Opinion
Plaintiffs Pedro Marrón and Maria Marrón, individually and as successors in interest of Lidia Marrón (together the Matrons), filed this petition for writ of mandate challenging the trial court’s order granting the motion of defendant Regents of the University of California (RUC) for summary adjudication of the Matrons’ dependent adult abuse cause of action against it. The Matrons contend the trial court erred by concluding Government Code section 818, which exempts public entities from liability for punitive or exemplary damages, precludes their cause of action against RUC for enhanced remedies under Welfare and Institutions Code section 15657. 1
Factual and Procedural Background 2
On August 23, 2000, Lidia Marrón, then 44 years old, entered UCSD Medical Center (the Hospital) for a liver biopsy. The Hospital is owned and operated by RUC, which is a division of the State of California. Complications arose during the procedure when the biopsy needle perforated Lidia’s middle colic vein, causing damage to her abdominal viscera and requiring emergency surgery. Following surgery, Lidia was admitted to the Hospital’s intensive care unit. During her subsequent two-month stay at the Hospital, she suffered complications, including fungus infections in her blood and lungs, peritonitis," intra-abdominal and pelvic abscesses, sepsis syndrome, hypotension, fevers, abdominal pain and hemorrhaging.
On October 28 she was discharged from the Hospital. On October 31 she returned to the Hospital because of a spiking fever. On November 8 she was discharged from the Hospital, but returned within 12 hours because of fevers, chills and severe pain. A CT scan showed an intra-abdominal abscess. She became progressively septic and was diagnosed with enterocutaneous fistula.
*1055 On December 13 Lidia died.
The Marrons, as Lidia’s parents and successors in interest, filed a complaint against defendants RUC and Tarek I. Hassanein, M.D., alleging causes of action for wrongful death and section 15657 dependent adult abuse. The dependent adult abuse cause of action alleges the defendants “failed to exercise the requisite degree of care but rather acted with recklessness in the failure to appropriately and adequately care for, monitor, and treat Lidia Marrón’s declining health condition from” August 23 through December 13, 2000. It further alleges the defendants “failed to recognize and treat obvious signs of uncontrolled hemorrhage, failed to protect [Lidia] from health and safety hazards, failed to assist in personal hygiene, failed to provide an adequate environment for the level of care that was needed, ignoring obvious signs of stress and disease, causing [her] to suffer protracted pain, discomfort, mental suffering, indignity and humiliation up to the time of her death.” The complaint seeks damages for Lidia’s pain and suffering and an award of reasonable attorney fees and costs pursuant to section 15657.
RUC filed a motion for summary adjudication of the dependent adult abuse cause of action, asserting, inter alia, that Government Code section 818 provided it with immunity against section 15657 damages and attorney fees and costs. 3 The Marrons opposed the motion, arguing that because section 15657 does not provide for punitive damages, Government Code section 818 does not bar an award of section 15657 enhanced remedies against RUC.
The trial court granted RUC’s motion for summary adjudication, stating: “[T]he [dependent adult abuse] cause of action impermissibly seeks punitive damages against a public entity in violation of Government Code section 818. . . . [T]he pain and suffering [Lidia] suffered was personal to her and ceased to be an element of compensation upon her death. As a result, . . . the Legislature’s decision [in section 15657] to abrogate [Code of Civil Procedure] section 377.34 as a result of a caregiver’s reckless neglect is punitive in nature, as it is intended to award damages in excess of just compensation. The same logic applies vis-á-vis the recovery of attorney’s fees, as this is an award in excess of just compensation for [Lidia’s] injuries.” 4 During oral argument on the motion, the trial court further stated: “To me [section 15657’s enhanced remedies constitute] a penalty. [They are] *1056 an amount of money in addition to compensation and [they penalize] someone for reckless conduct . . . .”
The Marrons filed this petition for writ of mandate, challenging the trial court’s order granting the motion for summary adjudication. RUC filed a response, arguing the trial court correctly concluded it was immune under Government Code section 818 from liability for section 15657 enhanced remedies. We issued an order to show cause, stayed trial of this matter and heard oral argument.
