The South Carolina Court of Appeals has upheld a lower court’s application of state law pertaining to emergency obstetrical care exceptions in which gross negligence is required to impose liability.

The mother, Phillippa Smalling, sued Dr. Lisa Maselli, on behalf of herself and her son, for his brachial plexus injury. During the birth in 2013, Maselli realized the baby’s top shoulder was stuck under the mother’s pubic bone, signaling shoulder dystocia, an obstetric emergency. Maselli called for a second labor and delivery nurse to assist in a McRoberts maneuver by hyperflexing the mother’s hips, according to the opinion filed Nov. 2.