This is a claim for damages for personal injury sustained by C at birth on the 6th September 1993… (paragraph 1)
The injury was a right brachial plexus injury, otherwise known as Erb’s Palsy. It has left C with permanent weakness and restriction of movement in her right upper limb. (paragraph 3)
C’s birth was complicated by the occurrence during labour of shoulder dystocia. (paragraph 5)
It is C’s case (paragraph 7) :
i) that at the time of delivery, the position of the head was left occipito anterior (LOA);
ii) that the right injured shoulder was in the anterior position facing the pubic symphysis of the mother and would have emerged before the left shoulder; and
iii) that the injury was caused by excessive pulling or traction to free the shoulder.
The case for the D is (paragraph 8):
i) that no excessive force was used;
ii) that, in any event, the head was right occipito anterior (ROA) and the right shoulder was in the posterior position; and
iii) that the likely cause of the injury was traction against the mother’s sacral promontory during a rapid delivery of a large baby.
the medical records document ROA (paragraph 16)
I find that the right shoulder was posterior and not anterior and that the brachial plexus injury is likely to have been caused by maternal propulsion in what was an extremely rapid delivery after labour had been induced, and not caused by excessive traction. (paragraph 78)
Even if I had found that the right shoulder had been anterior, I would still have found that it was impossible on the evidence to conclude that the injury was more likely than not to have been caused by excessive traction. As the authors of the Draycott paper observe, the assumption that presence of injury is evidence by itself of excessive traction is not valid. (paragraph 79)