Discussion
I
Consideration of the Petition
The Marrons contend we should consider their petition for writ of mandate because they have an inadequate remedy at law and will suffer irreparable injury if their petition is not granted. They argue the trial court’s order has the effect of barring a substantial portion of their case on the merits and a second trial would be a waste of judicial and litigant resources. Furthermore, they assert the instant issue is one of law that is of first impression and of public interest.
An order granting a motion for summary adjudication may be reviewed by way of a petition for writ of mandate. (Code Civ. Proc., § 437c, subd. (m)(l);
Federal Deposit Ins. Corp. v. Superior Court
(1997)
II
Summary Adjudication Standard of Review
“[A motion for] [s]ummary adjudication is properly granted when the evidence in support of the moving party establishes that there is no issue of
*1057
[material] fact to be tried as to a particular cause of action, affirmative defense, claim for damages or issue of duty. (Code Civ. Proc., § 437c, subd. (f);
Molko
v.
Holy Spirit Assn.
(1988)
Ill
Elder Abuse and Dependent Adult Civil Protection Act
The Elder Abuse and Dependent Adult Civil Protection Act (§ 15600 et seq., hereinafter the Act) provides for both criminal and private civil enforcement of elder and dependent adult abuse laws.
(Delaney
v.
Baker
(1999)
“(a) Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering^ or]
“(b) The deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.” The Act’s definition *1058 of “neglect” includes: “The negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise.” (§ 15610.57, subd. (a)(1).) The Act’s definition of “care custodian” includes members of the support staff of 24-hour health facilities as defined in Health and Safety Code sections 1250, 1250.2, and 1250.3. 5 (§ 15610.17, subd. (a).) The Act’s definition of a “dependent adult” includes “any person between the ages of 18 and 64 years who is admitted as an inpatient to a 24-hour health facility, as defined in Sections 1250, 1250.2, and 1250.3 of the Health and Safety Code.” (§ 15610.23, subd. (b).)
In 1991 the Act was amended to allow in certain circumstances awards of heightened or enhanced remedies that would not otherwise be recoverable in an ordinary private, civil action for elder or dependent adult abuse.
(ARA Living Centers—Pacific, Inc.
v.
Superior Court
(1993)
*1059 rv
Interpretation of Section 15657 and Government Code Section 818
The Matrons contend the trial court erred by concluding as a matter of law that RUC could not be found liable for section 15657’s enhanced remedies because they are precluded by Government Code section 818’s prohibition of awards of exemplary and punitive damages against public entities. As the parties note, this issue is a question of law that appears to be one of first impression in the California courts.
A
Government Code section 818 provides: “Notwithstanding any other provision of law, a public entity is not liable for damages awarded under Section 3294 of the Civil Code or other
damages imposed primarily for the sake of example and by way of punishing the
defendant.”
7
(Italics added.) “Government Code section 818 in context means that ... a plaintiff who alleges injury caused by a public entity may be entitled to actual damages for that injury, but not punitive damages. [Citations.]”
(Kizer v. County of San Mateo
(1991)
Compensatory damages are described in Civil Code section 3333: “For the breach of an obligation not arising from contract, the measure of damages, except where otherwise expressly provided by this code, is the amount [that] will compensate
for all the detriment proximately caused
thereby, whether it could have been anticipated or not.” (Italics added.) Those damages “compensate the victim
for injury suffered.
[Citation.]”
(Applied Equipment Corp.
v.
Litton Saudi Arabia Ltd.
