Shoulder dystocia is a birth complication that occurs when a baby’s head is stopped exiting the vaginal opening of the birth canal because the baby’s shoulder gets stuck on the mother’s pubic bone. This is a medical emergency, and if the baby’s head is improperly pulled or twisted with excessive force, permanent damage to the spinal cord nerves can occur. Proper obstetric maneuvers easily allow the baby to be safely delivered without any injury.
Three red flags for anticipating shoulder dystocia include: 1) if the mother has gestational diabetes, 2) if the baby’s weight is high, which indicates a large delivery, and 3) if the baby is past his or her due date.
In this case, a pregnant mother sought prenatal care from the Defendant Healthcare Corporation’s nurse midwife. The midwife had the knowledge and skill of an OBGYN, except she could not perform a cesarean section. She had only two years of experience since graduating from midwife school, she had zero experience with shoulder dystocia, and she skipped the voluntary medical training for how to safely deliver a baby when shoulder dystocia occurs.
The mother, who had gestational diabetes, had commented that the baby seemed “very big” but the midwife ignored her. Without taking an ultrasound, the midwife told the mother the baby would be about 6 lbs, but the baby ended up being 11.5 lbs.
During delivery, the midwife “pulled, twisted and yanked” the baby’s head around 180 degrees with so much excessive force that she pulled nerves from the baby’s spinal cord, broke his arm, and destroyed the baby’s brachial plexus nerve system. A biomechanical engineer testified that the Defendant used “seven to eight times the average traction used in routine delivery.” An episiotomy was required to deliver the baby using a vaginal incision.
Had the midwife taken the baby’s size and the mother’s inconclusive gestational diabetes test results into consideration, she would have known that shoulder dystocia was a major possibility, which would have enabled her and her team to prepare properly. Instead, she chose to continue the vaginal birth with excessive force until the baby’s arm was paralyzed.
Joe Crosby, Esq., needed jurors to understand how the midwife severely injured his client’s arm, but first: he needed them to comprehend what the brachial plexus is, how shoulder dystocia damages the brachial plexus, and how his client’s brachial plexus was specifically damaged. We delivered an animation and two illustrations to achieve the following visual objectives:
- Establish the normal brachial plexus anatomy.
- Demonstrate the mechanism of injury that damaged the brachial plexus.
- Illustrate the specific damage that resulted in paralysis.
The following visuals helped Mr. Crosby obtain an $8.9M verdict for his client.
Exhibit A: Establishing the Brachial Plexus Anatomy
Before jurors could comprehend the full magnitude of this injury, they needed a grounded understanding of the normal brachial plexus anatomy.
The brachial plexus is a network of nerves that branch out from the lower four cervical nerves (C5, C6, C7, C8) to the first thoracic nerve at T1. These roots extend throughout the arm into the ulnar, median, and radial nerves. Seeing how this complex network of nerves interconnects helped jurors understand how the damage in the next exhibit directly contributed to the baby’s paralyzed arm.
The illustrations brought to life the severity of the injury the midwife caused and was used with almost every defense expert. High Impact has an exceptional understanding of Med Mal cases and it’s like having another attorney with an unbiased set of eyes reviewing the case and seeing what is needed to help the jury get to a great verdict. Tyler Komarnycky and High Impact are awesome!Joe Crosby, Esq., Crosby Law Office, LLC, St. Paul, MN
Exhibit B: Animating Mechanism of Shoulder Dystocia
After establishing the normal brachial plexus anatomy, the next exhibit demonstrates what shoulder dystocia looks like, and how this injury directly damaged the baby’s brachial plexus nerves.
The animation - which can be customized for any shoulder dystocia case - introduces the baby as he’s stuck in the birth canal. We focus attention on the brachial plexus nerves as hands pull excessively on the head. With each pull, we highlight these nerves in red to convey the painful force being exerted on this baby. Finally, we focus in on a close-up of the damage to the baby’s Brachial Plexus nerves.
Exhibit C: Illustrating Damaged Brachial Plexus Nerves
After seeing how this baby’s shoulder was stretched beyond its limits, the next illustration highlights the specific nerve damage the baby suffered as a result of this excessive force.
The baby’s specific nerve damage included C5 and C6 root avulsions in which the nerves were completely ripped out of the spinal roots. The baby also suffered nerve root injuries at C7, C8, and T1. Comparing this damaged anatomy with the normal anatomy in Exhibit A made it easier for jurors to conclude that this injury directly paralyzed this child’s arm.
High Impact’s team of visual strategists, artists and developers can build and customize your digital presentation for any case involving personal injury, medical malpractice, birth trauma - or any subject involving complex information.