On March 31, 2013, plaintiff Kimberly Hole, 39, an oral surgeon’s assistant, reported to the urgent care clinic located on the Sutter Roseville Medical Center campus with complaints of left sciatica pain. Specifically, she reported that she had tightness in her left buttocks and hamstring, which made it difficult to walk. Hole was evaluated by Dr. Terry Arikawa, a family medicine physician who performed a physical examination of Hole. Arikawa palpated tenderness over the sciatic nerve area of the buttocks but reported no other abnormalities. He diagnosed Hole with lumbar sciatica and prescribed her Toradol (a nonsteroidal, anti-inflammatory drug), Vicodin, and a muscle relaxant. He also instructed Hold to seek further medical help, should her condition worsen. Hole returned home, but over the next two days, she developed fevers, rigors and was unable to put weight on her left leg. By the second morning, she had developed an altered mental status, which prompted her husband to drive her to the emergency room. Hole was diagnosed with sepsis and necrotizing myositis (also known as necrotizing fasciitis and sometimes referred to as a “flesh-eating” disease) in her gluteal muscles. She underwent nine surgical procedures over the next 10 days, which ultimately culminated in an amputation of her left leg and a hip disarticulation, which is the surgical removal of the entire lower limb by transection through the hip joint. Hole sued Arikawa and Arikawa’s employer, Sutter Medical Group, which also operated the urgent care center where she was initially treated. Hole alleged that Arikawa failed to diagnose and treat her condition and that Arikawa’s failure constituted medical malpractice. She also alleged that Sutter Medical Group was vicariously liable for Arikawa’s actions. Nail Solutions and its owner, Kapara Ham, were initially named as defendants. Hole claimed that a pedicure she had received a week before seeing Arikawa was the cause of her infection, in that the manicurist tore a cuticle on her left foot, which was allegedly the entry point for the viral infection. However, Nail Solutions and Ham settled out for a confidential amount. In addition, Sutter Roseville Medical Center, Sutter Medical Foundation, Sutter Roseville Urgent Care, Sutter Health Sacramento Sierra Region and California Emergency Physicians were named as defendants, but Sutter Roseville Medical Center and Sutter Medical Foundation were dismissed for waivers of costs, and Sutter Roseville Urgent Care, Sutter Health Sacramento Sierra Region and California Emergency Physicians were also let out of the case. The matter ultimately continued against Arikawa and Sutter Medical Group only. The plaintiff’s medical experts opined that the severity of Hole’s pain at the urgent care center should have alerted Arikawa that something more than lumbar sciatica was ailing Hole. They also opined that Arikawa did not examine the buttocks and hamstring area adequately because if he had, Arikawa would have noticed pain inconsistent with his diagnosis. The plaintiffs’ infectious-diseases expert opined that Hole had a prodromal infection that had not yet started to necrose at the time of the urgent care visit. As such, the expert felt that Hole’s leg could have been preserved had further treatment been administered on March 31, 2013. Defense counsel noted that it was essentially agreed by all experts that Hole’s only symptoms at the time of her visit to the urgent care clinic were pain in the buttocks, radiating into the hamstring, and pain with palpation over the sciatic nerve. Counsel also noted that all experts agreed that there would have been no skin changes, rash, erythema or swelling on the buttocks at that time. Based upon the agreed upon symptoms, the defense’s experts opined that Arikawa had performed an appropriate and thorough examination of Hole and that the findings were consistent with lumbar sciatica, a notoriously excruciating condition. Defense counsel contended that one week before Hole presented to the urgent care clinic, Hole had undergone a pedicure, which Hole claimed caused the group A streptococcus organism to enter her body, and had performed a strenuous workout, which likely caused tissue damage that attracted the organism. The defense’s infectious-diseases expert opined that while Hole may have had the group A streptococcus bacteria at the time of her visit to Arikawa, it either had not developed into an infection yet or the infection’s ailments had not yet manifested, as Hole was asymptomatic for an infection, particularly a necrotizing infection, which began deep within the gluteus muscles., Hole was diagnosed with sepsis and necrotizing myositis (also known as necrotizing fasciitis) in her gluteal muscles. She underwent daily, emergent surgical debridements of her left buttocks and left leg over a period of 10 days, during which her gluteal muscle and left hamstring muscle was removed. However, one week later, she required a complete amputation of her left leg, above the knee, during a hip disarticulation, which is the surgical removal of the entire lower limb by transection through the hip joint. Hole also required an ileostomy (a surgical operation in which a piece of the ileum was diverted to an artificial opening in the abdominal wall) and the placement of a feeding tube. The ileostomy was taken down approximately five months later, and Hole participated in an extensive course of physical therapy and occupational therapy. Hole was ultimately able to return to work. She initially worked part-time, but by the time of trial, she had returned to working full-time for an orthopedic surgeon. However, Hold now requires a prosthetic in order to be ambulatory. The plaintiff’s damages experts opined that Hole would not be able to sustain full-time employment after approximately five years and that she would eventually need to move to a lower-earning clerical position. The plaintiff’s prosthetic expert opined that Hole would require three different types of prosthetic legs which would need to be replaced every three to five years. Hole sought recovery for her past and future loss of income; past and future medical expenses, including attendant care; and past and future pain and suffering. The parties stipulated to the amount of Hole’s past medical expenses, which were primarily paid by Tricare and Medicare. Hole’s husband, Larry Hole, presented a derivative claim, seeking recovery for his loss of consortium.