Prescott v. Rady Children's Hospital-San Diego
265 F. Supp. 3d 1090
S.D. Cal.2017Background
- Plaintiff Katharine Prescott sued Rady Children’s Hospital, San Diego (RCHSD) on behalf of her deceased child, Kyler Prescott, alleging discrimination and mistreatment while Kyler was a psychiatric inpatient at RCHSD in April 2015.
- Kyler was a transgender boy who had socially transitioned and been receiving gender‑affirming care; RCHSD staff allegedly repeatedly referred to him with female pronouns despite being informed of his male identity.
- During a 5150 psychiatric hold at RCHSD’s CAPS unit, misgendering by staff allegedly increased Kyler’s distress; his mother reported staff blocked her calls and staff conduct contributed to his early discharge.
- Kyler died by suicide about six weeks after discharge; Prescott asserts causes of action under ACA §1557, the Unruh Act, Cal. Gov. Code §11135, the UCL, and California’s False Advertising Law (FAL), seeking damages and equitable relief.
- RCHSD moved to dismiss and to stay pending challenges to HHS regulations; the court addressed statutory interpretation, standing for various remedies, survival of emotional‑distress damages, and whether a stay was warranted.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does ACA §1557 prohibit discrimination against transgender persons for the conduct alleged (pre‑2016)? | §1557’s text incorporates sex‑discrimination law and covers gender identity discrimination; claim rests on statute not HHS regulation. | Transgender protections derived from HHS regulation effective in 2016 and cannot be applied retroactively. | Court holds §1557 (as interpreted via Title IX/Title VII principles) covers gender‑identity discrimination here; claim survives without relying on the 2016 HHS regulation. |
| Standing for injunctive and declaratory relief under §1557 | Seeks prospective relief to stop discriminatory care. | No likelihood of future harm; lack of redressability for decedent’s injuries. | Court dismisses plaintiff’s request for injunctive and declaratory relief under §1557 for lack of standing. |
| Can plaintiff recover non‑economic (pain and suffering) damages for decedent under §1557? | Federal common law governs and permits emotional‑distress damages. | California survival statute bars pre‑death emotional‑distress damages. | Court applies federal common law and permits emotional‑distress damages under §1557. |
| Standing to bring Unruh Act claim on behalf of decedent | As Kyler’s personal representative under Cal. survivorship statutes, Prescott can sue on his behalf. | Reliance on non‑applicable organizational‑standing authorities; challenges representative posture. | Court allows Unruh claim to proceed; Prescott may sue as Kyler’s personal representative. |
| Claim under Cal. Gov. Code §11135 (state funding anti‑discrimination) — available remedies | Seeks relief for sex and disability discrimination under §11135. | Remedies under §11135 are limited to equitable relief; plaintiff lacks standing for equitable relief (no likely future harm). | Court dismisses §11135 claim for lack of standing to pursue equitable remedies; leave to amend narrowly allowed. |
| UCL and FAL claims — standing and reliance | Alleges misrepresentations on RCHSD website about transgender care; Prescott incurred economic harms and relied on statements. | Argues no commercial speech, lack of reliance, and web statements not tied to CAPS unit. | Court permits UCL claim (fraudulent prong as to plaintiff individually and unlawful/unfair prongs for decedent); permits FAL claim for plaintiff but dismisses FAL as to Kyler for failure to allege reliance. |
| Motion to stay pending challenges to HHS regulation and Supreme Court guidance | N/A (defendant seeks stay until higher‑court resolution). | Sought stay pending Gloucester Ct y. and Franciscan Alliance injunctions. | Court denies stay: Gloucester remanded; this case does not depend on the HHS regulation’s constitutionality. |
Key Cases Cited
- Schwenk v. Hartford, 204 F.3d 1187 (9th Cir.) (Title VII sex discrimination analysis includes gender/nonconformity)
- Price Waterhouse v. Hopkins, 490 U.S. 228 (Sup. Ct.) (sex stereotyping is actionable sex discrimination)
- Franklin v. Gwinnett Cnty. Pub. Sch., 503 U.S. 60 (Sup. Ct.) (Title IX remedies discussion)
- Whitaker v. Kenosha Unified Sch. Dist. No. 1, 858 F.3d 1034 (7th Cir.) (gender‑identity discrimination actionable under Title IX framework)
- Glenn v. Brumby, 663 F.3d 1312 (11th Cir.) (discrimination against transgender persons is sex discrimination)
- Leyva v. Certified Grocers, 593 F.2d 857 (9th Cir.) (stay of proceedings pending resolution of related actions)
- Landis v. North American Co., 299 U.S. 248 (Sup. Ct.) (moving party’s burden to show hardship for stay)
- Lyons v. City of Los Angeles, 461 U.S. 95 (Sup. Ct.) (injunctive‑relief standing requires likelihood of future harm)
- Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (Sup. Ct.) (plausibility pleading standard)
- Ashcroft v. Iqbal, 556 U.S. 662 (Sup. Ct.) (pleading standard and inference of misconduct)