Judge: Virginia Keeny, Case: 21STCV46931, Date: 2025-01-16 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: 21STCV46931 Hearing Date: January 16, 2025 Dept: 45
ARCHINIEGA V. LOS ANGELES COUNTY,
ET AL.
DEMURRER WITH MOTION TO STRIKE FAC
Date of Hearing: January 16, 2025 Trial Date: February
2, 2026
Department: 45 Case
No.: 21STCV46931
Moving
Party: Defendants County of
Los Angeles, LAC + USC Medical Center, and
of Southern California, Keck School of Medicine
Responding
Party: Plaintiff
Eliana Arciniega, a minor individual by and through her Guardian Ad Litem, Joel
Arciniega
BACKGROUND
On
December 23, 2021, Plaintiff Eliana Arciniega, a minor individual by and
through her Guardian Ad Litem, Joel Arciniega (“Plaintiff”), filed the original
complaint alleging medical malpractice against Defendants Los Angeles County, a
municipal governmental entity; LAC + USC Medical Center, a public entity,
business form unknown; University of Southern California, Keck School of
Medicine, a non-profit corporation; Emily Johnson, M.D., an individual; Dana Rodney
Sajed, M.D., an individual; Kayla S. Jagoda, M.D., an individual; Taylor W.
Burkholder, M.D., an individual; Sylvia Hsin-Hue Yeh, M.D., an individual;
Michael Leeson, M.D., an individual; Annie Le, R.N., an individual; Casey
Rodriguez, R.N., an individual; Tracy Harada, R.N., an individual; Stephanie
Luong, R.N., an individual; and Does 1 to 100.
On
April 15, 2024, the Court granted Plaintiff’s motion for leave to amend
complaint.
On
April 16, 2024, Plaintiff filed the First Amended Complaint (“FAC”) against
Defendants Los Angeles County, a municipal governmental entity; LAC + USC
Medical Center, a public entity, business form unknown; University of Southern
California, Keck School of Medicine; Emily Johnson, M.D.; Dana Rodney Sajed,
M.D.; Kayla S. Jagoda, M.D.; Taylor W. Burkholder, M.D.; Sylvia Hsin-Hue Yeh,
M.D.; Michael Leeson, M.D.; Annie Le, R.N.; Casey Rodriguez, R.N.; Tracy
Harada, R.N.; Stephanie Luong, R.N.; Brenda Carolina Hernandez Mazariego; Jose
E. Esquilinbirriel; and Does 3-100, inclusive, alleging: 1. Negligence 2.
Medical malpractice 3. Failure to provide emergency services and care (Health
and Safety Code §§ 1317, et seq.) 4. Violation of Emergency Medical Treatment
and Active Labor Act (42 U.S.C. § 1395dd).
On
June 20, 2024, Defendants County of Los Angeles, LAC + USC Medical Center, and
University of Southern California, Keck School of Medicine filed the instant
demurrer to the FAC and a motion to strike portions of the FAC.
On
January 3, 2025, Plaintiff filed an opposition to the demurrer.
On
January 9, 2025, Defendants filed a reply and notice of Plaintiff’s non
opposition to motion to strike.
[Tentative] Ruling
Defendants’ Demurrer to the FAC is
SUSTAINED WITH LEAVE TO AMEND as to the third and fourth causes of action.
Defendants’
motion to strike is GRANTED.
LEGAL
STANDARD
When considering demurrers, courts read
the allegations liberally and in context. (Taylor v. City of Los Angeles
Dept. of Water and Power (2006) 144 Cal.App.4th 1216, 1228.) “A demurrer
tests the pleadings alone and not the evidence or other extrinsic matters.
Therefore, it lies only where the defects appear on the face of the pleading or
are judicially noticed.” (SKF Farms v. Superior Court (1984) 153 Cal. App.3d
902, 905.) “The only issue involved in a demurrer hearing is whether the
complaint, as it stands, unconnected with extraneous matters, states a cause of
action.” (Hahn v. Mirda (2007) 147 Cal.App.4th 740, 747.)
ANALYSIS
Meet
and Confer
Prior to filing a demurrer or a motion
to strike, the demurring or moving party is required to meet and confer with
the party who filed the pleading demurred to or the pleading that is subject to
the motion to strike for the purposes of determining whether an agreement can
be reached through a filing of an amended pleading that would resolve the
objections to be raised in the demurrer. (CCP §§ 430.41 and 435.5.)
Defendants’ counsel declares that she
met and conferred with Plaintiff’s counsel via video conference on May 17, 2024
regarding the issues raised in the demurrer but the parties were not able to
informally resolve the disputes. (Cho Decl. ¶ 3.) The Court finds the meet and
confer requirement to be satisfied.
Third
Cause of Action for Failure to Provide Emergency Services and Care (Health and
Safety Code sections 1317, et seq.
