Judge: Christian R. Gullon, Case: 20STCV48320, Date: 2024-02-07 Tentative Ruling

The Court may change tentative rulings at any time. Therefore, attorneys are advised to check this website to determine if any changes or updates have been made to the tentative ruling.

Counsel may submit on the tentative rulings by calling the clerk in Dept. O at 909-802-1126 before 8:30 the morning of the hearing. Submission on the tentative does not bind the court to adopt the tentative ruling at the hearing should the opposing party appear and convince the court of further modification during oral argument.

The Tentative Ruling is not an invitation, nor an opportunity, to file any further documents relative to the hearing in question. No such filing will be considered by the Court in the absence of permission first obtained following ex-parte application therefore.

Case Number: 20STCV48320    Hearing Date: February 7, 2024    Dept: O

Tentative Ruling

MOTION FOR SUMMARY JUDGMENT OF DEFENDANT NAGESWARA R. GUNTUPALLI, M.D is GRANTED, because Plaintiff did not meet his evidentiary burden as no expert spoke to whether a medical professional in Dr. Guntupalli’s like position would have suspected child abuse.

Background[1]

This case pertains to an alleged assault and battery. Plaintiff Joshua Acosta (“Plaintiff”) alleges the following against Defendants AURORA CHARTER OAK LOS ANGELES, LLC; NAGESWARA R. GUNTUPALLI, MD; WILLIAM M. GILLESPIE, MD, SIGNATURE HEALTHCARE SERVICES, LLC, SIGNATURE HEALTHCARE MANAGEMENT Inc; AURORA AURORA HEALTH CARE, Inc.: On or about August 7, 2018, when Plaintiff was trying to speak to his mother on the phone at the hospital, three hospital workers attacked him. (TAC p. 7, 8:9-10.)[2] They beat him all over his body, slammed his head onto the floor and strangled him. As a result of being strangled for so long, Plaintiff suffered petechial hemorrhaging and lost consciousness. After Plaintiff regained consciousness, he was dragged into a room that looked like a jail cell. (pp. 7-8.) The next day, when Plaintiff’s mother, Veronica Gallegos (“Plaintiff’s Mother”), went to visit her son, she inquired about the severe bleeding in his eyes and bodily bruising. She was told that it was an eye infection. As a result of the attack, Plaintiff has suffered neurological damage and the deterioration of his mental health. 

On January 4, 2021, Plaintiff Joshua Acosta and Veronica Gallegos (collectively, “Plaintiffs”) filed their First Amended Complaint against Defendants for the following fourteen (14) causes of action:

On January 27, 2023, Plaintiffs filed their amended third amended complaint (TAC), which added a fifteenth COA for ‘breach of duties established by California Penal Code section 273(d): Negligence Per Se’ asserted against Doe Defendants.

On July 27, 2023, Dr. Guntupalli filed the instant MSJ was filed.

On November 28, 2023, Plaintiff filed his opposition to the MSJ.  

On February 1, 2024, Dr. Guntupalli filed a reply. That same day, Plaintiff filed an Objection to Defendant Nageswara R. Guntupalli's Reply Evidence and Reply Separate Statement.

On February 5, 2024, Plaintiff filed Objection to Defendant Nageswara R Guntupalli Objections and
Objection to Defendant Nageswara R. Guntupalli, MD's Reply, New Evidence, Declaration of Kathleen McColgan, and the Records Submitted with the Motion.

Legal Standard

The law of summary judgment provides courts “a mechanism to cut through the parties’ pleadings in order to determine whether, despite their allegations, trial is in fact necessary to resolve their dispute.”  (Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 843 (Aguilar).)  In reviewing a motion for summary judgment, courts employ a three-step analysis: “(1) identify the issues framed by the pleadings; (2) determine whether the moving party has negated the opponent’s claims; and (3) determine whether the opposition has demonstrated the existence of a triable, material factual issue.”  (Hinesley v. Oakshade Town Center (2005) 135 Cal.App.4th 289, 294.) “The motion for summary judgment shall be granted if all the papers submitted show that there is no triable issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.”  (Code Civ. Proc., § 437c, subd. (c).)   

