Shoulder Dystocia and the Associated Complications Leading to Birth Injury Lawsuits

A birth injury recently led to the traumatic death of a newborn baby when the healthcare providers entrusted with his delivery allegedly failed to meet their standard of care. 

A young Georgia couple filed a lawsuit last August, claiming their child was decapitated during birth by a doctor who used “ridiculously excessive force” to resolve shoulder dystocia – a common labor and delivery complication that can result in serious injury if not quickly and safely corrected.

Shoulder dystocia is a medical emergency found in about three percent of vaginal deliveries, occurring when one or both of the infant’s shoulders get stuck inside the mother’s pelvis. According to the American College of Obstetricians and Gynecologists, most shoulder dystocia is relieved without injury to the fetus. 

However, according to the lawsuit, Jessica Ross discovered that Dr. Tracey St. Julian, who had been Ross’ OB-GYN throughout her pregnancy, had skipped several established protocols in favor of applying traction to the baby’s head, resulting in decapitation. 

Ross and her partner are suing St. Julian and Southern Regional Medical Center in Riverdale for gross negligence, fraud, and intentional infliction of emotional distress. Also named as defendants are St. Julian’s employer and six unnamed nurses. 

Research shows that up to half of birth injuries can be prevented when the physician meets the standard of care. When a provider’s negligence results in harm to the mother or baby, a birth injury attorney can help families recover compensation while they focus on healing.

Shoulder Dystocia: Risk Factors, Causes and Complications 

Shoulder dystocia is a birth injury that can happen to any infant, and there are no symptoms before delivery begins. However, there are risk factors that can indicate the possibility of shoulder dystocia before birth, including: 

• pre-existing or gestational diabetes
• short stature
• too-small pelvic opening
• late birth
• 35 years and older

If your labor is proving excessively long or difficult, your obstetrician (OB) may have to intervene, increasing dystocia risk. They may need to utilize tools like vacuum extractors or forceps or administer oxytocin to induce labor. 

There is a set of actions called HELPERR that an OB should take to resolve shoulder dystocia. They are:

• H (help) – call for help from other physicians, such as anesthesiologists or neonatologists
• E (evaluate for episiotomy) – decide whether to cut into the perineum to increase the vaginal opening and allow for rotation maneuvers
• L (legs) – pressing thighs against the belly, flattening and rotating the pelvis
• P (pressure) – press on the lower belly, above the pubic bone, to put pressure on the baby’s shoulder for safe rotation
• E (enter maneuvers) – reach into the vagina to rotate the baby
• R (remove) – remove one of the baby’s arms from the birth canal to make shoulder passage easier
• R (roll) – have the mother turn over on hands and knees for a better position

If none of these are successful, the OB may break the baby’s collar bone to release the shoulders, push the head back into the uterus and perform a C-section, or make an incision in the cartilage of the pubic bones to enlarge the pelvic opening. 

Improper handling of a baby with shoulder dystocia can result in severe complications, including a fractured collarbone or upper arm, a disorder called Horner’s syndrome affecting the eyes and face, or a compressed umbilical cord, which can cut off oxygen and blood flow. It can also cause serious injury to the mother, including postpartum hemorrhaging, uterine rupture, and pelvic separation.

What Is Brachial Plexus?

The most common birth injury resulting from shoulder dystocia is called brachial plexus palsy. 

The brachial nerves run from the spinal cord to the neck via the arm, providing feeling and movement in the arm, shoulder, and hand. Damaging these nerves can cause permanent weakness or paralysis. 

Brachial plexus injuries are categorized into five types based on severity:

1. Neuropraxia (stretch) – no nerves have torn and usually heal themselves
2. Rupture – the nerve is torn but still attached to the spinal cord
3. Neuroma – the nerve has torn and healed itself but leaves behind scar tissue that prevents communication between itself and the muscle
4. Neuritis – the nerves going into the shoulder, chest, arm, and hand experience sudden and intense pain, resulting in weakness or loss of muscle use/sensation
5. Avulsion – the nerve is severed from the spinal cord and can lead to permanent paralysis 

If brachial plexus injuries don’t heal themselves within the baby’s first year, medication, physical therapy, or surgery may be required. Sadly, some cases of brachial plexus injuries will never heal.

When Shoulder Dystocia Ends in Tragedy

According to the Jessica Ross lawsuit, her trusted obstetrician skipped every protocol to resolve her son’s shoulder dystocia, ignoring her pleas for a C-section until it was too late.

Instead, the suit said, Dr. Julian tried to pull the infant out, giving him multiple skull and facial fractures and hemorrhaging on his neck, brain, and spinal cord before finally separating his head from his body.

The hospital also allegedly failed to tell Ross that her son had been decapitated; instead, she was informed by the funeral home three days later. The county police have opened an investigation into the cover-up.

If your baby suffered brachial plexus or another birth injury due to labor and delivery negligence, you may have the grounds for a medical malpractice suit. A birth injury attorney can negotiate with the hospital, insurance companies, and courts on your behalf and secure compensation to help with medical bills, pain and suffering, and more.

You deserve to hold the professionals trusted with your child’s life accountable for their actions. The seasoned birth injury team at Paulson & Nace has been helping families protect themselves and their children for more than 40 years. We would be happy to review your case. Please call 202-463-1999 or fill out our online contact form for a free, confidential consultation.