On Dec. 24, 2009, plaintiff Takaria Hosea, 18, was brought by paramedics to Long Beach Memorial Medical Center in Long Beach, after being found on the floor in her bathroom. She subsequently came under the care of Dr. Gail Carruthers in the emergency room, where physical and neurologic examinations of Takaria were performed and determined to be normal, except for the fact that she was not speaking. Takaria cooperated with the examination and responded appropriately to questions with head nods and shakes, so it was thought that she was refusing to speak, instead of not being able to. As such, Takaria was discharged from the hospital that day with a diagnosis of a conversion reaction. She was also given specific instructions to return if her symptoms worsened or remained the same. As a result, the following day, on Dec. 25, 2009, Takaria presented to the E.R. at Children’s Hospital of Los Angeles, where she was diagnosed with both an acute stroke and evidence of a prior stroke. Approximately 12 days after her admission to Children’s Hospital of Los Angeles, Takaria underwent a transesophageal echocardiogram, which revealed multiple small, friable vegetations on her mitral valve. Shortly thereafter, she was diagnosed with noninfectious thrombotic (marantic) endocarditis, which was determined to be the cause of her strokes. Sharon Hosea, acting as the conservator and natural mother of Takaria, sued Carruthers, Long Beach Memorial Medical Center, Arrowhead Regional Medical Center, Dr. Chander Malhotra, Dr. Eugene Kwong, Dr. Jonathan Tsao and the county of San Bernardino. Arrowhead Regional Medical Center and Malhotra settled out prior to trial. In addition, Kwong and Tsao were dismissed from the case based upon the county’s settlement with Takaria. Thus, the matter only continued against Carruthers and Long Beach Memorial Medical Center. Plaintiff’s counsel contended that Carruthers failed to order a neurology consultation and obtain a CT scan of the brain, which would have diagnosed Takaria’s stroke. Counsel also contended that if a CT scan and neurology consultation occurred, Takaria would have been started on anticoagulation therapy (Heparin), which would have prevented the development of a subsequent stroke. However, counsel contended that failing to do this before she presented to Children’s Hospital of Los Angeles caused Takaria to suffer the subsequent stroke that caused the majority of her . Defense counsel contended that a physician would typically not expect a stroke in a patient of Takaria’s age. Counsel also contended that Takaria’s clinical presentation was more consistent with a patient that was not cooperative, as opposed to having an inability to speak. Moreover, defense counsel argued that the family shared with Carruthers and the staff at Long Beach Memorial Medical Center that Takaria had a history of responding to an emotional event by not speaking on prior occasions. As such, defense counsel contended that Takaria’s presentation was more consistent with a conversion reaction, and not a stroke, and, thus, a CT scan of the brain was not indicated. As for the administration of the anticoagulation therapy, defense counsel argued that Takaria’s second stroke did not occur until after leaving Long Beach Memorial Medical Center on Dec. 24, 2009. Counsel contended that the subsequent imaging obtained at Children’s Hospital of Los Angeles revealed a stroke in evolution, and not two identifiable infarcts. Thus, defense counsel argued that anticoagulation therapy in an acute, ischemic stroke setting was contraindicated due to the risk of hemorrhagic transformation., Takaria suffered from noninfectious thrombotic (marantic) endocarditis, which resulted in two strokes. The plaintiff’s neurology expert opined that as a result of the strokes, Takaria has safety awareness deficits and requires attendant care 24 hours a day. The expert also opined that Takaria experiences significant problems with both anterior and posterior dysphasia, right upper extremity weakness, incoordination and tingling, as well as possible impaired vision in the right hemi-fields. Plaintiff’s counsel contended that Takaria’s daily life activities have been further limited as a result of her difficulty with strength and coordination of her right dominant hand. Thus, plaintiff’s counsel asked the jury to award Takaria damages that included past medical costs of $232,985, future medical costs of $3,497,259, past loss of earnings of $47,300 and future lost earnings of $645,000.