On April 4, 2012, plaintiff Soyeun Kim, 4, underwent closed reduction and internal fixation of a displaced supracondylar fracture of her right arm’s humerus. The fracture occurred a day earlier. The surgery was performed at California Pacific Medical Center, in San Francisco, by Dr. Mohammad Diab, a pediatric orthopedic surgeon who was employed by The Regents of the University of California. At the conclusion of the surgery, Diab noted that Soyeun’s right hand was white and cool, with no radial or ulnar pulses, and delayed capillary refill in the index finger and thumb. Diab requested an immediate consultation by the hospital’s staff microvascular plastic surgeon, who, after examining Soyeun in the operating room, concluded that Soyeun had sustained a spasm of the brachial artery and that Soyeun did not require surgery for a brachial artery injury. After her pulses were monitored overnight, Soyeun was fitted with a cast and discharged from the hospital on the afternoon of April 5, 2012. On April 11, 2012, Soyeun and her parents presented for a follow-up clinical visit with Diab, at which time Soyeun’s cast was removed. Upon examination, Diab concluded that Soyeun had a neurovascular deficit in her right forearm that appeared to be either the sequelae of compartment syndrome or the sequelae of an ischemic injury. Diab offered Soyeun’s parents the option of performing surgery or continuing to observe Soyeun’s progress, but he also told them that he could not guarantee surgery would be a benefit to Soyeun. Soyeun’s parents opted to continue observing Soyeun’s condition. On April 13, 2012, Soyeun was brought to the University of California San Francisco Medical Center with complaints of increased pain. Dr. Lisa Lattanza, UCSF’s hand, elbow and upper extremity surgeon, examined Soyeun and offered Soyeun’s parents the option of performing surgery or continuing to observe Soyeun’s progress. She also informed the parents that she could not guarantee surgery would be of benefit to Soyeun. At that point, Soyeun’s parents decided to go forward with surgery. Although Soyeun’s hand strength and function improved over time after the surgery, she continues to have residual weakness and diminished use of her right hand. Soyeun’s mother, Minhi Kim, acting as Soyeun’s guardian ad litem, sued Diab and the operator of the University of California San Francisco Medical Center, the Regents of the University of California. Kim sued the Regents under a theory of respondeat superior, claiming that her daughter’s condition was a surgical emergency on April 11, 2012 and that the Regents was responsible for Diab’s failure to take Soyeun immediately to surgery. Diab was dismissed from the case early in the litigation. Defense counsel contended that Diab properly advised Soyeun’s parents of the risks and benefits of surgery in accordance with the current medical principle of shared decision-making. In that regard, counsel contended that Diab had a long and detailed discussion with Soyeun’s parents, during which he explained that medical literature suggested that if Soyeun’s pain was due to compartment syndrome, Soyeun’s symptoms and the amount of time since her injury suggested that the compartment syndrome was no longer active, in that it had come and gone, so surgery would most likely not be a benefit. Counsel contended that Diab also explained that medical literature suggested that if Soyeun’s pain was due to an ischemic injury, which is caused by diminished or absent blood flow, the condition would have also already been resolved, as Soyeun’s hand had pulses, was pink and was well-perfused, suggesting that she had established collateral circulation in the forearm, so surgery would most likely not be a benefit in that case either. Therefore, defense counsel argued that when asked if he could guarantee surgery would help Soyeun, Diab properly responded that he could not say for sure that it would. In addition, defense counsel noted that the plaintiff’s plastic surgery expert agreed with the Regents’ experts with respect to the timing of compartment syndrome, in that it is a condition that occurs within four to 36 hours of an injury and then is no longer active., During the surgery that was performed by Lattanza and Dr. Charles Lee, a plastic surgeon, on the evening of April 13, 2012, the fascial compartments in Soyeun’s forearm were opened, neurolysis was performed, and an intimal tear of the brachial artery was repaired. Soyeun later underwent additional surgeries. Soyeun, who was 11 years old at the time of trial, claimed that her life has been profoundly affected by the lack of strength and diminished use of her right hand. When she stretches her hand out, her fingers curl in. She claimed that she is also teased about the appearance of her arm. However, Soyeun admitted that she is still able to play softball, swim on a swim team and play the flute. Plaintiff’s counsel contended that Soyeun would need future medical visits, physical therapy, and tendon release and scar revision surgeries. Plaintiff’s counsel asked the jury to award Soyeun $707,179.82 in total damages, including $63,573.82 in past medical costs, $143,606 in future medical costs, and $500,000 in general damages for Soyeun’s past and future pain and suffering. Defense counsel argued that there was no loss because all of Soyeun’s expenses were paid by her parents’ insurance. Counsel also disputed the amount of Soyeun’s future medical treatments, arguing that the cost of the needed surgeries and therapies only totaled $91,363. However, defense counsel again argued that there was no loss because all of those expenses would be covered under Soyeun’s parents’ current insurance plan.