New York Injury News

Medical Malpractice Attorney Robert Sullivan Discusses Shoulder Dystocia, a Routine Complication of Birth that Often Leads to Medical Negligence with Serious Injury

In this timely article, New York medical malpractice lawyer Robert G. Sullivan reveals that a common occurrence at the delivery of babies often leads to negligence on the part of hospital staffs, resulting in permanent injury to the newborn.

Shoulder dystocia is a routine complication that arises during births.  Shoulder dystocia occurs when an infant’s shoulder is impacted on the pelvic bone of the mother during vaginal delivery.  What happens next is crucial to the well-being of the baby.

The first step is for the doctor delivering the baby to recognize that shoulder dystocia is taking place, and that this is not merely another long yet normal delivery.  Diagnosing and addressing shoulder dystocia, without causing injury, is part of what is known as “the standard of care” for obstetricians.  Anyone who works in a hospital delivery room – whether as an attending physician, a hospital resident, midwife, or OB/GYN nurse – should receive professional training in recognizing and managing shoulder dystocia.

Once a doctor realizes that a baby’s shoulder is stuck on the pelvic bone, he or she has a window of opportunity to perform one or more of the well known maneuvers to deliver the baby safely.  The “McRoberts’” maneuver is a required “first step” technique to alleviate shoulder dystocia so that the baby’s impacted shoulder may be dislodged from the mother’s pubic bone without causing injury.  Two hospital employees, trained in this procedure, will take the mother’s legs out of the stirrups, and raise and hold each of the mother’s legs so that the pubic bone shifts in place.  The result of the McRoberts maneuver is that the baby’s shoulder slips out more easily.

In addition, if necessary, the doctor may direct the usage of what is known as “subrapubic pressure.”  This type of pressure involves the direct application of pressure in the area above the mother’s pubic bone.  This often will move the baby’s shoulder in the right direction and allow for safe delivery.If the above maneuvers prove ineffective, a doctor should turn to the “Woods” maneuver. When performing the Woods maneuver, the obstetrician inserts his or her hand into the birth canal to rotate one shoulder of the baby in a corkscrew fashion to release the other, impacted shoulder.

While shoulder dystocia happens frequently enough so that it is not considered a rare condition, a doctor may fail to recognize and diagnose it, despite all the obvious signs.  For example, all too often, despite clear indications of shoulder dystocia, a doctor may fail to appreciate it, and erroneously assume that pulling the baby out is the solution.  In some instances, a doctor may even use forceps to extract the baby, injuring it terribly. 

The consequences of such error are all too often tragic.  Excessive traction – a doctor pulling too hard on a baby’s head, neck, and shoulders – will cause injury to the baby.  Upon delivery, the infant may have a limp arm that appears paralyzed.  Sometimes the nerves regenerate and the injury is temporary.

In other instances, the injury is severe and permanent, rendering the baby without the use of one arm for its lifetime. This type of injury is known as a “brachial plexus” injury.  Children with brachial plexus injuries are often diagnosed as having what is called “Erb’s Palsy,” a lifelong condition. Children with Erb’s Palsy usually require long term treatment by pediatric neurologists, surgeons, and rehabilitation experts, as well as occupational and physical therapy.  Even children with the most supportive families may suffer from emotional distress. 

Did a doctor commit malpractice in delivering a baby with shoulder dystocia?  Would a reasonable, average obstetrician, given all the medical signs, have diagnosed shoulder dystocia?  Were the medical professionals in the delivery room adequately trained in managing shoulder dystocia?  Did the hospital have training, policies and procedures as to shoulder dystocia, and were such protocols followed?  Or, did a doctor properly diagnose shoulder dystocia, but incorrectly and negligently perform the required maneuvers? 

These are just some of the questions that a skilled, qualified and experienced New York medical malpractice attorney will set out to investigate and answer. If a loved one has experienced a birth injury, you should consider a consultation with a medical malpractice attorney.  A birth injury may result in a lifetime of disability and suffering.  Compensation for the costs of medical care, loss of the enjoyment of life, pain and suffering, disability and lost earnings may be available in a medical malpractice claim. 

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