A critically ill newborn at the centre of a bitter surrogacy custody dispute has been placed back on a breathing tube after his condition worsened following open-heart surgery, according to court filings. The case, playing out in a Dallas courtroom, pits intended parents Nausheen Gilkar and Omar Ahmed against surrogate McKenna West, who is seeking sole conservatorship over the child after alleging the couple earlier asked her to terminate the pregnancy when a severe heart defect was diagnosed. The dispute has drawn national attention as a flashpoint in debates over surrogacy agreements and medical decision-making for critically ill infants.

The baby, whom the parents call Rumi and West calls Gabriel, was diagnosed at around 20 weeks with hypoplastic left heart syndrome, a condition that leaves one side of the heart underdeveloped and can be fatal without treatment. He underwent a Norwood procedure, the first of three open-heart surgeries typically used to treat the condition, on 17 August, but has since struggled to breathe, needed a blood transfusion and required re-intubation. Gilkar and Ahmed dispute West's account, saying they consented to the surgery, while West has said she would drop her custody claim if satisfied the couple remain committed to the child's life-saving care; the couple are also pursuing a separate $100,000-plus counterclaim against West alleging breach of their surrogacy agreement.