A moving defendant bears the initial burden of production to show that one or more elements of the cause of action cannot be established or that there is a complete defense to the cause of action, at which point the burden shifts to the plaintiff to make a prima facie showing of the existence of a triable issue.  (Code Civ. Proc., § 437c, subd. (p)(2).) “The motion shall be supported by affidavits, declarations, admissions, answers to interrogatories, depositions, and matters of which judicial notice shall or may be taken. The supporting papers shall include a separate statement setting forth plainly and concisely all material facts that the moving party contends are undisputed. Each of the material facts stated shall be followed by a reference to the supporting evidence. The failure to comply with this requirement of a separate statement may in the court’s discretion constitute a sufficient ground for denying the motion.” (Code Civ. Proc., § 437c, subd. (b)(1).)

The opposing party may not rely on the mere allegations or denials of the pleadings, but instead must set forth the specific facts showing that a triable issue exists as to that cause of action or a defense thereto.  (Aguilar, supra, at p. 849.) Specifically, “[t]he opposition, where appropriate, shall consist of affidavits, declarations, admissions, answers to interrogatories, depositions, and matters of which judicial notice shall or may be taken.” (Code Civ. Proc., § 437c, subd. (2).) 

Evidentiary Objections

Court need only rule on objections material to adjudication of the motion. (See Code Civ. Proc., § 437c, subd. (2), subs. (q) [“In granting or denying a motion for summary judgment or summary adjudication, the court need rule only on those objections to evidence that it deems material to its disposition of the motion. Objections to evidence that are not ruled on for purposes of the motion shall be preserved for appellate review.”].)  

Where relevant, the evidentiary objection will be discussed in the analysis. Should the objection not be discussed, they are deemed preserved for appeal.

Discussion

As the pleadings frame the issues on a summary judgment motion, the court turns to the allegations set forth against Dr. Guntupalli (“Defendant”), who worked as a medical provider as a psychiatrist at the Aurora Charter Oak Hospital and was one of Plaintiff’s treating providers. (TAC ¶1.) The only (remaining) COA asserted against Defendant is the 1^st COA for Statutory Claim Under CANRA, PC §11161.5, PC §11165.7 And PC §11166.01(A): Breach Of Mandatory Duty (TAC p. 11).[3] In turn, the relevant allegations that comprise the 1^st COA are as follows:

As least as of August 10, 2018, Defendant NAGESWARA R. GUNTUPALLI, MD wrote, in relevant part, in a report on file at the Aurora Charter Oak Hospital that "[t]he patient [Plaintiff JOSHUA ACOSTA's] mother came and was worried about the patient's subconjunctival hemorrhage." In the same report, Defendant NAGESWARA R. GUNTUPALLI, MD wrote, in relevant part, "it is reported that someone was holding [Plaintiff JOSHUA ACOSTA] too tight [and that may be] the reason why he has the bleeding in the eyes." On August 10, 2018, Plaintiff JOSHUA ACOSTA was still confined at the Aurora Charter Oak Hospital. Plaintiff VERONICA GALLEGOS spoke to Defendant NAGESWARA R. GUNTUPALLI, MD, on or about August 10, 2018. During that conversation, Defendant NAGESWARA R. GUNTUPALLI, MD, never disclosed to her that it had been "reported that someone was holding [Plaintiff JOSHUA ACOSTA] too tight [and that may be] the reason why he has the bleeding in the eyes." Additionally, Plaintiff VERONICA GALLEGOS spoke to Defendant NAGESWARA R. GUNTUPALLI, MD, on or about August 11, 2018. During that conversation, Defendant NAGESWARA R. GUNTUPALLI, MD, never disclosed to her that it had been "reported that someone was holding [Plaintiff JOSHUA ACOSTA] too tight [and that may be] the reason why he has the bleeding in the eyes." Defendant NAGESWARA R. GUNTUPALLI, MD, never reported the report of abuse of a minor to authorities. [] Defendant [] blatantly violated his/her duty to make the mandated report. (TAC pp. 13-14, emphasis added.)

