At approximately 10:40 p.m. on Oct. 2, 2015, plaintiff Robert Acquarelli, a radiologist, experienced strokelike symptoms while traveling in a car with his relatives. The driver pulled over, and Acquarelli began speaking in an abnormal fashion. Acquarelli indicated that he felt numbness and weakness on the left side of his body, and he commented that he believed he was having a stroke. An ambulance arrived, and Acquarelli instructed the ambulance personnel to advise the emergency room physician that if the stroke was non-hemorrhagic, tissue plasminogen activator (tPA) therapy, an intravenous medicine given for an ischemic stroke (which is caused by a blood clot), should be provided, as he had prior experience with stroke protocols in terms of timely diagnosing and treating non-hemorrhagic strokes. Acquarelli arrived at Los Robles Hospital and Medical Center, a certified primary stroke center in Thousand Oaks, at approximately 11:19 p.m. A non-contrast CT of his brain, as well as a CT angiography of his neck vessels and brain, were obtained and completed by approximately 11:40 p.m., but no bleed was seen. Two tele-radiologists, Dr. David Jackson and Dr. Arthur Fontaine, rendered reports on the initial CT and CTA studies that were ordered by the emergency room physician. Jackson called the non-contrast CT a normal study, and Fontaine read the CTA and concluded that the study was also normal. Acquarelli was also evaluated remotely by a neurointerventionalist, Dr. M. Asif Taqi, who looked at the films remotely and concluded that there was no radiographic evidence of a clot. Hence, Taqi determined that there was no indication for a thrombectomy. A neurologist, Dr. Liliana Cohen, completed an examination of Acquarelli by approximately midnight and found that Acquarelli’s National Institutes of Health stroke scale had decreased from 4, per the initial evaluation of the emergency room doctor, Dr. Helena Horak, down to zero or near zero. Cohen also noted a positive pronator drift (in which one arm may remain with a palm or forearm facing up, but drops lower than an unaffected arm, and the fingers and elbow might flex) on the left side. Acquarelli demanded that Cohen order tPA therapy, but Cohen stated that she would not do that based on the fact that tPA therapy was not indicated, given what appeared to be a rapid resolution of Acquarelli’s symptoms and her belief that Acquarelli was likely experiencing a transient ischemic attack. Taqi also conferred with Cohen before Cohen left the hospital at approximately 12:20 a.m., providing orders that Acquarelli be admitted for observation to a telemetry unit with certain laboratory studies being obtained, including undergoing an MRI the following morning during daylight hours. At approximately 4:15 a.m. on the morning of Oct. 3, 2015, Acquarelli was found to be unable to move the left side of his body and incontinent of urine. A nurse from the emergency department called Cohen at home, and Cohen ordered a stat MRI, which was carried out at approximately 6 a.m. Noted on the MRI was a significant infarction in the right, middle cerebral artery. Acquarelli underwent a catheter-based angiography, which was performed by Taqi at approximately 11 a.m.. The angiography confirmed a clot in the second segment of the right, middle cerebral artery. Acquarelli sued Horak; Cohen; Cohen’s professional corporation, Neuron Medical Corp.; Jackson; Jackson’s employer, Advanced Teleradiology LLC; Fontaine; a radiologist at the hospital, Dr. Sanjiv Sheel; Los Robles Regional Medical Center; and Los Robles Hospital and Medical Center. Acquarelli alleged that the defendants were negligent in the treatment of stroke. Sheel was removed from the case by way of an unopposed motion for summary judgment, and Horak and Advanced Teleradiology were dismissed from the case for waivers of costs. The matter continued against the remaining defendants. Plaintiff’s counsel contended that Cohen noted that Acquarelli had a pronator drift on his left side while in the emergency room and that a pronator drift may occur in patients with a cerebral injury, such as stroke or cervical spine injury. Counsel argued that since Acquarelli was left-handed and had a positive pronator drift on the left side, the standard of care was that a tPA should have been administered. Counsel also argued that Cohen should have administered the tPA therapy even after the film studies indicated that there was no bleed in Acquarelli’s brain. Plaintiff’s counsel contended that all of the physicians misread the imaging studies ordered from the emergency room. Counsel further contended that the two tele-radiologists, Jackson and Fontaine, misread the reports as "normal" and failed to identify a "hyperdense dot" on the initial non-contrast CT and CTA studies, which was suggestive of a clot in the right, middle cerebral artery. Plaintiff’s counsel argued that had the studies been read correctly, a stroke would have been timely diagnosed and would have been addressed via tPA therapy (as Acquarelli had demanded) and/or a thrombectomy. However, because no therapy was provided, Acquarelli experienced a second major stroke at 4:15 a.m., counsel contended. In addition, counsel noted tPA therapy was not reconsidered after Acquarelli decompensated at approximately 4:15 a.m., nor was further consideration given to a thrombectomy at that point. Jackson claimed that the non-contrast CT study was normal and that there was no "hyperdense dot." In addition, Fontaine maintained that the hyperdense dot claimed to have been present in the non-contrast CT was not present on the CTA and that even if it did appear on the CT study, the area of contention represented a benign microcalcification or artifact of some sort. Defense counsel argued that the catheter-based angiography, which was carried out by Taqi, occurred beyond the window of time in which a thrombectomy would be performed and that, in any event, the clot location in the second segment contraindicated a thrombectomy. Counsel argued that the standard of care had been met in all regards and that Acquarelli’s outcome was outstanding, noting that Acquarelli was discharged from Los Robles Hospital and Medical Center with a near-normal neurological examination on Oct. 16, 2015., Acquarelli maintained that he suffered permanent from the stroke activity he experienced as a result of not being given tPA therapy or undergoing a thrombectomy. He claimed that, as a result, he suffered a loss of fine dexterity and motor control in his left, major dominant hand, as well as some residual numbness. He also claimed that he has weakness in his left foot, which caused him to experience a foot drop problem when he exercised or became fatigued. Acquarelli’s expert life-care planner opined that Acquarelli would require future medical care at a cost of approximately $5 million to $6 million. Acquarelli claimed that, as a radiologist who did some interventional radiology, he was limited in his ability to carry out interventional radiology procedures as a consequence of his limitations and that all of the foregoing would have been avoided with appropriate tPA therapy and/or a thrombectomy. He also claimed that he will be forced to retire in July 2022, inasmuch as he had begun noticing severe fatigue in the nature of post-stroke syndrome ever since the stroke. Acquarelli’s expert economist opined that Acquarelli’s average annual income was approximately $510,000 prior to his retirement. Acquarelli sought recovery of approximately $10.3 million for his past and future loss of earnings, and approximately $5 million to $6 million in future medical costs. He also sought recovery of damages for past and future pain and suffering, which he left up to the discretion of the jury. Defense counsel disputed Acquarelli’s claimed damages and noted that Acquarelli agreed that he made more money on an annual basis after the October 2015 stroke than he had ever made before.