Justia California Court of Appeals Opinion Summaries

McNair obtained a commercial driver’s license (CDL) in 2000 and began driving. McNair has a history of diabetes and cognitive deficits. While under the care of Department of Public Health (DPH) physicians, McNair signed forms, stating that his medical records would not be released without his written authorization, absent an articulated exception. One exception applied if the DPH was “permitted or required by law” to release the information. In 2002, Dr. Pope advised “serious caution" in recommending that the CDL be renewed. In 2004. Dr. Kim refused to certify McNair for a CDL. None of the other physicians would agree to certify him. Dr. Kim wrote a letter to support McNair's application for SSI disability benefits, stating her opinion,that he was not able to hold down any type of full-time employment. Later, Alameda County Transit hired McNair as a bus operator. After learning of his job and that McNair had applied for a certificate to drive school busses, Kim contacted the DMV. McNair’s CDL was temporarily revoked. He lost his job. McNair filed suit alleging breach of his medical privacy rights. The court of appeal affirmed summary adjudication, finding his intentional tort and breach of contract claims barred by the litigation privilege, Civil Code 47(b); both claims were based solely on the propriety of Kim‟s letter to the DMV. View "McNair v. City and County of San Francisco" on Justia Law

This case presented two issues of first impression for the Court of Appeals’ review. The issues touched on the interaction between (a) hospital peer review proceedings against doctors governed by sections 805 to 809.7 of the Business and Professions Code, and (b) the hospital whistleblower statute, Health and Safety Code section 1278.5. The first question was left open by the California Supreme Court “Fahlen v. Sutter Central Valley Hospital,” (58 Cal.4th 655 (2014)). Fahlen held that a physician could prosecute a section 1278.5 action without first having to prevail in an administrative mandate proceeding attacking a peer review determination, but the court did not go so far as to excuse the physician from completing the internal peer review process before filing a section 1278.5 action. The second question was whether a physician bringing a section 1278.5 action could name as defendants individual physicians involved in the peer review process who allegedly instigated the process in retaliation for the physician’s whistleblowing. Based on the analysis of “Fahlen” and the text and legislative history of section 1278.5, the Court of Appeals held that a physician need not complete the internal peer review process prior to filing a section 1278.5 action. With respect to the second issue, the Court held that a physician may not name individual physicians in his/her 1278.5 complaint. A third issue involved the tripartite interaction of the anti-SLAPP stattue, the peer review process, and a physician’s religious discrimination claims against a hospital under FEHA. Specifically, the issue raised here was whether the fact the physician reiterated complaints of religious discrimination by the hospital in the context of protesting the initiation of peer review proceedings against him so intertwined his discrimination claims with the peer review proceedings as to subject his discrimination claims to an anti-SLAPP motion. The Court of Appeals found that based on the facts of this case, the physician first voiced his complaints of religious discrimination prior to the initiation of the peer review proceedings. His discrimination claims were therefore not based on activity protected under the anti-SLAPP statute. View "Armin v. Riverside Community Hospital" on Justia Law

Two weeks after Mr. Magney was hospitalized and while he was receiving palliative care, the course recommended by his treating physician (and by his prior treating physician and consulting cardiologist) and desired by both Magney and his wife, Humboldt County Adult Protective Services filed a petition under the Health Care Decisions Law (Prob. Code, 4600), ex parte and without notice, to effectively revoke Magney‘s written advance care directive (the validity of which has never been questioned) by removing his wife as his designated agent for health care decisions and to compel medical treatment. Two weeks later, Humboldt obtained a temporary treatment order. Within days, Humboldt withdrew its petition and the trial court vacated the order, but denied Magney’s request for statutory attorney fees. The court of appeal reversed, noting “an appallingly inadequate evidentiary showing,” and “misleading the trial court both as to pertinent provisions of the Health Care Decisions Law and as to Mr. Magney‘s medical status.” Humboldt had no reasonable cause to proceed under the Health Care Decisions Law. View "Humboldt County Adult Protective Services v. Superior Court" on Justia Law

