Medical Malpractice and Birth Injury-Related Klumpke’s Palsy

Advances in childbirth medical technology and physician training have reduced the incidents of birth injuries over the past several years. Nonetheless, birth injuries have not been completely eliminated. Circumstances might make some of those injuries unavoidable. In other instances, for example, where a doctor uses excessive force to pull a baby’s head through a birth canal, the baby’s shoulder can be stretched, which can damage certain nerve pathways down the baby’s arm. That damage can be treated if it is promptly and properly diagnosed, but if it is left untreated or the physician fails to diagnose the damage properly, the baby can be left with a lifelong disability known as Klumpke’s palsy or Klumpke’s paralysis. That disability will impair his or her hand mobility and hand and arm strength.

Klumpke’s palsy can result from head and neck injuries that occur later in a person’s life, but although it is a rare birth condition, it is more commonly associated with trauma that takes place during childbirth. Clinicians and researchers have identified risk factors in pregnant women that increases the likelihood of a Klumpke’s palsy birth injury. Pregnant women who have maternal diabetes tend to have larger babies with higher birth weights, and the combination of these factors increases the Klumpke’s palsy risk. Further, if a woman has a narrower birth canal, or her labor continues for an unduly long amount of time, the Klumpke’s palsy risk is increased. In this latter situation, a physician may elect to use forceps to assist in the delivery of the baby. Forceps give the physician greater leverage to assist the baby through the birth canal, but they also increase the extraction force that can stretch the baby’s shoulder to create the nerve damage that leads to Klumpke’s palsy.

A physician who suspects that a baby has suffered some shoulder and arm nerve damage during childbirth should initiate treatment to correct any problems immediately after the birth. The physician is obligated to apply generally accepted medical standards to determine whether a problem has occurred, particularly if any of the risk factors for Klumpke’s palsy were identified before the birth. A physician should look for symptoms such as “claw hand”, in which the hand on the baby’s affected arm is turned inward. The baby might also exhibit reduced arm and hand mobility. The physician should be particularly alert for these symptoms if the nursing staff or parents observe any unusual arm or hand limitations with the baby. Treatments can include physical therapy or surgery to remove scar tissue and to promote growth and repair of damaged nerves.

In Minnesota, a medical malpractice case must generally be filed within four years of an injured party’s discovery of the malpractice-related injury. Because babies have a limited ability to communicate, birth injuries that result from medical malpractice may be difficult to discover. Recognizing this, Minnesota has adopted an exception to this four-year statute of limitations for minor children, who (with certain other limitations) are allowed up to seven years to file a malpractice claim or to have a claim filed on their behalf. These limitations are difficult, if not impossible, to overcome. If new parents suspect that their baby has suffered a birth injury, their best course of action is to consult with an experienced medical malpractice attorney as soon as they can.

The attorney will likely explain that a medical malpractice claim for a Klumpke’s palsy birth injury will focus on four questions, namely:

1. Was there a physician-patient relationship between the baby and the care provider? In most cases, this is an easy question to answer. If liability will be extended beyond the physician who provided the first-hand care for the baby, the complicating factors will be whether the hospital or any of its staff had a physician-patient relationship with the injured baby.

2. What are the reasonable and customary medical standards that applied to the particular birth situation in question, and did the physician adhere to those standards? Standards can vary between urban hospitals and more remote medical centers. Moreover, medicine remains a blend of art and science, and common standards might defer to a local physician’s judgment. An experienced medical malpractice attorney will be able to explain the prevailing standards for any specific case.

3. Did the patient experience an injury because the physician did not follow the standards? It is not enough to prove that a physician did not follow certain standards. The physician’s failure must also be the proximate cause of the birth injury.

4. Did the birth injury impose extra medical costs on the patient, or did it cause any pain and suffering? Apart from actual damages that are related to greater medical costs, a medical malpractice claim will not be successful.

When a potential Klumpke’s palsy birth injury is the issue, an injured party or his or her representative can premise a medical malpractice claim either on undue trauma caused by a physician who managed the childbirth, or on a physician’s failure to properly diagnose the condition after the baby was born. Both situations should be analyzed in view of the four questions that apply to all medical malpractice cases.

The good news is that advances in childbirth medical technology and physician training have reduced the occurrence of Klumpke’s palsy birth injuries to fewer than one in three thousand births. The adverse news is that babies who do experience an injury and whose injury is not diagnosed properly might require costly lifelong medical case and therapy. If you suspect that your baby suffered a Klumpke’s palsy or any other birth injury as a result of a physician’s error or failed diagnosis, please contact us for a consultation about your situation.