Judge: Michael E. Whitaker, Case: 21STCV37567, Date: 2023-08-16 Tentative Ruling



Case Number: 21STCV37567    Hearing Date: April 18, 2024    Dept: 207

TENTATIVE RULING - NO. 1

 

DEPARTMENT

207

HEARING DATE

April 18, 2024

CASE NUMBER

21STCV37567

MOTION

Motion for Summary Judgment

MOVING PARTY

Defendant Andrew Gelis

OPPOSING PARTY

Plaintiff Pericles Chamis

 

MOVING PAPERS:

 

  1. Notice of Motion and Motion for Summary Judgment; Memorandum of Points and Authorities
  2. Separate Statement of Undisputed Material Facts
  3. Declaration of Kathleen A. Stosuy
  4. Notice of Lodging Separate Volume of Documentary Evidence

 

OPPOSITION PAPERS:

 

  1. Opposition to Motion for Summary Judgment; Memorandum of Points and Authorities
  2. Declaration of Waukeen McCoy
  3. Declaration of Vinay Ginjupalli
  4. Declaration of Marilyn E. McCullum
  5. Separate Statement of Disputed Material Facts
  6. Objections to Evidence

 

REPLY PAPERS:

 

  1. Reply in Support of Motion for Summary Judgment
  2. Evidentiary Objections

 

BACKGROUND

 

On or about November 4, 2020, Plaintiff Pericles Chamis (“Plaintiff”) underwent an upper endoscopy procedure, during which “Plaintiff began vomiting and convulsing on the operating table.”  (Fifth Amended Complaint [“5AC”] ¶¶ 20, 26.)  A subsequent MRI revealed that Plaintiff suffered a stroke, causing central visual impairment, dysphagia, and cognitive and behavioral issues.  (5AC ¶ 32.)  Plaintiff brought suit against the surgeon, Defendant Dale Prokupek, M.D. and Defendant Dale Prokupek, M.D., Inc. (“Prokupek”); Dr. Prokupek’s company, Defendant Millennium Medical Associates, Inc. (“Millennium”); Dr. Prokupek’s employee Defendant Andrew Gelis (“Gelis”); anesthesiologist Defendant Michelle Dinh, M.D. (“Dinh”), Defendant Soma Surgery Center, Inc. (“Soma”), where the endoscopy was performed; Defendant Sean Ravaei, owner and operator of Soma (“Ravaei”); nurse practitioner Defendant Jeanne Hershey-Weber (“Hershey-Weber”); and nurse Defendant Melanie Kerr (“Kerr”); alleging three causes of action: (1) professional negligence – medical malpractice; (2) breach of fiduciary duty; and (3) intentional misrepresentation.

 

On November 2, 2023, the Court sustained Defendant Gelis’s demurrer as to the first and second causes of action without leave to amend.  (November 2, 2023 Minute Order.)  Defendant Gelis now moves for summary judgment as to the third cause of action.  Plaintiff opposes the motion and Gelis replies.

 

EVIDENTIARY OBJECTIONS

 

            Plaintiff’s Objections to Gelis’s evidence

 

            The Court rules as follows with respect to Plaintiff’s evidentiary objections:

 

1.     Overruled

2.     Overruled

3.     Overruled

4.     Overruled

5.     Overruled

 

            Gelis’s Evidentiary Objections

 

            The Court rules as follows with respect to Gelis’s evidentiary objections:

 

1.     Overruled

2.     Overruled

3.     Overruled

4.     Overruled

5.     Sustained

 

LEGAL STANDARD – MOTION FOR SUMMARY JUDGMENT

 

“[T]he party moving for summary judgment bears the burden of persuasion that there is no triable issue of material fact and that he is entitled to judgment as a matter of law[.] There is a triable issue of material fact if, and only if, the evidence would allow a reasonable trier of fact to find the underlying fact in favor of the party opposing the motion in accordance with the applicable standard of proof.”  (Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 850.)  “[T]he party moving for summary judgment bears an initial burden of production to make a prima facie showing of the nonexistence of any triable issue of material fact; if he carries his burden of production, he causes a shift, and the opposing party is then subjected to a burden of production of his own to make a prima facie showing of the existence of a triable issue of material fact.”  (Ibid.)  

