The trial has begun for a Yakima, Wash. obstetrician-gynecologist accused of negligence during a delivery that resulted in the child suffering a permanent birth injury. The child’s parents say that the physician failed to make “necessary adjustments” during the delivery, despite previously noting the risk of complications during the mother’s prenatal examinations. This failure, the parents claim, resulted in an injury to the nerves in their son’s shoulder.

 Complication Risk Had Been Documented

The complaint states that the mother, Jennifer W., received prenatal care from the OB/GYN, Dr. Kevin H., beginning in September 2012. An examination revealed that her child was at risk for a condition known as shoulder dystocia. Described in the Journal of Prenatal Medicine as “the nightmare of obstetricians,” this condition is rare, but it poses a high injury risk for both mother and baby.

The condition occurs when the infant’s shoulders get stuck in the mother’s pelvis during delivery because the baby is too large to fit through the birth canal. Shoulder dystocia can also happen if a child exits the birth canal face first (known as the “turtle syndrome”) or during a breech birth (the child is delivered feet or buttocks first), according to the American Pregnancy Association.

Given the risk of shoulder dystocia, Dr. H. should have offered Jennifer the option of a cesarean section, according to the lawsuit. The couple maintains that the doctor failed to inform her of the risks of such a delivery, and thus, did not get her informed consent. Instead, when Jennifer went into labor eight months later, she says Dr. H. proceeded with a normal vaginal delivery, which the complaint says was negligent on his part.

Could the Birth Injury Have Been Avoided?

Jennifer’s complaint states that if Dr. H. had accurately diagnosed the infant’s condition, he could have delivered the baby in a manner that might have avoided the birth injury. Instead, Jennifer claims that the doctor pulled on the infant’s head and neck with greater force, something known as “lateral traction.”

Since then, Jennifer’s son has been diagnosed with a brachial plexus injury, a birth injury occurring when the nerves running between the spinal cord and the shoulder, arm and hand are stretched, compressed or are torn loose. During the first six years of his life, the couple’s son has required surgery, medical treatment and physical therapy, and will still never have full use of his arm, according to the complaint. The couple alleges the boy “has been and will continue to be unable to pursue normal activities and his ability to enjoy life has been permanently adversely affected.”

Washington ABC-affiliate KVEW reported that the doctor “deviated from the standard of care by ‘applying excessive lateral traction,’ essentially pulling harder on the baby’s head and neck.”

The plaintiff allege that Dr. H’s “excessive lateral traction” has led to permanent injuries on at least three other occasions.

The Defendant’s Response

Dr. H. has denied all the allegations. The University of Washington Medical School graduate says that he has delivered 7,000 babies over the course of his career. Responses to KVEW’s online story indicate that he is well-liked and respected by his former patients.

The trial is expected to last until late May.