Brachial Plexus Injury FAQs

The brachial plexus is a network of nerves extending from the neck through the shoulder and into the arm. A birth-related injury may involve stretching, scar tissue, a partial tear, a complete rupture, or separation of a nerve root from the spinal cord. The location and extent of the damage influence which muscles and sensations are affected. Erb's palsy generally involves the upper portion of the plexus and commonly affects shoulder and elbow movement. Klumpke palsy involves lower nerves and may have a greater effect on the forearm, wrist, and hand. A more extensive injury can involve the entire plexus. Physicians may use physical examinations, imaging, nerve conduction studies, electromyography, and surgical findings to classify the injury. The medical diagnosis is important, but a legal claim also requires evidence about how the injury happened and whether a provider's conduct departed from accepted medical practice.

Under New York law, an unfavorable outcome does not by itself establish medical malpractice. A family generally must prove that a physician, nurse, midwife, hospital, or other provider departed from the accepted standard of care and that the departure was a substantial factor in causing the child's injury. Questions may arise when the delivery team applies excessive force or lateral traction to the baby's head or neck, responds improperly to shoulder dystocia, fails to use accepted delivery maneuvers, or does not timely consider a cesarean delivery despite recognized risks. Obstetrical and pediatric experts typically review the records and testimony to determine whether the injury was an unavoidable complication, arose before labor, or was caused or worsened by preventable conduct during delivery.

A legal investigation brings together evidence from pregnancy, labor, delivery, and the child's subsequent care. Prenatal records may identify factors such as diabetes, suspected fetal size, prior shoulder dystocia, breech presentation, or a prolonged second stage of labor. Delivery records may document the time shoulder dystocia was announced, the sequence of maneuvers, the clinicians present, the duration of the emergency, and the baby's condition immediately afterward. Later records from neurologists, orthopedists, therapists, and surgeons can help establish the level of nerve damage, functional limitations, treatment, and prognosis. Witness testimony may be necessary when the chart is incomplete or uses general language. Counsel can work with qualified experts to reconstruct the delivery, compare the response with accepted practice, and evaluate whether the alleged departure caused the particular nerve injury.

New York generally requires a medical malpractice lawsuit to be commenced within two years and six months after the challenged act or omission, or after the end of qualifying continuous treatment for the same condition. Because the injured patient is usually an infant, a statutory infancy toll may extend the time, but in a medical malpractice case that toll generally cannot carry the deadline beyond ten years from accrual. Different and potentially shorter requirements may govern claims involving municipal hospitals, public authorities, or government-employed providers. Some matters require a notice of claim within ninety days, and certain actions against municipal defendants must be commenced within one year and ninety days. The proper deadline depends on the defendant's identity, the treatment history, the date the claim accrued, and other case-specific facts. Families should seek advice promptly rather than relying on a general deadline, since early investigation also helps preserve records, identify witnesses, and obtain an informed medical review.