On Jan. 19, 2010, the plaintiff, a 49-year-old home health aide, went by ambulance to a San Andreas emergency room with complaints of abdominal pain. She was seen by an E.R. physician, who obtained a history that the patient had a prior gastric bypass surgery four years earlier. The physician also obtained an abdominal X-ray, which was normal, and discharged the patient with a diagnosis of constipation. Two days later, on Jan 22, 2010, the plaintiff returned to the hospital and saw the same E.R. physician, who again examined her and this time ordered an abdominal CT scan, which showed a bowel obstruction. As a result, a surgeon was contacted at 10:30 a.m. and told about the CT findings, as well as was told that the patient was stable. The surgeon came to the hospital at around 12:30 p.m. and examined the plaintiff. He decided that she needed surgery, but he wanted the records from her prior gastric bypass surgery first. He then left and went to his office. At around 1:25 p.m., the patient had a drop in blood pressure, was seen by the “Medical Assessment Stat Help” team and was transferred to the Intensive Care Unit at 1:40 p.m. At 1:48 p.m., the medical records from the prior gastric bypass surgery were received by fax. However, the surgeon was not informed about the fax, the patient’s drop in blood pressure or the patient’s transfer to the ICU. The surgeon next saw the patient at 4:15 p.m. and decided that she needed urgent surgery, which began at 6:05 p.m. During the surgery, the patient was found to have a necrotic bowel, causing the need for a near total enterectomy, which is the removal of a segment of the intestine. The patient was later transferred to UCLA Medical Center on Jan. 27, 2010, for further evaluation, reversal of her gastric bypass surgery, and surgery to remove necrotic tissue and restore intestinal continuity by removing one foot of small intestine. Upon her discharge, the patient was informed that all but six inches of her small bowel was removed, resulting in short bowel syndrome. The plaintiff sued the original San Andreas hospital, as well as the E.R. physician. She alleged that the defendants failed to timely diagnose and detect her condition, and failed to timely seek a consult. She further alleged that these failures constituted medical malpractice. Plaintiff’s counsel contended that the E.R. physician was negligent for failing to order a CT scan on the patient’s first E.R. visit and for failing to diagnose a bowel obstruction at that time. Counsel further contended that the hospital was negligent on the patient’s second E.R. visit for failing to inform the surgeon about the change in the patient’s condition. Defense counsel contended that the standard of care was met on both the first and second emergency room visits. Counsel also contended that the E.R. physician promptly consulted with the surgeon and was not responsible for any delay after that consult. In addition, the hospital claimed that earlier surgery would not have resulted in saving enough bowel sections to avoid short bowel syndrome, and that the bowel was likely necrotic before the second E.R. visit., The plaintiff suffers from short bowel syndrome, which will require total parenteral nutrition hyperalimentation treatment, a treatment by which the body is supplied with nutrients by bypassing the digestive system and dripping nutrient solution directly into a vein, for the rest of her life. Since being discharged from UCLA Medical Center, the plaintiff’s adult daughter has been providing the set-up and take-down of the total parenteral nutrition, which is administered overnight. Thus, the plaintiff sought recovery of damages, including a past medical care lien by MediCal of $295,994, future medical care costs of $7 million annuity (which includes the cost of everyday use of 12-hour licensed vocational nursing care), and a future loss of earnings of approximately $200,000. Defense counsel disputed the plaintiff’s future loss of earnings based on prior disability status. Counsel also contended that the patient could care for her own total parenteral nutrition needs with minimal assistance of less than four hours per day.