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What is Erb's?/Dr. Hein on Erb's & Gherman/Erb's class action

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Old March 7th 04, 01:01 AM
Todd Gastaldo
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Default What is Erb's?/Dr. Hein on Erb's & Gherman/Erb's class action

PREGNANT WOMEN: It's EASY to allow your birth canal to open an "extra" up
to 30%! See below.

WHAT IS ERB'S? With the baby's head sticking out the vagina, sometimes
babies' shoulders get stuck inside the mother. OBs PULL ON and wrench
babies' spines - sometimes rupturing nerve sheaths and/or severing nerves
in the neck thereby paralyzing some babies' arms. Often the paralysis is
temporary - but some babies' are paralyzed for life. The most common form
of this paralysis is called Erb's palsy...

An estimated one to four babies out of every 1000 are affected [Hein


"Outward [the obstetrician is] icily calm, but inward [he] is extremely
harrassed...attempting to disguise how hard he is really pulling on the
fetal head."
--Kinch RA. Clin Obstet Gynecol 1962; 5:1031-43 quoted in Pauerstein CJ
(ed). Clinical Obstetrics. NY: John Wiley & Sons 1987:871.

(Not long ago, I saw a video of the obstetrician putting his foot on the
delivery table to be able to pull harder!)

HERMAN A. HEIN, MD (Univ. of Iowa) ) Delivering
physicians (and CNMwives) *are* doing something wrong at delivery! Please
see my Open Letter to you below; and see...

PREGNANT WOMEN: OBs and CNMwives routinely CLOSE birth canals up to 30%.

Semisitting and dorsal - medicine's most common delivery positions - close
the birth canal up to 30%.

LADIES: You can EASILY allow your birth canal to OPEN the "extra" up to
30% - see PREGNANT WOMEN below...



OBs suspect "big babies" are the problem ("fetal macrosomia") - which is
really an indirect suggestion that THEY (obstetricians) are causing ERB'S by
senselessly closing birth canals up to 30%.

INCREDIBLY, after some large women have their birth canals closed up to 30%
and their babies suffer Erb's - the hospital tells them their baby got
paralyzed because they - the mothers - were overweight - pre-diabetic
perhaps - which caused their babies to be big!!

Arrggghhh! Sorry to get E-motional here - but they don't call it
cephaloPELVIC disproportion for nothing! Yes, babies born to pre-diabetic
mothers are bigger - but -WHY are hospitals "forgetting" to mention the
PELVIC factor and the fact that OBs are knowingly closing birth canals up to
30%?! Yes, you read that right! OBs are *knowingly* closing birth canals!
See below...


See below.


HORNER'S SYNDROME - In a few cases, Erb's damage to a nerve at the base of
the baby's neck causes an eye problem called "miosis" - constriction of the
pupil - thought by some to be a bad prognostic sign for recovery of arm

More on Horner's below.

NEW ERB'S LIST Subscribe at http://lists.topica.com/lists/erbs


Some may remember me from the now-defunct Erbs Coollist, .

I am a retired^^^ doctor of chiropractic/DC interested in PREVENTING
plexus injury - or - in any event - halting the bizarre routine
obstetrician/CNMwife practice
of closing birth canals up to 30% at delivery.

^^^What do I mean by "retired"? Since my "retirement," I have been working
nearly non-stop making NON-SPINAL (educational) chiropractic adjustments
ANYONE can make - licensed, degreed or not.

Dr. DD Palmer, Founder of chiropractic, defined chiropractic in part as "the
mental act of
accumulating knowledge." [1910:19] DD's definition of chiropractic is not
so crazy as it sounds since medicine is RESTRICTING "the mental act of
accumulating knowledge" -
especially in regard to birth.


Back in the early 90s, after a man claiming to be Michael Schroeder attorney
for the California Board of Chiropractic Examiners told me it was
not within my scope of practice to tell pregnant women that obstetricians
were/are closing birth canals - so I became unlicensed by choice: I saw NO
reason to pay a chiropractic board to tell me I can't work to save tiny live
and tiny limbs and
PREVENT more vertebral subluxations than licensed DCs will ever be able to
adjust by hand. I would LOVE to hear though that the Calif. Board of
Chiropractic Examiners finds my non-spinal practice of chiropractic legal...

