Judge: Wesley L. Hsu, Case: 20STCV33881, Date: 2023-04-24 Tentative Ruling
Case Number: 20STCV33881 Hearing Date: April 24, 2023 Dept: L
BACKGROUND
This matter
arises from the suicide of Yaeli Mozzelle Galdamez aka “Andrew Galdamez/Andrew
Elijah Martinez” (“Decedent”) on September 4, 2019. On September 4, 2020, the
Estate of Yaeli Mozzelle Galdamez (the “Estate”) and Silvia Abigail Martinez
(“Martinez”) (collectively “Plaintiffs”) filed a complaint against several
defendants, including, Pomona Valley Hospital Medical Center (“PVHMC”). On
September 6, 2022, Plaintiffs filed the First Amended Complaint (“FAC”). On
January 13, 2023, the Court sustained in part PVHMC’s demurrer to the FAC, with
20 days leave to amend. On February 2, 2023, Plaintiffs filed the operative
Second Amended Complaint (“SAC”), alleging 1) negligence (wrongful death), 2)
medical malpractice, and 3) negligence. Only the first two causes of action are
alleged against PVHMC. PVHMC filed this demurrer without motion to strike on
February 28, 2023, demurring to the first and second causes of action in the
SAC. Plaintiffs filed an opposition on April 11, 2023. PVHMC filed a reply on
April 17, 2023.
DISCUSSION
Legal
Standard
A demurrer
for sufficiency tests whether the complaint states a cause of action. (Hahn v. Mirda (2007) 147 Cal.App.4th 740,
747.) 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.) In a demurrer proceeding, the defects must be
apparent on the face of the pleading or via proper judicial notice. (Donabedian v. Mercury Ins. Co. (2004) 116 Cal.App.4th 968, 994.) “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, supra, 147 Cal.App.4th at p. 747.)
Meet
and Confer
Before
filing a demurrer or motion to strike, the demurring or moving party shall meet
and confer with the party who has filed the pleading and shall file a
declaration detailing their meet and confer efforts. (Code Civ. Proc., §§ 430.41(a), 435.5(a).)
Here,
Daniel Dik, counsel for PVHMC, emailed and called Plaintiffs’ counsel, Vincent
Davis, on multiple occasions after the filing of the SAC to discuss perceived
deficiencies. (Declaration of Daniel Dik (“Dik Decl.”) ¶ 2.) Dik had difficulty
connecting with Davis, or Joyce Vega. (Id.) As of the filing of this
demurrer, the parties had not come to a resolution. (Id.) Plaintiffs do
not dispute that PVHMC made efforts to meet and confer.
Therefore,
the Court finds that PVHMC has satisfied its statutory requirement to meet and
confer.
Allegations
in SAC
Decedent
became a ward of Los Angeles County Department of Children and Family Services
(“LACDCFS”) in April, 2016. (SAC
¶ 11.) While Decedent was under the care of LACDCFS, Decedent showed a
desire to transition from female to male. (SAC ¶ 13.) While still
remaining under the care of LACDCFS, Decedent was transferred to a facility at
the Junior Blind of America, where Decedent received medications and counseling
designed to aid in Decedent’s transition. (SAC ¶ 15.)
Decedent
attempted suicide on June 7, 2019 by overdosing on Tylenol and Advil. (SAC
¶¶ 17, 20.) That day, Decedent was admitted to PVHMC and held on “Suicide
Watch” under California Welfare & Institutions Code, §5150. (SAC ¶ 20.) Decedent was an adult during the time of the § 5150 hold. (SAC ¶ 11.) Decedent remained hospitalized
at PVHMC for three days and was treated by Dr. Kalpesh Bhavsar and Dr.
Alexander Nguyen. (SAC ¶ 21.) Bhavsar was the mental health staff member at
PVHMC who was responsible for providing Decedent with mental health care,
treatment, and intervention. (SAC ¶ 6.) Nguyen was the general medicine
practitioner at PVHMC responsible for providing Decedent with general health
care and treatment. (SAC ¶ 7.) Nguyen set forth specific discharge
instructions that required additional psychiatric care
and treatment at a “Psychiatric Hospital” as a condition of Decendent’s discharge. (SAC ¶ 21.) Decedent was discharged
on June 10, 2019. (SAC ¶ 21.)
While
Decedent was at PVHMC, Bhavsar did "little or nothing to assist in the
care and treatment of Decedent.” (SAC
¶ 21.) Nguyen’s
“actions and omissions to act fell well below the standard of care when he
officially cleared Decedent for discharge without inquiring of Bhavsar as to
the medical appropriateness of such discharge.” (SAC ¶ 23.) Additionally,
neither Bhavsar, Nguyen, nor any other personnel employed at PVHMC “followed
the necessary standard of care to ensure Decedent was properly discharged with
the appropriate medical safeguards in place to look after a person who was
clearly mentally unstable and suicidal.” (SAC ¶ 22.) Bhavsar wrongfully
stated that Decedent’s “mood has improved with no self-injurious behaviors
noted here on the medical floor,” and “the patient is not in imminent danger to
self or others.” (SAC ¶ 22.)
