On Sept. 4, 2012, plaintiff Jennifer Garcia, 49, a former school bus driver who was previously disabled via head trauma from a prior accident, developed a prolapsed bladder and rectum, culminating in surgery in Bakersfield. Garcia previously began seeing Dr. James Tsai, an Ob-Gyn, for treatment of all her gynecologic needs on Feb. 14, 2007. Over time, Garcia underwent a hysterectomy with bilateral salpingo-oophorectomy — the removal of the uterus, cervix, fallopian tubes, and ovaries — in August 2010. Thereafter, she developed a severe urge to urinate and urinary stress incontinence-type problems. She also developed a prolapsed bladder and rectum. As a result, she underwent surgery in September 2012. Garcia returned to see Tsai in January 2013 because she found that it was not possible for her to engage in sexual intercourse due to a vagina that was 1-centimeter in length and due to persistent nerve pain at the entrance to her vagina. As a result, Tsai referred her to a physical therapist, who told Garcia that she needed a second opinion from a surgeon. Garcia then presented to the referred urogynecologist, at U.C. Irvine, in February 2013, and was diagnosed with a severe agglutination problem in which the vaginal vault seals shut, as well as provoked vulvodynia, which had rendered Garcia incapable of sexual intercourse. As a result, Garcia needed to undergo vaginal reconstruction surgery in March 2013. Garcia sued Tsai and his medical office, San Dimas Medical Group Inc. Garcia alleged that the defendants’ actions constituted medical malpractice. Garcia claimed that Tsai was negligent in failing to discuss or recommend non-surgical options that were available to treat urinary incontinence and that her prolapsed rectum and bladder were asymptomatic, which did not justify surgery based on that need alone. She also claimed that while she consented to the surgery, Tsai unnecessarily removed vaginal skin (mucosa), which caused the vagina to heal shut and which ultimately required a complete reconstruction. In addition, she claimed that her post-operative care by Tsai was below the standard of care, in that Tsai was unable to insert a speculum into her vagina during her two post-operative visits, but still released her from further care until her next well-woman examination in a year. She further claimed that Tsai negligently waited four months before responding to the agglutination problem and that, at that time, Tsai simply sent her for physical therapy, rather than to a women’s healthcare specialist. Plaintiff’s counsel noted that the plaintiff’s treating urogynecologist felt so strongly about what had been done to Garcia that she was willing to take time from her practice and teaching responsibilities at U.C. Irvine to drive to Bakersfield and testify on Garcia’s behalf, as the physician had never testified at trial before and had only testified twice in deposition before this case. Defense counsel argued that the standard of care was met in all respects and that agglutination is an extremely rare problem and beyond the control of an operating surgeon, since no surgeon can control the degree of scar tissue that may form following surgery. Counsel also argued that Garcia failed to follow Tsai’s instructions to begin having sex six to eight weeks after the surgery., Garcia was diagnosed with a severe agglutination problem in which the vaginal vault seals shut, as well as provoked vulvodynia, which rendered her incapable of sexual intercourse. She also claimed that her urinary tract problems persisted. As a result, she underwent vaginal reconstruction surgery on March 27, 2013. Garcia claimed that she uses a dilator almost daily since the March 2013 surgery in order to maintain the length of her vagina. However, she claimed that her dyspareunia (difficult or painful sexual intercourse) continues, causing her to be unable to engage in sexual relations since September 2012. As a result, she has ongoing psychological counseling, and has undergone various injections and physical therapy to address her . Thus, Garcia sought recovery of $21,000 in past medical and related expenses, and approximately $110,000 in future medical expenses. She also sought recovery of damages for her past and future pain and suffering. Garcia, who was disabled since an automobile accident that occurred years before the subject case, did not make a claim for lost earnings because she was on Social Security disability and Medicare secondary to the epilepsy she developed as a result of head trauma that occurred in the prior crash. Thus, plaintiff’s counsel asked the jury to award $761,000 in total damages.