On Dec. 27, 2017, plaintiff Ghassan Shankhour, 53, a handyman, was driving in the parking lot of Palomar Medical Center, in the Poway area of San Diego County. His vehicle was rear-ended by a vehicle operated by Gary Markum. Shankhour claimed that he suffered of his back and a hip. Shankhour sued Markum. The lawsuit alleged that Markum was negligent in the operation of his vehicle. Markum was suffering dementia at the time of the accident. Defense counsel conceded liability., Shankhour claimed that he struck a knee on the dashboard, which impacted his left hip. He ultimately claimed that the accident aggravated prior hip and lower back , causing a labrum tear of his left hip and protruding intervertebral discs at the L3-4 and L4-5 levels. Eight days after the accident, Shankhour began chiropractic care, but he claimed that his condition did not improve. He also underwent epidural injections, but he claimed that they also did not resolve his symptoms. In March 2019, Shankhour underwent labrum-repair surgery, which was performed by Dr. Michael Muldoon. Shankhour claimed that the surgery was unsuccessful in resolving his nerve pain. In October 2019, Shankhour underwent a fusion surgery at L3-4 and L4-5, which was performed by another orthopedic surgeon. Shankhour claimed that his nerve pain was alleviated by the spinal fusion. Shankhour’s regular, primary care physician testified that Shankhour had never reported hip or lower back pain to him for the six years preceding the accident. However, Muldoon and Shankhour’s expert orthopedist, Dr. William Tontz Jr., agreed that Shankhour’s hip and lumbar were caused by aggravations of pre-existing degenerative conditions. Muldoon also opined that it was impossible to predict whether Shankhour will require hip-replacement surgery. However, Tontz opined that, to a reasonable degree of medical probability, Shankhour will require lumbar fusion surgeries due to adjacent segment disease. Shankhour sought recovery of $313,968 in total recoverable past medical bills, which were entirely through attorney lien treatment. He also sought recovery of $500,000 in future medical expenses due to alleged subsequent spine surgeries and $284,887 in future loss of income and earning capacity. In addition, he sought recovery of damages for his past and future pain and suffering. Although there was $3,000 in property damage, defense counsel disputed the causation and extent of Shankhour’s alleged . The defense’s expert orthopedic surgeon testified that Shankhour’s hip and lower back were not injured at all during the accident but were strictly degenerative conditions unaffected by the crash.