On Tuesday, Aug. 27, 2013, plaintiff Gary Tilleskjor, 52, an unemployed Arizona resident, underwent a catheter ablation for treatment of an atrial fibrillation. The procedure was performed by Dr. Andrea Natale, a cardiologist and electrophysiologist, at Scripps Green Hospital, in La Jolla. Following the procedure, Tilleskjor was admitted to the hospital for an overnight observation, and at approximately 6 p.m., he received 8 milligrams of Warfarin. an anticoagulant. The following day, on Aug. 28, 2013, Tilleskjor’sinternational normalized ratio (INR) was 3.3, which is considered high and meant that Tilleskjor’s blood was too thin. In consideration of the upcoming three-day Labor Day holiday, the hospital instructed Tilleskjor to skip a dose of Warfarin, reduce his next dose, and then recheck his INR on the first working day following his travel, on Tuesday, Sept. 3, 2013. Tilleskjor was then discharged from the hospital, and he returned to Arizona. On Sept. 2, 2013, Tilleskjor presented to Tucson Medical Center, in Tucson, Ariz., with complaints of a sudden onset of nausea and vomiting, severe dizziness, and heart racing. His INR levels were noted to be low, and an MRI of his brain revealed a small, acute infarct involving the left, medial, superior cerebellum. Following treatment, Tilleskjor was discharged from the hospital on Sept. 4, 2013. Tilleskjor sued Natale; Natale’s medical office, Scripps Clinic Medical Group Inc.; Scripps Green Hospital; the health care system that operates Scripps Green Hospital, Scripps Health; and the nurse practitioner who adjusted Tilleskjor’s Warfarin before and after the catheter ablation, Linda Couts. Tilleskjor alleged that Natale and Couts failed to properly treat and monitor him and that their negligence constituted medical malpractice. He also alleged the Scripps entities were liable for the actions of Natale and Couts. Scripps Green Hospital and Scripps Health were ultimately let out of the case. Thus, the mater continued against Natale, Couts, and Scripps Clinic Medical Group Inc. Due to the employment relationship with Scripps Clinic Medical Group, the jury only considered the alleged negligence of Natale and Couts. Plaintiff’s counsel argued that Natale and Couts were negligent in providing care to Tilleskjor after the procedure. Counsel contended that Tilleskjor was given instructions for decreased Warfarin and told to follow up on Sept. 3, 2013, but that Tilleskjor should have been told to follow up sooner. Additionally, plaintiff’s counsel argued that Tilleskjor’s Warfarin was not properly managed, which caused his stroke. Specifically, counsel contended that Tilleskjor was not monitored closely and that although he was ordered to skip a Warfarin dose at one point, Tilleskjor should have been monitored instead. The plaintiff’s cardiology expert opined that Tilleskjor should have been monitored more frequently and should not have skipped a dose of Warfarin. Defense counsel noted that when INR levels are normal, they are “therapeutic;” when they are higher than normal, they are “supratherapeutic;” and when they are lower than normal, they are “subtherapeutic.” Counsel asserted that Tilleskjor’s INR levels were therapeutic both before the surgery and on the day of the procedure and that post-procedure, Tilleskjor’s INR levels were actually supratherapeutic. Counsel contended that as a result, Tilleskjor was instructed to skip a dose and to follow up with a decreased dose of Warfarin. Thus, defense counsel argued that all of the care was proper and that Natale and Couts did not negligently cause Tilleskjor’s . The defense’s expert pharmacologist opined that the proper instruction was given with regard to adjusted dosage and that Tilleskjor’s drastic decrease in INR indicated non-compliance. The defense’s expert electrophysiologist opined that it was proper to instruct a patient, such as Tilleskjor, who had supratherapeutic INR levels, to skip a dose. In addition, the expert testified that there can be many reasons for a post-ablation stroke., Tilleskjor suffered a stroke. When he presented to Tucson Medical Center’s emergency room for treatment of a sudden onset of nausea and vomiting, severe dizziness, and a racing heart, his INR levels were noted to be subtherapeutic. An MRI of his brain was also performed and it revealed a small, acute infarct involving the left, medial, superior cerebellum. As a result, Tilleskjor’s Warfarin was increased, he was monitored, and then discharged on Sept. 4, 2013. Tilleskjor was not employed, as he had chronic back problems unrelated to the incident. However, he claimed that after the stroke, his activities of daily living were further limited. Thus, Tilleskjor sought recovery for his medical expenses and pain and suffering. His wife, plaintiff Lina Tilleskjor, then age 39, sought recovery for her loss of consortium. Defense counsel contended that Mr. Tilleskjor already had pre-existing problems, probably due to his chronic back pain.