Justia California Court of Appeals Opinion Summaries

Mitchell swallowed 60 Naproxen tablets. With her husband, she arrived at the Hospital emergency department on May 27, 2017, alert, oriented, and with no acute distress. The physician noted no motor deficits or sensory deficits. A nurse placed an IV catheter in Mitchell’s forearm. Nearly two hours later, Mitchell walked to the toilet with assistance from her husband, then walked back to her bed without assistance. On the way back, Mitchell fell, causing abrasions to her face and severely injuring her knee. The nursing staff had no reason to suspect Mitchell presented a high fall risk because she did not complain of dizziness; they had no observed balance problems. An x-ray and CT scan of Mitchell’s knee showed serious injuries. Mitchell was referred to physical therapy and was discharged from Hospital.Mitchell filed her complaint, alleging general negligence and premises liability on May 17, 2019. The hospital argued that the complaint alleged professional negligence, rather than general negligence or premises liability, and was barred under Code of Civil Procedure section 340.5’s one-year limitations period. Mitchell acknowledged that the condition of the floor did not contribute to her fall. The court of appeal affirmed the dismissal of the complaint. The nursing staff’s decision to not assist Mitchell in walking to the restroom was “integrally related” to her medical care. View "Mitchell v. Los Robles Regional Medical Center" on Justia Law

As part of a request to receive a higher reimbursement rate, plaintiff Family Health Centers of San Diego (Family Health) submitted a cost report detailing the reimbursable costs incurred by its clinics in providing covered services to Medi-Cal patients. Because the costs were not allowable Medi-Cal costs, Family Health eliminated them from its cost report. As part of an audit, however, defendant State Department of Health Care Services (the Department) determined the costs should not have been eliminated from the cost report. Instead, the Department reclassified the costs to a nonreimbursable cost center, which had the effect of disallowing a proportionate share of the clinics’ administrative overhead costs. Family Health filed an administrative appeal to dispute the audit adjustments, but, after a formal hearing, its appeal was denied. Family Health then filed a petition for a writ of mandate challenging the administrative decision, which also was denied. On appeal, Family Health contended the Department did not establish a proper basis for reclassifying the costs to a nonreimbursable cost center, and that the decision to reclassify the costs was not supported by substantial evidence. Family Health separately argued that a significant subset of the costs should not have been included in the nonreimbursable cost center because they were not costs at all. After review, the Court of Appeal found no reversible error and affirmed the judgment denying the petition. View "Family Health Centers of San Diego v. State Dept. of Health Care Service" on Justia Law

Smith’s hip resurfacing implant consists of a metal ball that covers the top of the femur and a cup that fits inside the hip socket. When a surgeon puts these ball-and-cup surfaces in the joint, the polished metal surfaces are supposed to allow smoother movement than the damaged bone or cartilage they replace. Gall, who had hip resurfacing surgery for his left hip, recovered and became physically active. Years later, convinced his implant was unsatisfactory, Gall sued Smith.Gall argued that Smith failed to properly warn Gall’s surgeon, Dr. Hernandez, about the risks of using Smith’s product. The trial court granted Smith summary judgment because Hernandez independently knew these risks and whether Smith gave Hernandez redundant warnings did not matter. Gall also argued that Smith’s product was defective. The trial court granted summary judgment because Gall did not show anything was wrong with his implant. Gall did show Smith’s quality control procedures once failed to satisfy regulatory authorities, but the court concluded this fact did not imply the parts Gall received were defective. The court of appeal affirmed. Gall’s claims share the same causation element and Gall did not establish causation. View "Gall v. Smith & Nephew, Inc." on Justia Law

Gray received emergency medical care at St. Mary Medical Center, owned and operated by Dignity Health. He received a bill that included an “ ‘ER LEVEL 2 W/PROCEDU’ ” charge. Gray claims Dignity’s failure to disclose, before providing emergency medical treatment, that its bill for emergency services would include such a charge—either by posting “signage in and around” the emergency department or “verbally during the patients’ registration process” —is an unfair business practice under the Unfair Competition Law (UCL) and unlawful under the Consumers Legal Remedies Act (CLRA).The court of appeal affirmed the dismissal of the suit. Gray does not claim that by including an ER Charge in its billing, Dignity violated any of the extensive state and federal statutory and regulatory laws governing the disclosure of hospital billing information and the treatment of persons presenting for treatment at an emergency department. Nor does he take issue with the hospital’s “chargemaster” amount for the Level 2 ER Charge, which his medical insurance largely covered. View "Gray v. Dignity Health" on Justia Law

Plaintiff, a severely disabled child who suffered catastrophic injuries during her birth in 2015, filed suit against various medical providers for professional negligence. In 2019, the actions were settled for $3 million. DHCS, through its director, then asserted a lien on plaintiff's settlement to recover what DHCS paid for plaintiff's medical care through the state's Medi-Cal program. The trial court denied the lien, concluding that it was prohibited by the "anti-lien" provision of the federal Medicaid Act.The Court of Appeal concluded that the trial court erred in denying DHCS's lien. The court concluded that, while the anti-lien provision of the Medicaid Act generally prohibits liens against the property of Medicaid beneficiaries, other provisions of the Act carve out exceptions for settlements or judgments recovered from third-party tortfeasors, to the extent such settlements or judgments are attributable to payments made by the state for the beneficiaries' medical care. Accordingly, the court reversed and remanded for the trial court to determine what portion of the settlement properly is subject to DHCS's lien. View "L.Q. v. California Hospital Medical Center" on Justia Law

