Erb's Palsy Lawyer in Washington

If your baby was born with a limp arm, a weak grip, or an arm that stays turned in against the body, the doctor may have said Erb’s palsy or brachial plexus birth injury. These injuries happen when the nerves that run from the neck into the arm are stretched or torn during birth. Many babies recover on their own; others face therapy, surgery and lifelong limits in one arm.

Not every brachial plexus injury is someone’s fault. Some happen because the delivery team pulled too hard on the baby’s head, mishandled a stuck shoulder, or ignored warning signs that called for a different plan. Parents rarely get a straight answer about which it was.

This page explains what Erb’s palsy is, how delivery mistakes cause it, and what a records review looks for. Beverly Law reviews birth injury cases from Washington State for free through licensed local counsel, in English y Español, with no fee unless we win.

What is Erb’s palsy

The brachial plexus is a network of nerves near the neck that gives rise to all the nerves of the arm. Its roots, labeled C5 through T1, leave the spinal cord in the lower neck and carry the signals that let a child lift the shoulder, bend the elbow and close the hand.

Erb’s palsy is the most common brachial plexus birth injury. It affects the upper roots, C5 and C6, which control the shoulder and elbow, so the arm hangs straight and turned inward and cannot be raised. Klumpke’s palsy is a less common variant that injures the lower nerves and mainly affects the wrist and hand. A total (global) plexus injury damages the nerves from C5 to T1 and leaves the whole arm limp.

Doctors also grade the damage: a stretch (neurapraxia) is the mildest and most common; scar tissue can press on a healing nerve (neuroma); a nerve can be torn (rupture) or pulled from the spinal cord (avulsion). The last two do not heal on their own and usually need surgery.

Brachial plexus birth injuries occur in roughly one to three of every 1,000 births. Many babies improve within the first three to four months; when they do not, the injury is more likely to be permanent.

How mistakes during delivery cause it

The most common setting is shoulder dystocia: the baby’s head is delivered, but one shoulder gets stuck behind the mother’s pelvic bone and the body does not follow. It is an obstetric emergency, and what the team does next often decides whether the baby goes home with a healthy arm.

The nerves are injured when the baby’s head and neck are stretched away from the stuck shoulder. Pulling on the head, bending the neck to one side, or using force to speed a difficult delivery can stretch the nerves past their limit or tear them. The same can happen when tools such as forceps are used and the neck and shoulder are stretched.

The right response to shoulder dystocia is a set of trained maneuvers, not more pulling. The American College of Obstetricians and Gynecologists (ACOG) says a systematic approach and simulation training improve outcomes and documentation. A delivery note showing repeated traction, no maneuvers, or maneuvers in the wrong order becomes central to a negligence review.

Some risk factors are known before labor: a large baby (macrosomia), maternal diabetes, the mother’s weight, a previous shoulder dystocia, a breech position and a prolonged labor. ACOG notes they predict shoulder dystocia poorly in any single birth. But when several are present and documented, the standard of care may require discussing the risks, preparing for the emergency, or offering a cesarean, which lowers the risk even though it does not eliminate it.

Signs parents notice

These injuries are almost always noticed at birth or in the first days of life. Parents and nurses typically see:

If you notice these signs, ask for a pediatric neurology referral and start range-of-motion therapy as soon as the doctor allows, usually at about three weeks of age, so the joints do not stiffen while the nerves heal.

• One arm hangs limp or barely moves while the other moves normally
• No startle (Moro) reflex on the affected side
• The “waiter’s tip” position: arm straight and turned in, wrist bent, palm facing backward
• A weak or absent grip on that side
• Loss of feeling in the arm, or signs of pain when it is moved
• A drooping eyelid or smaller pupil on the same side (Horner’s syndrome)
• A broken collarbone or upper arm bone on X-ray, which often goes with a nerve injury

Is it medical negligence?

In Washington, a medical negligence claim asks one question, set out in RCW 7.70.040: did the doctor, midwife or nurse use the care, skill and learning expected of a reasonably prudent provider in the same profession, in Washington, acting in the same or similar circumstances? That level of care is the standard of care. Falling below it, when the failure is a proximate cause of the injury, is negligence.

Some brachial plexus injuries happen without anyone doing anything wrong. Shoulder dystocia is often unpredictable, the nerves can be stretched by the forces of labor itself, and even a cesarean does not remove the risk completely. A limp arm at birth does not, by itself, prove a mistake.

What separates a preventable injury from an unavoidable one is usually in the records. A review looks at whether the estimated fetal weight and maternal diabetes were tracked; whether there was a plan for a large baby; whether forceps or a vacuum extractor were used, and why; and, once the shoulder got stuck, which maneuvers were performed, in what order, and whether excessive force was applied to the head.

The type of injury matters too: an avulsion, a rupture, a total plexus injury, or a nerve injury with a fractured collarbone or arm bone suggests more force than a simple stretch. Beverly Law has obstetric and pediatric neurology experts compare the records against the standard of care before telling a family whether they have a case.

