On March 13, 2008, plaintiff Elizabeth Bolden, a 10-month-old child, was brought to Mary Howell, a physician’s assistant, with symptoms of a fever up to 104 degrees and vomiting. Her parents also described Elizabeth as being lethargic earlier in the day with forceful vomiting. They explained to Howell that they were concerned that their daughter had meningitis because she had not been vaccinated. Also, Elizabeth was treated for persistent ear infections and prescribed antibiotics in February and March 2008. Howell did not believe Elizabeth had meningitis, and she treated her for a viral infection. Howell also told the parents to have Elizabeth follow up with a pediatrician the next day and/or present to an emergency department if Elizabeth’s condition worsened. The parents initially believed that Elizabeth’s condition improved after the visit with Howell, but the next afternoon they brought Elizabeth to Dr. Pamela Verder-Bautista, a pediatrician, with the same symptoms, plus Elizabeth had developed diarrhea. Verder-Bautista determined that Elizabeth’s ear infections had resolved and that Elizabeth appeared to have a viral infection (gastroenteritis). She also determined that Elizabeth appeared improved, even from the night before, and noted that Elizabeth was afebrile. Verder-Bautista diagnosed Elizabeth with a viral infection. On March 16, 2008, Elizabeth’s condition changed dramatically. She was brought to an emergency department with a stiff neck and a bulging fontanelle, and she was unresponsive. Elizabeth was ultimately diagnosed with pneumococcal meningitis. Elizabeth, by and through her guardian ad litem, Heather Lange, sued Howell and Verder-Bautista. Lange alleged that Howell and Verder-Bautista failed to diagnose Elizabeth’s condition and that their failure constituted medical malpractice. Plaintiff’s counsel contended that Elizabeth had meningitis when she presented to both Howell and Verder-Bautista and that the providers misdiagnosed the meningitis. Defense counsel argued that Elizabeth did not show signs of meningitis during her examination with Howell. Counsel contended that Elizabeth was alert, awake and making good eye contact and that Elizabeth did not have a stiff neck or bulging fontanelle. Additionally, counsel contended that Elizabeth’s condition improved when her fever was lowered with Tylenol, which is inconsistent with meningitis, and that Elizabeth’s parents even initially claimed that their daughter was “definitely better” after the visit with Howell. Defense counsel further contended that after a thorough examination with Verder-Bautista, Elizabeth showed no signs of meningitis, as she was alert, awake and making good eye contact and that Elizabeth did not have a stiff neck or bulging fontanelle. As a result, counsel argued that Elizabeth presented with signs and symptoms of a viral infection (gastroenteritis) at both visits and that Elizabeth did not have meningitis at those visits, but rather a preceding viral infection, which was correctly diagnosed and treated. The defense’s pediatrics expert described the standard of care required for a pediatrician and a physician assistant practicing in a clinical outpatient setting. He also described the frequency with which pediatricians/providers see patients with complaints of elevated fevers and vomiting, and opined that a lumbar puncture to rule out meningitis was not indicated. The defense’s pediatric infectious diseases expert, who was published numerous times in various peer-reviewed journals and textbook chapters on the topic of bacterial meningitis, opined that Elizabeth did not have pneumococcal meningitis on March 13, 2008 or March 14, 2008, but, rather, the disease developed rapidly on or about March 15, 2008 or March 16, 2008. The expert explained that his opinion was based, not only on the drastic change in Elizabeth’s clinical presentation on the morning of March 16, 2008, but also on the white blood cell count and the breakdown of monocytes/neutrophils in the cerebral spinal fluid taken on March 16, 2008., At an emergency department, Elizabeth was diagnosed with pneumococcal meningitis, a life-threatening infectious disease that causes inflammation of the layers that surround the brain and spinal cord. Elizabeth survived the pneumococcal meningitis, but she lost her hearing. As a result, Elizabeth, who was a 12-year-old student at the time of trial, requires cochlear implants in both ears. Plaintiff’s counsel contended that Elizabeth’s condition will cause her to have delays in her education and that she would have eventually graduated college on time if not for the delays associated with her hearing loss. Elizabeth sought recovery of future medical expenses associated with the cochlear implants and future lost earnings due to her diminished earning capacity.