This case involves a 6-year-old child who experienced a complicated vaginal delivery at birth. Immediately following his birth, he was diagnosed with shoulder dystocia and secondary Erb’s Palsy of his left upper extremity. Over the course of the first year of his life, the Erb’s Palsy manifested signs of a brachial plexus injury with complete avulsion of the C8 nerve root. Despite surgical intervention in the first year of his life, the patient persisted with deficits that compromised his daily functioning and attainment of developmental milestones. A pediatric neurologist was sought to discuss the relationship between the initial injury and the patient’s ongoing neurological complications.
Question(s) For Expert Witness
- 1. Please describe your experience managing pediatric patients that have suffered neurological injury post-natally.
- 2. What is the extent of your familiarity with brachial plexus injuries in this context?
Expert Witness Response E-059943
As director of neonatal neurology at a large medical center, I developed the brachial plexus injury protocol used at our hospital. I evaluate inpatients and outpatients for brachial plexus injury and refer them for multidisciplinary treatment and/or surgery as clinically indicated. I see many patients with brachial plexus injuries for pediatric neurological assessment. I order diagnostic x-rays and refer them for treatment to physical therapists, physiatrists, and/or orthopedic surgeons on a case by case basis as determined by their needs. I train pediatric neurology residents and fellows about how to properly manage and treat brachial plexus injuries following complicated deliveries. I also lecture on this topic.