Neonatal brachial plexus palsy: obstetric factors associated with litigation

Our objective was to compare characteristics between neonatal brachial plexus palsy (NBPP) cases that were litigated versus those that were not.

From May to December 2012, the University of Michigan Interdisciplinary Brachial Plexus Program surveyed 51 consecutive families whose children were treated for NBPP. Obstetric data was self-reported. Unless NBPP resolved, children were followed for at least two years. Student's t-test and Chi-square test with odds ratio and 95% confidence intervals were calculated.

Among 51 families surveyed, obstetric data were available for 98% (n = 50). Litigation was pursued by 48% (n = 24). Comparing families that litigated versus those that did not, there were no differences in demographics, peripartum characteristics, operative versus spontaneous vaginal birth, shoulder dystocia in current pregnancy (65% versus 54%; p = 0.56) or birth weight above 9 lbs. The number of children having brachial nerve surgery was significantly higher among families that litigated (46%) versus those that did not (8%; p = 0.002).

Though there were no differences in peripartum events, almost 1 out of 2 children managed by interdisciplinary team had concomitant litigation. The only factor associated with litigation was having brachial nerve surgery. Efforts are warranted to avert NBPP and mitigate litigations.