United States District Court, D. New Jersey
June 9, 2005.
SHERNETT CAMPBELL, individually and as guardian ad litem of Keven Davis, an infant Plaintiff,
UNITED STATES OF AMERICA Defendant.
The opinion of the court was delivered by: MADELINE COX ARLEO, Magistrate Judge
FINDINGS OF FACT AND CONCLUSIONS OF LAW
Plaintiff, Shernett Campbell ("Campbell") individually and as
guardian ad litem of Keven Davis, her infant son, brought this
action against the United States of America pursuant to the
Federal Tort Claims Act, 28 U.S.C. §§ 2671-80, and the Federally
Supported Health Centers Assistance Act, 42 U.S.C. § 233(g)-(n).
She seeks damages for alleged personal injuries she and her son
sustained during his delivery on July 26, 1999 at Muhlenberg
Regional Medical Center ("Muhlenberg").
Campbell claims that the doctors and nurse-midwives*fn1
employed by Plainfield Neighborhood Health Center ("PNHC"), a
federally funded health center, deviated from accepted standards
of medical care with respect to the delivery of her baby.
Specifically, Campbell contends that Defendants (1) failed to
order a fourth ultrasound during the fortieth week of gestation
to estimate fetal weight when they suspected the baby would be
large for gestational age, and (2) consequently failed to present
an alternative course of delivery, namely, an elective cesarian
section ("c-section"). Campbell gave birth vaginally to a 12
pound 4½ ounce baby, and claims that she and her son suffered
permanent injuries therefrom. Finally, Campbell contends that
upon discharge from Muhlenberg, Defendants failed to advise her
to take stool softeners, which further aggravated her alleged
injuries. From April 19 to April 23, 2004, I presided over a non-jury
trial in which the parties were afforded a full opportunity to be
heard, to examine and cross-examine witnesses, to present
evidence bearing on the issues and to argue the law and the
Below I make the following Findings of Fact and Conclusions of
Law pursuant to Fed.R.Civ.P. 52(a) based on the competent
evidence presented at the trial:
FINDINGS OF FACT:*fn2
1. Campbell, at age thirty-seven, came under the care of PNHC
for her pregnancy on January 19, 1999. She had previously given
birth vaginally to a baby girl weighing approximately 6½ pounds.
(Stip. 1, Jt. Pretrial Order at 1.)
2. Plaintiff received comprehensive pre-natal care as a patient
at PNHC. Campbell was examined at PNHC by experienced certified
midwives, Kathryn McElroy ("McElroy") and Shirley McDuffie
("McDuffie") on eleven occasions between January 1999 and July
1999. (Stip.2, Jt. Pretrial Order at 2.)
3. Ultrasounds were performed three times during the course of
the pregnancy: the first, on February 8, 1999, at approximately
sixteen weeks; the second, on March 2, 1999, at approximately
twenty weeks; finally, the last, performed on May 27, 1999, at
approximately thirty weeks, which showed "appropriate interval
growth," and confirmed a due date of July 26, 1999. (Id.) The
ultrasounds also showed the presence of a fundal fibroid, which
the nurse-midwives monitored appropriately. The fibroid did not
interfere with the growth or development of the fetus. 4. In addition to the ultrasounds, Campbell received two
glucose tests, which confirmed that she was not diabetic.
(Id.) A diabetic pregnant woman is at greater risk for giving
birth to a macrosomic baby.*fn3 (Quartell, at 16.)*fn4
5. Campbell also received genetic counseling and an
amniocentesis to address any possible chromosomal abnormalities
of the fetus. The test results were normal. (McElroy, at 149.) At
trial, there was no dispute that all of the pre-natal care that
the PNHC employees provided up through July 21, 1999 was
appropriate. (Soffer, at 125-27.)
6. On Thursday, July 22, 1999 (four days before her due date),
Campbell was examined by nurse-midwife McElroy during her visit.
At that visit, Campbell complained of pelvic discomfort and pedal
edema (swelling of feet). McElroy was supervising Susan Wells
("Wells"), a student nurse-practitioner, that day. (McElroy, at
150-51.) Wells and McElroy both performed Leopold's
maneuvers*fn5 on Campbell during the visit. (McElroy, at
152.) McElroy also measured the fundal height. (Id. at 153.)
