On May 5, 2014, plaintiff Terry LaRue, a freelance sports videographer, sustained a Bennett’s fracture — a fracture of the base of the first metacarpal bone — of his left hand while working on an assignment near Denver. He was subsequently referred to an orthopedic surgeon to perform surgery the next day. However, LaRue was informed that the surgeon would not accept his insurance, which was issued by Health Net of California Inc. LaRue became covered under a Health Net Affordable Care Act plan, the IFP CommunityCare HMO plan, on May 1, 2014, four days before his injury. Health Net previously contracted with an independent physician association, Accountable Health Care IPA, in October 2013, under which Accountable agreed to maintain an adequate network of primary care physicians and specialists for Health Net CommunityCare members assigned to it, and ensure that the physicians had hospital privileges at CommunityCare network hospitals. When LaRue presented to the recommended orthopedic surgeon in Denver on May 5, 2014, he was advised that his Health Net coverage would not be accepted there. As a result, LaRue returned to California and told Health Net that he “urgently needed surgery,” but he was told that he needed to first see his primary care physician, Dr. Birinder Brara, to get a referral. Brara agreed that LaRue needed to be treated by an orthopedic surgeon and referred LaRue to a clinic with orthopedists, but it did not respond to LaRue’s requests for an appointment. LaRue was then instructed to see a series of doctors who confirmed the immediate need for surgery, but who admitted that they could not provide the necessary treatment, as they were not hand surgeons or contracted with CommunityCare network hospitals. Over the course of approximately seven weeks, LaRue made multiple attempts to contact Health Net and Accountable in attempted to arrange treatment for his injury. He was ultimately referred to a hand specialist on June 2, 2014, and the surgery was performed on June 19, 2014. However, by that time, LaRue’s fracture had partially healed and consolidated in a malposition. As a result, the metacarpal had to be re-fractured and pinned. LaRue claimed that the delay in receiving surgery caused permanent to his hand. LaRue sued Health Net of California Inc., Accountable Health Care IPA, and Dr. Birinder Brara. LaRue alleged that the actions of Health Net and Accountable constituted a breach of contract and that Accountable and Brara’s failure to timely refer him to an appropriate hand surgeon constituted medical malpractice. He also alleged that Accountable’s actions constituted negligence in violation of California Code § 3428, which mandates that managed care providers adhere to standards of “ordinary care.” Health Net and Brara ultimately agreed to settle with LaRue for confidential amounts. Thus, the matter proceeded to trial against Accountable only. LaRue claimed that although he made multiple requests and complaints regarding his severe injury, Accountable made no arrangements for the surgery. He alleged that, instead, he was instructed to see a series of doctors who confirmed the immediate need for surgery, but admitted that they could not provide the necessary treatment, as they were not hand surgeons or contracted with a network hospital. LaRue claimed that he was eventually able to make an appointment with an appropriate specialist after he complained again to Health Net about the lack of a referral to a specialist, but by that time, the damage was done to his hand. Thus, plaintiff’s counsel argued that Accountable failed to authorize the urgent surgery by an in-network hand surgeon and that Accountable’s inadequate network of care providers delayed his ability to find an orthopedic surgeon who could treat his fracture. Accountable’s counsel argued that Accountable did not deny any requests for authorization of treatment and that Accountable properly referred LaRue to medical professionals, but that the individual physicians declined to treat LaRue. Counsel further maintained that Accountable had no control over whether a given orthopedic surgeon would perform the hand surgery., LaRue sustained a Bennet’s fracture of his left, non-dominant hand. Given the nature of the injury, LaRue required relatively urgent treatment in order to prevent a permanent injury. However, he did not receive immediate treatment, resulting in the fracture healing incorrectly. As a result, the metacarpal bone had to be re-fractured in order to reset the bone during surgery. LaRue claimed that he developed complex regional pain syndrome, also known as reflex sympathetic dystrophy or causalgia, a chronic pain condition, as a result of the delayed treatment, re-fracturing of the metacarpal bone, and surgery. He alleged that his ability to move his left thumb has diminished and that he experiences constant pain and swelling. He claimed that his condition is permanent and that he is no longer able to hold or pick up anything involving the left thumb, which affects his ability to hold a video camera in his left hand in his capacity as a videographer. LaRue claimed that as a result, he can no longer work as a professional, action sports videographer, causing him significant financial loss. Thus, LaRue sought recovery of $1.3 million in future lost earnings and $2.5 million in future medical expenses. He also sought recovery of damages for his past and future pain and suffering. Accountable’s counsel noted that LaRue did not complain about the alleged CRPS condition until about a year later. Thus, counsel argued that LaRue’s CRPS was unrelated to the hand surgery.