On Sunday, May 16, 2010, plaintiff Jany Amoroso, 35, a paralegal, underwent a microdiscectomy to remove herniated disc material at Huntington Memorial Hospital, in Pasadena. The surgery was performed by Dr. Ben Pradhan, a spinal surgeon. Amoroso previously had a history of right back pain and a lumbar disc herniation dating back to at least 2008. After tripping and falling in March 2010, she experienced a recurrence of her symptoms. As a result, Amoroso was first referred to Pradhan by her pain management specialist. Upon presentation to Pradhan on May 14, 2010, Amoroso complained of severe lower back pain, which was radiating down her right leg, dorsiflexion weakness that may have been due to the sciatic pain, and decreased sensation down the back of her right lower extremity. An MRI revealed a large, 8-millimeter herniated disc at right-sided L5-S1, causing significant lateral recess and foraminal stenosis. Amoroso initially underwent conservative treatment with injections and pain medication, but they were unsuccessful and Amoroso was forced to be out of work as a paralegal. Given that conservative treatment had failed and that her symptoms were progressively worsening at a rapid pace, Amoroso was informed that she was a candidate for a microdiscectomy surgery to remove the herniated disc material. There was also concern about the development of cauda equina syndrome, which can cause permanent nerve damage and incontinence. She was also informed about the risks and benefits of the surgery, and given the option of being admitted to the hospital for the procedure over the weekend or to wait to have it done at a later date. When Amoroso’s condition further deteriorated, she elected to have the microdiscectomy and requested that the surgery be done as soon as possible. Thus, the surgery was performed on May 16, 2010. Following the procedure, Amoroso noted that the severe radiating pain was alleviated, but that she developed a foot drop, worsened dorsiflexion weakness, and numbness and tingling in the L5 distribution. A subfascial drain was subsequently placed, but it only drained a typical amount of fluid from the surgery site. Amoroso was ultimately discharged from the hospital the following day in a stable condition. However, she could not ambulate due to the onset of the foot drop. As a result, Pradhan prescribed Amoroso an ankle/foot orthotic. About one week after the surgery, Amoroso started to develop a fluid collection in her lower back. After Pradhan suggested that Amoroso begin physical therapy for her foot drop, Amoroso began leaking fluid out of her incision. Pradhan subsequently advised Amoroso to return to the emergency room for a follow-up surgery to explore and evacuate the fluid collection, which was most likely a cerebrospinal fluid (CSF) leak. Pradhan evacuated the fluid collection and reinforced the dura during a May 29, 2010 surgery. Amoroso then returned to Pradhan for follow-up visits on June 8, 2010 and July 6, 2010, during which Amoroso claimed that she still had a foot drop and that she had developed neuropathic pain down her right lower extremity with new burning sensations. She alleged that her sensation to touch on the dorsum of her right foot was better, but that it was not completely normal compared to the left side. She also alleged that her right dorsiflexion weakness was worsening. Pradhan then referred Amoroso back to a pain management specialist. Amoroso also sought treatment with a neurologist, who noted the neuropathic pain, foot drop, and worsening of dorsiflexion weakness. Amoroso eventually underwent surgery at Cedars-Sinai Medical Center, in Los Angeles, to repair her dura in October 2010. During the surgery, the neurosurgeon noted two holes in the L5 and S1 nerve root areas, which were allegedly stemming from Pradhan’s surgeries, and rootlets herniating from Amoroso’s dura, which were ultimately repaired during the October 2010 surgery. Amoroso claimed that following the last surgery, her condition slightly improved, but her foot drop, neuropathic pain, and dorsiflexion weakness still remained. She also claimed she never returned to the status she was prior to seeing Pradhan. Amoroso sued Pradhan and Pradhan’s medical practice, Risser Orthopedic Group. Amoroso alleged that the defendants failed to properly detect and treat her condition and that these failures constituted medical malpractice. Risser Orthopedic Group was ultimately dismissed from the case. Plaintiff’s counsel argued that Pradhan failed to appreciate a conjoined L5-S1 nerve and negligently injured Amoroso’s L5 nerve root during the surgery on May 16, 2010. Thus, counsel contended that Pradhan’s actions directly or indirectly caused all of Amoroso’s subsequent . Plaintiff’s counsel also argued that Pradhan caused a CSF leak during the surgery, which he tried to conceal. Amoroso claimed that she did not have any pre-operative dorsiflexion weakness or neurologic symptoms of the kind she allegedly developed post-surgery. She also claimed that her sciatic pain was resolved after subsequent surgeries, but that she developed new , including a right foot drop and neuropathic pain syndrome with a burning sensation. Plaintiff’s counsel contended that a microdiscectomy at L5-S1 never requires retraction of the L5 nerve root and that the only nerve root to retract is the S1. Thus, counsel argued that Amoroso’s stemmed from an injury to the L5 nerve root either upon retraction, or by not appreciating the conjoined nerve root and puncturing it. In either event, the conjoined nerve root was never appreciated, counsel argued. In