On July 13, 2014, at 10:57 p.m., plaintiff Francisco Quezada was born. He was born at Enloe Medical Center, in Chico. Prior to Francisco being born, his mother, plaintiff Sylvia Abrego was admitted to the Labor and Delivery Department of Enloe Medical Center at approximately 3:45 p.m. on the afternoon of July 13, 2014. An obstetrician/gynecologist, Dr. Walter Mazen Jr., was notified of her admission and gave initial admission orders. A vaginal examination revealed dilation of 4 centimeters with 60 percent effacement and a -2 station. As a result, the first stage of labor commenced at 6 p.m. Reference to the fetal heart tracing demonstrated good variability and accelerations with contractions approximately five minutes apart. The nurses’ notes indicate that Abrego was continuing to have variable decelerations at 8:30 p.m. At that point, Abrego was turned on her side and an epidural was placed to provide anesthesia. By 9:15 p.m., the nurses’ notes described prolonged decelerations of approximately three minutes down to 70 beats per minute. At that point, a fetal scalp electrode was attached and the doctor, Mazen, who was on his way to the hospital, was notified. At 10 p.m., Abrego was noted to have the urge to push, and Mazen was in the room for delivery at that time. It was found that Abrego was completely dilated as of 10:15 p.m., and the fetal monitor tracing was patchy and, at times, uninterpretable from 10:26 p.m. until the time of delivery at 10:57 p.m. There was an application of a vacuum, which initially occurred at approximately 10:35 p.m., and there were notations indicating a "loss of suction" of the vacuum at 10:37 p.m. and 10:39 p.m. The last application of the vacuum device occurred at approximately 10:43 p.m., which indicated a "pop-off" with discontinuation of the efforts at delivery by vacuum. Francisco was ultimately born at 10:57 p.m. At delivery, the Apgar scores were 0 at one minute, 0 at five minutes, and 2 at 10 minutes. As a result, a code for the infant was called at one minute of life and Francisco was intubated at six minutes of life.A pediatrician then arrived at 16 minutes of life. The cord blood gases revealed an arterial pH of 6.71 and a venous pH of 6.74. The base excess was -20, and Francisco was noted as having seizures. Sutter Memorial Hospital, in Sacramento, was contacted at 11:15 p.m., and the transfer team arrived the next morning, at 1:30 a.m. on July 14, 2014. Just prior to transfer, the venous blood gases were obtained, revealing a pH of 7.31 and a base excess, still markedly abnormal, at -17. Francisco was then transferred to Sutter Memorial Hospital for body cooling. He was ultimately diagnosed as having cerebral palsy. Francisco, by and through his guardian ad litem, and Francisco’s mother, Abrego, individually, sued Mazen; Masen’s medical practice, Ob-Gyn Associates of Chico; and the nurses’ employer, Enloe Medical Center. Francisco and his mother alleged that the defendants failed to timely and properly treat Francisco and his mother and that the defendants’ failures constituted medical malpractice. Mazen and Ob-Gyn Associates of Chico were dismissed from the case, and the matter proceeded to trial against Enloe Medical Center only. Plaintiffs’ counsel contended that the labor and delivery nurses and nursing staff committed numerous failures. Counsel argued the nurses and nursing staff failed to timely recognize the need for an emergency delivery, particularly when the heart rate was mostly undetectable. Counsel also argued that the labor and delivery nurses failed to timely advocate for an emergency delivery and failed to exercise the chain of command, as needed, when it was clear an emergency cesarean section was required. Plaintiffs’ counsel contended that the nurses started Pitocin when it was unnecessary and unsafe and that the nursing staff failed to call the pediatrician to come to the hospital, even though the heart rate was unusually low for about 40 minutes prior to birth. In addition, counsel contended that the nursing staff failed to timely establish an effective airway shortly after the delivery. Defense counsel argued that the nursing care provided throughout the labor and delivery, as well as the resuscitation, was appropriate and within the standard of care. Specifically, defense counsel contended that the fetal heart tracing was reassuring at the time of Abrego’s admission to the Labor and Delivery Department at approximately 3:45 p.m. Counsel also contended that the tracing showed good variability and no extended periods of bradycardia and that the fetal baseline rate was continually within normal ranges at approximately 130 beats per minute. Counsel further contended that although there were some variable decelerations, they recovered to baseline. Defense counsel maintained that at 9:15 p.m., the attending physician, Mazen, was notified of the Category 2 tracing in accordance with the policies and procedures of the hospital and that the fetal heart tracing became patchy approximately two minutes later. Counsel also maintained that Mazen was at the bedside at 9:35 p.m., at which time Mazen performed a sterile vaginal examination, and that Mazen returned to the room at 10 p.m., after being notified that Abrego had the urge to push. Thus, defense counsel contended that Mazen was present at the bedside from that point forward, was managing the labor and delivery process, and was fully informed of all pertinent information by the nursing staff. Counsel also contended that at 10:30 p.m., the fetal heart tracing showed a heart rate in the 60s and 70s and that shortly thereafter, Mazen decided to proceed to the vacuum extraction, which was appropriate and which the nursing staff had no reason to second-guess. Counsel further contended that after the vacuum delivery attempt was unsuccessful, Mazen elected to proceed to pushing, rather than perform a cesarean section, because he believed it would be the safest and most expedient way to deliver the infant and that as a result, a vaginally delivery was accomplished at 10:57 p.m. In addition, defense counsel contended that when Francisco was delivered without a detectable heart rate, the nursing staff complied with the current neonatal resuscitation program guidelines and that positive pressure ventilation was utilized in conjunction with chest compressions until intubation was accomplished., Francisco was diagnosed as having severe cerebral palsy. He is now 7 years old and is unable to walk, speak, live on his own, work or perform any of his activities of daily living independently. Plaintiffs’ counsel contended that Francisco will require attendant care for the rest of his life. Plaintiffs’ counsel asked the jury to award Francisco and his mother $61,267,976 for future medical expenses, $634,090 for past medical expenses, $5,648,967 for Francisco’s lost earning capacity and $500,000 in total non-economic damages for both Francisco and his mother, Abrego. Francisco’s father, Gerardo Quezada, brought a derivative claim.