When a child is born with weakness or paralysis in one arm, the cause is often a preventable injury to the brachial plexus — the network of nerves that runs from the neck through the shoulder and controls movement and sensation in the arm, hand, and fingers. Erb’s palsy is the most common form of this injury, and in many cases it results directly from a medical provider’s failure to manage a difficult delivery safely. These are not unavoidable birth complications. They are often the product of a specific occurrence of negligence that a trained medical team should have recognized and prevented.
At Davis & Davis, our Houston birth injury lawyers have focused exclusively on medical malpractice for nearly 70 years of combined experience. We have handled more than 300 jury trials and take every Erb’s palsy case on a no-upfront-fee basis, meaning you pay nothing unless we recover compensation for your family. If your child was diagnosed with Erb’s palsy following a difficult delivery, we are ready to evaluate what happened.
What Is Erb’s Palsy?
Erb’s palsy is a condition resulting from injury to the upper brachial plexus, specifically the C5 and C6 nerve roots near the neck. According to the National Institute of Neurological Disorders and Stroke, the brachial plexus carries signals from the upper spinal cord to the shoulder, arm, and hand, enabling movement and sensation. When these nerves are damaged during birth, a child may experience weakness, limited range of motion, or paralysis in the affected arm.
Erb’s palsy is not a birth defect. It is a birth injury — one caused by mechanical forces applied to the baby’s neck or shoulder during labor and delivery. The condition is distinct from cerebral palsy, which affects the brain, or other brachial plexus injuries affecting different portions of the nerve network.
Types of Brachial Plexus Nerve Injuries
Not all Erb’s palsy diagnoses involve the same degree of nerve damage. The severity and type of injury determines the child’s treatment path and prognosis. There are four recognized categories of brachial plexus nerve injury:
- Neuropraxia — the mildest form, involving nerve stretching without tearing. Most cases resolve within weeks to a few months with physical therapy.
- Neuroma — the nerve heals but scar tissue forms, pressing on surrounding nerves and causing incomplete recovery. Some function may return, though permanent limitations are possible.
- Rupture — the nerve is torn but not at the spinal cord. Surgical repair such as nerve grafting may be required to restore function.
- Avulsion — the most severe form, where the nerve root is torn completely from the spinal cord. Avulsions cannot be repaired directly and typically result in permanent impairment.
The type of injury present in your child’s case directly affects the legal claim, including the scope of damages and the lifetime care costs your attorney will pursue on your family’s behalf.
How Does Medical Negligence Cause Erb’s Palsy?
Erb’s palsy most commonly occurs during deliveries complicated by shoulder dystocia — a situation where the baby’s shoulder becomes lodged behind the mother’s pelvic bone after the head has delivered. Managed correctly, shoulder dystocia can be resolved without injury. When providers apply excessive lateral traction or pull the baby’s head and neck with too much force, the result can be permanent brachial plexus damage.
Other causes rooted in negligence include improper use of forceps or vacuum extraction devices, failure to recognize risk factors for a complicated delivery such as fetal macrosomia or maternal diabetes, and failure to perform a timely cesarean section when the delivery was not progressing safely. Providers are trained to anticipate and manage these circumstances. When they fail to do so, families have the right to seek accountability.
Signs of Erb’s Palsy in Newborns
Some signs of Erb’s palsy are visible immediately after birth. Others become more apparent over the first weeks and months of life. Knowing what to look for can help families seek evaluation quickly and protect both their child’s medical outcome and their legal rights.
Common early signs include the affected arm being held limply against the body with the elbow straight and the wrist turned inward — a position sometimes called the “waiter’s tip” posture. The baby may not move the arm spontaneously, may not respond normally when the arm is lifted, or may favor one side noticeably during feeding and movement. As the child grows, parents may notice one arm appearing shorter than the other, poor grip strength on the affected side, or difficulty lifting the arm above shoulder height. Any of these signs following a complicated delivery warrants immediate medical evaluation and, if negligence is suspected, prompt legal consultation.
Recovery and Treatment for Erb’s Palsy
Recovery depends entirely on the type and severity of the nerve injury. Milder neuropraxia cases often resolve within three to six months with consistent physical therapy. Cases involving neuroma formation may show partial improvement over a longer timeline but may leave the child with lasting limitations in strength or range of motion. Ruptures and avulsions typically require surgical intervention — nerve grafts, nerve transfers, or muscle and tendon procedures — and may result in permanent functional deficits even with treatment.
