On April 30, 2008, plaintiffs’ decedent Dean Russell, 56, a finance director at Northridge Toyota, presented to Facey Medical Group’s urgent care center in Mission Hills with complaints of a cough (especially at night), post-nasal drip, a throat tickle and sinus tenderness. Russell had a significant history of coronary artery disease with a myocardial infarction when he was 29. His coronary risk factors included hypertension, cardiac arrhythmia, being over-weight and hyperlipidemia. While at the hospital in April 2008, Russell was evaluated by Dr. Kevin Vuong, and diagnosed with sinusitis and bronchospasm. He was subsequently prescribed antibiotics and an albuterol inhaler. On June 17, 2008, Russell presented to Dr. Wei-Cheng Jen, his primary care physician at Facey, with a number of complaints, including dry cough, chest and nasal congestion, itchy throat, wheezing of the lungs, and chest tightness. Russell underwent a spirometry test and Jen noted evidence of reversible airway disease, most likely due to allergic asthma. As a result, Jen prescribed Prednisone and an albuterol inhaler, among other medications. Russell was also referred to an allergist. On June 23 and July 2, 2008, Russell was evaluated by Dr. Cornelia DeLicona, who, with her partners Dr. Jacob Offenberger and Dr. Joseph Shapiro, was a contracted allergist with Facey Medical Group. After conducting an allergy sensitivity test that showed that Russell was allergic to tree pollens, DeLicona diagnosed allergic asthma. Also, Russell reported improvements of his symptoms with the use of the previously prescribed medications. Russell eventually returned to Jen on July 31, 2008, at which time Russell’s total cholesterol and LDL counts were noted to be elevated. As a result, it was thought that the Simvastatin recommended by his insurance company was not effective. Jen subsequently asked the insurance company to put Russell back on Lipitor. Russell also complained of a cough, chest tightness, wheezing, nasal swelling and a dry cough. Jen felt that the symptoms were still due to allergic asthma and continued the use of asthma medications. On Aug.18, 2008, Russell made an urgent visit to Facey Medical Group because he was unable to sleep at night due to shortness of breath. This time, he was seen this time by Offenberger, who also diagnosed allergic asthma and continued Russell on allergic asthma medications. Russell was last seen by Shapiro at Facey Medical Group on Aug. 17, 2008. Russell reported improvement of his symptoms, but complained of daily burning in his chest with a little bit of tightness with exertion. Shapiro felt Russell had allergic asthma and continued him on the allergic asthma medications. Russell was also asked to go to Shapiro’s private office (outside of Facey Medical Group) to undergo an exhaled nitric oxide test to determine titration of asthma medications. However, Russell did not return to his physicians before he died at work on Sept. 17, 2007, as a result of sudden chest pain and an acute myocardial infarction. No autopsy was performed on the decedent. The decedent’s widow, Lori Russell, his children from another marriage, Melissa and Brian Russell, sued Facey Medical Group, Facey Medical Foundation, Vuong, Jen, DeLicona, Offenberger and Shapiro. They alleged that the defendants failed to properly diagnose the decedent’s condition and that their failures constituted medical malpractice. Thus, they alleged that the defendants were liable for the decedent’s wrongful death. Vuong, Jen, DeLicona, Offenberger and Shapiro were ultimately dismissed from the case, and the matter proceeded to trial against Facey Medical only. Plaintiffs’ counsel contended that the five physicians at Facey Medical Group who treated the decedent mistakenly diagnosed him with allergic asthma, when he was actually experiencing cardiac ischemic symptoms, including those consistent with cardiac asthma. Counsel argued that the physicians should have suspected a cardiac problem given the decedent’s high risk factors and history of coronary artery disease, and that a consultation by a cardiologist was required under the standard of care. Counsel contended that a cardiologist would have made the correct diagnosis, and that the decedent’s life would have been saved by an angioplasty or coronary artery bypass surgery. Additionally, plaintiffs’ counsel argued that Facey Medical Group was vicariously liable for the three allergists on the theory of ostensible agency because these independent contractors treated the decedent at Facey Medical Group’s facilities. Facey’s counsel argued there were objective lab results to support the diagnosis of allergic asthma, and that the standard of care did not require any of the physicians to refer the decedent to a cardiologist., Dean Russell suffered sudden chest pain while at work and died of an acute myocardial infarction. No autopsy was performed on the decedent, but his family claimed he was suffering from cardiac asthma prior to his death. Russell was 56. He left behind a wife, and a son and daughter from another marriage, both who were in their 20s. Russell’s family sought recovery of economic damages for the loss of the decedent’s earnings, claiming $376,034 in past lost earnings and $932,294 in future lost earnings. They also sought recovery of $250,000 to $2 million in non-economic wrongful death damages. Defense counsel contended that decedent suffered an unpredictable and unpreventable plague rupture in a coronary artery, which caused the sudden myocardial infarction and the decedent’s demise.