On Nov. 12, 2014, plaintiff Clara Barreto, 57, a retiree, was driving on westbound Alessandro Boulevard, near the intersection with Nason Street, in Moreno Valley, when her vehicle was rear-ended by a vehicle operated by Sandra Betancourt. Barreto claimed to her neck, resulting in the alleged need for a cervical fusion and possible revision surgery. Barreto sued Betancourt, alleging that Betancourt was negligent in the operation of her vehicle. Jose Castillo was also named as a defendant, but he was ultimately dismissed from the case. Barreto claimed her vehicle was rear-ended while stopped at a red light. Betancourt claimed that Barreto made a sudden and unexpected stop at a green light, which caused the collision., Barreto, who was on disability due to a prior workers’ compensation injury to her back, claimed the accident caused whiplash to her neck and aggravation of her pre-existing cervical condition. She claimed the aggravation caused bulging cervical discs that resulted in the need for a two-level cervical fusion. At the time of the collision, Barreto went to a Kaiser hospital, but she chose to leave before being seen by any medical providers due to the long wait time. Two weeks later, she saw a chiropractor, who was referred to her by her attorney, in order to treat her neck complaints. After completing a course of chiropractic treatment with allegedly little to no improvement, she saw an attorney-referred pain management specialist, who administered injections to her neck. However, Barreto claimed the injections provided only temporary relief. Thereafter, she was seen by an attorney-referred neurosurgeon, who recommended an MRI of the cervical spine, which revealed cervical disc bulges. Based on the MRI findings and Barreto’s ongoing neck complaints, the plaintiffs treating neurosurgeon performed a two-level cervical fusion at C5-6 and C6-7 approximately 16 months after the subject accident. Thereafter, Barreto underwent a course of post-surgical physical therapy, which lasted a few months. Approximately one year after physical therapy ended, Barreto was involved in a major, subsequent accident, wherein she was a passenger in a vehicle that was hit by a drunk driver at a high rate of speed on the freeway. Barreto admittedly lost consciousness as a result of the accident, and she claimed she re-injured her neck. An ambulance rushed her to a hospital and she later presented to an attorney-referred orthopedic surgery expert a few weeks after the subsequent accident. The expert orthopedic surgeon initially opined that Barreto aggravated her neck injury, but after Barreto underwent a recommended CT scan of the cervical spine, it was revealed that Barreto had pseudarthrosis at C5-6 and C6-7. The expert opined that the pseudarthrosis was not a result of the subsequent accident, but a recognized complication of the prior surgical fusion. In September 2017, the plaintiff’s expert orthopedic surgeon recommended a second cervical fusion to address Barreto’s pseudarthrosis. The expert opined that the reasonable cost of all of Barretto’s past medical treatment totaled more than $300,000 and that the reasonable cost of the recommended future cervical revision surgery was approximately $200,000 to $250,000. Barreto claimed that her ongoing neck pain severely affected her daily activities. She alleged that she could no longer exercise, hike, walk, or participate in martial arts and Tai Chi, all of which she did before the subject accident. She further alleged that she could no longer ride in a car for long periods to visit her daughter or travel out of state to visit her aging mother. Barreto sought recovery of more than $300,000 in past medical costs, approximately $200,000 to $250,000 in future medical costs, and an unspecified amount of damages for her past and future pain and suffering. The defense’s expert neuroradiologist opined that the imaging studies did not show any evidence of a neck injury as a result from the subject accident in November 2014. The defense’s accident reconstruction and biomechanical expert opined that the forces involved in the subject accident were minimal and that the forces to Barreto’s cervical spine would have been similar to those involved in exercise with a jump rope. The defense’s expert neurosurgeon performed an independent medical examination and opined that Barreto sustained a neck strain and sprain as a result of the subject accident. The expert also opined that Barreto’s should have resolved after minimal conservative treatment. In addition, the defense’s billing expert opined that the reasonable cost of all of Barreto’s past medical treatment was less than $50,000.