On April 30, 2012, the plaintiff, an infant, was born. The infant’s mother, Micaela Palacio previously presented to Banner-Lassen Medical Center, in Susanville, expecting to deliver her daughter on the evening of April 29, 2012. The delivering doctor, Dr. Paul Davainis, a family practitioner who was the on-call obstetrician with full obstetrical privileges, was called and he arrived at the hospital expecting that a vaginal delivery could occur within the hour. Palacio quickly progressed from 4-centimeters at admission at 11 p.m. to between 8- and 9-centimeters at 2:15 a.m. The fetal monitor tracing on admission was a Category I, but became a Category II at 1:30 a.m. with decelerations, although with moderate variability. Cervical dilation did not become complete until after 2 a.m., although Davainis observed some continued progress in labor. As a result, he was hopeful that the baby could be delivered vaginally. The fetal monitor strip continued to show a Category II tracing with deeper decelerations that became progressively repetitive. At 4:00 a.m., Palacio had dilated to a rim of cervix. Davainis then had Palacio push even though she was not completely dilated. However, at 5 a.m., he called for delivery by caesarean section, and asked for the assistance of an assistant surgeon and a surgical scrub technician. When they arrived at the operating room by 5:15 a.m., fetal heart tones were lost and Davainis asked the certified registered nurse anesthetist to give Palacio general anesthesia. Surgery was subsequently started at 5:22 a.m., and the baby was delivered between 5:24 a.m. and 5:28 a.m. However, when the baby was delivered, she had the umbilical cord wrapped around her neck and she was limp, blue and not breathing. The Apgar scores were 0, 2, 3 at 1, 5, and 10 minutes. As a result, full resuscitation was performed with intubation and epinephrine. The baby was then transferred to UC Davis Medical Center for brain cooling. The baby was ultimately diagnosed with hypoxic-ischemic encephalopathy. The baby, through a guardian ad litem; Micaela Palacio; and Facundo Palacio Diaz, the infant’s father, sued Davainis’ employer, the United States of America. They also sued the operator of Banner-Lassen Medical Center, Banner Health. The matters were ultimately consolidated. The Palacio alleged that Davainis was employed by the Northeastern Rural Health Clinic, in Susanville, which was a federally funded clinic. Thus, they alleged that United States was liable for the negligence of Davainis. They also alleged that Banner Health was liable for the negligence of Davainis and its staff. Banner Health subsequently brought a third-party action against Davainis. However, prior to trial, Banner Health confidentially settled with Facundo Palacio Diaz and his child, so it was let out of the case. Plaintiffs’ counsel contended that the standard of care required Davainis to have delivered the baby by 4 a.m. at the latest and that it was negligent for Davainis to wait so long before calling for a C-section. Counsel also contended that had the baby been delivered earlier, she would not have suffered any injury. In addition, plaintiffs’ counsel contended that the medical care provided in the resuscitation of the baby was negligent. Counsel for the United States argued that the standard of care did not require a C-section before it was called at 5 a.m. because variability in the fetal heart rate persisted, which indicated that the fetus was not acidotic. Counsel also argued that the C-section did not need to be started earlier because Davainis observed continued labor progress that made it reasonable for him to anticipate a likely vaginal delivery. The United States’ counsel further contended that the delivery occurred within 30 minutes of when the C-section was called, which was consistent with The American Congress of Obstetricians and Gynecologists’ standards, and that the infant’s injury was caused by an unpredictable cord accident and had nothing to do with any alleged delay in performing the C-section. In addition, counsel contended that the resuscitation was performed quickly and efficiently, ultimately saving the infant’s life., The infant was born with the umbilical cord wrapped around her neck. She was limp, blue and not breathing. Full resuscitation was performed with intubation and epinephrine. The baby was then transferred to UC Davis Medical Center for brain cooling. She had a gastrostomy tube (g-tube) placed for feeding and she spent five weeks in the hospital before being released home. She was ultimately diagnosed with hypoxic-ischemic encephalopathy. The child of Micaela Palacio and Facundo Palacio Diaz was 3.5-years-old at the time of trial. She continues to require frequent suctioning and has occasional seizures. Due to her birth injury, she will never be able to walk, talk, or care of herself. She also cannot see and she must be fed through a feeding tube into her stomach. Plaintiffs’ counsel contended that the child will require 24-hour licensed vocational nursing care for the rest of her life. Counsel also contended that the child will require therapies to prevent complications and to teach her how to vocalize and have some motor control. Counsel also contended that as a result of the child’s condition, the child has a drastically reduced life expectancy and is likely to live only 20 more years. Thus, the child’s family sought recovery of $87,521.30 in past medical care costs (per the MediCal lien), $7,753,349 in future medical care costs for the child’s 24-hour LVN care, $544,139 for other future care costs, and $967,796 for the child’s future loss of earnings. In addition, Micaela Palacio claimed emotional distress as a result of the delivery and sought recovery of emotional distress damages. The United States’ counsel contended that the child only requires home health aide care, as both the plaintiff’s and defense’s experts agreed that the child’s parents, who are not LVNs, have provided adequate care. Thus, counsel argued that the child’s future medical care costs only totaled $2,473,823 for 24-hour home health aide care, $517,882 for other future care costs, and $464,311 for future loss of earnings.