Justia California Court of Appeals Opinion Summaries

Plaintiff Rodney Davis, a physician assistant, learned to perform liposuction under the guidance of a physician. Davis grew dissatisfied with the physician for whom he worked, so he decided to establish a new practice. To do so, Davis needed a physician to serve as his supervising physician. Davis found Dr. Jerrell Borup, who had been an anesthesiologist for 18 years, but who had not practiced medicine for 12 years. Before meeting Davis, Borup had never performed liposuction or other surgery. Borup agreed to serve as “Medical Director,” although he would never perform a procedure at the new practice. Borup’s role, in practice, consisted of reviewing charts. Davis, who gave himself the title of “Director of Surgery,” would perform all of the liposuction procedures. Davis opened his practice, Pacific Liposculpture, in September 2010. In 2015, the Physician Assistant Board (the Board) filed an accusation accusing Davis of, among other things, the unlicensed practice of medicine, gross negligence, repeated negligent acts, and false and/or misleading advertising. An administrative law judge (ALJ) found the Board’s accusations were established by clear and convincing evidence, and recommended the revocation of Davis’s license. The Board adopted the ALJ’s findings and recommendations. Davis filed a petition for a writ of administrative mandamus seeking, inter alia, a writ compelling the Board to set aside its decision. The trial court denied the petition. On appeal, Davis argued the ALJ erred in finding that he committed the various acts alleged, and that the findings were not supported by substantial evidence. He further claimed that the discipline imposed constituted a manifest abuse of discretion. Finding no reversible error, the Court of Appeal affirmed. View "Davis v. Physician Assistant Board" on Justia Law

Plaintiff Darren Hulbert, a self-represented indigent inmate, appealed the dismissal of his medical malpractice suit Richard Cross, M.D. Dr. Cross performed a radial head resection and arthroplasty on Hulbert’s right elbow. Hulbert alleged that Dr. Cross negligently failed to tighten a screw in the implant, which resulted in the screw coming loose and damaging Hulbert’s elbow joint, cartilage, and surrounding tissue. To help establish his claim, Hulbert filed a motion for appointment of legal counsel and a medical expert. The trial court denied the motion and subsequently found that Hulbert could not rebut the declaration of Dr. Cross’s medical expert without providing medical expert evidence of his own. On this basis, the trial court granted Dr. Cross’s motion for summary judgment. On appeal, Hulbert contended: (1) he was deprived of meaningful access to the courts because the trial court denied him the assistance of a medical expert while requiring a medical expert to establish a triable issue of material fact; (2) the trial court failed to exercise its discretion by considering all of the remedies available to ensure that he had meaningful access to the courts; (3) the trial court erred in determining there was no triable issue of material fact because the loose screw itself did not prove medical negligence; (4) the trial court erred in refusing to appoint legal counsel; (5) Dr. Cross did not provide informed consent prior to the procedure; (6) the declaration by Dr. Cross’s medical expert was insufficient to overcome a presumption of negligence because Dr. Cross’s operation notes failed to show compliance with the implant manufacturer’s instructions. After review, the Court of Appeal concluded the trial did not properly exercise informed discretion with respect to ensuring access to the courts when it denied Hulbert’s motion for appointment of a medical expert. The trial court’s statement that it lacked authority to appoint legal counsel required remand to allow the trial court to consider and clarify which remedies were appropriate in this case to protect Hulbert’s right to meaningful access to the court. View "Hulbert v. Cross" on Justia Law

Plaintiff-appellant Joanna Grabowski brought claims for medical malpractice against Kaiser Foundation Health Plan, Inc., Southern California Permanente Medical Group, and various associated physicians (collectively, Kaiser). The claims were heard by an arbitrator, pursuant to a contractual arbitration agreement. After a contested hearing, the arbitrator awarded judgment in favor of Kaiser. Grabowski petitioned the trial court to vacate the arbitration award, alleging: (1) the arbitrator committed misconduct, and revealed disqualifying bias, by engaging in an ex parte communication with Kaiser’s counsel about Grabowski’s self-represented status; (2) the arbitrator failed to disclose two matters involving Kaiser where he was selected as an arbitrator; and (3) the arbitrator improperly denied Grabowski’s request for a continuance of the arbitration hearing. The trial court found that “the arbitrator’s conduct did not rise to a level that substantially prejudiced [Grabowski’s] rights” and dismissed her petition. Grabowski appealed. After review, the Court of Appeal agrees the award should have been vacated. The Court concluded the arbitrator committed misconduct on several levels, at least one required vacating the arbitration award. The ex parte communication between the arbitrator and Kaiser’s counsel was recorded by Grabowski’s mother as part of her effort to document the arbitration hearing; the audio recording revealed comments by the arbitrator making light of Grabowski’s self- representation and her inability, in the arbitrator’s view, to effectively represent herself. The arbitrator volunteered these comments to Kaiser’s counsel, ex parte, and “they shared a hearty laugh about Grabowski’s perceived shortcomings as an advocate.” Because the arbitrator was aware of this communication and did not disclose it to Grabowski, the award had to be vacated. View "Grabowski v. Kaiser Foundation Health Plan, Inc." on Justia Law

