Judge: John J. Kralik, Case: 23BBCV02892, Date: 2025-06-06 Tentative Ruling

Case Number: 23BBCV02892    Hearing Date: June 6, 2025    Dept: NCB

Superior Court of California

County of Los Angeles

North Central District

Department B

BACKGROUND

A.    Allegations

Plaintiffs Andrea Ramos Caraballo and Bernardo Flores Herrera (“Plaintiffs”) allege that on December 28, 2022, Mrs. Caraballo placed herself under the sole and exclusive care and control of Defendants Carlos Alberto Flores, M.D. (“Dr. Flores”) and Providence Saint Jospeh Medical Center (“Providence”) for medical, surgical, hospital, diagnostic, nursing, and other care necessary in connection with her ongoing medical care for the pregnancy and delivery of her child.  (Compl., ¶8.)  Plaintiffs allege that Defendants negligently examined, diagnosed, provided informed consent, treated, performed and interpreted diagnostic procedures, cared for, administered, and otherwise handled and controlled Mrs. Caraballo.  (Id., ¶9.) 

Plaintiffs bring a loss of consortium claim on behalf of Mr. Herrera, who is the spouse of Mrs. Caraballo.

The complaint, filed December 5, 2023, alleges causes of action for: (1) medical negligence; and (2) loss of consortium.

On January 5, 2024, Plaintiffs amended the complaint, naming Facey Medical Group – Mission Hills OB/GYN a Doe 1.  On September 30, 2024, Plaintiffs amended the complaint. naming Facey Medical Group, a Medical Corporation, as Doe 1.  On October 10, 2024, Plaintiffs dismissed with prejudice from the complaint Facey Medical Group, a Medical Corporation (Doe 1) (also sued/served as Facey Medical Group – Mission Hills OB/GYN (DOE 1)). 

B.     Motion on Calendar

On February 21, 2025, Providence filed a motion for summary judgment against Plaintiff’s complaint.  

The Court is not in receipt of an opposition brief.   On April 30, 2025, Plaintiffs filed a Notice of Non-Opposition of Providence’s motion for summary judgment. 

DISCUSSION

            Providence moves for summary judgment, arguing that it complied with the standard of care and did not cause Mrs. Caraballo’s injury.

The underlying facts are undisputed as Plaintiff has not filed an opposition brief.  Mrs. Caraballo was admitted to Providence on December 28, 2022 at 1356 hours and was seen by Dr. Flores.  She was sent from his office due to elevated blood pressures with an admission diagnosis for unspecified pre-eclampsia, complicating childbirth.  (Fact 1.)  Dr. Flores conducted an obstetrical history and physical, noting that she complained of hypertension, was 39 weeks and 2 days pregnant, and had gestational diabetes.  (Fact 2.)  The onset of labor was charted at 1505 hours.  (Fact 3.)  On December 29, 2022, fetal hear rate was tracing to 130’s with moderate variability accelerations at 0617 per a physician note by Deborah Yu, M.D.  (Fact 4.)  An epidural catheter placement occurred at 0823 hours, performed by Victor Slupski, M.D.  (Fact 5.)  Dr. Mary Olender examined Ms. Caraballo at 0930 hours and noted that she was comfortable overall. (Fact 6.)  At 1715 hours, full dilation was reached.  (Fact 7.)  At 1733 hours, pushing commenced.  (Fact 8.)  At 1810 hours, rupture of membranes occurred.  (Fact 9.)  A vaginal delivery was accomplished with use of a Kiwi vacuum assist at 1907 hours.  (Fact 10.) The placental delivery was spontaneous and appeared intact. There was a loose nuchal cord with 3 vessels that had a single loop around the head. (Fact 11.)  An episiotomy was made for delivery and, after delivery, a fourth-degree tear was noted and repaired and the estimated blood loss was 400 cc.  (Fact 14.)  The labor length was charted as follows: Stage 1 – 10 hours; Stage 2 – 1 hour 52 minutes; Stage 3 – 0 hours 0 minutes. (Fact 15.) An obstetrical delivery note was prepared by Dr. Flores on December 19, 2022, stated:

31 y.o. 2P0010 39w 3d presented for induction of labor due to GDM and preeclampsia. GBS Positive. Treated with PCN x several doses prior to delivery. Epi placed. Pitocin per protocol. Progressed to complete. Pushed approx. 60 min. to have a vacuum assisted vaginal delivery due to maternal exhaustion and OP position. After consent obtained, Kiwi vacuum applied approximately 2 cm anterior to the posterior fontanelle along midsagittal suture. Total time applied was 60 seconds with 4 pop-offs. Fetus rotated to OA and episiotomy made. Infant delivered, cord clamped and cut and handed off to NICU team. Placenta delivered spontaneously with 3VC. Fourth degree vag lac repaired. EBL 400. All counts correct. Mom and baby stable in room. APGARS 8/9. Weight 7 lb 6 oz.

(Fact 12, 13, 16.)  Dr. Flores rounded on Ms. Caraballo on December 30 at 1716 hours. He noted she was feeling well postpartum and magnesium was to be discontinued, with a plan to continue routine postpartum management.  (Fact 17.)  On December 30 and 31, the nursing chart noted Mrs. Caraballo’s perineal discomfort and documented remedies.  (Fact 18-19.)  On December 31, Mrs. Caraballo was discharged in a stable condition.  (Fact 20.)  The final diagnoses were as follows: “Unspecified pre-eclampsia complicating childbirth; single live birth; Streptococcus B carrier state complicating childbirth; Labor and delivery complicated by meconium in amniotic fluid; Maternal exhaustion complicating labor and delivery; Anemia complicating childbirth; fourth-degree perineal laceration during delivery.”  (Fact 21.)  On January 9, 2023, Dr. Flores saw Ms. Caraballo for a postpartum visit and noted a dehiscence of the fourth-degree tear and now a fistula.  (Fact 22.)  Subsequent to discharge, Ms. Caraballo was diagnosed with a fourth-degree laceration with dehiscence of the previous repair at delivery, such that she developed a fistula. (Fact 23.) 

In support of the motion, Providence provides the declaration of Paul R. Weber, M.D., Ph.D.  Dr. Weber reviewed Mrs. Caraballo’s medical records and opines “to a reasonable degree of medical probability, [Providence] complied with the standard of care in the care and treatment of Andrea Ramos Caraballo.”  (Weber Decl., ¶15.)  He further states that “to a reasonable degree of medical probability, [Providence] did not cause or contribute to the alleged injuries sustained by Mrs. Caraballo.”  (Id., ¶16.)  He states that nothing Providence did or did not do caused the medical issues to occur.  (Id., ¶30.)

Here, Providence has established its initial burden on summary judgment.  The motion is not opposed by Plaintiff or Dr. Flores.  Plaintiffs submitted a notice of non-opposition to Providence’s motion.  As such, no triable issues of material fact have been raised.  Accordingly, the motion for summary judgment is granted.

CONCLUSION AND ORDER

Defendant Providence Saint Jospeh Medical Center’s motion for summary judgment is granted. 

Defendant shall provide notice of this order.  

DATED:  June 6, 2025                                                           ___________________________

                                                                                          John J. Kralik

                                                                                          Judge of the Superior Court