Justia California Court of Appeals Opinion Summaries

Plaintiff and appellant Rhonda S. is the conservator, appointed pursuant to section 5350 of the Lanterman-Petris Short Act (LPS), of her adult son David S. Plaintiff sued Defendants and respondents Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals for a declaration of their obligations, under LPS and the terms of David’s health plan, to transport and accept for “assessment and evaluation” (each as defined in LPS) conservatees like David upon their conservators’ demand. The trial court sustained Kaiser’s demurrer.
The Second Appellate District affirmed. The court explained that it rejects Plaintiff’s implication that an LPS conservatee is per se suffering from an “Emergency Medical Condition” at all times following the judicial determination of grave disability. The purposes of LPS conservatorship include providing treatment to the conservatee. (Section 5350.1.) To assume a conservatee’s condition remains static following the conservatorship order is to assume treatment is always ineffectual. We are offered no basis for such an assumption. For a mental health condition to be an “Emergency Medical Condition” under the plan, “acute symptoms of sufficient severity” must result in an “immediate” specified danger or mental health disorder-induced disability. Second, even if conservatees were in a state of perpetual “Emergency Medical Condition” within the meaning of the plan, Plaintiff’s requested declaration would eliminate the coverage requirement that a “reasonable person would have believed that the medical condition was an Emergency Medical Condition which required ambulance services.” View "Rhonda S. v. Kaiser Foundation Health Plan" on Justia Law

Genentech manufactures and sells Rituxan, a drug used to treat leukemia and lymphoma. Rituxan is sold in single-use vials. Williamson was diagnosed with follicular lymphoma and was treated with Rituxan. Williamson later sued Genentech, on behalf of himself and a putative class of similarly situated individuals. He claims that Genentech violates the unfair competition law by selling Rituxan (and three other medications) in excessively large single-use vials; because the appropriate dosage varies based on a patient’s body size, Genentech’s vial sizes are too large for most patients. He argues Genentech should be required to offer smaller vials to reduce the waste of expensive medicine. In addition to injunctive relief, Williamson seeks to recover the amount the class spent on wasted Rituxan (and three other medications). Williamson took only Rituxan, not the other three medications, and paid a $231.15 deductible– the rest of the payments were made by his health insurer.The court of appeal affirmed the dismissal of the case for lack of standing under California’s unfair competition law (Bus. & Prof. Code 17200). Williamson suffered no economic injury caused by the alleged unfair practices and cannot establish standing by borrowing an economic injury from his insurer. The collateral source rule, under which a tortfeasor must fully compensate a victim and cannot subtract compensation the victim may have received from their insurer or another collateral source, does not apply. View "Williamson v. Genentech, Inc." on Justia Law

Plaintiff Gene Moran, who was a patient at Huntington Beach Hospital (the Hospital) three times in 2013, sued defendants Prime Healthcare Management, Inc., Prime Healthcare Huntington Beach, LLC, Prime Healthcare Services, Inc., and Prime Healthcare Foundation, Inc. (collectively defendants) under various theories in 2013. In a prior opinion, the Court of Appeal found that while most of Moran’s claims lacked merit, he had sufficiently alleged facts supporting standing to claim the amount that self-pay patients were charged was unconscionable, and reversed the trial court’s dismissal of the case. Moran’s sixth amended complaint included both the allegations regarding unconscionability and a new theory of the case: defendants had violated the Unfair Competition Law (UCL), and the Consumer Legal Remedies Act (CLRA) by failing to disclose Evaluation and Management (EMS) fees charged in the emergency room through signage or other methods. The complaint sought relief under both the old and new theories for violations of the UCL, CLRA, and for declaratory relief. Defendants moved to strike the allegations regarding EMS fees, arguing their disclosure obligations were defined by statute. The trial court agreed and struck the allegations from the sixth amended complaint. Finding no reversible error in that decision, the Court of Appeal affirmed. View "Moran v. Prime Healthcare Management, Inc." on Justia Law

Petitioner sued directors and staff of a structured sober living facility, including a real party in interest Peter Schuster, for dependent adult abuse. The trial court found Petitioner failed to comply with Code of Civil Procedure section 2031.210 because his statement of compliance in response to Schuster’s document requests failed to identify which documents would relate to which specific requests. The court imposed sanctions against Petitioner and his attorney in the amount of $910 for misusing the discovery process. Petitioner filed the instant petition for a writ of mandate directing the court to reverse the sanctions order. He argued that a statement of compliance in response to a production demand need not identify which document pertains to which request; such identification need only occur when the documents are produced.   The Second Appellate District granted Petitioner’s petition. The court explained that based on the plain language of section 2031.210, a statement of compliance need not identify the specific request to which each document will pertain. Because Petitioner substantially complied with his discovery responsibilities in this regard, the court’s imposition of sanctions was an abuse of discretion. View "Pollock v. Superior Court" on Justia Law

Vilches, the father and guardian of Doe (age 7), took her to Leao for treatment. Vilches later sued Leao to compel the release of Doe’s therapy records. Under Health and Safety Code 123110, the personal representative of a minor is entitled to access the minor’s patient records unless “[t]he health care provider determines that access to the patient records ... would have a detrimental effect on the provider’s professional relationship with the minor patient or the minor's physical safety or psychological well-being. The decision of the health care provider ... shall not attach any liability to the provider unless the decision is found to be in bad faith. Leao indicated she had determined that it would have a detrimental impact on Doe’s ability to trust in general, and would negatively impact the patient-counselor relationship. She was also concerned that Vilches would use the records to coach his daughter's responses in a court evaluation in an upcoming custody proceeding.The court of appeal affirmed summary judgment in favor of Leao, rejecting an argument that the absence of bad faith does not immunize a therapist’s determination from judicial review and that section 123110 creates a presumption of entitlement to disclosure. The statute does not require separate determinations for each type of patient record. When the provider makes the detriment determination, a plaintiff must show bad faith to compel disclosure. View "Vilches v. Leao" on Justia Law

