Birth Injury Cases
Erb's palsy and brachial plexus birth injuries: what causes them, when shoulder dystocia mistakes are malpractice, recovery odds and Kentucky deadlines.
Reviewed by Larry Forman, Attorney
A baby born with a limp or weak arm may have Erb's palsy, an injury to the nerves that control the shoulder and arm. Many babies recover. Some don't, and face surgeries and lifelong weakness. When the injury happened because a delivery complication was handled improperly, the family may have a claim. This page explains what Erb's palsy is, how it happens, what recovery looks like, and how a Kentucky claim works.
The brachial plexus is a network of nerves near the neck that controls movement and feeling in the shoulder, arm, hand and fingers. A brachial plexus birth injury damages those nerves. Erb's palsy is the most common form: it affects the upper nerves, so the baby may not move the shoulder or bend the elbow but can move the fingers. Klumpke's palsy affects the lower nerves and the hand. Some babies have injuries to the whole plexus.
The American Academy of Orthopaedic Surgeons (AAOS) estimates that one or two of every 1,000 babies has a brachial plexus birth injury.
AAOS says the injury is often caused when a baby's neck is stretched to the side during a difficult delivery. It's associated with a large baby, maternal diabetes, prolonged labor and breech delivery.
The classic scenario is shoulder dystocia: the baby's head delivers, but a shoulder gets caught behind the mother's pubic bone. The delivery team has to free the shoulder quickly using recognized maneuvers, such as repositioning the mother's legs (the McRoberts maneuver) and applying pressure just above the pubic bone. Pulling hard on the baby's head, or pushing on the top of the uterus, can stretch or tear the nerves.
AAOS also notes that brachial plexus injuries can occur in babies without any risk factors and in babies delivered by C-section. That matters: not every Erb's palsy case is malpractice.
A claim may exist when the injury was caused by care below the accepted standard, for example:
The defense usually argues that the natural forces of labor, not the delivery team, caused the injury. Answering that argument takes a careful review of the delivery records by qualified obstetricians.
AAOS describes four types of nerve injury, and the type largely determines recovery:
| Type | What happens | Typical outlook |
|---|---|---|
| Neurapraxia | Nerve stretched but not torn | Most common; usually heals on its own, often within 3 months |
| Neuroma | Some fibers damaged; scar tissue forms | Some recovery, usually not complete |
| Rupture | Nerve torn apart | Won't heal on its own; may be repaired with a nerve graft |
| Avulsion | Nerve torn from the spinal cord | Can't be reattached; nerve transfers may restore some function |
Most babies with brachial plexus birth palsy recover movement and feeling. But AAOS notes that many children continue to have some weakness, and that the affected arm may grow more slowly and end up noticeably smaller.
Birth injury claims are medical malpractice claims; see our medical malpractice page for the full rules.
Many families wait to see whether the arm recovers. That's understandable, but evidence and the parents' deadlines don't wait. A lawyer can secure the records while you watch the recovery.
A child's settlement has to be protected under Kentucky law, often in a restricted account, annuity or structured settlement (KRS 387.278 covers smaller settlements). Health plans and Medicaid may need repayment; see medical liens in a Kentucky settlement.
We obtain the complete delivery records and have qualified obstetricians and pediatric orthopedic and nerve surgeons review how the delivery was handled and what the long-term outlook is. If there's no case, we'll say so. We prepare every case for trial. Larry Forman has tried 50+ jury trials and won 95% of them. See our case results (past results don't guarantee a similar outcome) and our main birth injury lawyer page.
Kentucky gives you a right to your own chart. On your written request, a licensed hospital or health care provider must give you one copy of your medical record free of charge; a second copy can cost up to $1 a page (KRS 422.317). Federal privacy law adds a deadline: a provider generally has 30 days to act on your request, with one 30-day extension if it explains the delay in writing (45 CFR 164.524).
For an Erb’s palsy claim, ask for more than the visit notes. Request the labor and delivery notes describing how the baby was delivered (including any note of shoulder dystocia and the maneuvers used), the baby’s estimated and actual weight, the newborn exam, and later EMG, therapy and nerve-surgery records. Keep the copies together with a simple log of every appointment, test and missed workday. That record is often what proves how the injury has changed your life.
Usually stretching of the nerves in a baby's neck during a difficult delivery, often with shoulder dystocia. It can also occur without risk factors and after a C-section.
Most babies do, especially with stretch injuries. Tears and avulsions may need surgery, and some children keep lasting weakness.
No. A claim exists when the injury was caused by care below the standard, such as excessive traction or mismanaged shoulder dystocia.
A doctor may suggest nerve surgery if there's no improvement over the first 3 to 6 months.
Malpractice claims generally have one year from discovery. The child's own claim usually gets extra time, but the parents' claims may not.
No. Erb's palsy is a nerve injury to the arm. Cerebral palsy is caused by brain injury; see our cerebral palsy and HIE birth injury pages.
Call (502) 931-6788 or request a free case evaluation. No fee unless we win. Our office is at 1139 S. 4th St., Louisville, KY 40203.
This page is general information as of October 2026, not legal or medical advice.
