Judge: Andrew E. Cooper, Case: 22CHCV01133, Date: 2024-08-06 Tentative Ruling

Counsel wishing to submit on a tentative ruling may inform the clerk or courtroom assisant in North Valley Department F51, 9425 Penfield Ave., Chatsworth, CA 91311, at (818) 407-2251.  Please be aware that unless all parties submit, the matter will still be called for hearing and may be argued by any appearing/non-submitting parties. If the matter is submitted on the court's tentative ruling by all parties, counsel for moving party shall give notice of ruling. This may be done by incorporating verbatim the court's tentative ruling. The tentative ruling may be extracted verbatim by copying and specially pasting, as unformatted text, from the Los Angeles Superior Court’s website, http://www.lasuperiorcourt.org. All hearings on law and motion and other calendar matters are generally NOT transcribed by a court reporter unless one is provided by the party(ies).

Case Number: 22CHCV01133    Hearing Date: August 6, 2024    Dept: F51

MOTION FOR SUMMARY JUDGMENT

Motion Filed: 5/17/24                                                                        NON-JURY TRIAL: 2/3/25

MOVING PARTY: Defendant Providence Health System – Southern California dba Providence Holy Cross Medical Center (erroneously sued as Providence Holy Cross) (“Moving Defendant”)

RESPONDING PARTY: Plaintiff Ceasar Carrillo, an individual, by and through his mother, Maria G. Carrillo in her capacity as his guardian ad litem (“Plaintiff”)

NOTICE: OK 

RELIEF REQUESTED: An order granting summary judgment in favor of Moving Defendant and against Plaintiff on Plaintiff’s complaint.

TENTATIVE RULING: The motion is granted.

Plaintiff is reminded to review the 5/3/19 First Amended General Order Re Mandatory Electronic Filing for Civil. When e-filing documents, parties must comply with the “TECHNICAL REQUIREMENTS” which are set forth at page 4, line 4 through page 5, line 12 of the Court’s 5/3/19 First Amended General Order Re Mandatory Electronic Filing for Civil (particularly bookmarking declarations and exhibits). (CRC 3.1110(f)(4).) Failure to comply with these requirements in the future may result in papers being rejected, matters being placed off calendar, matters being continued so documents can be resubmitted in compliance with these requirements, documents not being considered and/or the imposition of sanctions.

BACKGROUND

This is a medical malpractice action in which Plaintiff alleges that in 2016, at Moving Defendant’s hospital, nonmoving defendant medical providers negligently treated his mother, Maria Carillo (“Ms. Carillo”), who was 34 weeks pregnant with Plaintiff, resulting in Ms. Carillo’s appendix bursting and Plaintiff being born several weeks premature, “with numerous and significant complications, including but not limited to respiratory distress, neonatal sepsis, right sided intraventricular brain hemorrhage and grade IV left sided intraventricular brain hemorrhage, subdural hematoma, and subarachnoid hemorrhage resulting in hydrocephalus that has required the implantation of a ventriculoperitoneal shunt in Ceasar Carrillo’s brain.” (Compl. ¶¶ 12–15.)

On 11/10/22, Plaintiff filed his complaint, alleging against five named defendants the sole cause of action for Medical Malpractice. On 4/11/23, Moving Defendant filed its answer.

On 5/17/24, Moving Defendant filed the instant motion for summary judgment. On 7/25/24, Plaintiff filed his opposition. On 8/1/24, Moving Defendant filed its reply.

ANALYSIS

The function of a motion for summary judgment or adjudication is to allow a determination as to whether an opposing party cannot show evidentiary support for a pleading or claim and to enable an order of summary dismissal without the need for trial. (Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 843.) Code of Civil Procedure section 437c, subdivision (c) “requires the trial judge to grant summary judgment if all the evidence submitted, and ‘all inferences reasonably deducible from the evidence’ and uncontradicted by other inferences or evidence, show that there is no triable issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” (Adler v. Manor Healthcare Corp. (1992) 7 Cal.App.4th 1110, 1119.) “The function of the pleadings in a motion for summary judgment is to delimit the scope of the issues; the function of the affidavits or declarations is to disclose whether there is any triable issue of fact within the issues delimited by the pleadings.” (Juge v. County of Sacramento (1993) 12 Cal.App.4th 59, 65, citing FPI Development, Inc. v. Nakashima (1991) 231 Cal.App.3d 367, 381–382.) 

