In July 2013, plaintiff Kimberly De Pinto, an unemployed woman in her 50s, suffered a trimalleolar ankle fracture, in which her left ankle fractured in three places. She subsequently presented to Tahoe Forest Hospital, in Truckee, where Dr. Jeffrey Dodd, an orthopedic surgeon, performed an open reduction and internal fixation procedure on De Pinto’s ankle. However, the fixation failed. As a result, Dodd performed a revision procedure one month later, in August 2013. De Pinto then left the area and continued treatment with a podiatry expert from Southern California, who performed a complete ankle replacement in November 2014. De Pinto claimed sequelae to her left ankle. De Pinto sued Dodd, alleging that Dodd failed to properly perform the fixation procedure and that this failure constituted medical malpractice. Plaintiff’s counsel contended that Dodd negligently performed the fixation procedure. Specifically, the plaintiff’s treating podiatry expert opined that the initial fixation was performed below the standard of care because Dodd did not fixate the ankle properly and should have used more screws in securing the fixation. Dodd claimed that he properly performed the procedure and tested the fixation under fluoroscopy intraoperatively. The defense’s expert orthopedic surgeon, who trained with the surgeon who developed the anti-glide technique used by Dodd, testified that the reduction and fixation were performed appropriately, but that De Pinto, unfortunately, suffered a well-known and disclosed complication of the procedure, which was a loss of the fixation. The expert also opined that the fixation was promptly re-achieved. The defense’s expert also expressed criticism of a podiatrist performing an ankle replacement, as was done by the plaintiff’s treating expert podiatrist in this case. Thus, the defense’s expert orthopedic surgeon opined that De Pinto’s alleged ongoing ankle complaints, including post-traumatic arthritis, was not due to the fixation or re-fixation of the ankle, but, rather, due to the initial trimalleolar fracture Dodd suffered., De Pinto claimed that she needed an ankle replacement as a result of the initial failed fixation. She also claimed the failed fixation caused her to develop traumatic arthritis in her ankle, and some ongoing pain and stiffness. The plaintiff’s treating podiatry expert affirmed that the failed initial fixation made it necessary for De Pinto to undergo the ankle replacement. Dodd and the defense’s expert orthopedic surgeon both opined that any complaints of post-traumatic arthritis were natural sequelae of the initial serious fracture, and not due to the subsequent procedures.