Nationally Recognized Birth Injury Lawyers in Arizona
Giving birth has inherent risks, including the potential for various complications that require accurate diagnoses, appropriate treatment, and medical intervention in order to reduce risks of serious and preventable injuries. Unfortunately, doctors, nurses, and other healthcare providers don’t always uphold their duty to provide an acceptable standard of care when handling complications such as shoulder dystocia.
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When preventable birth injuries occur, families have the right to seek justice and compensation for their child’s immediate, ongoing, and possibly lifelong care. At Cullan & Cullan, our legal team is comprised of proven and experienced trial lawyers, four of whom are also doctors. Our insight, resources, and unwavering commitment have been utilized in thousands of forensic investigations involving birth injuries, and by numerous families who placed their trust in us during difficult times.
Our firm knows how to handle the most challenging birth injury cases. Discuss your potential case by calling (602) 900-9483 or contacting us online. Consultations are free and confidential.
What is Shoulder Dystocia?
Shoulder dystocia is a delivery complication that occurs when an infant’s shoulders become stuck behind the mother’s pelvic bone. This obstruction can prevent the baby from easily passing through the pelvis posing risks of injury to both mother and child. Because the condition does pose serious risks, it is vital that healthcare professionals overseeing pregnancy, labor, and delivery adequately evaluate potential risk factors for a difficult birth and respond appropriately if the complication occurs.
Shoulder Dystocia & Preventable Birth Injuries
Investigations of birth injury cases involving shoulder dystocia focus on whether attending medical professionals – whether a doctor, nurse, or midwife – failed to meet their duty of care, and whether that failure more likely than not resulted in preventable injuries.
Common birth injuries resulting from shoulder dystocia include:
- Oxygen deprivation/brain damage
- Perinatal hypoxia and Hypoxic ischemic encephalopathy (HIE)
- Long-term impairment or disability, including cerebral palsy
- Injuries to the brachial plexus, including nerve damage and Erb’s palsy
- Fractures and broken bones
- Uterine rupture, bruising or tearing of the cervix, vagina, or rectum, and hemorrhaging (in mothers)
- Horner Syndrome
How Common Is Shoulder Dystocia?
The likelihood of shoulder dystocia varies by a baby’s weight, but that alone is not a significant enough risk factor to identify likely cases before birth. Maternal diabetes may also play a factor but, likewise, does not cause shoulder dystocia enough to serve as a data point in predictions.
Studies show that, by weight, the likelihood of shoulder dystocia is:
- 0.6–1.4% of infants (6-14 per 1,000) weighing between 5lb, 8oz. and 8lb, 13oz.
- 5-9% of infants (50-90 per 1,000) weighing between 8lb, 13oz. and 9lb 14oz.
- The likelihood of shoulder dystocia continues to increase with the baby’s weight
What Are the Signs of Shoulder Dystocia?
Shoulder dystocia usually comes on with no warning, revealed by a pattern called “turtling” where the baby’s head will appear and then be pulled back. In some instances, the baby’s face and chin will not make it through the mother’s vulva. Delivery will stall, and intervention is necessary for both mother and baby’s health.
Other signs of shoulder dystocia include:
- Assistance Required: Additional maneuvers or assistance from medical personnel, such as the use of forceps or vacuum extraction, may be needed to deliver the baby.
- Visible Signs of Distress: The baby may show signs of distress, such as a change in heart rate, due to the prolonged delivery process.
- Increased Risk Factors: If the mother has risk factors such as gestational diabetes, a previous history of shoulder dystocia, or a large baby (macrosomia), the likelihood of shoulder dystocia occurring may be higher.
- Maternal Complications: The mother may experience complications such as tears in the perineum or uterus due to the prolonged and difficult delivery process.
- Professional Reaction: Healthcare providers may call for additional assistance, change the mother's position, or attempt various maneuvers to resolve the shoulder dystocia and safely deliver the baby.
