At 4 years old, Alessandra Villalobos spends nearly all of her time confined to a bed. She is severely brain-damaged, can neither walk nor talk and is at the center of a medical malpractice lawsuit and a custody fight waged in two Nashville courts.

The child-custody case is complex because of the girl's extraordinary health conditions. Alessandra requires round-the-clock nursing care — the result, lawyers say, of a medical mishap when she was 3 that forever altered her life. If the lawsuit is successful, it could provide millions of dollars to cover the cost of her care.

But the battle over the child is complicated even more because her mother, Ingrid Diaz, is in the country illegally and facing deportation while her daughter was born in the U.S. and is an American citizen.

Diaz, who moved from Mexico to Nashville five years ago, says she wants to keep her child but is willing to relinquish custody if it's in her daughter's best interests.

"All I want is what's best for her, and if other people think that she should be with someone else, I'm willing to accept that, as long as it's best for Alessandra," the mother said last week, speaking through an interpreter.

A local nurse has been fighting for custody of Alessandra for the past seven months. The nurse, Amanda Stinnett, 50, of Nashville, once cared for the girl while Diaz was facing a drug charge that eventually was dismissed.

Stinnett first said she would comment for this story with permission from a lawyer appointed to represent the child but did not return follow-up phone calls seeking an interview.

A Nashville judge ordered the child removed from the mother's care and placed with Stinnett in March when Diaz faced eviction from her Nashville apartment because the rent was overdue.

The mother's lawyers say her immigration status has put her in the worst kind of Catch-22: If she doesn't work, she can't provide a home for her sick child and can't have custody. But if federal immigration officials, who are monitoring the mother, catch her working, Diaz risks being deported and losing her daughter forever.

Davidson County Probate Court Judge Randy Kennedy ordered the child removed from Diaz and placed with Stinnett after nurses said that they feared for Alessandra's safety. The electricity — vital for all the child's medical equipment — was in danger of being disconnected, and nurses reported roaches crawling on the child's bedroom wall and medical equipment.

"I was in Alessandra's room two days before (the child's removal), and I didn't see any roaches," Laura Stewart, one of the mother's lawyers, said.

Because the 24-year-old mother is in the country illegally, she's not entitled to public assistance. Her daughter, however, is an American citizen because she was born in Nashville.

Diaz initially lost custody of her daughter last year when she and the child's father were arrested on felony drug charges. The girl's father, Manuel Villalobos, pleaded guilty to selling drugs and has been deported to Mexico. Diaz denies any involvement with drugs and once her charge was dismissed, Nashville's Juvenile Court returned Alessandra to her custody.

Immigration officials have allowed Diaz to stay in the country while she fights for custody and awaits the result of a medical malpractice lawsuit filed against Vanderbilt University Medical Center. Hospital staff is accused of puncturing one of the child's veins, causing massive internal bleeding, shock and brain damage.

A hospital lawyer said a thorough review of the girl's treatment showed that complications from a serious medical condition, not malpractice, are to blame.

"We're strongly of the opinion that the care was entirely appropriate," Steve Anderson, one of the hospital's lawyers, said.

The case is in probate court to protect any money that may come to Alessandra as a result of the lawsuit.

Kennedy has postponed deciding the custody issue and given Diaz 90 days to find suitable housing. Another hearing is set for July 16 to review Diaz' housing and consider other custody issues.