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From the University of Medicine and Dentistry of New Jersey, Department of Pediatrics in Camden (McAbee) and the Department of Family Medicine at the University of Medicine and Dentistry of New Jersey–School of Osteopathic Medicine in Stratford (Ciervo). Dr McAbee is also a member of the Division of Child Neurology at Children's Regional Hospital in Camden.

Address correspondence to Gary N. McAbee, DO, JD, Division of Child Neurology, Children's Regional Hospital at Cooper University Hospital, Robert Wood Johnson School of Medicine, 3 Cooper Plaza, Suite 309, Camden, NJ 08103-1438. E-mail: mcabee-gary{at}cooperhealth.edu

Injuries to the brachial plexus in neonates present a malpractice dilemma not only for physicians who provide obstetric care, but also for those who administer immediate postnatal treatment for newborns who have these injuries and comorbid medical conditions. Although trauma remains the probable etiology for many brachial plexus injuries, other, nontraumatic etiologies need to be considered. The authors review current medical and legal principles related to brachial plexus injuries—principles that are of concern to all practitioners who provide obstetric and newborn care. They also make a number of recommendations for practitioners to reduce the risk of malpractice lawsuits related to these injuries. Among these recommendations are increasing one's awareness of nontraumatic origins; making sure that appropriate testing (eg, electromyography) is performed for infants whose conditions fail to improve within several months after birth; and taking a proactive role in discussing brachial plexus injuries with patients' families.