 

“On a summary judgment motion, the court must therefore consider what inferences favoring the opposing party a factfinder could reasonably draw from the evidence. While viewing the evidence in this manner, the court must bear in mind that its primary function is to identify issues rather than to determine issues.  Only when the inferences are indisputable may the court decide the issues as a matter of law. If the evidence is in conflict, the factual issues must be resolved by trial.”  (Binder v. Aetna Life Ins. Co. (1999) 75 Cal.App.4th 832, 839 [cleaned up].)  Further, “the trial court may not weigh the evidence in the manner of a factfinder to determine whose version is more likely true.  Nor may the trial court grant summary judgment based on the court's evaluation of credibility.”  (Id. at p. 840 [cleaned up]; see also Weiss v. People ex rel. Department of Transportation (2020) 9 Cal.5th 840, 864 [“Courts deciding motions for summary judgment or summary adjudication may not weigh the evidence but must instead view it in the light most favorable to the opposing party and draw all reasonable inferences in favor of that party”].) 

 

DISCUSSION

 

1.     INTENTIONAL MISREPRESENTATION

 

“The elements of intentional misrepresentation are (1) a misrepresentation, (2) knowledge of falsity, (3) intent to induce reliance, (4) actual and justifiable reliance, and (5) resulting damage.” (Aton Center, Inc. v. United Healthcare Ins. Co. (2023) 93 Cal.App.5th 1214, 1245.)

 

Plaintiff alleges Gelis altered Plaintiff’s medical records (1) “to cover Hershey-Weber’s improper instructions she gave to Plaintiff regarding stopping his Xarelto Regimen” (5AC ¶ 40); and (2) “to obscure the cause of Plaintiff’s injuries” (5AC ¶¶ 82, 102, 118.) 

 

The medical records in question are (1) the June 22, 2020 progress notes; (2) the October 14, 2020 progress notes; and (3) the November 4, 2020 Operative Report.

 

Gelis argues that Plaintiff cannot prove (1) Gelis’s alterations to the June and October 2020 were misrepresentations made to Plaintiff; (2) Gelis did not intend Plaintiff to rely on any misrepresentations in the medical records; (3) Plaintiff did not rely on Gelis’s misrepresentations to his detriment because he told his medical care providers in the emergency room on November 4, 2020 when he stopped taking his Xarelto; and (4) Gelis did not make any changes to the November 4, 2020 Operative Report.

 

a.     Defendant’s Evidence          

 

Gelis first argues that Gelis’s alterations to Plaintiff’s medical records were not directed at the Plaintiff, nor were they intended for Plaintiff to rely on them.  In support, Gelis provides evidence that the changes were the inadvertent result of a template update, and Gelis did not intentionally enter Plaintiff’s medical record to make any changes. 

 

Specifically, Gelis provides the audit log showing the changes that Gelis made to the record on June 22, 2020 (Exhibit C) and October 14, 2020 (Exhibit E) and demonstrating that the changes made on August 16, 2021 were modified by “template”; expert deposition testimony from Dean F. Sittig, Ph.D. explaining and interpreting the audit logs consistent with Gelis’s narrative; deposition testimony from Dr. Prokupek indicating that after Dr. Prokupek learned he was being sued, he implemented changes to the template for the electronic medical record system (Exhibit G at pp. 68:24-70:22); and deposition testimony from Gelis indicating his understanding was the purpose of the template changes was not to adjust existing records, but to help prevent lawsuits in the future.  (Exhibit H at pp. 89:17-25; 203:3-7.)