After a surgeon competently performed a gastric re-sleeving surgery on plaintiff, she filed suit against him for negligence in recommending gastric re-sleeve surgery as a viable course of treatment and in not obtaining her informed consent to the surgery.The Court of Appeal held that a physician may be liable for negligently recommending a course of treatment if (1) that course stems from a misdiagnosis of the patient's underlying medical condition, or (2) all reasonable physicians in the relevant medical community would agree that the probable risks of that treatment outweigh its probable benefits. The court also held that a patient's informed consent to a negligently recommended course of treatment does not negate the physician's liability for his negligence in recommending it. In this case, although the trial court erred by instructing the jury that plaintiff's informed consent negated any liability for the surgeon's recommendation, the court concluded that this error did not prejudice her case because her negligent recommendation theory should never have gone to the jury in the first place. In this case, the evidence, viewed in the light most favorable to plaintiff, does not support the conclusion that the surgeon was negligent in recommending that plaintiff undergo the gastric re-sleeve surgery where she suffered from morbid obesity. Accordingly, the court affirmed the judgment. View "Flores v. Liu" on Justia Law

Alice Borman filed this action against defendants Tara Brown, M.D. and North County Eye Center, Inc. (NCEC). Borman alleged that she sought treatment from defendants for a “droopy eyelid and brow.” According to Borman, Dr. Brown told Borman that Brown could perform a “brow lift” to correct the problem, but that a brow lift would not be covered by Borman’s insurance. Borman further alleged that Dr. Brown told Borman that she could instead perform a blepharoplasty, which would be covered by Borman’s insurance. Borman further claimed that Dr. Brown’s statement that a brow lift would not be covered by Borman’s insurance was false, and that Dr. Brown had no reasonable basis for making the statement. Borman alleged that she relied on Dr. Brown’s representations and agreed to undergo a blepharoplasty. After undergoing the blepharoplasty, Borman claimed that she continued to have physical difficulties with her eyelid and her brow. Borman consulted another doctor who advised Borman that Dr. Brown had “performed the wrong procedure and that a brow[ ]lift should have been performed instead.” The trial court denied Borman's motion for summary judgment, denied the motion for summary adjudication of the professional negligence and lack of informed consent causes action, but granted the motion for summary adjudication as to Borman’s fraud and deceit and battery causes of action. The trial court entered judgment in favor of defendants, and awarded costs to defendants as prevailing parties. Borman appealed, arguing the trial court erred in granting defendants' motion for summary adjudication with respect to her fraud and deceit cause of action, because the trial court should have permitted her to “proceed at trial on a claim for ‘[n]egligent [m]isrepresentation.’ ” The Court of Appeal concluded the record contained evidence from which a reasonable jury could find that Dr. Brown intended for Borman to rely on her statement that a brow lift would not be covered by Borman’s insurance. Since that was the sole element of a negligent misrepresentation theory of liability that the trial court found Borman would be unable to prove, the Court further concluded the trial court erred in granting summary adjudication of Borman’s fraud and deceit cause of action. The trial court's postjudgment cost order, and the order granting summary adjudication of Brown’s fraud and deceit cause of action were both reversed, and the matter remanded for further proceedings. View "Borman v. Brown" on Justia Law

Filosa began complaining of headaches in 2004-2005. By 2010, the headaches were constant with acute episodes. In 2010, his doctor ordered an MRI. Dr. Alagappan, a radiologist, interpreted the results and did not detect any abnormalities. Filosa’s headaches worsened. He began taking antidepressants. Filosa’s symptoms affected his performance at work. He took medical leaves of absence in 2011 and 2012. He described vision problems, eye strain, extreme fatigue, and an inability to concentrate. Filosa’s employer demoted him for performance problems. Filosa asked a doctor whether he might have a brain tumor. His doctor dismissed the suggestion, saying nothing in Filosa’s blood work indicated he had cancer and that he had already had a negative MRI. In 2014, his headaches were sometimes incapacitating. He again raised the possibility of a tumor. He was referred to a neurologist and underwent brain imaging. He was told in December 2014 that the test showed a cyst or a tumor in his brain. A re-review of the 2010 MRI imaging showed a “relatively subtle” mass, which had increased. Filosa underwent surgery, which caused adverse physical effects. Filosa sued for medical negligence in 2016 based on the failure to diagnose the brain mass after his 2010 MRI. The trial court granted the defendants summary judgment, citing the statute of limitations. The court of appeal reversed. There is a triable issue of fact as to the date of Filosa’s injury and his discovery of the injury, View "Filosa v. Alagappan" on Justia Law