Based on these measurements, McElroy estimated that the baby was
between 8 and 8½ pounds. (Id. at 152.) She did not suspect
macrosomia. (Id. at 159.)
7. After her examination of Campbell, McElroy consulted with
the obstetrician/gynecologist on duty, Robert Beim, M.D. ("Dr.
Beim"), who examined the patient with her. (Id. at 151-52,
157-58.) McElroy's management plan at this point was to induce
delivery on the due date, July 26, 1999. Dr. Beim concurred in this plan. (Stip.3, Jt. Pretrial Order at
2.) Dr. Beim and McElroy discussed the possibility of getting a
fourth ultrasound to check the fetal weight. (McElroy, at 157.)
They recognized that to schedule a Level II ultrasound on a
non-emergent basis would take approximately one to two weeks.
(Id. at 159.) Considering all the factors, including Campbell's
prior vaginal delivery, her large "proven" gynecoid
pelvis,*fn6 and her growing discomfort, Dr. Beim and McElroy
concluded that induction was the appropriate course of treatment.
8. McElroy spoke to Campbell about inducing labor on Monday,
July 26, 1999, her actual due date. (Jt. Exh. 1, at 20; McElroy,
at 153-54.) She did not discuss the option of performing an
elective c-section with Campbell because she did not believe it
was indicated at the time. (McElroy, at 154.) Assessing the
situation with Campbell, McElroy believed that an induction and a
vaginal delivery would be the best course of treatment. (McElroy,
at 153-54.) Campbell agreed, and McElroy scheduled the induction.
9. Student Wells wrote a "progress note" for Campbell's July
22, 1999 visit. (McElroy, at 152.) She entered a note in the
chart which indicated, inter alia, "r/o macrosomia . . . will
induce on 7/26/99." The note also indicated "EFW-?"*fn7 (Jt.
Exh. 1, at 10), but there is no recorded estimated fetal weight
in the chart. McElroy did not review or co-sign the note because
she was on the phone with Muhlenberg scheduling the induction as
well as speaking with Campbell. (McElroy, at 160.) However,
McElroy testified that she did not believe the baby was
macrosomic, and that Campbell was not sent for an induction due to suspected macrosomia.
McElroy's testimony on this point was credible.
10. Campbell was admitted to Muhlenberg on the morning of July
26, 1999 under the care of midwife McDuffie and Dr. Mary Powderly
("Dr. Powderly"), director of the OB/GYN Department at PNHC. (Jt.
Exh. 3, at 12.) She presented weighing 208 pounds, and was having
contractions every six to eight minutes. The admitting
examination revealed that she was already two centimeters
dilated. Campbell was in the early latent phase of labor when she
arrived at Muhlenberg. (Quartell, at 43.)
11. At approximately 9:30 a.m., McDuffie performed a cervical
exam and Leopold's maneuvers on Campbell. (Jt. Exh. 3 at 12;
McDuffie, at 11-12) McDuffie's contemporaneously recorded note
indicated an estimated fetal weight of 9 pounds. (Joint Exh. 3,
at 12.) McDuffie discussed her findings, including estimated
fetal weight, with Dr. Powderly. (McDuffie, at 12.)
12. Dr. Powderly also reviewed Campbell's chart and examined
her. (Powderly, at 174-75.) Dr. Powderly determined that Campbell
had a large gynecoid pelvis. (Id. at 176-77.) She also
estimated the fetal weight of the baby to be approximately 9
pounds, which was large for gestational age,*fn8 but Dr.
Powderly testified that she did not suspect macrosomia. (Id. at
177.) Consequently, Dr. Powderly decided to follow a standard
induction procedure and a trial of labor based on her estimates
of fetal weight. (Id. at 177-78.) Dr. Powderly's testimony on
this point is credible.
13. Anthony Quartell, M.D., Defendants' expert in obstetrics
and gynecology, testified at trial that there are several methods
for estimating fetal weight. These methods include (1) comparing fundal height to gestational age; (2) performing
Leopold's maneuvers; and (3) performing an ultrasound. Neither
method is more accurate than any other. The Court finds Dr.
Quartell's testimony to be trustworthy and supported by his
expertise in obstetrics.