Health and Safety Code section 1317
mandates that emergency services and care be provided to anyone who requests
them, or for whom they are requested, for conditions involving danger to life
or serious injury or illness. These services must be delivered without
discrimination based on a person’s characteristics and without questioning
their ability to pay. (Health & Saf. Code, § 1317(a), (b), (d).) Section
1317(b) explicitly prohibits emergency services and care from being influenced
by factors such as a person’s ethnicity, citizenship, age, preexisting medical
condition, insurance status, economic status, or ability to pay. (Health &
Saf. Code, § 1317(b).) Health facilities and their employees are not liable for
refusing emergency services if, using reasonable care, they determine that the
person is not suffering from an emergency medical condition. (Health & Saf.
Code, § 1317(c).)
California Health and Safety Code
section 1317 is considered the state’s equivalent of the federal Emergency
Medical Treatment and Active Labor Act (EMTALA), codified at 42 U.S.C. § 1395dd.
(Booker v. Desert Hospital Corp. (9th Cir. 1991) 947 F.2d 412, 415.)
Hospitals licensed under this chapter with emergency departments must provide
care to any person in need when they have the appropriate facilities and
qualified personnel to treat the emergency condition or active labor. (Health
& Saf. Code, § 1317(a).) Emergency services are defined as medical
screenings, examinations, and evaluations by a physician to determine the
existence of an emergency medical condition or active labor, and if confirmed,
the care, treatment, or surgery necessary to resolve the condition within the
facility’s capabilities. (Health & Saf. Code, § 1317.1(a)(1).)
Furthermore, emergency care provision
must comply with Civil Code section 51, which ensures equal rights for all
persons in California regardless of sex, race, color, religion, ancestry,
national origin, disability, mental condition, marital status, or sexual
orientation. (Health & Saf. Code, § 1317(b); Civ. Code, § 51(b).)
Disabilities under this rule are defined as physical or mental conditions that
limit major life activities, including physical, mental, and social activities,
as well as working. (Civ. Code, § 51(e)(1); Gov. Code, § 12926(j)(1)(B), (C).)
These provisions collectively reinforce the obligation of California health
facilities to provide non-discriminatory and comprehensive emergency care to
all individuals, ensuring alignment with both state and federal standards.
The Court finds that Plaintiff fails to
provide sufficient facts to support her claims of emergency services
discrimination as they lack specific factual allegations of discriminatory acts
by defendants based on her personal characteristics, as required by Brousseau
v. Jarrett (1977) 73 Cal.App.3d 864, 872. Plaintiff argues that the “infantile
inability to speak” constitutes a disability under Health and Safety Code
section 1317 but fails to support this with any legal authority or factual
basis. The Court finds that an infants’ inability to speak does not qualify as
a “mental condition” under Government Code section 12926(j)(1).
Additionally, Plaintiff fails to
establish that Defendants knowingly or intentionally discriminated against her
based on age or other personal characteristics. Plaintiff admits in the FAC
that she received emergency services, and her allegations of inadequate care
sound in medical negligence, not discrimination. (See FAC ¶¶ 90, 93.)
Finally, the FAC and Opposition fail to
demonstrate that Defendants breached their obligations under section 1317(a) to
detect or treat an emergency condition, as clarified in Jackson v. East Bay
Hosp. (9th Cir. 2001) 246 F.3d 1248, 1260 (“If a hospital does not diagnose
an emergency condition, it cannot ‘refus[e] to render emergency care,’ because
one cannot ‘refuse’ to treat a condition one does not detect.”) Defendants
provided an initial medical screening and care as required by law, and there
are no facts to support Plaintiff’s claim of emergency services discrimination.
Accordingly, the third cause of action
is SUSTAINED WITH LEAVE TO AMEND.
Fourth
Cause of Action for Violation of Emergency Medical Treatment and Active Labor
Act (42 U.S.C. § 1395dd)
Defendants
argue that Plaintiff’s EMTALA claim is barred by the statute’s explicit
two-year limitations period under 42 U.S.C. § 1395dd(d)(2)(C) and that state
tolling provisions for minors do not apply to EMTALA claims, citing Bunnell v. Department of Corrections (1998) 64 Cal.App.4th 1360. However, Plaintiff
relies on Johns v. County of
San Diego (9th Cir. 1997) 114 F.3d 874,
where the Ninth Circuit Court allowed the tolling of federal claims under
California’s tolling statutes for minors, emphasizing the court’s
responsibility to exercise “jealous care” when a minor’s rights are at stake.
Similarly, in Pauly
v. Stanford Health Care (N.D. Cal.
2019) 2019 WL 1756540, the court declined to dismiss a minor’s EMTALA claim,
recognizing no binding authority requiring the rejection of state tolling
provisions. While Defendants rely on Fourth Circuit cases such as Vogel v. Linde (4th Cir. 1994) 23 F.3d 78 to argue that EMTALA’s
limitations period cannot be tolled, the Court notes these cases are not
binding in California or the Ninth Circuit. Moreover, Defendants distinguish Johns and Pauly by asserting that those cases involved minors
without proper representation, while Plaintiff here has a guardian ad litem and
legal counsel. However, this distinction does not negate the fundamental
principle that California tolling provisions for minors should apply unless
explicitly precluded by federal law. California Code of Civil Procedure section
352 provides for tolling until a minor reaches the age of majority, and there is
no evidence that Congress intended to override such protections in EMTALA.
