On March 16, 2015, plaintiff’s decedent Aregnazan Babayan, 53, was admitted to Glendale Memorial Hospital to undergo a left pars plana vitrectomy, a surgical procedure that involves removal of vitreous gel from the eye, to treat her diabetic retinopathy. When Babayan arrived, Dr. Ricky Sedgwick, an anesthesiologist, performed a bedside evaluation of Babayan and found Babayan’s glucose level to be 143 micrograms per declitier, which was slightly above normal. Dr. Alfret Moradian, a family physician, then filled out a history and physical short form that described Babayan’s medical history and cleared her for the procedure. Babayan was previously referred to Moradian by Dr. Sam Nikou, an ophthalmologist, who had tried and failed to perform a pan-retinal photocoagulation on Babayan’s eye. Babayan first met with Moradian on Feb. 20, 2015, and Moradian noted Babayan’s history of uncontrolled diabetes. Moradian also performed a physical examination, which showed a regular heart rate and rhythm. Initial tests showed a high glucose level of 253 mg/dL and an elevated HbA1c of 11.4 percent. As a result, he prescribed additional diabetes medications and instructed Babayan to follow an appropriate diet. Moradian continued to treat Babayan for her diabetes over the month prior to the pars plana vitrectomy and, on March 5, 2015, tests again showed a normal blood pressure and no cardiac issues. However, the vision in both of her eyes had continued to deteriorate. In response to the lab results, Moradian again prescribed additional diabetes medications. On March 11, 2015, Babayan had another appointment with Nikou. He found that the vision in her left eye had worsened to 20/200. As a result, he scheduled Babayan for surgery on March 16, 2015. During the surgery, doctors had trouble controlling Babayan’s bleeding. As a result, she received medication to lower her blood pressure. However, her heart rate dropped, and she had to be revived on the table. Babayan died a few hours later. A subsequent autopsy revealed an 80 to 90 percent blockage of the left, anterior, descending coronary artery. The decedent’s widower, David Babayan, sued Nikou, Moradian and Sedgwick. Mr. Babayan claimed that the doctors were negligent, that their negligence constituted medical malpractice, and that this malpractice led to his wife’s wrongful death. Nikou was let out of the case prior to trial, and the claim against Sedgwick settled for a substantial amount. Thus, the trial solely addressed the allegations against Moradian. Plaintiff’s counsel argued that Moradian did not properly manage the decedent’s diabetes. Counsel contended that the 143 mg/dL glucose reading immediately before the surgery was evidence that Ms. Babayan’s diabetes was not under control. Plaintiff’s counsel also argued that Moradian should not have cleared the decedent for surgery due to the abnormal test results and that Moradian should have asked to delay the surgery to give the new medications more time to take effect. The plaintiff’s expert endocrinologist opined that Moradian should have prescribed insulin to lower Babayan’s glucose and HbA1c levels. The decedent’s family claimed that Babayan complained of shortness of breath and chest pain prior to the eye surgery. Plaintiff’s counsel argued that those symptoms, and the decedent’s history of diabetes, should have led Moradian to order a full cardiac evaluation prior to the surgery. Counsel further argued that those tests would have revealed the clogged coronary artery and that as a result, doctors would have performed surgery to clear the artery before the pars plana vitrectomy, which would have prevented the decedent’s death. Per plaintiff’s counsel, the defense’s family medicine expert admitted that Moradian should have performed a pre-operative echocardiography and that Moradian should have spoken to Nikou and Sedgwick about whether the decedent’s diabetes was under control. Defense counsel argued that Ms. Babayan’s diabetes was sufficiently under control at the time of the vitrectomy. Counsel contended that the decedent’s glucose level had declined in the weeks since she started treating with Moradian and that if Moradian had told doctors to delay the surgery, the decedent could have gone blind in her left eye. Defense counsel also maintained that no cardiac workup was necessary because the decedent’s prior blood pressure and heart rhythm exams were normal. Counsel specifically noted that when doctors took the decedent’s vital signs shortly before the surgery, she had a regular heart rhythm and only a slightly elevated blood pressure. The defense further argued that a full cardiac exam was unnecessary because the decedent had no family history of heart problems. Counsel also disputed whether the decedent had complained about chest pain and shortness of breath, noting that there was no mention of those symptoms in her medical records. In addition, defense counsel argued that the blockage of the left, anterior, descending coronary artery would not have appeared on an EKG or any pre-operative testing. According to plaintiff’s counsel, the defense implied that Sedgwick and Nikou should be held liable since they knew about the decedent’s HbA1c test results, but failed to stop the eye surgery. However, the argument was limited by a court order, which stated that counsel could not discuss the other two defendants during the trial., Babayan’s heart rate dropped during the eye surgery, and she had to be resuscitated. She was revived and taken to the Intensive Care Unit, where she died a few hours later. A subsequent autopsy listed several causes of death, including anoxic brain injury, cardiac arrhythmia, complications from the left eye surgery, and atherosclerotic cardiovascular disease. The autopsy specifically concluded that Babayan had an 80 to 90 percent blockage of the left, anterior, descending coronary artery. Plaintiff’s counsel argued that the blockage of the coronary artery caused Babayan’s death. The plaintiff’s expert cardiologist similarly opined that Babayan died from a massive, intraoperative heart attack. The plaintiff sought recovery of past and future non-economic damages. Defense counsel disputed whether Babayan died from a heart attack, which is when blood flow to the heart is blocked. Counsel instead argued that Babayan passed away from cardiac arrest, which is when the heart malfunctions and suddenly stops beating, and that the cardiac arrest was unrelated to the clogged artery. Counsel contended that the deceased suffered from bradycardia and asystole, which means she had no discernible electrical activity on the EKG monitor during the eye surgery and that those were signs of cardiac arrest, not a heart attack. Defense counsel specifically noted that the eye surgery was supposed to just take approximately 40 minutes, but, instead, lasted longer than expected due to the continued bleeding. Counsel contended that as a result, Moradian had to manipulate the nerves around the eye for an extended period of time and that it led to occulocardiac reflex, a known, but rare, complication of the pars plana vitrectomy that leads to bradycardia and arrhythmia. Defense counsel maintained that this caused Babayan’s cardiac arrest and death and noted that the autopsy report also mentioned occulocardiac reflex. Plaintiff’s counsel countered that whether Babayan suffered a heart attack or occulocardiac reflex, Babayan’s death resulted from her uncontrolled diabetes and, therefore, Moradian was liable for failing to control the disease prior to the surgery.