On May 30, 2012, plaintiff Irene Carlson, 63, a retiree, presented to the La Jolla office of Dr. Grey Cunningham, a dentist, for a follow-up evaluation due to the bone grafting (ridge augmentation and sinus lift) of Carlson’s upper jaw, which was performed six days earlier. At the evaluation, Carlson complained of discomfort, which Cunningham assessed was normal healing. Carlson then returned to Cunningham’s office on June 1, 2012, and again complained of discomfort. Cunningham again assessed that Carlson was healing normally, but noted that he did observe herpetic lesions on Carlson’s palette. After returning from a one-week vacation, Carlson once again returned to Cunningham with further complaints on June 8, 2012. Cunningham noted the presence of exudate (pus), which was indicative of a potential infection, but ultimately concluded that Carlson was healing normally. However, this time, Cunningham switched Carlson’s antibiotic and he had Carlson examined by a neighboring periodontist, who made the same assessment as Cunningham. Carlson then treated with Cunningham once more on June 13, 2012, during which Cunningham drained inflammatory material, but further assessed that Carlson was healing normally in the presence of the potential infection being treated by the antibiotic. The following day, on June 14, 2012, Carlson presented to an oral surgeon, not referred by Cunningham, for a second opinion. The oral surgeon subsequently ordered cultures and diagnosed Carlson with an oral infection that required prompt debridement. Carlson was then admitted to a hospital and the surgeon debrided the oral operative sites. Carlson sued Cunningham, alleging that the defendant failed to promptly recognize and adequately treat her oral infection and that these failures constituted dental malpractice. Plaintiff’s counsel argued that Cunningham was negligent for failing to recognize and adequately treat the oral infection on May 30, 2012 and June 1, 2012. Counsel contended that after those two dates — when Carlson presented to Cunningham with ongoing complaints — the damage had already been done. Plaintiff’s counsel argued that had Cunningham diagnosed and treated the infection during either of those visits, all subsequent complications and procedures would have been prevented. The plaintiff’s general dentistry expert testified that the standard of care required a culture as early as June 1, 2012. Defense counsel argued that Cunningham did not deviate from the standard of care throughout his treatment of Carlson and that while Carlson did suffer an infection that required a debridement, it occurred outside of any alleged negligence. Counsel contended that during the visits on May 30, 2012, and June 1, 2012, Carlson was treated appropriately and did not present with any symptoms indicative of an infection. Counsel argued that as such, there was no reason to order cultures until, arguably, June 8, 2012, when Cunningham assessed that Carlson was healing normally and appropriately switched Carlson’s antibiotics. Thus, defense counsel argued that the June 8, 2012 assessment and treatment complied with the standard of care., Carlson claimed that she developed an oral infection that required a debridement at the oral operative sites. She was then admitted to a hospital, where she remained for four days, and was discharged with a PICC line that remained for eight weeks. On Nov. 30, 2012, Carlson underwent a revision of the bone-grafting procedure to build up the maxilla for implants. The second procedure was performed by the oral surgeon whom Carlson went to for the second opinion. Carlson claimed she then endured a subsequent infection and had surgery to debride the infection, which, in scope, did not result in bone loss. She then had subsequent procedures to place the implants and rebuild gum tissue. Carlson claimed she still requires one more procedure — a gum grafting to restore gum tissue, which is cosmetically related. Thus, she sought recovery of $86,000 in past dental costs (paid by insurance) and $15,000 in future dental costs. (The jury was instructed to consider the fact that Carlson had health insurance to pay her past medical costs via MICRA.) Carlson also sought recovery of $280,000 in damages for her past pain and suffering and $20,000 in damages for her future pain and suffering. Defense counsel contended that the debridement surgery was prompted by the oral surgeon’s principal concern about Carlson’s pre-existing heart condition, which included a history of bypass surgery and multiple stents, and that the surgeon felt that this prior condition placed Carlson at risk to develop a cardiac-related infection. Defense counsel noted that the oral surgeon testified that if Carlson did not have those cardiac-related concerns, he would have continued monitoring Carlson’s healing, but suggested that Carlson would have likely needed the debridement procedure anyway.