1^st COA for Violation of Child Abuse and Neglect Reporting Act (CANRA)

California Penal Code sections 11164–11174.4, also known as CANRA, require certain mandated reporters, including, but not limited to, physicians, psychiatrists, and psychologists, to exercise vigilance in identifying and disclosing instances of abuse. (Cal. Pen. Code, §§ 11164, 11165.7.) Specifically, Penal Code section 11166 provides:

(a) . . . a mandated reporter shall make a report to an agency specified in Section 11165.9 whenever the mandated reporter, in the mandated reporter's professional capacity or within the scope of the mandated reporter's employment, has knowledge of or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect. The mandated reporter shall make an initial report by telephone to the agency immediately or as soon as is practicably possible . . . . (1) For purposes of this article, “reasonable suspicion” means that it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on the person's training and experience, to suspect child abuse or neglect. “Reasonable suspicion” does not require certainty that child abuse or neglect has occurred nor does it require a specific medical indication of child abuse or neglect; any “reasonable suspicion” is sufficient . . . . (Penal Code §11166, emphasis and underline added.)[4]

Thus, the issue presented is whether Dr. Guntupalli knew facts from which a reasonable person in a like position would have suspected that Plaintiff had been abused.

For reasons to be discussed below, the evidence—when read in the light most favorable to the Plaintiff—is insufficient to refute the admissible evidence offered by Dr. Guntupalli.

A.     Dr. Guntupalli’s Evidentiary Burden

Defendant argues that, based upon the objective facts known to Dr. Guntupalli during Plaintiff’s admission to Aurora, no reasonable psychiatrist would have suspected child abuse. Defendant submits the expert declaration of Dr. Joseph Sison.

Re: Evidentiary Objections as to Dr. Sison’s Declaration, Which Are Overruled in its Entirety.

Preliminary, Plaintiff objects to Dr. Sison’s declaration on multiple grounds.

First, Plaintiff argues that Dr. Sison’s resume is hearsay. Not so as Dr. Sison laid the foundation for his curriculum vitae.

Next, Plaintiff argues that the police and hospital records are inadmissible hearsay. Not so. As noted by Defendant in reply, the records (police reports and hospital records) are submitted under the business records exception to the hearsay rule (Evidence Code §1271) and Kathleen McColgan identifies each of the custodian of records declarations.

To the extent Plaintiff objects on 2/4/24 that Colgan’s declaration was filed “for the first time with Defendant’s Reply,” that is not so. Colgan’s declaration, which authenticates Exhibit 1, was attached to the motion (see Motion pp. 19-20).

To the extent that Plaintiff argues that the declaration Alicia Adams does not authenticate Olive View hospital records. not so. (See Defendant’s Exhibit List p. 96 of 629 of PDF.) To the extent that Plaintiff cites to People v. Turner (2020) 10 Cal.5th 786, 822-823 for the proposition that to lay the foundation for business records, the person laying the foundation must link his description of the office’s procedures to the preparation of the records at issue, Turner is distinguishable on two important fronts. In Turner, the record at issue was an autopsy report and it was a criminal case. (Id. at pp. 823-824 [“The foundational showing here is notably thinner than we have encountered in upholding rulings to admit other autopsy reports  . . . while our treatment of hearsay has changed in light of evolving Supreme Court jurisprudence [internal citation omitted] this change does not make it appropriate in this case to uphold the admission of hearsay against a criminal defendant.”], emphasis added.)

To the extent that Plaintiff avers that Chelsea Steven does not properly authenticate medical records from Queen of the Valley hospital, it is unclear how so when her declaration meets the requirements of Evidence Code section 1561. (See Defendant’s Exhibit List, Ex. F, p. 414 of 629 of PDF.) To the extent that Plaintiff avers that the record from Queen of the Valley is inadmissible because it is not accompanied by the original subpoena and cites to Evidence Code section 1560, the statute provides no such requirement.

