Opinion
Traditional California tort law holds a tortfeasor liable not only for the victim’s original personal injuries but also for any aggravation caused by subsequent negligent medical treatment, provided the injured party exercised reasonable care in obtaining the medical treatment. The subsequent tortfeasor, in turn, is also liable to the injured party for the enhanced injuries he or she has caused. Does Civil Code section 1431.2, 1 adopted by the voters *446 in 1986 as Proposition 51 (The Fair Responsibility Act of 1986), which provides in personal injury actions based upon principles of comparative fault “the liability of each defendant for non-economic damages shall be several only and shall not be joint,” modify the injured party’s right to recovery in these cases? That is, in a lawsuit brought by the injured party against the original tortfeasor alone, is the defendant entitled to reduce his or her exposure to noneconomic damages by proving the medical professionals share fault for the aggravated injuries suffered by the plaintiff?
The trial court in this premises liability action ruled homeowners Joe and Judy Henry, sued by Larry Reinink for injuries suffered as a result of a fall on their property, could not introduce evidence that medical malpractice by emergency room doctors at Kaiser Permanente (Kaiser), who are not parties to this action, aggravated Reinink’s injuries. Because section 1431.2 generally precludes joint liability for noneconomic damages in personal injury actions, providing a defendant shall be liable only for those noneconomic damages directly attributable to his or her own percentage of fault, and because none of the limited exceptions to section 1431.2 is applicable in this case, we grant the petition for writ of mandate filed by the Henrys and direct respondent Los Angeles Superior Court to vacate its order excluding evidence of subsequent negligence by Kaiser physicians treating Reinink’s injuries and to enter a new order permitting such evidence if it is otherwise admissible.
FACTUAL AND PROCEDURAL BACKGROUND
1. Reinink’s Fall at the Henrys’ Residence; the Reininks’ Complaint and the Henrys’ Answer
Reinink was hired by the Henrys to clean and repair their swimming pool and its equipment. On April 3, 2003 Reinink worked at the Henrys’ property from midaftemoon until it began to get dark. As he was leaving, Reinink fell over what he believed was an unmarked, unlit concrete step along the walkway between the pool and an access gate at the south end of the property, injuring his shoulder. Paramedics transported Reinink to the emergency room at Kaiser where doctors treated him. Thereafter, Reinink underwent a series of surgeries to further treat his injury.
On June 26, 2003 the Reininks filed a Judicial Council form complaint for personal injuries (negligence/premises liability) against the Henrys, alleging “an unmarked, unexpected and unlit dropoff on the cement walkway” constituted a dangerous condition and the Henrys had breached their duty to correct the condition or warn Reinink about it. Sandra Reinink also asserted a claim for loss of consortium. In their answer to the complaint the Henrys alleged as an affirmative defense that the fault of others contributed to Reinink’s injuries *447 and their liability for noneconomic damages should therefore be allocated in direct proportion to their own percentage of fault.
2. The Trial Court’s Order Excluding Evidence Kaiser’s Negligence Contributed to Reinink’s Injuries
Trial in the matter was scheduled to begin on July 9, 2007. 2 On June 28, 2007 the Henrys filed proposed jury instructions and a statement of the case to be read to the jury, describing the case as involving a trip and fall. 3 On July 9, 2007 the Henrys filed an amended statement of the case that added the contention “[Reinink’s health care] providers were negligent in the treatment of the plaintiff.” According to the Henrys, Reinink’s shoulder had only been dislocated with a minor fracture when he fell. Physicians at Kaiser, however, had aggravated that injury and committed malpractice when they broke Reinink’s shoulder in four places while trying to put it back into place, necessitating the surgeries. The Henrys also filed new proposed jury instructions regarding medical malpractice.
