Erb's Palsy

Erb's palsy is a condition caused by damage to the brachial plexus — the network of nerves that runs from the spinal cord through the shoulder and controls movement and sensation in the arm, elbow, wrist, and hand. When these nerves are damaged at birth, a baby may be unable to lift or rotate the affected arm, and in severe cases, may have no feeling or movement in that arm at all.

Erb's palsy almost always occurs during a difficult delivery, particularly when a baby is large (macrosomic), when delivery is prolonged, or when a complication called shoulder dystocia occurs — a situation in which the baby's shoulder becomes stuck behind the mother's pubic bone after the head is delivered.

Here is what's important to understand: shoulder dystocia is a recognized medical emergency, and there are established protocols — called HELPERR maneuvers — for managing it safely. When these protocols are followed correctly, the baby is delivered without injury. When a doctor applies excessive traction (pulling force) on the baby's head in an attempt to free the stuck shoulder, the brachial plexus nerves can be torn, stretched, or permanently damaged.

This means that many cases of Erb's palsy are the direct result of a physician using excessive force during a delivery complication they were trained to handle differently. This is textbook medical negligence.

Signs and symptoms of Erb's palsy typically include:

• An arm held limply at the side, often slightly bent at the elbow
• Limited or no movement in the shoulder, arm, elbow, or hand
• Decreased grip strength on the affected side
• "Waiter's tip" posture — arm rotated inward with wrist bent downward
• Numbness or abnormal sensation in the affected arm

Treatment may include physical therapy, occupational therapy, or surgery. Many children show significant improvement with early treatment, but some are left with permanent weakness, limited range of motion, or muscle atrophy. The costs of long-term therapy and surgical intervention can be substantial.

If your child was diagnosed with Erb's palsy or brachial plexus injury, please reach out for a free case review. Your delivery records will tell the story — and we'll help you understand what they mean.