Barbara Green (Barbara) filed this wrongful death action after her son Jeffrey Green (Green) jumped from the roof of drug rehabilitation treatment facility Anaheim Lighthouse (Lighthouse), and ended his life. Lighthouse appealed the judgment following a jury verdict in Barbara’s favor. Specifically, it claimed the trial court committed reversible error by refusing to instruct the jury Green’s suicide was a superseding cause of harm and on premises liability. It also claimed the judgment should have been reversed because the court improperly allowed opinion testimony by an undisclosed rebuttal expert. After review, the Court of Appeal found no error and affirmed the judgment. View "Green v. Healthcare Services" on Justia Law

Allstate Insurance Company et al. (Allstate) filed a complaint on behalf of itself and the People of California (qui tam) against Dr. Sonny Rubin and related medical providers (Rubin). Allstate generally alleged Rubin prepared fraudulent patient medical reports and billing statements in support of insurance claims. Rubin filed an anti-SLAPP motion, arguing the preparation and submission of its medical reports and bills were protected litigation activities. The trial court denied Rubin’s motion. "Litigation is not 'under [serious] consideration' - and thereby protected activity under the anti-SLAPP statute - if the ligation is merely a 'possibility.'" The Court of Appeal found that Rubin failed to show its medical reports and bills were prepared outside of its usual course of business in anticipation of litigation that was “under [serious] consideration.” Thus, the Court affirmed the trial court’s order denying Rubin’s anti-SLAPP motion. View "California ex rel. Allstate Ins. Co. v. Rubin" on Justia Law

Petitioner Jose Medina was placed in custody in November 2016 on charges of second degree robbery and misdemeanor sexual battery. In June 2017, the respondent court found that Medina was mentally incompetent to stand trial and had a developmental disability under Penal Code section 1370.1. Since the time Medina was adjudicated to be mentally incompetent, he has received neither treatment nor a trial. The regional center and the California Department of Developmental Services (DDS), which have the responsibility for providing services for people with developmental disabilities, disagreed with the court’s adjudication and concluded that Medina did not have a developmental disability. Although the incompetency order was legal and binding on the regional center and the DDS, they declined to offer Medina services or recommend placement. At issue was that the version of Penal Code 1369 and 1370.1 in effect in 2017 did not require the regional center’s determination that a defendant have a developmental disability. In 2017, a trial court’s findings of mental incompetence and developmental disability were sufficient, without concurrence by the regional center, to cause the suspension of criminal proceedings. In July 2020, the respondent court attempted to end the standoff by vacating the 2017 order adjudicating Medina to be incompetent. The court ordered new examinations and another competency hearing to be held. Medina challenged the respondent court’s actions by this petition for writ of mandate/prohibition. The Court of Appeal granted the petition in part and ordered the issuance of a writ directing the respondent court to vacate its order, reinstate the orders adjudicating Medina to be incompetent to stand trial and to have a developmental disability, and determine whether the maximum period of confinement has elapsed. View "Medina v. Superior Court" on Justia Law

In the lawsuit underlying these consolidated writ proceedings, the People of the State of California, by and through the Santa Clara County Counsel, the Orange County District Attorney, the Los Angeles County Counsel, and the Oakland City Attorney, filed an action against defendants— various pharmaceutical companies involved in the manufacture, marketing, distribution, and sale of prescription opioid medications. The People alleged the defendants made false and misleading statements as part of a deceptive marketing scheme designed to minimize the risks of opioid medications and inflate their benefits. This scheme, the People alleged, caused a public health crisis in California by dramatically increasing the number of opioid prescriptions, the use and abuse of opioids, and opioid-related deaths. These proceedings pertained to a discovery dispute after several of the defendants served subpoenas on two nonparty counties, petitioners County of Los Angeles and County of Alameda, seeking records of patients in various county programs, including individual prescription data and individual patient records related to substance abuse treatment. After petitioners and the Johnson & Johnson defendants engaged in various informal and formal means to attempt to resolve the dispute, the superior court issued a discovery order granting the Johnson & Johnson defendants’ motions to compel production of the records. The Court of Appeal concluded petitioners established that the superior court’s order threatened a serious intrusion into the privacy interests of the patients whose records were at issue: the Johnson & Johnson defendants failed to demonstrate their interests in obtaining “such a vast production of medical information” outweighed the significant privacy interests that the nonparty petitioners identified. Accordingly, the Court granted petitioners’ writ petitions and directed the superior court to vacate its order compelling production of the requested documents, and to enter a new order denying Johnson & Johnson defendants’ motions to compel. View "County of Los Angeles v. Superior Ct." on Justia Law

CMA and others filed suit against Aetna, seeking among other claims, an injunction for alleged violations of the Unfair Competition Law (UCL; Bus. & Prof. Code, section 17200). The trial court found that CMA lacked standing under the UCL because it was not directly injured by Aetna's policy.The Court of Appeal affirmed the trial court's grant of Aetna's motion for summary judgment, concluding that the body of law permitting an association to bring a nonclass representative action does not bestow standing upon CMA to seek an injunction against Aetna under the UCL, whether or not CMA individually suffered injury in fact and lost money or property. The court also concluded that CMA's evidence that it diverted substantial resources to assist its physician members who were injured by Aetna's policy did not create a material disputed fact as to whether CMA itself suffered injury in fact and lost money or property. The court explained that an association must sustain direct economic injury to itself and not just its members to bring a UCL claim. Furthermore, evidence that an association diverted resources to investigate its members' claims of injury and advocate for their interests is not enough to show standing under the UCL. In this case, the federal authorities CMA cites are neither binding on this court nor instructive. View "California Medical Ass'n v. Aetna Health of California, Inc." on Justia Law