The Reininks objected to expanding the scope of the trial to include Kaiser’s alleged negligence in treating Reinink’s injury because, among other reasons, they had not named Kaiser as a defendant in their lawsuit and the Henrys had not sought to include Kaiser by way of cross-complaint. Relying on
Marina Emergency Medical Group v. Superior Court
(2000)
On July 11, 2007, during further proceedings before the trial court on motions in limine, the Henrys requested the court revisit its decision precluding them from introducing evidence of Kaiser’s negligence. After extensive argument the court reaffirmed its previous ruling: “It’s still my opinion that the premises liability defendants still can’t give the comparative fault of a malpracticing [sic] physician as a defense or an apportionment of the wrongdoing. ... It’s a completely different class of negligence. And as plaintiff’s counsel said, it’s comparing apples versus oranges.” The court continued the trial date to permit the Henrys to seek writ relief from this court.
3. The Writ Petition
On July 20, 2007 the Henrys petitioned this court for a writ of mandate compelling the trial court to vacate its order precluding them from presenting evidence of Kaiser’s negligence and to enter a new order permitting them to do so. The Henrys also sought an immediate stay of the trial court proceedings. On July 23, 2007 we issued an order to show cause why the requested relief should not be granted and stayed all trial court proceedings.
CONTENTION
The Henrys contend they are entitled under section 1431.2 to introduce evidence of Kaiser’s negligence to limit their liability for noneconomic damages to their percentage of fault. 4
DISCUSSION
1. Proposition 51 Limits Liability for Noneconomic Damages to Several Only When Liability Is Based upon Comparative Fault
The basic rules governing comparative responsibility and apportionment of liability among multiple tortfeasors are not seriously disputed by the
*449
parties. “Under well-established common law principles, a negligent tortfeasor is generally liable for all damage of which his negligence is
a
proximate cause .... A tortfeasor may not escape this responsibility simply because another act—either an ‘innocent’ occurrence such as an ‘act of God’ or other negligent conduct—may also have been a cause of the injury.”
(American Motorcycle Assn. v. Superior Court
(1978)
“In cases involving multiple tortfeasors, [this] principle . . . has commonly been expressed in terms of ‘joint and several liability.’ ”
(American Motorcycle, supra,
These doctrinal advances went a considerable distance toward ensuring an injury caused by two or more tortfeasors would be apportioned according to their respective shares of comparative responsibility. Nonetheless, joint and several liability imposed on the remaining defendants the risk of paying more than their proportionate share if one or more tortfeasors liable for the plaintiff’s damages were insolvent or otherwise unavailable to respond to a judgment. (See
Evangelatos
v.
Superior Court, supra,
To effectuate the voters’ intent, section 1431.2, subdivision (a), states, “In any action for personal injury, property damage, or wrongful death, based upon principles of comparative fault, the liability of each defendant for non-economic damages shall be several only and shall not be joint. Each defendant shall be liable only for the amount of non-economic damages allocated to that defendant in direct proportion to that defendant’s percentage of fault, and a separate judgment shall be rendered against that defendant for that amount.” “Economic” damages encompass all “objectively verifiable monetary losses including medical expenses, loss of earnings, burial costs, loss of use of property, costs of repair or replacement, costs of obtaining substitute domestic services, loss of employment and loss of business or employment opportunities.” (§ 1431.2, subd. (b)(1).) “Non-economic” damages are such “subjective, non-monetary losses [as] pain, suffering, inconvenience, mental suffering, emotional distress, loss of society and companionship, loss of consortium, injury to reputation and humiliation.” (§ 1431.2, subd. (b)(2).) Thus, “Proposition 51 . . . retains the joint liability of all tortfeasors, regardless of their respective shares of fault, with respect to all objectively provable expenses and monetary losses,” but “the more intangible and subjective categories of damage [are] limited ... to a rule of strict proportionate liability. With respect to these noneconomic damages, the plaintiff alone now assumes the risk that a proportionate contribution cannot be obtained from each person responsible for the injury.” (DaFonte, supra, 2 Cal.4th at p. 600.)
2. An Original Tortfeasor Is Jointly Liable to the Injured Party for Aggravation of Personal Injuries Caused by Negligent Medical Treatment
In
Ash v. Mortensen
(1944)
Like the bases for joint and several liability, the doctrinal underpinnings for the line of cases represented by
Ash,
most often involving automobile accidents followed by negligent medical treatment, are causation and foreseeability: “[T]he law regards the act of the original wrongdoer as a proximate cause of the damages flowing from the subsequent negligent medical treatment. . . .”
