On April 4, 2003, the plaintiff, a baby girl, was born with no heartbeat and was not breathing. During the pregnancy, the plaintiff’s mother, 37, developed gestational diabetes, like she had during her previous pregnancy. Her condition was treated with a special diabetic diet on both occasions, rather than with insulin or oral medication. The obstetrician subsequently followed the mother throughout the duration of her pregnancy, up until March 24, 2003, after which he went on vacation. Since the mother’s second child was due on April 10, 2003, the obstetrician made arrangements for other obstetricians in his office to see the mother and his other patients during his absence. On April 1, 2003, the plaintiff’s mother went to her obstetrician’s office for a regular prenatal visit and saw a covering obstetrician, a partner, because her physician was still on vacation. The mother informed this partner obstetrician that she had experienced some cramping that morning, but there was no vaginal bleeding and she made no complaint of decreased fetal movement. In addition, an ultrasound performed in the office demonstrated positive fetal breathing, positive fetal tone, and positive fetal movement. On April 4, 2003, the plaintiff’s mother went for a regularly scheduled prenatal visit, during which the covering obstetrician noted that the mother was complaining of decreased fetal movement since the evening of April 3, 2003. As a result, the covering obstetrician performed a non-stress test at the office, which was found to be non-reactive and non-reassuring. The tracing showed minimal long-term and short-term variability. A biophysical profile was then obtained via ultrasound, and was scored as 6 out of 10. The covering obstetrician noted adequate amniotic fluid volume and no fetal breathing. As a result, he instructed the mother to go to the hospital. The covering obstetrician then called the perinatologist who previously performed an amniocentesis on the mother earlier in the pregnancy due to her advanced maternal age and asked the perinatologist to further evaluate the mother when she arrived at the hospital. The covering obstetrician also called the labor and delivery nurse at the hospital and stated that he was sending over a patient from his office whom had a non-reactive, non-stress test for further evaluation. He also stated that he had asked the perinatologist to come to the hospital to further evaluate the patient. The mother went directly to the hospital and, upon arrival, went straight to labor and delivery, where she was connected to an electronic fetal monitor by 5:55 p.m. The tracing showed minimal-to-absent long and short-term variability, as well as recurrent late decelerations, virtually from the start. At 6:03 p.m., a nurse made an entry in the mother’s chart indicating that the mother had been sent from her physician’s office for decreased fetal movement and a non-reactive, non-stress test, and that the mother had gestational diabetes. Despite her concern that the baby might need to be delivered emergently, the nurse did not contact any physician at that time because, based on her conversation with the covering obstetrician, she understood that the perinatologist was already on his way. However, when the perinatologist didn’t arrive by 6:45 p.m., the nurse called him and was told that he will come by to do an ultrasound later. At 6:48 p.m., the nurse noted that one of the obstetrical residents, which was part of the hospital’s in-house obstetrical team that provided coverage 24-hours a day, was at the patient’s bedside. At 6:56 p.m., the perinatologist arrived to perform the ultrasound, at which time the fetal monitor was discontinued. Per the perinatal consultation note, the plaintiff’s mother reported that she was no longer feeling any fetal movement. As a result, the perinatologist reviewed the fetal monitor tracing and described it as “a flat line with no variability and occasional dips suggestive of late decelerations,” causing him to conclude that it was “ominous.” He also performed a BPP, noting that there was no fetal movement, no fetal breathing, and no fetal tone. Thus, he scored the BPP as a 2 out of 10. Within 10 minutes of his arrival at the mother’s bedside, the perinatologist had concluded that the mother needed an emergency expeditious Cesarean section, which meant that it should be done within the next 20 to 30 minutes. Since the perinatologist did not have privileges to deliver babies, he contacted the partner obstetrician to come in for a consultation and perform the Cesarean section. The partner obstetrician subsequently stated he would be there in 15 to 20 minutes. After answering the patient’s questions and notifying the nurses, the perinatologist left the hospital. However, according to the three nurses involved in the mother’s care, nothing was communicated to nursing personnel about the Cesarean section needing to be performed on any kind of an expedited or emergent basis. When the covering obstetrician arrived at around 7:30 p.m., it was noted that the fetal heart rate was undetectable. However, despite an undetectable heartbeat, no steps were taken to treat the situation as a “crash” Cesarean section. As a result, the baby was not delivered until 8:02 p.m., at which time the baby had no heartbeat