Three
months after the suicide attempt, on September 4, 2019, Decedent committed suicide by being run over by a train at 2870 Pomona
Boulevard in Pomona, CA. (SAC ¶ 12.)
Analysis
PVHMC (hereinafter “Defendant”) demurs to the first and second causes of action in
the SAC. PVHMC argues that the SAC
does not adequately plead duty, breach, or causation, elements common to
negligence and medical malpractice. It also contends that Plaintiffs’ action is
barred by Decedent’s suicide.
“The elements of a cause of
action for wrongful death are a tort, such as negligence, and resulting death.” (Lopez v. City of Los Angeles (2011) 196 Cal.App.4th 675,
685.) Wrongful Death is a statutory claim sounding in negligence. (Code Civ.
Proc., §§ 377.60– 377.62.) The purpose of
Wrongful Death is “to compensate specified
persons—heirs—for the loss of companionship and for other losses suffered as a
result of a decedent's death.” (Quiroz v. Seventh Ave.
Center (2006)
140 Cal.App.4th 1256, 1263 (Quiroz).) “The elements of the cause of
action for wrongful death are the [tort of Negligence], the resulting death,
and the damages, consisting of the pecuniary loss suffered by the heirs.” (Ibid.) (internal quotations omitted).
A
prima facie case for medical malpractice consists of (1) a duty to conform to the relevant
standard of care; (2) a breach of that duty, i.e., the negligent conduct; (3) a
proximate causal connection between the negligent conduct and the injury; and
(4) resulting damage. (Lattimore v. Dickey (2015) 239 Cal.App.4th 959, 968.) In
particular, a healthcare provider is negligent if he or she fails to use the
level of skill, knowledge, and care in diagnosis and treatment that other
reasonably careful healthcare providers of the same type would use in the same
or similar circumstances. (Landeros v. Flood (1976) 17 Cal.3d 399, 408.)
Duty
The Court
finds that the SAC pleads facts sufficient to show PVHMC owed a duty to Decedent.
Plaintiffs
allege that Defendants, including PVHMC, owed a duty of care to Decedent when
Decedent was admitted to PVHMC for the § 5150 hold in June, 2019—specifically,
the duty to provide adequate professional care, follow safety regulations,
avoid discharging Decedent without a proper follow up plan, and adequately and
appropriately follow up with Decedent after discharge. (SAC ¶¶ 63, 68.)
PVHMC does
not dispute that it owed a duty to Decedent while Decedent was under the
§ 5150 hold. Rather, PVHMC argues that its duty did not extend beyond that
three-day period. It argues that it had no right to force treatment upon
Decedent after the three-day evaluation period ended and that doing so actually
would have constituted a breach of its duty to Decedent.
PVHMC
relies on Thor v. Superior Court for the proposition that Decedent possessed
the ultimate right to refuse life-sustaining treatment. (Thor v. Superior
Court (1993) 5 Cal.4th 725.) However, PVHMC’s attempt to analogize the
circumstances here to those in Thor misses the mark. In Thor, a a
state prisoner was paralyzed in escape attempt. (Id.) The state sought
to keep him alive with force feedings and medical treatment. (Id.) The
prisoner did not want to live paralyzed, and refused, and sought an order of
court that he could refuse further care. (Id.) The Supreme Court held
that as a matter of personal autonomy, the prisoner had the right to refuse
life sustaining treatment. (Id. at 731.) Here, unlike in Thor, at
no point does the SAC allege that Defendants attempted to hold Decedent beyond
the end of the three-day period or that Decedent refused to receive continued
treatment. Instead, the SAC alleges that PVHMC and its employees did not
provide adequate care during the § 5150 hold and failed to properly assess the
threat to Decedent’s life or others’ lives were it to release Decedent. It
alleges that Defendants did not adequately consider Decedent’s recent suicide
attempt and did not follow the correct medical procedures to ensure that
Decedent was "properly discharged with the appropriate medical safeguards
in place to look after a person who was clearly mentally unstable and suicidal.” It further alleges that, as a result of poor
treatment during the hold, Decedent was led to commit suicide. PVHMC’s argument that its duty did not extend
for three months after the hold ended fits more appropriately under the
discussion of causation, below.
PVHMC also
argues that it did not owe a duty to prevent Decedent’s suicide. Under
California law, there is generally no duty to prevent suicide unless there is a
special relationship between the defendant and the decedent that gives rise to
such a duty.¿(Nally v.
Grace Cmty. Church, 47 Cal.
3d 278, 293 (1988).)
Courts have imposed a duty to prevent suicide only where the defendant has
physical custody and substantial control over a person or where the defendant
has special training or expertise in mental illness and has sufficient control
over a person to prevent the suicide.¿(Walsh, 997 F.
Supp. 2d at 1085.) Typically, such
defendants are a prison, jail, or hospital.¿(Id.)¿Under such circumstances, the defendant has a
custodial relationship over others that uniquely place the defendant in a
position to detect and prevent suicide.¿(Id.¿at 1086.) Here, the exception applies.
