Narakas Brachial Plexus Injury: When Oregon Medical Malpractice Causes Erb’s Palsy

Understanding Narakas’ Brachial Plexus Injuries and Erb’s Palsy from Oregon Medical Malpractice


Brachial plexus injuries can be sustained at any time throughout a person’s life.  Most commonly are in motor vehicle accidents due to seatbelt injuries, but most of these brachial plexus injuries completely resolve.  When we talk about brachial plexus injuries and medical malpractice, while these injuries could occur during a surgery, they are most likely going to occur during childbirth.


The birthing process is a very rigorous process.  Some newborns may need to be pushed or pulled through the birth canal in an effort to be delivered.  But some over-zealous physicians may push and pull too hard, or manipulate a baby’s arm into a compromised position.  When the shoulder is compromised, it can be pulled, stretched, yanked, or tugged on in a manner which damages the nerves.  The nerves originate from the cervical (neck) spinal cord and extend through the shoulder and towards the fingers.  The nerves send both sensation and motor signals from the brain to the extremity.


When these nerves are severely injured, they can shut off sensation or motor feeling for part of the arm, hand, or fingers.  As little as the sides and tip of two fingers could be shut off, or as much as the entire arm.  Some injuries are only temporary, some injuries are permanent.  There are many factors which govern the classification of a brachial plexus injury.


Classifying Brachial Plexus Injuries: Narakas’ Classification System


If you or a loved one have suffered a brachial plexus injury, you may have heard a physician mention the Narakas’ scale.  This is the classification system used to diagnosis the severity of the injury.  Here are the following types of classification which may be caused by a birth injury caused by Oregon medical malpractice:


  • Group 1 – Duchenne-Erb’s Palsy – This damage to the nerves of C5-C6, which causes paralysis of the deltoid and biceps, but the wrist and finger movement is preserved.
  • Group 2 – Intermediate Paralysis – This damage to the nerves extends one more level than Erb’s Palsy and is C5 through C7, and causes paralysis of the deltoid, biceps, and the wrist and finger (digital) extension.  However, flexion remains.
  • Group 3 – Total Brachial Plexus Palsy – This damage extends another level to the top of the thoracic vertebra from C5-T1, and causes complete severance of the nerve without Horner’s syndrome.
  • Group 4 – Total Brachial Plexus Palsy with Horner’s Syndrome – This damage is the same as above, but more severe and causes Horner’s syndrome.


Horner’s syndrome is a condition caused by damage to the nerve along the neck (different part of the brachial plexus) which causes other symptoms to the face such as a contracted pupil, dropping upper eyelid, and the inability to sweat on one side of the face.


Victims of Oregon Medical Malpractice Causing Birth Injuries May Have a Case


Looking at Narakas’ brachial plexus injury classification, if you or your newborn have been injured to due a healthcare provider’s medical error, you may be entitled to compensation.  Brachial plexus injuries are very severe.  They are extremely debilitating and create great hardship.


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