EXHIBIT ID: OB_A_1072

Right Anterior Shoulder Dystocia During Delivery - Eventual Cesarean Section

This custom legal animation explains a story to the jury. The patient began to push. The patient pushed for approximately 1 hour. The patient was visually exhausted. The fetal vertex progressed to the 3+ station. Variable decelerations were identified. The nadir extended to the 110s. During this period, the patient was noted to have a low grade temperature of 100.2. The fetal heart tones had risen to the 170s and 180s. They remained at this level for a while. They then dropped to the 160s. The patient desired assistance at this time. Variable decelerations were identified. The nadir extended to the 110s. During this period, the patient was noted to have a low grade temperature of 100.2. The fetal heart tones had risen to the 170s and 180s. They remained at this level for a while. They then dropped to the 160s. The patient desired assistance at this time. A midline episiotomy was performed. One pop off was noted. This was reapplied to assist delivery of the vertex. This occurred over approximately 1.5 minutes. Once the vertex delivered, the infant was not noted to deliver spontaneously. At this time a shoulder dystocia was noted. The patient was placed in the McRoberts position. Suprapubic pressure was applied by the nursing staff and gentle downward traction was applied by Dr. Sylvester. Attempts to release the shoulder were unsuccessful. The Wood’s maneuver was attempted to try and free the anterior shoulder. No rotation could be obtained. Attempts to remove the posterior arm were unsuccessful. Doctor was close by and called into the room. He attempted similar procedures, attempted rotation, attempted to reduce the posterior arm, and McRoberts continued during this time. The vertex was delivered for 3 minutes. Following these procedures, it was decided to attempt to replace the vertex. The vertex was flexed and Dr. Sylvester and Dr. Randall were both able to replace the vertex. A STAT caesarean section was called. The patient was then taken to the operating room. The baby was delivered successfully by Caesarean section.