On Oct. 25, 2015, plaintiff’s decedent Imelda Roxas, 49, a homemaker, was transported by ambulance to San Antonio Regional Hospital, in Upland, after complaining of chest pain. Roxas had an artificial aortic valve, but an evaluation at the hospital, including an X-ray of the chest, proved negative for a heart attack. Roxas was discharged with a diagnosis of gastroesophageal reflux disease. The following day, a radiologist reviewed the chest X-ray and noted a right, upper chest mass. He sent a report of his findings to the emergency department. The physician on duty, Dr. Debbie Bervel, reviewed the report and called Roxas’ husband, who stated that his wife was still experiencing chest pain. Bevel requested that he bring Roxas back to the emergency department for further evaluation. The couple presented to the emergency department just after 3 p.m., and a triage nurse performed an evaluation of Roxas about 30 minutes after Roxas checked in. The triage nurse noted that Roxas was hypertensive and complaining of generalized pain to her abdomen and back. The nurse assigned a Canadian acuity of ESI-2, which is considered emergent. However, after triage, Roxas was directed to the lobby, where she remained until 5:40 p.m., when she suddenly arrested. Despite aggressive and prolonged CPR, Roxas could not be resuscitated and was pronounced dead. The decedent’s husband, Andrew Roxas, sued San Antonio Regional Hospital; Bervel; two other medical doctors, Dr. Michael Mammone and Dr. John Abed; and three registered nurses, Amanda Sutphen, Amanda Clay and Binh Lieng. Mr. Roxas alleged that the individual doctors and nurses were negligent in the treatment of Ms. Roxas and that the hospital was vicariously liable for the negligence of the individual doctors and nurses. Ms. Roxas’ daughters, Niliwona Cunanan, Janelle Anasco and Danielle Anasco, were initially named as plaintiffs in the case, but they were later dismissed from the case. The individual doctors and nurses were also ultimately dismissed from the case. As a result, the matter continued with Mr. Roxas’ claim against the hospital only. Plaintiff’s counsel contended that there was sufficient time to save Ms. Roxas from the time the triage nurse evaluated her up to the time she arrested, but that the triage nurses failed to follow hospital policies and procedures. According to the estate’s expert in hospital medicine, the policies of a hospital require any patient with an ESI-2 acuity to be immediately placed in a bed and monitored. The estate’s counsel contended that the mass on the X-ray was an aneurysm that ruptured while Ms. Roxas was in the emergency department lobby and that the rupture resulted in Roxas’ almost immediate death. Counsel also contended that, with timely intervention, the probability of survival was 90 percent. Defense counsel argued that the policies of a hospital do not establish standard of care. With respect to cause of death, the defense argued that the autopsy report was inconsistent with an aortic dissection or a rupture. Defense counsel argued that Roxas actually suffered a massive heart attack from a left coronary artery occlusion. Counsel contended that in order to prevent blood clotting in her artificial aortic valve, Roxas took the blood thinning medication Coumadin and that records reflected that Roxas had a subtherapeutic level of Coumadin for at least 12 months preceding her death. Defense counsel further contended that a photograph from the autopsy reflected a blood clot on the aortic valve and, therefore, asserted that a clot broke off and lodged in the left coronary artery, resulting in almost immediate myocardial infarction and death. Defense counsel argued that as a result, the hospital’s personnel could not have anticipated or prevented Roxas’ death., Roxas died on Oct. 26, 2015. She was 49 years old. She was survived by her husband, Andrew Roxas, who was a 52-year-old car broker at the time, and their three daughters, Niliwona Cunanan, Janelle Anasco and Danielle Anasco. Ms. Roxas’ family claimed that she suffered a ruptured aneurysm that resulted in her almost immediate death. The estate’s counsel asked the jury to award Roxas’ family $195,000 in economic damages, plus an unspecified amount in noneconomic damages. Defense counsel contended that Roxas had a blood clot on the aortic valve that broke off and lodged in the left coronary artery, resulting in almost immediate myocardial infarction and death.