Judge: Gary I. Micon, Case: 21STCV07986, Date: 2024-02-29 Tentative Ruling

Case Number: 21STCV07986    Hearing Date: February 29, 2024    Dept: F43

Dept. F-43

Date: 2-29-24

Case # 21STCV07986, Abel Luna vs. CareMeridian, LLC, et al.

Trial Date: 10-14-24

SUMMARY JUDGMENT

MOVING PARTY: Defendant Providence Health System-Southern California dba Providence Holy Cross Medical Center

RESPONDING PARTY: Plaintiff Abel Luna

RELIEF REQUESTED

Motion for Summary Judgment, or in the alternative, Summary Adjudication

RULING: Summary adjudication granted for the dependent adult abuse-neglect cause of action; summary judgment is denied for the entire complaint.

SUMMARY OF ACTION

Plaintiff Abel Luna (Plaintiff) has asserted two causes of action for dependent adult abuse-neglect and negligence against Defendant Providence Health System-Southern California (Defendant). Plaintiff was severely injured in a car accident and was thereafter transported to Defendant’s facility where he was treated in its intensive care unit. Plaintiff alleges that he then experienced skin breakdown and pressure sores. Plaintiff was admitted to the hospital on February 2, 2019, and discharged on March 11, 2019.

During his hospital stay, it was noted that Plaintiff was at a high risk for loss of skin integrity due to his condition from the car accident. Over the course of his stay at Defendant’s facility, Plaintiff began to develop pressure injuries on different parts of his body. Defendant claims that Plaintiff received continuous care while admitted to its hospital and refused repositioning on certain occasions.

Defendant filed its motion for summary judgment on August 11, 2023. Plaintiff filed his opposition on February 15, 2024. Defendant filed its reply on February 23, 2024.

ANALYSIS

Defendant’s Request for Judicial Notice: Defendant has requested that the Court take judicial notice of a publication from the U.S. Department of Health and Human Services regarding pressure injuries. The Court grants this request, as the document is an official publication by a branch of the Executive Department of the U.S. (See Evidence Code § 452.)

Defendant’s Evidentiary Objections:

Declaration of Nurse Charlene Gozony, MSN, RN, CCRN, LNC

Sustained: None

            Overruled: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20

            Declaration of John Lynn Baeke, M.D.

Sustained: 2

            Overruled: 1, 3, 4, 5, 6, 7, 8

Defendant moves for summary judgment on grounds that the declaration of its expert shows that the standard of care was met and skin integrity issues were not caused by negligence or neglect-abuse. Defendant also argues that Plaintiff’s issues with skin integrity were the result of the natural course of his condition and treatment. Alternatively, Defendant argues that summary adjudication should be granted for Plaintiff’s cause of action for dependent adult abuse.

Plaintiff in opposition argues that triable issues of fact exist as to Plaintiff’s causes of action for negligence and neglect-abuse. Plaintiff also argues that Plaintiff can establish custodial care to support a cause of action for dependent adult abuse and neglect. Finally, Plaintiff argues that he is permitted to bring both causes of action for negligence and dependent adult abuse and neglect.

Defendant argues in its reply that summary adjudication for the cause of action for dependent adult abuse should be granted. Defendant also argues that summary judgment should be granted because Plaintiff’s experts’ opinions were improper and circular.

The purpose of a motion for summary judgment “is to provide courts with 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. Atl. 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 pleadings frame the issues for motions, “since it is those allegations to which the motion must respond. (Citation.)” (Scolinos v. Kolts (1995) 37 Cal. App. 4th 635, 640-641; FPI Development, Inc. v. Nakashima (1991) 231 Cal.App.3d 367, 382-383; Jordan-Lyon Prods., LTD. v. Cineplex Odeon Corp. (1994) 29 Cal.App.4th 1459, 1472.) “On a motion for summary judgment, the initial burden is always on the moving party to make a prima facie showing that there are no triable issues of material fact.” (Scalf v. D.B. Log Homes, Inc. (2005) 128 Cal.App.4th 1510, 1519.) A defendant moving for summary judgment “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 . . . cannot be established.”  (CCP § 437c(p)(2).) “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 the cause of action or a defense thereto.” (Ibid.)

“When deciding whether to grant summary judgment, the court must consider all of the evidence set forth in the papers (except evidence to which the court has sustained an objection), as well as all reasonable inference that may be drawn form that evidence, in the light most favorable to the party opposing summary judgment.” (Avivi, 159 Cal.App.4th at 467; see also CCP § 437c(c).) “An issue of fact can only be created by a conflict in the evidence.  It is not created by speculation, conjecture, imagination or guesswork.” (Lyons v. Security Pacific National Bank (1995) 40 Cal.App.4th 1001, 1041 (citation omitted).)

First, Defendant moves for summary judgment on the entire complaint based on its affirmative defense of Civ. Code § 1714.8(a). That sections states “No health care provider shall be liable for professional negligence or malpractice for any occurrence or result solely on the basis that the occurrence or result was caused by the natural course of a disease or condition, or was the natural or expected result of reasonable treatment rendered for the disease or condition.” (Civ. Code § 1714.8.)

