Judge: Mel Red Recana, Case: 21STCV01578, Date: 2024-10-03 Tentative Ruling

All rulings shown here are TENTATIVE ONLY, and thus oral argument WILL be heard. All Counsel are still required to attend.

Case Number: 21STCV01578    Hearing Date: October 3, 2024    Dept: 45

Superior Court of California

County of Los Angeles

Hearing Date:             October 03, 2024

Moving Party:             Defendant Rajan M. Patel, M.D.

Responding Party:       None

Motion for Summary Judgment

The court has considered the moving papers. No opposition has been filed.

The court GRANTS Defendant Rajan M. Patel, M.D’s (Defendant) motion for summary judgment with respect to the First Amended Complaint.

Background

Plaintiffs Larisa Stepantsova and Lana Kruglyakova (Plaintiffs) are the wife and adult daughter, respectively, of decedent Vyacheslav Stepantsov (Decedent). Plaintiffs allege that Decedent died as a result of a right shoulder arthoplasty surgery in which Defendant was the orthopedic surgeon. (Complaint, ¶ 11.)

In December 2019, Decedent consulted with Defendant, complaining of right shoulder pain and weakness. (UMF, ¶ 6.) Decedent had previously consulted with Defendant in 2015. (UMF, ¶ 1.) In a patient intake form, Decedent reported significant medical history for headaches, glaucoma, high blood pressure, stroke, osteoarthritis, gout, prostate issues, depression, and seizures, and reported taking numerous medications. (UMF, ¶ 8.) Defendant performed a physical examination on Decedent, finding moderate to severe painful arch and moderate crepitus among other issues. (UMF, ¶ 11.) Defendant concluded that Decedent’s best treatment option was consideration for reverse shoulder replacement, and discussed the risks, limitations, expectations, and possible complications in detail with Decedent. (UMF, ¶ 13.) Decedent subsequently signed a consent form for the reverse right shoulder surgery. (UMF, ¶ 14.)

Defendant ordered blood tests, urinalysis, chest X-ray, and history and physical examinations to be performed prior to the surgery. (UMF, ¶ 16.) Defendant Gary Reznick, M.D., stated that Decedent had no medical or cardiac contraindications to undergo the surgery, and defendant David Vizel, M.D., stated that Decedent had no acute contraindications to undergo the surgery. (UMF, ¶¶ 17-18.) Labs were repeated on January 7, 2020, finding that glucose, BUN, creatinine, and PTT were higher than normal, while hemoglobin and hematocrit were slightly below normal. (UMF, ¶ 19.)

The surgery was performed on January 16, 2020. (UMF, ¶ 21.) Decedent was given general anesthesia and placed in the beach chair position. (UMF, ¶ 23.) Estimated blood loss during the surgery was 50 milliliters, and Defendant did not note any complications. (UMF, ¶ 32.) Defendant gave postoperative medical orders. ((UMF, ¶¶ 33-35.)

Decedent was transferred to the post-anesthesia care unit (PACU), at which point his blood pressure was measured 83/44, and it remained hypotensive while Decedent was in the PACU. (UMF, ¶ 36.) Defendant did not monitor Decedent in the PACU; instead, defendant Ernest Schmidt, M.D. as well as the PACU nurse, Felicia Armstead Watt, RN, monitored Decedent and provided Defendant with updates regarding Decedent. (UMF, ¶ 38.) Watt did not contact Defendant to evaluate Decedent or issue orders.

Approximately five hours after being transferred to the PACU, Decedent was transferred to Cedars Sinai Medical Center. (UMF, ¶ 40.) Decedent died there on January 25, 2020. (UMF, ¶ 40.)

The operative complaint contains a cause of action against Defendant for wrongful death arising from medical negligence.

On July 24, 2024, Defendant filed this motion for summary judgment. No opposition has been filed.

Legal Standard

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.) In analyzing motions for summary judgment, courts must apply 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.) Summary judgment is proper “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 judgment as a matter of law.”  (Code Civ. Proc., § 437c, subd. (c).)

            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. (Scalf v. D. B. Log Homes, Inc. (2005) 128 Cal.App.4th 1510, 1520.) 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 motion for summary judgment must be denied where the moving party's evidence does not prove all material facts, even in the absence of any opposition or where the opposition is weak (Leyva v. Sup. Ct. (1985) 164 Cal.App.3d 462, 475; Salesguevara v. Wyeth Labs., Inc. (1990) 222 Cal.App.3d 379, 384, 387).

            Once the defendant has met that burden, the burden shifts to the plaintiff to show that a triable issue of material fact exists as to that cause of action or defense. 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, 166.)

