Why would a hospital with a licensed neonatal intensive care unit allegedly turn away an expectant mother in pain and just six months into her pregnancy?
That question is at the heart of a civil lawsuit recently filed in San Diego Superior Court against Sharp Grossmont Hospital in La Mesa that alleges wrongful death, medical negligence and infliction of emotional distress and seeks unspecified monetary damages.
The suit includes recordings of two emergency calls made on May 5, 2024, and obtained by Janna M. Trolia, the Santa Ana attorney representing Hannah Michaelis, 30, and her mother, Carla Michaelis of El Cajon, in the death of Samuel Vorenkamp, who was born weighing just 1.54 pounds in a vehicle parked just outside of Grossmont’s labor and delivery entrance on a Sunday afternoon.
According to the lawsuit, he died on May 10, 2024, at Sharp Mary Birch Hospital for Women and Newborns in Serra Mesa.
His death certificate, included in the legal filing as an exhibit, lists bleeding in the brain — an intracranial hemorrhage — as the immediate cause of death. The injury is listed as “non-traumatic,” meaning that it was not likely caused by an external force applied to the skull. Medical research shows that these injuries are more common in preterm babies, especially those born at least 10 weeks early, because a cluster of blood vessels in the brain called the germinal matrix is not yet fully developed, making it more fragile.
Delivery at 24 weeks is considered to be the edge of viability by the American College of Obstetricians and Gynecologists. According to the national standards-setting body, neonatal survival “to discharge,” meaning the point at which babies are sent home from the hospital, is between 42% and 59% at 24 weeks of gestation.
Carla Michaelis said her daughter is too distraught to discuss what transpired on that day. But in an interview last week, she recounted the events leading up to the death of her grandson. She said her daughter visited Grossmont three times in four days with concerning abdominal tightness and what she described as flank pain just as her pregnancy reached the 24-week mark, a full term still three months away.
“It’s her first pregnancy, so all I could think of was, well, maybe, if she’s worried and doesn’t feel right, because she’s a pretty tough girl, then I’m going to have her checked,” Michaelis said.
In fact, the lawsuit states that a visit just one day earlier for “cramping and pain” had turned up no definitive cause. Before discharging her home, doctors recommended that she should be examined by her regular doctor, whose office was near a UC San Diego Health facility, Michaelis said.
But when the pain came back stronger on Sunday, mother and daughter went back to the Grossmont hospital, following what it said on the discharge papers from the previous day’s visit to go to the closest emergency department if her condition worsened.
Emergency personnel, Michaelis said, seemed to agree that an examination was necessary, but agreed that it would be faster for mother and daughter to drive to Grossmont’s labor and delivery entrance, given that it was on the other side of the large medical complex and driving could be faster than being pushed through hallways to the destination.
The lawsuit accuses Grossmont of denying “Hannah entry to the hospital and refused to provide medical care despite Carla’s repeated pleas on her daughter’s behalf,” stating that “medical intervention was only provided after baby Samuel was born spontaneously while Hannah remained in her car and was then moved to a wheelchair.”
After parking, Michaelis said she entered the building, moving to the nursing station.
“I was pleading with them,” Carla Michaelis said. “I said, ‘I need your help. My daughter’s in the car, and she’s in extreme pain. I need someone to come out and help.’
“And the nurse said, ‘well, how far along is she?’ and I said, ‘she’s 24 weeks.’ She said, ‘we can’t help you here, you need to go somewhere else.’”
Frustrated, she said she ran back out to the car, pulling out her cellphone to dial 911.
A digital recording of that call, obtained by the family’s legal representation, is not only referenced, but an online link to the file also appears in the lawsuit’s text:
“She’s six months pregnant, and she’s having excruciating pain,” Michaelis told the dispatcher. “They said they can’t really see her here because, if she is in labor … they can’t take care of it, so they told me to take her to UCSD.
“I can’t drive her to UCSD, she’s in excruciating pain. She’s screaming.”
“Okay ma’am … I just want to confirm you’re at the hospital,” the dispatcher replied.
“Currently, I am,” Michaelis said. “I’m outside the Sharp Grossmont Hospital for Women and Newborns.”
“Okay, unfortunately, the fire department, if you’re at the hospital, we don’t respond to the hospital to take you to a different hospital,” the dispatcher said.
A second recording, also provided in the lawsuit, documents a conversation between dispatch and an unidentified hospital employee.
“I just had a mother call in, I guess she has her daughter; are you guys with her?” the dispatcher asks. “I don’t know what happened.”
“It’s, I don’t know, she’s yelling and screaming,” the hospital employee said. “I have a nurse going out to her car right now.
“She was told to go to UCSD yesterday if she had any further complications, and she just kind of stormed out that she was going to call 911, and I was like, no, they’re not going to take you to another hospital anyway.”
With no resolution forthcoming after these conversations, Michaelis said she re-entered the hospital and demanded that someone get a wheelchair and bring her daughter inside.
But what she found when she got back outside was even more worrisome.
“Her water had broken and there was blood all over the seat, you know, like amniotic fluid,” she said, recalling what Hannah said in that moment. “She goes, ‘but something else is wrong, I put my hand in my pants and I could feel his arms and legs.’”
But when this information was relayed to the hospital worker who came outside, Michaelis said that it was dismissed.
“She rolled her eyes (and said) ‘there’s no baby yet, it’s just her water broke,’” Michaelis said. “She didn’t check her, she just moved her from the front seat of the car into the wheelchair with the baby in her inner shorts and wheeled her back into the hospital and took her into a room.”
Once in the room, she said, nurses discovered how far along the delivery actually was.
“I followed behind, and when I got there, they had pulled the baby out of her pants and they were holding him up and he was moving and breathing and making little baby noises,” she said.
But after leaving the room to collect herself, Michaelis said a transfer team from Sharp Mary Birch Hospital for Women and Newborns, a facility with an 84-bed neonatal intensive care unit and one of the largest delivery hospitals in the nation, came and transferred Samuel from Grossmont to the facility in Serra Mesa.
It was only later that mother and grandmother were able to see and hold Samuel, discovering that his tiny body had been heavily bruised during delivery. It was not clear why the worker in the Grossmont labor and delivery unit discussed mother and daughter going to UC San Diego for care, though Hannah, Carla said, did tell hospital workers that she received prenatal care at a doctor’s office across the street from a UCSD hospital during her visit on May 4.
Sharp issued a short statement when asked about the case.
“Sharp caregivers are committed to providing high-quality care to all patients. While we cannot comment on cases in litigation, Sharp has found that often, when patient incidents are publicly reported, the timeline and information differ from what actually occurred. We cannot offer any additional details about the case at this time. Our hearts go out to this family, and all families, when any life is lost.”
Michaelis said her daughter lives in rural Tennessee. With the nearest doctor’s office at least a half-hour away from home, she said she told Hannah to come out to San Diego, where major medical resources are closer.
“I begged her to come to San Diego so she’d have good medical care,” she said. “… so I kind of feel like I kind of dropped the ball.”
Hospitals have obligations under federal law when patients arrive in distress.
The Emergency Medical Treatment & Labor Act of 1986 (EMTALA), requires all hospitals providing emergency services and that participate in Medicare, the health insurance program for Americans age 65 and older, “to provide a medical screening examination when a request is made for examination or treatment for an emergency medical condition, including active labor, regardless of an individual’s ability to pay.” Hospitals must stabilize patients before transferring them to other facilities.
At issue is whether Grossmont’s response, which did include both admission and transfer to Mary Birch, just not quickly enough to prevent the birth outside the hospital, was enough to meet the standard. The case is scheduled for a case management conference on Oct. 3.