A 39 2/7–week gestational age female infant with a birthweight of 2,995 g was born to a 31-year-old gravida 3 para 2 woman with an unremarkable pregnancy. Membranes ruptured spontaneously 19 hours before delivery with clear fluid. Because labor was not progressing, oxytocin was used to “expedite” the process. The fetus was initially occiput transverse, then occiput posterior. The obstetrician applied vacuum on the fetal scalp twice, but no descent was recorded. It was unclear what station the fetus was in when the vacuum was applied because of lack of documentation. The obstetrician retained by the plaintiff was critical of the treating obstetrician for not documenting the station of the fetus and repeating the vacuum because no descent was found after the first pull. He stated that without descent, reapplication of the vacuum is below standard. The obstetrician requested Simpson forceps after the failed vacuum. The treating nurse, in her...

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