FAQs

Question 1

What is Erb’s Palsy?

Accepted Answer

Erb’s Palsy is a form of obstetric brachial plexus disorder, and is caused by damage to the nerves during birth. Brachial plexus injuries affect the network of five primary nerves responsible for movement and feeling in the shoulder, elbow, wrist and hand.

Damage to any or all of these nerves can leave a child with a disability, the form and severity of which depending on which nerves have been damaged. It is estimated that 1-2 babies out of every 1,000 will be born with Erb’s Palsy.

Question 2

How is Erb’s Palsy diagnosed?

Accepted Answer

Often, signs of Erb’s Palsy will be obvious to healthcare professionals immediately following birth. These include:

A lack of movement, or no movement, of the affected arm
Poor reflexes
Abnormal positioning of the arm
Poor grip strength
Contracture of the elbow

Sometimes in mild cases of Erb’s Palsy, it may take a couple of weeks before the symptoms become recognisable, particularly for new parents who may not know what to expect from their baby’s arm movements.

Question 3

How is Erb’s Palsy caused?

Accepted Answer

When a midwife or obstetrician is concerned about a birth for one reason or another, there can be increased pressure to get the baby out quickly. Shoulder dystocia is a prominent example of an obstetric emergency – when one or both of the baby’s shoulders gets stuck during birth, typically against the pelvis of the mother, this places the baby at risk of oxygen deprivation.

While there are a number of approved procedures to ensure smooth delivery, if the person delivering the baby pulls too hard, that can stretch the nerves in the baby’s shoulder, which could cause Erb’s Palsy.

Links Between Shoulder Dystocia Risk Factors and Erb's Palsy: Infographic

Screening mothers prior to delivery and offering a caesarean section can prevent birth injuries like this occurring.

Question 4

When is medical negligence to blame for Erb’s Palsy?

Accepted Answer

Sometimes there is nothing that can be done to prevent a baby being born with Erb’s Palsy. The natural process of birth can lead to excessive stretching to the baby’s shoulder. Approximately a third of Erb’s Palsy cases affect the baby’s posterior shoulder (the shoulder that is delivered last). In these cases, it is rare that the injury will be due to the actions of a healthcare professional. If the injury is sustained by the anterior shoulder (the shoulder that is delivered first), this is more likely due to a substandard response. In the event of an obstetric emergency, midwives and obstetricians should be trained in the appropriate manoeuvres and techniques to manage these situations and avoid significant harm to the baby. These include:

The McRoberts Manoeuvre
The Gaskin Manoeuvre
Suprapubic pressure
An episiotomy

If a healthcare professional fails to carry out these actions as intended, there is an avoidable delay in applying these actions, or they apply excessive force, or they have not picked up on warning signs early enough to prevent a severe injury, this may be grounds for an Erbs Palsy compensation case. In addition, a failure to recommend a caesarean section, or not take action and refuse to accept a mother’s request for a caesarean section when there is a potential risk of shoulder dystocia can also be considered negligent.

Question 5

How does Erb’s Palsy affect a child’s life?

Accepted Answer

The scope of an Erb’s Palsy injury is vast and entirely individual to the affected child. For some, the damage will be minor and may heal over time. For others, they could lose all function in their arm for the rest of their lives and require long-term care. The extent of the child’s injury and the long-term consequences of it will depend on the amount of force placed on the baby’s shoulder during birth, and how long the stretching lasted. Minimal, brief stretching could result in a minor nerve injury such as neuropraxia. Severe, extended pressure on the shoulder could restrict the growth and mobility of their arm or hand completely. It also depends on whether Erb’s Palsy affects the child’s dominant hand or not. If it does, then the impact can be even more substantial, as they will have to learn to function with their naturally weaker hand. Depending on the severity, permanence and location of the nerve damage, Erb’s Palsy negligence can have life-changing repercussions for the child:

They may be unable to take part in sport and other physical activities
They may require specialist equipment and aids
They may need to undertake regular physical therapy appointments to preserve the health of their arm
They may require home adaptations – rails, lifts, voice-activated technologies, etc.
They may be unable to perform typical daily tasks such as washing up, driving a car, riding a bike, lifting heavy objects, bathing, etc.
They may be limited in the job roles and other opportunities they pursue, resulting in future loss of earnings

As well as the physical consequences, Erb’s Palsy can also cause a great deal of emotional trauma leading to mental health conditions. The need for additional assistance or abnormal arm growth could alienate someone from their peers, and affect how they perceive their body image. They could also miss numerous childhood pastimes and milestones, from learning to ride a bike to taking their first swimming lesson.