Therefore, the Court finds that Plaintiff’s EMTALA claim is timely.
Defendants also
contend that the relation back doctrine does not apply because the original
complaint alleged “inadequacy of care” rather than “withholding of care,” and
that these claims are distinct. However, California law focuses on whether the
original complaint provided sufficient notice of the claim’s nature and scope.
In Pointe San Diego Residential Cmty.,
L.P. v. Procopio, Cory, Hargreaves & Savitch, LLP (2011) 195 Cal.App.4th 265, 279, the court held
that the relation back doctrine applies if the defendant could reasonably
foresee the later allegations based on the original complaint. Here,
Plaintiff’s original complaint explicitly alleged a “failure to provide
adequate emergency medical care.” (Compl. ¶ 21.) Specific allegations included
Defendants’ failure to order laboratory and radiology tests, failure to treat
the conditions Plaintiff presented with, and failure to provide discharge
procedures. (Compl. ¶¶ 42-46, 54.) The Court finds that these allegations,
contrary to Defendants’ argument, may cover the scope of acts of withholding
care. The FAC strengthens these allegations by providing additional detail, but
both the original complaint and the FAC arise from the same transaction:
Plaintiff’s presentation at Defendants’ facility and the failures that occurred
during her treatment and discharge. Thus, Defendants were on notice of the
nature and scope of Plaintiff’s claims such that the relation back doctrine
supports Plaintiff’s claim.
As to the
sufficiency of the EMTALA claim itself, the Court finds that Plaintiff has not
alleged sufficient facts to establish a violation of EMTALA. Plaintiff’s EMTALA
claim is based on the same factual allegations as her third cause of action,
which primarily concerns medical negligence rather than violations of EMTALA.
Plaintiff alleges that Defendants failed to provide an “appropriate medical
screening” and stabilize her condition. However, Plaintiff acknowledges that
Defendants provided an “initial medical screening” and, based on observed
clinical symptoms, determined that her condition was non-urgent. (FAC, ¶¶ 90, 93.)
Plaintiff fails to explain in her opposition how this constitutes an EMTALA
violation as it appears the appropriateness of the screening is rather a matter
of medical negligence.
EMTALA
requires hospitals to provide an appropriate medical screening to determine
whether an emergency medical condition exists and to stabilize such conditions
before discharge or transfer. (42 U.S.C. § 1395dd (a); (c).) Plaintiff fails to
allege specific symptoms or allege facts showing that her condition was
unstable during her stay at LAC+USC Medical Center. Nor does she allege why her
condition necessitated transfer to another facility. Without such facts, her
EMTALA claim lacks the particularity required to overcome a demurrer.
Accordingly, the fourth cause of action
is SUSTAINED WITH LEAVE TO AMEND.
Motion
to Strike
Defendants
request that the Court strike portions of the FAC that seek punitive and
exemplary damages against the medical and hospital Defendants. Specifically,
they move to strike Paragraph 70 of the Second Cause of Action, Paragraph 110
of the Third Cause of Action, Paragraph 129 of the Fourth Cause of Action, and
Paragraph 3 of the Prayer for Relief.
Defendants
argue that The County of Los Angeles and LAC+USC Medical Center, as government
entities, are exempt from claims for punitive damages under the Government
Code. Additionally, Defendants contend that the County of Los Angeles, LAC+USC
Medical Center, and the University of Southern California, Keck School of
Medicine are protected because the Plaintiff failed to comply with the
requirements of Code of Civil Procedure section 425.13, which mandates that a
Plaintiff obtain prior court approval before including a claim for punitive
damages against healthcare providers.
Plaintiff
does not provide any arguments in opposition.
Government
Code section 818 bars claims for punitive damages against public entities,
stating that “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.” Both the County of Los Angeles
and LAC+USC Medical Center qualify as public entities under Government Code
section 811.2. As such, the Court finds that Plaintiff’s prayer for punitive
damages is barred by statute and must be stricken.
Additionally,
the Code of Civil Procedure section 425.13 requires plaintiffs in actions
arising from professional negligence by healthcare providers to obtain a court
order before amending a complaint to include a claim for punitive damages. Here,
Plaintiff’s claims arise directly from the professional services provided by
Defendants, yet Defendants argue that Plaintiff failed to seek or obtain court
permission to include a punitive damages claim. Defendants point out that Plaintiff
acknowledged during a prior hearing—and the Court noted in its April 15, 2024
Minute Order—that punitive damages were being sought only against driver
defendants, not the medical and hospital Defendants. It appears that Plaintiff
has since contradicted that position by continuing to seek punitive damages
against the medical and hospital Defendants in the FAC. The Court finds this to
be improper.
Accordingly,
the Court GRANTS Defendants’ motion to strike.
CONCLUSION
Defendants’
Demurrer to the FAC is SUSTAINED WITH LEAVE TO AMEND.
Defendants’
motion to strike is GRANTED.