In February 2015, plaintiff Lana Gleckman, 51, a student at an esthetics school in San Francisco, went to a medical convention that was occurring at a hotel in Squaw Valley. The convention was the 15th annual education seminar of the California Society of Facial Plastic Surgery, of which Dr. Corey Maas, a plastic surgeon, was president of the organization. The seminar was on procedures and how to best do them. Gleckman was previously the Northern California sales representative for Topix Pharmaceutical Co. During that time, in 2007, she periodically went to Maas’ clinic, The Maas Clinic in San Francisco, to sell pharmaceutical products used by facial plastic surgeons. When Gleckman heard about the seminar while she was at her school in February 2015, and heard that Maas was one of physicians setting up the convention, Gleckman decided to go to the convention with several other classmates. At the convention, Gleckman volunteered to be one of the “patients” for one of the procedures being demonstrated at the conference. The procedure involved the use of the Ulthera ultrasound device to raise her right eyebrow, as she had inequality in the height of her two eyebrows. Gleckman had previously undergone the Ultherapy procedure — a non-invasive procedure that uses advanced ultrasound technology administered through an interactive applicator to lift and tighten the neck, chin and brow, and improve lines and wrinkles on the chest — several times by her treating esthetician and expert witness. However, Gleckman claimed that during the demonstration at the conference, Maas’ office assistant, Teressa Luu, improperly/negligently used the Ulthera ultrasound device and wrongly performed the procedure, even though Maas and an Ulthera representative were present, and thereby caused a cataract in her right eye. Gleckman sued Maas and the manufacturer of the Ulthera ultrasound device, Ulthera Inc. (which was acquired by Merz North America). Gleckman alleged that Maas was liable for his staff’s negligent performance of the procedure and that this negligence constituted medical malpractice. Gleckman also alleged that Ulthera/Merz defectively manufactured the Ulthera device and that Maas was negligent for using the defective product. During pretrial negotiations, Gleckman dismissed Ulthera/Merz as a defendant, but maintained the second cause of action against Maas. However, Maas’ counsel filed a motion for summary judgment as to Maas’ involvement in the second cause of action, and the motion was granted by the court on July 5, 2017. The plaintiff’s treating esthetician testified that, according to the user manual and teaching techniques of Ulthera representatives, which she, herself, was for several years, Luu was negligent in the use of the Ulthera device. However, the treating esthetician admitted to having been friends with Gleckman for eight years, so defense counsel extensively contested the judge’s decision to allow the esthetician to testify as a standard of care expert witness. Maas denied that Luu improperly used the Ulthera device during the demonstrated procedure and testified that the procedure was performed correctly. He also denied that the Ulthera device was the cause of Gleckman’s cataract. Maas and Luu both testified that Maas taught Luu regarding the usage of the device and that Maas certified Luu’s abilities to use the device. Defense counsel read the deposition testimony of the defense’s national and international expert in facial plastic surgery, who was a consultant to Ulthera during the development of the device. According to the deposition testimony, the standard of care was not set forth in the Ulthera device’s user manuals or teaching techniques because the ultimate method for the use of the device was up to the physicians and their employees who used the device. The expert also opined that Maas and Luu followed the accepted standards of care., Gleckman claimed she suffered a traumatic cataract in her right eye. She alleged that she immediately believed that her eye had been injured during the procedure by ultrasound energy from the Ulthera ultrasound device entering her right eye and damaging the lens. After the demonstration, Maas looked into Gleckman’s eye, but Maas believed that the irritation was from mascara or the gel that was used on Gleckman’s forehead during the procedure. The next day, on Feb. 27, 2015, Gleckman went to the emergency room at Tahoe Forest Hospital, in Truckee, where Dr. Jeffery Camp, an ophthalmology consultant, diagnosed the problem in the right eye as a traumatic cataract. Camp opined that, based on the time of the occurrence, the injury was probably caused by the Ulthera ultrasound device used the night before during the demonstrated procedure. Gleckman was then seen by her treating cataract surgeon in San Francisco a few days later and ultimately underwent cataract surgery on March 25, 2015. During the surgery, Gleckman’s lens was removed and a new intraocular lens was replaced. Thus, Gleckman claimed, without any support from a current physician, that the vision in her right eye has been impaired. Gleckman had a bachelor’s degree from the University of California, Los Angeles; was married with children; and had worked for many years for companies in the beautification industry, including Ulthera. However, she claimed that she now continues to suffer from vision problems, such as blurriness, and that her condition could get worse. At the time of trial, in January 2018, Gleckman, 54, had gone back to school, this time to a different school (Santa Rosa Junior College), to get a degree in nursing. Thus, plaintiff’s counsel asked the jury to return over $650,000 in general damages for Gleckman’s vision problems. Defense counsel noted that while plaintiff’s counsel called Gleckman’s treating physician, Dr. Steven Cohen, as a causation expert to testify that the Ulthera ultrasound device was the cause of Gleckman’s cataract, the 72-year-old ophthalmologist, who was practicing part time in San Francisco, had not performed cataract surgery in over eight years and did not know anything about the Ulthera ultrasound device. In contrast, defense counsel called Dr. Neil Friedman, a Menlo Park ophthalmologist who was performing cataract surgery on a regular basis and had written in the ophthalmologic literature about cataracts. He also had a clinical teaching position at Stanford Medical School. The defense’s expert ophthalmologist explained to the jury about cataracts, including how they are formed and treated. Using a blow-up of the eye for demonstrative purposes, the expert opined that the position of the Ulthera device was too far away to have caused its energy to go into Gleckman’s eye. He also used photographs taken of Gleckman’s right eye to demonstrate the characteristics of the cataract and demonstrated that it was an “old cataract” and not a new, traumatic cataract. The cataract, according to the defense expert, had been present many months before Gleckman had the demonstrated procedure, but that it was not previously noticed by Gleckman, as is the situation with millions of people before they know they have a cataract. The defense’s plastic surgery expert also explained how the Ulthera device could not have caused the cataract in Gleckman’s right eye. Defense counsel noted that Gleckman claimed that she had been worrying about her vision for years since the March 26, 2015 cataract surgery, but that she never called an ophthalmologist and that she never returned to see either her cataract surgeon or her retinal specialist. As a result, defense counsel called Gleckman’s treating cataract surgeon as a witness. The surgeon testified that Gleckman’s cataract was removed from her right eye and that he could not determine the cause of the cataract. He also opined that Gleckman now has normal vision and that he did not anticipate Gleckman having any vision problems in the future. The surgeon further testified that although he asked Gleckman to return in a year, she never came back to see him. Defense counsel also called a retinal specialist who saw Gleckman only one time, on May 7, 2015, to testify as a witness. The retinal specialist testified that he evaluated the entire retina of Gleckman’s eye and could not see any evidence of an injury. He also claimed that he too asked Gleckman to return if she had any problems with her vision, but that she never returned.