Union of Medical Marijuana Patients, Inc. (UMMP) appealed a trial court judgment denying its petition for writ of mandate, which challenged the City of San Diego's enactment of an ordinance adopting regulations for the establishment and location of medical marijuana consumer cooperatives in the City. UMMP argued that the City did not comply with the California Environmental Quality Act (CEQA) when enacting the ordinance. After review, the Court of Appeals concluded that the ordinance did not constitute a "project" within the meaning of CEQA, and accordingly the City was not required to conduct an environmental analysis prior to enacting the ordinance. View "Union of Med. Marijuana Patients v. City of San Diego" on Justia Law

A person who pays for a trip to the emergency room out-of-pocket can be charged significantly more for care than a person who has insurance. This case centered on whether a person could maintain an action challenging this variable pricing practice under the Unfair Competition Law, the Consumer Legal Remedies Act or and action for declaratory relief. The Court of Appeals concluded after review of this case that most of the claims asserted by plaintiff Gene Moran lacked merit. However, he sufficiently alleged facts supporting a conclusion that he had standing to claim the amount of the charges defendants' hospital bills self-pay patients was unconscionable. Therefore, the Court reversed the trial court's dismissal of Moran's case, and remanded for further proceedings. View "Moran v. Prime Healthcare" on Justia Law

After Gloria Glover Woods suffered a psychotic episode, the hospice provider directed that she be transferred from St. John to an acute care hospital for evaluation and treatment. When her treatment was concluded, St. John refused to readmit her to the first available bed under 42 C.F.R. 483.12. Section 483.12 governs the requirements for a skilled nursing facility’s involuntary transfer or discharge of a resident. After an administrative hearing, DHCS ordered St. John to readmit Ms. Woods, and the superior court denied St. John’s petition for writ of administrative mandate seeking to vacate the order. The court concluded that, in light of developments during the pendency of the appeal, the order requiring Ms. Woods’ readmission is now moot. However, because there is a separate civil lawsuit between the parties in which the issue is likely to arise again, the court exercised its discretion and concluded that section 483.12 does not exempt a skilled nursing facility from the readmission requirement when the transfer to an acute care hospital from which the resident is returning was ordered by the resident’s hospice care provider rather than the facility itself. Therefore, to the extent St. John contends that its refusal to readmit Ms. Woods did not constitute an involuntary transfer because she was returning from an acute hospitalization ordered by her hospice care provider, and that therefore St. John was not bound by the involuntary transfer requirements of section 483.12, St. John is mistaken. The court also rejected St. John’s contention that readmitting Ms. Woods and thereafter discharging her after complying with section 483.12’s requirements would have subjected St. John to liability under Health and Safety Code section 1432. View "St. John of God Retirement v. Dep't of Health Care Serv." on Justia Law

Plaintiff filed a class action against United Healthcare, alleging claims of unfair competition, unjust enrichment, and financial elder abuse. Plaintiff had enrolled in a private health plan offering benefits to persons 65 and over as well as disabled persons under the federally funded Medicare Advantage program, 42 U.S.C. 1395w-21 et seq. After he went to an urgent care center outside of the plan's network, he was forced to pay a $50 copayment instead of the $30 copayment for in-network centers. Plaintiff alleged that the plan’s marketing materials misled him (and other enrollees) as to the availability of in-network urgent care centers (and their smaller copayments) and that the absence of any in-network urgent care centers in California rendered the plan’s network inadequate. The court concluded that plaintiff’s misrepresentation and adequacy-of-network based claims was expressly preempted by the preemption clause applicable to Medicare Advantage plans, 42 U.S.C. 1395w-26(b)(3). The court also concluded that plaintiff’s claims, to the extent they challenge a denial of benefits, are subject to dismissal because plaintiff did not first exhaust his administrative remedies under the Medicare Act, 42 U.S.C. 405(g), (h) and 1395ii. Accordingly, the court affirmed the trial court's dismissal of the complaint. View "Roberts v. United Healthcare" on Justia Law

