Florida Midwife Sizzly M. Auer Faces Severe Allegations of Newborn Injury, Professional Misconduct, and License Violations

A Florida-licensed midwife, Sizzly Maria Auer, is currently at the center of a grave administrative complaint filed by the Florida Department of Health, facing accusations of professional misconduct, negligence resulting in permanent injury to a newborn during a home birth, and multiple violations related to record-keeping and licensing. The allegations detail a harrowing November 2021 delivery that reportedly left infant Dylan Davis with severe, lifelong disabilities, stemming from Auer’s alleged failure to adhere to basic safety protocols and her use of excessive force during a critical medical emergency. This case underscores the profound responsibilities inherent in midwifery and raises significant questions about regulatory oversight and patient protection within the home birth community.

The administrative complaint outlines a series of alleged failures and violations that paint a troubling picture of the circumstances surrounding Dylan Davis’s birth. According to the state’s detailed account, Auer, who has been a licensed midwife since 2010, was overseeing the home birth of Victoria Vasser’s child when the labor encountered a formidable complication: shoulder dystocia. This obstetric emergency occurs when, after the baby’s head has been delivered, one or both of the baby’s shoulders become lodged behind the mother’s pubic bone, preventing further descent. It is a time-sensitive situation that demands immediate and skilled intervention to prevent serious injury or even death to the infant.

The Traumatic Home Birth: Allegations of Negligence and Excessive Force

The incident, which forms the core of the administrative complaint, occurred in November 2021, when Victoria Vasser, the expectant mother, was undergoing a planned home birth under Auer’s care. The initial stages of labor reportedly progressed, but complications arose when Dylan Davis’s head emerged, and his shoulders subsequently became impacted, signaling the onset of shoulder dystocia. This is a critical juncture in any delivery, whether in a hospital or home setting, where the expertise and adherence to established medical protocols are paramount.

According to the Florida Department of Health’s complaint, Auer allegedly deviated significantly from these recognized medical standards. Rather than employing one or more of the widely accepted maneuvers designed to resolve shoulder dystocia — techniques such as the McRoberts maneuver (hyperflexion of the mother’s hips), suprapubic pressure (pressure applied above the pubic bone to dislodge the anterior shoulder), or the Gaskin maneuver (all-fours position) — Auer is accused of failing to utilize any appropriate strategies to mitigate injury or facilitate delivery. The complaint specifically states that Auer "failed to employ one or more recognized maneuvers that could have released Infant D’s shoulder(s) and enabled Infant D to be born while mitigating injury."

Instead, the complaint alleges a far more aggressive and potentially damaging approach. Investigators claim that Auer repeatedly pulled on Dylan’s head and neck with what is described as "excessive and/or aggressive" force. The document further elaborates that Auer "pulled continuously and forcibly" with both hands in a persistent attempt to complete the delivery despite the ongoing obstruction. Such actions are highly contentious within the medical community, as excessive traction on an infant’s head and neck during shoulder dystocia is a known risk factor for brachial plexus injuries.

Adding to the gravity of the allegations, Auer is also accused of instructing Vasser to push during the shoulder dystocia. This instruction, as highlighted in the complaint, is contrary to established best practices. Medical guidelines generally advise against maternal pushing efforts during shoulder dystocia because it can exacerbate the impaction, potentially worsening the situation and increasing the risk of injury to the baby. The document explicitly states, "Licensed midwives should not instruct patients to ‘push’ during a shoulder dystocia."

The delivery took place in a birthing pool, a common feature of many home birth plans. The complaint introduces another alarming detail related to this setting: after Dylan’s head emerged and he reportedly gasped for air, Auer allegedly allowed his head to go back underwater. This scenario presents a significant danger, as it can lead to aspiration, where an infant inhales fluid into their lungs, potentially causing severe respiratory distress or other complications. After multiple attempts to resolve the situation in the water, the mother was moved to the floor, where the delivery was ultimately completed.

Devastating Consequences: A Lifetime of Injury

The infant, Dylan Davis, was born with severe injuries directly attributed to the traumatic delivery. The Florida Department of Health reports that the child suffered a "right global brachial plexus palsy due to trauma" sustained during birth. The brachial plexus is a network of nerves that originates in the spinal cord and extends through the neck into the arm, controlling movement and sensation. A brachial plexus palsy results from damage to these nerves. In Dylan’s case, the injury was described as "global," indicating damage to multiple or all nerve roots of the plexus, leading to significant impairment of the entire arm.