14. After consultation, Dr. Powderly and McDuffie explained the
induction and trial of labor plan to Campbell. Dr. Powderly
explained to Campbell that she felt Plaintiff could successfully
deliver vaginally and that the induction of labor would proceed
according to standard protocol. (Id. at 175-76.) Furthermore,
Dr. Powderly informed Campbell that in case of any difficulty,
such as labor failing to progress, the patient "[falling] off
Friedman's curve,"*fn9 or fetal distress, Dr. Powderly would
perform a c-section.
15. It was undisputed at trial that Campbell's labor did in
fact proceed normally, in accordance with Friedman's curve. From
the point of Campbell's induction, throughout her delivery, labor
did not fail to progress. (Soffer, at 127.) Indeed, Plaintiff's
expert for obstetrics and gynecology, Jeffrey C. Soffer, M.D.,
testified that the induction was properly performed, and the
labor progressed "nicely." (Id. at 127-29.)
16. McDuffie examined Campbell at approximately 4:30 p.m. Prior
to that time, Campbell had received an epidural. McDuffie noted
that the contractions were in a pattern, and that the baby was
not in any distress. (Jt. Exh. 3, at 12a; McDuffie, at 18.)
17. Dr. Powderly examined Campbell again at approximately 5:00
p.m. (Jt. Exh. 3, at 19; Powderly, at 179-81.) Dr. Powderly
determined that she was progressing well through labor, and that
there was no reason to send her for an ultrasound or to perform a
c-section. (Powderly, at 180-82.) In fact, Campbell exceeded Friedman's curve and went through
labor more quickly than anticipated. (Powderly, at 179; McDuffie,
18. C-sections are surgical procedures which carry significant
risks for the mother. Risks include damage to surrounding organs,
hemorrhage, blood clots, bowel obstructions, and infection
leading to septicemia which can result in hysterectomy. (Soffer,
19. Campbell started pushing at approximately 6:40 p.m. (Jt.
Exh. 3, at 12a; McDuffie, at 19.) McDuffie performed an
episiotomy under local anesthesia. (McDuffie, at 19.) During the
delivery, the baby's head crowned and then retracted back up to
Campbell's perineum, a movement referred to as the "turtle sign."
(McDuffie, at 19; Powderly at 182.) This is a warning sign of
shoulder dystocia. (Powderly, at 182.) McDuffie immediately
recognized that the baby's shoulder was stuck behind the mother's
pubic bone. (McDuffie, at 19-20.)
20. Shoulder dystocia is a condition that occurs when the
baby's shoulder is stuck behind the mother's pubic bone and
consequently obstructed in its passage from the vagina.
21. McDuffie alerted Dr. Powderly. Dr. Powderly and the
pediatrician on call, Dr. Huey, came to the delivery room
immediately. (McDuffie, at 20.) Measures were taken to increase
the space available for the baby's passage through the birth
canal: a Foley catheter was placed to drain Campbell's bladder;
Dr. Powderly extended the episiotomy; Campbell's body was
maneuvered into a McRoberts position. (Powderly, at 182-83.)
Plaintiff's expert, Dr. Soffer, conceded at trial that these
procedures were performed correctly. (Soffer, at 127-29.)
22. McDuffie applied suprapubic pressure and Dr. Powderly
applied traction to the baby's head. The shoulder dislodged and
the baby was delivered with the next contraction. (McDuffie, at
20.) The baby was immediately handed over to Dr. Huey. (Id.)
Vaginal delivery occurred at 7:07 p.m. He weighed 12 pounds 4½ ounces. (Stip. 8, Jt. Pre-Trial
Order at 3.)
23. Shoulder dystocia occurs in approximately one out of 1,000
births without regard to fetal weight. (Quartell, at 27.)
Dystocia is a problem associated with vaginal delivery. There are
varying degrees of severity of dystocia. Mild to moderate
dystocia is resolved with suprapubic pressure. Shoulder dystocia
can lead to injury to the fetus, including, inter alia, injury
to the brachial plexus*fn10 resulting in Erbs palsy or
Klumke's palsy. Brachial plexus injuries can resolve
spontaneously over time as neurologic recovery occurs. (Diamond,
at 132, 144.)
24. During delivery, Campbell suffered a partial third-degree
laceration of the perineum right below the area of the
episiotomy. The laceration was properly repaired by Dr. Powderly.
(Soffer, at 128-29.) Partial third-degree lacerations commonly
occur in 20 to 30 percent of all deliveries. (Quartell, at 50.)