 

Gelis’s evidence that he altered Plaintiff’s medical records inadvertently by way of a global template update, as opposed to intentionally accessing Plaintiff’s specific medical record to make changes, goes to the elements of Gelis’s knowledge of falsity and intent to induce Plaintiff’s reliance, not whether Gelis made a misrepresentation to Plaintiff, as Gelis has argued.

 

Gelis next argues that Plaintiff did not rely on Gelis’s alterations to the medical records to his detriment.  In support, Gelis has produced the November 4, 2020 ED Provider Notes from Providence St. Joseph’s Medical Center Emergency Department, where Plaintiff was treated immediately following the procedure at Soma.  The Providence notes indicate “He […] was on Xarelto which was stopped on October 30.”  (Exhibit M.)

 

Thus, because Providence was clearly aware that Plaintiff had been off his Xarelto medication since October 30, Gelis has met his burden of persuasion/production of evidence to show that Plaintiff will be unable to establish that Plaintiff relied on the altered Soma medical records (which obscured his cessation of Xarelto) to his detriment. 

 

As such, Gelis has shifted the burden of production to Plaintiff to raise triable issues of material fact as to the 4th element of the cause of action -- actual and justifiable reliance. 

 

b.     Plaintiff’s Evidence

 

Plaintiff disputes that it was Plaintiff who told the Providence emergency department about the esophagogastroduodenoscopy (EGD) or that he stopped taking his Xarelto medication, arguing that Plaintiff was in no condition to tell the emergency department staff about his condition, as he was unable to even sign his name following the EGD procedure and complications.  (See Plaintiff’s Separate Statement No. 13.)  In support, Plaintiff points to Plaintiff’s medical records from Soma Surgery Center.  (McCoy Decl., Ex. D.) 

 

As a threshold matter, the Court sustains Gelis’ objections to those medical records, as they have not been properly authenticated, and therefore they have no evidentiary value.

 

Nevertheless, there is no indication in the cited Soma Surgery Center medical records that Plaintiff was unable to communicate with the Providence emergency department staff following his EGD procedure at Soma.  To the contrary, the cited medical records indicate, “Immediately after the procedure the patient was awake and alert with a soft non tender abdomen, lack of any type of pain, breathing normally and with stable blood pressure, pulse and temperature.”  The records further indicate that Plaintiff was given oral and written instructions and “Patient verbalizes understanding of these instructions and agrees to comply with them.”  (McCoy Decl., Ex. D.)

 

But even if Plaintiff were unable to personally communicate with the Providence Emergency Department, the fact remains that Plaintiff’s November 4, 2020 Providence medical records state Plaintiff underwent an EGD procedure and had stopped taking his Xarelto medication on October 30.  Thus, regardless of who communicated the information to Providence, Providence was clearly aware during Plaintiff’s November 4 visit that Plaintiff had stopped taking his Xarelto medication as of October 30.

 

Moreover, Plaintiff indicates in Plaintiff’s opposition to Undisputed Material Fact No. 4, “Defendants further failed to provide records to the emergency department at Providence Hospital.”  Therefore, Providence knew Plaintiff had stopped his Xarelto and did not have Plaintiff’s health care records suggesting otherwise.  This further underscores that the altered Soma medical records were not relied upon and did not play a part in affecting Plaintiff’s subsequent care at Providence.

 

Plaintiff has also not provided any evidence indicating that the altered Soma medical records impacted any of Plaintiff’s care after November 4, 2020.

 

Plaintiff also cites to the deposition transcripts of Dr. Prokupek and of Defendant Gelis in opposition to Undisputed Material Fact No. 15.  However, Gelis’s cited testimony that he did not know where Millennium was located and Dr. Prokupek’s cited testimony that he is 100% owner of the company do not demonstrate that Plaintiff relied on the altered medical records to his detriment.

