Brenner v. Universal Health etc.
D071094
| Cal. Ct. App. | Jun 7, 2017Background
- Dale Brenner (71) was hospitalized after a stroke, treated at Inland Valley Medical Center, transferred to Scripps, and died about a month later; death certificate listed acute respiratory failure with contributing right neck hematoma and cerebrovascular accident.
- Nancy (wife, experienced nurse) repeatedly complained about care at Inland Valley on her husband’s behalf; central line placed by Dr. Lee on June 10–11 with a subsequent right neck hematoma discovered the next day.
- Plaintiffs (Nancy as personal representative of Dale’s estate, and son Zach individually) sued UHS (hospital) and Dr. Young H. Lee for wrongful death/medical negligence, retaliation under Health & Safety Code §1278.5, and elder abuse under Welf. & Inst. Code §§15610 et seq.
- Defendants moved for summary judgment; each submitted expert declarations opining no causation (death caused by large left hemispheric stroke and complications), plaintiffs submitted opposing expert (Dr. Hadian) asserting possible causation and breaches but equivocal language ("could have survived").
- Trial court granted summary judgment/adjudication for Lee and UHS; plaintiffs appealed. Court of Appeal affirms as to wrongful death (causation), retaliation (statutory scope/standing), and elder abuse (insufficient evidence of recklessness). Court also affirms denial of leave to amend for punitive damages as moot given judgment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Wrongful death (medical negligence) — causation | Plaintiffs argued defendants' breaches (aspiration, feeding while on BiPAP, central line complications, poor glucose control) substantially caused death; expert said breaches could have changed outcome | Defendants' experts said death was caused by massive stroke and complications; any other events were not substantial factors | Affirmed: Plaintiffs' expert gave only possibility ("could have")—insufficient to create triable issue; defendants met burden on causation |
| Statutory retaliation (Health & Safety Code §1278.5) — individual liability (Lee) | Plaintiffs sought relief against Lee and UHS for retaliation after Nancy's complaints | Defendants argued statute targets health facilities and certain individuals who themselves engaged in whistleblowing; does not create claim against individual physicians or for complaints by third parties | Affirmed: §1278.5 does not create a claim against individual doctors; Lee not liable |
| Statutory retaliation (§1278.5) — standing and scope against UHS | Plaintiffs argued complaints made on patient’s behalf support retaliation claim; Nancy (as rep) could assert survivor claim | UHS argued statute protects only the persons who themselves complained (patient, employee, staff), not third parties | Affirmed: Court harmonized (b) and (c) to allow patient protection only where complaint was by patient or by facility staff on patient’s behalf; Nancy was not facility staff, so UHS entitled to summary adjudication |
| Elder abuse (Welf. & Inst. Code) — heightened showing of recklessness | Plaintiffs relied on Dr. Hadian to show reckless conduct by nursing staff (delays in insulin, aspiration risk, failure to document, inaction during respiratory distress) | Defendants argued the record and experts show at most negligence; elder-abuse remedies require clear-and-convincing proof of recklessness/intentional wrongdoing causally producing harm | Affirmed: Expert opinions were speculative or conclusory about causation and recklessness ("could," no proof of resulting physical/mental harm); summary adjudication proper |
Key Cases Cited
- Aguilar v. Atlantic Richfield Co., 25 Cal.4th 826 (rule on burdens in summary judgment) (explains burden shift and plaintiff's obligation to show triable issue)
- Bromme v. Pavitt, 5 Cal.App.4th 1487 (medical causation standard in wrongful death) (requires reasonable medical probability—more likely than not—that negligence caused death)
- Collin v. CalPortland Co., 228 Cal.App.4th 582 (summary judgment mechanics) (movant makes prima facie showing of nonexistence of triable issue)
- Bozzi v. Nordstrom, Inc., 186 Cal.App.4th 755 (when movant uses competent expert, opposing party must submit competent contrary expert) (applicable to medical-malpractice summary judgment)
- Uriell v. Regents of University of California, 234 Cal.App.4th 735 (medical probability vs. possibility) (distinguishes sufficient expert proof of probability from mere possibility)
- Delaney v. Baker, 20 Cal.4th 23 (Elder Abuse Act limits and standards) (professional negligence is insufficient for enhanced elder-abuse remedies)
- Covenant Care, Inc. v. Superior Court, 32 Cal.4th 771 (Elder Abuse Act remedies) (describes heightened remedies and clear-and-convincing standard for oppression/fraud/malice)
- Lattimore v. Dickey, 239 Cal.App.4th 959 (causation standard reaffirmed) (expert proof of reasonable medical probability required)