Judge Stephen I. Goorvitch, Case Number: 25STCP00714, Date: 2025-05-07 Tentative Ruling

Judge: Stephen I. Goorvitch, Case: 25STCP00714, Date: 2025-05-07 Tentative Ruling

Department: 82 CHA Hollywood Medical Center, L.P. Judge: Stephen I. Goorvitch

Petitioner Medical Staff of Hollywood Presbyterian Medical Center (“Petitioner”) filed this action against CHA Hollywood Medical Center, L.P., doing business as “Hollywood Presbyterian Medical Center” (the “Hospital” or “Respondent”). Petitioner alleges that the Hospital has failed to abide by California and Federal laws and regulations, Medicare Conditions of Participation, and Joint Commission accreditation standards. Petitioner asserts three causes of action. First, Petitioner seeks a writ of mandate to enforce all Medical Staff Bylaws, to allow the medical staff to conduct a new election, and to solicit and obtain review by the Medical Executive Committee before entering into or terminating an exclusive contracts with healthcare providers. Second, Petitioners assert a cause of action for “preliminary and permanent injunction.” Third, Petitioners seek a declaratory declaration on certain issues in dispute. Respondent demurs, arguing: (1) Plaintiff fails to allege sufficient facts to establish that Alexander Marmureanu, M.D. has authority to bring this action; and (2) The complaint is vague, ambiguous, and unintelligible, and fails to comply with statutory requirements.[1]

A demurrer tests the sufficiency of a pleading, and the grounds for a demurrer must appear on the face of the pleading or from judicially noticeable matters. (Code Civil Proc. § 430.30, subd. (a); Blank v. Kirwan (1985) 39 Cal.3d 311, 318.) The court “assumes the truth of all well-pleaded facts, as well as those that are judicially noticeable, but not contentions, deductions or conclusions of fact or law.” (Van de Kamps Coalition v. Board of Trustees of Los Angeles Community College Dist. (2012) 206 Cal. App. 4th 1036, 1045.) The allegations in the petition must be liberally construed in favor of Petitioner on demurrer. (See Mobil Oil Corp. v Exxon Corp. (1986) 177 Cal.App.3d 942, 947.) “A demurrer must dispose of an entire cause of action to be sustained.” (Poizner v. Fremont General Corp. (2007) 148 Cal.App.4th 97, 119.) “A demurrer tests the pleadings alone and not the evidence or other extrinsic matters.” (Hahn v. Mirda (2007) 147 Cal.App.4th 740, 747.)

Respondent requests judicial notice of a motion to intervene filed by six physicians. The request for judicial notice is denied. Respondent improperly relies on this extrinsic evidence to create a factual dispute that cannot be resolved on demurrer.

According to the petition, Respondent “is a general acute care hospital located in Los Angeles, California … [and] owned by an affiliate of CHA Health Systems, a South Korea based enterprise.” (Petition for Writ of Mandate (“Pet.”) ¶ 4.) Petitioner “is a self-governing, unincorporated association . . . comprised of physicians who provide professional services to patients of the Hospital.” (Id. ¶ 3.) In summary, the petition alleges that Respondent “has failed to abide by California and Federal laws and regulations, Medicare Conditions of Participation, and Joint Commission accreditation standards which are specifically designed to allow physicians to make clinical decisions in the best interests of patient safety and quality of care without undue influence from the Hospital.” (Id. ¶ 1.) These allegations are sufficient for pleading purposes.

Respondent argues that the verification—signed by Alexander Marmureanu, M.D. (“Dr. Marmureanu”) is “defective” because Petitioner fails to allege facts “demonstrating Dr. Marmureanu’s authority to bring this action.” (Memorandum of Points & Authorities in Support of Demurrer (“Dem.”) at 8:12-13.) The verification states that Dr. Marmureanu is the President of the Medical Staff of Hollywood Presbyterian Hospital and that he is “authorized to make this verification for and on its behalf.” (Pet. p. 195.) Nothing further is required to plead Dr. Marmureanu’s authority to verify the petition. (See Code Civ. Proc. § 446 [“When a corporation is a party, the verification may be made by any officer thereof.”].) Essentially, Respondent conflates the concept of standing with the authority to act on behalf of the organization. (Dem. 8-9.) Respondent argues that, notwithstanding the verification, Dr. Marmureanu lacks authority under the Medical Staff Bylaws to verify the petition or cause it to be filed. (Dem. 8, fn. 2.) Respondent further argues the point based upon other physicians having filed a motion to intervene to challenge Dr. Marmureanu’s actions. Respondent raises a disputed issue of fact that cannot be resolved on demurrer.

Respondent also contends that the Medical Staff Bylaws require Petitioner to “obtain Active Medical Staff membership approval for donations and/or single item costs of $10,000 or more” and Petitioner “fails to plead facts to show whether all Active Members approved the costs to retain counsel for this suit.” (Dem. 9.) Respondent cites no authority holding that an organization must plead such facts in the petition. At best, Respondent raises a fact question that cannot be determined from the face of the pleading.

Based upon the foregoing, the court overrules the demurrer to the first cause of action. Respondent is free to raise this arguments at trial when the court may consider the evidence and resolve factual disputes.

Respondent contends that injunctive relief is not an independent cause of action and must be dismissed. (Dem. 7-8.) “Injunctive relief is a remedy, not a cause of action. A cause of action must exist before a court may grant a request for injunctive relief.” (Ivanoff v. Bank of America, N.A. (2017) 9 Cal.App.5th 719, 734.) Therefore, the court sustains the demurrer without leave to amend to the second cause of action for injunctive relief. This order shall not preclude Petitioner from seeking an injunction based on the first cause of action for writ of mandate. (See County of DelNorte v. City of Crescent City (1999) 71 Cal.App.4th 965, 973 [injunctive relief “is available in a mandamus proceeding and is appropriate to restrain action which, if carried out, would be unlawful”].) The court shall interpret paragraphs 58-64 of the petition as providing notice in this regard and as part of the prayer.

Respondent contends that “[t]he third cause of action for declaratory relief is predicated on and derivative of the first cause of action, which fails based on the reasons explained in this Demurrer.” (Dem. 9.) Ultimately, Respondent may be correct. However, the court cannot resolve this issue on demurrer. Accordingly, the court overrules the demurrer to the third cause of action. Respondent is free to raise this issue at trial.

2. The court sustains the demurrer to the second cause of action without leave to amend. The court shall interpret the petition for writ of mandate as seeking a permanent injunction as alleged in the complaint.

5. Respondent’s counsel shall provide notice and file proof of service with the court.

[1] In the demurrer, Respondent also argued that Petitioner failed to exhaust administrative remedies. Respondent subsequently filed a notice withdrawing those arguments.