On Jan. 29, 2009, plaintiff Dusten Chevalier, 24, presented to Kaiser Permanente Hospital in Fresno with complaints of abdominal pain. Even though he wasn’t a Kaiser member, he was admitted for a perceived appendicitis and had his appendix removed. A CT scan of the appendix following removal showed some degree of abnormality, but appeared grossly normal. Chevalier was then evaluated for five days before being released on Feb. 3, 2009. When he was discharged, Chevalier claimed he had signs of a possible arm infection from his IV. On Feb. 4, 2009, Chevalier returned to Kaiser Permanente with increasing redness on his arm and continued abdominal pain. The physician who saw him noted a red and raised area around the prior IV site, and Chevalier was prescribed pain medication and antibiotics for a possible infection, as well as had blood cultures taken. The physician also contacted Kaiser’s infectious disease department and arranged an appointment for Chevalier the next day, which he did not go to. Two days later, the medical staff at the hospital discovered from the cultures that Chevalier had blood-borne methicillin-resistant Staphylococcus aureus (MRSA), a dangerous condition commonly treated with IV antibiotics. Chevalier later developed an abscess growth on his spine over the course of a month. He subsequently went to Madera Community Hospital three times in February 2009, as well as one visit to Saint Agnes Medical Center in Fresno with continued complaints of abdominal and back pain. On March 1, 2009, Chevalier went to Community Regional Medical Center with complaints of debilitating pain, and was diagnosed with osteomyelitis in his spine. Doctors attempted an emergency decompression surgery, but Chevalier’s spine became completely decimated and he was rendered an incomplete paraplegic. Chevalier sued Kaiser Permanente Hospital, Kaiser Foundation Hospitals, Kaiser Foundation Health Plan Inc., and The Permanente Medical Group Inc. He also sued a number of individual Kaiser physicians, who were all dismissed from the case prior to trial. Chevalier alleged that the Kaiser defendants were negligent by failing to timely contact him about the infection that was diagnosed after his discharge, and that this failure constituted medical malpractice. Chevalier further sued Madera Community Hospital; a Madera emergency room physician, Dr. David Smith; and his assistant, Duane Pitts. He alleged that Madera had a duty to contact Kaiser and obtain medical records when he presented to the hospital in February 2009. He also alleged that Smith and Pitts failed to take reasonable steps to diagnose the developing spinal epidural abscess. However, Smith was ultimately dismissed from the case for a waiver of costs, while Madera Community Hospital and Pitts reached separate settlements with Chevalier that totaled $400,000. Thus, the matter proceeded to trial only against Kaiser Permanente Hospital, Kaiser Foundation Hospitals, Kaiser Foundation Health Plan Inc., and The Permanente Medical Group Inc. Chevalier claimed that Kaiser made insufficient attempts to contact him after his diagnosis of MRSA. He alleged that he had given the Fresno hospital a copy of his driver license, which was inexplicably shredded and which listed his home town address in Kerman, where he was staying with his mother in February 2009. Chevalier also alleged that he had initially told doctors that he was staying with step-mother in Clovis, but that the home became vacant. Thus, he claimed that after Kaiser sent police to the home and was told that it was vacant, the hospital should have broadened its search for him. He claimed that after Clovis Police went to the vacated home, Kaiser should have asked the police to help locate him and that if it had done so, the police would have learned from a search of data from the Department of Motor Vehicles that he had a Kerman address, which was where he was staying with him mother at the time. Chevalier claimed that, instead, Kaiser never followed up on the matter after the initial call to the police. Chevalier further claimed that Kaiser failed to refer back to his paper chart, which was undisputedly listed his mother and her cell phone number. He alleged that due to Kaiser’s failure to track him down and alert him of his MRSA infection, he had no knowledge that he had MRSA. Chevalier claimed that if he had been told of his condition, he would have sought treatment sooner and that left untreated, the MRSA led to spinal disease and caused him to become paraplegic. Kaiser disputed Chevalier’s claims, arguing that the plaintiff did not keep the appointment with the infectious disease department even though the Kaiser physician emphasized the importance of the appointment to both Chevalier and his mother. It claimed that once the diagnosis of MRSA was made on Feb. 6, 2009, it tried to contact Chevalier at the phone numbers in the “patient demographics” section of the Kaiser electronic record, but could not reach