"The facts as alleged in the complaint and in plaintiff’s declaration in opposition to the motion to strike are not at all clear." Plaintiff Un Hui Nam, a new medical resident in the anesthesiology department at UC Davis Medical Center, "got off to a rocky start" in July of 2009. The Court of Appeal surmised that there appeared to have been some tension and misunderstandings right from the beginning of plaintiff's residency. What occurred thereafter and why was the subject of the underlying lawsuit and appeal. Plaintiff labeled the hospital's actions as "retaliation" when she questioned whether residents were allowed to intubate patients. She expressed her disagreement with any policy that would compel the residents in an emergency to wait for the on-call team rather than independently intubating a patient. The week prior to this email, she had received excellent performance evaluations. Plaintiff copied all of the residents in her email. Some of these residents thereafter informed her that she should expect retaliation for sending it. Defendant, however, insisted the e-mail excited no such reaction. Defendant’s version of plaintiff's residency file consisted of a series of complaints, warnings, investigations, and leaves of absence necessitated by plaintiff’s "shortcomings" over a three-year period and culminating in her ultimate termination. The record contained both complaints and testimonials about plaintiff’s performance. Apparently she had a particularly good rapport with nurses. Defendant built a paper trail of warnings for unprofessional conduct and an inability to get along with other doctors. But many of defendant’s allegations were not substantiated during the internal investigations that ensued, and the anesthesiology department was criticized repeatedly for what it did, and did not do, to teach plaintiff the clinical and interpersonal skills needed to succeed in the program. Plaintiff requested, without success, a formal hearing to contest the termination. In January 2013 she filed her complaint for retaliation, discrimination, sexual harassment, wrongful termination, violations of the Business and Professions Code, and breach of contract. Defendant filed a motion to strike pursuant to section 425.16 of the Code of Civil Procedure, alleging that plaintiff’s complaint constituted a SLAPP (strategic lawsuit against public participation) and arose from written complaints made in connection with an official proceeding. Defendant argued that the investigations and corrective action were protected conduct. The trial court disagreed and denied the motion. The trial court's denial of defendant's motion to strike was affirmed: "It is hard to imagine that a resident’s complaint alleging retaliatory conduct was designed to, or could, stifle the University from investigating and disciplining doctors who endanger public health and safety. The underlying lawsuit may or may not have merit that can be tested by summary judgment, but it is quite a stretch to consider it a SLAPP merely because a public university commences an investigation." View "Nam v. Regents of UC" on Justia Law

After Siasmorn Gopal was admitted to the emergency room at Kaiser Foundation Hospitals and died after she was transferred to another hospital, Gopal's husband and the trustee of her estate filed suit alleging that defendants violated California law. Plaintiffs alleged that Kaiser Hospitals, SCPMG, and Health Plan treated Gopal differently than they would have treated a member and that the different treatment caused her death. The court affirmed the trial court's rejection of plaintiffs' enterprise theory of liability. The court concluded that there is nothing inequitable in requiring plaintiffs to look to Kaiser Hospitals and SCPMG - the providers at issue - for compensation for their claims. Thus, plaintiffs are not without recourse or remedy. The court noted that the fact that health care providers, and not health plans, are subject to the Medical Injury Compensation Reform Act of 1975 (MICRA), Civ. Code, 3333.2, is not an inequitable result, but a public policy determination made by the Legislature. Accordingly, the court affirmed the judgment. View "Gopal v. Kaiser Found. Health Plan" on Justia Law

Jesse G. appealed the trial court’s orders appointing the Mendocino County Public Guardian conservator of his person and estate pursuant to section 5350 of the Lanterman-Petris-Short Act (LPS Act), Welf. & Inst. Code, 5000, et seq., and imposing certain special disabilities. The totality of the evidence presented in this case did not support the trial court’s finding that Jesse G. was gravely disabled under the LPS Act. The court concluded that substantial evidence did not support the trial court's finding that the public guardian satisfied its burden of proving beyond a reasonable doubt that Jesse G. would remain gravely disabled where the evidence at trial did not support an objective finding that he, as a result of his mental disorder, is incapacitated or rendered unable to carry out the transactions necessary for survival. Accordingly, the court reversed the order appointing a conservator. View "Conservatorship of Jesse G." on Justia Law