On Feb. 9, 2017, plaintiff Javier Sastoque, 67, a retired auto body technician, was walking in a Jack in the Box restaurant, in San Diego, when he slipped and fell near an area where an employee was mopping. Sastoque claimed to his back and right shoulder. Sastoque sued the franchisor of the Jack in the Box location, QSC Ventures Inc., and four employees of the restaurant, Davis Gonzalez, Porfirio Hernandez, Sander Baltazar and Diana Gaona. Sastoque alleged that the defendants’ negligently maintained the restaurant and failed to warn of the dangerous condition. Plaintiff’s counsel contended that employees of QSC Ventures failed to place visible warning cones near the area that was being mopped and that as a result, Sastoque slipped and fell. The defendants admitted liability., Sastoque was taken to an urgent care facility on the date of the incident, and he reported a swollen shoulder with diminished range of motion. He claimed he sustained a tear of his right shoulder’s rotator cuff, resulting in adhesions, and protruding discs at the L4-5 and L5-S1 levels, with radiculopathy. Sastoque sought conservative care for his shoulder, but it was allegedly unsuccessful. He then underwent arthroscopic surgery in June 2017, followed by rehabilitation and physical therapy. Sastoque reported improvement to his right shoulder, but claimed he still had pain and a loss of range of motion. He then received multiple subsequent injections to his right shoulder, but he claimed he obtained no additional relief. Sastoque’s back complaints were first documented six days after the incident, on Feb. 15, 2017. Subsequent imaging, in March 2017, showed normal degenerative changes and 1 to 2 millimeter and 2 to 3 millimeter disc protrusions to his lumbar spine. An April 2017 evaluation noted no back pain, and Sastoque sought no medical treatment for his lower back from April 2017 until April 2018. Sastoque eventually received one epidural injection in April 2018. In June 2018, Sastoque and his wife moved to Florida. Following the move, Sastoque’s symptoms were documented to be significantly worse. He underwent conservative care, which was alleged unsuccessful, and he had a two-level lumbar fusion performed at L4-5 and L5-S1 in February 2019. However, Sastoque claimed that the spinal fusion failed and that his back and radicular symptoms dramatically worsened. As a result, he underwent a revision surgery at L4-5 and L5-S1 in July 2019 to correct the failed fusion. Sastoque claimed that the surgical revision resulted in some improvement, but that he continued to have significant back pain and limitations. Sastoque claimed he requires future medical treatment, primarily in the form of pain management and home care assistance, and that he will require treatment for the remainder of his life. Sastoque was retired, so he did not make a loss of earnings or loss of earning capacity claim. However, he sought recovery of $551,125.97 in past medical costs. Sastoque also sought recovery of damages for his past and future pain and suffering. His wife, Elizabeth Sastoque, sought recovery of damages for her loss of consortium based on the effects of her husband’s and limitations on their 42-year marriage. Defense counsel disputed causation and damages. Counsel denied the subject fall caused Mr. Sastoque’s back and shoulder complaints, and contended that Sastoque’s back injury was not consistent with the fall, not promptly reported and not supported by the initial imaging studies. Counsel also contended that Sastoque showed no sign of a significant back injury until after his cross-country move to a new home in Florida and that Sastoque’s complaints were further exacerbated by an unreasonable and unnecessary spinal fusion procedure that failed. Thus, defense counsel asserted that the true cause of Sastoque’s back injury was physical activity during the move or from the surgery two years after the subject slip and fall. Defense counsel disputed the amount of medical special damages, noting that Sastoque was on Medicare and treated, in part, through Medicare, but that Sastoque also incurred expenses from multiple surgeries on lien in order to inflate his damages. In addition, counsel asserted that any further significant medical treatment or in-home care would be unreasonable and unnecessary.