(1994)
Although a victim ordinarily may be entitled to compensation for pain and suffering sustained from a defendant’s breach of a noncontractual obligation, that compensation generally cannot be recovered after the victim’s death because of Code of Civil Procedure section 377.34, which provides: “In an action or proceeding by a decedent’s personal representative or successor in interest on the decedent’s cause of action, the damages recoverable are limited to the loss or damage that the decedent sustained or incurred before death, including any penalties or punitive or exemplary damages that the decedent would have been entitled to recover had the decedent lived, and do *1061 not include damages for pain, suffering, or disfigurement.” (Italics added.) That statute distinguishes between a decedent’s pain and suffering damages and a decedent’s punitive or exemplary damages. Because a decedent’s representative or successor in interest may pursue a cause of action for recovery of punitive damages to which the decedent would have been entitled had the decedent lived, but may not recover damages for pain and suffering the decedent sustained before his or her death, it appears the decedent’s pain and suffering damages are distinct and different from punitive or exemplary damages.
B
We conclude the enhanced remedies available under section 15657 are
not
punitive or exemplary damages under Government Code section 818, and the trial court erred by granting RUC’s motion for summary adjudication on the Marrons’ section 15657 cause of action. Had Lidia lived despite the alleged dependent adult abuse, she would have been entitled to recover any and all pain and suffering damages in a section 15657 action against RUC.
8
(ARA Living Centers—Pacific, Inc.
v.
Superior Court, supra,
RUC argues, and the trial court concluded, that section 15657’s express exception to Code of Civil Procedure section 377.34’s general preclusion of awards of a decedent’s pain and suffering damages equates to an award of punitive or exemplary damages under Government Code section 818. However, considering the language of those statutes and the general statutory and common law regarding compensatory and punitive damages, we conclude section 15657’s enhanced remedies are
not
punitive or exemplary in nature
*1062
or “damages imposed primarily for the sake of example and by way of punishing the defendant” under Government Code section 818.
9
An award of Lidia’s pain and suffering damages that Code of Civil Procedure section 377.34 otherwise would preclude is based on, and measured by, Lidia’s
actual loss or injury.
Lidia’s alleged pain and suffering damages are part of the compensation “for all the detriment proximately caused” by RUC’s alleged reckless neglect. (Civ. Code, § 3333.) An award of Lidia’s alleged pain and suffering damages would provide the Matrons with compensation
for the injury
Lidia sustained.
(Applied Equipment Corp. v. Litton Saudi Arabia Ltd., supra,
Punitive damages are
dissimilar
to pain and suffering and other compensatory damages.
(Nakamura
v.
Superior Court, supra,
83 Cal.App.4th at pp. 835-836.) Furthermore, under Code of Civil Procedure section 377.34, a decedent’s representative or successor in interest may pursue a cause of action for recovery of punitive damages to which the decedent would have been entitled had the decedent lived, but may not recover damages for pain and suffering the decedent suffered before his or her death. The decedent’s pain and suffering damages are therefore distinct from punitive or exemplary damages. Under Government Code section 818, “a plaintiff who alleges injury caused by a public entity may be entitled to
actual damages for that injury,
but not punitive damages. [Citations.]”
(Kizer v. County of San Mateo, supra,
RUC argues that section 15657, subdivision (c)’s incorporation of the standard for holding employers liable for punitive damages under Civil Code section 3294, subdivision (b) shows section 15657’s enhanced remedies were intended to be, and are, punitive damages. Section 15657, subdivision (c) provides: “The standards set forth in subdivision (b) of Section 3294 of the Civil Code regarding the imposition of punitive damages on an employer based upon the acts of an employee shall be satisfied before any damages or attorney’s fees permitted under this section may be imposed against an employer.” Civil Code section 3294, subdivision (b) provides: “An employer shall not be liable for damages pursuant to subdivision (a) [i.e., where, by clear and convincing evidence, plaintiff shows defendant’s breach of a *1064 noncontractual obligation is done with oppression, fraud, or malice], based, upon acts of an employee of the employer, unless the employer had advance knowledge of the unfitness of the employee and employed him or her with a conscious disregard of the rights or the safety of others or authorized or ratified the wrongful conduct for which the damages are awarded or was personally guilty of oppression, fraud, or malice. With respect to a corporate employer, the advance knowledge and conscious disregard, authorization, ratification or act of oppression, fraud, or malice must be on the part of an officer, director, or managing agent of the corporation.” We are not persuaded by RUC’s argument. Section 15657, subdivision (c)’s incoiporation of Civil Code section 3294, subdivision (b)’s standard for holding an employer liable for punitive damages based on an employee’s outrageous conduct does not show section 15657’s enhanced remedies are intended to be punitive damages. Rather, incorporation of that standard is merely a simple statutory means for setting forth what actions of an employer suffice for holding that employer liable for an employee’s reckless neglect or other egregious conduct under section 15657. Section 15657, subdivision (c) incorporates a standard of conduct rather than the remedy or damages to be awarded if that conduct is found to have occurred. Because section 15657 and Civil Code section 3294 provide for different remedies, their use of a common standard for initially determining an employer’s liability is irrelevant in determining whether section 15657’s enhanced remedies are to be considered punitive damages. Furthermore, RUC’s argument does not apply to section 15657 cases that do not involve employers. The characterization of section 15657 enhanced remedies presumably should not change based on whether the defendant is an individual or an employer of that individual.