(Ash, supra,
At least prior to the adoption of Proposition 51 in 1986, the rule a tortfeasor responsible for an accident is also liable for any additional injuries suffered during medical treatment following the accident was one of joint and several liability for the enhanced injuries if the medical care provider was negligent.
(Blecker
v.
Wolbart, supra,
167 Cal.App.3d at pp. 1202-1203 [concept of partial indemnity among joint tortfeasors on comparative fault basis, approved in
American Motorcycle,
applies to successive tortfeasors as recognized in
Ash]; Kitzig v. Nordquist
(2000)
Blecker
v.
Wolbart, supra,
The joint nature of the liability of the original and subsequent tortfeasors for the enhanced injuries caused by an accident followed by negligent medical treatment is confirmed by section 1431, which prior to adoption of Proposition 51 provided, “An obligation imposed upon several persons, or a right created in favor of several persons, is presumed to be joint, and not several . . . .” Section 1431 still contains the same presumption of joint liability “except as provided in Section 1431.2”—that is, except that the liability of each defendant for noneconomic damages in a personal injury action based upon principles of comparative fault is several only. (See §§ 1431, 1431.2, subd. (a).)
*454
Notwithstanding case law and statutory authority recognizing joint liability for aggravated injuries based on subsequent negligent medical treatment, the Reininks argue joint and several liability in these circumstances depends on the existence of an “indivisible injury” caused by multiple tortfeasors, not two separate and distinct physical injuries, which they assert exist in this case.
8
Without question, over the years the concept of “indivisibility” in tort law has been somewhat amorphous; and a number of cases do refer to joint and several liability for “indivisible injuries” without additional explanation. (See, e.g.,
American Motorcycle, supra,
20 Cal.3d at pp. 586-587;
Willdan v. Sialic Contractors Corp., supra,
The concept, at bottom, is one of legal causation (that is, are multiple tortfeasors responsible for the plaintiff’s injuries), not the precise nature of the resulting damage. As the Supreme Court explained in
American Motorcycle, supra,
*455
To the extent damages for Reinink’s injured shoulder can in fact be divided by causation into distinct component parts—the original injury that resulted from the fall at the Henrys’ property and the aggravation of that injury caused by Reinink’s negligent treatment by Kaiser physicians— liability for each indivisible component part should be considered separately. The Henrys, if they were negligent, are solely responsible for the initial injury; liability for the indivisible enhanced or aggravated injury, however, is properly apportioned between the Henrys and the Kaiser physicians in accordance with the rules of comparative fault and section 1431.2. (See Rest.3d Torts, § 26, at p. 320 [apportionment of liability when damages can be divided by causation]; see also
Arena
v.
Owens-Corning Fiberglas Corp.
(1998)
3. Because Their Potential Liability Is Based on Culpable Conduct, Section 1431.2 Permits the Henrys to Limit Their Liability for Noneconomic Damages to Their Proportionate Share of Fault
Under the established principles discussed above, the Henrys, if found liable to the Reininks, will be entitled to file a separate action seeking partial equitable indemnification from Kaiser with respect to those damages for which the Henrys and Kaiser are jointly and severally liable. (See, e.g.,
Blecker
v.
Wolbart, supra,
The Reininks attempt to avoid the clear mandate of section 1431.2 by arguing the Henry s’ liability for the aggravated injuries caused by Kaiser’s negligence under the line of cases represented by
Ash
is “imputed” or “derivative” and, therefore, outside the rules for several liability adopted by Proposition 51. The Reininks are correct courts have held section 1431.2 inapplicable when joint liability is imposed based solely on the relationship between two tortfeasors or because of statutory mandate, not because each such party has acted in a manner causing or contributing to the plaintiff’s injury—that is, when liability is imputed rather than based on actual fault or culpable conduct. For example, in
Miller v. Stouffer
(1992)
The
Miller
court explained section 1431.2’s rule of several liability based upon comparative fault, rather than joint liability, for noneconomic damages is unsuitable to cases involving the vicarious liability of one of the defendants: “If . . . Proposition 51 shields every defendant from liability for noneconomic damages beyond that attributable to that defendant’s own fault, it largely would abrogate the vicarious tort liability of persons for the acts of others. Nothing in the language or intent of Proposition 51 conveyed to the voters in June 1986 dictates such a drastic change in California tort law.”