I now devote near full-time to helping pregnant women
engage in "the mental act of accumulating knowledge" - esp.
regarding obstetricians/CNMwives gruesomely manipulating most babies'

NOTE: ALL spinal manipulation is gruesome with the birth canal senselessly
closed up to 30%.

MY DEFINITION OF CHIROPRACTIC ("a science of applied neurophysiologic
diagnosis") appears in three editions of Dorland's Illustrated Medical
Dictionary [1988, 1994, 2000]...

See Dorland's: Preventing VS by educating OBs (also: New defn of chiro in


Incidentally, an Attorney Michael Schroeder, attorney for the California
Board of Chiropractic Examiners helped 10 MD-obstetricians judicially
rubberstamp his (Schroeder's) Rule 302 which explicitly made it illegal for
Calif. DCs to so much as sever umbilical cords!

This same Attorney Michael Schroeder - who subsequently became Chairman of
the Calif. Republican Party - later sued me for one million dollars for
publicly suggesting that his Rule 302 illegally narrowed the California
scope of chiropractic practice. I spent about $2500 dollars trying to move
the trial to Oregon - but Atty Schroeder won that jurisdiction battle and -
in his jurisdiction was awarded a default judgement of $25,000 dollars - the
merits of the case never having been argued.

"Chiropractic" Attorney Schroeder is STILL not helping me stop OBs from
closing birth canals and gruesomely manipulating most babies' spines at

Attention Calif. DCs: JUST THINK Calif. OBs can gruesomely manipulate
babies' spines and sometimes sever spinal nerves - but under Schroeder's
Rule 302 - Calif. DCs - who used to attend homebirths - explicitly can't
sever umbilical cords! (Schroeder's Rule 302 is now being challenged in
court in Tain et al. v State Board of Chiro Examiners. See Dorland's, URL

"Chiropractic Education...include[s]...OBSTETRICS..."
--American Chiropractic Association/ACA Chairman James Edwards, DC and
Cynthia Vaughn, DC
http://www.jamesedwards.com/educate.htm (emphasis added)

"Obstetrics is the art of midwifery...If the accoucheur is a Chiropractor,
he can adjust...thereby preventing disease."
--Dr. DD Palmer, Founder of Chiropractic [1910:789]

I personally think autonomous homebirth midwifery licensure is the way to

Chiropractors don't need to attend births to prevent disease - to stop OBs
from closing birth canals!


Most parents of Erb's babies *understandably* don't want to look back at
a bad birth experience - those parents should just delete my posts.

Some parents however are suing their
OBs - or are considering suing...

KEY POINT Like it or not, malpractice suits are this culture's method of
compensating victims and putting the brakes on an
otherwise mostly unrestrained medical profession...

So I am *very* interested in parents who are suing or are considering suing
their OBs...


I would like to stimulate an Erb's class action to compensate tiny victims
finally STOP the bizarre OB/CNMwife practice of closing birth canals up to
30% at delivery.

To my knowledge, no jury has ever heard that OBs are senselessly closing
birth canals!

Attorney Kathleen Zellner won $3,000,000 million dollars for one Erb's baby.

See Attorney Kathleen Zellner's birth trauma jackpots...

Imagine how successful a birth trauma attorney could be if the jury were
told OBs are knowingly closing birth canals up to 30%!

Imagine how fast the bizarre obstetric practice of closing birth canals
would end!

Of course, many (most?) birth trauma lawsuits would dry up - which may
explain why Attorney Kathleen has not responded yet. Nor have any other
birth trauma

See also: See Atila the OB, hospital ordered to pay $63 million...

Has ANYONE heard about a birth trauma attorney telling a jury that OBs are
senselessly closing birth canals?

If you have, please email me!!

Keep in mind: OBs indirectly admit ON VIDEO that they are closing birth
canals! See below.


FACT: If you gave birth on your back or on your butt (dorsal or
semisitting) the OB closed your birth canal up to 30%.

If your baby experienced shoulder dystocia, it is possible - even probable -
that your OB KEPT your
birth canal closed up to 30% **with more force**. See "the kicker" below...

Obstetricians are KNOWINGLY closing birth canals up to 30%.

In ACOG's Shoulder Dystocia Drill video, American MDs purport to tell each
other how to allow birth canals to open maximally when shoulders get stuck -
which means MDs know they are CLOSING birth canals most of the time.


ACOG's method of allowing the birth canal to open actually
keeps it closed!