25. Upon discharge from Muhlenberg, PNHC's agents did not
prescribe stool softeners for Campbell. (Powderly, at 185.) When
a tear of the rectal mucosa or a complete laceration of the anal
sphincter (i.e., a complete third-degree or a fourth-degree
laceration) occurs during delivery, standard medical protocol
requires the patient to take stool softeners for seven to ten
days postpartum to protect the repair from breakdown. (Id.;
Quartell, at 59.) Campbell did not have that degree of
laceration, thus, stool softeners were not prescribed. Campbell
was given a laxative at the hospital and moved her bowels before
discharge without problem. (Campbell, at 72; Jt. Exh. 3, at 34.)
26. On July 28, 1999, the baby, Keven Davis, was x-rayed at
Muhlenberg and diagnosed with a dislocated right shoulder. (Stip. 4, Jt. Pre-Trial Order,
at 3.) Keven Davis was later diagnosed with a brachial plexus
injury resulting in a mild right Erbs palsy.
27. Defense expert, Martin Diamond, M.D., a specialist in
pediatric physiatry, testified that Keven's brachial plexus
injury was resolving to the extent that, upon examination,
Keven's ability to move seemed unimpaired and his wrist, hand and
finger movements were normal. (Diamond, at 151-56.) Dr. Diamond
further indicated that Keven's play skills were normal for his
age, that he was verbal and conversant with no evidence of other
developmental problems, that there was no indication that Keven
was in any pain or had any abnormalities in sensation that would
limit his ability to use his hands. Finally, Dr. Diamond
testified that no ongoing formal therapy or intervention is
necessary; simply performing normal childhood activities would
help to strengthen his muscles and develop coordination.
(Diamond, at 158-59.) The Court finds Dr. Diamond's testimony
credible and persuasive.
28. Keven was also diagnosed with a mild ptosis affecting his
right eye. A ptosis is a drooping of the eyelid.
29. Rudolph S. Wagner, M.D., a pediatric ophthalmologist,
testified for the defense that Keven has a slight ptosis of the
right eyelid which does not affect his vision or eye function in
any way. Keven's pupils are not unequal. No surgery is necessary
to correct the condition. Moreover, Dr. Wagner testified that the
origin of the majority of isolated findings of ptosis, like the
kind Keven has, cannot be determined, and is not necessarily a
result of shoulder dystocia during delivery. Dr. Wagner's
testimony on this point was credible and persuasive.
30. Campbell had her first post-partum visit at PNHC on August
10, 1999. At this time, she did not complain of hard stools, pain
in the perineal/rectal area, or fecal incontinence. (Jt. Exh. 1, at 9.) Upon examination, McDuffie found a small cystocele and
rectocele. (Jt. Pre-Trial Order at 16.) A rectocele is a
condition where the bottom of the vagina is herniated upwards, by
the forces of the rectum below. A cystocele is a similar
condition but the herniation occurs from the top of the vagina.
Both conditions can be associated with vaginal deliveries.
(Soffer, at 57.) They are common in women who have given birth.
(Jt. Exh. 1 at 9; Quartell, at 55-57.) Both conditions become
less pronounced within approximately one year after giving birth.
(Quartell, at 57.) Additionally, McDuffie observed during this
visit that Campbell's anal sphincter was "intact" with "good
rectal tone and control." (Jt. Exh. 1, at 9; McDuffie, at 23.)
There was no evidence of a breakdown of either the sutures or the
episiotomy. (Jt. Exh. 1, at 9; McDuffie, at 24.)
31. McDuffie saw Campbell again on September 13, 1999 for a
second post-partum visit. At this visit, Campbell complained of
some normal pelvic discomfort. (McDuffie, at 24.) McDuffie noted
in the chart that Campbell's menses had not resumed and that she
had not yet engaged in coitus. (Jt. Exh.1, at 8.) Campbell
requested birth control. (Id.) At this visit, Campbell did not
complain of hard stools, constipation, or fecal incontinence.
(Id.) McDuffie performed a digital examination of Campbell's
rectum. (McDuffie, at 25.) She found her rectal tone to be good.
(Id.) McDuffie advised Campbell to continue to do Kegel
exercises for six months and return for reevaluation in six
months. (Id. at 26; Jt. Exh. 1, at 8.) There was no evidence at
this point of a breakdown of the episiotomy or repair of the
laceration. (Jt. Exh. 1, at 8; McDuffie, at 26.) The Court
credits McDuffie's testimony on this point.