(Miller, supra, 9
Cal.App.4th at p. 85; see also
Srithong v. Total Investment Co., supra,
Similarly, some courts have held section 1431.2 does not require apportionment of liability for noneconomic damages in a products liability action among defendants who are in the chain of distribution of a defective product. (E.g.,
Wimberly v. Derby Cycle Corp.
(1997)
The Reininks note several cases have described the original tortfeasor’s liability for any aggravation of injuries caused by subsequent negligent medical care as “a unique rule of causation more analogous to imputed negligence than joint feasance.”
(Progressive Trans. Co. v. Southern California Gas Co.
(1966)
The Reininks’ conclusion simply does not follow from their premise. Section 1431.2, subdivision (a), expressly applies to “any action for personal injury, property damage, or wrongful death, based upon principles of comparative fault” and was intended to stave off the “catastrophic economic consequences” and remedy the inequity resulting from holding a party *459 bearing only a fraction of the fault financially responsible for the entirety of damages. (§ 1431.1, subd. (c) [findings and declaration of purpose].) Thus, the critical question is not whether liability is “imputed” in some manner, but the reason for imposing joint liability in a particular context. And the decisive factor is fault.
Proposition 51 (that is, § 1431.2) is inapplicable when “liability for the negligent acts of another is imposed not because of independent culpability which can be measured and evaluated but because of status or relationship.”
(Rashtian
v.
BRAC-BH, Inc., supra, 9
Cal.App.4th at p. 1854.) In
Miller v. Stouffer, supra, 9
Cal.App.4th 70, liability was imposed because an employer-employee relationship existed between the defendants; in
Rashtian,
at page 1851, liability was found based on “statutory fiat”; in products liability cases liability is imposed based upon the defendant’s presence in the chain of distribution
(Wimberly, supra,
56 Cal.App.4th at pp. 627-628). In none of those cases is there any negligence or fault on the part of the party to whom liability is being imputed. (See
id.
at p. 629 [“[w]here a defendant’s ‘joint and several liability’ is not based on his or her own negligence, but on vicarious liability, defendant cannot invoke Proposition 51 to reduce or eliminate responsibility for plaintiff’s noneconomic damages”]; see also
Kesmodel
v.
Rand, supra,
119 Cal.App.4th at pp. 1143-1145.) In contrast, the original tortfeasor’s liability for a plaintiffs enhanced injuries caused by negligent medical care is expressly predicated on his or her culpable conduct, which set in motion the events that ultimately led the plaintiff to seek medical treatment.
(Ash, supra,
4. Application of Section 1431.2 in Cases Involving an Original Tortfeasor’s Liability for Subsequent Negligent Medical Treatment Is Not Limited to Successive Instances of Medical Malpractice
In
Maxwell v. Powers
(1994)
Noting the principle holding a tortfeasor liable for subsequent injuries caused by negligent medical care “usually appears in cases involving automobile accidents”
(Maxwell
v.
Powers, supra,
As discussed, in
Marina, supra,
For purposes of applying the principles of comparative responsibility and apportionment of liability, it is simply not significant that the nature of the Henry s’ alleged negligence may be different from that of the Kaiser emergency room doctors. Juries are often confronted with apportioning fault among defendants sued on different theories of liability: “Past California cases have made it clear that the ‘comparative fault’ doctrine is a flexible, commonsense concept, under which a jury properly may consider and evaluate the relative responsibility of various parties for an injury (whether their responsibility for the injury rests on negligence, strict liability, or other theories of responsibility), in order to arrive at an ‘equitable apportionment or allocation of loss.’ ”
(Knight v. Jewett
(1992)
*462 DISPOSITION
The petition is granted. A peremptory writ of mandate shall issue directing respondent superior court to vacate its order excluding evidence of subsequent negligence by Kaiser physicians treating Reinink’s injuries and to enter a new order permitting such evidence if it is otherwise admissible. The Henrys are to recover their costs in this proceeding.
