant or adult patient in order to properly diagnose a BPN. Often, BPNs are diagnosed as other conditions, or the symptoms are discounted entirely.

Common symptoms of a BPN include:

  • Numbness – BPNs typically lead to numbness in the hand, arm, or shoulder area. Severe cases may involve complete loss of sensation in one or more of these areas.
  • Abnormal sensations – A BPN can lead to abnormal sensations, such as burning or tingling in the areas next to the damaged nerves. These typically occur in the hand or arm.
  • Weakness – A decreased ability to lift or extend the arm is common in BPN injuries. Weakness in the hands is the most common symptom of a BPN.
  • Horner Syndrome – This is a rare complication that may indicate that the patient has suffered from a BPN. Horner Syndrome appears following interruptions of the nerve signals that control the face. This results in a constricted pupil, eyelid droops, and an inability to sweat on the affected area of the face.

Can BPN be Cured or Treated?

Most treatments for a BPN focus on correcting the underlying causes and improving the range of motion.  In some rare cases, there is no treatment required.

Over-the-counter medications are used to control any inflammation or pain. Furthermore, a physician may need to prescribe tricyclic antidepressants and anticonvulsants to help with the symptoms and complications of a BPN. Physical therapy may be required to increase the infant’s or adult’s range of motion. Orthopedics may be required to improve range of motion, or to generally assist the patient in functioning.

What Happens When a BPN is Left Untreated?

The permanent consequences of a BPN depend on a few factors. First, the location of the injury to the nerves will determine the condition that evolves from the BPN. If the nerves on the lower half are injured, this is likely to lead to a condition known as Klumpke’s palsy. If the nerves of the upper half are involved, then Erb’s palsy is what likely results.

If there is minor damage, the nerves may heal on their own in about three months. More serious injuries can take as much as two years to recover. If, however, there was a tear in or rupture of the nerves in the brachial plexus region, then the damage is most likely permanent and irreversible – even with surgery.

There are treatments available to help lessen the damage to the nerves. If these injuries are left untreated, mild levels of damage could become a permanent, serious injury.

Is It Negligence?

There are instances when these injuries are solely due to common complications known to happen with particular procedures or surgeries. However, it could be negligence if:

  • The doctor does not realize that the baby’s head is too large for the birth canal,
  • The physician does not notice the baby’s position,
  • The physician fails to notice fetal distress symptoms,
  • The physician does not notice that the umbilical cord is compressed,
  • The physician does not order a C-section when one is warranted, or
  • The physician does not provide proper care to the infant after birth.

Can a BPN be Avoided?

Most of the brachial plexus injuries that occur during birth are a form of negligence, as they are highly preventable. If a physician or healthcare provider pays attention to the mother and baby’s condition, he or she can typically avoid complications that lead to such an injury. Consider, for example, an instance of breech baby: This can be detected early, and the baby may be delivered via C-section to ensure that there are no injuries to the nerves. Most babies’ positions are determined by 32 weeks, so an emergency C-section should not be required. Instead, the issue must be noticed immediately.

Filing a Lawsuit for a BPN

Caring for the needs of a person who is suffering from a BPN is costly and time-consuming. Even mild cases of BPN will require months of therapy and will add up significantly in terms of both finances and time.

A brachial plexus lawsuit against the physician or hospital can help loved ones recover medical costs that have been paid, as well as provide for future medical costs associated with the injury and treatment. In addition, the injury case will hold all responsible parties liable for any mistakes and negligence. In turn, this helps prevent future injuries to other infants and their families.

To succeed in a BPN case, families must be able to prove that their case is valid. This usually means working with a medical malpractice attorney to gather evidence and establish fault. To win, the attorney must prove several factors:

  1. Establish that a duty of care existed. This means that the defendant was responsible for the care of the patient at the time of the injury.
  2. The duty of care was breached. In other words, the defendant was negligent, reckless, or careless in providing his or her duty of care to the patient.
  3. The breach of that duty was the cause of the brachial plexus injury.
  4. There are damages associated with the brachial plexus injury.

Will Your BPN Case go to Trial?

Most medical malpractice lawsuits will settle outside of court. It is less time-consuming and costly for a physician or hospital to settle than take the case to trial. However, if settlement negotiations are not favoring of the plaintiff’s needs, an attorney may advise to take the case to trial rather than waste more time and resources negotiating.

A medical malpractice attorney will establish the case before trying to settle it. That will include establishing and providing evidence that the defendant caused the injury. When the evidence is strong enough, the defense is more likely to settle the case then take it to trial, where they are likely to lose. But, there is always the chance that a medical malpractice case will go to trial. While rare, these cases can move forward if the defendant refuses to settle.

It is best if all plaintiffs prepare themselves for the possibility of going to trial. By doing so, they can be prepared for testifying, having witnesses testify against them, and for the additional time needed before a resolution can be reached.

Understanding Compensation Options and Case Length

Most birth injury and medical malpractice cases take months – or even years – to complete. If the case goes to trial, it will take longer than if the case were to settle outside of court.

The discovery phase, which is where both sides will collect evidence against the other side to strengthen the case, is the phase that takes the longest. This can last several months. If the case does go to trial, that could take a few more months, and the defense still has the option of appealing the decision. For this reason, a case could drag on longer than expected.

In terms of compensation, the amount available to loved ones and the injured will depend on a few factors, including the severity of the injury, the prognosis, and where the injury is located. Physicians must testify to the extent of the damages, as well. In general, once a plaintiff wins his or her case, compensation will be received for:

  • All medical expenses, including estimated future medical costs for the injured.
  • In-home care, if it is required, to help assist for the care of the injured.
  • Physical therapy treatments, rehabilitation costs, and occupational therapy (if required).
  • Emotional suffering, pain and suffering, and the mental trauma associated with the injury.
  • Lost wages or the costs of reduced hours to help care for the patient, or the lost hours that the patient encounters because of the injury.

Receive a Free Consultation for Your BPN Now

Those suffering from a BPN should consult with an attorney right away. Because these injuries are typically the result of negligence, a medical malpractice attorney may be able to help. Contact Berkowitz and Hanna LLC today to schedule a no-obligation case evaluation.