How Should Doctors Handle Shoulder Dystocia?
There are multiple methods doctors can use to progress labor in cases of shoulder dystocia, but their success rates may vary. Their responses may include:
- The McRoberts’ maneuver
- Applying suprapubic pressure
- Internally rotating the baby
- Repositioning the patient during delivery to be on all fours
If unsuccessful, a doctor may opt for more drastic measures that put the mother and baby at risk. They should never pull on the baby’s head or neck, because doing so is both ineffective and harmful to the baby.
Long-Term Effects of Shoulder Dystocia
Brachial plexus injury is one of the most common long-term effects of shoulder dystocia. The brachial plexus is a network of nerves that control movement and sensation in the shoulder, arm, and hand. During shoulder dystocia, these nerves can stretch or tear, leading to conditions such as Erb's Palsy and Klumpke's Palsy.
Other long-term effects include:
- Fractures and Injuries: The baby may suffer fractures of the clavicle (collarbone) or other bones due to the maneuvers used to free the shoulders.
- Hypoxic-Ischemic Encephalopathy (HIE): In severe cases, prolonged shoulder dystocia can lead to decreased oxygen supply to the baby, potentially causing brain damage and neurological deficits.
- Developmental Delays: Babies who experience shoulder dystocia and its complications may face delays in reaching developmental milestones, particularly in motor skills related to the affected arm.
- Psychological Impact: For both the child and the parents, the experience of shoulder dystocia and its aftermath can lead to emotional stress and anxiety, particularly if long-term disabilities or challenges arise.
Treatment for shoulder dystocia include:
- Immediate Management: During childbirth, immediate actions focus on resolving the shoulder dystocia to minimize potential harm to the baby. Techniques may include changing the mother's position, using specific maneuvers (such as McRoberts maneuver, suprapubic pressure, or rotational maneuvers), or episiotomy (if necessary).
- Medical Monitoring: After delivery, the baby will be closely monitored for any signs of injury or distress. This may include neurological assessments to detect any nerve injuries or signs of HIE.
- Physical Therapy: If nerve injuries like brachial plexus injuries occur, physical therapy may be necessary to help improve range of motion, strength, and function of the affected limb.
- Surgical Intervention: In severe cases of brachial plexus injuries or fractures, surgical intervention may be required to repair nerves or bones, although this is less common.
- Long-Term Follow-Up: Babies who experience shoulder dystocia and associated complications often require long-term follow-up with pediatricians, neurologists, orthopedic specialists, and physical therapists to monitor their development and address any ongoing issues.
Medical Negligence: Do You Have a Case?
Whether you have a potential birth injury case depends on the unique facts and circumstances involved. Generally, victims may have the right to pursue compensation when injuries resulted from a medical professional’s negligence or their deviation from accepted medical standards. Examples of substandard care and negligence in relation to shoulder dystocia injuries include:
- Failure to address risk factors and increased potential for complications (i.e. large babies, maternal diabetes, shoulder dystocia in previous deliveries, etc.)
- Failure to monitor signs of fetal heart rate, vitals, distress
- Delayed C-sections or failures to perform C-sections
- Improper manipulation of the baby, or the improper use of forceps and vacuums
- Improper use of labor-inducing drugs, including Pitocin
Call (602) 900-9483 to Request a FREE Consultation
Doctors, nurses, and others who care for pregnant mothers and facilitate deliveries have a legal obligation to provide care that meets the accepted standard of their profession. When they fail to do so, and preventable birth injuries occur, victims and their loved ones may have the right to pursue accountability and financial compensation through the civil justice system. Working with experienced and proven attorneys can help families make the most of this right.
Our team at Cullan & Cullan has cultivated a reputation for helping families navigate what are often trying and emotionally turbulent experiences, and for our ability to guide clients toward the justice they deserve. If you have questions about our team, or wish to discuss a potential case involving shoulder dystocia or any other type of birth injury, contact us for a FREE consultation.