On April 5, 2015, plaintiff Ronald Zannini, 76, became paralyzed and was transported to the emergency department at Henry Mayo Newhall Memorial Hospital, in Santa Clarita, where he was met by hospital staff in the ambulance bay. A neurosurgeon who performed surgery on Zannini a few days earlier, Dr. Mark Liker, happened to be at the hospital and accompanied Zannini to the CT scanner, which was adjacent to the emergency department. The CT scans did not reveal the cause of the paralysis. In addition, Liker was on his way to the airport when Zannini arrived at the hospital. As a result, Liker ordered MRIs of the cervical and thoracic spine, and handed off Zannini to the on-call neurosurgeon for the emergency department, Dr. Martin Mortazavi. Prior to being brought to hospital, Zannini developed neck pain that radiated down his shoulders and left arm, resulting in weakness. He saw a neurologist who ordered a cervical MRI, which revealed a 4-millimeter disc osteophyte complex and moderate-to-severe canal stenosis from C3 through C7. Zannini was then referred to Liker and his medical group, Neurosurgical Associates of Los Angeles Inc., on an urgent basis. After examining Zannini and reviewing the imaging studies, Liker assessed that Zannini was suffering cervical myelopathy and recommended surgery, which Zannini agreed to. Zannini underwent the recommended surgery on his cervical spine at Henry Mayo Newhall Memorial Hospital on March 25, 2015. The surgery, which was performed by Liker, consisted of a cervical laminectomy on the C3, C4, C5 and C6 vertebrae and a cervical posterior instrumented fusion and a cervical posterolateral fusion on the C3-4, C4-5, C5-6 and C6-7 levels. The surgery was uneventful, and Zannini was discharged from the hospital two days later, on March 27, 2015. However, Zannini called Liker’s office the next day and reported bilateral arm weakness. Arrangements were made for Zannini to present to the emergency department at Henry Mayo Newhall Memorial Hospital to undergo an MRI. However, the MRI did not reveal any concerns and it showed no evidence of a cervical hematoma. As a result, Zannini was discharged with instructions to take steroids for the suspected neuropraxia. During the afternoon of April 5, 2015, Easter Sunday, Zannini was applying the lotion to his lower extremities when he felt a sudden warm wave come over his body, and he became paralyzed. After 9-1-1 was called, Zannini was transported to Henry Mayo Newhall Memorial Hospital, where he was met by hospital staff in the ambulance bay at approximately 5:21 p.m. A code trauma was called, and Liker, who happened to be at the hospital, accompanied Zannini to the CT scanner, which was adjacent to the emergency department. The CT scans were obtained at 5:45 p.m., but they ruled out trauma or hardware failure, and did not reveal the cause of the paralysis. As a result, MRIs of the cervical and thoracic spine were ordered at 6:11 p.m. However, the hospital does not have MRI staff working on weekends, so an MRI technician was contacted to perform the scan. Since Liker was on his way to the airport when Zannini arrived at the hospital, Liker dictated a note and called his on-call colleague, Mortazavi, who confirmed that he would perform any neurosurgical intervention, if warranted, based on the MRI findings. Due to spinal shock, Zannini remained in an unstable condition while in the emergency department. As a result, he required a continuous infusion of pressors to maintain his blood pressure. Hospital staff attempted to stabilize Zannini, and an MRI-compatible pump needed to be located prior to commencing the MRI. Zannini was then transported for the MRI suite, which was located in a separate building on the Henry Mayo campus, at 7:40 p.m. The MRI scans ultimately commenced at 8 p.m. and concluded at approximately 9:10 p.m. The scans revealed a large epidural hematoma of the cervical spine, and the results were communicated to Mortazavi at approximately 9:30 p.m. Mortazavi then requested an operating room for an emergent evacuation of the cervical hematoma, but he was informed that an operating room would not be available until 11 p.m. After Liker and his staff called, arrangements were made to have an operating room available. Mortazavi arrived at approximately 10:45 p.m., and Zannini was transported to the operating room at approximately 11 p.m. Surgery to evacuate the hematoma began at 11:35 p.m. and concluded at 12:25 a.m. on April 6, 2015. However, Zannini remained paralyzed. Zannini sued Henry Mayo Newhall Memorial Hospital (which was initially sued as “Henry Mayo Newhall Community Medical Center”); Liker; Liker’s medical group, Neurosurgical Associates of Los Angeles Inc.; Mortazavi; Mortazavi’s medical group, California Neurological Institute Inc.; two treating emergency medicine doctors at the hospital, Dr. Robert Casey and Dr. Elaine Lee; Casey and Lee’s medical group; Santa Clarita Emergency Medical Group Inc.; and a treating general surgeon at the hospital, Dr. Ranbir Singh. Zannini alleged that the defendants failed to timely diagnose and treat his condition and that the defendants’ failures constituted medical malpractice. Mortazavi and Casey were dismissed from the case, and several other defendants were granted summary judgment in their favor. Thus, the matter continued against Liker and his medical group only. Plaintiff’s counsel argued that Liker, despite not being on call, was the “captain of the ship” and that as such, Liker should have supervised an immediate MRI. Counsel contended that had Liker done so, the diagnosis would have been made sooner. Counsel also contended that Liker’s departure caused a delay in the commencement of the surgery and that Mortazavi should have been physically present for the handoff of Zannini prior to Liker’s departure. Defense counsel for Liker and his medical group contended that it was reasonable to order an MRI and that Mortazavi was aware that the study was pending and confirmed that he was available to provide neurosurgical intervention, if warranted. Counsel also contended that the MRI was obtained in a reasonable time frame for a community hospital and that the timing of the MRI study was not related to any alleged breach of the standard of care on the part of Liker., Zannini underwent surgery to evacuate the hematoma at 11:35 p.m. on April 5, 2015. The surgery concluded at 12:25 a.m. on April 6, 2015. Zannini then underwent a long course of rehabilitation, but he ultimately only regained some gross motion in his upper, left extremity. He otherwise remained paralyzed from the shoulders down. Zannini was determined to be tetraplegic. Medi-Cal asserted a lien for $351,175.66, and Medicare asserted a lien for $471,166.06. As a result, Zannini sought recovery of $822,341.72 in past medical costs and over $2.5 million in future medical costs for her needs based on a life care plan. He also sought recovery of damages for his past and future pain and suffering. His wife, Bonnie Zannini, presented a derivative claim seeking recovery for her loss of consortium.