On Sept. 1, 2011, plaintiff Pamela Salazar, an unemployed 47 year old, went with her husband to Arrowhead Regional Medical Center, in Colton, for her husband’s medical appointment. At approximately 2 p.m., before entering the hospital, Salazar slipped and fell on an outdoor access ramp on the sidewalk. Salazar sustained a fracture of her left ankle and allegedly aggravated a pre-existing lower back condition. Salazar sued the county of San Bernardino. (Arrowhead Regional Medical Center, a department of the county, was initially erroneously named. Thus, the county was the only proper defendant.) Salazar alleged that the county was negligent and that it failed to properly repair and/or maintain the ramp area, creating a dangerous condition of public property. The negligence cause of action was nonsuited, and the matter proceeded on the dangerous-condition claim. Salazar claimed that there was loose sand from a broken irrigation pipe, creating a slipping hazard on the access ramp, and that the county had constructive notice of this dangerous condition. She also claimed the county failed to repair and maintain the subject ramp before the accident. Defense counsel argued that the county did not have any notice whatsoever of any alleged dangerous condition existing with the ramp., Salazar sustained a fracture of the left ankle. She was subsequently admitted to the Emergency Room at Arrowhead Regional Medical Center and underwent surgery with the insertion of pins and screws. She then followed up with roughly six weeks of physical therapy. Salazar claimed she also aggravated a pre-existing lower back condition in the slip and fall, causing further pain and discomfort. As a result, she underwent lower back surgery in December 2012. Salazar claimed she did not fully heal from her ankle surgery, in that she still experiences pain, discomfort, and reduced mobility. She alleged that as a result, her daily activities and hobbies are restricted. Salazar also claimed she might eventually require a fusion of her left ankle with subsequent treatment. Thus, Salazar sought recovery of general damages for her pain and suffering. Most of her medical bills were covered by a Medicaid expansion pursuant to the Affordable Care Act (known as “Arrowcare”). Thus, Salazar also sought recovery of the remaining $30,830.59 in past medical costs, which she still owed, as well as recovery of future medical costs. Defense counsel did not dispute the severity of Salazar’s ankle fracture, but argued that Salazar healed well from the injury and did not require any further surgery or treatment. Counsel also argued that Salazar’s lower back surgery was not causally related to the subject incident.