On the evening of Feb. 3, 2010, the plaintiff, a baby boy, was born via a cesarean section. He was diagnosed with cerebral palsy and spastic quadriplegia. Earlier that morning, the plaintiff’s mother, Jennifer Lara, a first time mother, presented to Sutter Davis Hospital, in Davis, at 41 weeks. She was in early, prodromal labor, but had developed pregnancy-induced hypertension. As a result, the on-call OB/GYN, Dr. Susan Maayah, decided to admit Lara and commence induction. Since Lara received her prenatal care from the certified nurse-midwives at Salud Clinic, a federally qualified community clinic in West Sacrament, her labor and delivery was to be handled by the midwives, once Lara was admitted. Per the hospital’s midwife practice guidelines, the midwives consulted with the on-call physician, Maayah, who recommended induction and admission, and thereafter, the labor continued to be managed by the midwives. Lara remained in early labor throughout the day, but she was behavioral and difficult to monitor. As a result, she had an epidural placed shortly after 9 p.m., so the nurses were better able to monitor maternal and fetal status thereafter. The fetal heart tracings showed moderate variability, although the fetus developed some tachycardia at 10 p.m. Due to the fetal tachycardia and continued labile maternal blood pressure, the midwives consulted with Maayah at approximately 10:25 p.m. However, since the fetal heart tracings continued to depict moderate variability, indicating the baby was well oxygenated, the plan was to continue to monitor the fetal heart rate and maternal blood pressures. Lara was resting in her room when a sudden fetal bradycardia occurred at 10:41 p.m. The fetal health rate dropped to 90 and then 60, and did not respond to intrauterine resuscitation. As a result, an emergent C-section was performed, but before it could commence, Lara suddenly deteriorated and became hemodynamically unstable. Both Lara and her child survived, but the involved providers concluded that Lara had suffered from an amniotic fluid embolus, a rare obstetrical complication. As a result, the baby suffered perinatal anoxia and brain damage, resulting in cerebral palsy and spastic quadriplegia. Carolyn Young, acting as the infant’s guardian ad litem, sued Sutter Davis Hospital, Sutter Medical Group (which was erroneously named as Sutter West Women’s Health, which is not an entity), and Maayah. Young alleged that the defendants were negligent in the handling of the infant’s birth and that this negligence constituted medical malpractice. Sutter Davis Hospital subsequently filed a third-party claim against Salud Clinic and the midwives, seeking indemnification. In doing so, the United States of America deemed Salud Clinic and the midwives as employees of the Public Health Service and acting in the course and scope of their employment at the time of the infant’s delivery. As a result, the United States removed the case to federal court and was substituted in as a cross-defendant in place of Salud Clinic and the midwives. Judge William Shubb granted the United States’ motion for summary judgment, so the midwives were out of the case. Sutter Davis Hospital also settled out of the case prior to trial. Thus, the matter continued against Maayah and Sutter Medical Group only. The plaintiff’s perinatology expert opined that Lara was a high-risk patient because she was past her due date, had preeclampsia, had not dilated beyond 2 centimeters after several days of early labor, and her unborn baby had not yet descended into the birth canal. Lara was given medication to stimulate her labor, but after 16 hours, she remained dilated to only 3 centimeters and her baby still had not descended into the birth canal. In addition, Lara and her child each developed an abnormal rapid heart rate. The plaintiff’s expert also noted that fetal monitoring, when it was being done, indicated that the fetus was in distress and needed to be delivered at least an hour before one of the midwives phoned Maayah at 10:15 p.m. The expert opined that, based on the information provided by the midwife, Maayah should have ordered the preparation for an emergency C-section to be started during that call and should have immediately come to the hospital to see Lara. While the plaintiff’s expert conceded that an amniotic fluid embolism could not be predicted, he testified that it was not the cause of injury to the infant. The involved midwives testified that Lara fully met criteria for midwife management of her labor and delivery and that, at all times, in advance of the sudden event at 10:41 p.m., they felt comfortable managing Lara’s labor. They further testified that maternal and fetal status was reassuring until the sudden event. The defense’s perinatology expert opined that Lara’s labor fully met the criteria for midwife management and was appropriately managed by the midwives. The expert also opined that Maayah met the standard of care in her role as a consultant. The defense’s expert further opined that no act or omission by Maayah caused the amniotic fluid embolus and that the embolus could not have been prevented nor predicted., Lara remained intubated as she was admitted to the Intensive Care Unit. She ultimately stabilized and made a full recovery. Lara’s son suffered a significant neurologic insult, including cerebral palsy, spastic quadriplegia, and a seizure disorder. He remains dependent in all activities of daily living and is dependent on a gastrostomy tube (also called a G-tube) for feeding. He is now 7 years old. Carolyn Young, acting on behalf of the child, sought recovery of $356,580 in past medical expenses and $18,286,514 in future medical expenses and attendant care (assuming the child lived to the age of 40). She also sought recovery of $1,289,425 for the child’s loss of earning capacity and an unspecified amount of damages for the child’s past and future pain and suffering. During closing arguments, plaintiff’s counsel asked the jury to award the child $23,960,414 in total damages.