addition, plaintiff’s counsel contended that the L5 nerve root should not have been retracted and that any injury to the L5 distribution, which includes the right foot drop and neuropathic pain syndrome, should not have occurred and was completely avoidable. Thus, plaintiff’s counsel argued that Pradhan was negligent for failing to take precautions to avoid injury to that nerve. Plaintiff’s counsel further argued that Pradhan changed his medical records after Amoroso’s microdiscectomy. Counsel contended that prior to the subject surgery, Pradhan’s consultation did not include any notes about a foot drop or difficulty walking. Amoroso then underwent the microdiscectomy until about 10 a.m. A faxed copy of Pradhan’s consultation was then sent to his office at Risser Orthopedics at 11 a.m. However, plaintiff’s counsel contended that when Amoroso woke up with a foot drop, Pradhan changed his records and added to the consultation report that Amoroso had a foot drop prior to the surgery, even though she did not, and nowhere in his medical records or any other physician’s medical records prior to the surgery did it state that Amoroso had one. Plaintiff’s counsel argued that this was because Pradhan caused the foot drop by the L5 nerve during the surgery and then tried to cover his tracks. Counsel further argued that the consultation report that ultimately ended up in the Huntington Memorial Hospital records had the additions to it. Pradhan maintained that he acted within the standard of care at all times and that he did not cause or contribute to the Amoroso’s . He contended that all of Amoroso’s alleged were pre-existing, though they may have been temporarily exacerbated due to nerve irritation as a result of the intraoperative traction required to manipulate the nerves over the large herniated disc. In addition, defense counsel noted that all of the experts agreed that nerve irritation from traction is a known complication that can occur in the absence of negligence. Pradhan denied concealing any information about a CSF leak (also a known complication) from Amoroso, as evidenced by the dozens of emails he exchanged with her at the time that included, in part, his explicit opinion that there was a likely CSF leak, as well as similar documentation in her medical records to the same effect., Amoroso claimed that following the microdiscectomy on May 16, 2010, she developed an ongoing right foot drop, neuropathic pain, and dorsiflexion weakness. She ultimately underwent additional surgery at Cedars-Sinai Medical Center, in Los Angeles, to repair her dura in October 2010. During this surgery, the neurosurgeon noted two holes in the L5 and S1 nerve root areas, which were allegedly stemming from Pradhan’s surgeries, and rootlets herniating from Amoroso’s dura, which were ultimately repaired during the October 2010 surgery. Amoroso claimed that following the October 2010 surgery, her condition slightly improved, but her foot drop, neuropathic pain, and dorsiflexion weakness remained. She also claimed she never returned to the status she was prior to seeing Pradhan. She claimed her pain never resolved, and she has had continuous foot drop and weakening in her ankle, which has caused her to fall numerous times. Thus, she alleged that she has sustained multiple from her falls, resulting in various orthopedic and complex regional pain syndrome — also known as reflex sympathetic dystrophy or causalgia, a chronic pain condition — in her lower right leg. Although she attempted to continue working as a paralegal, Amoroso ultimately could not perform her work at the same level and allegedly had to go on disability due to her emotional distress, pain, lack of sleep from all her medications, and spasms that were keeping her up at night. She also claimed that it was difficult to wear her ankle/foot orthotic because it required wearing closed-toe shoes and she was not able to wear anything other than flip flops due to the hypersensitivity she developed after Pradhan’s surgeries. In addition, she claimed that the configuration of the ankle/foot orthotic brace put pressure on her knee in the very area that she developed the neuropathic pain. Thus, Amoroso sought recovery of between $1.6 million and $2.4 million in lost income/earning capacity, and approximately $125,000 in past and future medical costs. She also sought recovery of $670,000 in past and future non-economic damages for her pain and suffering. Defense counsel argued that not only did Amoroso’s alleged occur after she had returned to her pre-operative baseline, but that they also occurred when Amoroso was not wearing the ankle orthotics/braces prescribed for her by multiple physicians. Counsel also argued that, regardless, Amoroso has continued to improve up to the present day and that she has far surpassed her pre-operative physical condition. Defense counsel further argued that Amoroso’s condition was ultimately much improved following the surgery and that there is no reason that she could not return to work as a paralegal, as she did, in fact, continue to work full-time as a paralegal following the surgery until January 2012. Additionally, counsel contended that recent social media postings and sub rosa video footage of workouts demonstrated that Amoroso has no physical deficits in her right lower extremity at the S1 level and that she can run, jump, and hike on uneven surfaces with care while wearing a compression ankle sock. In response, plaintiff’s counsel contended that no videos or posting showed any activity utilizing the L5 nerve root, which includes dorsiflexion of the right ankle.