On June 8, 2012, plaintiff Christina Avalos, 41, a nurse, underwent lumbar surgery performed by Dr. William Dobkin, a spinal surgeon at Hoag Memorial Hospital Presbyterian, in Newport Beach. During the procedure, Dobkin used the “Infuse” spinal implant, which consists of a sponge containing growth-stimulating protein that is placed inside a small metal cage. Twelve days after the initial surgery, on June 20, 2012, Avalos underwent a revision surgery by Dobkin. Avalos was later determined to have developed an excessive, ectopic, bone growth in her back, which was confirmed by film 11 months after the surgeries. Avalos sued Dobkin and the manufacturers of the Infuse implant, Medtronic Inc. and Medtronic Sofamor Danek USA Inc. The trial only continued against Dobkin, as the other defendants were dismissed from the case. Plaintiff’s counsel argued that Dobkin used the “Infuse” spinal implant during the surgery without Avalos’ consent and that Avalos’ presurgical chart did not include any mention of Infuse. Counsel also argued that Dobkin negligently used the Infuse implant in addition to another spinal implant, a cage, which was manufactured by Globus Medical Inc. Counsel contended that the Infuse implant received Food & Drug Administration approval in 2002 for use in specialized back surgeries, but that physicians soon began using it to treat a wider variety of more common conditions. (Off-label use is legal in the United States because the FDA regulates medical devices and not the actual treatment that patients receive.) Plaintiff’s counsel contended that the Infuse implant was not approved for use in posterior lumbar surgeries, but that Dobkin used Infuse in 99 percent of his patients. Counsel argued that the fact that Dobkin used Infuse in most of his patients was related to Medtronic investing in a medical software company that Dobkin founded and thus created a conflict of interest. Plaintiff’s counsel also contended that the use of the Infuse implant with the cage resulted in Avalos’ and that Avalos had to have the revision surgery because of inflammation caused by the unapproved use of the Infuse implant. Dobkin claimed that he obtained the proper consent from Avalos and that he had no relationship with Medtronic or Globus that influenced his treatment decisions. Defense counsel contended that Dobkin discussed the risks and benefits of the Infuse implant and properly obtained Avalos’ informed consent. Counsel also contended that the use of Infuse to treat Avalos was consistent with the standard of care and that Avalos’ continued pain was the result of pre-existing medical conditions that the surgery failed to cure., Prior to her surgeries, Avalos suffered from chronic back pain. After her surgeries, she was diagnosed with an excessive bone growth in her back, which has grown on her nerves, as well as inflammation. She claimed that as a result, she suffers from disabling pain. Avalos claimed that she needs another surgery, but that the risk of another surgery is too great, as it could lead to paralysis and other . She alleged that as a result, she suffers from a permanent nerve injury that requires a revision surgery that is too risky to undergo. In addition, she alleged that she has been determined to be disabled and unable to resume work and that ultimately developed colon cancer, which diagnosed in February 2016. Thus, Avalos sought recovery of $6.4 million in total damages. Defense counsel argued that Avalos’ pain was due to her pre-existing back problems and not due to using the subject implant.