We also conclude that an award of reasonable attorney fees and costs under section 15657 cannot be considered punitive or exemplary damages under Government Code section 818. Section 15657’s authorization of awards of attorney fees and costs was intended to act as an incentive for attorneys to accept elder or dependent adult abuse cases that involve recklessness or more egregious conduct. In enacting the 1991 amendments to the Act that included section 15657, “[t]he Legislature pointed out that few civil actions were being brought in connection with elder [or dependent adult] abuse due in part to lack of incentives. It then provided some incentives [i.e., reasonable attorney fees and costs and limited pain and suffering damages].”
(ARA Living Centers—Pacific, Inc.
v.
Superior Court, supra,
18 Cal.App.4th at pp. 1564-1565.) Section 15600, subdivision (h) states: “The Legislature further finds and declares that infirm elderly persons and dependent adults are a disadvantaged class, that cases of abuse of these persons are seldom prosecuted as criminal matters, and few civil cases are brought in connection with this abuse due to problems of proof, court delays,
*1065
and the lack of incentives to prosecute these suits.” Section 15600, subdivision (j) states: “It is the further intent of the Legislature in adding [section 15657 et seq.] to this chapter to enable interested persons to engage attorneys to take up the cause of abused elderly persons and dependent adults.”
Delaney
noted: “As was stated in the Senate Rules Committee’s analysis of Senate Bill No. 679, ‘in practice, the death of the victim and the difficulty in finding an attorney to handle an abuse case where attorneys fees may not be awarded[] impedes many victims from suing successfully. [TJ] This bill would address the problem by: . . . authorizing the court to award attorney’s fees in specified cases; [and by] allowing pain and suffering damages to be awarded when a verdict of intentional and reckless abuse was handed down after the abused elder dies.’ (Sen. Rules Com., Analysis of Sen. Bill No. 679 (1991-1992 Reg. Sess.) as amended May 8, 1991, p. 3.)”
(Delaney v. Baker, supra,
Fee-shifting statutes generally are intended to enable parties to retain attorneys to represent them in certain types of cases. The goal of those statutes is “to enable private parties to obtain legal help in seeking redress for injuries resulting from the actual or threatened violation of specific . . . laws. Hence, if plaintiffs . . . find it possible to engage a lawyer based on the statutory assurance that he [or she] will be paid a ‘reasonable fee,’ the purpose behind the fee-shifting statute has been satisfied.”
(Pennsylvania v. Del. Valley Citizens’ Council
(1986)
Furthermore, awards of statutory attorney fees are usually considered an element of costs. (7 Witkin, Cal. Procedure (4th ed. 1997) Judgment, § 146, p. 661;
Santisas
v.
Goodin
(1998)
Because awards of statutory attorney fees generally are considered awards of costs and not damages, we conclude an award of reasonable attorney fees and costs under section 15657 cannot be considered an award of punitive damages (unless possibly there is no fee agreement and no fees have been paid). (Code Civ. Proc., § 1033.5, subd. (a)(10)(B);
Flannery
v.
