When a newborn’s arm hangs limply at their side, unable to move, parents know immediately that something is wrong. Erb’s palsy—a type of brachial plexus injury—is one of the most common birth injuries, occurring in approximately 1-2 out of every 1,000 births. While some cases resolve with physical therapy, many children face permanent disability that could have been prevented with proper medical care.
At Phillips Law Offices, our Chicago birth injury attorneys have helped families across Illinois understand how Erb’s palsy happens, when medical negligence is to blame, and what compensation is available to help their child thrive despite this injury.
What Is Erb’s Palsy?
Erb’s palsy (also called Erb-Duchenne palsy or brachial plexus birth palsy) is a nerve injury that affects the arm. It occurs when the brachial plexus—a network of nerves running from the spinal cord through the neck and into the arm—is damaged during birth.
The brachial plexus controls movement and sensation in the shoulder, arm, and hand. When these nerves are stretched, compressed, or torn during delivery, the result can range from temporary weakness to permanent paralysis.
Types of Brachial Plexus Injuries
- Neurapraxia (stretch): The mildest form, where nerves are stretched but not torn. Usually heals within 3 months.
- Neuroma: Stretched nerves that have formed scar tissue, putting pressure on healthy nerves. May require surgery.
- Rupture: Nerves are torn but not at the spinal cord. Requires surgical repair.
- Avulsion: The most severe form, where nerves are torn from the spinal cord. Cannot be repaired; may require nerve transfer surgery.
Signs and Symptoms of Erb’s Palsy
Erb’s palsy is usually noticeable immediately after birth. Signs include:
- The “waiter’s tip” position: The affected arm hangs limply with the elbow straight, forearm rotated inward, and wrist bent
- Inability to move the arm or shoulder: The baby cannot lift or rotate the affected arm
- Lack of grip strength: Weak or absent grip in the affected hand
- Lack of Moro reflex: The baby doesn’t exhibit the normal startle response on the affected side
- Numbness or decreased sensation: In the affected arm and hand
In severe cases, there may also be:
- Drooping eyelid on the affected side (Horner syndrome)
- Complete paralysis of the arm
- Permanent muscle atrophy if untreated
How Erb’s Palsy Happens During Birth
Erb’s palsy occurs when excessive force is applied to the baby’s head, neck, or shoulders during delivery. The most common scenario is shoulder dystocia—when the baby’s shoulder becomes stuck behind the mother’s pelvic bone after the head has been delivered.
When faced with shoulder dystocia, doctors may use maneuvers that stretch or tear the brachial plexus nerves:
- Excessive lateral traction: Pulling too hard on the baby’s head to free the shoulder
- Improper use of forceps or vacuum: These delivery tools can apply damaging force if used incorrectly
- Fundal pressure: Pushing on the mother’s abdomen, which can drive the shoulder further into the pelvis
- Failure to perform proper maneuvers: Not using proven techniques like the McRoberts maneuver or suprapubic pressure
Risk Factors Doctors Should Recognize
Experienced obstetricians know to watch for conditions that increase shoulder dystocia risk:
- Large baby (macrosomia): Babies over 8 lbs 13 oz face higher risk
- Maternal diabetes: Often leads to larger babies
- Maternal obesity: Increases delivery complications
- Post-term pregnancy: Babies past 40 weeks tend to be larger
- Previous shoulder dystocia: History of difficult deliveries
- Prolonged labor: Especially prolonged second stage
- Assisted vaginal delivery: Use of forceps or vacuum
When these risk factors are present, doctors should anticipate potential complications and take preventive measures—including recommending cesarean delivery when appropriate.
When Is Erb’s Palsy Medical Malpractice?
Not every case of Erb’s palsy involves medical negligence. However, malpractice may have occurred if:
- Risk factors were ignored: Doctors knew the baby was large but proceeded with vaginal delivery without proper precautions
- Shoulder dystocia was mishandled: Medical providers didn’t use appropriate maneuvers or used excessive force
- Improper delivery techniques: Doctors pulled too hard on the baby’s head or improperly used forceps/vacuum
- Failure to perform timely C-section: When complications arose, doctors waited too long to perform cesarean delivery
- Inadequate prenatal care: Failure to diagnose gestational diabetes or accurately estimate fetal size
- Poor communication: Failure to inform parents of risks and delivery options
Long-Term Effects of Erb’s Palsy
The severity of Erb’s palsy varies widely:
Mild Cases
With mild nerve stretching (neurapraxia), many babies recover full or nearly full arm function within 3-6 months with physical therapy. These children may have no lasting limitations.
