On April 7, 2011, claimant James Vaughn, 41, an engineer at Sea World, was undergoing a physical therapy session at Kaiser Permanente-Clairemont Mesa in San Diego when he injured his right, dominant shoulder. Vaughn brought a claim against the operators of the facility, Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals, and Southern California Permanente Medical Group. He alleged that the defendants’ physical therapist was negligent in the treatment of his shoulder and that this negligence constituted medical malpractice. Specifically, Vaughn claimed that the defendants’ physical therapist was over-aggressive and forced his arm beyond the point of extreme pain, resulting in a tear of his rotator cuff. Respondents’ counsel contended that all of Vaughn’s treatment was appropriate and complied with the standard of care. Counsel also contended that Vaughn had a pre-existing injury to his shoulder and that the rotator cuff tear was likely present before Vaughn presented for the subject session at Kaiser Permanente-Clairemont Mesa., Vaughn suffered a rotator cuff tear of his right, dominant shoulder. He claimed pain and trauma from the incident and ultimately underwent surgical repair on Aug. 9, 2011. Vaughn claimed he remains unable to return to work at his prior occupation as a result of ongoing symptoms with his dominant shoulder. Thus, he sought recovery of $250,000 in noneconomic damages, $80,000 in future medical care, and an unspecified amount of damages for his loss of earnings. Respondents’ counsel contended that the rotator cuff tear was likely present before Vaughn presented for the subject physical therapy session and that this session did not cause or aggravate his shoulder condition. Counsel also contended that Vaughn had failed conservative physical therapy prior to his repair surgery.