On Sept.11, 2013, plaintiffs’ decedent Gerald L. Wolford, 70, a retiree, presented for outpatient bladder cancer surgery at Bakersfield Memorial Hospital, in Bakersfield, under the service of a Bakersfield urologist, Dr. Shabbir Shakir. Wolford had smoked for approximately 50 years and was known to have chronic obstructive pulmonary disease. He also weighed approximately 300 pounds. When Wolford was diagnosed with bladder cancer, a transurethral resection of two bladder tumors was planned. As a result, Shakir ordered a pre-operative evaluation in the nature of lab studies, a chest X-ray, and an electrocardiography (ECG), all of which were within normal limits. Victor Onuaguluchi, a certified registered nurse anesthetist, also interviewed Wolford before the surgery and requested that Wolford take a few puffs from his Albuterol inhaler before going back to the operating room for induction under general anesthesia. The family disputed whether Wolford had his Albuterol inhaler with him on the day of the surgery, but agreed that he did have his other routine inhaler, Advair, with him. In any event, the induction with routine agents went smoothly and there were no complications of any kind during the maintenance phase of the surgery. In addition, Wolford’s vital signs remained completely normal. After Wolford was extubated, he was initially observed to do well on the operating room table, but displayed some agitation shortly before being moved to a gurney for transport to the recovery unit. Wolford was then reassured and encouraged to take deep breaths, and he was able to follow commands. The transient agitation eventually disappeared, and Onuaguluchi and a number of operating room nurses moved Wolford to a gurney for transport from the operating room. However, after moving to the gurney, Wolford displayed agitation once again and, similar to the first episode, he was able to be successfully calmed down. As the gurney started to roll away from the doorway of the operating room, Onuaguluchi observed a dusky hue to Wolford’s skin. As a result, Onuaguluchi elected to return Wolford to the operating room, where all of the monitors were reattached. During the foregoing time frame, Wolford was getting supplemental oxygen by mask and upon returning to the operating room, the oxygen mask was removed and the larger face mask used during surgery was re-applied. Positive pressure ventilation was then given by Onuaguluchi. (However, Wolford’s family later disputed that such was the case.) Initially, Wolford’s oxygen saturation levels seemed to respond, but the oxygen saturation levels dropped once again, down to 65 percent. At that point, the surgeon, Shakir, stopped by the operating room after noting that Wolford was not in the recovery area. Onuaguluchi requested that Shakir secure additional help, and another anesthesiologist was summoned from the physicians’ lounge in order to assist. Wolford was ventilated for an additional two to three minutes by Onuaguluchi and other anesthesiologists before the decision was made to re-intubate Wolford. Wolford was re-intubated at 12:32 p.m., or approximately 22 minutes after he had been extubated, and at approximately 12:40 p.m., a code was called. Wolford was eventually resuscitated, but he never awoke following surgery. He ultimately passed away on Sept. 27, 2013, after comfort measures were instituted at the request of the family. The decedent’s widow, Patsy Jo Wolford, and their adult children, Gerald W. Wolford and Tina Crisler, sued Onuaguluchi (who was initially erroneously sued as “Onyaguluchi”); Shakir; and Onuaguluchi’s medical group, Premier Anesthesia Medical Group. The decedent’s family alleged that the defendants failed to properly monitor the patient and were negligent for delaying treatment. They also alleged that the defendants’ actions constituted medical malpractice. Shakir was ultimately dismissed from the case. Plaintiffs’ counsel argued that after extubation, there was a failure to monitor the decedent, inasmuch as he was not re intubated until 12:32 p.m., or approximately 22 minutes after he had been extubated at 12:10 p.m. Counsel also argued that positive pressure ventilation should have been utilized much sooner than it was and that Wolford should have been re-intubated much sooner. Counsel further argued that when Wolford initially displayed signs of agitation on the operating room table after extubation, Onuaguluchi should have realized that a problem was brewing and the decedent should have been either re-intubated at that point or given positive pressure ventilation with a request from Onuaguluchi for assistance from an anesthesiologist. Defense counsel contended that Wolford’s post-extubation deterioration was secondary to a bronchospasm due to a long smoking history of 50-plus years. Counsel also contended that the pre-operative work-up would not have predicted a problem for the decedent and that because the plaintiff’s expert agreed that the timing for extubation was appropriate, the decedent simply experienced the onset of a complication, in the nature of a bronchospasm, which could not have been predicted. In addition, defense counsel denied that there had been a failure to monitor, and contended that not all agitation, following extubation, is secondary to hypoxia since patients frequently display agitation when emerging from anesthesia. Thus, defense counsel argued that there was no credible evidence to establish that with earlier re-intubation, the decedent’s florid bronchospasm could have been broken and/or his outcome would have been materially different., Gerald L. Wolford suffered from transient agitation following the surgery and was re-intubated. However, a code needed to be called and Wolford was resuscitated, but he never awoke. He eventually died on Sept. 27, 2013, after comfort measures were instituted at the request of the family. He was 70 years old. The decedent was survived by his wife, Patsy Jo Wolford (then age 70); his son, Gerald W. Wolford (then age 50); and his daughter, Tina Crisler (then age 48). The family claimed that the decedent died as a result of hypoxia following the surgery. The family, who all resided together, sought recovery of $465,000 in total damages, including $300,000 in wrongful-death damages and $165,000 for the loss of household services. Defense counsel argued that the decedent’s death was caused by a florid bronchospasm due to a long smoking history of 50-plus years.