Kelsey Carpenter gave birth to a baby girl at home, alone, after deciding that she would not risk having her child removed from her custody as had happened with her two older children when they tested positive for drugs after being delivered at the hospital. She again used drugs during her pregnancy. After Carpenter’s daughter was born, the baby struggled to breathe, and Carpenter attempted to provide her with CPR. Carpenter also cut the baby’s umbilical cord but did not clamp it, and the umbilical stump continued to bleed. Carpenter bathed, diapered, clothed, and attempted to breastfeed the baby before seemingly passing out. When she woke up, her newborn daughter was dead. Before Health & Saf. Code, § 123467(a) was effective, the State charged Carpenter with implied malice murder and felony child endangerment, contending that Carpenter intentionally chose an unattended at-home delivery, despite being warned of the dangers, in an effort to evade child welfare services and at the risk of her daughter’s life. According to the State, Carpenter’s acts and omissions, including her failure to seek medical assistance after realizing her baby was in distress, caused the baby to bleed to death. Carpenter challenged the superior court’s order denying her motion to set aside the information for lack of probable cause under Penal Code section 995. She contended she was immune from prosecution based on the new law, which went into effect after the preliminary hearing, but before the superior court ruled on her section 995 motion. While the Court of Appeal agreed that Carpenter could not be prosecuted for her decision to have an unattended home birth or any effect that her alleged drug use or lack of prenatal care during pregnancy may have had on her baby, the law did not preclude the State's prosecution for her acts and omissions after her daughter was born alive. The Court therefore denied Carpenter's petition. View "Carpenter v. Super. Ct." on Justia Law

A healthcare provider contended it was underpaid for substance abuse treatment that it rendered to 29 patients. Seeking to recover the difference directly from the insurance company, the provider filed suit alleging the insurer entered into binding payment agreements during verification of benefits and authorization calls with the provider and otherwise misrepresented or concealed the amounts it would pay for treatment. The trial court entered summary judgment against the provider. After review, the Court of Appeal concluded the court did not err in determining one or more elements of the provider’s causes of action could not be established. View "Aton Center v. United Healthcare Ins. Co." on Justia Law

As four medically comprised inmates who required skilled nursing care were approaching their parole dates, the California Department of Corrections and Rehabilitation (CDCR) unsuccessfully attempted to locate post-parole skilled nursing facilities. When their parole dates arrived, the CDCR paroled them to Kern County and transported them to the emergency department at Kern Medical Center (KMC), a licensed general acute care hospital. Kern County Hospital Authority (Hospital Authority), which operates KMC, sought a peremptory writ of mandate and injunction against the CDCR and its Secretary.The trial court granted the Writ, and the CDCR appealed, arguing it does not have a ministerial duty to obtain Hospital Authority’s express consent before transporting parolees to KMC’s emergency department.The Fifth Appellate District reversed, holding that the Department failed to comply with regulation 79789 when transferring the parolees to KMC, and therefore abused its discretion. However, finding that the injunction was overbroad, the Fifth Appellate District remanded to the trial court for issuance of a new peremptory writ. View "Kern County Hospital Auth. v. Dept. of Corrections & Rehabilitation" on Justia Law

Plaintiff was employed by Defendant and, as a condition of employment, was required to get a flu vaccine. Plaintiff sought an exemption based on a medically recognized contraindication, presenting a doctor's note that recommended she avoid the vaccine based on her history of cancer and general allergies. However, neither of these was a medically recognized contraindication, and Defendant terminated her employment.Plaintiff filed suit under the FEHA for disability discrimination. The trial court granted summary judgment in Defendnat's favor, plaintiff appealed.The Second Appellate District affirmed, finding that Defendant did not engage in disability discrimination and that Defendant's reason for terminating Plaintiff's employment was legitimate and lacked pretext. Further, the court rejected Plaintifff's retaliation claim. View "Hodges v. Cedars-Sinai Medical Center" on Justia Law

The Plan is a nonprofit health care service plan subject to Health & Safety Code 1340, including the Parity Act, under which: “Every health care service plan contract . . . that provides hospital, medical, or surgical coverage shall provide coverage for the diagnosis and medically necessary treatment of severe mental illness of a person of any age, and of serious emotional disturbances of a child . . . under the same terms and conditions applied to other medical conditions.”Plaintiffs alleged that the Plan violates the Parity Act by “deterring members from obtaining one-on-one mental health therapy without making individualized determinations … encouraging ‘group’ therapy, without making individualized determinations" where similar practices are not followed in the treatment of physical health conditions. An Unruh Civil Rights Act claim alleged that the Plan intentionally discriminated against persons with mental disabilities or conditions. The court granted the Plan summary judgment.The court of appeal affirmed the rejection of one plaintiff’s individual claims; the Plan is not liable for the acts of its subsidiary by whom the plaintiff’s coverage was issued. The court otherwise reversed. On an Unfair Competition Law claim, the court failed to consider how the Plan’s conduct undermines its contractual promises of covered treatment in violation of the Parity Act. On the Unruh claim, triable issues of fact exist as to whether the plaintiffs were denied medically necessary treatment as a result of intentional discrimination. View "Futterman v. Kaiser Foundation Health Plan, Inc." on Justia Law