On June 19, 2013, plaintiff Michele Durand, 58, a disabled hospice nurse who had retired in 2003, underwent a manipulation of her left knee under anesthesia in order to break up the scar tissue in an attempt to regain mobility. Durand previously suffered from chronic left knee problems and had been treating her condition conservatively with Dr. Christopher Hutchins Fleming at his practice, Community Medical Group of Riverside Inc., since 2004. As a result, Durand received cortisone shots, physical therapy and pain management, as she wanted to avoid any surgery. However, throughout the years of conservative treatment, Durand was told that she would eventually need a knee replacement, even though she wanted to avoid it, as her condition continued to get worse. In June 2013, Fleming informed Durand that she needed the knee replacement, as all conservative treatment options were no longer viable. The only alternative discussed was a gentle manipulation under anesthesia to break up the scar tissue in order to regain mobility. However, Fleming informed Durand that due to her osteoarthritis and osteoarthrosis, there was a possibility that Durand’s femur could break. Regardless, Durand preferred the manipulation over the knee replacement or surgery. The knee manipulation was performed by Fleming on June 19, 2013. However, during the procedure, Durand’s femur snapped above the knee. As a result, Durand had to have a left knee replacement in November 2013. Durand sued Fleming and Community Medical Group of Riverside Inc. Durand alleged that the defendants negligently performed the manipulation and failed to obtain a proper informed consent. She further alleged that Fleming’s actions constituted medical malpractice. Plaintiff’s counsel contended that Fleming allegedly told Durand on numerous occasions that Durand was not a good candidate for a knee joint replacement for several reasons, including the fact that Durand had a prior history of a methicillin-resistant staphylococcus aureus (MRSA) infection. Counsel further contended that due to Durand’s osteoarthritis and osteoarthrosis, Fleming was negligent for offering the manipulation as an option and for actually performing the manipulation. The plaintiff’s expert orthopedic surgeon opined that the manipulation was not a proper surgical recommendation given Durand’s underlying problems. Defense counsel argued that the manipulation was an acceptable means of practice and that Fleming had full consent from Durand for the risks involved. Counsel contended that Fleming went over the pros and cons and that Durand elected to undergo the manipulation, but that in reality, Durand would eventually need a knee replacement. Defense counsel contended that Durand had chronic knee issues and would have needed a knee replacement anyway. The defense’s expert orthopedic surgeon opined that any procedure recommended was appropriate and that Fleming discussed the risks and obtained adequate informed consent. The expert testified that the recommendation for the knee replacement being made for many years prior to the manipulation was of no surprise to him and that Durand’s limitations were due to her chronic knee problems and not the broken femur., Durand suffered a fracture to his left femur during a knee manipulation. She subsequently required a total left knee replacement in November 2013. Durand claimed that as a result of the fracture, the knee replacement procedure was more complex and more difficult. She also claimed that as a result, her left leg became shorter than her right leg and that she now requires a wheelchair when she needs to go long distances. Thus, Durand alleged that she can no longer walk, bike, hike, or do any of the physical activities that she did before, like rock climbing and zip lining. She further alleged that she has difficulty traveling. The plaintiff’s expert orthopedic surgeon opined that much of Durand’s disability was due to the femur fracture. Thus, the expert opined that Durand would now require a possible future knee revision. Durand sought recovery of $250,000 in damages and her partner, Linda Gort, sought recovery of $250,000 for her loss of consortium. Defense counsel stipulated to $28,000 for medical expenses not paid by insurance. However, defense counsel denied that Durand is wheelchair-bound and argued that Durand’s limitations are not because of the manipulation, but due to Durand’s chronic knee problems that pre-existed the manipulation (and had existed since 1979). Counsel also noted that physician notes showed that Durand’s physical activity decreased over time due to her chronic problems.