Construction of the San Bernardino County Medical Center was halted because eight endangered Delhi Sands Flies were "believed to occupy the site." After a year's delay, an additional $3.3 million in expenses, and numerous negotiations with the U.S. Fish and Wildlife Service and the California Department of Fish and Game, the facility was redesigned and relocated to provide almost two acres of protected habitat for the insects. The cost per fly came to $413,774.25, approximately what it costs to treat 494 inpatients or 23,644 outpatients at the medical center.

The Fish and Wildlife Service initially demanded that the county set aside the entire 68-acre hospital site as a fly preserve. One official even demanded that Interstate 10, a heavily trafficked eight-lane highway, be shut down—or at least that the speed limit be reduced to 15 m.p.h. during August and September, when the fly is past its pupae stage, airborne, and in danger of ending up on a car's windshield. When Robert H. Gerdeman, a county representative, balked at these demands, the official threatened to arrest him and fine him $25,000, according to his sworn affidavit.

Eventually the county sued the federal government following a dispute involving improvements to a nearby intersection to allow increased emergency access to the hospital. The county argued that the land-use restrictions to protect the fly were unconstitutional, falling far outside Congress's authority to regulate interstate commerce. But U.S. District Judge Ricardo M. Urbina ruled in favor of the federal government. "The government has offered uncontroverted evidence that the Fly is, and would likely continue to be, an article in interstate commerce," Judge Urbina wrote. As evidence, the government showed that a total of five Delhi Sands flies legally entered the stream of interstate commerce before the fly was protected under the Endangered Species Act. At the time, the flies sold for an average of $2 each.

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