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A Florida Department of Health complaint accuses a licensed midwife of using excessive force during a November 2021 home birth, leaving the newborn with permanent nerve damage. The case raises new questions about safety in unattended deliveries, midwife oversight, and the limits of civil recovery when practitioners lack liability insurance.
The complaint names Sizzly Maria Auer, licensed in Florida since 2010, and ties multiple alleged professional failings to the delivery of infant Dylan Davis in a family home. Authorities contend those missteps — described in newly filed administrative papers — produced lifelong harm to the child and exposed gaps in recordkeeping and licensure compliance.
What the state alleges
According to the Department of Health filing, the labor was complicated by shoulder dystocia, a situation where a baby’s shoulders become lodged after the head is delivered. The complaint says Auer did not use recognized techniques to free the infant’s shoulder and instead applied repeated, forceful traction to the newborn’s head and neck while the birth was underway.
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Investigators additionally contend the midwife advised the mother to push during the obstruction — an action the complaint links to worsening the entrapment — and allowed the newborn’s head to be submerged in the birth pool after it emerged and the infant gasped for air. The delivery was later completed on the floor of the home.
The child was later diagnosed with a severe nerve injury described by the state as a right global brachial plexus palsy. Surgical reports included multiple nerve ruptures and avulsions, injuries in which nerve roots are torn from the spinal cord; the Department of Health says the result will be “permanent and severe deficits” in the affected arm.
Alleged administrative and licensing breaches
Beyond the events of the labor and delivery, the complaint lists several professional shortcomings tied to Auer’s practice:
- Failure to create or retain required informed consent documentation and an emergency care plan.
- Incomplete or insufficient clinical records for the prenatal, intrapartum, and postnatal care provided.
- Repeated assertions on licensing renewals that she was not actively practicing in Florida — a classification that can affect the obligation to carry professional liability coverage — despite evidence of ongoing patient care and deliveries.
- Not producing proof of required liability insurance for multiple renewal cycles between 2017 and 2023.
The state is pursuing disciplinary measures that could include license suspension or revocation, fines, probationary conditions, or other administrative penalties. Auer has the statutory right to contest the allegations and request a hearing before any sanctions are imposed.
Legal and practical stakes
The administrative action arrives after a separate civil case ended in a default judgment against Auer for $12 million, according to the victim’s family and local reporting. The family says the judgment has not produced compensation because the practitioner lacked professional liability insurance at the time, underscoring a financial barrier that can leave injured families without recourse even after winning in court.
For regulators and families, the case highlights two intersecting concerns: clinical practice during obstetric emergencies and the administrative systems that govern midwifery licensing. Advocates of out-of-hospital birth point to autonomy and continuity of care; regulators emphasize that certain complications require rapid, evidence-based interventions and clear documentation to protect patients.
Why this matters now
As home births and midwifery care remain part of the broader maternity-care landscape, this complaint is part of a broader policy conversation about when and how out-of-hospital models should be allowed to operate independently. The allegations here — if upheld — illustrate how clinical decisions, missing paperwork and gaps in insurance coverage can combine to produce devastating outcomes for families and complex enforcement challenges for state agencies.
For parents considering birth setting options, the case underscores practical steps to discuss with any care provider: what emergency protocols they follow, how they document informed consent and contingency plans, and whether they maintain active malpractice coverage. For policymakers, it raises questions about monitoring, reporting and safeguards that could prevent similar injuries.
State officials say the complaint is under administrative review; no final disciplinary action has been announced.
