Judge: Ronald F. Frank, Case: 22TRCV00427, Date: 2022-12-06 Tentative Ruling

Case Number: 22TRCV00427    Hearing Date: December 6, 2022    Dept: 8

Tentative Ruling¿ 

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HEARING DATE:                 December 6, 2022¿¿ 

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CASE NUMBER:                  22TRCV00427

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CASE NAME:                        Christina Marie New v. Providence Health Systems – Southern California, et al

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MOVING PARTY:                Defendant, Providence Health System – Southern California dba Providence Little Company of Mary Medical Center, Torrance 

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RESPONDING PARTY:       Plaintiff, Christina Marie New,

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TRIAL DATE:                        None set¿ 

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MOTION:¿                              (1) Demurrer¿ 

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Tentative Rulings:                  (1) Defendant Demurrer is DENIED¿ 

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I. BACKGROUND¿¿ 

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A. Factual¿¿ 

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On May 26, 2022, Plaintiff, Christina Marie New (“Plaintiff”) filed this action against Defendants, Providence Health System – Southern California dba Providence Little Company of Mary Medical Center, Torrance, Mia Je Naee Sanders, and Does 1 through 100. Plaintiff alleged the following causes of action: (1) Medical Battery; (2) Intentional Infliction of Emotional Distress; and (3) Medical Malpractice.  The Complaint alleges that following the delivery of Plaintiff’s baby, Dr. Sanders-Madati did not perform a tubal ligation as per the written informed consent, but rather the doctor removed Plaintiff’s fallopian tubes, rendering Plaintiff permanently infertile.  On September 15, 2022 the Court considered and overruled the Demurrer of the alleged treating physician, Dr. Mia J. Sanders-Madatai M.D. (“Dr. Sanders-Madati”) which was brought on different grounds than the hospital’s demurrer to the same Complaint. 

 

B. Procedural¿¿ 

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On October 31, 2022, after the ruling on the treating doctor’s demurrer, Defendant, Providence Health System – Southern California dba Providence Little Company of Mary Medical Center, Torrance (“Providence”) filed this demurrer to the 1st and 2nd causes of action, for battery and intentional infliction of emotional distress (“IIED”).  On November 21, 2022, Plaintiff filed an opposition. On November 28, 2022, Providence filed a reply brief.

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¿II. MOVING PARTY’S GROUNDS FOR THE DEMURRER¿¿ 

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Providence demurs to Plaintiff’s complaint on the grounds that: (1) Plaintiff’s First Cause of Action for Battery is uncertain, as it is ambiguous and unintelligible. (Code of Civil Procedure §430.10(f).) It also fails to state facts sufficient to constitute a cause of action against this demurring defendant. (Code of Civil Procedure §430.10(e).); and (2) Plaintiff's Second Cause of Action for IIED is uncertain, as it is ambiguous and unintelligible. (Code of Civil Procedure §430.10(f).)  The Demurrer asserts that the Complaint also fails to state facts sufficient to constitute an IIED cause of action against this demurring defendant, and fails to sufficiently plead extreme and outrageous or intentional conduct. (C.C.P. § 430.10(e); C.C.P. § 430.10(f); Cochran v. Cochran (1998) 65 Cal.App.4th 488, 494; Plotnik v. Meihaus (2012) 208 Ca1.App.4th 1590, 1609; Larson v. UHS of Rancho Springs, Inc. (2014) 230 Ca1.App.4th 336, 340.)  The gravamen of the hospital’s Demurrer is that while the Complaint may be detailed enough to state causes of action against the obstetrician/gynecologist defendant Dr. Sanders-Madati, it is not sufficiently specific as to what the hospital or any of its unidentified nurses or staff did or failed to do to satisfy the requirements for pleading an intentional tort. 

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¿III. ANALYSIS¿ 

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A. Demurrer¿¿¿ 

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A demurrer can be used only to challenge defects that appear on the face of the pleading under attack or from matters outside the pleading that are judicially noticeable. (Blank v. Kirwan (1985) 39 Cal.3d 311, 318.) “To survive a demurrer, the complaint need only allege facts sufficient to state a cause of action; each evidentiary fact that might eventually form part of the plaintiff’s proof need not be alleged.” (C.A. v. William S. Hart Union High School Dist. (2012) 53 Cal.4th 861, 872.) For the purpose of testing the sufficiency of the cause of action, the demurrer admits the truth of all material facts properly pleaded. (Aubry v. Tri-City Hospital Dist. (1992) 2 Cal.4th 962, 966-967.) A demurrer “does not admit contentions, deductions or conclusions of fact or law.” (Daar v. Yellow Cab Co. (1967) 67 Cal.2d 695, 713.)¿¿¿ 