 

As such, Plaintiff has not met his burden of production to create a triable issue of material fact that Plaintiff relied upon the altered health care records to his detriment.[1]

 

CONCLUSION AND ORDER

 

Therefore, Gelis’s Motion for Summary Judgment is granted.  Gelis has demonstrated that Plaintiff will be unable to prevail on intentional misrepresentation cause of action against Gelis and Plaintiff’s proffered evidence is insufficient to meet Plaintiff’s burden of production to make a prima facie showing of the existence of triable issues of material fact.  

 

Further, the Court will enter the proposed Judgment in favor of Gelis. 

 

Gelis shall provide notice of the Court’s ruling and file a proof of service regarding the same. 

 

 

DATED:  April 18, 2024                                                        ___________________________

                                                                                          Michael E. Whitaker

                                                                                          Judge of the Superior Court



[1] Because the Court finds the issue of actual and justifiable reliance dispositive, it does not analyze whether Gelis altered the November 4, 2020 Operative Report or whether Gelis’s alterations to the June and October progress notes were the result of an inadvertent template update or intentional changes.

TENTATIVE RULING - NO. 2

 

DEPARTMENT

207

HEARING DATE

April 18, 2024

CASE NUMBER

21STCV37567

MOTION

Motion for Summary Adjudication

MOVING PARTY

Defendant Dale Prokupek, M.D.

OPPOSING PARTY

Plaintiff Pericles Chamis

 

MOVING PAPERS:

 

  1. Notice of Motion and Motion for Summary Adjudication; Memorandum of Points and Authorities
  2. Separate Statement of Undisputed Material Facts
  3. Notice of Lodging Separate Volume of Documentary Evidence
  4. Compendium of Evidence
  5. Declaration of Kathleen A. Stosuy

 

OPPOSITION PAPERS:

 

  1. Memorandum of Points and Authorities in Opposition to Motion for Summary Adjudication
  2. Separate Statement of Disputed Material Facts
  3. Declaration of Waukeen McCoy
  4. Declaration of Vinay Ginjupalli
  5. Declaration of Philip Bickler, M.D.
  6. Declaration of Daniel Brelian M.D.
  7. Declaration of Elena Rubin, M.D.
  8. Declaration of Andrew Pham, M.D.

 

REPLY PAPERS:

 

  1. Reply to Plaintiff’s Opposition to Motion for Summary Judgment
  2. Objections to Evidence

 

BACKGROUND

 

On or about November 4, 2020, Plaintiff Pericles Chamis (“Plaintiff”) underwent an upper endoscopy procedure, during which “Plaintiff began vomiting and convulsing on the operating table.”  (Fifth Amended Complaint [“5AC”] ¶¶ 26, 72.)  A subsequent MRI revealed that Plaintiff suffered a stroke, causing central visual impairment, dysphagia, and cognitive and behavioral issues.  (5AC ¶ 32.)  Plaintiff brought suit against the surgeon, Defendant Dale Prokupek, M.D. (“Prokupek” or “Defendant”) and Defendant Dale Prokupek, M.D., Inc. (“Prokupek Inc.”); Dr. Prokupek’s company, Defendant Millennium Medical Associates, Inc. (“Millennium”); Dr. Prokupek’s employee, Defendant Andrew Gelis (“Gelis”); anesthesiologist Defendant Michelle Dinh, M.D. (“Dinh”), Defendant Soma Surgery Center, Inc. (“Soma”), where the endoscopy was performed; Defendant Sean Ravaei, owner and operator of Soma (“Ravaei”); nurse practitioner Defendant Jeanne Hershey-Weber (“Hershey-Weber”); and nurse Defendant Melanie Kerr (“Kerr”); alleging three causes of action: (1) professional negligence – medical malpractice; (2) breach of fiduciary duty; and (3) intentional misrepresentation.

 

Defendant Prokupek now moves for summary adjudication, on the following issues:

 

(1)   Plaintiff cannot maintain all required elements of the second cause of action for Breach of Fiduciary Duty – Lack of Informed Consent against Defendant Prokupek

(2)   Plaintiff cannot maintain all required elements of the third cause of action for Intentional Misrepresentation on the issue of informed consent against Defendant Prokupek

 

(3)   Plaintiff cannot maintain all required elements of the third cause of action for Intentional Misrepresentation on the issue of changes to medical records against Defendant Prokupek.