For causation, “The law is well settled that in a personal injury action causation must be proven within a reasonable medical probability based upon competent expert testimony.” (Jones v. Ortho Pharmaceutical Corp. (1985) 163 Cal.App.3d 396, 402; see also Williams v. Wraxall (1995) 33 Cal.App.4th 120, and Mayes v. Bryan (2006) 139 Cal.App.4th 1075, 1093.) A plaintiff alleging injury from medical care must prove “cause-in-fact” by proper expert testimony – “Proof that a negligent act was a substantial factor in causing the injury does not relieve the plaintiff of the burden of proving the negligent act was a cause-in-fact of the injury.” (Jennings v. Palomar Pomerado Health Systems (2003) 114 Cal.App.4th 1108, 1115.)

Defendant has provided an expert declaration from Dr. Emanuel. Dr. Emanuel opines that Plaintiff’s skin injuries were, to a reasonable degree of medical probability, caused by the natural course of, or the natural expected result of, the reasonable treatment of Plaintiff as a trauma patient with his particular injuries and were complicated by his pre-existing health conditions. Dr. Emanuel also indicated that the physician orders not to turn Plaintiff were reflective of medical judgment relative to precautions based on Plaintiff’s spinal instability. Based on this, Defendant argues that Plaintiff’s injuries were due to negligence.

In opposition, Plaintiff has provided two expert declarations that state that Defendant’s care of Plaintiff was inadequate. “When a defendant moves for summary judgment and supports his motion with expert declaration that his conduct fell within the community standard of care, he is entitled to summary judgment unless the plaintiff comes forward with conflicting expert evidence.” (Munro v. Regents of the University of California (1989) 215 Cal.App.3d 977, internal citations omitted.) An expert declaration offered in support of an opposition to a motion for summary judgment is entitled to all favorable inferences that may be derived from that declaration. (Powell v. Kleinman (2007) 151 Cal.App.4th 112, 124.) Generally, when a declaration is offered to counter a motion for summary judgement, it is sufficient that the declaration disclose the existence of a material triable issue of fact to overcome the motion for summary judgment, it does not need to prove plaintiff’s case. (AARTS Productions, Inc. v. Crocker National Bank (1986) 179 Cal.App.3d 1061, 1065.)

Though the Court sustained some of Defendant’s objections to the declarations of Plaintiff’s experts, the substance of the declarations still stands. What remains presents a triable issue of material fact because Plaintiff’s experts opine that the care provided to Plaintiff was inadequate for Plaintiff’s needs and condition. Plaintiff’s experts have testified that to a reasonable degree of medical probability, the inadequate care that Plaintiff received caused the pressure injuries which developed during his stay at Defendant’s facility.

Based on the foregoing, a triable issue of material fact exists regarding the care Plaintiff received. Defendant’s motion for summary judgment for the entire complaint is denied.

Alternatively, Defendant argues that summary adjudication should be granted for Plaintiff’s cause of action for Dependent Adult Abuse. In Winn v. Pioneer Medical Group, Inc. (2016) 63 Cal.4th 148, the California Supreme Court sustained a demurrer to a theory of elder abuse, concluding a plaintiff does not have a theory of elder-dependent abuse when the plaintiff’s relationship with the defendant is consistent with “an able-bodied and fully competent adult’s reliance on the advice and care of his or her medical providers.” (Winn at 165.)

Winn explained that a claim for elder-dependent abuse based on a caretaker-custodian’s “‘[f]ailure to provide medical care for physical and mental health needs’” pertains to “a determination made by one with control over an elder whether to initiate medical care at all.” (Id. at 158, quoting Welf. & Inst. Code § 15610.57(b)(2) [italics in original].) Winn explained that the elder-dependent statutes were “not meant to encompass every course of behavior that fits either legal or colloquial definitions of neglect.” (Id. at 159.) Winn distinguished between medical negligence and elder-dependent abuse and cautioned against “[b]lurring the distinction between neglect under the Act and conduct actionable under ordinary tort remedies.” (Id. at 160.)

Neglect as contemplated by the Act is separate and distinct from professional negligence. (See Covenant Care, Inc. v. Superior Court (2004) 32 Cal.4th 771; see also Delaney v. Baker (1999) 20 Cal.4th 23.)

The case law demonstrates that hospitals, as facilities that provide medical care that a fully able-bodied and fully competent adult could not provide for themselves, are typically not liable for elder abuse. In this case, Plaintiff’s allegations refer to Defendant’s acts or omissions as a medical provider, not as a caretaker-custodian responsible for Plaintiff’s everyday care. Able-bodied and mentally competent adults are not able to care for themselves after a catastrophic car accident. Nor was there any deprivation of medical services on the part of Defendant that would indicate neglect. Instead, Plaintiff’s allegations are for medical negligence.

In opposition, Plaintiff appears to misunderstand the standard for Dependent Adult Abuse. Though Plaintiff was dependent on Defendant’s doctors and nurses during his stay there, he was there for medical care as a result of a catastrophic accident. The hospital was not his caretaker or custodial caregiver in the sense contemplated by the Act.

Defendant would not be liable for Plaintiff’s cause of action for dependent adult abuse-neglect because Defendant was acting in the role of medical provider, not as Plaintiff’s custodial caregiver. Defendant was not acting in the role of deciding whether to give Plaintiff medical care at all; it was providing medical care to Plaintiff as a result of Plaintiff’s accident. Accordingly, Defendant’s motion for summary adjudication on this cause of action is granted.

The motion for summary judgment is denied for the entire complaint. Summary adjudication is granted for the cause of action for dependent adult abuse-neglect.

Trial remains set for October 14, 2024.

Moving party to give notice.