On Nov. 27, 2013, plaintiff Lisa Hirsch, a physician and surgeon, was scheduled to undergo oral surgery at the La Veta Surgical Center, in Orange. Given her reported history of difficult intubations, allegedly requiring fiberoptic assistance, she contacted the medical director at La Veta Surgical Center, Dr. Donald Ruhland, and the anesthesiologist, Dr. Silvia Nicolae, to confirm that fiberoptic equipment would be available and that Nicolae was skilled in the use of fiberoptic equipment. Hirsch claimed that she expressly conditioned her consent to surgery on the intubation being a fiberoptic intubation. The surgery was performed with nasotracheal intubation being accomplished via a direct laryngoscope, not with fiberoptic assistance. The intubation was allegedly uneventful. Hirsch claimed that she awoke from anesthesia with terrible pain in her throat and repeatedly murmuring the words, “bad intubation.” She alleged that her complaints of pain were ignored by the post-anesthesia care unit and that she was eventually given a couple of sprays of a topical anesthetic to her throat before discharging her home. After being discharged, Hirsch was driven home by a friend, who spent the night as planned. At approximately midnight, Hirsch awoke with difficulty breathing. She checked her oxygen saturation levels with a home monitor kept by her bedside, and the monitor allegedly revealed that her oxygen saturations were at a critical level of 51 percent. Hirsch called the surgeon to report the alleged development and then had her friend drive her to the emergency room at St. Joseph Hospital, in Orange, where she was evaluated by an otolaryngologist, Dr. Felizardo Camilon, in the early morning hours of Thanksgiving, Nov. 28, 2013. Camilon described blood clots in Hirsch’s nasal cavity and swelling in the airway, which he characterized as “laryngeal intubation trauma,” and prescribed steroids and antibiotics to Hirsch before discharging her home that morning. Over the ensuing days, weeks and months, Hirsch allegedly noted the onset of severe, disabling symptoms, including alleged brain damage from a purported anoxic event. Hirsch sued Nicolae; Ruhland; the operator of La Veta Surgical Center, Surgicare of La Veta, Ltd.; an outpatient surgical center that is partnered with Surgicare of La Veta, Surgical Care Affiliates, LLC; Camilon; and her treating oral surgeon, Dr. Sanford Ratner. Ratner and Camilon, were voluntarily dismissed prior to trial. Plaintiff’s counsel contended that Hirsch had limited her consent to anesthesia to a fiberoptic intubation, specifically to avoid any difficulty with intubation, trauma to her airway, and any hypoxic events. Counsel argued that the failure to abide by the terms of her consent resulted in laryngeal intubation trauma and a hypoxic event during surgery, at home or both, resulting in hypoxic brain damage. Plaintiff’s counsel further argued that Hirsch’s condition in the PACU, following surgery, should have alerted the defendants to her alleged laryngeal intubation trauma and that intervention at that time would have averted the purported hypoxic brain injury. Defense counsel denied Hirsch’s allegation regarding her consent, asserting that the only agreement was to perform a fiberoptic intubation if that became necessary. Counsel argued that Hirsch did not, in fact, have a history of difficult intubations nor had she ever undergone a fiberoptic intubation. Instead, defense counsel argued that Hirsch had an extensive, undisclosed history of psychiatric treatment, during which she repeatedly reported, in the months leading up to her surgery, that the Affordable Care Act was destroying her medical practice and that she would soon be forced to close her practice. Defense counsel contended that Hirsch never conditioned her consent to anesthesia on receipt of a fiberoptic intubation, but Hirsch believed a fiberoptic intubation would likely be necessary. For that reason, it was agreed that Hirsch had insisted that fiberoptic equipment be available and that her anesthesiologist be prepared to perform a fiberoptic intubation, if needed. However, counsel contended that at the time of surgery, the anesthesiologist was presented with a Grade I view of the vocal cords and had no need to perform a fiberoptic intubation., Hirsch claimed that she suffered a hypoxic brain injury, resulting in disabling symptoms that would persist for the remainder of her life. Her symptoms allegedly included hearing loss, loss of taste and smell (anosmia), cognitive dysfunction, memory loss, migraine-like episodes (both with and without headaches), loss of concentration, and severe mood swings or outbursts. Hirsch contended that she is no longer competent to function as a physician and surgeon. She claimed that as a result, she was forced to prematurely close her medical practice as of mid-2014 and that she will lose millions of dollars in income over the remainder of her life expectancy. Hirsch sought recovery of $7.9 million in past and future loss of wages due to the loss of her medical practice. Her counsel also asked the jury, during closing arguments, to award at least $5 million in non-economic damages for Hirsch’s past and future pain and suffering. Defense counsel argued that there was no significant laryngeal intubation trauma caused by the easy intubation and that Hirsch never experienced any hypoxic event or any hypoxic brain injury. Instead, the defense argued that Hirsch suffered from a psychiatric somatoform disorder, which produced her disabling symptoms.