Judge: Mark A. Young, Case: 22STCV11302, Date: 2023-10-03 Tentative Ruling
Case Number: 22STCV11302 Hearing Date: October 3, 2023 Dept: M
CASE NAME: St. Page, et
al., v. Regents of the University of Cal., et al.
CASE NO.: 22STCV11302
MOTION: Motion
for Leave to Add Punitive Damages
HEARING DATE: 10/3/2023
Legal
Standard
In any action¿for professional negligence¿against a health
care provider, no claim for punitive damages may be included in an original
complaint.¿¿(CCP,¿§ 425.13 (a).)¿Rather, a¿plaintiff must file a motion¿for
leave¿to amend the complaint and add a prayer for punitive damages.
¿
A¿motion¿for leave to amend under section 425.13¿must be
supported by declarations establishing facts sufficient to support a finding
there is a “substantial probability” the¿plaintiff will prevail on the punitive
damages claim. “Substantial probability” requires the plaintiff to show a
legally sufficient claim substantiated by competent, admissible evidence.¿(College
Hospital Inc. v. Superior Court (1994) 8 Cal.4th 704, 719.)¿
The plaintiff must make a sufficient prima facie showing of facts to sustain
the punitive damage claim,¿taking into
account¿the higher “clear and convincing”
standard of proof required for such claims under Code of Civil Procedure
section 3294.¿(Looney v. Superior Court¿(1993)¿16 Cal.App.4th 521,
538-540.)¿“Consistent with the legislative intent to protect health care
defendants from the drastic effects of unwarranted punitive damage claims, the
entire package of materials submitted in support of the¿section 425.13(a) motion
should be carefully reviewed to ensure that a genuine contestable claim is
indeed proposed.” (College Hospital, supra,¿8 Cal.4th at pp.
719–720.)
Nevertheless, the court may not assess credibility or weigh
conflicting evidence.¿(Id.¿at 539; see also Looney, supra,
16 Cal.App.4th at p. 539 [“In making this judgment, the trial court’s
consideration of the defendant’s opposing affidavits does not permit a weighing
of them against the plaintiff’s supporting evidence, but only a determination
that they do or do not,¿as a matter of law,¿defeat that
evidence”].)¿The¿court must not reject a well-pled and factually supported
punitive damages claim simply because the court believes the evidence is not
strong enough for probable success before a jury.¿(College Hospital, supra,¿8
Cal.4th¿at¿709.)
The basic elements of a punitive damages claim are set out
in section 3294 of the Civil Code.¿There must be proof of “oppression, fraud,
or malice.” (Civ. Code § 3294 (a).) As defined in Civil Code section 3294(c),
“the punishable acts which fall into these categories are strictly defined.¿
Each involves ‘intentional,’ ‘willful,’ or ‘conscious’ wrongdoing of a
‘despicable’ or ‘injur[ious]’ nature. [Citation].” (College Hospital Inc.,¿supra,¿8
Cal.4th at 721.)¿Punitive damages are only proper when the tortious conduct
arises to the level of extreme indifference to the plaintiff’s rights, a level
which decent citizens should not have to tolerate.¿(Tomaselli v.
Transamerica Ins. Co.¿(1994) 25 Cal.App.4th 1269, 1287.)¿Despicable conduct
has been characterized as conduct that is so vile, base, contemptible,
miserable, wretched or loathsome that it would be looked down upon and despised
by ordinary decent people.¿(Mock v. Michigan Millers Mutual Ins. Co.¿(1992)
4 Cal.App.4th 306, 331.)
Analysis
Plaintiffs Estate of Emily Page St.
Martin, Laura St. Martin, and John Michael St. Martin move for leave to amend
to seek punitive damages against defendants Regents of the University of
California and Radhika Rible, M.D.
Plaintiffs bring this action for
medical malpractice against Defendants for the wrongful death of newborn infant
Decedent Emily Page St. Martin. Dr. Rible was the attending obstetrician during
Laura St. Martin’s labor and delivery. Plaintiffs allege that Dr. Rible acted
with a conscious disregard for the rights and safety of the mother and her
unborn child. Plaintiffs contend that Dr. Rible's conduct exceeded a mere
departure from the standard of care, requiring an imposition of punitive
damages to deter her and other health care providers employed by the Regents
from engaging such despicable behavior which resulted in the death of an otherwise
healthy full-term newborn baby.
In support of their motion, Plaintiffs
present the testimony of Laura St. Martin, expert witness testimony of Dr. Howard
C. Mandel, and the complete medical records of the labor including the electronic
Fetal Heart Tracings (FHT). Dr. Mandel testifies
that on March 8, 2021, Laura St. Martin presented to UCLA Medical Center with
decreased fetal movement and mild contractions. (Mandel Decl., ¶ 10.) An
ultrasound revealed moderate oligohydramnios (a low level of amniotic fluid).