him. Kaiser also claimed that after Clovis Police discovered that the Clovis address Chevalier provided was vacant, no further efforts were undertaken to locate Chevalier because it was assumed that the patient would follow through on his plan to seek further care at a different institution. Kaiser contended that Chevalier provided incomplete, outdated and even false “demographics” information during the intake procedures at his emergency room visit because he was a drug seeker with a pattern of providing false symptoms to obtain Dilaudid. Defense counsel subsequently presented evidence that Chevalier had visited various hospitals with complaints of pain and a history of kidney stones in order to obtain Dilaudid, and contended that a common practice was to introduce blood into a urine sample as a means of tricking the clinic into prescribing pain medication. Kaiser claimed that copies of driver’s licenses were obtained only for business purposes and were promptly shredded if there was no evidence to retain them. It claimed that the license was never intended to be part of the patient’s medical record, and that contact information was entered into the computer system based on the information provided by the patient. Kaiser further claimed that the standard of care did not require a review of Chevalier’s paper chart, as nursing notes were not a place where contact information would be expected to exist, and that it was entitled to rely on the contact information provided by the plaintiff, himself. In addition, the defense’s experts testified that the steps Kaiser undertook to locate Chevalier were reasonable because the standard of care requires only that police be dispatched to the address provided by the patient if he cannot be reached by phone. Thus, defense counsel contended that Chevalier was negligent for failing to keep his infectious disease appointment, failing to follow discharge instructions, and failing to disclose his pending blood cultures to physicians at Madera and St. Agnes. Chevalier countered that he could not afford the visit at the Infectious Disease Department and that when his mother called Kaiser, she was instructed to have him go to a county hospital. He claimed that since he did not know the extent of his health (the MRSA infection), and since the county hospital told him over the phone that it would take weeks for an appointment, he did not follow through with it. Chevalier further claimed that he always provided accurate contact information, but conceded that he may have exaggerated his symptoms in the past to obtain pain medication. However, he denied ever introducing blood into his urine sample and claimed to have collected 25 kidney stones that he had passed in the several years before he treated with Kaiser., Chevalier was diagnosed with methicillin-resistant Staphylococcus aureus (MRSA), which led to osteomyelitis in this spine. Emergency decompression surgery was attempted, but his spine became completely decimated and he was rendered an incomplete paraplegic. Chevalier is now wheelchair-bound with only minimal sensation in his lower extremities. He claimed that due to having some sensation, as opposed to none, he deals with chronic pain, for which he requires constant medication. He also claimed that he has had several emergency room visits to treat bowel obstructions and other complications from his paralysis. As a result, Chevalier claimed that he will require additional pain management, attendant care and potential surgery for any associated problems. He also claimed that his disability prevents him from pursuing his planned career in equipment operation. In addition, Chevalier claimed that he was very active prior to becoming paralyzed, such as enjoying dirt biking and snowboarding, and that his loss of enjoyment of life has caused him emotional distress. Plaintiff’s counsel contended that Chevalier’s past medical costs amounted to $435,000, and that his future medical costs and life care would amount to $4.2 million to $5.3 million. Counsel also contended that Chevalier’s loss of future earning capacity would be in the range of $470,000 to $880,000, and that his non-economic damages were in the upper seven figures. The defense’ experts testified regarding the future care needs of Chevalier and introduced a life care plan valued at $1.7 million. Defense counsel also argued that future wage loss was considered nominal as result of Chevalier’s poor work history, felony conviction, drug dependency, and that the plaintiff’s receipt of a monthly Social Security benefit should serve as an offset against any future earnings loss. Defense counsel argued that Chevalier will retain the Social Security benefit for the rest of his life and could supplement it with earnings from part-time employment. Counsel further argued that following a period of training, it is expected that Chevalier will be able to work at least half-time, and possibly full-time, in a clerical-type position.