This case involves a 34-year-old overweight female with gestational diabetes. The patient was screened 10 weeks prior to delivery and it was discovered she had gestational diabetes. She was referred to a nutritionist and given a printout of a diet. The patient did not receive any additional follow-up to monitor her blood sugar levels following that visit. The patient went into labor at 34 weeks gestation. Prior to the delivery, the patient requested delivery by Cesarean section. She communicated this request to the nurse, but the nurse never communicated the request to the doctor because he felt it was not a necessary precaution. During delivery, the baby developed shoulder dystocia. The baby was delivered with a subgaleal hemorrhage and passed away a week later.