Hospital Refuses to Treat Child for Erb’s Palsy; Arm May Get Paralyzed

A little girl in the UK will have permanent and complete paralysis of her arm if she does not receive surgery within the next few weeks.  Sanika Ahmed is eight months old and was born in Hampshire to Bangladeshi parents.  Because their visa expired, the RNO Hospital in Middlesex has refused to treat Sanika.

Understanding Erb’s Palsy

Sanika suffers from nerve damage caused by birth trauma to her shoulders, a condition called Erb’s palsy.  Erb’s palsy is a weakening or paralysis of the arm caused by injury to the arm’s upper group of main nerves.  The injury usually occurs during a difficult childbirth when a physician puts downward traction on a baby’s head and neck when the baby gets stuck in the birth canal.

Without Early Surgery for Severe Erb’s Palsy, Paralysis Likely

Nerve graft surgery, or nerve transplantation/transfers, is the most effective way to treat severe Erb’s palsy, and it is the only option when the spine nerve roots have been torn from the spinal cord.  The surgery must be performed by approximately nine months of age.

Sanika’s parents told the press how upsetting it is for the family to watch Sanika slowly become paralyzed.  The Ahmeds have applied for permission to stay in the UK and have engaged a law firm to help them obtain judicial  review.  They have an appeal hearing next month that will rule on their legal right to remain in the UK.  RNO Hospital has offered to treat Sanika privately, but the Ahmed family cannot afford the treatment, which is estimated to cost tens of thousands of dollars.

The Ahmeds need to obtain valid status before Sanika’s time runs out and her arm becomes permanently paralyzed.  A spokesperson for The Erb’s Palsy Group told the Huffington Post UK: “Most consultants would not operate after nine-ten months for nerve graft surgery because the results would be so disappointing.  There’s a variety of ancillary surgeries you can have after this point but nothing that would restore nerve function in the arm.  You are looking at ameliorating the situation rather than restoring movement.”

Indeed, most studies report that after nine months, nerve transplants usually are not carried out. After 9 months, the procedure does more harm than good, resulting in nerve damage in the area from which the nerves were taken.

Signs and Symptoms of Erb’s Palsy

With severe Erb’s palsy, timing is crucial.  If a baby suffered an Erb’s palsy injury during birth, it was likely noticed right away.  In the event that it was not, parents should be on the lookout for signs that a child may be suffering from Erb’s palsy.

These signs include:

  • A lack or limited amount of movement in the upper or lower arm, elbow, hand or  fingers
  • A continuous flex (bend) at the elbow with the arm held against the body
  • A lack of grip strength in one or both hands
  • Lack of sensation in any part of the arm
  • Missing Moro reflex, which causes the baby to react when startled by a sudden, loud noise by stretching out the arms and flexing the legs

Risk Factors for Erb’s Palsy

Erb’s palsy is typically caused by trauma.  Risk factors for Erb’s palsy include the following:

  • Baby macrosomic or large for gestational age (LGA)
  • Small maternal pelvis
  • Maternal obesity
  • Previous hisotry of macrosomic births
  • Breech presentation
  • Gestational diabetes
  • Cephalopelvic disproportion
  • Multiparity
  • The second stage of labor lasts more than 60 minutes
  • Assisted delivery (eg, use of forceps and vacuum extractors)
  • Forceful downward traction on the head during delivery
  • Previous child with Erb’s palsy
  • Intrauterine torticollis (the baby’s head is malpositioned in the uterus)
  • Shoulder dystocia (baby’s shoulders cannot pass through the birth canal)

Medical Negligence and Erb’s Palsy

If a baby has risk factors for Erb’s palsy, and/or shows any signs or symptoms of the condition, it is critical that the physician closely monitor the baby.  Without early treatment, a baby’s arm can become permanently paralyzed.  Failure to recognize and treat Erb’s palsy is negligence.  If this negligence results in worsening of the condition or paralysis, it is medical malpractice.

The attorneys at Reiter & Walsh, P.C. focus only on birth injuries. We consult with in-house medical staff in reviewing you and your child’s medical records. If we determine that medical malpractice has occurred, we can assist you in securing the financial compensation to which you are entitled.

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