and was not breathing. Her Apgar scores at one, five, 10 and 15 minutes were 0, 0, 0 and 0 (out of 10). CPR was subsequently started at 8:03 p.m., at which time the baby was intubated and given five doses of epinephrine. A heartbeat was first noted at 8:19 p.m. and her Apgar score at 17 minutes of life was 2. An arterial umbilical cord blood gas at birth revealed a pH of 6.77, a pCO2 of 142, a pO2 of 14, a bicarbonate of 20, and a base excess of -17. Those findings are indicative of severe metabolic acidosis with secondary respiratory acidosis, consistent with an acute injury just before birth. Thus, the infant’s mother claimed her baby’s were caused by errors made by the obstetrician, the covering obstetrician, the perinatologist and the hospital. The child, through her guardian ad litem, sued the obstetrician, the partner obstetrician, the perinatologist and the hospital. She alleged that the defendants negligent treatment of her mother and failure to timely perform an emergency C-section constitute medical malpractice. Plaintiff’s counsel contended that since the infant’s mother was near term, had a history of gestational diabetes, complained of decreased fetal movement, and had a non-reactive non-stress test, the standard of care required immediate delivery. Thus, counsel asserted that if any of the defendants had complied with the applicable the standard of care, the infant would have been delivered well before her devastating brain injury occurred. Plaintiff’s counsel contended that due to the failure of any of the defendants to recognize and/or communicate the urgent need for delivery, the infant suffered from a severe, hypoxic ischemic injury around the time of birth, as evidenced by her loss of heart beat just 10 minutes before finally being delivered. Each of the defendants claimed that they met the standard of care and that the infant’s mother’s condition did not represent an obstetrical emergency. The obstetrician was ultimately dismissed from the case. Regarding when the perinatologist arrived at the hospital, he testified that he was not initially on his way to see infant’s mother at the hospital because he was waiting for the nurse to call him and tell him the mother had arrived, but that the nurse only called him because she had expected him to arrive sooner. Regarding the perinatologist leaving the hospital, he testified that after answering the patient’s questions and notifying the nurses about the patient’s condition, he would have left the hospital, regardless of whether the obstetrician had arrived or not. In addition, the perinatologist and the hospital claimed that the covering/partner obstetrician unreasonably delayed in coming to the hospital and starting the Cesarean section. All of the defendants claimed that based on entries in the medical record stating “decreased fetal movement x 2 days” at the time the mother arrived at the hospital on April 4, 2003, the infant’s brain injury occurred approximately two days before birth. They also claimed that they believe the brain injury occurred two days earlier based on the flat fetal monitor tracing throughout the time the mother was at the hospital on the evening of delivery; the cranial ultrasound showing edema and small ventricles at 22 hours of life; the marked, prolonged elevation in nucleated red blood cells following the infant’s birth; the timing of onset and severity of persistent pulmonary hypertension of the newborn; and per the defense’s expert neurologist, the timing of the onset of hypertonicity in the infant after birth., The infant suffered severe hypoxic-ischemic encephalopathy with obtundation, seizures, low blood sugar, elevated liver enzymes, low urine output and elevated creatinine, which, along with the low urine output, was indicative of ischemic kidney damage. She also suffered persistent pulmonary hypertension, requiring inhaled nitrous oxide until day four, and hypotension, requiring fluid boluses and pressors that were gradually weaned. The infant also underwent coagulopathy, requiring fresh frozen plasma, cryoprecipitate and platelet transfusions. The infant remained in the neonatal intensive care unit for 5 weeks, until May 9, 2003. The infant’s head circumference was in the 50th percentile at birth, but she showed poor head growth during her neonatal hospitalization and her head circumference dropped to the 20th percentile by the time of discharge. Plaintiff’s counsel contended that this is consistent with an acute injury shortly before birth. Also at the time of discharge, the infant’s weight was lower than her birth weight, and a concern was noted regarding a failure to thrive and her treating neonatologists anticipated that she would be microcephalic in the near future. The infant continues to suffer from constant, intractable seizures, cognitive impairment and motor impairment. She has consistently exhibited global delay over her lifetime and she appears to be functioning well below what would be expected for her chronological age. Thus, plaintiff’s counsel contended that the infant’s future medical costs amounted to $40,703,983 and her loss of earnings amounts to between $2 million and $3.2 million. Defense counsel contended that the present cash value of the infant’s economic damages was between $2 million and $5 million.