Judge: Alison Mackenzie, Case: 23STCV00571, Date: 2024-09-17 Tentative Ruling
Case Number: 23STCV00571 Hearing Date: September 17, 2024 Dept: 55
NATURE OF PROCEEDINGS: Hearing on Kaiser
Foundation Health Plan, Inc.’s Motion for Summary Judgment
Kaiser Foundation Health Plan, Inc.’s
Motion for Summary Judgment is granted.
BACKGROUND
Plaintiff Angela Reyes brings
this action against Kaiser Foundation Health
Plan, Inc. (“the Plan”), Kaiser Foundation Hospitals, Southern
California Permanente Medical Group, Chuong Khac Do, M.D., and Doe defendants 1
to 50 alleging that while treating Plaintiff, Defendants failed to remove a
surgical sponge, resulting in an infection.
The causes of action are: 1) Medical Negligence and 2) Managed Care Negligence.
The motion now before the Court is the Plan’s Motion for Summary Judgment. Plaintiff did not file an opposition.
LEGAL STANDARD
In moving for summary judgment or summary
adjudication, a “defendant… has met his or her burden of showing that a cause
of action has no merit if the party has shown that one or more elements of the
cause of action, even if not separately pleaded, cannot be established, or that
there is a complete defense to the cause of action.” Code Civ. Proc., § 437c,
subd. (p)(2). Once the defendant has satisfied that burden, the burden shifts
to the plaintiff to “show, by responsive separate statement and admissible
evidence, that triable issues of fact exist.” Ostyan v. Serrano Reconveyance
Co. (2000) 77 Cal.App.4th 1411, 1418, disapproved on other grounds by Black
Sky Cap., LLC v. Cobb (2019) 7 Cal.5th 156, 165; see also Code Civ. Proc.,
§ 437c, subd. (p)(2). Courts “liberally construe the evidence in support of the
party opposing summary judgment and resolve doubts concerning the evidence in
favor of that party.” Dore v. Arnold Worldwide, Inc. (2006) 39 Cal.4th
384, 389.
ANALYSIS
The Knox-Keene Health Care Service Plan Act of 1975
(Knox-Keene) governs health care services in California. Gopal v. Kaiser
Foundation Health Plan, Inc. (2016) 248 Cal.App.4th 425, 430 (Gopal);
see Health & Saf. Code § 1340 et seq. Under the Act, a “health care service
plan” is defined as “[a]ny person who undertakes to arrange for the provision
of health care services to subscribers or enrollees, or to pay for or to
reimburse any part of the cost for those services, in return for a prepaid or
periodic charge paid by or on behalf of the subscribers or enrollees.” Health
& Saf. Cod, § 1345(f)(1). Health care service plans “are not health care
providers under any provision of law,” (Civ. Code, § 3428 (c)), but “may
employ, or contract with, any professional” licensed in the state. Health &
Saf. Code § 1395 (b). A “provider” is “any professional person, organization,
health facility, or other person or institution licensed by the state to
deliver or furnish health care services.” Health & Saf. Code § 1345(i).
“Knox-Keene bars claims against a plan for vicarious
liability.” Gopal, supra, 248 Cal.App.4th at p. 431. “A plan, any entity
contracting with a plan, and providers are each responsible for their own acts
or omissions, and are not liable for the acts or omissions of, or the costs of
defending, others.” Health & Saf. Code § 1371.25. Likewise, a healthcare
service plan generally cannot be held liable under an enterprise theory of
liability. See Gopal, supra, 248 Cal.App.4th at p. 432.
Here, the Plan proffers the following facts: Defendant
is a health care service plan licensed by the California Department of Managed
Health Care under the Knox Keene Health Care Service Plan Act of 1975. Separate
Statement of Undisputed Material Facts (“UMF”) 13. The Plan contracts with
Permanente Medical Groups and Kaiser Foundation Hospitals to arrange for the
provision of healthcare services for its members. UMF 14. As a plan member,
Plaintiff was provided medical care and treatment by the physicians and staff
of Southern California Permanente Medical Group and Kaiser Foundation
Hospitals. The Plan did not provide medical care or treatment to Plaintiff at
any time. UMF 16. Both of Plaintiff’s causes of action concern Defendants’
alleged negligence in their management of Plaintiff’s treatment and breach of
the duty of care by not ensuring that all sponges and gauzes were removed
following surgery. UMF 8-11.
Because the Plan has established that it is a health
care service plan under the Knox-Keene Act, it did not owe Plaintiff a duty of
care for medical treatment and cannot be held vicariously liable for the other
Defendants’ alleged negligence. Therefore,
the Plan has met its burden to demonstrate that there are no triable issues of
material fact.
As she did not file an opposition, Plaintiff has not
met her burden of showing that a triable issue of material fact exists.
Accordingly, the Plan’s Motion for Summary Judgment is granted.
CONCLUSION
The Plan’s Motion for Summary
Judgment
is granted.