See ACOG birth crime video evidence

PREGNANT WOMEN: To allow your birth canals to open the "extra" up to 30%,
all you
have to do is roll onto your side as you push your baby out - or go to
hands-and-knees, kneeling, kneeling on one knee, standing, squatting -
virtually ANY delivery position will do the trick EXCEPT dorsal or
semisitting - both of which close the birth canal. Talk to your
obstetricians and CNMwives about this TODAY...

delivery position WARNING: Some MDs and CNMwives will let you "try" an
"alternative" delivery position but will move you back to semisitting or
dorsal (close your birth canal!) for the actual delivery!

See again: ACOG birth crime video evidence

Back to Horner's Syndrome...


According to Mike and Brenda Moore's recent Erb's Newsletter, "Horner's
Syndrome is when facial nerves are also involved," as in,

"The Erb's List...March 1, 2004...Keeping you up-to-date!...An Erb's Palsy
Injury is a specific brachial plexus injury which involves injury to the
upper trunk nerves- C5, C6 and sometimes C7...Klumpke's Palsy is an injury
to the lower trunk nerves- usually C7, C8, and sometimes T1...Horner's
Syndrome- is when **facial nerves** are also involved..." [**emphasis
--Mike and Brenda Moore on the Erb's List

(BTW, I am NOT trying to embarrass Mike and Brenda. I thank them for
running the Erb's list.)

The University of Iowa's HERMAN HEIN, MD does not mention facial nerves in
his brief mention of Horner's Syndrome...

Herman writes:

"[O]cular asymmetry may indicate involvement of the stellate ganglion with
the associated Horner's syndrome (ptosis, myosis [sic], enophthalmosis, and
anhydrosis) that indicate possible involvement of TI. This finding would
most likely be associated with total BPP."

Herman's description of Horner's - his mention of the first thoracic nerve
and no mention of facial nerve involvement - accords with my recollection;
but if facial nerves *are* involved, will someone please correct me?

Oh, this just in from Kath on :

"Hi...I am right obpi [obstetric brachial plexus injury] and I have Horner's
syndrome ... it is usually associated with T-1 damage. The right side of my
face is often cold and does not perspire... They should also check for
vision problems when the children begin or before school. Reading and
sometimes I have heard of central sight vision loss ... sometimes parents
are told the children have Lazy eye...."


If forceps are used in the birth as occurs in some brachial plexus
injuries - facial and brachial plexus palsies could occur together...

I wonder how often this happens... Anyone know?

According to Bhat et al. [Indian J Pediatr. 1995 Mar-Apr;62(2):207-12,
PubMed abstract],

"Brachial plexus injury (1/1000) and facial nerve injury (0.74/1000)
accounted for 98% of nerve injuries. Both the right and left side were
involved equally...."

According to the same study - brachial plexus and facial nerve palsy after
cesarean sections,

"Injuries to brachial plexus and facial nerve were seen even in babies born
by caesarean section, when it was performed for obstructed labour caused by
cephalo-pelvic disproportion and abnormal presentations."

Regarding cesareans...

REMEMBER: OBs are CAUSING cephalopelvic disproportion then performing
cesareans BEcause of cephalopelvic disproportion!



One woman on
said her pediatrician said Horner's is common
to Erb's babies.

This got me thinking of frequency of Horner's...

Herman Hein, MD (cited above) says that Horner's "would most likely be
associated with total BPP" - which I take to mean damage to all 5 mixed
nerve roots -
C5 to T1.

A 2000 Croatian study on PubMed gave these numbers...

"...21 cases of Erb's palsy (65.63%), 2 cases of Klumpke's palsy (6.25%).
Total plexus palsy was present in 9 children (28.63%), and Horner's Syndrome
in 1 case."
[Buljina et al. Med Arh. 2000;54(5-6):283-4. ]

Onward to...



HERMAN A. HEIN, MD (quoted above) says Gherman et al. "clearly refute" the
notion/assumption that in Brachial Plexus Injury the delivering physician is
doing something wrong at delivery...

