Negligent use of forceps results in long-term Erb’s Palsy injury

The Incident

In September 2009, our client, a baby girl, was delivered with the use of forceps at North Middlesex University NHS Trust which resulted in an Erb’s Palsy injury.

Following instruction to use forceps, it was later documented in the records “mild difficulty” was encountered during the birth.

On delivery, the child was delivered in good condition, but it was noted that her left arm was floppy and weak.

Subsequent examination confirmed a left-side Brachial Plexus Palsy injury, more commonly known as an Erb’s Palsy injury, and our client was referred for physiotherapy.

The case

In May 2014, the mother of our client contacted Fletchers Solicitors.

We accepted the case in view to assessing whether North Middlesex University NHS Trust were accountable for birth injury negligence, specifically relating to Erb’s Palsy.

As our client was a child, our team informed the family that although we would investigate further, the cause could not settle until our client reached skeletal maturity.

In addition to this, any future settlement would also need to be approved by the court at an approval hearing.

In total, Fletchers spent four years investigating further. We obtained important medical records and supporting medical evidence from a range of experts ahead of serving a Letter of Claim, which was completed in 2018.

Within that time, the Defendant, North Middlesex University NHS Trust, responded reasonably promptly with regards to the care provided.

They also admitted that their care did cause the client to suffer a right sided Erb’s palsy injury.

Despite this, however, we still needed to quantify the claim and required further expert reports and advice from Counsel.

The aftermath

Following her birth, our client’s Erb’s Palsy injury continued into childhood.

As time went on, her family found that she was unable to flex her forearm, extend her wrist or supinate her forearm.

Following further physiotherapy and exercises, our client underwent surgery for release of upper portion of subscapularis tension and coracoidectomy. The coracoid is a stout strong bone that connects the cranial edge of the sternum to the shoulder joint complex.

Throughout our client’s young life, she has had to adapt to her circumstances and requires assistance with washing her hair, when showering and lifting objects above her head.

She has previously struggled with PE classes at school, including some dance classes and with swimming; all the practical elements of being a young child and wanting to enjoy life are all the more difficult.

As well as this, our client has a cosmetic 4cm scar on her weaker arm and continues to have marked functional disability in the left upper limb.

The reality of this means that she has reduced muscle bulk in the left shoulder girdle elbow, forearm and hand. There is also evidence of muscle imbalance in the ulna nerve distribution.

Our client is unable to fully raise her left arm above her head and is unable to fully abduct the left arm away from her body and above her head.

Furthermore, due to a soft tissue contracture at the elbow, our client cannot fully straighten her weaker arm and has reduced power in the left upper limb. She has since been informed that reduced sensory awareness will affect her functional capacity, meaning that she will have difficulty identifying objects held in her left hand.

The case outcome

In May 2021, a final settlement was approved by the Court and our client was awarded £320,000.

At the approval hearing, she was given permission to obtain a payment from the agreed damages to buy a laptop. The remainder was lodged into the Court Office Funds and the client will be obtaining the damages when she is 18 years old.

In total, the damages covered an element for her injuries, which include:

• Permanent impairments affecting the whole shoulder complex
• Elbow
• Forearm
• Wrist and hand function

Whilst part of the settlement goes towards previous care costs provided by the family, including bringing her to doctor appointments, a large sum relates to our client’s future care.

In terms of general living, she will require help with washing, putting extensions in her hair and tying her hair each day. As well as this, she struggles with opening anything with tight lids and tops, or anything that requires reasonable force in her hands.

The reality of our client’s injuries mean she will require physiotherapy throughout her life.

After the settlement was confirmed, our client’s mother commented:

“I cannot even begin to express my feelings on how Fletchers and Niall handled this case, I will forever be grateful. The whole process, from start to finish, has been remarkable. I was never shut out from the process, and if I didn’t understand a letter, Niall would always call me and explain it in a way I could then understand.

“All the assessments we attended, both at home and out, everyone was great. They took time to listen to our daughter’s voice which was very important. Everyone I know, I have told them how fantastic Fletchers were, they followed up this case more in the interest of C first before anything else.

“I just want to say thank you so much on behalf of C. The whole process and how it was handled from the beginning made C want to study Law.”

“I can finally have closure and stop beating myself up every day. C will be able to have all the help she needs in future and it’s all thanks to Fletchers.”