In March 2009, plaintiff Anna Rahm, 16, saw her primary care physician and a physical medicine specialist at Kaiser Permanente Woodland Hills Medical Center, in Woodland Hills, and requested an MRI due to her ongoing back pain. Anna previously began to complain of back pain in August 2008, and her condition progressed until she was suffering radiating pain down her right leg in January 2009. As a result, she was brought to her family’s chiropractor, who was not affiliated with Kaiser Permanente, in February 2009. When treatments were unsuccessful, Anna’s treating chiropractor became concerned about the cause of Anna’s pain and urged her to go to Kaiser Permanente to seek an MRI. Anna and her mother, Lynnette Rahm, then presented to Kaiser Permanente Woodland Hills Medical Center in March 2009 to request the MRI, but Anna’s treating physicians at Kaiser Permanente refused. During a telephone call with Anna’s primary care physician on June 16, 2009, Anna’s mother laid out the history of her daughter’s conservative care and again asked the doctor for an MRI, which the doctor ordered and performed on July 2, 2009. The MRI revealed that the cause of Anna’s pain was a large, aggressive, malignant tumor in her pelvis, known as a pelvic osteosarcoma. Thereafter, Anna had to undergo radical surgery to amputate her right leg, remove half her pelvis and fuse her spine. On July 15, 2010, Anna, through her parents, James Rahm and Lynnette Rahm, filed suit against Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals, and Kaiser Permanente Insurance Co., alleging bad faith, breach of contract, and emotional distress. Anna alleged that Kaiser should be held liable for failing to give her a timely MRI to diagnose the cancer in her pelvis. Kaiser Permanente Insurance Co. was ultimately dismissed from the case in October 2010, and Southern California Permanente Medical Group was added as a defendant. In addition, Kaiser Permanente’s counsel moved for summary judgment on the three causes of action (bad faith, breach of contract, and emotional distress), arguing that Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals could not be held liable for bad faith as a matter of law since the claim was based on the alleged conduct of the treating doctors who were employees of Kaiser Permanente. In addition, counsel argued that Kaiser Permanente is not an insurance company and that it could therefore not be held liable for alleged bad faith or breach of contract. Ultimately, on Sept. 11, 2012, after over two years of litigation, Judge James Dunn granted the motion for summary judgment, as to all defendants and all remaining causes of action. However, on Sept. 19, 2012, Anna’s counsel filed a motion for leave to amend the complaint to add a medical negligence cause of action against Kaiser Permanente. Kaiser’s counsel opposed the request, arguing that the case had been pending for over two years and that the defendants would be prejudiced since they would now be forced to re-litigate the case as a medical-malpractice action. Despite Kaiser’s counsel’s arguments, Dunn granted Anna’s counsel’s motion to amend the complaint. As a result, on Jan. 28, 2013, Kaiser Permanente’s counsel moved to have the plaintiff pay a portion of Kaiser Permanente’s costs, in the amount of $52,720, as a condition of the recent amendment, per C.C.P. § 473(a)(2). Over plaintiff’s counsel’s opposition, Dunn granted the motion and Anna, then 21 years old, paid the fees in order to continue the case. Thus, the case survived a petition to compel arbitration, two motions for summary judgment, two writs to the Court of Appeal, three petitions to the California Supreme Court, and a published Court of Appeal opinion. After trial continuances, the case, which was amended to be just Anna’s claim of medical malpractice against only Southern California Permanente Medical Group, ultimately began trial on Feb. 25, 2015. At trial, plaintiff’s counsel argued the physicians employed Southern California Permanente Medical Group failed to timely diagnose Anna’s malignant tumor. Anna claimed that between March 2009 and June 2009, both she and her mother repeatedly requested an MRI from her treating physicians at Kaiser Permanente Woodland Hills Medical Center, but that both doctors refused to order one and failed to document the MRI requests in her medical records. She also claimed that her mother became incensed with the doctors’ refusals to order an MRI, causing her mother to call her primary care physician on June 16, 2009, and beg for an MRI. Anna alleged that as a result, the doctor relented and ordered the MRI, which was eventually performed on July 2, 2009, and which ultimately revealed the large, aggressive pelvic osteosarcoma. Thus, plaintiff’s counsel argued that if Southern California Permanente Medical Group’s physicians had ordered the MRI when it was originally requested, they would have diagnosed Anna’s cancer four months earlier, and Anna’s right leg would have been saved. Counsel for Southern California Permanente Medical Group argued that Anna only saw each of her physicians one time and that Anna failed to follow-up, despite being asked to return if her symptoms did not get better or got worse. Counsel also argued that Anna was prescribed conservative care, including physical therapy, by the physical medicine specialist in March 2009, but that Anna failed to attend physical therapy until May 2009, having canceled two prior visits in April 2009. Defense counsel contended that, instead, Anna’s mother took her to private Pilates, yoga, and acupuncture. In addition, defense counsel argued that the treating chiropractor that saw Anna in February 2009 and March 2009 had ordered an X-ray of Anna’s spine that, in retrospect, showed the osteosarcoma, which had already invaded Anna’s pelvis, sacrum, and spine before she ever came to Kaiser Permanente. Thus, counsel argued that the diagnosis was missed by both the chiropractor and the radiologist who interpreted the X-ray, neither of which were sued by Anna., Anna was diagnosed with a large, aggressive, malignant tumor in her pelvis, known as a pelvic osteosarcoma. She subsequently underwent approximately 10 weeks of chemotherapy, beginning in July 2009. She then required numerous surgeries in October 2009, one of which resulted in an above-the-knee amputation of her right leg, a removal of half of her pelvis, and a fusion of her spine after a portion was removed. Anna then resumed chemotherapy treatment on Oct. 30, 2009, but was not able to complete the full regimen due to an infection. On Nov. 20, 2009, Anna underwent an irrigation and debridement for an extraintestinal Clostridium difficile infection, and then underwent further irrigation and debridement on Nov. 25, 2009. She then went through a recovery period at home from Dec. 1, 2009, through Jan. 24, 2010. While at home, Anna had in-home care and a wound vac. On Jan. 25, 2010, she began chemotherapy once again, which she underwent for four months. Anna finished her 18th and final week of chemotherapy on June 25, 2010. The last round of chemotherapy began on July 21, 2009, and included other treatments, such as blood transfusions and platelet transfusions. Anna and her family claimed that they hope that Anna will never have to undergo another round chemotherapy. However, Anna continues to require a regular schedule of check-ups, lab work, PET scans, bone scans, CAT scans and MRIs. Anna claimed that she suffers from phantom limb pain. She also claimed that since her October 2009 surgery, she has suffered bouts of depression and severe anxiety, as she faces a life much different than she could have ever imagined due to losing her leg, a portion of her pelvis, and a portion of her spine. Plaintiff’s counsel contended that Anna is now 90 percent cured, five years after the October 2009 surgery. Counsel also contended that Anna’s cancer was aggressive and fast growing and that if it had been diagnosed three months earlier, Anna would have had treatment options, as opposed to being told that there was nothing that could be done short of a hemipelvectomy. According to defense counsel, a treating oncologic surgeon, as well as other experts, opined that the same surgery would have been necessary had the diagnosis been made in March 2009 because the osteosarcoma was already in the location that required the amputation of the leg in order to save Anna’s life.