 

Plaintiff opposes the motion and Prokupek replies.

 

EVIDENTIARY OBJECTIONS

 

            The Court rules as follows with respect to Prokupek’s evidentiary objections:

 

1.     Overruled

2.     Overruled

3.     Overruled

4.     Overruled

5.     Overruled

6.     Overruled

7.     Overruled

8.     Sustained

9.     Sustained

10.  Sustained

 

LEGAL STANDARDS – SUMMARY ADJUDICATION

 

A party may move for summary adjudication as to one or more causes of action, affirmative defenses, claims for damages, or issues of duty if that party contends that there is no merit to the cause of action, defense, or claim for damages, or if the party contends that there is no duty owed.  (See Code Civ. Proc., § 437c, subd. (f)(1).)  “A motion for summary adjudication shall be granted only if it completely disposes of a cause of action, an affirmative defense, a claim for damages, or an issue of duty.”  (Ibid., emphasis added)  A cause of action has no merit if: (1) one or more elements of the cause of action cannot be separately established, even if that element is separately pleaded, or (2) a defendant establishes an affirmative defense to that cause of action.  (See Code Civ. Proc., § 437c, subd. (n); Union Bank v. Superior Court (1995) 31 Cal.App.4th 573, 583.)  Once the defendant has shown that a cause of action has no merit, the burden shifts to the plaintiff to show that a triable issue of material fact exists as to that cause of action.  (See Code Civ. Proc., § 437c, subd. (o)(2); Union Bank v. Superior Court, supra, 31 Cal.App.4th at p. 583.) 

 

“[T]he party moving for summary judgment bears the burden of persuasion that there is no triable issue of material fact and that he is entitled to judgment as a matter of law[.] There is a triable issue of material fact if, and only if, the evidence would allow a reasonable trier of fact to find the underlying fact in favor of the party opposing the motion in accordance with the applicable standard of proof.” ¿(Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 850 (hereafter Aguilar).) ¿“[T]he party moving for summary judgment bears an initial burden of production to make a prima facie showing of the nonexistence of any triable issue of material fact; if he carries his burden of production, he causes a shift, and the opposing party is then subjected to a burden of production of his own to make a prima facie showing of the existence of a triable issue of material fact.” ¿(Ibid.; Smith v. Wells Fargo Bank, N.A. (2005) 135 Cal.App.4th 1463, 1474 [summary judgment standards held by Aguilar apply to summary adjudication motions].)  Further, in line with Aguilar, “[o]n a motion for summary adjudication, the trial court has no discretion to exercise.  If a triable issue of material fact exists as to the challenged causes of action, the motion must be denied. If there is no triable issue of fact, the motion must be granted.”  (Fisherman's Wharf Bay Cruise Corp. v. Superior Court (2003) 114 Cal.App.4th 309, 320.) 

 

Further, “the trial court may not weigh the evidence in the manner of a factfinder to determine whose version is more likely true.  Nor may the trial court grant summary judgment based on the court's evaluation of credibility.”  (Aguilar, supra, 25 Cal.4th. at p. 840 [cleaned up]; see also Weiss v. People ex rel. Department of Transportation (2020) 9 Cal.5th 840, 864 [“Courts deciding motions for summary judgment or summary adjudication may not weigh the evidence but must instead view it in the light most favorable to the opposing party and draw all reasonable inferences in favor of that party”].) 

 

EXCESS PAGES OPPOSITION

 

            In Reply, Prokupek objects that the Opposition brief contains 22 pages, in contravention of California Rules of Court, rule 3.1113(d), limiting opposition briefs to 20 pages, absent leave of court.   Therefore, the Court disregards the excess pages 21 and 22 of the Opposition brief.