Early intervention makes a meaningful difference. Physical therapy, occupational therapy, and, where appropriate, surgical consultation should begin as soon as possible. The cost of treatment over a child’s lifetime, including ongoing therapy, surgery, adaptive equipment, and educational support, can be substantial. A successful medical malpractice claim may recover all of these costs.
Compensation Available in a Texas Erb’s Palsy Case
Texas law provides for both economic and non-economic damages in medical malpractice cases. Economic damages have no cap and can include past and future medical expenses, physical and occupational therapy costs, surgical fees, adaptive equipment and home modifications, special education services, and lost wages for caregiving parents. Non-economic damages, including pain and suffering, loss of enjoyment of life, emotional distress, and scarring or disfigurement, are subject to statutory caps under Texas law.
For a child whose Erb’s palsy results in permanent limitations, the lifetime value of an economic damages claim can be significant. Davis & Davis’s trial-tested legal team works with life care planners, pediatric specialists, and economists to build a complete picture of your child’s future needs and pursue maximum recovery.
How Our Houston Erb’s Palsy Lawyers Can Help
Proving that medical negligence caused your child’s Erb’s palsy requires a thorough investigation into the circumstances of the delivery. Our attorneys gather all relevant evidence — fetal monitoring strips, delivery room documentation, nurse notes, hospital policies, and records of the provider’s training — and work with qualified medical professionals whose testimony can establish exactly where the standard of care failed.
We handle every aspect of the claim: establishing that a duty of care existed, demonstrating the specific breach, connecting the breach directly to your child’s injury, and documenting the full scope of damages. We also manage all communication with the opposing side, including required pre-suit notices under Texas law, so that you can focus on your child’s care and recovery.
Frequently Asked Questions About Erb’s Palsy
Can Erb’s Palsy Be Prevented During Delivery?
Many cases of Erb’s palsy can be prevented when medical providers properly recognize risk factors such as fetal macrosomia, maternal diabetes, or prior delivery complications, and take appropriate steps such as planning a cesarean section or using accepted shoulder dystocia management techniques. When a provider’s failure to act on these risk factors results in a preventable injury, families may have grounds to pursue a medical malpractice claim.
How Long Does Recovery From Erb’s Palsy Take?
Recovery time varies based on the type and severity of the nerve injury. Mild neuropraxia cases often show significant improvement within three to six months with physical therapy. More severe injuries involving nerve rupture or neuroma formation may take a year or longer to reach maximum recovery, and some children require surgical intervention. Avulsion injuries, where the nerve root is torn from the spinal cord, typically result in permanent impairment. Early evaluation by a specialist is the best way to determine the likely recovery path for your child.
What Is the Difference Between Erb’s Palsy and Other Brachial Plexus Injuries?
Erb’s palsy specifically involves damage to the upper brachial plexus — the C5 and C6 nerve roots — and primarily affects the shoulder and upper arm. Klumpke’s palsy, by contrast, involves the lower brachial plexus and affects the forearm, wrist, and hand. Total plexus injuries affect the entire arm and carry the most severe prognosis. Each type has different clinical presentations, treatment approaches, and implications for a legal claim.
How Much Does It Cost to Treat Erb’s Palsy?
Treatment costs depend on severity and can range from thousands to hundreds of thousands of dollars over a child’s lifetime. Expenses may include physical therapy, occupational therapy, multiple surgical procedures, adaptive equipment, and home modifications. For children with permanent limitations, lost earning capacity in adulthood may also be factored into a damages calculation. A medical malpractice claim, if successful, may recover all of these costs.
Contact Davis & Davis About Your Child’s Erb’s Palsy Case
Erb’s palsy resulting from a difficult delivery is among the most preventable birth injuries. When it results from an occurrence of negligence in the delivery room, your family deserves answers and accountability. Texas law imposes a two-year statute of limitations for medical malpractice claims, and certain procedural steps — including written pre-suit notice to providers — must be completed before a lawsuit can be filed. Taking action promptly protects both your rights and the evidence needed to build your case.
Davis & Davis handles Erb’s palsy cases on a no-upfront-fee basis, advancing all costs throughout the process. Our firm brings nearly 70 years of combined experience and more than 300 jury trials to every case we take. Use our contact form to request a free case evaluation.