Subsequent medical evaluations and surgical interventions revealed the extent of the damage: multiple ruptures and avulsions of critical nerves. An avulsion is the most severe type of nerve damage, where the nerve root is torn completely from the spinal cord, often resulting in permanent loss of function in the affected muscles. Ruptures involve a tear in the nerve, but not from the spinal cord itself. These types of injuries are notoriously difficult to repair and often lead to lasting deficits. Despite undergoing multiple surgeries and requiring ongoing intensive treatment, medical professionals expect Dylan Davis to endure "permanent and severe deficits" in his right arm for the remainder of his life. This prognosis implies a future marked by limited mobility, strength, and sensation, profoundly impacting his daily life and development.

Understanding Shoulder Dystocia and Brachial Plexus Injuries

To fully grasp the gravity of the allegations against Auer, it’s essential to understand the medical context of shoulder dystocia and brachial plexus injuries. Shoulder dystocia is a relatively rare but highly unpredictable obstetric emergency, occurring in approximately 0.2% to 3% of all vaginal births. While certain risk factors exist (e.g., gestational diabetes, maternal obesity, post-term pregnancy, large fetal size), it can happen in any delivery, making preparedness crucial. The primary concern is the potential for fetal asphyxia due to compression of the umbilical cord within the birth canal and the risk of trauma, particularly to the brachial plexus.

Standard management protocols for shoulder dystocia emphasize a systematic approach, often summarized by mnemonics like "HELPERR" (Help, Episiotomy, Leg hyperflexion/McRoberts, Suprapubic pressure, Enter internal rotation/Wood’s Screw/Reverse Wood’s Screw, Remove posterior arm, Roll over/Gaskin). These maneuvers are designed to change the spatial relationship between the baby’s shoulders and the mother’s pelvis, ideally without applying excessive force to the baby’s head or neck. The failure to attempt these recognized maneuvers, as alleged against Auer, represents a significant departure from the standard of care.

Brachial plexus palsy, often referred to as Erb’s palsy or Klumpke’s palsy depending on the specific nerves affected, is a nerve injury that can range from mild stretching to complete tearing of the nerves. The incidence of birth-related brachial plexus injuries is estimated to be between 0.5 and 2.6 per 1,000 live births. While some mild cases may resolve spontaneously, more severe injuries involving ruptures or avulsions often result in permanent weakness, paralysis, or loss of sensation. The long-term implications can include contractures, limb length discrepancies, and chronic pain, requiring extensive physical therapy, occupational therapy, and potentially multiple surgeries throughout a person’s life. The type of injury sustained by Dylan Davis, involving multiple ruptures and avulsions, indicates a severe and likely permanent impairment.

Pattern of Professional Misconduct and Licensing Violations

Beyond the immediate circumstances of the delivery, the Florida Department of Health’s complaint details a pattern of alleged professional misconduct and licensing violations on Auer’s part, extending over several years. These allegations underscore a broader concern about her adherence to regulatory requirements designed to protect public safety and ensure accountability within the midwifery profession.

One significant area of concern involves Auer’s alleged failure to meet basic professional documentation requirements. The complaint asserts that she did not complete or maintain required informed consent forms, which are crucial for ensuring patients understand the risks and benefits of home birth. Furthermore, she allegedly failed to prepare an emergency care plan, a vital document outlining protocols for transferring a patient to a higher level of care should complications arise. Proper documentation of the care provided was also reportedly lacking, hindering any subsequent review or accountability.

Perhaps one of the most serious allegations pertains to Auer’s repeated misrepresentation of her licensure status over several years. The complaint states that on multiple license renewal applications, Auer falsely claimed she was not actively practicing midwifery in Florida. This designation is significant because it would exempt a midwife from the mandatory requirement to carry professional liability insurance. Between 2017 and 2023, the Department of Health alleges, Auer failed to provide proof of the required professional liability coverage while actively continuing to see patients and perform deliveries.

Professional liability insurance, also known as malpractice insurance, is a cornerstone of patient protection in healthcare. It provides financial coverage for claims of negligence or errors that result in patient injury. For high-risk professions like midwifery, especially in the context of home births where emergency medical resources are not immediately available, such insurance is critical. Its absence not only leaves patients vulnerable to uncompensated damages but also reflects a disregard for regulatory obligations intended to safeguard the public. The Florida Department of Health mandates this insurance precisely to ensure that victims of medical negligence have a means to seek redress for their injuries and associated costs.