As to each claim as framed by the complaint, the defendant moving for summary judgment must satisfy the initial burden of proof by presenting facts to negate an essential element, or to establish a defense. (Code Civ. Proc., § 437c, subd. (p)(2); Scalf v. D. B. Log Homes, Inc. (2005) 128 Cal.App.4th 1510, 1519–1520.)  

Once the defendant has met that burden, the burden shifts to the plaintiff to show that a triable issue of one or more material facts exists as to that cause of action or a defense thereto. To establish a triable issue of material fact, the party opposing the motion must produce substantial responsive evidence. (Sangster v. Paetkau (1998) 68 Cal.App.4th 151, 163.) 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.) 

A.    Medical Malpractice

Plaintiff’s first cause of action alleges against all Defendants Medical Malpractice – Professional Negligence. “The elements of a cause of action for medical malpractice are: (1) a duty to use such skill, prudence, and diligence as other members of the profession commonly possess and exercise; (2) a breach of the duty; (3) a proximate causal connection between the negligent conduct and the injury; and (4) resulting loss or damage.” (Chakalis v. Elevator Solutions, Inc. (2012) 205 Cal.App.4th 1557, 1571.)

Here, Plaintiff alleges an agency theory of liability against Moving Defendant. “An agency is either actual or ostensible.” (Civ. Code § 2298.)

1.      Actual Agency

“An agency is actual when the agent is really employed by the principal.” (Civ. Code § 2299.) Here, Moving Defendant argues that Ms. Carillo’s treating physicians were not Moving Defendant’s employees/agents, but independent contractors. (MSJ 5:26–27.) In support of this argument, Moving Defendant proffers the sworn declaration of its Chief Medical Officer attesting as such. (Ex. F to Decl. of Megan P. Best, ¶ 3.) Based on the foregoing, the Court finds that Moving Defendant has satisfied its initial burden to negate an element of Plaintiff’s Medical Malpractice cause of action. As Plaintiff does not dispute these facts, the Court finds that no triable issue exists as to whether the treating physicians were actual agents of Moving Defendant.

2.      Ostensible Agency

Under some circumstances, a hospital or other institution, under the doctrine of ostensible agency, may become directly liable to the patient for the malpractice of health care providers, including those in independent, non-salaried practices. (Jacoves v. United Merchandising Corp. (1992) 9 Cal.App.4th 88, 103–104.) “An agency is ostensible when the principal intentionally, or by want of ordinary care, causes a third person to believe another to be his agent who is not really employed by him.” (Civ. Code § 2300.) The elements required for a finding of ostensible agency are: (1) the patient dealing with the ostensible agent must do so with the reasonable belief in the agent’s authority; (2) such belief must be generated by some act or neglect of the principal (i.e., the hospital) sought to be charged; and (3) the patient, in relying on the agent’s apparent authority, must not be negligent in doing so. (J.L. v. Children's Institute, Inc. (2009) 177 Cal.App.4th 388, 403–404; Stanhope v. Los Angeles College of Chiropractic (1942) 54 Cal.App.2d 141, 146.)

An ostensible agency may be found “when the hospital ‘holds itself out’ to the public as a provider of care.” (Mejia v. Community Hospital of San Bernardino (2002) 99 Cal.App.4th 1448, 1453.) “A hospital is generally deemed to have held itself out as the provider of care, unless it gave the patient contrary notice.” (Id. at 1454 [emphasis added].) “Prior notice may not be sufficient to avoid liability in an emergency room context, where an injured patient in need of immediate medical care cannot be expected to understand or act upon that information.” (Ibid.) “Thus, unless the patient had some reason to know of the true relationship between the hospital and the physician—i.e., because the hospital gave the patient actual notice or because the patient was treated by his or her personal physician—ostensible agency is readily inferred.” (Id. at 1454–1455 [emphasis added].)

Here, Moving Defendant argues that Plaintiff was given a Conditions and Admissions form each time she visited the hospital for care, which she signed on three of the four instances. (MSJ 1:13–3:11.) The form contains a provision titled “PHYSICIANS ARE INDEPENDENT CONTRACTORS,” and stating that “the undersigned recognizes that all physicians, physician assistants, and surgeons furnishing service to the patient, including the radiologist, pathologist, anesthesiologist, emergency room physician, physician assistants, and the like, are independent contractors and are not employees or agents of the hospital.” (Ex. A to Best Decl., ¶ 14.)

