On Aug. 18, 2014, plaintiff Robbie Parker, 40, a correctional officer for the California Department of Corrections and Rehabilitation, visited the emergency department of Bakersfield Memorial Hospital, in Bakersfield. He presented complaints of severe abdominal pain that had commenced one evening earlier. Parker underwent a subtotal colectomy at USC Norris Comprehensive Cancer Center and Hospital, in Los Angeles, on July 17, 2014, because of multiple abnormal polyps found in his large bowel. The procedure was performed by Dr. Kyle Cologne, a general surgeon. When Parker was determined to be doing well postoperatively, he was discharged home. When Parker presented to Bakersfield Memorial Hospital on Aug. 18, 2014, an emergency room physician performed a CT scan of Parker’s abdomen and pelvis, and suspected a perforated viscous, including a possible leak at the site of the anastomosis, which was done during the surgery 30 days earlier at USC. The emergency room doctor contacted Dr. Roland Rodriguez, a general surgeon, and Parker went to surgery that evening. The exploratory surgery was negative, meaning that no perforation could be found. However, Rodriguez could not visualize the site of the previous anastomosis because of scar tissue, inflammation, adhesions and loops of small bowel. As a result, he ordered that a gastrografin enema be performed the following morning to confirm the integrity of the anastomosis, since the absence of findings during the surgery did not cause him to suspect an actual leak at the anastomotic site, despite the fact that it could not be visualized during the surgery in question. Parker declined to undergo the gastrografin enema the following day and likewise declined to undergo the gastrografin enema on Aug. 20, 2014. During that two-day period, Parker’s vital signs were improving and his white count was decreasing, which tended to reinforce the idea that Parker may not have had an anastomotic leak at all and that the CT scan may have been misread by the interpreting radiologist, or alternatively, that the anastomotic leak had spontaneously sealed and that Parker might not need surgical intervention after all. However, on the morning of Aug. 21, 2014, Parker’s white count increased to more than 30,000, and his pulse rate remained tachycardic in the 130s and higher. That time, the hospitalist was able to successfully convince Parker to undergo a gastrografin enema, which was interpreted to show the presence of a leak at the site of the anastomosis. Parker underwent surgery that afternoon, during which Rodriguez resected the anastomosis and placed an ileostomy stoma. In the late evening hours of Aug. 21, 2014, Parker lost kidney function, liver function and developed respiratory problems consistent with septic shock. Two code blues were called, and Parker was resuscitated successfully each time. Parker was then discharged from Bakersfield Memorial Hospital on Sept. 12, 2014, but he was readmitted to Keck Hospital of USC, in Los Angeles, on Sept. 18, 2014, and he remained hospitalized there for rehabilitation through Oct. 2, 2014. Ultimately, Cologne took down Parker’s stoma in July 2015. Parker sued Rodriguez; Cologne; the operator of USC Norris Comprehensive Cancer Center and Keck School of Medicine of USC, USC; the operator of Bakersfield Memorial Hospital, Dignity Health; and several other physicians and entities. Parker alleged that the defendants failed to appropriately and timely treat his condition and that their failure constituted medical malpractice. Parker settled with multiple defendants before trial, and the matter continued against Rodriguez only. Parker’s counsel contended that Rodriguez should have dissected down to the site of the anastomosis during the surgery on Aug. 18, 2014. Alternatively, counsel contended that Rodriguez should have obtained an intraoperative gastrografin enema or performed an “air-leak test” during surgery, which would have allegedly been positive, thereby proving an anastomotic leak. Plaintiff’s counsel further contended that had the foregoing occurred, the surgery done on Aug. 21 would have been done on the night of Aug. 18 and that Parker would have not gone on to develop septic shock. Rodriguez’s counsel contended that, in a community hospital such as Bakersfield Memorial Hospital, an after-hours gastrografin enema could not be obtained whether in the operating room or in the department of radiology, such that the order for a gastrografin enema could not be done until the following morning. Counsel also contended that as a Board-certified general surgeon, Rodriguez had not been trained in his residency program to do the type of air-leak test recommended by Parker’s general surgery expert and described by the expert as the “required by the standard of care.” Counsel further contended that it was too dangerous to continue dissecting to the site of the anastomosis, given the findings Rodriguez observed, including the absence of positive findings one would have expected to see had there been a leak at the site of the anastomosis of any great consequence. In addition, Rodriguez’s counsel noted that while Parker could not recall anything about the hospitalization due to being critically ill, Rodriguez was able to recall that Parker adamantly refused to undergo the gastrografin enema test that had been recommended until postoperative day number three. As a result, Rodriguez’s counsel argued that Rodriguez was not negligent in the treatment of Parker based on the doctrine of informed refusal, which is when an individual refuses recommended medical treatment based upon an understanding of the facts and implications of not following the treatment., Parker claimed that the failed anastomosis of the large bowel resulted in septic shock and ileostomy. He claimed that he missed time from work as a result of his treatment. Parker sought recovery of approximately $40,000 in lost earnings, $100,000 in hospital costs and an unspecified amount of damages for his pain and suffering.