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.
About the author
Wendy Ketner, M.D.
Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.
Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.
Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.