Herman writes:

"Gherman et al, (Am J Obstet Gynecol 1998;178:423-7) recently provided
evidence that, taken together with previous reports, suggests that not all
Erb's palsy is traction related. Rather, an in utero insult perhaps combined
with a susceptibility to pressure or traction may be etiologic....The
information provided by Gherman et al is extremely important for physicians
to understand. A lawsuit following BPP is commonly settled on behalf of the
plaintiff, because the assumption has been made that the delivering
physician did something wrong. The Gherman data clearly refute this notion
and in fact promote the strong possibility that the infants who do the worst
in terms of recovery of function are those who were not influenced by
obstetric techniques."
--Herman A. Hein, M.D. )
Last Revised: September 2003

OPEN LETTER (archived for global access at:

Herman A. Hein, M.D. )
Professor of Pediatrics
University of Iowa Hospitals and Clinics


Delivering physicians ARE doing something wrong at delivery - something
QUITE wrong - something quite relevant to brachial plexus injury...

Significantly, Gherman - who you say has "clearly refuted" this notion -
radiated fetuses in a lame attempt to cover-up this
massive obstetric crime.

See ACOG birth crime video evidence

Note: The Merck Manual has the SAME grisly shoulder dystocia birth gaff -
MDs admitting they are routinely closing birth canals!

Note also: "Alternative" birth experts (including doulas and midwives) are
bizarrely silent - babies be damned...

See NPR: How to make labor more painful (SURPRISE!)


Herman, your research interests include "social correlates," as in:

"Social correlates of infant mortality [and] effects of regional systems of
perinatal health care on neonatal outcome..."

Please look into the "social correlates" that have delivering physicians
knowingly closing birth canals up to 30%, Gherman fraudulently radiating
fetuses to cover-up - and "alternative" birth experts remaining silent...

NOTE: Gherman - a military MD - likely used US tax dollars in his lame
radiation attempt to cover-up the massive obstetric crime...

NOTE ALSO: The Gherman et al. article you promote is based on only 40 cases
of Erb's palsy total (!) - this according to the PubMed abstract as

Gherman et al. write:

"We compared the time course of resolution and incidence of persistent
injury at 1 year of age in 17 cases of Erb's palsy without shoulder dystocia
and 23 cases associated with shoulder dystocia." RESULTS: The rate of
persistence at 1 year was significantly higher in those Erb's cases without
identified shoulder dystocia, 7 of 17 (41.2%) versus 2 of 23 (8.7%), p =
0.04. These cases of Erb's palsies also took longer to resolve (6.4 +/- 0.9
vs 2.6 +/- 0.7 months, p = 0.002), had a higher rate of associated
clavicular fracture (12 of 17 vs 5 of 23, p = 0.006), and were more likely
to occur in the posterior arm (10 of 15 vs 4 of 21, p = 0.009). CONCLUSIONS:
Erb's palsy occurring without shoulder dystocia may be a qualitatively
different injury than that occurring with shoulder dystocia. [Gherman et al.
Am J Obstet Gynecol. 1998 Mar;178(3):423-7 (PubMed abstract).]

Obstetricians have little incentive to volunteer/"identify" shoulder
dystocia info in birth records...

And, as indicated above, obstetricians have been characterized as trying to
conceal how hard they are pulling, as in,

"Outward [the obstetrician is] icily calm, but inward [he] is extremely
harrassed...attempting to disguise how hard he is really pulling on the
fetal head."
--Kinch RA. Clin Obstet Gynecol 1962; 5:1031-43 quoted in Pauerstein CJ
(ed). Clinical Obstetrics. NY: John Wiley & Sons 1987:871.

Gherman co-authored a second article in the same journal/same year/1998...

There appears to be a fairly major "direct fetal manipulation" flaw in the
PubMed abstract...

"We sought to determine the fetal injury rate associated with shoulder
dystocia and to determine whether there is a higher rate of brachial plexus
injury or bone fracture when fetal manipulation techniques are required for
delivery. STUDY DESIGN: A retrospective review of 285 cases of shoulder
dystocia that occurred between January 1991 and December 1995 was performed.
The type, sequence, and combination of obstetric maneuvers used to relieve
the shoulder dystocia were noted. These cases were divided into two groups,
as follows: (1) those resolved with McRoberts' maneuver, suprapubic
pressure, or proctoepisiotomy or a combination of these and (2) those that
required the addition of direct fetal manipulative maneuvers (Woods,
posterior arm, or Zavanelli). Fetal injury was defined as the occurrence of
brachial plexus palsy, clavicular fracture, humeral fracture, or fetal death
caused by asphyxial complications. RESULTS: The fetal injury rate was 24.9%
(71/285), including 48 (16.8%) brachial plexus palsies, 27 (9.5%) clavicular
fractures, and 12 (4.2%) humeral fractures. Sixteen infants had both nerve
injury and bone fracture. Four (8.9%) brachial plexus palsies had documented
persistence at 1 year of follow-up. One neonatal death occurred at age 3
months after an episode of hypoxic ischemic encephalopathy. The incidence of
bone fracture was not higher when direct fetal manipulation was required: 21
of 127 (16.5%) versus 18 of 158 (11.4%), p = 0.21. The incidence of brachial
plexus palsy was also similar in both groups (27/127 vs 21/158, p = 0.1).
CONCLUSIONS: Direct fetal manipulation techniques used to alleviate shoulder
dystocia are not associated with an increased rate of bone fracture or
brachial plexus injury. [Gherman et al. Am J Obstet Gynecol. 1998
Jun;178(6):1126-30. (PubMed abstract)]