PVHMC and its employees, some of whom were mental health specialists, treated
Decedent during Decedent’s § 5150 hold. Therefore, PVHMC had a special
relationship with Decedent as the healthcare provider during the § 5150 hold.
Breach
The Court
finds the SAC’s allegations of breach are well-pled.
While
Decedent was at PVHMC, Bhavsar did "little or nothing to assist in the
care and treatment of Decedent.” (SAC
¶ 21.) Meanwhile,
Nguyen’s “actions and omissions to act
fell well below the standard of care when he officially cleared Decedent for
discharge without inquiring of Bhavsar as to the medical appropriateness of
such discharge.” (SAC ¶ 23.) Additionally, neither
Bhavsar, Nguyen, nor any other personnel employed at PVHMC “followed
the necessary standard of care to ensure Decedent was properly discharged with
the appropriate medical safeguards in place to look after a person who was
clearly mentally unstable and suicidal.” (SAC ¶ 22.) Bhavsar wrongfully stated that Decedent’s “mood has improved with no
self-injurious behaviors noted here on the medical floor,” and “the patient is not in imminent
danger to self or others.” (SAC ¶ 22.)
Moreover,
Defendants failed to correctly evaluate, diagnose, and treat Decedent’s
condition, failed to adequately and appropriately consider Decedent’s mental
and emotional state, and failed to correctly diagnose and provide Decedent with
appropriate follow up care when Decedent was discharged on June 9, 2019. (SAC
¶ 69.) Defendants also failed to appropriately supervise, review and
ensure the competence of the treating medical staff’s provision of care as well as
the provision of their own care and diagnosis of Decedent, and failed to enact
appropriate standards and procedures or take action that would have prevented
such harm to Decedent upon discharge. (SAC ¶ 70.)
Therefore,
the SAC adequately alleges that Defendants owed a duty to Decedent and breached
that duty.
Causation
The Court
finds that the SAC puts forth facts sufficient to support the element of
causation.
Plaintiffs allege that it was reasonably
foreseeable that as a result of the acts and omissions of PVHMC, Bhavsar, and
Nguyen, Decedent would commit suicide and, that, as a direct and proximate
result of said acts and omissions and breach of duty, Decedent did commit
suicide. (SAC ¶¶ 64, 65.) Plaintiffs allege that
Defendants had notice that Decedent had attempted suicide and wrongfully
concluded that Decedent was not a risk to commit suicide.
PVHMC
argues that causation is not adequately plead because there was a three-month
period between when PVHMC is alleged to have last provided services and
decedent's suicide. PVHMC also contends that Decedent’s suicide bars this action
because courts consider suicide a superseding cause of harm unless a defendant
engaged in intentional conduct creating an irresistible impulse to commit
suicide, and here, the SAC does not allege such conduct on the part of PVHMC or
its employees. The Court disagrees on both grounds.
First,
PVHMC does not cite to any authority that states that the three-month period
defeats causation.
Bellah
v. Greenson,
on which PVHMC relies, does not address causation. In Bellah, plaintiffs
brought a wrongful death action against a psychiatrist two years after their
daughter’s suicide alleging that defendant had failed to take appropriate
preventive measures. (Bellah v. Greenson (1978) 81 Cal.App.3d 614.) The trial court sustained a
demurrer to the complaint and plaintiffs appealed. (Id.) Though the
Court of Appeal upheld the demurrer on other grounds, it held that defendant’s
knowledge of the daughter’s likelihood to commit suicide and failure to take
appropriate preventive measures were sufficient to state a cause of action for
breach. (Id.) The case never even reached the issue of causation.
PVHMC also
cites Hernandez v. KWPH Enterprises, where the court of appeal found
that medical technicians transporting a mentally ill woman to the hospital at
her request assumed no special relationship requiring them to protect her from
suicidal conduct causing her death by car when she ran away from ambulance
after its arrival at hospital. (Hernandez v. KWPH Enterprises (2004) 116
Cal.App.4th 170.) Hernandez is not applicable as it involves a summary
judgment motion, an entirely different standard.
Secondly,
in general, if the risk of injury is reasonably foreseeable, the defendant is
liable. (Cline v. Watkins (1977)
66 Cal.App.3d 174, 178.) It is true that in an action for wrongful death of an individual who has
committed suicide, the intentional act of suicide “is a superseding cause of harm
and relieves the original actor of liability unless such act was reasonably
foreseeable or the failure to foresee such act was a factor in the original
negligence.” (Lucas v. City of Long Beach (1976) 60 Cal.App.3d 341, 351 (Lucas).) However, case law endorses
the principle that the very conduct forming the basis for a plaintiff's
negligence claim cannot also be a superseding cause. (Lugtu v. California
Highway Patrol (2001) 26 Cal.4th 703,
725-726.)
Here,
Decedent’s suicide could not have “broken the chain of causation” since, according to the SAC, it was the very
foreseeable risk that rendered PVHMC’s conduct negligent.
Therefore,
the issue of causation is well-pled.