Deadline to file in Washington

In Washington State, a medical malpractice case must be filed within the time set by RCW 4.16.350: three years from the act or omission, or one year from when the injury and its cause were discovered or reasonably should have been, whichever expires later. For a child, that clock is generally paused until age 18. In Schroeder v. Weighall (2014), the Washington Supreme Court struck down the law that denied minors this pause in malpractice cases, and the Legislature removed it in 2023. For a baby hurt during labor or delivery, that usually means the child’s own case can be filed until about the 21st birthday. The old eight-year outer limit was struck down in Bennett v. United States (2023). Parents’ own claims are not paused, and claims against public hospitals add a required step, so it is safer to get advice early.

Some Washington babies are born at public hospitals, and a claim against them starts with paperwork, not a lawsuit. The University of Washington, which runs UW Medical Center, is part of state government: under RCW 4.92.100 and 4.92.110, a claim on the state’s standard tort claim form must be presented to the Office of Risk Management, and no lawsuit may be filed until 60 days after that. Public hospital districts, such as Valley Medical Center in Renton and EvergreenHealth in Kirkland, are local government entities: under RCW 4.96.020 the claim goes to the agent the district has appointed, within the time limit for the lawsuit, followed by the same 60-day wait. Harborview Medical Center is owned by King County and operated by UW Medicine, so a claim may need to go to more than one public body. The filing deadline is paused during the 60 days, but a missing or misdirected claim can put a case at risk.

What compensation covers

A child with a lasting brachial plexus injury may need care for decades. Compensation is meant to cover the full cost, past and future, so the burden does not fall only on the family.

Medical costs come first: surgery such as nerve grafts, nerve transfers and later tendon transfers; hospital stays; MRI and EMG testing; and follow-up with pediatric neurologists and orthopedic surgeons. Nerve surgery is usually done in the first year of life and tendon transfers between ages one and three.

Physical and occupational therapy can continue for years to keep the joints flexible, build strength and teach a child to use the arm. A claim can also cover braces, adaptive equipment, home modifications and the future care a life-care planner projects the child will need as an adult.

When an arm never regains full function, the child’s lost earning capacity over a working lifetime is part of the claim, along with pain and suffering: the physical pain, the limits on play and sports, and the weight of growing up with a visible disability.

Washington does not cap damages in a medical malpractice case. In Sofie v. Fibreboard Corp. (1989), the Washington Supreme Court held that the state’s limit on non-economic damages violated the right to a jury trial in article I, section 21 of the state constitution, and in 2023 the Legislature repealed that old limit (RCW 4.56.250). A jury can award the full amount of a child’s losses: economic damages such as lifetime medical care, therapy, equipment, home modifications and lost earning capacity, and non-economic damages such as pain, suffering and loss of enjoyment of life, with no statutory ceiling on either. Under RCW 4.24.010, parents can also recover their own losses, including the child’s medical expenses and the injury to the parent-child relationship. Any settlement for a child must be approved by a court.

What to ask the hospital for

In Washington you have the right to a copy of your medical records and your child’s, and under RCW 70.02.080 a health care provider must respond to a written request no later than 15 working days after receiving it. Ask in writing and ask for the complete chart, not a summary. The most useful documents are:

Request them soon, since some records are kept for a limited time. If the hospital delays, an attorney can obtain them directly.

• Prenatal records, including every ultrasound and each estimated fetal weight
• Diabetes screening results and weight gain during the pregnancy
• The labor and delivery record, fetal heart-rate strips, and any use of oxytocin (Pitocin)
• Nursing notes from labor, delivery and the newborn nursery
• Documentation of shoulder dystocia: which maneuvers were used, in what order, and by whom
• Time stamps for delivery of the head and of the body
• Any use of forceps or a vacuum extractor, and the reason given
• The newborn exam and Apgar scores, including Moro reflex, grip and arm movement
• Pediatric neurology consults, EMG results, and imaging such as X-rays and MRI

How Beverly Law helps

Beverly Law is a Los Angeles personal injury firm. In Washington State, we take birth-injury cases through licensed local counsel. Birth injury cases turn on medical records, expert testimony and strict deadlines, and our team knows how to get the complete chart and put it in front of the right obstetric and pediatric experts.

When you call, someone who speaks your language will listen, explain your options and tell you honestly whether the facts support a claim. If we take your case, we and our Washington counsel handle the records, the experts, any claim form a public hospital requires, the insurance company and the court while you focus on your child.

The consultation is free, and there is no fee unless we win. Call 1 (877) 427-2752 any time, in English y Español.

Questions parents ask

Related pages

Cerebral Palsy · HIE / Oxygen Deprivation at Birth · Statute of Limitations · Damages in Washington · Washington birth injury lawyers

Important: This page is general information about birth injuries and Washington law, not legal advice, and reading it does not create an attorney-client relationship with Beverly Law. Every case is different — talk to a lawyer about your own situation. Attorney advertising. Prior results do not guarantee a similar outcome. No fee unless we win. Last reviewed: 2026-09-30.