On Sept. 29, 2010, plaintiff Ginger Cantwell, an unemployed 60 year old, presented to Fred Fermin Soeprono, M.D., a dermatologist at his clinic, Advanced Dermatology & Laser Center, in Redlands. Cantwell, who had been on three different anti-hypertensive medications between several months to over one year, reported a skin rash in sun-exposed areas on the tops of her hands and forearms. Soeprono testified that it was his opinion the rash could be related to the current medications Cantwell was on, but he never took a detailed history of Cantwell, or a medication history, to investigate what specific medications she was on. Instead, Soeprono opined that the rash was photodermatitis, an abnormal skin reaction to sunlight, and prescribed Triamcinolone, a corticosteroid cream, to apply to the rash for two months before returning. The rash then moved up Cantwell’s arms, prompting her to return to Soeprono two weeks later, on Oct. 13, 2010. Soeprono continued with the photodermatitis diagnosis and continued to treat Cantwell with the Triamcinolone cream, but this time prescribed her the antifungal, Lamisil. Soeprono testified that he still thought the rash on the arms was caused by Cantwell’s prior medications, but still neglected to inquire about what medications she was on, despite the symptoms worsening. After taking the Lamisil for approximately three weeks, Cantwell broke out into a full body rash. She presented to an Urgent Care facility on Nov. 6, 2010, with complaints of an itchy, burning rash covering her back. By Nov. 8, 2010, her entire back consisted of red, raised plaques. On Nov. 12, 2010, she visited the emergency room, as the rash had spread to her whole body and was treated with heavy amounts of steroids. Cantwell then returned to the hospital on Nov. 14, 2010, and was admitted to a hospital with the full body rash, along with large bullous lesions spread throughout her body. She was again treated with steroids, but during her admission, her skin began sloughing and she was clinically diagnosed with a condition considered severe enough to be Stevens-Johnson syndrome. Following recovery from the skin sloughing, Cantwell claimed physical problems that she never before experienced, including dry eyes and dry mouth. Following lab work, she was diagnosed with a connective tissue disease known as Sjögren’s syndrome. Cantwell claimed that the antifungal medication that Soeprono prescribed induced the connective tissue disease because the severe skin reaction that hospitalized her caused a substantial negative effect on her immune system. Cantwell sued Soeprono and Advanced Dermatology & Laser Center. She alleged that the defendants failed to properly treat her following the diagnosis of photodermatitis and failed to confirm a diagnosis prior to prescribing an antifungal medication, and that these failures constituted medical malpractice. Plaintiff’s counsel contended that Soeprono failed to inquire or investigate what caused Cantwell’s initial reaction when she presented to him in September 2010, and failed to treat the underlying cause of the rash she initially presented with. Counsel argued that Soeprono, thereby, allowed the underlying condition to continue to exist. Plaintiff’s counsel also contended that although Soeprono prescribed the corticosteroid, it was only intended to reduce the reaction and not treat the underlying condition. Counsel further contended that when Cantwell returned to Soeprono two weeks later, in October 2010, Soeprono still continued with the diagnosis of photodermatitis, still did not investigate or test what was the cause of the reaction, moved onto diagnose Cantwell with a skin fungus, and prescribed her an antifungal medication. In addition, plaintiff’s counsel contended that the Lamisil that Soeprono prescribed caused the reaction that resulted in Cantwell’s hospitalization. Defense counsel argued that the medications Cantwell was taking, and not the Lamisil, was what led to her hospitalization. Soeprono contended that he did observe a fungus when he saw Cantwell in October 2010 and that he appropriately prescribed Lamisil at that time. The defense’s rheumatology expert attributed Cantwell’s skin reaction to any of the medications she was previously taking prior to her presenting to Soeprono., On Nov. 6, 2010, Cantwell first went to an Urgent Care facility with complaints of an itchy, burning rash covering her back. She claimed that by Nov. 8, 2010, her entire back consisted of red, raised plaques. She then presented to an emergency room on Nov. 12, 2010, when the rash spread to her whole body. Cantwell was subsequently given antibiotics and steroids on Nov. 6, 2010, and Nov. 12, 2010, to try to calm the reaction. However, she ultimately returned to the hospital on Nov. 14, 2010, with the full body rash, along with large bullous lesions spread throughout her body. Cantwell was subsequently admitted to the hospital for three days and two nights, as her full body rash subjected her to infection and her skin began peeling off. As a result, Cantwell was given more steroids and intravenous therapy to keep her hydrated. At the hospital, she was clinically diagnosed with a condition considered severe enough to be Stevens-Johnson syndrome and, over the next two months, Cantwell’s skin peeled in thick chunks from head to toe. Cantwell claimed that after approximately two months, the Stevens-Johnson syndrome of her skin had resolved. However, she claimed that following recovery from the skin sloughing, she noted physical problems that she never before experienced, including dry eyes and dry mouth, and that she was ultimately diagnosed with Sjögren’s syndrome, a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands that produce tears and saliva. Cantwell claimed that she stopped using the initial medications that caused the skin reaction and is currently taking Plaquenil to treat her Sjögren’s syndrome. She alleged that, physically, she was left with hypopigmentation issues where the rash was and that, emotionally, she suffered tremendously from not understanding what was happening to her. Cantwell claimed that as a result, she suffered deep depression and anxiety and that due the appearance of her skin now, she is constantly reminded of what she went through. In addition, Cantwell claimed that she is fearful of taking any medications and has trust issues with physicians. As a result, Cantwell started treating with a counselor at a local sliding scale clinic for psychological counseling, which she continues to date. Defense counsel disputed whether Cantwell ever had Stevens-Johnson syndrome because she never had any of the typical signs and symptoms of Stevens-Johnson syndrome, and because no tests to confirm the diagnosis were ever performed.