On May 23, 2012, plaintiff Joseph Brook, 83, a race horse trainer/owner, was scheduled for open reduction and internal fixation surgery to treat his femur fracture. The prior morning, at approximately 8 a.m., Brook was training horses at Golden Gate Fields racetrack in Berkeley. As he was walking in the barn area, Brook was struck and run over by a pickup truck. Brook suffered a comminuted displaced intertrochanteric femur fracture of his left leg/hip, among other . He was subsequently transported to the trauma center at Highland Hospital in Oakland, which was part of the Alameda County Medical Center. Brook was then scheduled for surgery on May 23, 2012. The primary surgeon assigned was Dr. Afshin Arianjam, a third year orthopedic surgery resident, and the attending surgeon assigned to supervise the surgery was Dr. William Billings Jr., a board certified orthopedic surgeon on the teaching faculty at Highland Hospital. During the open reduction and internal fixation procedure, two complications occurred that prevented the surgery from being completed as scheduled. First, the tip of a reamer being used by Arianjam to ream, or size, Brook’s femoral canal for placement of the titanium rod became dislodged and wedged inside the femoral canal. Efforts made to retrieve the retained tip (for roughly 45 minutes to an hour) were unsuccessful, and it was decided that the tip should be left in the femoral canal. Secondly, the titanium helical blade, which was the portion of the metallic implant system used to join the femoral rod to the femoral head, was mispositioned in the femoral head. As a result, the tip of the blade accidentally penetrated the femoral head, and entered the cartilage and joint space. Due to the length of the surgery and the amount of blood lost, as well as Brook’s age and medical co-morbidities, the surgery was terminated. Brook was then returned to the intensive care unit, and a revision of the open reduction and internal fixation was scheduled for May 25, 2012, in order to reposition the helical blade. At that time, a different surgical team, headed by the chief of the trauma department, removed and replaced the misaligned helical blade, left the retained reamer tip in place, and completed the procedure successfully and without complication. Brook sued Alameda County Medical Center; Highland Hospital-Alameda County Medical Center; Arianjam; Billings; and Dr. Adam Brooks and Dr. Matthew Lilley, two junior orthopedic surgery residents who were involved in minor capacities (mostly observation) during the May 23, 2012 surgery. Brook alleged that the defendants’ actions constituted medical malpractice and negligence. (Prior to the filing of the medical malpractice lawsuit, Brook exhausted the minimal liability policy of the pickup driver and his own underinsured-motorist coverage. Brook also sued the owners and operators of Golden Gate Fields and one of their agents in another lawsuit, alleging general negligence and premises liability claims, and settled for an undisclosed amount.) Prior to the medical malpractice trial, Brook settled with Billing and Alameda County Medical Center/Highland Hospital-Alameda County Medical Center for an undisclosed amount. Doctors Brooks and Lilley were dismissed for a waiver of costs, and Brook proceeded to trial against Arianjam only. Plaintiff’s counsel argued that Arianjam breached the standard of care in connection with the initial open reduction and internal fixation procedure on May 23, 2012, by failing to possess and exercise the knowledge and skill of an orthopedic surgeon under the circumstances. Counsel also argued that Arianjam’s errors caused the surgical complications that resulted in a second surgery under general anesthesia, prolonged recovery, and residual permanent symptoms of pain and disability. Plaintiff’s counsel further argued that Brook was unaware the surgery was going to be performed by a third-year resident and that there was a lack of informed consent. Counsel contended that Brook spoke with his cardiologist before the surgery, who advised him not to undergo such a surgery late at night, and that Brook tried to protest the surgery, but to no avail. Arianjam denied breaching the standard of care and asserted he met the standard of care expected of him as a resident working under the supervision of an attending surgeon. Defense counsel contended that the surgical complications occurred despite compliance with the standard of care. Thus, counsel moved to dismiss the plaintiff’s claims of lack of informed consent and battery. The court ultimately granted a directed verdict on the defense’s motion., Brook underwent a revision of the open reduction and internal fixation procedure on May 25, 2012, in order to reposition the titanium helical blade, which had accidentally penetrated the femoral head, and entered the cartilage and joint space during the prior surgery. At that time, a different surgical team, headed by the chief of the trauma department, removed and replaced the misaligned helical blade, left the retained reamer tip in place, and completed the procedure successfully and without complication. As a result, Brook remained hospitalized at Highland Hospital until May 31, 2012. He required three weeks of inpatient rehabilitation care at Alta Bates Medical Center/Herrick campus, followed by seven months in an assisted living facility. He returned to living independently in his San Francisco home in January 2013. Brook claimed that Arianjam’s errors caused the surgical complications that resulted in the need for a second surgery under general anesthesia, prolonged hospitalization, rehabilitation admission, and assisted living requirements. He also claimed that the helical blade misalignment produced permanent damage to his hip joint, causing residual pain, disability and limitations that will require a total hip replacement in the future. In addition, Brook claimed the lengthened hospitalization and rehabilitation led to urologic symptoms, requiring more than two months of catheterization and related pain, inconvenience and treatment expenses. Brook claimed he is now married to a cane, in that he has a lot of difficulty standing and walking, which has affected his ability to train horses in a hands-on role. He alleged that as a result, he has had to take on more of a supervisor role. However, Brook did not make a claim for lost earnings as a horse trainer/owner. Instead, Brook sought recovery of past and future out-of-pocket medical expenses of approximately $50,000. He also sought recovery of $700,000 to $800,000 in damages for his pain and suffering. Arianjam’s counsel contended that the surgical complications caused no significant harm and that Brook made a satisfactory recovery from the serious he suffered when he was run over by the pickup truck.