To the extent that Plaintiff relies upon People v. Sanchez (2016) 63 Cal.4th 665 for his proposition that medical records are “specific hearsay, and an expert is not allowed to based his opinion on them,” (Opp. p. 6), absent a pincite to the case, the court finds no such rule found in Sanchez. To the extent that Plaintiff conclusively cites to People v Reyes, 12 Cal.3d 486, 503  (1974) and People v Young, 189 Cal.App.3d 891, 912 (1987) for a similar position, again no such language is found in those cases.[5]

To the extent that Plaintiff argues that the medical records were “obtained illegally,” there is no elucidation on how so. What is more, even if the subpoenas were improper, Plaintiff has waived any objections by not filing a timely motion to quash at least five days before the date of production of documents. (Code of Civ. Proc., § 1985.3.)

To the extent that Plaintiff avers that Dr. Sison is not qualified in biomechanics, physics, or 24 human factors to be able to opine that Plaintiff's injuries were lawfully inflicted (Opp. p. 6), it is unclear as to the relevance of this argument. While Aurora Defendants and Signature Defendants need have provided expert testimony that discussed what happened and whether the injuries were lawfully inflicted, Dr. Guntupalli’s expert need only opine as to what another psychiatrist would have suspected. Put differently, while Plaintiff avers that an expert was required to attest as to the cause of Plaintiff’s problem (Opp. p. 7:4-11), that is there is no causation requirement in CANRA. (See also generally Reply pp. 7-8.)

To the extent that Plaintiff argues Dr. Sison’s opinion should be disregarded because it is not stated in the Separate Statement, the facts he relied upon were stated in the SS. Even if there were defects in the SS, the court exercises its discretion to overlook the defects as the SS was overall compliant with statutory requirements. (See Beltran v. Hard Rock Hotel Licensing, Inc. (Cal. Ct. App., Dec. 5, 2023, No. G062736) 2023 WL 8430581 [discussion on separate statements].)

To the extent that Plaintiff argues Dr. Sison’s declaration should be inadmissible because
“Defendant unreasonably failed to allow Plaintiff to take the deposition of Dr. Sison” (Opp. p. 18:16-18), Plaintiff’s Counsel did take Dr. Sison’s deposition. To the extent that Plaintiff argues that Defense Counsel’s conduct “was the worst that the undersigned has ever witness” with Defense Counsel’s “loud tone, histrionic conduct, constant interruption, and rudeness” (Opp. p. 18), a review of the deposition transcript shows otherwise. (See Plaintiff’s Exhibit list, Ex. U, starting at p. 15 of 64 of PDF.) Counsel Brandmeyer was merely making objections to limit the questions to the court’s very specific order which limited the scope of questions to Dr. Sison’s opinions.

Lastly, Plaintiff argues Dr. Sison's opinions should be disregarded “because he has an inherent bias (that he concealed by omission) in that he works for defendant Signature Healthcare Services, LLC, the moving party's employer and a co-defendant in this action,” (Opp. p. 8.) Dr. Sison states that his employer is Sacramento Behavioral Healthcare. According to Plaintiff’s Counsel, a filing by Sacramento Behavioral Healthcare Hospital, LLC, Defendant Signature Healthcare Services, LLC, owns the Sacramento Behavioral Healthcare hospital. A website page of the Sacramento Behavioral Healthcare hospital also states that it is owned by Defendant Signature Healthcare Services. However, as noted by Defendant in Reply, Plaintiff offers no evidence that Dr. Guntupalli works for Signature Healthcare Systems, LLC.

All in all, as Plaintiff’s evidentiary objections lack merit, they are OVERRULED [but see ‘Dr Sison’s Employment’ section, infra].

Dr. Sison specializes in Child/Adolescent Psychiatry. (Sison Decl., ¶1.) The materials Dr. Sison reviewed did not include any interviews with Does 1-4. Sison’s declaration explains the following:

-        On August 6, 2018, Plaintiff was transferred to Olive View Hospital for suicidal and homicidal ideations.

-        On August 7, 2018 at 17:45, Plaintiff was admitted to Aurora Charter Oak.