Moderate Cases
Children with more significant nerve damage may have:
- Permanent weakness in the arm or hand
- Limited range of motion
- Muscle contractures (shortened muscles)
- Bone growth abnormalities
- Need for ongoing physical and occupational therapy
Severe Cases
Children with severe injuries (ruptures or avulsions) may experience:
- Permanent paralysis of the affected arm
- Inability to perform basic tasks with the arm/hand
- Chronic pain
- Multiple surgeries throughout childhood
- Psychological impacts from disability and visible difference
- Limitations in career options as adults
Treatment Options
Treatment depends on the severity of the injury:
Physical and Occupational Therapy
All children with Erb’s palsy benefit from therapy to:
- Maintain range of motion
- Prevent contractures
- Strengthen muscles as nerves recover
- Develop compensatory techniques
Surgical Options
For severe cases that don’t improve with therapy, surgical options include:
- Nerve graft surgery: Replacing damaged nerves with healthy nerve tissue from elsewhere in the body
- Nerve transfer: Rerouting working nerves to restore function
- Muscle transfer: Moving muscles to improve function
- Tendon transfer: Repositioning tendons to restore movement
- Osteotomy: Repositioning bones to improve arm function
Surgery is typically performed between 3-12 months of age if nerve function doesn’t return naturally.
Compensation for Erb’s Palsy Injuries
If medical negligence caused your child’s Erb’s palsy, your family may be entitled to compensation for:
Economic Damages
- Medical expenses: Past and future surgeries, hospitalizations, therapy
- Physical and occupational therapy: Often needed throughout childhood and beyond
- Assistive devices: Braces, adaptive equipment
- Special education services: If needed
- Lost earning capacity: If the injury limits future career options
- Home modifications: If severe disability requires accommodation
Non-Economic Damages
- Pain and suffering: Physical pain from the injury and treatments
- Emotional distress: Psychological impact on the child and family
- Loss of enjoyment of life: Limitations on activities, sports, hobbies
- Disfigurement: Visible disability, muscle atrophy, scarring from surgeries
Erb’s palsy settlements and verdicts can range from tens of thousands to several million dollars, depending on severity and long-term prognosis.
Illinois Statute of Limitations for Erb’s Palsy Cases
Under 735 ILCS 5/13-212 (the Illinois medical malpractice statute of limitations), special rules apply to birth injury cases involving minors:
- Claims must be filed within 8 years of the injury
- But no later than the child’s 22nd birthday
- Parents’ individual claims (emotional distress, medical expenses) must be filed within 2 years of discovery
Additionally, Illinois follows a modified comparative negligence rule under 735 ILCS 5/2-1116. You can recover damages as long as you are less than 50% at fault—though your recovery may be reduced by your percentage of fault.
However, we strongly advise filing claims as soon as possible. Medical records can be lost, witnesses’ memories fade, and expert opinions are more reliable when injuries are fresh.
How Phillips Law Offices Investigates Erb’s Palsy Cases
Proving medical negligence in Erb’s palsy cases requires careful analysis:
- Medical record review: We examine prenatal records, labor and delivery records, fetal monitoring strips, and nursing notes
- Expert consultation: We work with obstetricians, neonatologists, and pediatric neurologists who can evaluate whether the standard of care was breached
- Delivery reconstruction: We analyze exactly what happened during delivery—what maneuvers were used, how much force was applied
- Causation analysis: We establish that the medical provider’s actions (or inactions) caused the nerve injury
- Long-term prognosis: We consult with specialists to determine your child’s future medical needs and limitations
What Parents Should Do
If your child has been diagnosed with Erb’s palsy:
- Get proper treatment: Early intervention improves outcomes—don’t delay physical therapy
- Request medical records: Obtain complete records of your pregnancy, labor, delivery, and your child’s treatment
- Document your child’s condition: Keep a journal of symptoms, limitations, doctor visits, and therapy sessions
- Consult a birth injury attorney: A free consultation can help you understand whether you have a case
- Don’t wait too long: While you have years to file, evidence is easier to gather when injuries are recent
Related Birth Injury Resources
Learn more about other birth injuries and your legal options:
- Cerebral Palsy Birth Injury Guide
- HIE (Hypoxic-Ischemic Encephalopathy)
- Delayed C-Section Birth Injuries
Free Consultation: We’re Here to Help
If your child has been diagnosed with Erb’s palsy and you believe medical negligence may be the cause, contact Phillips Law Offices today for a free case evaluation.
Our Chicago birth injury attorneys have the experience, resources, and compassion to help your family seek justice. We work on contingency—you pay nothing unless we recover compensation for your child.
Call (312) 346-4262 or contact us online to schedule your free consultation.
Phillips Law Offices represents families throughout Chicago, Cook County, and all of Illinois in Erb’s palsy and brachial plexus birth injury cases.