On May 17, 2010, plaintiff Megan Isbel, 19, an obese college softball player, underwent an L4-5 laminectomy and discectomy with the removal of a prominent midline bone fragment from the L4 vertebra. The surgery was performed by Dr. Peter Newton to address an L4-5 disc herniation and an avulsion of a bony fragment of the inferior aspect of the L4 vertebra, which Isbel had sustained in the fall of 2009. During the course of the removal of the bony fragment, there was a small tear in the dura on the ventral side as a result of the dura being adherent to the bony fragment. In addition, a nerve root herniated out of the ventral dural tear, which could not be repaired directly because of its ventral location. Newton then performed an intentional durotomy (dural tear) on the dorsal side of Isbel’s thecal sac and went through the sac to pull the protruding nerve root back into the dural sac. He then repaired the ventral tear with a DuraGen patch and Tisseel fibrin sealant, and repaired the dorsal dural incision with sutures and Tisseel fibrin glue. At the end of the procedure, both repaired durotomies were checked and found to be watertight. Isbel was then discharged from the hospital on May 20, 2010. At the time, Isbel was capable of walking and urinating on her own. While at home on May 22, 2010, Isbel developed urinary retention consistent with cauda equine symptoms (pressure on the nerves and nerve roots in the cauda equina). As a result, she returned to the hospital, where a lumbar MRI showed a likely fluid collection at the L4-5 level, consistent with a cerebrospinal fluid (CSF) leak, putting pressure on the thecal sac. Isbel then underwent a second surgery, which was performed by Dr. Hal Meltzer, to close a dural CSF leak, which was found upon gaining access to the dorsal dura on May 23, 2010. A CSF leak was also presumed to be present on the ventral side, and a drain was placed for that potential source of CSF leak. After the surgery, Isbel began to do better at the hospital. However, after her drainage tube was removed, she again developed cauda equina symptoms on May 28, 2010. As a result, Meltzer and Newton took Isbel back into surgery in the early morning hours of May 29, 2010, in order to close the persistent CSF dural leak and to explore the intradural compartment. Meltzer documented that the nerve roots were normal in appearance and freely mobile within the dura with no evidence of excessive scarring or arachnoiditis. He then placed an intradural lumbar peritoneal shunt to drain excess CSF and placed an extra dural drain. Isbel was then discharged from the hospital on June 10, 2010, but she was still having symptoms, post-discharge, consistent with a CSF leak. On July 20, 2010, a neurosurgeon and an orthopedic spinal surgeon brought Isbel to surgery at a different hospital, but they did not find much of a CSF leak. Instead, they recorded that they found a suture through a lumbar nerve root in the area of the prior dural repair. Isbel sued Newton; Meltzer; the Regents of the University of California (which was initially erroneously sued as the University of California San Diego Health System); Rady Children’s Hospital-San Diego; Children’s Specialists of San Diego, A Medical Group, Inc. (which was initially erroneously sued as Rady Children’s Specialists of San Diego AMG Inc.); Dr. Karen Kling; Dr. Michael Levy; Dr. Robert Lark; Dr. Burt Yaszay; and Dr. Tamara Zagustia. Several of the defendants were dismissed from the case, and the matter continued against Newton, Meltzer, Children’s Specialists of San Diego and the Regents of the University of California only. Plaintiff’s counsel agreed that the ventral dural tear was not an indication of a breach in the standard of care, but argued that Newton failed to properly seal the dorsal durotomy. Counsel also argued that Meltzer was negligent in placing a suture through a nerve root during Isbel’s third surgery. Thus, counsel argued that the negligent surgeries constituted medical malpractice. Newton and Meltzer both claimed that their care complied with the applicable standard of care and that they did not cause Isbel any injury or damages., When Isbel still had symptoms consistent with a CSF leak after her May 2010 surgery, she presented to a neurosurgeon and an orthopedic spinal surgeon at a different hospital. She ultimately underwent another surgery on July 20, 2010, but the surgeons did not find much of a CSF leak. Instead, they recorded a suture through a lumbar nerve root in the area of the prior dural repair. Since that surgery, Isbel has greatly improved, but at the time of trial, she was still complaining of cauda equina compressive symptoms and lower extremity weakness and pain. Isbel claimed that she has not yet returned to her previous level of daily activities. She alleged that she suffers from pain to her back, leg, and neck, and that she is unable to sit for a long time, play most sports, or walk for more than about 100 yards. Thus, Isbel sought recovery of $24,348.48 in past medical costs, $517,000 in non-economic damages against Newton and Children’s Specialists of San Diego, and $417,000 in non-economic damages against Meltzer and the Regents of the University of California.