 

DISCUSSION

 

  1. BURDEN SHIFTING – ISSUES NO. 1 AND 2

 

“A defendant or cross-defendant 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, even if not separately pleaded, cannot be established, or that there is a complete defense to the cause of action. Once the defendant or cross-defendant has met that burden, the burden shifts to the plaintiff or cross-complainant to show that a triable issue of one or more material facts exists as to the cause of action or a defense thereto.”  (Code Civ. Proc., § 437c, subd. (p)(2); accord Doe v. Good Samaritan Hosp. (2018) 23 Cal.App.5th 653, 661 [“It is not until the defendant meets this burden that the burden of production shifts to the plaintiff to show that a triable issue of one or more material facts exists as to the defense”].) 

 

Furthermore, “[t]he requirement of a separate statement from the moving party and a responding statement from the party opposing summary judgment serves two functions: to give the parties notice of the material facts at issue in the motion and to permit the trial court to focus on whether those facts are truly undisputed.”  (Parkview Villas Assn., Inc. v. State Farm Fire & Casualty Co. (2005) 133 Cal.App.4th 1197, 1210.)   Stated in a different way, “[t]he purpose of a summary judgment proceeding is to permit a party to show that material factual claims arising from the pleadings need not be tried because they are not in dispute. The purpose is carried out in section 437c, subdivision (b)(1) by requiring the moving party to include in the moving papers a separate statement setting forth plainly and concisely all material facts which the moving party contends are undisputed together with a reference to the supporting evidence.  The complaint measures the materiality of the facts tendered in a defendant's challenge to the plaintiff's cause of action, hence the moving party's separate statement must address the material facts set forth in the complaint.”  (Teselle v. McLoughlin (2009) 173 Cal.App.4th 156, 168 [cleaned up].)  And “[w]here the evidence presented by defendant does not support judgment in his favor, the motion must be denied without looking at the opposing evidence, if any, submitted by plaintiff.”  (Hawkins v. Wilton (2006) 144 Cal.App.4th 936, 940.) 

 

            Prokupek contends that there are 5 Undisputed Material Facts which support his arguments that Plaintiff cannot prevail on either the second or third causes of action vis-à-vis Issues Nos. 1 and 2.  To support his arguments, Prokupek advances in pertinent part the Deposition Transcript of Plaintiff, 38:6-22, in support of Undisputed Material Fact Nos. 5 and 10 which state:  “Plaintiff knew he was taking Xarelto to thin his blood to protect him from blood clots.” 

 

 

But Undisputed Material Fact Nos. 5 and 10 are not wholly supported by the cited evidence.  In particular, Plaintiff does not testify that he knew that taking Xarelto protected him from blood clots.  (See Defendant’s Notice of Lodging Separate Volume of Documentary Evidence, Exh. 2, 38:6-22.)  As such, Prokupek’s Undisputed Material Fact Nos. 5 and 10 are in part without evidentiary support.  And in the absence of such material facts, Prokupek will not be able to persuade the Court that there are no triable issues of material fact concerning Plaintiff’s Second and Third causes of action vis-à-vis Issues Nos. 1 and 2.   

 

In short, because Prokupek fails to support all of the facts it claims are material and undisputed with sufficient, competent evidence, the Court finds that Prokupek has not met his initial burdens of production and persuasion.  Consequently, the Court determines that the burden of production does not shift to Plaintiff to produce evidence that raises triable issues of material fact vis-à-vis Issues Nos. 1 and 2. 

 

  1.  BREACH OF FIDUCIARY DUTY

 

Notwithstanding the procedural defect addressed above in Section 1, the Court alternatively addresses Prokupek’s motion regarding Issue No. 1. 

 

To prevail on a claim of breach of fiduciary duty, Plaintiff must prove (1) the existence of a fiduciary duty; (2) breach of the fiduciary duty; and (3) damage proximately caused by the breach. (Jameson v. Desta (2013) 215 Cal.App.4th 1144, 1164.) “A physician has a fiduciary duty to disclose all information material to the patient’s decision when soliciting a patient’s consent to a medical procedure. (Ibid.)