32. Campbell did not return to PNHC for a six-month check-up.
(Campbell, at 35.)
33. Instead, on March 30, 2000, approximately eight months
after delivery, Campbell saw Dr. Elrick A. Murray for complaints
of lower abdominal pain and pain with intercourse. (Campbell, at 79-80.) At this visit, Campbell did not complain of fecal
incontinence. Dr. Murray referred Campbell to a doctor at St.
Peter's University Hospital ("St. Peter's") for treatment of
vaginal vault prolapse. (Jt. Exh. 7.)
34. Campbell did not seek the referral appointment at St.
Peter's until August 10, 2000, more than one year after delivery.
On that date, Campbell was examined by Dr. Hatangadi. For the
first time Campbell complained of fecal incontinence, urinary
incontinence, and passing "gas through vagina." (Jt. Exh. 5, at
126; Soffer, at 146.) Dr. Hatangadi ultimately performed two
surgeries: a sphincterplasty, to repair the anal sphincter
muscle, and a colporraphy, to repair a rectocele.
CONCLUSIONS OF LAW
1. This Court has exclusive jurisdiction over this matter
pursuant to 28 U.S.C. § 1346(b).
2. Venue properly lies in this judicial district.
28 U.S.C. § 1391(b).
3. The parties have consented to my jurisdiction.
28 U.S.C. § 636(c).
4. This case arises under the Federal Tort Claims Act ("FTCA"),
28 U.S.C. §§ 2671-80, which provides in pertinent part that:
The United States shall be liable, respecting the
provisions of this title relating to tort claims, in
the same manner and to the same extent as a private
individual under like circumstances . . . for . . .
personal injury . . . caused by the negligent or
wrongful act or omission of any employee of the
Government while acting within the scope of his
office or employment, under circumstances where the
United States, if a private person, would be liable
to the claimant in accordance with the law of the
place where the act or omission occurred.
28 U.S.C. § 2674.
5. The alleged actions at issue in this case occurred in New
Jersey. Therefore, this Court applies New Jersey law to resolve the matter.
6. Campbell bears the burden of proving all of the elements of
her medical negligence claims. A claim for medical malpractice
and a claim for failure to obtain informed consent are "subgroups
of a broad claim of medical negligence." Howard v. Univ. of Med.
& Dentistry of N.J., 172 N.J. 537, 545 (2002).
7. To prove medical malpractice, Campbell must present expert
testimony to prove "(1) the applicable standard of care; (2) a
deviation from that standard of care; and (3) that the deviation
proximately caused the injury." Gardner v. Pawliw,
150 N.J. 359, 375 (1997). The proximate cause inquiry in the instant
situation where Campbell's claim is premised on a preexisting
condition, that being pregnancy, requires her to "demonstrate to
a reasonable degree of medical probability that the failure to
give the test increased the risk of harm from the preexistent
condition." Id. at 387.
8. "[T]o sustain a claim based on a lack of informed consent,
the patient must prove that the doctor withheld pertinent medical
information concerning the risks of the procedure or treatment,
and alternatives, or the potential results if the procedure or
treatment were not undertaken." Howard, 172 N.J. at 548. The
prima facie elements are "(1) the physician failed to comply
with the reasonably-prudent-patient standard for disclosure; (2)
the undisclosed risk occurred and harmed the plaintiff; (3) a
reasonable person under the circumstances would not have
consented and submitted to the [procedure] had she been so
informed; and (4) the [procedure] was a proximate cause of the
plaintiff's injuries." Howard, 172 N.J. at 549 (citations
omitted). The proximate causation inquiry of an informed consent
claim has two prongs: first, the patient must demonstrate that
the undisclosed risk actually materialized; second, that the
injury to patient resulted from treatment provided. Id. (citing
Canesi v. Wilson, 158 N.J. 490, 505-06 (1999)). 9. The objective "prudent patient" standard is defined as "all
material information that a prudent patient might find
significant for a determination of whether to undergo the
proposed therapy." Blazoski v. Cook, 346 N.J. Super. 256, 267
10. Not every risk need be disclosed. Id. at 268.
11. The test for determining whether a particular risk is
significant, and therefore must be disclosed, is whether the risk
is material to the patient's decision. Id. "A risk is deemed
`material' when a reasonable patient in what the physician knows
or should know to be the patient's position, would be likely to
attach significance to the risk or cluster of risks in deciding
whether to forego the proposed therapy or to submit to it." Id.
