Erb's Palsy: reports of negligence at birth

Kristian was born December 28th, 2004 and we still don't know exactly what happened, but I'm sure Erb's Palsy could have been avoided. Now that I know my son is not going to be OK without surgery I am really mad.

Roseanna Morrow, Kankakee, Illinois:

When the doctors started talking about surgery I got concerned. My doctor called me several times after Kristian was born to see if he was OK. I think she must have thought that I was going to sue her. At the time I wasn't going to, but now I am having second thoughts. I always thought I should have had an episiotomy.

I think that some kind of concession should have been made when I told my doctor that he is going to be a big baby. I don't think she took my concerns seriously.

Why wasn't I given an episiotomy? I was worried that I was gaining so much weight and he was going to be so big but my doctor just blew it off and told me not to eat so much. I made a conscious effort not to eat but I just kept getting bigger and bigger. I gained 50 lbs.

We are still trying to figure out why it wasn't discovered earlier, and how it could have been prevented. I discovered that the majority of Erb's palsy cases happen to babies with an above average birth weight and Kristian was 9 lbs, 2 ounces, a big boy. My obstetric doctor thinks that he might have stretched or torn his arm in utero.

When Kristian was born they said that something was wrong with his arm and didn't rule out a fracture. An orthopedic surgeon looked at him the next day. He wanted to be absolutely sure, but believed Kristian might have Erb's palsy. He wanted to get a second opinion from a pediatric orthopedic specialist, and didn't want to put his arm in a sling at that time. Kristian could move his fingers a bit so we assumed the tendon wasn't torn. He didn't seem distressed.

We were sent to Dr. Christopher Sullivan at the University of Chicago's Midwest physician's group. He took x-rays to see if it was a fracture. A few weeks later he determined there was no fracture and it was indeed Erb's palsy. We had already started physical therapy when he was two months old, to get range of motion and strength in his arm.

We have exercises to do at home. He is now 18 months old and overall he is progressing. He isn't that far off developmentally but had a lopsided crawl, and he can't put much pressure on his arm. Kristian doesn't have as much strength in his right arm as his left and doesn't have a full range of motion. His arm hangs kind of funny and they are talking about surgery.

At first I was so upset, everybody wants a perfect baby. He was healthy but different. I know he isn't going to be normal. He won't be able to throw a ball or pick up something like other kids. Therapy works, especially right away - I can't stress that enough. I believe this was integral, otherwise he wouldn't be able to do anything with his right arm. My doctor kept saying it must have happened in utero, but I don't buy that anymore.

Erb's Palsy, also known as Brachial Plexus Paralysis, is mainly caused by trauma at birth. It can affect one or all five of the primary nerves that supply movement and feeling to an arm. Erb's palsy can range from partial to complete paralysis, and each nerve can be damaged due to bruising or tearing. Some babies can recover completely while others need physical therapy and even surgery. Early intervention is key to ascertain the extent of damage and treatment needed.