On March 14, 2018, plaintiff Nicholas Merlo, 39, a loan officer, underwent an esophagogastroduodenoscopy: endoscopic exploration of the esophagus, stomach and small intestine. The procedure was performed by a gastroenterologist, Dr. Pralahad Jajodia, at Pristine Surgery Center, in Fresno. During the procedure, a certified registered nursing anesthetist, Simranjit Singh Bassi, reported that Merlo’s oxygen saturation had declined. He terminated the procedure, administered oxygen and medication, and intubated Merlo. An ambulance was summoned. Bassi subsequently administered a muscle relaxant, rocuronium, that completely paralyzed Merlo. An ambulance, staffed by a paramedic, Brina Portillo, and an emergency medical technician, Ashley Bowman, arrived. Portillo and Bowman summoned another ambulance to assist in transferring Merlo to a gurney. The second ambulance was staffed by a paramedic, Allison Freer, another paramedic, Katherine Schneider, and an emergency medical technician. Jajodia told the ambulance crew to transport Merlo to Clovis Community Medical Center, in Clovis, where Jajodia had privileges. Bowman drove the ambulance, and Freer, Portillo and Schneider rode in the back to monitor Merlo. They detected a loss of the left lung’s function, so they decided to extubate and re-intubate. They were not able to perform the re-inutbation. Upon arrival at Clovis Community Medical Center, Merlo suffered cardiac arrest caused by a lack of oxygen. He suffers permanent residual damage of his brain. Merlo’s wife, Kaci Merlo, acting as her husband’s conservator and guardian ad litem, sued Pristine Surgery Center’s operator, Pristine Surgery Center Inc.; Jajodia; Bassi; Bassi’s employer, Regional Anesthesia Associates; Portillo; Freer; Bowman; Schneider; and the ambulances’ operator, American Ambulance. The lawsuit alleged that Jajodia and Bassi failed to properly treat Nicholas Merlo, that their failure constituted malpractice, and that Portillo, Freer, Bowman and Schneider were grossly negligent in their care and treatment of Merlo. The lawsuit further alleged that Pristine Surgery Center Inc. was vicariously liable for Jajodia’s actions, that Regional Anesthesia Associates was vicariously liable for Bassi’s actions, and that American Ambulance was vicariously liable for the actions of Portillo, Freer, Bowman and Schneider. Bowman, Jajodia, Pristine Surgery Center Inc. and Regional Anesthesia Associates were dismissed. The matter proceeded against Bassi, Portillo, Freer, Schneider and American Ambulance. Plaintiffs’ counsel argued that Bassi was negligent for beginning a cascade of events by failing to adequately sedate Nicholas Merlo and failing to travel with him in the ambulance to the hospital. Plaintiffs’ counsel also argued that Portillo, Freer and Schneider were grossly negligent for failing to contact the base hospital and for pulling Merlo’s endotracheal tube in the ambulance. Plaintiff’s counsel contended that the paramedics were also grossly negligent for not contacting Clovis Community Medical Center before extubating Merlo; for failing to use a proper monitor during their re-intubation attempts; for failing to assess Merlo’s airway; for accepting the destination decision from Jajodia, rather than taking Merlo to the closest hospital; and for waiting for the second ambulance. Plaintiffs’ counsel further contended that if the paramedics felt the tube placement was not good, then they were grossly negligent for taking Merlo in the ambulance and for not asking Bassi for assistance. Bassi contended that he had properly placed the endotracheal tube and that the paramedics were grossly negligent for removing the endotracheal tube while Merlo was in the ambulance being transported to the hospital. Counsel for American Ambulance and its employees argued that American Ambulance’s employees were properly trained, were not grossly negligent, and acted in accordance with their training. Counsel contended that Bassi initially placed the breathing tube incorrectly, and American Ambulance’s personnel claimed that there was some conversation regarding whether the endotracheal tube that had been placed was a "good tube" or had "good placement." However, Bassi denied that those conversations occurred, and he testified that Merlo was hemodynamically stable for transport to the hospital when he left the surgery center. The three paramedics testified that while they were in transit, Merlo’s oxygen saturation levels dropped to levels that were inconsistent with what was documented in the ambulance record. Portillo, who was responsible for accurately recording the events as they occurred in the back of the ambulance, testified that the ambulance record she created contained 15 errors or mistakes that were never corrected or told to American Ambulance. Counsel of American Ambulance and its personnel further argued that the emergency room physician at Clovis Community Medical Center, Dr. Eric Graham, was negligent for not intubating Merlo quickly enough when Merlo arrived at the emergency room. Although Graham was not a defendant, he was included on the verdict form as an "other nonparty" at the request of American Ambulance’s counsel., Merlo suffered a hypoxic brain injury. He also suffered a cardiac arrest. Merlo exists in a permanent vegetative state. Kaci Merlo sought recovery of her husband’s past and future medical expenses, damages for his past and future loss of earnings, and damages for his past and future pain and suffering. Kaci Merlo, who was 8.5 months pregnant at the time she took her husband to the surgery center, also sought recovery for the loss of her husband’s love, companionship, comfort, care, assistance, protection, affection, society, moral support, enjoyment of sexual relations, and ability to have children.