-        On August 7, 2018 at 20:30, Plaintiff began yelling on the phone with this mother

-        On August 7, 2018 at 21:30, Dr. W. Gillispi ordered Haldol, Ativan, and Benadryl for severe agitation and psychosis.

Importantly, while Plaintiff disclosed the incident to his mother; he did not tell anyone, other than his attorney or mother about the incident. (Sison Decl., p. 6, citing Exhibit G, p. 491-492 of 629 of PDF [“Q: Did you tell anyone, other than your attorney about the incident, other than your mother? A: No.”].)

1.     On August 8, 2018, Dr. Guntupalli dictated a Psychiatric Evaluation pertaining to Plaintiff Acosta on the morning of August 8, 2018. The history was obtained from the patient and reviewing the admission papers. There is no reference by the plaintiff to any beating he claims to have sustained upon admission the night before.

2.     On the morning of August 8, 2018, Plaintiff underwent another evaluation by another physician; there is no reference to medical issues or problems and no reference to any beating the plaintiff claims to have sustained upon admission the night before. (Exhibit E, pages 21-23).

3.     In the afternoon on August 8, 2018, Plaintiff attended a meeting regarding setting boundaries in relationships; There is no reference in this note of any beating that plaintiff claims occurred the night before.

4.     On August 8, 2019 at 14:09 (after the meeting above), Plaintiff was assessed regarding his prior being on 1 on 1 care; it was then denoted that he no longer needed 1:1; no reference in this note of any beating that plaintiff claims occurred the night before.

5.     On August 8, 2018, shortly after the 1^st meeting, Plaintiff attended another meeting about boundaries; There is no reference in this note of any beating that plaintiff claims occurred the night before.

6.     On August 8, 2018, the case manager’s notes also did not reference any beating that plaintiff claims occurred the night before.

7.     On August 9, 2018, Dr. Guntupalli saw Plaintiff; Plaintiff did not mention any thing about any beating that he claims to have sustained upon admission the evening of August 7, 2018.

8.     On August 9, 2018, Plaintiff was admitted by a doctor who assessed bilateral subconjunctival hemorrhage; Plaintiff did not mention any thing about any beating.

9.     On August 9, 2018, the following was noted at 19:00: Dr. Guntupalli was notified, he was aware of the subconjunctival hemorrhage and though he feels emergency services are not necessary, he said to call the medical doctor, Dr. Solomon. Dr. Solomon was notified and gave order to send Joshua to ER for further evaluation.

10.  On August 9, 2018 at 23:15, Plaintiff was seen in the Emergency Department of Queen of the Valley Hospital where “Patient says he was being belligerent on Wednesday when he was placed on a 52-85. Patient states he was fighting and straining and that is when they notice the redness to his eyes.” In the same note, it was noted that “physical abuse/neglect was not suspected.”

11.  On August 10, 2018, Dr. Guntupalli spoke with Plaintiff’s mother who was concerned about the subconjunctival hemorrhage and potential beating. According to the complete report, Dr. Guntupalli spoke to staff and interviewed Plaintiff. Based on his report, Plaintiff explained that whenever he gets upset or tends to get anxious, he had subconjunctival hemorrhage, but on the other hand it is reported that someone was holding him too tight that is the reason why he has bleeding in the eyes.

Here, the court finds that Dr. Sison’s declaration satisfies Defendant’s evidentiary burden.

Dr. Sison concludes that the objective facts known to Dr. Guntupalli during Plaintiff’s admission to Aurora would not cause a reasonable psychiatrist to have entertained a suspicion to suspect child abuse because (1) none of the medical physicians who treated Plaintiff noted any suspicion that plaintiff Acosta may have been subjected to child abuse or neglect and (2) the standard of care did not require Dr. Guntupalli to report that plaintiff Acosta had been, or may have been, the victim of child abuse as a result of being held tightly. In fact, other medical professionals (i.e., those who also treated Plaintiff at Aurora such that they were arguably in an identical position as Defendant) did not make any reports of suspected child abuse. To the contrary, the Emergency Department did not detect any suspected child abuse.