Question 6

Claiming for Erb’s Palsy

Accepted Answer

Erb’s Palsy can have a life-altering impact on an individual and those around them. Restrictions to their independence may burden them for the rest of their lives.
If these circumstances are the result of substandard care by a healthcare professional, our solicitors are here to establish what happened and secure the compensation your child deserves.

Question 7

How long do Erb’s Palsy claims take to settle?

Accepted Answer

We would typically anticipate an Erb’s Palsy claim to take between 2-5 years to reach final settlement. During this time our solicitors will guide you through every stage of the claims process, determining:

Whether a healthcare professional’s care towards a claimant was negligent
The claimant suffered physical, psychological or financial harm
The claimant received their injuries as a result of the negligence they endured

We will also work with relevant experts to quantify the value of a birth injury claim based on the injuries sustained, how that has altered the claimant’s expected prognosis, and the long-term support they will need based on the severity of their Erb’s Palsy.

Question 8

How long do you have to make a claim?

Accepted Answer

As the claimant in an Erb’s Palsy claim will typically be under the age of 18, they will have until their 21st birthday to make a claim. There is no time limit for anyone who is mentally incapacitated.

In special circumstances, the Courts sometimes allow claims outside these time limits. However, we would always advise that there is no benefit to delaying an injury compensation claim, and it is helpful to get in touch with legal services as soon as possible.

Questions about Erb's Palsy claims? Complete our online claim assessment

Question 9

What is the average settlement amount for Erb’s Palsy claims?

Accepted Answer

The final settlement for an Erb’s Palsy claim can vary significantly. It will depend on several factors:

How severe the injury was to the claimant
How much functionality the claimant has lost due to their nerve damage
How permanent the nerve damage is expected to be
The extent of the care, equipment and therapies the claimant needs to help them live as comfortable and fulfilling a life as possible

A temporary, transient weakness of the arm that will recover over time would therefore be valued substantially lower than a case where the claimant will require specialist care and equipment to support them for the rest of their life. In circumstances where the claimant will require long-term care, it is common for compensation to be awarded as both a lump sum and annual periodic payment orders (PPOs). These annual payments help ensure that the claimant will always receive the financial support they need to cover their care requirements.

Question 10

What can compensation for Erb’s Palsy help with?

Accepted Answer

The compensation that a claimant receives following a successful Erb’s Palsy claim can be a crucial support for their entire lives, ensuring they have access to the treatments and therapies they need to make their life as straightforward as possible. They may also need specialist equipment throughout their lifetime.

Question 11

How do I make a claim and what should I expect?

Accepted Answer

Unlike other forms of medical negligence claim, the law does not allow someone under the age of 18 or a protected party (someone who lacks the mental capacity to make certain decisions for themselves) to bring a medical negligence claim on their own. Therefore in the majority of Erb’s Palsy claims, a parent or guardian of the claimant will act as a litigation friend. A litigation friend assumes the role of the claimant throughout the claim, providing evidence and statements where necessary. At Gadsby Wicks, our solicitors are there to guide you through this important role. From your initial consultation we offer dedicated legal advice built on decades of helping clients make successful claims against NHS trusts, private hospitals and independent healthcare professionals.

We have been dedicated to medical negligence since 1993
We are authorised and regulated by the Solicitors Regulation Authority
We are the first firm in England to have two or more lawyers accredited as accredited clinical negligence specialists by the Association of Personal Injury Lawyers
Four of our solicitors are also accredited by the Law Society’s Clinical Negligence Accreditation Scheme
We have in-house medical professionals to assist with your case
Managing Partner Gillian Gadsby is on the Clinical Negligence Specialist Panel for the Action Against Medical Accidents (AvMA) charity

We will investigate all medical records, witness statements and further evidence to establish what happened, and work closely with trusted medical experts to determine the cause of a claimant’s injury and quantify the value of their claim.