On Dec. 21, 2014, plaintiff Vanessa Hernandez Garcia was born at Providence Little Company of Mary Medical Center Torrance. She weighed nearly 9 pounds at the time of the delivery. Dr. Jamie Lipeles, an obstetrician, was performing the vaginal delivery when a left shoulder dystocia was encountered. Lipeles tried a variety of maneuvers — including the McRoberts maneuver, suprapubic pressure and the Woods corkscrew maneuver — and attempted to deliver the posterior shoulder. He then repeated suprapubic pressure, freed the shoulder and accomplished the delivery about 90 seconds after appreciating the shoulder dystocia. After her birth, Vanessa was diagnosed with a permanent injury of her brachial plexus, which is a network of nerves emanating from the spine to the shoulder, arm, hand and fingers. Vanessa’s mother, Irais Garcia, acting on behalf of her daughter, sued Lipeles and the medical center’s operator, Providence Health System Southern California. Garcia alleged that Lipeles failed to properly manage the shoulder dystocia and that this failure constituted medical malpractice. Garcia also alleged that the medical center was liable for Lipeles’ actions. Providence Health System Southern California was dismissed prior to trial. The plaintiff’s expert obstetrician testified that a permanent injury to the brachial plexus nerve can only occur due to excessive and prolonged traction by the physician. Garcia claimed that a prior delivery resulted in shoulder dystocia. While the prior delivery took place at another hospital with a different doctor, Garcia claimed that she told Lipeles about the earlier condition. Plaintiff’s counsel contended that the prior dystocia put Garcia at a high risk of her child developing shoulder dystocia during the next delivery. Counsel argued that because of Garcia’s prior history and Vanessa’s large size, Lipeles should have insisted that Garcia undergo a Caesarean section. The defense’s expert obstetrician opined that while excessive force can cause a brachial plexus injury, it can also occur without any negligence or malpractice on the part of the doctor. Defense counsel contended that prenatal records showed no evidence of a prior shoulder dystocia. Lipeles also claimed that Garcia never told him about the prior complication. He further claimed that although he did not know about the prior dystocia, he still offered Garcia the option of undergoing a C-section because of Vanessa’s estimated fetal weight of 8 pounds 8 ounces, but that Garcia refused this offer. As a result, Lipeles maintained that even if he had known about the earlier shoulder dystocia, he would not have done anything differently. Defense counsel noted that the Practice Bulletin published by The American College of Obstetricians and Gynecologists regarding shoulder dystocia states that even if a pregnant woman encountered a shoulder dystocia event in the past, C-sections are not universally performed for subsequent deliveries. As a result, defense counsel argued that Lipeles’ offer of a C-section was sufficient and that Lipeles did not have to insist on performing the procedure., Vanessa was diagnosed with a moderate brachial plexus nerve injury to her left, non-dominant shoulder. She and her mother were discharged from the hospital two days after the birth. Vanessa then began a course of physical and occupational therapy that continued through at least 2018. She also underwent a tendon transfer surgery at the age of 2. Vanessa was left with a winged scapula as a result of her injury. Her mother also claimed that Vanessa still has some weakness and limited range of motion in her left arm as a result of the injury. The plaintiff’s expert pediatric neurologist testified that when Vanessa gets older, she might have trouble storing overhead luggage on an airplane, reaching high shelves and carrying groceries. Vanessa’s counsel also argued that Vanessa might eventually need help bathing herself and doing her hair. As a result, the plaintiff’s expert pediatric neurologist testified that Vanessa might need additional physical therapy to learn to drive and perform other activities. The expert further opined that Vanessa might eventually become self-conscious about her condition and may require psychological counseling. Garcia, acting on Vanessa’s behalf, sought recovery of $27,000 in past medical expenses, $60,000 in future medical expenses, and $500,000 in damages for Vanessa’s past and future pain and suffering. Garcia also initially asked for Vanessa to recover $650,000 and $1.25 million in future lost earnings, but Judge Michael Harwin determined that there was no medical evidence of Vanessa not being able to achieve her educational or employment goals. Thus, the lost earnings claim was excluded and did not appear on the verdict sheet. Defense counsel disputed the cost of Vanessa’s future medical expenses. Counsel noted that Vanessa’s current medical bills were paid by MediCal and contended that the arrangement would likely continue in the future. Counsel also argued that the recommendation for future psychological counseling was speculative. In addition, defense counsel contended that Vanessa has minimal limitations, noting that Vanessa still has the full use of her fingers and is able to button her sweater, type and use a computer. Counsel further noted that the injury was to Vanessa’s non-dominant arm. As a result, defense counsel argued that Vanessa has a bright future, and should be able to go to college or obtain any job she wants.