On Dec. 3, 2009, plaintiff Steven Roth, 37, a self-employed insurance and financial consultant, presented to the office of Dr. Dale Prokupek, a gastroenterologist. A friend referred Roth to Prokupek for possible testosterone therapy. Roth presented with complaints of low energy, lethargy, decreased libido, and decreased mood. Prokupek examined Roth, initiated lab tests, and suggested testosterone therapy. As a result, Prokupek prescribed injectable testosterone to Roth. (At the time, Roth was taking Propecia to prevent hair loss, and had been taking it for several years.) Other than some intervals when he stopped testosterone injections for as long as eight weeks, Roth continued the testosterone therapy from the end of December 2009 through June 10, 2012. Beginning in early 2012, Roth and his wife, plaintiff Paula Roth, wanted to have a child, but were unable to conceive. As a result, Ms. Roth also obtained care and treatment from Prokupek in April 2012 and May 2012. However, she did not advise Prokupek that she was trying to conceive, nor did Mr. Roth. In June 2012, Mr. Roth underwent sperm count testing and learned that his sperm count was low with the most likely cause being the testosterone therapy. He immediately stopped the testosterone therapy and was placed on Clomid, which was designed to send signals to the brain to restart semen production. Mr. Roth also underwent bilateral varicocele repair in March 2013 to address varicose veins in the genital area. In addition, he underwent treatment with human chorionic gonadotropin (hCG), a hormone to boost his sperm count. As a result, his total testosterone recovered to pre-treatment levels. Around the same time, Ms. Roth was artificially inseminated (intravaginal insemination), which resulted in the birth of a son in July 2013. In 2014, Mr. Roth underwent an MRI, which showed that the size of the pituitary gland was small and that there was a tumor — a microadenoma — that comprised 30 percent of the pituitary gland. The Roths also conceived a second son, whom was born in October 2014, without the aid of any medical intervention, and Ms. Roth was pregnant and expecting their third child at the time of trial, in late January 2017. Mr. Roth sued Prokupek, alleging that Prokupek was negligent for prescribing the testosterone therapy, for not obtaining his informed consent, and for insufficient monitoring. Mr. Roth alleged that Prokupek’s negligence constituted medical malpractice. Mr. Roth claimed that as a result of taking testosterone, his energy and libido had decreased. He also claimed that he was not able to function at his job and that he did not have any sex drive or energy for activities. Plaintiff’s counsel argued that it was inappropriate to prescribe and administer testosterone to a male with normal testosterone levels. Counsel also argued that Prokupek failed to obtain Mr. Roth’s informed consent and was negligent in the monitoring of Mr. Roth’s blood levels and follow-up care. Plaintiff’s counsel contended that, in fact, there were no follow up lab tests from Prokupek until June 2012, when Mr. Roth requested one. The court granted motions in limine prohibiting non-retained expert witnesses from testifying about their review of materials obtained, other than through their own treatment of Mr. Roth, and prohibiting cumulative testimony by expert witnesses. As a result, the plaintiff’s endocrinologist was not identified by plaintiff’s counsel as a non-retained expert, but was allowed to testify as a subsequent treating physician. The plaintiffs’ treating urologist in male reproduction opined that the prescription and administration of testosterone therapy to Mr. Roth, whose testosterone levels were normal in his blood work, did not meet the standard of care. The urologist also opined that Mr. Roth’s symptoms of low energy, fatigue, and feeling “lousy” and “foggy” could have been caused by being placed on testosterone therapy that was withdrawn. He further testified that the standard of care required Prokupek to disclose to Mr. Roth the effect the testosterone would have on the production of semen. Defense counsel argued that Prokupek was not negligent in his care and treatment of Mr. Roth, that Mr. Roth’s current complaints and alleged damages are not a result of the testosterone therapy and, instead, resulted from Mr. Roth’s long-term history of using Propecia, which led to post-finasteride syndrome. The defense’s endocrinology expert opined that Mr. Roth’s alleged symptoms of lethargy, decreased energy, confusion, fogginess, decreased memory, and difficulty concentrating following testosterone therapy were, to a reasonable degree of medical probability, not a result of testosterone therapy and were, to a reasonable degree of medical probability, caused by Mr. Roth’s long-term history of using Propecia, which led to post-finasteride syndrome; a small pituitary gland with a tumor occupying 30 percent of the gland; and a varicocele, a condition involving varicose veins located in the genital area. The expert testified that the pituitary gland’s smaller size and the presence of a tumor was a substantial factor in causing Mr. Roth’s complaints. The defense’s preventive medicine expert opined that Prokupek was within the standard of care when he prescribed testosterone therapy to Mr. Roth, age 37, and that age is not the determining factor to place a patient on testosterone therapy. The expert also opined that the treatment was appropriate for Mr. Roth’s reported symptoms of decreased energy, decreased libido, and decreased well-being. He testified that the goal was to improve the patient’s symptoms and that it was within the standard of care to prescribe a trial of testosterone therapy to Mr. Roth, whose testosterone level was within a normal range but had symptoms of decreased energy, decreased libido, and decreased well-being, which improved as a result of the testosterone therapy. The preventive medicine expert further testified that no disclosure of the effects of the testosterone on semen production was necessary, as it is not a side effect or complication, and is, rather, the natural expected course and result of the therapy., Mr. Roth claimed that as a result of taking testosterone his energy and libido had decreased. He also claimed that he was not able to function at his job as a self-employed consultant and that he did not have any sex drive or energy for activities. Mr. Roth claimed that he is, presently, 80 to 85 percent back to normal. The plaintiffs’ treating endocrinologist testified that although some patients do not fully recover, Mr. Roth is still improving and has 85 to 90 percent recovered. He opined that Mr. Roth’s improvement is a very good sign that he will completely recover. He also did not believe that Mr. Roth would back-slide. The plaintiffs’ economics expert testified that based upon the hours worked, as reported by Mr. Roth, the number of hours that Mr. Roth’s ability to work productively decreased over 160 hours per month after the treatment with Prokupek. Thus, the economist opined that Mr. Roth’s past loss of earnings totaled $2.8 million and future loss of earnings will total approximately $300,000. Thus, Mr. Roth sought recovery for his past and future loss of earnings, and for his past and future mental suffering and loss of enjoyment of life. His wife, Ms. Roth, brought a derivative claim, seeking recovery for her loss of consortium. The essence of her claim was that she no longer has as frequent intimate relations with her husband. The defense’s economics expert opined that the records produced by Mr. Roth in discovery, and those relied upon by the opposing economics expert, were insufficient; inadequately verified; available, but not provided; had inconsistencies; and included data that was incomplete as to expenses. The defense expert further opined that the available records did not establish a reasonable basis to determine Mr. Roth’s self-employment earnings.