## Facts

- Julia Burgess received prenatal and labor-and-delivery care from obstetrician Narendra Gupta, M.D., at a hospital in Los Angeles County.
- On February 26, 1988, during labor, Gupta artificially ruptured Burgess’s membranes and soon diagnosed a prolapsed umbilical cord, prompting emergency preparations for a cesarean section.
- Approximately 21 minutes elapsed between the diagnosis and Burgess being taken for emergency surgery; during that interval, Burgess heard statements indicating fetal oxygen deprivation.
- Burgess underwent a cesarean section under general anesthesia and was later informed that something was wrong with her baby; she was given additional sedatives.
- The infant suffered substantial oxygen deprivation resulting in permanent brain and nervous system damage; Burgess learned of the extent of the injuries after she awoke and was no longer sedated.
- Burgess sued Gupta and others for malpractice and asserted a personal claim for negligent infliction of emotional distress (NIED) based on the delivery-related negligence and resulting injury to her child.

## Issues

1. Whether a mother whose physician allegedly commits obstetrical malpractice that injures the fetus/infant may pursue NIED as a “direct victim,” rather than being limited by the bystander requirements of *Thing v. La Chusa*.
2. Whether a physician’s duty arising from the physician–patient relationship with the mother includes a duty whose breach can support the mother’s recovery for emotional distress when negligent care during labor and delivery injures the child.
3. Whether, and to what extent, emotional-distress damages are limited to distress proximately caused by the negligent delivery itself, as opposed to later distress associated with living with the child’s impairments or the child’s death.

## Decision

- The California Supreme Court held that Burgess could pursue emotional-distress damages as a direct victim because the alleged malpractice breached a duty owed to her within the physician–patient relationship.
- The Court ruled that the trial court erred by treating Burgess as a bystander and applying *Thing*’s restrictive bystander criteria to bar her claim.
- The Court affirmed issuance of writ relief allowing Burgess’s NIED claim to proceed on a direct-victim theory.
- The Court limited recoverable emotional-distress damages, excluding damages for loss of affection, society, companionship, or similar harms associated with adjusting to the child’s impairments.

## Legal Principles

- NIED liability may be based on a “direct victim” theory when emotional distress is a foreseeable result of a breach of duty owed directly to the plaintiff, including duties arising from a preexisting professional relationship.
- *Thing v. La Chusa* governs “bystander” NIED claims (emotional distress from perceiving injury to another) and does not restrict direct-victim claims grounded in a duty owed to the plaintiff.
- In obstetrical care, a physician’s duty to the mother encompasses the labor-and-delivery process and foreseeably includes the mother’s emotional well-being when negligent care during delivery injures the fetus/infant.
- A mother may recover emotional-distress damages proximately caused by negligent conduct during labor and delivery, but may not recover NIED damages for subsequent loss-of-companionship-type harms associated with the child’s long-term impairments.

## Conclusion

Because the alleged negligent delivery breached duties owed to the mother within the physician–patient relationship, the mother was a direct victim and could pursue NIED without satisfying *Thing*’s bystander requirements, although her recoverable emotional-distress damages were limited to distress proximately caused by the negligent delivery and excluded loss-of-companionship-type harms from later adjustment to the child’s impairments.


Burgess v. Superior Court, 2 Cal. 4th 1064 (Cal. 1992)