On March 17, 2014, plaintiff Eduardo Ruiz, 37, a maintenance worker, was stopped in traffic on State Route 52, near the intersection with Interstate 805, in San Diego County. A vehicle operated by William Sanders rear-ended a vehicle that was stopped behind Ruiz, causing that vehicle to rear-end Ruiz’s vehicle. Ruiz claimed to his lower back and right knee. Ruiz sued Sanders and Sanders’ employer, Block Island Remodeling Inc. Ruiz alleged that Sanders was negligent in the operation of his vehicle and that Block Island Remodeling was vicariously liable for Sanders’ actions while in the course and scope of his employment. The defendants admitted liability., Ruiz claimed he suffered a meniscal tear in his right knee and an aggravation to his lower back as a result of the collision. Ruiz previously suffered from degenerative disc disease to the lumbar spine, which was worse at the L5-S1 level. Nine days after the collision, he sought medical care with a chiropractor. Ruiz received two epidural injections eight months after the accident and two facet injections two years after the crash. He then sought follow up care with an orthopedic surgeon. In the fall of 2016, Ruiz received platelet rich plasma injections to his knee. Ruiz claimed that his knee pain went away after the injections. However, he claimed the injections to his lower back only provided temporary relief. Two different doctors recommended a lumbar fusion, but Ruiz had not undergone the procedure by the time of trial. The plaintiff’s orthopedic surgery expert opined that Ruiz’s meniscal tear may have been degenerative or caused by the collision, but that, either way, the pain in the right knee was caused by the collision. Ruiz went to work every day after the crash, and he claimed that he can still do all of his normal daily activities. However, he claimed that he has pain while doing his everyday activities. Ruiz claimed that as a result of his pain, he still wants to undergo the recommended lumbar fusion. Ruiz sought recovery of $61,250 in past medical costs, an unspecified amount of future medical costs, and an unspecified amount of damages for his past and future pain and suffering. Defense counsel noted that Ruiz had a one year gap in treatment after he had his first injections in December 2014 until he sought follow up care with an orthopedic surgeon in November 2015. Counsel also noted that Ruiz had another gap in treatment from January 2017 until the time of trial. Based on the gaps in treatment, defense counsel argued that only an MRI and three months of conservative care were reasonable for Ruiz’s lower back. Counsel further argued that the platelet rich plasma injections that Ruiz had to his knee were not warranted and that Ruiz should have only had a single cortisone injection, at most. Defense counsel argued that Ruiz should only be awarded $25,000.