A woman who has been in a vegetative state for several years after an accident gave birth in a Phoenix care facility this week, prompting several sexual assault investigations, a report says. The 20-year-old victim became comatose after a swimming accident and has for several years been a patient in the Hacienda Healthcare facility in Phoenix, Arizona, Fox 13 reported. The birth shocked staffers at the facility when they began hearing the comatose woman vocalizing groans and grunts as the birthing process began. Staffers told police they were completely unaware she was pregnant. The mother and her baby boy are being treated at Maricopa Medical Center, according to reports. The baby is healthy, doctors said. Phoenix Police surmised that the woman must have been raped by someone working at the facility because they are the only ones with such easy access. Hacienda Healthcare initially refused to comment on the incident, saying that an internal investigation is underway and that the company is cooperating with police. According to an interview with someone working at the facility, male staffers are now required to be accompanied by a female staffer when working with female patients, AZFamily reported. Dr. Greg Marchand told AZFamily that it is a miracle the baby lived and that there were no serious consequences for the comatose woman. After all, a woman in a vegetative state cannot help with the birthing process by pushing the baby out. “It could have been an active labor for hours or even days. This easily could have resulted in a fetal death,” the doctor said. On Friday, both the Arizona Department of Health Services and the Arizona Department of Economic Security said they would launch their own investigations into the shocking sexual assault. Arizona Gov. Doug Ducey also released a statement, noting that his office is aware of the situation and is following it closely. Ducey also pointed out that “records reveal that the Hacienda HealthCare facility has a checkered past.” As Gov. Ducey highlighted, Hacienda has received several citations, the last in 2017. In one case, an employee was fired for sexual impropriety with patients. The company released a long statement on Friday as the story began to go viral: Hacienda HealthCare has been in business in Arizona for more than 50 years. In that time, we have reliably and safely served thousands of residents and their families. We are proud of our record and our position as an industry leader in caring for the intellectually and developmentally disabled. With that said, we have recently become aware of a deeply disturbing incident involving the health and safety of a Hacienda resident. While federal and state privacy laws prohibit us from publicly discussing a patient’s health or case, Hacienda has and will continue to cooperate fully with law enforcement and all the relevant regulatory agencies regarding this matter. As an organization, Hacienda HealthCare stands fully committed to getting to the truth of what, for us, represents an unprecedented matter. We are already conducting a comprehensive internal review of our processes, protocols, and people to ensure that every single Hacienda resident is as safe and well cared for as possible. Anything less than that is unacceptable to our team, our company’s leaders and the communities we serve.” All investigations are ongoing. Follow Warner Todd Huston on Twitter @warnerthuston.<doc-sep>(CNN) — News of a woman in a vegetative state for more than a decade giving birth to a boy on December 29 has stirred emotions nationwide. The rare medical event raises many questions, including: How can a woman who is unconscious give birth? “It is very rare,” said Dr. Deborah Feldman, who has heard about “maybe two or three cases” in the past two decades. Feldman, director for maternal fetal medicine at Hartford HealthCare Medical Group, treated a woman 20 years ago who had a stroke that rendered her brain-dead during her second trimester and who went on to have the baby. Feldman has read about, but has no direct knowledge of, the Arizona case. The new case “speaks to the fact that the patient actually had largely normally functioning organs,” Feldman said. “I can say that, biologically, her body actually was functioning very well in order to grow a full-term baby.” Because she is the victim of sexual abuse, CNN is not reporting the name of the patient, who was in long-term care at a Phoenix medical facility. A person in a coma is unconscious, though breathing independently, for a prolonged period of time. If a coma continues, it is considered a “persistent vegetative state.” By contrast, a brain-dead patient is unconscious, has lost the capacity to breathe and requires mechanical respiration. Though it is unusual that no one noticed the Arizona patient’s pregnancy, many healthy women deliver babies with no prenatal care. “Most of the time, those babies are healthy and robust,” Feldman said. “Nature takes care of itself.” She believes the same will be true of the child in this case. “In a persistent vegetative state, your organs still work, and your fertility is still there,” she said. The risks in such cases would be poor fetal growth as well as all the usual risks of pregnancy found in healthy women, including diabetes and hypertension. “Patients who are not moving don’t really have any caloric expenditure, but they’re also not eating,” Feldman said. “My guess is that she probably had a feeding tube. That really helps with the nutritional support, and babies tend to grow well even with just that.” Unlike IV fluids, a feeding tube is surgically placed in the stomach instead of a vein and provides formula for a patient. When a patient is unconscious and unable to push, delivery is “very difficult,” Feldman said. “In most cases, we rely on medication to strengthen the contractions – so that would be oxytocin administered in an IV. That allows the contractions to be strong enough so the patient doesn’t have to do anything.” During the delivery, doctors would use forceps or a vacuum to assist. “Always, a c-section will be the easiest way to deliver the baby, but obviously that’s riskier for the mom because it is a surgical operation,” Feldman said. “The recovery would be essentially the same as for a normal patient, with probably slightly increased risk of infection.” “It’s hard to know” whether the woman knew that she was pregnant (or delivering a baby) or whether she experienced pain, Feldman said, without knowing the specifics of the woman’s brain injury. “I can tell you that to go through labor and deliver a baby with absolutely no analgesic is difficult, but I can’t speculate as to what this patient felt, if she felt any pain, if she knew it was happening,” Feldman said. “It’s so sad she had to endure that. It’s awful.” Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team. “I feel like every five to 10 years, this comes up somewhere in the country, and usually, I get an email or a call because someone sees the paper that I wrote,” said Feldman, who researched about 10 additional cases beyond her own patient. Thaddeus Mason Pope, director of the Health Law Institute at the Mitchell Hamline School of Law in Minnesota, wrote in an email that the case illustrates the issue of patient safety in long-term care. “Obviously, the biggest issue is the criminal battery that caused her impregnation,” said Pope, who has no direct knowledge of the Arizona woman’s case, as this was clearly not consensual sex.<doc-sep>In the 911 call, the nurse at Hacienda HealthCare repeatedly says staff members at the facility 'had no idea' the woman was pregnant 'The Baby's Turning Blue! ': Panicked 911 Call After Woman in Coma Gives Birth in Nursing Facility Phoenix police have released the 911 call from inside an Arizona nursing facility after a woman in a long-term vegetative state gave birth to a baby boy. On the audio, which was obtained by PEOPLE, a nurse at the long-term care facility run by Hacienda HealthCare expresses shock and fear that the child might not survive. Get push notifications with news, features and more. “The baby’s turning blue! The baby’s turning blue!,” the nurse says in the Dec. 29 call released by police investigating the birth to the 29-year-old mother as the result of a sexual assault. “One of the patients just had a baby and we had no idea she was pregnant,” the nurse frantically tells a paramedic on the line in the 5-minute, 15-second call. “And the mom is doing OK?” the paramedic asks. “We’re not sure, we had no idea this patient was pregnant,” the nurse replies. The records obtained by PEOPLE from Maricopa County Superior Court date back to a 2009 order that transferred guardianship of the woman from her biological father to her mother. According to the documents, the woman suffers from quadriplegia, recurrent pneumonia and a seizure disorder. The documents do not reveal what led to her condition. The facility described the assault as “deeply disturbing but unprecedented.” Gary Orman, the facility’s executive vice president, pledged to assist with the police investigation, which includes collecting DNA samples from male staffers who work at the facility. The company’s CEO resigned following reports of the birth. • Want to keep up with the latest crime coverage? Click here to get breaking crime news, ongoing trial coverage and details of intriguing unsolved cases in the True Crime Newsletter. In the 911 call, the nurse assures the paramedic that CPR is being performed on the newborn. The paramedic asks how far along the woman’s pregnancy was. “We have no idea,” the nurse says. “This is a complete surprise. We were not expecting this.” Moments later, after asking someone in the background if the baby has begun breathing, the nurse says with obvious relief, “Oh, the baby’s breathing. Oh my god, thank God.” The paramedic confirms he hears the sounds of a newborn crying in the background. “You guys did great, OK,” he says, before confirming that paramedics are “on the way.” John Micheaels, an attorney for the woman’s family, said in a statement to PEOPLE that they were “outraged and traumatized,” by the incident but added, “The family would like me to convey that the baby boy has been born into a loving family and will be well cared for.”<doc-sep>
911 call: We had no idea she was pregnant (CNN) — Police investigators have begun to gather DNA from men who work at an Arizona care facility where a woman in a vegetative state gave birth last month. Phoenix police Sgt. Tommy Thompson said Wednesday the woman and child, who was in medical distress after being delivered December 29, remain in the hospital. CNN is not reporting the woman’s name because she is the victim of sexual abuse. Detectives have asked men at the Hacienda HealthCare facility in Phoenix to give buccal swabs, Thompson said. Investigators got court orders for those who didn’t voluntarily give samples. There is no suspect, Thompson said. “The family obviously is outraged, traumatized and in shock by the abuse and neglect of their daughter at Hacienda HealthCare,” the family’s attorney, John Micheaels said. “The family would like me to convey that the baby boy has been born into a loving family and will be well cared for.” Thompson said the sexual assault investigation will take some time. “We’re not going to point out who we’ve obtained DNA from or who we intend to get DNA from,” he said. “But suffice it to say, it is a large number of individuals. We have a very wide scope at this point.” Detectives also served a search warrant Tuesday to gather records relevant to the ongoing investigation, he said. Thompson would not say whether people who visited the facility have also given DNA samples. Woman is a member of Apache tribe The woman is a member of the San Carlos Apache Tribe and has long been in a vegetative state, the tribe’s chairman said Tuesday. San Carlos Apache Tribe chairman Terry Rambler called for justice. “When you have a loved one committed to palliative care, when they are most vulnerable and dependent upon others, you trust their caretakers,” he said Tuesday. “Sadly, one of her caretakers was not to be trusted and took advantage of her.” The woman has been a patient at the facility since 1992, according to court records. CNN affiliate KPHO/KTVK had earlier reported she had been at the facility for at least a decade following a near-drowning incident, the Phoenix-based station quoted a source as saying. Facility: It is an ‘absolutely horrifying situation’ Hacienda officials have called the situation “a deeply disturbing incident” and said they are cooperating with law enforcement and state agencies. The company’s chief executive officer, Bill Timmons, resigned Monday. Hacienda “will accept nothing less than a full accounting of this absolutely horrifying situation, an unprecedented case that has devastated everyone involved, from the victim and her family to Hacienda staff at every level of our organization,” said Gary Orman, executive vice president of Hacienda HealthCare’s board of directors. Last week the state’s department of economic security sent investigators to the facility for health and safety checks. Spokesman Brett Bezio said the work was finished but didn’t give any details about the results of the visits with patients. The department of health ordered Hacienda to implement “heightened safety measures,” spokeswoman Melissa Blasius-Nuanez said. Thompson told reporters that changes apparently have been made. “At this point it is our understanding that steps have been taken to protect anybody that’s there, and that was one of our concerns from the beginning,” he said. This story has been updated to clarify the woman’s medical condition. She is in a vegetative state, not a coma. It has also been updated to give the correct number of years she has been a patient at the facility. CNN’s Sara Sidner reported from Phoenix. CNN’s Keith Allen and Steve Almasy reported and wrote from Atlanta. CNN’s Amanda Watts, Sheena Jones, Marlena Baldacci and Chris Boyette contributed to this report.