Yoder v. Okhovat CA2/1
B320945
| Cal. Ct. App. | Aug 24, 2023Background
- Plaintiff Janine Yoder (in propria persona) sued Dr. Mahyar Okhovat for medical malpractice arising from a January 8, 2019 EMG; she alleges Okhovat forcefully twisted her left foot/ankle during the test, producing a "pop," acute pain, and subsequent Achilles tendinitis and complex regional pain syndrome (CRPS).
- Defendants moved for summary judgment arguing lack of breach and, alternatively, lack of causation; they relied chiefly on the declaration of neurologist Peter‑Brian Andersson, M.D., who reviewed Yoder’s records and concluded, to a reasonable medical probability, that Okhovat’s conduct did not cause or contribute to her injuries.
- Dr. Andersson identified normal EMG results from the study, a normal same‑day ankle x‑ray, absence of objective signs (swelling, wasting, reflex loss), and MRIs showing mild/chronic conditions (e.g., Achilles tendinitis, chronic ligament sprain) inconsistent with a single inward twisting trauma; he also explained records do not support a CRPS diagnosis under the Budapest Criteria.
- Yoder opposed with lay witness declarations (notably Steve Frlekin, who was present during the EMG and described a forceful inward push and audible "pop"), family witness statements, and later medical letters/reports—several of which were unsigned or not verified under penalty of perjury; she submitted a later, unsworn letter from Dr. Fihman asserting symptoms consistent with CRPS.
- The trial court sustained defendants’ evidentiary objections to plaintiff’s medical statement(s), found defendants met their initial burden as to causation, concluded Yoder failed to produce conflicting admissible expert evidence creating a triable issue, granted summary judgment for defendants, and the judgment was affirmed on appeal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether defendants carried their summary judgment burden on causation | Frlekin’s eyewitness account plus later medical records and physician notes show the EMG/manipulation caused ongoing injuries (tendinitis, CRPS) | Andersson’s expert opinion, based on contemporaneous records, shows normal EMG/x‑ray and that alleged injuries are chronic/idiopathic—not caused by the EMG | Defendants met burden; Andersson’s reasoned declaration sufficed to negate causation and shift burden to Yoder |
| Whether plaintiff produced admissible expert evidence opposing causation | Submitted later medical letters/reports (Dr. Fihman, Dr. Singh, etc.) purporting to link symptoms to the EMG | Defendants objected that those statements lacked foundation and verification (unsworn or unverified) | Court sustained objections to key statements (e.g., Dr. Fihman); plaintiff failed to produce admissible, qualified expert evidence creating a triable issue |
| Whether lay witness testimony (Frlekin) creates a triable issue on medical causation | Frlekin witnessed forceful manipulation, heard a pop, and saw immediate injury — this proves causation | Even if the manipulation occurred, complex medical causation (e.g., CRPS) requires expert proof; lay testimony cannot substitute | Even accepting Frlekin’s account, it did not create a triable issue on medical causation absent conflicting expert opinion |
| Appealability / procedural posture of appeal | Notice cited order denying reconsideration (March 10, 2022) | Order denying reconsideration is not appealable; appeal must be construed from final judgment | Court construed the notice as an appeal from the judgment entered March 23, 2022 and proceeded to review the summary judgment ruling |
Key Cases Cited
- Aguilar v. Atlantic Richfield Co., 25 Cal.4th 826 (2001) (summary judgment burden‑shifting framework and standard for triable issues)
- Jones v. Ortho Pharmaceutical Corp., 163 Cal.App.3d 396 (1985) (medical malpractice causation requires expert proof within a reasonable medical probability)
- Powell v. Kleinman, 151 Cal.App.4th 112 (2007) (defendant’s expert in support of summary judgment prevails absent conflicting expert evidence from plaintiff)
- Bushling v. Fremont Medical Center, 117 Cal.App.4th 493 (2004) (expert declaration must provide a reasoned explanation linking underlying facts to ultimate conclusion)
- Hodjat v. State Farm Mutual Automobile Ins. Co., 211 Cal.App.4th 1 (2012) (procedural objection requirements for opposing separate statement in summary judgment practice)
- Walker v. Los Angeles County Metropolitan Transportation Authority, 35 Cal.4th 15 (2005) (construing notices of appeal so they effectuate review of final judgments)