R ose Hernandez s infant died shortly after delivery at the Happy Birthing Center. Discovery will reveal the following facts:

The death of the infant is attributable to the negligence of Dr. Jones, the physician who attended Ms. Hernandez at the Center during delivery. The death was caused in part by the infant s aspiration of meconium into the lungs. Although the Center is equipped to suction meconium and other materials from a newborn s throat, it is not equipped to perform the tracheotomy required to suction meconium from the lungs. To receive a tracheotomy, the infant would have to be transferred to the hospital. Even if the infant had been transferred, it would probably have suffered brain damage due to oxygen deprivation before the procedure could have been undertaken.

DR. Jones has a spotless record, but over the two weeks preceding the incident he had appeared at the hospital smelling of alcohol and evidencing other symptoms of intoxication. He was apparently having marital problems at the time. Nurses at the hospital had reported this behavior to their supervisor and had watched the physician s work very carefully. The nurse supervisor had reported the situation to the Chief of OB/GYN, who said he would look into it. Ms Hernandez noticed the smell of liquor on Dr. Jones breath during labor, and was upset by this. DR. Jones has also dropped his malpractice coverage, a fact of which the hospital is aware.

The nurse midwife at the Center had observed that Dr. Jones acts were questionable, but she had not intervened because she knew of his excellent reputation. She knew that doctors were resentful of the independence of nurse midwives at the Center, and she believed she could compensate for his mistakes during delivery. By the time she realized the extent of Dr. Jones intoxication and took over the delivery, it was too late.

In exploring the relationship between Hapless Hospital and the Happy Birthing Center a complicated connection emerges. The hospital found that it needed to increase its patient census. To do this and to better serve the community, it joined in the establishment of the Happy Birthing Center. The hospital receives a percentage of he profits of the Center.

The Center is located in a former convent one block from the Hospital. The hospital owns the building and rents it to the Center. This particular birthing center, according to its promotional literature, offers both a home-like setting for the delivery of your child and the security of the availability of back-up physicians and hospital care. The Center is separately incorporated and has its own Board of Directors. It is totally self governing and is solely responsible for staff, provision of equipment, and policy.

The phone listing in the Yellow Pages describes the Hospital as a cooperating hospital that will provide care for mother and child if needed. Hapless has a contract with the Center requiring the Center to establish a screening program that will exclude high-risk patients and that doctors attending patients at the Center have privileges at Hapless Hospital. The Hospital allows employees of the Center to participate in the hospital s group health and pension plans. Nurses from the Hospital moonlight at the Center. When they do so, they receive a separate paycheck from the Center.

Although the Center s by-laws provide for a committee to review the qualifications of physicians who attend at the Center, it has instead relied on the hospital s review of qualifications because the Hospital has a better opportunity to review credentials and performance. It is not clear that the Hospital is aware of this; while it does notify the Center of the suspension, denial or revocation of privileges (pursuant to the above mentioned contract), it does not provide the Center with information used in investigations.

Ms. Hernandez wishes to sue for damages for the death of her infant. Who, if anyone should she sue? Describe your theories based on the information discovered. Against whom, or which entity, if any, would she likely recover and why?