On April 18, 2010, at around 12:11 a.m., plaintiffs’ decedent, Miguel Heredia, 16, a high school student, was admitted to St. Francis Medical Center in Lynwood, after sustaining gunshot wounds. Early, on April 17, 2010, Miguel and his friend were both shot at a party located on the 1400 block of 59th Street in Lynwood. The shooting was described as gang related. Miguel was subsequently transported to the hospital in the early morning hours of April 18, 2010, and was evaluated by Dr. Maxine Anderson, who noted that Miguel was extremely combative and had alcohol in his system, as well as noted that Miguel had active bleeding from the rectum. As a result, Miguel had to be intubated for airway protection. Anderson then noted that Miguel had two gunshot wounds to the back of his head from small pellets, as well as gunshot wounds to his left buttock and to both his left and right thighs. As a result, Anderson performed an exploratory laparotomy and diverting colostomy. At the outset of the surgery, Anderson performed a proctosigmoidoscopy, but a specific injury could not be found due to significant amount of gross blood. She then ran the bowels and found no injury. Since the injury appeared to be extraperitoneal, Anderson then performed a diverting colostomy. Miguel was then seen by an orthopedic surgeon in regard to a minor pelvic fracture and it was determined that the fracture did not require treatment. As a result, Miguel was allowed to weight bear, as tolerated, but was advised that sitting would be painful for six to eight weeks. The next day, on April 19, 2010, Miguel was seen by Dr. Tchaka Shepherd, who noted that Miguel was stable, and underwent a physical therapy evaluation. Anderson then evaluated Miguel again on April 20, 2010, and noted that Miguel’s white blood cell count was 15 with few bands and that his maximum temperature was 99.2 degrees. As a result, Miguel was determined to be making a satisfactory recovery. However, at 2 p.m., Miguel complained of having 10/10 pain, which was reflected in a heart rate of 124 beats per minute and a blood pressure measurement of 126/80. He was otherwise stable, recuperating appropriately and able to ambulate. Anderson then saw Miguel again on April 21, 2010, and noted that Miguel had been tolerating a clear liquid diet and that the patient’s colostomy bag contained some stool, but that Miguel did have a little nausea. As a result, the plan was for Miguel to continue with ambulation, advance his diet and learn about colostomy care. At 2:58 a.m., on the morning of April 22, 2010, the covering surgeon ordered 4 milligrams of Zofran to be administered by IV for nausea and vomiting. At 7:30 a.m., a nurse noted that Miguel was “alert and awake,” that his respiration was unlabored, that the dressing to the abdomen was clean and dry, that the colostomy was intact with minimal bloody output, and that Miguel was in no acute distress. A half hour later, it was determined that Miguel was without an infection, his blood pressure was 105/60, his pulse was 115 beats per minute and his respiration was at 19 breaths per minute. However, when the covering surgeon arrived for rounds at about 8:45 a.m., he was told that Miguel had not been able to urinate since the prior night and had been given multiple episodes of coffee ground emesis. In addition, Miguel told the covering surgeon, “I don’t feel good.” Upon examination, the covering surgeon noted that Miguel’s vital signs were stable and that he was afebrile (without infection), but that Miguel’s abdomen was mildly distended and that the patient had some tenderness over the lower abdomen. Therefore, at 9:00 a.m., the covering surgeon ordered that the IV be restarted and that Miguel be made nil per os, or be given nothing by mouth. He also ordered a replacement of the Foley catheter, lab work and Protonix, and discontinued the Vicodin, as well as changed the pain medication to morphine. In addition, he ordered X-rays of Miguel’s kidney, ureters and bladder. The covering surgeon then signed Miguel out to the on-call trauma surgeon, Shepherd. After the order, the covering surgeon spoke to Anderson, who recommended ordering a CT of Miguel’s abdomen and pelvis with oral and IV contrast in order to rule out an intra-abdominal abscess. As a result, the covering surgeon cancelled the X-rays. At 11:10 a.m., a nurse noted that she had an order to replace the Foley catheter, but was unable to do so. As a result, three nurses also tried to