 

Plaintiff alleges Prokupek breached his fiduciary duty to obtain Plaintiff’s informed consent by failing to inform Plaintiff of the “inherently dangerous” risks of ceasing his Xarelto medication when instructing Plaintiff to cease taking that medication 5-7 days prior to undergoing the upper endoscopy procedure.  (5AC ¶¶ 89-90.)

 

Defendant provides excerpts of the deposition of Nurse Hershey-Weber, indicating that Nurse Weber was the one who, on both June 22, 2020 and October 14, 2020, instructed Plaintiff to stop taking his Xarelto medication five days prior to the upper endoscopy procedure.  (Ex. B at pp. 79:20-81:12; Ex. C at pp 92:16-93:10.)  Defendant further provides excerpts of Plaintiff’s deposition, indicating that Plaintiff knew he was taking Xarelto to thin his blood. (Ex. D at p. 38:6-22.)

 

Regarding Prokupek’s first argument that it was Nurse Hershey-Weber, not Prokupek, who gave Plaintiff the instruction to stop taking his Xarelto medication five days prior to the procedure, the Court previously noted, in connection with Nurse Hershey-Weber’s motion for summary judgment:

 

In California, Nurse Practitioners are not authorized to treat patients without a supervising physician. (See Plaintiff’s Opposition to Separate Statement of Disputed Material Facts, fn. 1.) Therefore, to the extent there was a fiduciary duty to disclose the risks of going off his Xarelto medication and undergoing the endoscopy procedure, that duty attached to Dr. Prokupek, not Hershey-Weber. (See Moore v. Regents of University of California (1990) 51 Cal.3d 120, 133.)

 

Therefore, the fact that it was Nurse Hershey-Weber who gave the instruction to Plaintiff, and not Prokupek, is not persuasive, because the ultimate fiduciary duty to disclose belongs to Prokupek, as Nurse Hershey-Weber’s supervising physician, who signed off on the medical record and progress notes.  (See Ex. B at p. 80:9-10.)

 

Further, with respect to Defendant’s argument that Plaintiff was already aware of the inherent dangers of going off the medication he was taking to thin his blood and prevent blood clots, the Court disagrees.  Plaintiff may not have been aware that going off the medication for five days would increase his risk of blood clots and stroke as much as it did.

 

Therefore, the Court finds that Prokupek has not met his initial burdens of production and persuasion to establish that Plaintiff will be unable to establish that Prokupek breached his fiduciary duty to obtain informed consent when his nursing staff instructed Plaintiff to stop taking his Xarelto. 

 

  1. INTENTIONAL MISREPRESENTATION

 

“Fraud is an intentional tort; it is the element of fraudulent intent, or intent to deceive, that distinguishes it from actionable negligent misrepresentation and from nonactionable innocent misrepresentation. It is the element of intent which makes fraud actionable, irrespective of any contractual or fiduciary duty one party might owe to the other.” (City of Atascadero v. Merrill Lynch, Pierce, Fenner & Smith, Inc. (1998) 68 Cal.App.4th 445, 482.)  And “The well-established common law elements of fraud which give rise to the tort action for deceit[1] are: (1) misrepresentation of a material fact (consisting of false representation, concealment or nondisclosure); (2) knowledge of falsity (scienter); (3) intent to deceive and induce reliance; (4) justifiable reliance on the misrepresentation; and (5) resulting damage.” (Id. at p. 481.)[2]

 

Plaintiff alleges Prokupek (1) “falsely advised Plaintiff that it was safe for him to stop taking Xarelto for one week prior to his procedure” (5AC ¶ 108); and (2) altered Plaintiff’s medical records to remove indications that Plaintiff was advised to stop taking Xarelto to obscure the cause of Plaintiff’s stroke (5AC ¶ 112.)