In 2014, plaintiff-respondent Keith Burchell underwent what was supposed to be a simple, outpatient procedure to remove a small mass in his scrotum for testing. His surgeon, Dr. Gary Barker, discovered that the mass was more extensive than expected, believing the mass was malignant. Without consulting either Burchell (who was under anesthesia) or the person Burchell had designated as his medical proxy, Barker removed the mass from both the scrotum and the penis, a different and substantially more invasive procedure than had been contemplated. Burchell suffered serious side effects, some of which are permanent and irreversible. The mass turned out to be benign. Burchell brought suit, alleging professional negligence and medical battery. A jury returned a verdict for Burchell on both causes of action, awarding him $4 million in past noneconomic damages and $5.25 million in future noneconomic damages against Dr. Barker and defendant-appellant Faculty Physicians & Surgeons of the Loma Linda University School of Medicine (FPS). On appeal, FPS argued the award of noneconomic damages should have been reduced to the $250,000 limit on such damages in “any action for injury against a health care provider based on professional negligence” provided by Civil Code section 3333.2(a), part of the Medical Injury Compensation Reform Act of 1975 (MICRA). In the alternative, FPS argued the award of noneconomic damages was excessive and the product of improper argument by Burchell’s counsel, so the Court of Appeal should reverse and remand for new trial unless Burchell accepts a reduction of the award to an amount we deem reasonable. Finally, FPS argued Burchell’s offer to compromise pursuant to Code of Civil Procedure section 998 was invalid, so the award of expert witness fees and prejudgment interest should also be reversed. After review, the Court of Appeal rejected FPS' first two arguments, but concurred that Burchell’s section 998 offer was invalid, and therefore reversed the award of expert witness fees and prejudgment interest. View "Burchell v. Faculty Physicians & Surgeons etc." on Justia Law

Plaintiff Christi McAlpine filed a medical malpractice action against defendant Dr. Daniel Norman for injuries she suffered as a result of colonoscopies performed on her in 2015. In 2018, with trial approaching, Norman filed a summary judgment motion, supported by a declaration from an expert who reviewed McAlpine’s medical records, and opined that Norman’s actions were within the standard of care. McAlpine opposed the motion, but did not submit a competing expert opinion. While the summary judgment motion was pending, McAlpine sought leave to amend her complaint. The trial court denied leave to amend and granted summary judgment. McAlpine appealed the grant of summary judgment and the order denying her motion for leave to amend, arguing that the expert declaration presented in support of the motion for summary judgment was conclusory and insufficient to meet the initial burden for summary judgment. She also argued the trial court abused its discretion in denying her request for leave to amend. The Court of Appeal found no abuse of discretion in the order denying leave to amend, but agreed the trial court improperly granted summary judgment based on an expert opinion unsupported by factual detail or reasoned explanation. Accordingly, the Court reversed the grant of summary judgment and remanded for further proceedings. View "McAlpine v. Norman" on Justia Law

In November 2007, Marten performed surgery on Doe’s face and neck. In June 2008, Doe sent Marten a letter stating she was considering suing him and demanded that he preserve her documents, files, and photos. In November, Doe’s attorney served Marten with a written demand for arbitration pursuant to a Physician-Patient Arbitration Agreement. In January 2009 Marten’s counsel responded, identifying an arbitrator, without questioning the origin of the agreement or disputing that Marten had signed it. The applicable one-year statute of limitations ran in March 2009. (Code Civ. Proc.340.5) In May 2009, Merten subpoenaed and obtained the records of Dr. Daniel, whom Doe earlier consulted. Located within Daniel’s records was a signed arbitration agreement. Nearly three years later, Marten’s counsel first confronted Doe with the arbitration agreement and refused to continue with the arbitration.Doe sued for medical malpractice and medical battery. The court overruled dismissal motions, finding triable issues as to whether equitable tolling or equitable estoppel disallowed the statute of limitations defense. The court imposed sanctions after hearing evidence that Marten destroyed electronically stored information. After the close of evidence, the trial court dismissed the medical battery claim. On the malpractice claim, the jury awarded over $6.3 million in damages. The court then found the malpractice claim time-barred. The court of appeal reversed in part. The medical malpractice claim was not time-barred because Merten’s conduct actually and reasonably induced Doe to refrain from filing a timely action. View "Doe v. Marten" on Justia Law

The Court of Appeal affirmed the trial court's grant of summary judgment in favor of the hospital in an action brought by the family of an emergency room patient who was released from the hospital and died eight hours later of "acute dissection of aorta."The court held that no evidence showed that the nursing staff caused or contributed to the patient's death; no evidence showed the hospital was negligent in the selection and retention of the two emergency room doctors who treated the patient; and the evidence conclusively established the emergency room doctors were not the ostensible agents of the hospital. View "Wicks v. Antelope Valley Healthcare District" on Justia Law