This case involves a two-day-old male who developed neonatal respiratory distress syndrome shortly after birth. The boy was born prematurely at thirty-two weeks gestation. The mother was concerned about the early delivery but her physician reassured her that the baby was in good health. Shortly after delivery, the child showed signs of breathing difficulties evidenced by tachypnea, tachycardia, chest wall retractions, grunting, and nasal flaring. An x-ray was taken which showed a uniform infiltrate with a ground-glass appearance. The child was diagnosed with neonatal respiratory distress syndrome secondary to poor lung development as a consequence of prematurity. During the pregnancy, a lecithin-to-sphingomyelin ratio (LS ratio) was never ordered. The child now required continuous positive airway pressure (CPAP) and intravenous fluids. Even after these therapies were initiated, the child still showed signs of breathing difficulties. This required the placement of an endotracheal tube to assist with respirations. An artificial surfactant was also administered to the child and a one-month hospitalization was warranted. Upon discharge, the mother was told that the child developed bronchopulmonary dysplasia as a consequence of his condition. The finding was supported by inflammation and scarring of the child’s lungs. During the following months, the child’s pediatrician expressed concern that the child did not properly develop. Normal pulmonary functioning in the child was also never fully restored.