On Jan. 27, 2014, plaintiff Aaron Hiatt, 42, an ironworker, underwent the surgery at Mercy General Hospital Outpatient Surgery Center, in Sacramento, to repair tendons in his left ankle. Hiatt previously injured his left ankle at work on April 9, 2013. He was subsequently referred to Dr. Phong Le, a podiatrist at Rubin Orthopedic Group, for care and treatment beginning in July 2013. Various conservative treatment modalities were attempted, but Hiatt’s symptoms did not improve. An MRI scan of his left ankle ultimately revealed a peroneus brevis tendon tear and peroneus longus tendinopathy. Due to Hiatt’s persistent complaints of pain, inability to work, and objective findings on the MRI, Le recommended surgery to repair the tendons. Le went over the risks of surgery, including the possibility that blood clots may develop, after which Hiatt provided his informed written consent to have the operation performed. During the Jan. 27, 2014 surgery, Le noted that there was a greater than 50 percent tear of the peroneus brevis tendon with significant synovitis, as well as synovitis within the peroneus longus tendon. Due to the severity of Hiatt’s injury, Le exercised his judgment to perform a subtalar joint arthrodesis (fusion) procedure, in addition to a repair of the tendons. There were no intraoperative complications, and Hiatt was discharged home following the outpatient procedure. However, postoperatively, Hiatt developed deep venous thrombosis in his left, lower extremity and a pulmonary embolism. Hiatt sued Le; an orthopedist, Dr. Roy Rubin; and Le and Rubin’s orthopedic group, Rubin Orthopedic Group. Hiatt alleged that the defendants were negligent in the performance of the surgery and in the rendering of post-operative care. He also alleged that the defendant’s negligence constituted medical malpractice. Martha Hanson was initially named as a plaintiff, but she was ultimately dismissed as part of a demurrer before trial. Hiatt claimed that Le performing the fusion is what caused the DVT and pulmonary embolism. Although he acknowledged that there was no issue with the repair of the tendons, he claimed that the subtalar joint arthrodesis aspect of the surgery was unnecessary and below the standard of care. Hiatt further claimed that he did not need the fusion, that the fusion was unnecessary, and that the fusion would have laid him off of work for longer than he wanted. In addition, he claimed that the defendants were negligent in the post-operative care provided to him, as they did not respond to his telephone calls and reports of symptoms consistent with DVT. The plaintiff’s podiatry expert relied on Hiatt’s deposition, in which Hiatt claimed that he had all the “classic” symptoms for DVT, that Hiatt attempted to call the orthopedic group but could not get through, that he also could not get in touch with Le, and that this caused Hiatt to present to Woodland Memorial Hospital, in Woodland, for care. The expert testified that he believed Hiatt and that if what Hiatt said was true, then the actions of Le and the orthopedic group were below the standard of care. Thus, the podiatry expert supported Hiatt’s contentions, and opined that the fusion was overkill and not necessary. Specifically, the expert opined that it was not necessary for the ankle to be stabilized. Le claimed that he talked with Hiatt prior to the surgery about stabilizing the ankle, as Hiatt was 5 foot, 9 inches tall and well over 300 pounds. Thus, he claimed he ultimately performed the subtalar joint arthrodesis in order to maximize Hiatt’s stability in the left foot and ankle. Defense counsel contended that the medical chart from Rubin Orthopedic Group only documented a single telephone call by Hiatt after the surgery on Feb. 3, 2014, at which time Hiatt requested a refill of his pain medication only. Counsel also contended that there were no complaints of DVT symptoms documented in that note and that Hiatt’s symptoms appeared after his last call, which was after the surgery. Thus, defense counsel argued that the defendants complied with the standard of care in all respects. The defense’s two expert podiatrists opined that the subtalar joint arthrodesis aspect of the surgery was indicated in order to stabilize Hiatt’s left foot and ankle. The experts also supported the post-operative care provided by the Rubin Orthopedic Group. Defense counsel called to testify the hospitalist who cared for Hiatt at Woodland Memorial Hospital. The hospitalist testified that Hiatt reported that his DVT symptoms did not begin until two days before his admission to the hospital, or Feb. 5, 2014, and that Hiatt’s pulmonary embolism symptoms did not begin until Feb. 6, 2014. Based on that information, the lack of documented complaints of DVT/pulmonary embolism symptoms beforehand, and the pathophysiology of those conditions, the defense’s pulmonology expert testified that it was more probable than not that Hiatt’s DVT symptoms did not begin until after Feb. 3, 2014, which refuted Hiatt’s contention that he reported such symptoms earlier., On Feb. 7, 2014, Hiatt was admitted to Woodland Memorial Hospital, where he was diagnosed with deep vein thrombosis and a pulmonary embolism. He subsequently received anticoagulation treatment. Hiatt’s condition improved, and he was discharged home six days later. He then continued to follow up with Le through May 2014, during which time he recovered from surgery. Hiatt asserted that he was harmed when he developed the pulmonary embolism and that he now requires ongoing anticoagulation in the form of Coumadin medication. Thus, Hiatt sought recovery of $56,000 in past lost earnings for the time he was not able to work. He also sought recovery for his past and future medical costs, and past and future pain and suffering. Defense counsel contended that Hiatt had an optimal result from the surgery. Defense counsel also noted that the plaintiff’s podiatry expert testified that he was not able to say, with a reasonable degree of medical probability, that Hiatt was harmed by undergoing the subtalar joint arthrodesis. One of the defense’s podiatry experts, Dr. Thomas Chang, testified about his evaluation of Hiatt and opined that, once Hiatt healed and had physical therapy, Hiatt had a good result from the surgery and that Hiatt’s prognosis was good. The expert further opined that the fusion was solid and that Hiatt would be able to continue to work.