On May 8, 2012, plaintiffs’ decedent Cecilia Jose, 54, a registered nurse, presented to the emergency room at St. Jude Medical Center, in Fullerton, where she also worked, with complaints of shortness of breath, a cough, nausea, a fever, chills, and the beginning of a rash on both hands and in her oral cavity. She subsequently underwent a chest X-ray, which was suggestive of pneumonia in the right lung, and the emergency room physician, Dr. Mark Song, initiated antibiotic therapy. Jose returned to the emergency room on May 14, 2012 with worsening of her symptoms. As a result, she remained in the hospital for the next 20 days under the care of numerous internal medicine, rheumatology, infectious disease, and pulmonology physicians, including Dr. Tuan Trinh (an internal medicine specialist/hospitalist), Dr. Adrian Bose (a pulmonologist) and Dr. Joel Trotter (an infectious disease specialist). Medical treatment in the hospital consisted primarily of antibiotics and steroids, but the consulting physicians were not able to dramatically improve Jose’s condition or reach a diagnosis about the cause of her complaints. Multiple consultants suggested the possibility of performing an open lung biopsy, or video-assisted thoracoscopic surgery (VATS), in order to arrive at a diagnosis, but no such diagnostic test was attempted. In late May 2012, Jose was taken off of antibiotics because there was thought to be no active infection. She was also taken off steroids to see whether she would improve or deteriorate without the steroids. Jose immediately deteriorated, so she went back on steroids, but not antibiotics. Without the benefit of antibiotics, Jose maintained a normal white blood cell count. On June 1, 2012, Bose ordered a sputum culture. While the labs were out, Jose continued to have a normal white blood cell count, but her bands became elevated on June 2, 2012, with a left shift, indicative of an infection. That same day, Trinh discharged Jose home on a high dose of steroids without a resolution of Jose’s complaints and without a diagnosis of the cause of her condition. The next day, after her discharge, the lab results on the sputum culture was reported to be positive for Klebsiella pneumoniae, which is a “superbug” that causes a range of diseases, depending on which part of the body it infects. However, no health care provider was aware of the lab result nor did any health care provider respond to the lab result. On June 6, 2012, Jose presented to the office of her primary care physician, Dr. Leo Garcia, with tachycardia and an oxygen saturation rate of 75 percent. Garcia advised Jose that she should follow up with her pulmonologist and her rheumatologist, but did not otherwise respond to Jose’s condition. Jose was next seen by her pulmonologist, Dr. Dana Tran, on June 14, 2012. At that time, Jose had an oxygen saturation rate of 67 percent and marked new production of sputum upon coughing. As a result, she was rushed to the hospital and admitted with a presumed super bacterial infection (Klebsiella pneumoniae) due to her immunosuppressed state from long-term, high-dose steroid therapy. Jose came under the care of Dr. Pius Kim, an internal medicine specialist/hospitalist. Antibiotics were again initiated and steroids continued, but no open lung biopsy was attempted. It eventually became necessary to intubate Jose with increasing ventilation pressures in order to maintain oxygenation, but Jose eventually succumbed to her illness on June 19, 2012. Jose’s husband, Marcelino Lunasco, and her two children, Mariel Lunasco and John Lunasco, sued St. Jude Medical Center; St. Jude Medical Inc.; physicians Song, Trinh, Bose, Trotter, Garcia, and Kim; and the physicians’ employer, St. Jude Heritage Medical Group. Song and Trotter were ultimately dismissed from the case prior to trial. In addition, Kim was dismissed from the litigation during trial, but prior to the end of the plaintiffs’ case. Plaintiffs’ counsel contended that the standard of care required that an open lung biopsy be performed long before Jose became acutely ill on June 14, 2012 in order to arrive at a definitive diagnosis of the underlying autoimmune lung condition. Counsel argued that if that step had been taken, and therapy tailored to the specific autoimmune condition, Jose would have survived and been alive today. Moreover, plaintiffs’ counsel argued that, given the plan to maintain Jose on chronic high-dose steroids, the standard of care required that prophylactic antibiotics also be prescribed, which would have averted the super bacterial infection of Klebsiella pneumoniae that had developed as of June 14, 2012 and had been present as of June 1, 2012. Counsel further argued that even if “prophylactic” antibiotics had not been required by the standard of care, they were certainly required once Jose’s sputum culture was positive for Klebsiella pneumoniae and Jose’s bands became elevated. In addition, counsel contended that the defendants had an opportunity to save Jose on June 6, 2012, before she became acutely ill, when she was seen with tachycardia and an oxygen saturation rate of 75 percent, which was described by the plaintiffs’ expert witnesses as a “panic value.” Defense counsel argued that Jose’s condition was simply too difficult of a diagnosis to reach given the results of all diagnostic and therapeutic efforts. Counsel contended that while an open lung biopsy or VATS would have provided a more definitive diagnosis, it was too risky of a diagnostic option while Jose was viewed to be slowly improving on steroid and antibiotic therapy. Defense counsel further argued that the elevated bands at the time of discharge were not terribly concerning and that the positive sputum culture for Klebsiella pneumoniae was likely mere colonization at that time, not an active infection, for which no treatment was indicated. With regard to the office visit on June 6, 2012, defense counsel conceded that the oxygen saturation rate of 75 percent was a concerning value, but contended that it was either a mistake in documentation or simply inconsistent with the remainder of Jose’s clinical picture on that date. Counsel also contended that, in retrospect, Jose likely had rapidly progressive pulmonary fibrosis, for which no treatment would have afforded a probability of saving her life, even with a known diagnosis and tailored therapy., Jose died from an illness to her lung. Plaintiffs’ counsel contended that Jose was suffering from a super bacterial infection (Klebsiella pneumoniae). As a result, Jose was rushed to a hospital, where antibiotics were again initiated and steroids continued. She was eventually intubated with increasing ventilation pressures in order to maintain oxygenation. However, Jose eventually died from her illness on June 19, 2012. She was 54 years old, and she was survived by her husband, Marcelino Lunasco, and two children, Mariel Lunasco and John Lunasco. Jose’s family claimed that they all lived together until Jose’s death. Thus, they alleged that they suffered from the emotional loss of their wife and mother, as well as from the loss of Jose’s financial support and household services. They sought recovery of $1,763,487 in total economic damages, including $455,552 for past loss of financial support, $1,422,562 for future loss of financial support, $61,505 for past loss of household services, $271,420 for future loss of household services, and $8,000 for funeral and burial expenses. Defense counsel disputed the cause of Jose’s death, arguing that Jose likely had rapidly progressive pulmonary fibrosis, for which no treatment would have afforded a probability of saving her life.