Erb's Palsy Claims: When Shoulder Dystocia Is Negligently Managed

What is Erb's palsy?

When is delivery care negligent in Erb's palsy?

Erb's palsy negligence typically falls into one of these categories:

What is the standard of care when shoulder dystocia occurs?

RCOG Green-top Guideline 42 sets the benchmark. The first response is the McRoberts manoeuvre (the mother's legs are hyperflexed against her abdomen by two attendants) with suprapubic pressure applied by a third — a combination that resolves the majority of cases without injury. If that fails, internal manoeuvres follow: Rubin II to rotate the posterior shoulder forward, and delivery of the posterior arm. Fundal pressure and excessive lateral traction on the head are specifically warned against. NHS Litigation Authority data cited in the guideline found that 46% of shoulder dystocia injuries were associated with a poor standard of care.

How do severity and prognosis affect an Erb's palsy claim value?

Erb's palsy outcomes vary widely. At the milder end, neuropraxia involves bruising or stretching of the nerve without structural rupture, and spontaneous recovery within three to six months is common. Further along the spectrum, nerve rupture or root avulsion produces permanent deficit that cannot fully recover through natural healing — surgical nerve grafting or tendon transfer may improve function but rarely restores it to normal. Severity is assessed by neonatal clinical examination, EMG and nerve conduction studies, and MRI of the brachial plexus, and directly shapes both general damages and the special-damages schedule.

What evidence will be needed for an Erb's palsy claim?

• The full antenatal record showing what risk factors were identified and discussed.
• Intrapartum notes, the CTG trace, and the delivery contemporaneous notes — including the timed sequence of manoeuvres applied.
• The neonatal examination and any record of arm movement, grip and reflexes at birth.
• EMG / nerve conduction studies and brachial plexus MRI imaging.
• Independent expert evidence from a consultant obstetrician, midwife, paediatric neurologist and (where surgery is in issue) a brachial plexus surgeon.

How much compensation is awarded?

NHS Resolution 2022/23 data records the average total Erb's palsy negligence settlement at £809,485. The Judicial College Guidelines 18th edition (April 2026) contains brackets for brachial plexus injury graded by severity — applied alongside the special-damages schedule for therapy, surgery, adaptive equipment, and any loss of future earning capacity where the injury affects the dominant arm or restricts career options.

Under the CFA Order 2013, the 25% success-fee cap applies only to general damages and past financial losses. Future losses — projected therapy, surgical costs and lost earnings — are paid in full and entirely outside the cap.

Funding and time limits

Erb's palsy claims are typically funded by a Conditional Fee Agreement — no upfront costs, no fees if the claim fails. Legal aid is not available for Erb's palsy alone, but does apply where the child also suffered severe neurological brain injury within eight weeks of birth (see the cerebral palsy claims guide). The child's own three-year limitation clock under section 28 of the Limitation Act 1980 only begins on their 18th birthday — but acting far earlier through a parent or litigation friend preserves evidence and opens the door to interim payments. For maternal injuries sustained during the same delivery, the standard three-year rule applies from the date of injury or knowledge.

Frequently asked questions

Related guides

• Birth injury compensation — how awards are calculated
• Cerebral palsy claims
• Brain damage at birth (HIE) claims
• Birth injury — category overview
• Evidence for a medical negligence claim
• No win, no fee funding