This case involves a 44-year-old male patient with a history of arthritis who developed a small, benign germ cell tumor in his chest. Following the surgical removal of the tumor, the patient experienced severe bilateral diaphragm paralysis. The patient required several diaphragm plication surgeries to correct this. In spite of the correctional surgeries, the patient could not breathe on his own and was put on permanent ventilation. An expert in cardiothoracic surgery was sought to review the records and opine on surgical technique, causation of paralysis, liability for subsequent ventilation, and the general standard of care for patients under these conditions.