Managing Risk in Shoulder Dystocia and Appropriate Documentation

Managing Risk in Shoulder Dystocia and Appropriate Documentation 

Emphasis: Neonatal injuries related to alleged negligent management of shoulder dystocia is a common cause for medical malpractice litigation. Frequently, the clinician is accused of failing to consider the potential for this complication when the medical record lacks documentation of clinical screening and/or maternal counseling for shoulder dystocia. Incomplete documentation of the events surrounding a shoulder dystocia delivery may impair the team’s ability to recall specific details of the delivery complicating the team member’s ability to defend their actions. Inconsistencies or discrepancies in the medical record may arouse suspicion of the team’s effectiveness and performance in the minds of third-party reviewers. This supplemental module will focus on a clinical scenario of shoulder dystocia to highlight a well-prepared, team-based response to this obstetrical emergency to highlight an important clinical pearl. Complete and accurate medical record documentation is an invaluable resource when defending an alleged malpractice claim involving a shoulder dystocia delivery.


Hours: 0.50


Certificates provided by accrediting body (2 Match)

Accreditation Council for Continuing Medical Education


Relias LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Relias LLC designates this enduring material activity for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 0.50 contact hours for participating in this course.

Course Details

Course Code: REL-AC-APSG-0-PEARL12
Hours: 0.5
Type: Online Course
Content Expiration Date: 12/31/2022
Learning Objectives:
Explain the importance of universal screening and counseling for shoulder dystocia.
Explain the importance of adopting a standard definition for shoulder dystocia.
List the key components of a comprehensive shoulder dystocia delivery note.
How is a diagnosis of newborn brachial plexus injury (BPI) best established?

Introduction A. Summary Managing Risk in Shoulder Dystocia and Appropriate Documentation A. Managing Risk in Shoulder Dystocia and Appropriate Documentation

Instructor: William Cusick, MD
Dr. Cusick earned his medical degree from the Medical College of Ohio in 1988, before completing his internship, residency and a fellowship at the University of CT School of Medicine / John Dempsey Hospital in 1994. He is board certified with the American Board of Obstetrics and Gynecology in both Obstetrics and Gynecology and Maternal Fetal Medicine. Dr. Cusick has special expertise and interest in perinatal ultrasound, fetal Down syndrome screening, 1st trimester ultrasound screening, and perinatal safety. His contributions to the medical literature include dozens of original peer reviewed article, medical textbook contributions, and presentations at national medical meetings.

Dr. Cusick is a member of the American College of Obstetrics and Gynecology, the Society for Maternal-Fetal Medicine, the American Institute of Ultrasound in Medicine and the Ascension Health System Perinatal Safety Committee. He serves as a board member on the Fetal Medicine Foundation USA.

He is the Director of Maternal Medicine Services for St Vincent's Medical Center and The Western Connecticut Health Network. In addition to his clinical MFM practice, Dr. Cusick serves as Chairperson for the Dept of Obstetrics and Gynecology at St Vincent's Medical Center.[Cusick, William MD]  He is an Associate Professor in Obstetrics and Gynecology at The University of Connecticut School of Medicine and the Frank Netter School of Medicine at Quinnipiac University where he also serves as the Clinical Chairperson for the department.

Disclosure: William Cusick, MD has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Ronald Iverson, MD, MPH
Disclosure: Ronald Iverson, MD, MPH has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Nancy Irland, DNP, RN, CNM
Disclosure: Nancy Irland, DNP, RN, CNM has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Sandhya Gardner, MD, FACOG

Sandhya Gardner serves as Chief Medical Officer of Relias. She joined Relias in December 2016 with the acquisition of Advanced Practice Strategies (APS), a Boston-based healthcare education and technology company where she served as Chief Content Officer. APS has partnered with over 100 major US health systems to improve patient care and outcomes through the delivery of assessment-driven, adaptive learning solutions to physicians and nurses. Using a data-driven approach and innovative solutions designed to reduce variation in practice & improve the reliability of care, the company transformed the way that learning is leveraged in the healthcare space.

Prior to her role at APS, Sandhya was as a practicing physician, specializing in Obstetrics & Gynecology. She worked in private practice in the greater Boston area for over 10 years, serving a diverse population of women of all ages, demographics, and needs. The relationships that she fostered with her patients and the impact that she was able to make on their health remains one of the greatest privileges of her life. Sandhya earned both a BS in Psychology and her M.D. from Brown University. She completed her Obstetrics and Gynecology residency at the University of Massachusetts. She is a board-certified physician and Fellow of the American College of Obstetricians & Gynecologists.

Disclosure: Sandhya Gardner, MD, FACOG has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Nurses; Physicians; in the following settings: Acute Care Facility.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
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All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
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