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Military Doctor Refuses Request for C- Section

$1,259,970.00 – Medical Malpractice/Negligence


Military doctor ignores prior shoulder dystocia birth history and refuses C-section. The almost 11-pound baby was born with a brachial plexus injury and limp left arm.

Jane Doe’s first baby weighed 9 lbs, 7 oz. A shoulder dystocia (anterior shoulder becomes impacted behind the pubic symphysis) was encountered. The delivering physician, through the use of an appropriate maneuver, was able to deliver the child without injury. The parents were advised that with future pregnancies, they should inform the treating OB/GYN that a shoulder dystocia had been encountered previously and should discuss whether a C-section should be considered.

Jane Doe became pregnant again. Because of previous problems with medical care at Balboa Hospital (the Naval Medical Center) and their concerns about the potential complications associated with her pregnancy, Jane Doe and her husband applied to receive care outside of the military system. That request was made to Manuel Rivera, M.D., who was head of Obstetrics and Gynecology at Balboa Hospital at the time. He denied the request and told the parents that he would handle the pregnancy himself as the “high risk” OB/GYN at Balboa.

On numerous occasions during the pregnancy, the parents advised Rivera about the prior shoulder dystocia and their concerns for the pending delivery. They made multiple requests for an elective C-section because of their concerns about the size of the baby. Rivera refused those requests and also refused to refer Jane Doe to another physician. At the time of birth on January 5th, when Rivera attempted to deliver Baby Doe vaginally, he encountered a shoulder dystocia. Baby Doe weighed nearly eleven pounds at birth. Rivera applied substantial traction and the baby was born with bruising on his head, left earlobe, left lateral portion of his back near his armpit and shoulder, and his left arm was completely limp. He suffered a brachial plexus injury.

In the first few months following their son’s birth, and after an intensive search by the parents to find the best care for his brachial plexus injury, they came upon two surgeons at Texas Children’s Hospital with impeccable reputations. The government not only allowed them to have Baby Doe treated there, but also agreed to pay for it, finding it to be “in the Command’s best interest.”


Jane Doe and Baby Doe sued the United States under the Federal Tort Claims Act. They alleged that Rivera applied excessive downward traction to Minor Doe’s head and neck to remove him from the birth canal. The alleged had Jane Doe been offered an elective C-section, she would have accepted, and to a very high degree of medical probability, the injuries to both Minor Doe and Jane Doe would not have occurred.

The defendant contended that Minor Doe’s injury occurred as he traveled down the birth canal, as a result of the natural forces of labor and before the delivery actually occurred, and that Rivera complied with the standard of care.


Brachial plexus traction injury; emotional distress; incontinence; short bowel syndrome; shoulder dystocia

Special Notes

The case was filed under the Federal Tort Claims Act. Under the FTCA, the case is tried before a federal judge rather than a jury.




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