I doubt very much that "direct fetal manipulation" is not used before
attempting McRoberts' maneuver, suprapubic pressure and proctoepisiotomy!

Maybe it's just a typo in the PubMed abstract...

You know what though, Herman?

Obstetricians should be immediately stopped from senselessly closing birth
canals REGARDLESS whether they are causing Erb's palsy or worse.

Please use your authority as Iowa Statewide Perinatal Care Program Director
to publicly call for an end to the obstetric travesty.

If you have any questions, please feel free to email me at:



Dr. Gastaldo


Herman, first you write in your Brachial Plexus Palsy piece (last revised
Sept 2003) that surgical reconnection of avulsions does not appear to be
possible, as in,

"[A]vulsions...rootlets [are] torn from the spinal cord proximal to the
formation of a mixed nerve root...[S]urgical reconnection of nerve rootlets
to the spinal cord does not appear to be possible."

Then at the end...

"Microsurgical grafting of critical components of the brachial plexus can be
done in cases of root avulsion."^^^

^^^Added comment of Dr. Kumar Kadiyala, Assistant Professor of Orthopaedic
Surgery at University (of Iowa) Hospitals

Maybe "microsurgical grafting" and "surgical reconnection" are two different


Brazilians Bertelli and Ghizoni [2004] write:

"Reconstruction of C5 and C6 brachial plexus avulsion injury by multiple
nerve transfers: spinal accessory to suprascapular, ulnar fascicles to
biceps branch, and triceps long or lateral head branch to axillary nerve."
[J Hand Surg [Am]. 2004 Jan;29(1):131-9.]

Copied to Bertelli and Ghizoni via

(Please say hello to "chairless schools" Prof. Dr. Moyses Paciornik, MD in
Curitiba! And hello also to Jaime Lerner - now/still governor of Parana


Herman A. Hein, MD says,

"An apparently common misconception in the state of Iowa is
that no surgeons within the state have had experience in successfully
dealing with BPP corrective surgery. The Department of Orthopaedic Surgery
at the University of Iowa has experienced surgeons with the expertise to
care for the BPP patient from birth to adulthood."

To be sure, brachial plexus surgeries are pure wizardry - medicine at its

But brachial plexus surgeons should be working like hell to PREVENT that
which they profit from - i.e. - surgeons should be working like hell to
stop obstetricians from pulling
on babies' heads with birth canals senselessly closed...

One of the world's most experienced BPI surgeons is remaining silent (or
maybe he just didn't get or read my email)...

See my Open Letter to Rahul Nath, MD in ACOG birth crime video evidence


I am in favor of pardons in advance for MDs. MDs are just academic prime
cuts forced through this culture's most powerful mental meatgrinder -
medical school.

Pardons in advance would allow MDs to keep doing their valid medical work so
they will have money to pay the inevitable civil damages.

In this latter regard, I say again: I would like to stimulate an ERB'S

Attorney Kathleen Zellner won $3,000,000 million dollars for one
Erb's baby, URL above.

Has ANYONE heard about a birth trauma attorney telling a jury that OBs are
knowingly closing birth canals?

Just ONE birth trauma attorney telling a jury about the obvious criminal
negligence would dry up much Erb's business for MDs not to mention much
Erb's business for attorneys...

Which may explain the bizarre attorney/MD silence so far - babies be damned.

Herman A. Hein, MD, you still reading?

Again, please use your authority as Iowa Statewide Perinatal Care Program
Director to publicly call for an end to the obstetric travesty.

Thanks for reading.



Dr. Gastaldo

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