Zelon, J., and Wiley, J., * concurred.
The petition of real parties in interest for review by the Supreme Court was denied May 21, 2008, SI62452.
Notes
Statutory references are to the Civil Code.
Earlier in the proceedings the trial court had granted the Henrys’ motion for summary judgment, finding, as a matter of law, the step was not a dangerous condition. We reversed on the ground there were triable issues of fact whether the Henrys’ walkway, at dusk, was unreasonably unsafe without lighting or markings. (Reinink v. Henry (Nov. 1, 2006, B185422) [nonpub. opn.].)
The Henrys proposed the jury be told, “This case involves an April 3, 2003 trip and fall incident by plaintiff Larry Reinink at the home of defendants Joe and Judy Henry. [Reinink] alleges that [the Henrys] negligently maintained their property and is seeking to recover monetary damages for injuries sustained. [The Henrys] deny responsibility for [Reinink’s] fall and dispute the nature and extent of [Reinink’s] injuries and damages.”
In addition to arguing as a matter of law the Henrys are not entitled to limit their liability for noneconomic damages under section 1431.2 based on Kaiser’s negligent treatment of Reinink, in their answer to the petition for writ of mandate the Reininks raise a host of procedural and evidentiary challenges to the Henrys’ proposed evidence of medical malpractice. Those issues are all properly addressed by the trial court in the first instance.
Although the principle that a tortfeasor responsible for an accident is also liable for injuries occurring during medical treatment for injuries suffered in the accident is often referred to as “the
Ash
rule,” as discussed, the doctrine was recognized in California at least 20 years prior to the Supreme Court’s decision in
Ash, supra,
The original tortfeasor’s liability for enhanced injury suffered during medical treatment is not limited to additional harm caused by negligence. “If death resulted from a risk inherent in the medical treatment reasonably required to cure the injuries caused by the accident, [the original tortfeasors] would be liable irrespective of whether such treatment was rendered in a proper or a negligent manner. The question is one of causation, and where the additional harm results either from the negligence of doctors or hospitals who furnish necessary medical care, or from the materialization of a risk inherent to necessary medical care, the chain of causation set in motion by the original tort remains unbroken.”
(Hastie v. Handeland
(1969)
We recently confirmed the
Blecker
court’s observation that the availability of an action for partial equitable indemnity based on principles of comparative fault is not dependent on the existence of “ ‘joint tortfeasors’ in the classic sense of that term.”
(Willdan v. Sialic Contractors Corp.
(2007)
The Reininks attempt to support this argument with language from the Supreme Court’s decision in
Ash, supra,
As discussed above, if the Henrys’ and Kaiser’s separate torts caused injuries that can be divided by causation (that is, there is a reasonable basis for the fact finder to determine the amount of damages attributable to the allegedly negligent medical treatment of Reinink, for which the Henrys and Kaiser are jointly responsible), then only the liability for the enhanced or aggravated injury is properly apportioned on the basis of their comparative fault. (See Rest.3d Torts, § 26, p. 320.)
The Court of Appeal in
Kitzig, supra,
Judicial Council of California Civil Jury Instructions (2007) CACI No. 3929, “Subsequent Medical Treatment,” provides, “If you decide that [name of defendant] is legally responsible for [name of plaintiff]’s harm, [he/she/it] is also responsible for any additional harm resulting from the acts of others, in providing aid that [name of plaintiff]’s injury reasonably required, even if those acts were negligently performed.” Citing
Marina, supra,
Judge of the Los Angeles Superior Court, assigned by the Chief Justice pursuant to article VI, section 6 of the California Constitution.