Prentice, supra,
V
RUC’s Asserted Independent Grounds for Summary Adjudication
RUC contends there are grounds independent of Government Code section 818 on which the trial court’s grant of its motion for summary adjudication can be affirmed.
RUC argues that Lidia could not be considered a “dependent adult” under the Act because there is no evidence she suffered from a disability that precluded her from carrying out normal activities or being able to protect her rights. However, the Act’s definition of a “dependent adult” includes “any person between the ages of 18 and 64 years who is admitted as an inpatient to a 24-hour health facility, as defined in Sections 1250, 1250.2, and 1250.3 of the Health and Safety Code.” (§ 15610.23, subd. (b).) RUC argue that the *1067 Act’s other definition of a “dependent adult” in section 15610.23, subdivision (a) is a prerequisite to Lidia’s qualification as a dependent adult under the Act. Section 15610.23, subdivision (a) provides: “ ‘Dependent adult’ means any person between the ages of 18 and 64 years who resides in this state and who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, including, but not limited to, persons who have physical or developmental disabilities, or whose physical or mental abilities have diminished because of age.” Section 15610.23, subdivision (a) provides an alternative definition of a “dependent adult” and is not a prerequisite to qualification as a “dependent adult” under the definition in section 15610.23, subdivision (b).
Citing section 15657, subdivision (c), RUC argues the Matrons did not allege or submit evidence supporting an inference that it ratified the actions of its employees, which actions allegedly constituted reckless neglect in caring for Lidia. However, the Matrons’ complaint alleges RUC “failed to exercise the requisite degree of care but rather acted with recklessness in the failure to appropriately and adequately care for, monitor, and treat Lidia Matron’s declining health condition . . . .” As a public entity, RUC can act only through its employees or agents. It is implied that the acts alleged in the complaint were done by RUC’s employees or agents. Therefore, the complaint, by alleging RUC is liable under section 15657, implicitly alleges the requirements of section 15657, subdivision (c) are satisfied. To the extent the complaint should have expressly stated that allegation, any demurrer based on that deficiency should be sustained only with leave to amend the complaint. Furthermore, regarding RUC’s assertion the Matrons did not submit any evidence that it ratified the reckless neglect of its employees, the Matrons submitted evidence showing that Mary Middleton, the Hospital’s director of patient care services, had actual knowledge of understaffing complaints made by nurses caring for Lidia and apparently did not take any remedial action. 12 The Matrons also submitted excerpts from the deposition testimonies of percipient witnesses regarding the specific acts of reckless neglect allegedly committed in caring for Lidia. 13 Furthermore, the Matrons’ separate statement of disputed facts asserted that Mary Middleton, as the *1068 Hospital’s director of patient care services, was responsible for the Hospital’s nursing services and staffing and therefore was a managing agent of RUC. The Marrons submitted sufficient evidence to raise a triable issue of material fact whether a managing agent of RUC ratified the alleged reckless neglect of the Hospital’s nurses in caring for Lidia.
RUC also argues the Marrons, in opposing its motion for summary adjudication, did not submit any admissible evidence to support an inference that RUC or its employees acted with reckless neglect in caring for Lidia. Rather than arguing that the Marrons’ evidence does not show reckless neglect, RUC argues that the evidence submitted by the Marrons in opposing the summary adjudication motion lacked a proper foundation because that evidence was uncertain regarding the specific time or place of the act or the specific person who committed the act. However, our review of the Marrons’ opposition papers does not support RUC’s assertion. Many of the alleged instances of reckless neglect consisted of acts of omission, not commission, and therefore a specific time, place, or person may not necessarily be identified with the alleged omission. Furthermore, the excerpts from the deposition testimonies of percipient witnesses sufficiently described, for purposes of successfully opposing the summary adjudication motion, the specific acts and omissions constituting the alleged reckless neglect. To the extent the Marrons are required to show that RUC or its employees acted with “ a ‘conscious choice of a course of action . . . with knowledge of the serious danger to others involved’ ” (Delaney v. Baker, supra, 20 Cal.4th at pp. 31-32) as RUC asserts, the Marrons’ opposing papers therefore included sufficient admissible evidence to support an inference that there was reckless neglect in caring for Lidia. Although at trial the trial court may exclude evidence that is irrelevant or does not have a proper foundation, RUC has not shown that all of the Marrons’ evidence submitted in opposition to the summary adjudication motion is inadmissible or insufficient to show reckless neglect.
