Legal: Brachial plexus injury without shoulder dystocia

A Missouri woman was admitted to a hospital for prostaglandin gel induction in 1996. Early the next morning, after her membranes spontaneously ruptured, oxytocin was given, and later that day she began pushing. The on-call obstetrician ordered fundal pressure during the last four contractions before delivery. Forceps were applied and the fetus was delivered. The delivery note identified the anterior shoulder as the right shoulder and the infant was diagnosed with injury to the brachial plexus on the right side.

The patient sued the physician, nurses, and hospital involved and claimed the injury was due to the fundal pressure and to forceps being improperly used, leading to shoulder dystocia. She also claimed the obstetrician applied excessive lateral traction.

The defense argued that fundal pressure and forceps were properly used and there was no shoulder dystocia or excessive traction. They contended that the natural forces of labor and delivery caused the brachial plexus injury. A defense verdict was returned.