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A pleading is uncertain if it is ambiguous or unintelligible. (Code Civ. Proc., § 430.10, subd. (f).) A demurrer for uncertainty may lie if the failure to label the parties and claims renders the complaint so confusing defendant cannot tell what he or she is supposed to respond to.¿ (Williams v. Beechnut Nutrition Corp. (1986) 185 Cal.App.3d 135, 139, fn. 2.) However, “[a] demurrer for uncertainty is strictly construed, even where a complaint is in some respects uncertain, because ambiguities can be clarified under modern discovery procedures.” (Khoury v. Maly's of California, Inc. (1993) 14 Cal.App.4th 612, 616.)¿¿ 

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Medical Battery

 

 As alleged, Plaintiff’s Complaint provides that Plaintiff’s consent extended only to the undergoing a bilateral tubal ligation surgery. (Compl., ¶ 4.) Instead, Plaintiff’s Complaint alleges that Dr. Sanders-Madati did not perform a tubal ligation, but instead removed Plaintiff’s fallopian tubes, without justifiable medical cause or Plaintiff’s consent, rendering Plaintiff permanently infertile. (Compl.,  ¶ 5.) Therefore, the Complaint alleges there was no consent received for the surgery performed, giving rise toa  claim for medical battery.

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In Providence’s moving papers it asserts that all of the allegations in Plaintiff’s complaint focus on Dr. Sanders-Madati’s treatment and do not allege that Dr. Sanders-Madati is employed by Providence. Additionally, Providence asserts that the only reference to Providence is that its nurses “aided and abetted” Dr. Sanders-Madati in committing a medical battery.  Plaintiff’s Opposition notes that paragraph 3 of her Complaint states that Dr. Sanders-Madati “is a physician specializing in obstetrics and gynecology who is affiliated with defendant [Providence] as a partner, shareholder, employee, or agent and was plaintiff’s physician.” (Compl., ¶ 3 [emphases added].)   The Complaint also includes some specifics as to the unidentified members of the hospital staff, as follow: “the nurses who assisted defendant Sanders-Madati were agents and/or employees of [Providence] knowingly assisted defendant Sanders-Madati in the removal of plaintiff’s fallopian tubes, despite their knowledge that plaintiff had consented only to a bilateral tubal ligation.” (Compl., ¶ 6 [emphasis added].) Additionally, the Complaint alleges that “[t]he nurses of defendant [Providence] knew that plaintiff had not consented to a bilateral salpingectomy but nevertheless aided and abetted the battery performed by defendant Sanders.” (Compl., ¶ 11 [emphasis added].)

“California case precedent establishes a hospital may be held liable for a doctor's [negligence] when the physician is actually employed by the hospital or is ostensibly the agent of the hospital.” (Elam v. Coll. Park Hosp. (1982) 132 Cal. App. 3d 332, 337); see also id. at 340 (“a hospital has a duty of reasonable care to protect patients from harm”.)  If an employment or agency relationship is sufficient to allege a cause of action against a hospital for a doctor’s tort committed on hospital premises, it logically follows that a Complaint sufficiently alleges a cause of action against a hospital by including agency or employment or aiding and abetting relationships between a doctor and nurses or other staff and the treating physician.  While the Demurrer contends the Complaint fails to allege an employment relationship, Providence is mistaken per Paragraphs 2, 3, and 6. 

The California Supreme Court has also established that “an employee's willful, malicious and even criminal torts may fall within the scope of his or her employment for purposes of respondeat superior, even though the employer has not authorized the employee to commit crimes or intentional torts.”   (Lisa M. v. Henry Mayo Newhall Memorial Hospital (1995) 12 Cal.4th 291, 296–297.)  Where is the line to be drawn for vicarious liability for intentional torts when an agent or employee or independent contractor is sued along with her principal?   Lisa M discussed circumstances where a principal or employer will not be held liable for an assault or other intentional tort “that did not have a causal nexus to” the employee or agent or contractor’s  work.  (Id. at p. 298.)  What is required for vicarious liability to attach was pleading and proof, in addition to “but for” causation, “that the risk of the tort have been engendered by, ‘typical of or broadly incidental to,’ or, viewed from a somewhat different perspective, ‘a generally foreseeable consequence of,’ [the] Hospital's enterprise.”  (Id. at 301, quoting Hinman v. Westinghouse Elec. Co. (1970) 2 Cal.3d 956, 960.)  In Lisa M, the intentional tort was a sexual battery of a 19-year-old pregnant patient in a hospital by an ultrasound technician who was ultimately criminally prosecuted and pleaded no contest to a felony charge arising out of his molestation of the plaintiff there.  The agent/employee in Lisa M was shown to have motivating emotions were not causally attributable to his employment but rather was an ultrasound technician who simply took advantage of solitude, access and superior knowledge to commit a sexual assault.  Summary judgment in the hospital’s favor was affirmed. 

