On April 24, 2009, plaintiff Maria Silva, 39, a house cleaner, was driving her 1999 Toyota Corolla in stop-and-go traffic on southbound US-101. When she was just north of Broadway Avenue in Millbrae, her vehicle was rear-ended by a 2006 Ford Explorer that failed to stop for traffic. Silva sued the driver of the Ford Explorer, Allen Moore. She alleged that the defendant was negligent in the operation of his vehicle. Moore conceded liability., Following the collision, Silva experienced increasing pain in her back and head. She was transported by ambulance to Peninsula Medical Center in Burlingame. Notes from the visit showed that Silva was diagnosed with lower back pain syndrome and was prescribed pain medications. Silva claimed she continued to experience increased pain in her back and persistent headaches, and on April 26, 2009, she returned to the emergency department at Doctors Medical Center. Silva completed 15 chiropractic sessions from May 12, 2009, until Sept. 21, 2009. The plaintiff’s chiropractor confirmed that Silva demonstrated significant lower back mobility impairment, range of motion restrictions due to spinal pain, spasms and leg radiation. The chiropractor also noted that Silva’s condition was exacerbated by usual work activities, which included leaning, bending and lifting repetitions, and he confirmed that Silva had to be placed on disability. Silva claimed that her symptoms continued to worsen and that she was referred by her prior attorney to an orthopedic surgeon on Jan. 12, 2010. MRIs subsequently revealed a 2.5-millimeter cervical disc bulge at the C5-6 level, and 5-millimeter and 6-millimeter lumbar disc bulges at the L4-5 and L5-S1 levels. On April 5, 2012, the plaintiff’s expert orthopedic surgeon saw Silva and deemed her a candidate for disc replacement surgery. At trial, Silva claimed she experienced severe residual physical pain and limitation that affected all her activities of daily living. She also claimed that a few months before trial, she could not keep her neck still for more than five minutes at a time and could not sleep on either arm. She also said that, in the past, she was able to lift 40 to 50 pounds, but could now only lift up to 5 pounds. However, Silva claimed that those neck, upper back and arm symptoms had almost completely resolved by the time of trial, but that her main problem was her lower back. She alleged that the pain in her back and leg continued to wake her in her sleep, especially during cold weather. She also alleged that she continued to have difficulty walking up and down stairs, ramps and inclines, and could not sit or stand for prolonged periods of time. She further alleged that she was unable to walk for more than 10 minutes at a time, and was unable to do her regular household chores, such as mopping, sweeping, vacuuming or doing laundry. In addition, Silva alleged that she was unable to play with her 9-year-old daughter and was unable to work as a house cleaner from April 24, 2009, to July 20, 2009, and was placed on light duty, thereafter. Thus, Silva claimed past medical expenses of $21,828.29 and future medical expenses of $175,000 for the surgery. Before trial, Silva made a loss of income claim of $28,000 for the seven months of missed work, but she waived that claim at trial. She claimed that she had returned to cleaning houses, but continues to only do light duties, such as dusting, and could not do any heavy lifting. According to defense counsel, plaintiff’s counsel asked the jury to award the plaintiff $1.5 million in total damages. Defense counsel contended that Silva left the emergency room before she was treated. Counsel also contended that the original orthopedic surgeon recommended against surgery and suggested a course of conservative care, which included facet injections and possibly epidural injections, but that Silva did not follow those recommendations. Counsel contended that, instead, Silva obtained a new attorney, who recommended that she see another orthopedic surgeon, which was the plaintiff’s expert at trial. Defense counsel argued that Silva suffered only soft-tissue neck and back from an impact of less than 10 mph, which created a slight dent in the defendant’s license plate and pushed in the back portion for the plaintiff’s car. Counsel also argued that Silva’s treatment was sporadic for the 3.5 years following the accident and was directed primarily by her attorneys. Defense counsel noted that Silva was on her third attorney at the time of trial. In addition, defense counsel argued that the degenerative changes in Silva’s lower back predated the accident and were not aggravated by the crash. Silva was examined by the defense’s expert orthopedic surgeon, who testified that he noted “pain behaviors” that were not consistent with the plaintiff’s objective findings. The defense’s expert subsequently recommended against surgery and said that a conservative, well-planned future course of treatment costing $25,000 to $30,000 would be reasonable. He also opined that the past medical expenses were reasonable. The defense’s expert radiologist confirmed the opinions of the expert orthopedic surgeon, and indicated that a verdict of $50,000 to $60,000 would be reasonable.