(Id.) Oligohydramnios places the baby at substantial risk of fetal distress,
injury, and possible death in the event of a prolonged induction of labor
because the flow of oxygen through the umbilical cord is likely to be
compromised. (¶ 11.) According to Dr. Mandel, the standard of care in this
situation would require an in-depth discussion with the patient and her partner
about the risks and options available for delivery; either vaginal delivery or cesarean
section delivery. (¶ 12.) The records reflects that no such discussion
regarding the alternatives occurred. (Id.)
Ms. St. Martin was admitted and
labor was induced with the administration initially of Cytotec and then of
Pitocin. (Mandel Decl., ¶ 13.) According to Dr. Mandel, Pitocin must be
monitored closely to determine whether the dose should be increased, decreased
or discontinued depending on the effect it is having on the fetal heart rate.
(¶ 14.) Further, physicians and nurses must watch closely for potential red
flags posed by abnormal FHT. (¶ 15.) If a Category II tracing persists or
repeats when the patient is remote from delivery, then c-section is recommended
and a detailed discussion with the patient and her partner is required to
explain the risks of continuing with induction. (Id.) If a Category II tracing
turns into a Category III tracing at any time, then it is a medical emergency
which requires an immediate Caesarean delivery with an expeditious discussion
of the mother's options. (Id.) On March 8 and 9, 2021, Ms. St. Martin had a
Category I tracing. (Id.) If the baby had been delivered at any time on March 8
or March 9, 2021, she would have been healthy. (Id.)
On March 10, 2021, the FHT's began
to show cord compression with persistent minimal variability. (¶ 17.) At 3:26
a.m. on March 10, 2021, the FHT showed a Category III tracing, which required
an emergency c-section. (Id.) The records show that this did not occur. (Id.) By
4:00 a.m., the baby's baseline fetal heart rate had increased to tachycardic
levels of 170 beats per minute, showing that Pitocin should have been
discontinued. (¶ 18.) By 6:36 a.m., the baby's baseline fetal heart rate
further increased to 190 beats per minute. (¶ 19.) Despite all these red flags,
no one explained anything to the parents, no one turned off the Pitocin, and no
one took the patient for a crash c-section. (Id.) Instead, at 7:48 a.m., Dr.
Rible had Laura start pushing. (¶ 21.) At 9:20 a.m., Dr. Rible noted a sudden
deceleration of fetal heart rate to 60 beats per minute. (¶ 22.) Dr. Rible had Ms.
St. Martin repositioned on her hands and knees and then applied a vacuum while
the baby was still too high in the birth canal. (Id.) The vacuum popped off,
causing a 7.5 cm laceration from her cervix to her uterus. (Id.) At 9:31 a.m.,
Dr. Rible decided to perform a crash c-section, but by then, the baby had
already suffered terminal bradycardia. (¶ 23.) Dr. Mandel considers this a
conscious disregard for the rights and safety of Ms. St. Martin and Emily St.
Martin. (¶¶ 17-31.)
In addition
to Dr. Mandel’s evidence, Laura St. Martin’s declaration details her labor
experience. (L. St. Page Decl., ¶¶ 4-20.) The declaration is consistent with
the above facts. Ms. St. Martin emphasizes that during her labor, Dr. Rible did
not discuss anything with her prior to 7 a.m. on March 10, 2021, when Dr. Rible
told her to start pushing. (¶ 14.)
Fully crediting Plaintiffs’
presented evidence, Plaintiffs still do not present sufficient prima facie
evidence of that they will prevail under the clear and convincing standard
required of punitive damages. More specifically, Plaintiffs lack substantial evidence
of Dr. Rible’s conscious disregard of Laura St. Martin’s and Emily St.
Martin’s safety. At best, they show that a reasonable doctor, considering the
FHT readings, would have known to perform a c-section at certain junctures of
the labor. Further, Plaintiffs
demonstrate that Dr. Rible failed to provide critical information to Plaintiffs
regarding the risks associated with inducing vaginal delivery and the option to
perform a c-section.
For instance, in order to conclude
that Dr. Rible despicably and consciously disregarded Plaintiffs’ safety, the
Court would expect evidence showing Dr. Rible’s consciousness of the risks of
continuing with labor in light of the FHT, such that a trier of fact could
conclude that Dr. Rible’s conduct was despicable. Plaintiffs do not present
evidence that Dr. Rible was actually aware of the probable consequences of her
actions or inactions. Therefore, the evidence does not show whether Dr. Rible acted
willfully or deliberately. Instead, this action currently sounds in medical
negligence in properly assessing Plaintiffs’ condition, rather than despicable
conduct.
The motion also fails to the extent
that it seeks leave for punitive damages against the Regents. “[A] public
entity is not liable for damages awarded under Section 3294 of the Civil Code
or other damages imposed primarily for the sake of example and by way of
punishing the defendant.” (Gov. Code § 818.) Further, there is no evidence
supporting the requirements of Civil Code § 3294(b).
Accordingly, the motion is DENIED.