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.

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.

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.

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.

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