Therefore, Defendant has demonstrated that during Plaintiff’s admission to Aurora, no reasonable medical professional would have suspected child abuse.

The burden now shifts to Plaintiff.

B.     Plaintiff’s Evidentiary Burden

In Opposition, Plaintiff focuses on photographs depicting injuries on Plaintiff Joshua Acosta that had been taken by his mother, and how the photographs show strangulation. (Opp. pp. 13-15, citing Gallegos Affidavit; Amber O. Malley; Avery J. Knapp, Jr, MD.) Dr. Sison did not review the photos in forming his expert opinion.

Re: DEFENDANT’S EVIDENTIARY OBJECTIONS TO THE PHOTOGRAPHS: OVERRULED.

Preliminary, Defendant objects to the 18 photos on the grounds of hearsay and authenticity.

Hearsay: it is unclear how photographs are hearsay; photographs are not “statements.”

Authenticity: Next, Defendants argue that the photos have somehow been altered because “[I]n each of the three sets of 18 photos the color and vertical and/or horizontal lines are different, indicating the photos have been altered and that we are presented with three sets of the 18 photos.” However, Plaintiff’s mother, who authenticates the photos, avers that she has “never re-touched those photos of altered them in any way.” (‘Affidavit of Veronica Gallegos in Opposition to Defendant Nageswara R. Guntupalli’s Motion for Summary Judgment,’ p. 2.) (Plus, a review of the photos does not illustrate Defendant’s point of mismatching lines of sorts.) Therefore, as Plaintiff (through Veronica) has properly authenticated the 18 photos, the photos are admissible evidence.

Notwithstanding the foregoing, the evidence is irrelevant.

Neither Dr. Avery J. Knapp, Jr (a neuroradiologist) nor Amber O’Malley (forensic nurse examiner) state that under the objective facts known to Dr. Guntupalli at the time a reasonable psychiatrist would have suspected Joshua Acosta was the victim of child abuse or neglect. Instead, Dr. Knapp opines that “the few scattered predominantly subcortical matter zone of hyperintensities on T2 and FLAIR weighted imaging could have been caused by trauma.” And Nurse O’Malley states in her declaration that plaintiff’s injuries are consistent with strangulation by a forearm choke hold. However, injuries are not an element of a CANRA violation, and a large portion of even the opposition is dedicated to the injuries. (See Reply p. 12.)

Therefore, absent an unequivocal statement that a reasonable person in Defendant Guntupalli's position would have had reasonable suspicion of child abuse before August 10, 2018, Knapp’s and O’Malley’s declarations do not raise a triable issue of material fact, meaning Plaintiff did not satisfy his evidentiary burden.

To the extent that Plaintiff argues that a female nurse told Plaintiff’s mother that the nurse was directed not to talk to Plaintiff’s mother about what happened to Plaintiff, that is but a statement taken out of context. For one, any statements made by a nurse would be inadmissible hearsay. Second, a nurse may have been directed to not speak of the incident because of patient confidentiality. Third, even assuming a nurse saw unlawful restraint being applied to Plaintiff, there is no evidence that Dr. Guntupalli was informed of such purported abuse. Plaintiff merely speculates that Dr. Guntupalli was told by hospital workers. (See Opp. p. 12 [“That suggestion that Defendant Guntupalli was never told by hospital workers about the attack simply beggars belief. Defendant Guntupalli had been working at Aurora Charter Oak hospital for years.”].)

Conclusion

All in all, even when viewing “the evidence in the light most favorable to the opposing party and accept all inferences reasonably drawn therefrom,” the evidence points to one undisputed fact: there were no reports of child abuse in Plaintiff’s medical charts for Dr. Guntupalli to suspect otherwise. And to the extent that certain injuries should have made Dr. Guntupalli suspicious, Plaintiff provides no evidence of what a medical professional in a like position would have done.

Based on the foregoing, Dr. Guntupalli is entitled to summary judgment as a matter of law.[6]