On Jan. 28, 2011, plaintiff Minoo Sohaey, 68, a homemaker who also worked in her husband’s medical practice, presented to Dr. Scott Carstens, a rheumatologist, at his office in San Diego and received a Synvisc injection to her left knee. Sohaey, who had a lengthy history of osteoarthritis in both knees, claimed she subsequently developed a left knee infection (streptococcus viridans), requiring her to undergo two wash-out procedures and IV antibiotics. Sohaey sued Carstens. She alleged that the defendant’s negligent treatment caused her knee infection and that this negligence constituted medical malpractice. Sohaey claimed that Carstens failed to use a sterile technique when performing the injection by either contaminating the needle or failing to properly remove bacteria from the skin during his sterile preparation. She also claimed the infection, a streptococcus viridans bacterium that is generally mouth borne, is almost impossible to occur in a knee if a sterile technique is used. Thus, she maintained that because this type of incident did not ordinarily occur unless someone was negligent, then it follows that Carstens was negligent. Sohaey further claimed that she should have been started on antibiotics three days earlier, when her first culture results showed the rare strep bacteria. Carstens maintained that infections are a well-recognized risk of any interventional medical procedure. He claimed that while steps are taken to minimize the risk of infection, one can never completely eliminate the risk, and infections can and do occur despite a physician’s best efforts. Carstens further claimed that he documented his use of sterile preparation, and that he appropriately ordered the necessary follow-up tests to determine whether or not the strep bacteria was a contaminate or pathogen. In addition, he maintained that because of his thorough follow-up care, Sohaey received the appropriate treatment she needed, once a diagnosis was made., Sohaey claimed she developed streptococcus viridans bacteria in her left knee after receiving the Synvisc injection from Carstens. As a result, Sohaey required two wash-out procedures and IV antibiotics. Sohaey claimed she still experiences residual left knee pain, and that the infection caused her to miss a planned trip to Antarctica. Thus, she sought recovery of $35,593.04 in past medical costs, $1,131.41 in co-payments, $1,000 in her missed vacation expenses, and $7,725.75 in household/gardener expenses. Plaintiff’s counsel subsequently asked the jury to award Sohaey roughly $285,000 in total damages, when factoring in Sohaey’s pain and suffering. Defense counsel noted that Sohaey was a candidate for a total left knee replacement pre- and post-infection. Thus, the defense’s infectious disease expert testified that even if Sohaey’s diagnosis was made three days earlier, her treatment and outcome would have remained the same.