In September 2018, plaintiffs’ decedent Julia Mercado, 68, fell down stairs at her home in San Diego. Mercado had a history of pulmonary embolisms and previously lost most of her small bowel when she developed a blood clot in her mesenteric vein after she was started on replacement estrogen. The events leading to the loss of a portion of her small bowel was adjudicated in a previous arbitration in 2002. In that claim, Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and Southern California Permanente Medical Group were sued for allegedly causing Mercado’s short bowel syndrome and sequela by her physician ordering her to take certain medications, specifically Estrogen. That claim led to Mercado receiving $3,581,529, which she used to purchase an annuity that was guaranteed for 10 years and conditional upon life for an additional 10 years. Approximately 16 years after the prior arbitration, Mercado fell down the stairs at her home and suffered an acute subdural hematoma. She ultimately died on Feb. 4, 2019. The immediate cause of death was determined to be from status epilepticus, and the underlying causes of death included an acute subdural hematoma in a setting of trauma/anticoagulation, end-stage renal disease on hemodialysis, and short bowel syndrome. The decedent’s husband (Jose Mercado) and her six children (Patricia Darenbourg, Jose Mercado Jr., Julissa Franco, Juan Mercado, Edith Mercado Aguilar and Cristal Corona) brought claims against Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and Southern California Permanente Medical Group. The decedent’s family alleged that the decedent’s short bowel syndrome and its sequela were a factor in causing her death. Thus, they alleged that the prior medical malpractice of Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and Southern California Permanente Medical Group caused the decedent’s wrongful death. The Mercado family’s counsel contended that because the decedent, Ms. Mercado, had all but 10 inches of her small bowel removed, she could not digest liquids or foods, and was dependent on total parenteral nutrition (TPN), which is a method of feeding that bypasses the gastrointestinal tract. Counsel contended that as a result, Ms. Mercado became emaciated and weak over time. Counsel also contended that Ms. Mercado required dialysis as a result of kidney failure, was on blood thinners and required over 10 TPN catheter surgeries. Thus, counsel asserted that Ms. Mercado’s short bowel syndrome caused her to become very frail, which made her more prone to falling. The Mercado family’s counsel further asserted that Ms. Mercado’s ability to recover from her head injury was limited because of her weakened state. The respondents’ counsel contended that complications from short bowel syndrome were previously adjudicated in the prior arbitration hearing in 2002 and that the multiple co-morbidities were a remote factor since Ms. Mercado survived for 20 years with short bowel syndrome and sequela. Counsel also contended that the fall was unrelated to Ms. Mercado’s short bowel syndrome and that the same harm would have occurred to Ms. Mercado regardless of the length of her small bowel., Ms. Mercado suffered blunt force trauma to her head, resulting in an acute subdural hematoma. She also developed seizures. To treat the subdural hematoma, Ms. Mercado underwent surgery, which consisted of drilling boreholes into her cranium in an attempt to drain the brain bleed. She ultimately died on Feb. 4, 2019. Her cause of death was determined to be from status epilepticus, which is a seizure that lasts longer than five minutes, or having more than one seizure within a five minute period, without returning to a normal level of consciousness between episodes. The Mercado family’s counsel asserted that Ms. Mercado would have lived for at least 20 years after the annuity was created, if it had not been for the fall. However, counsel contended that Ms. Mercado’s condition as a result of the prior loss of most of her small bowel caused her to become emaciated and weak over time, which caused her to fall and affected her ability to recover from her . Thus, counsel asserted that three years of annuity payments were forfeited as a result of Ms. Mercado’s death 17 years after the annuity was created and that the respondents were responsible for that loss. Ms. Mercado’s family sought recovery of wrongful death damages. Specifically, her husband, Jose Mercado, sought recovery of damages for the loss of support from his wife’s annuity benefits and social security. Her children — Patricia Darenbourg, Jose Mercado Jr., Julissa Franco, Juan Mercado, Edith Mercado Aguilar and Cristal Corona — sought recovery of general damages for the loss of love, companionship, comfort, care, assistance, protection, affection, society and moral support. The respondents’ counsel asserted that Ms. Mercado’s death was due to the brain bleed and resulting from the fall only and that Ms. Mercado’s prior injury was far too remote to have caused her death.