Moving Defendant argues that “any allegations that conduct by Providence Holy Cross would have caused a reasonable person to believe the defendant physicians were agents or employees of the hospital are rebutted by the four written notices of the lack of an agency or employment relationship that were received and reviewed by Ms. Carrillo.” (MSJ 8:6–10.) In support of its argument, Moving Defendant proffers copies of the four separate Conditions and Admissions forms, three of which are signed and initialed by Ms. Carillo, including her initials next to the subject provision, with the fourth form signed and initialed by her mother. (Exs. A, C–E to Best Decl.) Moving Defendant also proffers Ms. Carillo’s deposition testimony, wherein she states that she was alert and able to communicate and understand her nurses and physicians at the time she was given the forms. (Ex. B to Best Decl., 197:13–208:13.)

Based on the foregoing, the Court finds that Moving Defendant has met its initial burden to negate an element of Plaintiff’s Medical Malpractice cause of action. The burden thus shifts to Plaintiff to produce substantial evidence showing that a triable issue remains.

Plaintiff argues in opposition that a triable issue remains because “for her part, undoubtedly due to the emergent circumstances of her admission to Providence Holy Cross, coupled with extreme pain, and justifiable concern about her baby, Ms. Carrillo never obtained an understanding of the legal relationship between Providence Holy Cross and the physicians treating her there, assuming that they were all employees of the hospital.” (Pl.’s Opp. 7:6–11, citing Ex. 2 to Decl. of Kenneth J. Melrose, ¶¶ 3–5.) “Even with respect to the forms signed earlier on February 27, 2016, Ms. Carrillo did not remember reviewing them, thought [sic] she did not dispute they bore her signature. (Id. at 7:19–21, citing Ex. B to Best Decl., 199:21–200:15.)

Plaintiff therefore argues that “it is a clear question of fact whether at any time, Ms. Carrillo knew that the physicians providing care at Providence Holy Cross were independent contractors and Plaintiff has adduced clear evidence that she did not.” (Id. at 7:25–8:1.) Moving Defendant argues that “Plaintiff’s anticipated argument regarding Ms. Carrillo’s capacity to understand the document on March 16, 2016, is belied by Ms. Carrillo’s repeated receipt of the Conditions of Admission forms, repeated signatures and initials on the forms, and her ‘capacity of reading and understanding’ (she testified she was alert and oriented) the Conditions of Admission forms, all of which were confirmed during the course of her deposition.” (MSJ 10:27–11:4.)

“The general rule is that when a person with the capacity of reading and understanding an instrument signs it, he is, in the absence of fraud and imposition, bound by its contents, and is estopped from saying that its provisions are contrary to his intentions or understanding.” (Jefferson v. California Department of Youth Authority (2002) 28 Cal.4th 299, 303.) Here, the Court finds that Moving Defendant has proffered evidence that Ms. Carillo had the capacity to read and understand each Conditions and Admissions form before she signed it, and further notes that Plaintiff does not allege any fraud or imposition in Ms. Carillo’s assent to the terms.

As Moving Defendant argues in reply, “the undisputed facts do not show the existence of an ostensible agency relationship between Holy Cross and the co-defendant physicians, and do not overcome the presumption that Ms. Carrillo had actual notice of the lack of any employment or agency relationship.” (Def.’s Reply 7:8–11.) “Ms. Carrillo repeatedly received actual notice of the lack of agency or employment relationship and repeatedly signed and initialed forms indicating she read and understood the lack of agency and employment relationship.” (Id. at 8:2–4.) “It is uncontested that Ms. Carrillo was alert, able to communicate, and able to comprehend each time she received and signed the Conditions of Admission forms.” (Id. at 9:3–5.)

Based on the foregoing, the Court finds that Plaintiff, by way of Ms. Carillo’s declaration, has failed to create an issue of material fact regarding Ms. Carillo’s treating physicians being ostensible agents of Moving Defendant. Accordingly, the motion for summary judgment is granted.

CONCLUSION

The motion is granted. Defendant to submit proposed Judgment within 10 days.