Disposition
Let a writ of mandate issue directing the superior court to vacate its order of October 25, 2002, granting RUC’s motion for summary adjudication of the dependent adult abuse cause of action and to enter a new order denying *1069 the motion. Costs are awarded to the prevailing party. The stay issued by this court on January 16, 2003, is vacated.
Nares, Acting P. J., and McIntyre, J., concurred.
A petition for a rehearing was denied June 13, 2003.
Notes
All further statutory references are to the Welfare and Institutions Code unless otherwise specified.
The factual summary in this opinion is based on the allegations in the Matrons’ complaint and the parties’ separate statements of material facts.
RUC alternatively asserted: (1) there was no evidence it acted with recklessness, oppression, fraud or malice as required under section 15657; (2) there was no evidence or allegation that a managing agent of RUC ratified the alleged misconduct; and (3) Lidia did not qualify as a dependent adult under the dependent adult abuse law.
The trial court did not address the alternative grounds RUC asserted for summary adjudication.
RUC does not dispute that the Hospital is a 24-hour health facility as defined in Health and Safety Code sections 1250, 1250.2, and 1250.3.
Civil Code section 3333.2, subdivision (b) provides: “In no action shall the amount of damages for noneconomic losses exceed two hundred fifty thousand dollars ($250,000).”
Civil Code section 3294, subdivision (a) provides: “In an action for the breach of an obligation not arising from contract, where it is proven by clear and convincing evidence that the defendant has been guilty of oppression, fraud, or malice, the plaintiff, in addition to the actual damages, may recover damages for the sake of example and by way of punishing the defendant.”
Code of Civil Procedure section 377.34’s general preclusion of an award of pain and suffering damages does not apply unless the victim has died.
DuBois v. Workers’ Comp. Appeals Bd.
(1993)
In
Matter of Guardianship/Conservatorship of Denton, supra,
RUC argues section 15657’s pain and suffering damages must be considered punitive damages because a decedent cannot be made whole or be compensated for pain and suffering sustained before his or her death. However, the crucial issue is whether those damages are for a loss or injury suffered by the decedent, not whether a decedent can be compensated for that loss or injury after his or her death. Therefore, section 15657’s limited revival of a decedent’s pain and suffering damages, as an express exception to the survival statute (i.e., Code Civ. Proc., § 377.34), is not intended to punish a defendant and does not provide for punitive or exemplary damages under Government Code section 818. Section 15657 does not cause a public entity or other defendant to pay damages in excess of lawful compensation.
The nurses’ complaints alleged they were given assignments that “posed a potential threat to the health and safety of [their] patients” and staffing was insufficient to “meet the individual patient care needs/requirements of [their] patients.”
Those excerpts were submitted in support of the Marrons’ separate statement of disputed facts, which stated: “1. On many occasions Lidia had feces or other soiling in her bed and the nurses would take hours to clean it after having notice of the problem, often resulting in a family member changing the sheets. [H] 2. On many occasions, the nurses would not bathe Lidia Marrón despite her being soiled with blood or feces and despite the nurses having knowledge of this condition, [f] 3. Lidia Marrón had fungus growing in her mouth and the nurses were not brushing her teeth or otherwise keeping her mouth clean. flj] 4. Lidia was not being assisted to the bathroom by the nurses despite her incontinent condition, resulting in her *1068 having to lie in soiled sheets. [f[. . . [1|] 7. During one protracted hemorrhaging incident, the nurses would not assist in putting pressure on the wound or sopping up the blood, thus requiring the family members who were present to attempt to control the bleeding on their own. fl)] 8. On some occasions, Lidia’s blood sugar would [be] too low and the nurses would not assist, requiring the family members to attend to this medical problem.”
