In follow up to my Shoulder Dystocia Pearl

Dr. DePriest Whye has some legal pearls for us:

Erbs Palsy( Brachial Plexus Injury) is a known complication of shoulder dystocia and is due to traction on the arm that causes stretching of the brachial plexus.

• Should an Erb's Palsy result as a consequence of a shoulder dystocia, a medical malpractice suit is inevitable.
• The medical record documentation is particularly critical in defending the medical care rendered.
• The medical record should reflect timely recognition of the shoulder dystocia.
• It is important that appropriate implementation of the maneuvers described last week are done in a timely fashion.
• Vital documentation should describe the amount of traction placed if any.
• Terms such as minimal or mild or light traction should be used.
• Terms such as strong, forceful, significant traction should be avoided.
• Never state in the record that uterine pressure was used as opposed to suprapubic pressure.
• Uterine pressure is contraindicated.

Erb's Palsy cases are difficult to defend. They are impossible to defend with improper documentation.