The Administrative Complaint and Disciplinary Action

The administrative complaint filed by the Florida Department of Health serves as a formal initiation of disciplinary proceedings against Sizzly Maria Auer. The DOH, as the primary regulatory body for healthcare professionals in the state, is tasked with investigating allegations of misconduct, ensuring compliance with licensing laws, and protecting the health and safety of Floridians. The charges against Auer include unprofessional conduct, along with multiple recordkeeping and licensing violations.

The state is seeking comprehensive disciplinary action, which could encompass a range of severe penalties. These include the revocation or suspension of her midwife license, effectively barring her from practicing in Florida. Other potential penalties involve substantial fines, periods of probation with specific conditions, mandatory continuing education, or other restrictions deemed appropriate by the Department of Health to ensure public protection. Auer retains the right to contest these allegations, request a formal hearing, and present her defense, adhering to the due process established under Florida administrative law. The outcome of this administrative process will determine the future of her professional license and set a precedent for similar cases.

Prior Legal Action: A $12 Million Judgment Uncollectible

Adding another layer of complexity and frustration to Dylan Davis’s plight is the outcome of a prior civil lawsuit filed by his mother, Victoria Vasser, against Sizzly M. Auer. As reported by St. Petersburg, Florida, CBS affiliate WTSP, Vasser successfully obtained a $12 million judgment against Auer. However, this substantial judgment remains uncollectible due to Auer’s alleged failure to maintain professional liability insurance.

The civil lawsuit proceeded to a default judgment because Auer reportedly failed to respond to the complaint or appear for the legal proceedings. A default judgment is entered against a party who fails to defend themselves in court. While a legal victory for the victim, the absence of liability insurance has rendered the judgment largely symbolic. Victoria Vasser has publicly stated her inability to collect on the judgment, leaving her and Dylan Davis to bear the significant financial burden of the child’s lifelong medical care, therapies, and special needs without the compensation awarded by the court. This situation tragically highlights the critical importance of mandatory professional liability insurance for all healthcare providers, serving as a vital safety net for patients who suffer harm due to negligence. Without it, legal recourse can become a hollow victory.

Broader Implications for Home Birth Safety and Midwifery Practice

This case has profound implications for several stakeholders: the families choosing home births, the midwifery profession, and the regulatory bodies overseeing healthcare. For families, it serves as a stark reminder of the potential risks associated with home births, particularly when care providers allegedly fail to adhere to established safety protocols and professional standards. It underscores the necessity for thorough due diligence when selecting a midwife, including verifying licensure, checking for disciplinary actions, and confirming adequate professional liability insurance.

For the midwifery profession, cases like Auer’s can erode public trust, despite the vast majority of midwives being highly competent and dedicated professionals. It emphasizes the critical importance of self-regulation within the community, peer review, and adherence to evidence-based practice guidelines. The case also highlights the ethical and legal obligations of midwives to maintain proper documentation, informed consent, and emergency preparedness. Moreover, it reinforces the need for rigorous initial training, ongoing continuing education, and a culture of accountability to ensure patient safety remains paramount.

From a regulatory perspective, the allegations against Auer — particularly concerning the long-term misrepresentation of her licensure status to avoid insurance requirements — underscore the challenges in oversight. It may prompt a review of monitoring mechanisms and enforcement strategies to prevent such alleged circumventions of vital patient protection measures. The outcome of the Florida Department of Health’s administrative action will be closely watched, as it will signal the state’s commitment to upholding professional standards and protecting vulnerable patients.

The tragic injury to Dylan Davis and the subsequent difficulties in securing financial compensation also ignite a broader discussion about the balance between patient autonomy in birth choices and the robust regulatory oversight required to ensure safety. While home births are a legitimate option for many, especially those with low-risk pregnancies, this case serves as a powerful testament to the necessity of highly skilled, compliant, and accountable care providers, backed by appropriate legal and financial safeguards.

As the administrative proceedings unfold, Sizzly Maria Auer’s case will continue to draw attention to the critical responsibilities of healthcare professionals and the enduring need for stringent regulatory enforcement to protect patients from alleged negligence and misconduct. The lasting impact on Dylan Davis and his family serves as a poignant reminder of the human cost when these protections allegedly fail.