12. In according significance to a particular risk, no bright
line measure exists. Id. "Rather, whenever nondisclosure of a
particular risk is open to debate by reasonable-minded persons,"
the issue of the significance of the risk is one for the fact
13. The overwhelming evidence at trial demonstrated that
Defendants exercised proper medical judgment and did not deviate
from the accepted standard of care as it relates to the
measurement of fetal weight.*fn11 First, this Court finds
that a failure to order the ultrasound at any point during her
pregnancy was not medical malpractice. Based on the competent
evidence presented at trial, this Court finds that performing
Leopold's maneuvers to determine fetal weight was medically
acceptable and appropriate at this late stage of pregnancy.
14. As mentioned above, Dr. Quartell testified that there are
three methods for estimating fetal weight, none being more accurate than the other. Dr.
Quartell's testimony on this point was credible. Thus, the use of
Leopold's maneuvers in the fortieth week of gestation is at least
as accurate as ultrasound to measure fetal weight. Leopold's
maneuvers were performed here by multiple healthcare
professionals none of whom suspected a macrosomic baby as a
result of their examinations. Thus, the Court finds that
Defendants adhered to the applicable standard of care in their
use of Leopold's maneuvers to determine fetal weight;
consequently, Defendants did not deviate from the standard of
care when they proceeded to induction and a trial of labor based
on their estimations of fetal weight, rather than obtain a fourth
15. Furthermore, this Court finds that Campbell's claim for
informed consent fails as a matter of law. The overwhelming trial
evidence demonstrated that performing a c-section was not
medically indicated. Campbell has not met her burden to prove
that Defendants failed to disclose material risks to her in the
decision to proceed with a vaginal delivery.
16. The plan to induce Campbell and to proceed with a trial of
labor was consistent with the appropriate standard of care. Thus,
there was no need to discuss the option of performing an
ultrasound or a c-section.
17. Defendants estimated, based on their reasonable
examinations, that the fetus weighed between 8 and 9 pounds.
Thus, there was no duty to disclose risks associated with a
suspected macrosomic delivery.
18. Although the fetus was suspected to be large for
gestational age, the doctors and midwives who examined Campbell
on July 22, 1999 at PNHC for her final clinic visit, and again on
July 26, 1999 at Muhlenberg, mere hours before delivery,
reasonably believed that Campbell could succeed at labor based on
her prior vaginal delivery and her large, "proven" pelvis. 19. The healthcare professionals here were not responsible to
explain every conceivable risk associated with delivering a baby.
Rather, they were only obligated to disclose those risks that
were material to Campbell's decision to be induced and to attempt
labor. Campbell was thoroughly apprised of all material facts
associated with childbirth; she was apprised of her medical
treatment plan for the birth and she consented to it. The
disclosure was reasonable and appropriate under the
circumstances. This Court is satisfied, based on the overwhelming
trial evidence, that Defendants did not deviate from any accepted
standards of care by failing to disclose any material
20. Since this Court finds no deviation from accepted standards
of care in the failure to order an ultrasound or based on
informed consent, the Court does not reach the issue of
21. This Court also finds that Defendants did not deviate from
accepted standards of medical care by failing to prescribe stool
softeners for a partial third-degree laceration of the perineum.
22. Even if this Court were to find a deviation from accepted
medical standards related to stool softeners (it has not),
Campbell has failed to prove proximate causation. Campbell did
not complain of fecal incontinence, urinary incontinence, or
passing gas through her vagina at either of the two post-partum
examinations at PNHC in August and September 1999. Both of
Campbell's post-partum examinations at PNHC were normal. After
the September 1999 post-partum visit, Campbell never returned to
PNHC. This Court finds that Campbell has failed to prove any
causal connection between her alleged injuries, about which she
did not complain to any healthcare professional until more than
one year after the delivery, and Defendants' conduct.
23. Since this Court finds that there was no medical
malpractice by Defendants, it does not reach the issue of damages
as to Keven Davis. CONCLUSION
For the foregoing reasons, a judgment in favor of Defendant,
United States of America, and against Plaintiff, Shernett
Campbell, individually and as guardian ad litem of Keven Davis,
shall be entered. A Form of Order consistent with these Findings
of Fact and Conclusions of Law is attached.