Physician A documents the following:

March 13, 2012

I attended the delivery of this 35-week, 2.1-kg female, born by cesarean delivery, at the request of Dr Jones, following abruption of the placenta. At delivery the neonate was floppy with poor respiratory effort. Heart rate was greater than 100 beats per minute. She failed to respond to blowby oxygen and stimulation, so positive-pressure ventilation was initiated. She failed to establish adequate respiratory effort and was intubated at 4 minutes of life. She was pale with poor perfusion. An umbilical venous line was placed for volume resuscitation. She responded to one 10-mL per kilogram bolus of normal saline with improved perfusion. Her 1-minute Apgar was 4 and her 5-minute Apgar was 7.

Physical examination: A comprehensive examination is documented.

Chest x-ray: Diffuse granular haziness and underinflation were seen throughout the lung fields consistent with respiratory distress syndrome.

Assessment: 35-week post-menstrual aged newborn,...

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