378 P.3d 736
Ariz. Ct. App.2016Background
- Sandra Shaw, a 74‑year‑old vulnerable adult, was discharged from hospital to a ManorCare facility with multiple medical issues (UTI, chronic kidney disease, recent acute renal failure, meningioma, delirium, etc.).
- During her stay Shaw became increasingly confused, refused medications/food, had a cloudy urine sample, was diagnosed with “early sepsis” by Dr. Cuzner, and received limited follow‑up care. She died shortly after transfer to long‑term care; death certificate listed sepsis with underlying conditions.
- Marika Delgado (personal representative of Shaw’s estate) sued ManorCare and related defendants asserting medical malpractice, wrongful death, and an APSA claim for abuse/neglect (failure to seek/provide medical care).
- ManorCare moved for summary judgment on the APSA claim arguing the alleged negligence involved treatment of an acute medical condition unrelated to Shaw’s incapacity; the trial court granted summary judgment.
- On appeal the court assumed Shaw died of sepsis and considered whether ManorCare’s alleged failure to obtain/provide further medical care was sufficiently related to Shaw’s incapacity under the McGill factors to state an APSA claim.
- The court reversed summary judgment, finding genuine factual disputes (expert affidavits and staff testimony) that ManorCare’s alleged failures could be related to Shaw’s incapacity and thus actionable under APSA.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether APSA covers alleged negligence that caused Shaw’s death | Delgado: ManorCare failed to obtain/provide medical care for an incapacitated resident; but for incapacity Shaw could have sought care herself, so APSA applies | ManorCare: The alleged negligence concerned an acute medical condition (sepsis) unrelated to Shaw’s incapacity and therefore falls outside APSA | Reversed: Triable issues of fact exist whether failures to seek/provide care were related to problems causing incapacity; summary judgment improper |
| Whether claim preclusion bars Delgado’s APSA claim because malpractice/wrongful death claims were dismissed | Delgado: APSA claim is distinct within the same action and not precluded | ManorCare: Dismissal of related claims precludes negligence-based APSA claim | Held: Claim preclusion inapplicable because the APSA claim was not a prior suit; all claims were in the same action |
| Whether expert affidavits supporting negligence were conclusory and insufficient to defeat summary judgment | Delgado: Nursing and medical expert affidavits created triable issues on standard of care and relation to incapacity | ManorCare: Expert affidavit (Dr. Williams) was conclusory and could be disregarded | Held: Court did not find the affidavit rejected below; even if attacked, other evidence creates triable issues, so summary judgment improper |
| Whether APSA’s McGill factors were met (focus on factor 4: relation to problems causing incapacity) | Delgado: Alleged failures to seek/provide care were linked to Shaw’s incapacity because she depended on caregivers to obtain treatment | ManorCare: Sepsis and related treatment were acute and not tied to incapacity issues | Held: Material factual disputes exist as to McGill factor 4; cannot rule as matter of law that negligence was unrelated to incapacity |
Key Cases Cited
- Estate of McGill ex rel. McGill v. Albrecht, 203 Ariz. 525 (Ariz. 2002) (articulates four McGill factors for when negligence can constitute APSA abuse/neglect)
- Equihua v. Carondelet Health Network, 235 Ariz. 504 (App. 2014) (applied McGill to feeding‑tube negligence and held APSA could apply where service was the precise care undertaken because of incapacity)
- In re Estate of Wyatt, 232 Ariz. 506 (App. 2014) (discusses nature of caregiver relationship and scope of care under APSA)
- Florez v. Sargeant, 185 Ariz. 521 (1996) (court may disregard conclusory expert affidavits at summary judgment)
- Law v. Verde Valley Medical Center, 217 Ariz. 92 (App. 2007) (principle on vicarious liability and preclusion in related contexts)