Here, there are no allegations of “emotional involvement” or an “aberrant decision to engage in conduct unrelated to” the alleged agent or employee’s job duties at a hospital, which was not foreseeable in the context of the claimed principal’s particular enterprise as in Lisa M.   Reviewing the pleadings here, the Court cannot say as a matter of law that it is not foreseeable that an OB/GYN specialist’s (or her attending staff or nurses’) alleged intentional act of completely removing rather than merely cutting and tying off plaintiff’s fallopian tubes was not “broadly incidental to” or a “generally foreseeable consequence” of Providence’s enterprise.  Thus, at the pleading stage, the Court finds plaintiff has sufficiently alleged a potential vicarious liability relationship between Dr Sanders-Madati and the hospital, and between the unidentified nurses and the hospital, to pass muster under California’s liberal pleading rules.  Whether the salpingectomy rather than tubal ligation is a medical battery “is a factual question for a finder of fact to decide and, at least in this instance, not one capable of being decided on demurrer.”  (Kaplan v. Mamelak (2008) 162 Cal.App.4th 637, 647) (error to sustain demurrer on medical battery cause of action where orthopedic surgeon mistakenly operated on wrong thoracic discs.)

The Court expressly makes no determination or finding based on a review of evidence, as the Lisa M Court did on motion for summary judgment, as to whether the facts of this case will or will not be sufficient to warrant a trial against Providence.  But the allegations are sufficient at the pleading stage. 

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Intentional Infliction of Emotional Distress

“The elements of a prima facie case for the tort of intentional infliction of emotional distress are: (1) extreme and outrageous conduct by the defendant with the intention of causing, or reckless disregard of the probability of causing, emotional distress; (2) the plaintiff’s suffering severe or extreme emotional distress; and (3) actual and proximate causation of the emotional distress by the defendant’s outrageous conduct. Conduct to be outrageous must be so extreme as to exceed all bounds of that usually tolerated in a civilized community.” (Wilson v. Hynek (2012) 207 Cal.App.4th 999, 1009, citation and ellipses omitted.)

Plaintiff’s Complaint alleges that “[t]he actions of defendant sanders and the nurses of defendant LCOM were outrageous and with reckless disregard of the probability that plaintiff would suffer emotional distress upon learning that her fallopian tubes had been removed without her consent.” (Compl., ¶ 13.)

Providence asserts that Plaintiff has not alleged sufficient facts to support a claim for intentional infliction of emotional distress because there is no reference or citation to specific facts of “extreme and outrageous” conduct on the part of Providence, or a specific employee. Providence asserts that alleging that unidentified nurses somehow aided and abetted Dr. Sanders-Madati in battery is insufficient.   Providence is partially correct, in that there is no specific allegation as to what Providence itself did or what any specifically identified employee of the hospital did that was extreme or outrageous.  But Providence urges a standard for more specific pleading than what the law requires. 

In opposition, Plaintiff cited to a Second District case where plaintiff awoke from a dilation and curettage procedure following a miscarriage, and was visually confronted with a container filled with plaintiff's blood and tissue that may have been remnants of her unfortunate pregnancy outcome. (So v. Shin (2013) 212 Cal.App.4th 652.)  The So v. Shin Court reversed a trial court’s sustaining of a demurrer, holding: “There is no bright line standard for judging outrageous conduct and . . . its generality hazards a case-by-case appraisal of conduct filtered through the prism of the appraiser’s values, sensitivity threshold, and standards of civility.  . . . .) Thus, whether conduct is ‘outrageous’ is usually a question of fact.” (So v. Shin (2013) 212 Cal.App.4th 652, 671–672.) Here, Plaintiff’s Complaint alleged that while in the operating room, “she learned that her fallopian tubes had been removed and then saw [them] in a clear plastic container.” (Compl.,  ¶¶ 7.)  Paragraph 7 thus alleges very similar facts to those the Second District found sufficient to state a cause of action for IIED in the medical setting.

 The vicarious liability allegations discussed above apply with equal force and effect as to the battery causes of action as they do the IIED cause of action.  Discovery will inform the parties as to precisely what the factual context was, what persons or person placed or left the clear plastic container in the plain view of the patient, whether the informed consent discussed other topics or granted more patient approvals than those alleged in the Complaint, and other facts pertinent to the IIED cause of action. 

 

IV. CONCLUSION¿¿ 

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For the foregoing reasons, Defendant’s Demurrer is OVERRULED.¿¿ Unless notice is waived, plaintiff shall give notice of the Court’s ruling.  ¿¿¿¿ 

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