 

a.     INFORMED CONSENT

 

Again, notwithstanding the procedural defect addressed above in Section 1, the Court alternatively addresses Prokupek’s motion regarding Issue No. 2. 

 

In support of Issue 2, Prokupek provides the same evidence that it was Nurse Hershey-Weber, not Prokupek, who gave Plaintiff the instruction to stop taking his Xarelto, and that Plaintiff was aware of the inherent risks in going off the medication he took to thin his blood to prevent blood clots.

 

As discussed above, the fact that it was Nurse Hershey-Weber, as opposed to Prokupek, who instructed Plaintiff to stop taking his Xarelto, does not change the fact that Prokupek was ultimately the supervising physician, who signed off on the medical notes for Plaintiff’s visits with Nurse Hershey-Weber.  It also does not change the fact that Prokupek knew of the risks, yet failed to disclose them, either directly or through his staff.  And the fact that Plaintiff knew generally that he took Xarelto to thin his blood does not mean Plaintiff was aware of the degree of risk of stopping the medication for five days.

 

Therefore, Prokupek has not met his burdens of production or persuasion to establish that Plaintiff will be unable to prevail on his third cause of action for intentional misrepresentation under a theory that Dr. Prokupek failed to disclose the risks of going off his Xarelto medication.

 

b.     ALTERATIONS TO PLAINTIFF’S MEDICAL RECORDS

 

For the same reasons the Court articulated in the concurrent tentative ruling on Defendant Gelis’s motion for summary judgment, Plaintiff’s theory of liability based upon the alleged alterations to his medical records fails, because Plaintiff has not demonstrated any actual and justifiable reliance on the altered records.  However, “[a] motion for summary adjudication shall be granted only if it completely disposes of a cause of action, an affirmative defense, a claim for damages, or an issue of duty.”  (Code Civ. Proc., § 437c, subd. (f)(1).) 

 

Because the Court finds Prokupek has not met his burdens of production and persuasion with respect to Issue 2, Issue 3 would not completely dispose of the intentional misrepresentation cause of action.  Therefore, the Court cannot grant summary adjudication as to Issue 3, notwithstanding Plaintiff’s failure to demonstrate actual and justifiable reliance.

 

CONCLUSION AND ORDER

 

Therefore, Prokupek’s Motion for Summary Adjudication is denied.  Prokupek has not met his burdens of production and persuasion to show that Plaintiff will be unable to prevail on the Second or Third causes of action. 

 

The Clerk of the Court shall provide notice of the Court’s ruling. 

 

 

 

DATED:  April 18, 2024                                                        ___________________________

                                                                                          Michael E. Whitaker

                                                                                          Judge of the Superior Court



[1] “A deceit, within the meaning of the last section, is either:

1. The suggestion, as a fact, of that which is not true, by one who does not believe it to be true;

2. The assertion, as a fact, of that which is not true, by one who has no reasonable ground for believing it to be true;

3. The suppression of a fact, by one who is bound to disclose it, or who gives information of other facts which are likely to mislead for want of communication of that fact; or,

4. A promise, made without any intention of performing it.” (Civ. Code, § 1710.)

 

[2] “[Name of plaintiff] claims that [name of defendant] made a false representation that harmed [him/her/nonbinary pronoun/it]. To establish this claim, [name of plaintiff] must prove all of the following:

1. That [name of defendant] represented to [name of plaintiff] that a fact was true;

2. That [name of defendant]'s representation was false;

3. That [name of defendant] knew that the representation was false when [he/she/nonbinary pronoun] made it, or that [he/she/nonbinary pronoun] made the representation recklessly and without regard for its truth;

4. That [name of defendant] intended that [name of plaintiff] rely on the representation;

5. That [name of plaintiff] reasonably relied on [name of defendant]'s representation;

6. That [name of plaintiff] was harmed; and

7. That [name of plaintiff]'s reliance on [name of defendant]'s representation was a substantial factor in causing [his/her/nonbinary pronoun/its] harm.” (CACI 1900 (2022 ed.).)