On Dec. 30, 2013, plaintiff’s decedent Dona Higgins, 73, was admitted to the Acute Rehabilitation Unit at Providence Little Company of Mary Medical Center San Pedro, a hospital in San Pedro, for acute rehabilitative care following neck surgery. Upon admission, she was to be at risk for aspiration, and required maximum assistance with feeding. The physician’s orders subsequently required the nursing staff to supervise Higgins during all meals, and to hold oral feeding if she were coughing or lethargic. On Jan. 3, 2014, a peripherally inserted central catheter line was re-inserted. However, the next day, Higgins started developing swallowing problems, and was noted as having crackling sounds in her lungs and having thick brown, yellow secretions. As a result, she required suctioning. Higgins was then seen by a speech therapist, who recommended that Higgins’ diet be downgraded from regular to finely-chopped due to her dysphagia (difficulty swallowing). In addition, the speech therapist recommended that a videoesophagram be performed. Higgins’ physician followed the recommendation, and ordered the diet be changed to finely-chopped and ordered a videoesophagram be performed on Monday, Jan. 6, 2014, because a videoesophagram was not available over the weekend. On Sunday, Jan. 5, 2014, Higgins’ labs returned and showed a white blood count of 34.4, which is critically high. Her physician subsequently noted the lab results, but did not make any orders for treatment of the elevated white blood count. However, since Higgins continued to have swallowing problems, had lost her voice, and suspected to have possible vocal cord paralysis, her physician downgraded her diet from finely-chopped to pureed, and ordered the staff to watch Higgins frequently with feeding. On the morning of Jan. 6, 2014, the hospital’s speech therapist did a bedside swallow evaluation, testing Higgins with a regular diet of scrambled eggs and oatmeal from her breakfast tray, which should have been pureed. Within an hour, Higgins was found in respiratory failure and pulmonary arrest. During intubation, the pulmonologist noted that copious amount of secretions, which looked like tube feeding, were suctioned from her trachea. As a result, it was determined that Higgins had aspirated her breakfast. She then remained ventilator dependent until her death on April 4, 2014. The decedent’s husband, Gary Higgins, sued the operator of Providence Little Company of Mary Medical Center San Pedro, Providence Health System-Southern California. He alleged that the hospital’s staff negligently treated his wife and that this negligence constituted medical malpractice, resulting in his wife’s wrongful death. Plaintiff’s counsel contended that the staff of Little Company of Mary Medical Center failed to take all aspiration precautions with the decedent during her admission, knowing that she was at high risk for aspiration. Counsel asserted that throughout the decedent’s admission until Jan. 6, 2014, the hospital’s nursing staff failed to supervise or assist the decedent with meals. Counsel also asserted that the hospital’s nursing staff failed to notify the decedent’s physician of the critical white blood count and that the high white blood count should have been monitored by either hospital physicians or nursing staff, but it was not. In addition, the decedent’s family testified that although the decedent’s physician ordered to have the decedent’s food pureed, the decedent always received a regular diet, up until her aspiration event on Jan. 6, 2014. Plaintiff’s counsel further asserted that that there was no documented evidence showing that the decedent received the correct diet(s) after the physician changed it. The plaintiffs’ experts testified that the staff of Little Company of Mary Medical Center breached the standard of care in failing to assist and supervise the decedent with all meals. The experts also testified that the hospital’s staff breached the standard of care by failing to make the decedent “NPO” (nothing by mouth), starting Jan. 4, 2014 until the videoesophagram was performed on Jan. 6, 2014, to protect her airway while she was waiting for the test. The plaintiffs’ medical experts further testified that the decedent had a pulmonary arrest due to her aspiration on breakfast that morning. Defense contended that the orders for change in diet were signed off by the hospital’s nursing staff, but because the tray tickets are only maintained for 60 days, there was no documented evidence showing that the decedent received the correct diet(s) after the physician changed it. However, defense counsel asserted that the consistency of the eggs and oatmeal on the decedent’s breakfast tray was what both the plaintiff’s and defense experts testified to as being the appropriate consistencies of food that speech therapy should use for testing swallowing ability. Defense counsel asserted that there was never any signs or symptoms of aspiration, as noted by the speech therapist after testing. Thus, counsel argued that the decedent aspirated during the Code Blue as a result of the performed chest compressions, a common occurrence of which is regurgitation, and that the decedent’s aspiration was not a result of swallowing food particles. Defense counsel also contended that it was noted by subsequent treating physicians that what was found in the trachea were “gastric contents” and/or “tube feeding,” despite the fact that the decedent was not on tube feeding, and that no solid food material was found. In addition, defense counsel argued that the decedent’s arrest on Jan. 6, 2014 was due to septic shock from the infection she developed from the PICC line and that it was not the result of aspiration. Counsel contended that although the decedent’s treating physician noted the lab results on Jan. 5, 2014, the physician failed to make any orders for treatment of the elevated white blood count. Counsel argued that as a result, Higgins was not given an antibiotic for the critical white blood count, and it was the defense’s expert’s opinion that had the decedent received IV antibiotics starting on Jan. 5, 2014, more likely than not, the decedent would not have gone into arrest on Jan. 6, 2014. In response, plaintiff’s counsel contended that the decedent was not on a gastric tube, and the plaintiff’s experts opined that more likely than not the alleged “tube feeding” content was the oatmeal, since it was the same color., As a result of the aspiration event on Jan. 6, 2014, Dona Higgins went into pulmonary arrest, requiring intubation. She then developed aspiration pneumonia and was on a ventilator for the remainder of her life. To treat the aspiration pneumonia and recurring pneumonia, it was undisputed that Ms. Higgins required to be on prolonged antibiotics, which caused her to develop clostridium difficile (C.Diff), a potentially life-threatening bacteria, and sepsis. She ultimately died on April 4, 2014 from sepsis secondary to C.Diff. The decedent’s husband, Mr. Higgins, sought recovery of wrongful death damages for the loss of his wife. He also sought recovery of $239,005.63 in past medical costs, based on the Medicare lien. The decedent’s daughters, Shawna Higgins and Shelle Higgins, were named as nominal defendants in the case. They claimed that they were very involved in their mother’s care, and they were present throughout the entire trial.