reinsert the Foley catheter, but were also unable to do so. A call was then placed to Shepherd, who gave new orders for a consult from a urologist. At 11:35 a.m., Miguel vomited 100 cc of coffee ground emesis and at 11:40 a.m., Zofran was ordered. Vital signs were next recorded at 12 noon, during which Miguel was determined to be still afebrile, but his pulse was 145 beats per minute, his blood pressure was 90/50, and his respirations were 19 breaths per minute. At 12:25 p.m., Miguel was noted to be lying on the bed, in no distress, and with his mother at his bedside. At 1:15 p.m., plaintiff Teresa Heredia, Miguel’s mother, came out of the room and stated that her son was having blurry vision and still could not void. The nurse noted that Miguel was sitting on the chair and had some complaints of blurry vision, but was able to return to bed. Five minutes later, the nurse tried to reinsert the Foley catheter without success. As a result, Shepherd was called at 1:37 p.m. and made aware of Miguel’s complaints of blurry vision and not being able to void. As a result, Shepherd re-ordered the X-rays of Miguel’s kidney, ureters and bladder, and advised the nurse that he would be up to see Miguel. At approximately 2 p.m., the nurse placed Miguel on an oxygen monitor and was trying to attach it to the wall when she noted that Miguel had drainage coming out of his nose. She subsequently called for help as Miguel began throwing up brown emesis. While Miguel was still in a chair, he went limp, causing the nurse to call a Code Blue, which was commenced two minutes later. CPR was undertaken for more than an hour and Miguel was ultimately pronounced dead at 3:18 p.m. on April 22, 2010. An autopsy performed by the Los Angeles County Department of Coroner indicated that the cause of Miguel’s death was cardiac arrhythmia-ventricular tachycardia progressing to ventricular fibrillation as a result of the prior gunshot wound to his left buttock. As a result, the mode of death was determined to be homicide. Miguel’s parents, Teresa Heredia and Miguel Heredia Sr., sued St. Francis Medical Center, Anderson and Shepherd. The hospital was ultimately let out of the case on summary judgment, while Anderson was dismissed from the case. Thus, the matter continued against Shepherd only. Plaintiffs’ counsel contended that Miguel became dehydrated, which triggered a cardiac arrhythmia around 2 p.m. on April 22, 2010, which ultimately led to his death. Counsel argued that Shepherd should have investigated further and asked questions when he was contacted by the nurse at approximately 11:10 a.m. or when he was contacted by the nurse at approximately 1:37 p.m. on April 22, 2010. Counsel contended that inquiring further at either of those times would have provided Shepherd with information that would have led to a diagnosis of fluid depletion, leading to hypovolemic shock. Counsel also contended that if the appropriate inquiries were made at either of those times, Miguel would have been treated properly with hydration, further vital sign and lab study management would have been timely ordered to more closely monitor Miguel, and Miguel would not have become dehydrated or died. Shepherd contended that at all times, he complied with the standard of care in the management of Miguel after surgery. Defense counsel argued that when Shepherd was contacted by the nurses in the morning and early afternoon of April 22, 2010, there was no information provided that would have made a reasonable on-call trauma surgeon suspicious of a patient becoming severely dehydrated. Counsel also argued that Miguel did not die from fluid depletion or hypovolemic shock, but that Miguel most likely died suddenly from an acute pulmonary embolus that had become dislodged at the time of the Code or from an intrinsic cardiac arrhythmia that was an unfortunate, but unpreventable, consequence of Miguel’s overall medical status., Miguel suffered a cardiac arrhythmia-ventricular tachycardia that progressed to ventricular fibrillation as a result of a prior gunshot wound to his left buttock. He ultimately died on April 22, 2010. Miguel was 16. The decedent’s parents sought recovery of wrongful death damages for the death of their only son. Defense counsel argued that the cause of Miguel’s death was not fluid depletion or hypovolemic shock, as Miguel’s parents alleged, but contended that Miguel most likely died suddenly from an acute pulmonary embolus or from an intrinsic cardiac arrhythmia.