UMEM Educational Pearls

Category: Obstetrics & Gynecology

Title: Shoulder Dystocia Legal Pearl

Keywords: Erb's Palsy, Dystocia, Legal (PubMed Search)

Posted: 7/14/2007 by Michael Bond, MD (Emailed: 7/8/2007) (Updated: 11/27/2020)
Click here to contact Michael Bond, MD

In follow up to my Shoulder Dystocia Pearl

Dr. DePriest Whye has some legal pearls for us:

Erbs Palsy( Brachial Plexus Injury) is a known complication of shoulder dystocia and is due to traction on the arm that causes stretching of the brachial plexus.

  • Should an Erb's Palsy result as a consequence of a shoulder dystocia, a medical malpractice suit is inevitable.
  • The medical record documentation is particularly critical in defending the medical care rendered.
  • The medical record should reflect timely recognition of the shoulder dystocia.
  • It is important that appropriate implementation of the maneuvers described last week are done in a timely fashion.
  • Vital documentation should describe the amount of traction placed if any.
  • Terms such as minimal or mild or light traction should be used.
  • Terms such as strong, forceful, significant traction should be avoided.
  • Never state in the record that uterine pressure was used as opposed to suprapubic pressure.
  • Uterine pressure is contraindicated.

Erb's Palsy cases are difficult to defend. They are impossible to defend with improper documentation.