Discussion

Defendant moves for summary judgment on the grounds that (1) Defendant complied with the applicable standard of care at all times; and (2) nothing Defendant did or did not do, caused the death of Decedent or plaintiffs’ injuries and claimed damages.

Professional Negligence

The elements of a negligence claim are duty, breach of duty, causation, and damages.  (Salinas v. Martin (2008) 166 Cal.App.4th 404, 411.) Defendant argues that Plaintiffs cannot establish that he breached his duty of care and that they cannot establish that his acts or omissions were the cause of Decedent’s death or Plaintiffs’ injuries and claimed damages.

Breach of Duty of Care

A physician’s standard of care requires that they “exercise the degree of skill, knowledge and care ordinarily possessed and exercised by members of the medical profession under similar circumstances.” (Selden v. Dinner (1993) 17 Cal.App.4th 166, 173.) A medical standard of care can be established only by expert medical testimony. (Ibid.)

The court finds that there is no triable issue of material fact as to whether Defendant has breached his duty of care owed to Decedent, and Defendant is entitled to judgment as a matter of law.

Here, Defendant presents the declaration of Eric S. Milstein, M.D., as expert medical testimony to establish that Defendant’s actions did not fall below the standard of care. Dr. Milstein opines that, to a reasonable degree of medical certainty, Defendant at all times complied with the standard of care in his care and treatment of Decedent, including in his preoperative test orders, his surgical technique, and his postoperative deference to anesthesiology and nursing to monitor and treat Decedent in the PACU. (Milstein Decl., ¶ 10.)

Based on the above, the court finds that Defendant has carried his initial burden. Thus, the burden now shifts to Plaintiffs to show that triable issues of material fact exist as to the issue of Defendant’s breach of his duty of care.

Plaintiffs have failed to carry their shifted burden. Plaintiffs have not filed an opposition to Defendant’s motion for summary judgment. Plaintiffs also have not presented any expert medical testimony to establish that Defendant did not comply with the operative standard of care in his care and treatment of Decedent.

The evidence presented to the court indicates that there is no triable issue of material fact as to the issue of Defendant’s breach of his duty of care. Defendant has presented expert medical testimony opining that Defendant did not breach his duty of care, and Plaintiffs have failed to present expert medical testimony opining that Defendant did breach his duty of care.

Causation

In a personal injury action for medical malpractice, “causation must be proven within a reasonable medical probability based upon competent expert testimony. Mere possibility alone is insufficient to establish a prima facie case.” (Jones v. Ortho Pharmaceutical Corp. (1985) 163 Cal.App.3d 396, 402.) A possible cause becomes probable when it is more likely than not that the injury was a result of the cause. (Id., at p. 402.)

The court finds that there is no triable issue of material fact as to whether there is a reasonable medical probability that Defendant’s acts or omissions were the cause of Decedent’s death or Plaintiffs’ claimed injuries or damages, and Defendant is entitled to judgment as a matter of law.

Here, Defendant presents the declaration of Dr. Milstein as expert medical testimony to establish that Defendant’s acts or omissions were not the cause of Decedent’s death or Plaintiff’s claimed injuries or damages. Dr. Milstein opines that, to a reasonable degree of medical probability, nothing Defendant did or failed to do caused or contributed to Decedent’s death or Plaintiffs’ claimed injuries or damages; in particular, Dr. Milstein notes that although there is an increased risk of hypoperfusion when performing surgery on a patient in the modified beach chair position, Decedent’s blood pressures were being maintained during the surgery, so hypoperfusion was not a problem during the surgery. (Milstein Decl. ¶ 11.)

Based on the above, the court finds that Defendant has carried his initial burden. Thus, the burden now shifts to Plaintiffs to show that triable issues of material fact exist as to the issue of Defendant’s causation of Decedent’s death or Plaintiffs’ claimed injuries or damages.

Plaintiffs have failed to carry their shifted burden. Plaintiffs have not filed an opposition to Defendant’s motion for summary judgment. Plaintiffs also have not presented any expert medical testimony to establish that Defendant’s acts or omissions caused Decedent’s death or Plaintiffs’ claimed injuries or damages.

The evidence presented to the court indicates that there is no triable issue of material fact as to the issue of Defendant’s causation of Decedent’s death or Plaintiffs’ claimed injuries or damages. Defendant has presented expert medical testimony opining that Defendant did not cause Decedent’s death or Plaintiffs’ claimed injuries or damages, and Plaintiffs have failed to present expert medical testimony to the contrary.

            Based on the foregoing, the court GRANTS Defendant’s motion for summary judgment.

It is so ordered.

Date: October 03, 2024

_______________________

MEL RED RECANA

Judge of the Superior Court