Opinion
This is an appeal by plaintiff Donna Sue Tresemer from the grant of summary judgment in favor of defendant Morton Barke, M.D. The action, filed on April 12, 1976, is for damages allegedly sustained by plaintiff from a Daikon Shield intrauterine device. Plaintiff’s third amended complaint charges Dr. Barke, who inserted the device in August 1972, with willful misconduct (count one) and medical malpractice (count two). Mario De Lara, M.D., who attempted to remove the device on April 17, 1975, 1 is charged with willful misconduct (count three) and medical negligence (count four), and A. H. Robbins Company is charged with the manufacture and distribution of harmful contraceptive intrauterine devices (count five).
After demurrers had been sustained to three separate complaints, Dr. Barke (hereinafter defendant) responded to the third amended complaint by a demurrer and motion to strike along with a motion for summary judgment. Plaintiff filed no written opposition to the motions. The motion to strike and demurrer were placed off calendar and the motion for summary judgment was granted, predicated on the grounds that the statute of limitations (Code Civ. Proa, §§ 340.5 and 340, subd. 3) barred the action, the action was without merit, and plaintiff had presented no triable issue of fact. We conclude defendant’s moving papers do not show that plaintiff’s action is barred by time limitations and do not rebut all elements of defendant’s liability.
Inasmuch as this case reaches us on appeal from a summary judgment in favor of defendant, we need only determine whether there is a reasonable
possibility
that plaintiff may be able to establish its case. vVhen the moving party is the defendant, he must conclusively negate a necessary element of plaintiff’s case or establish a complete defense, and
*662
thereby demonstrate that under no hypothesis is there a material factual issue which requires the process of a trial.
(Frazier, Dame, Doherty, Parrish & Hanawalt
v.
Boccardo, Blum, Lull, Niland, Teerlink & Bell
(1977)
“The summary judgment procedure is drastic and should be used with caution so that it does not become a substitute for an open trial. . . . ‘Summary judgment is proper only if the affidavits in support of the moving party would be sufficient to sustain a judgment in his favor . . . and doubts as to the propriety of granting the motion should be resolved in favor of the party opposing the motion.’ [Citations.] A defendant who moves for summary judgment must prevail on the basis of his own affidavits and admissions made by the plaintiff, and unless the defendant’s showing is sufficient, there is no burden on the plaintiff to file
*663
affidavits showing he has a cause of action or to file counteraffidavits at all. A summary judgment for defendant has been held improper where his affidavits were conclusionaiy and did not show that he was entitled to judgment and where the plaintiff did not file any counteraffidavits. [Citations.]”
(Rowland v. Christian
(1968)
In the instant case, plaintiff filed no opposition to defendant’s motion for summary judgment, and made no formal request that the trial court take judicial notice of any document, declaration or affidavit. However, defendant’s moving papers are insufficient to establish his defense that plaintiff’s causes of action against him were barred by the applicable statutes of limitations. (Cf.
Butcher
v.
Okmar Oil Co.
(1977)
Although generally a personal injury claim accrues and the period of limitations commences when the wrongful act takes place, an exception is presented when the pathological effect occurs without perceptible trauma and the victim is “blamelessly ignorant” of the cause of injury. In such case the statute of limitations does not begin to run until the person knows or, by the exercise of reasonable diligence, should have discovered the cause of injury.
(G. D. Searle & Co.
v.
Superior Court
(1975)
Medical negligence claims are governed by Code of Civil Procedure section 340.5. Before the advent of section 340.5 in 1970, such malpractice actions were also governed by Code of Civil Procedure section 340, subdivision 3,
supra,
and judicial decisions had firmly established the principle that the one-year limitations period commences to run when the plaintiff discovers the injury and its negligent cause, or through the exercise of reasonable diligence should have discovered it.
(Larcher
v.
Wanless
(1976)
In 1975 section 340.5
2
was amended. The amended section was in effect
*664
when the present suit was filed and is controlling as to the causes of action alleging medical negligence. The Legislature retained the one-year “discovery” limitations period in the 1975 version of section 340.5, reduced the four-year maximum limitation to three years and provided that ■“ ‘[i]n no event shall the time for commencement of legal action
exceed three years
....’” unless affected by one of its three specific tolling provisions. (Italics in original.
Sanchez
v.
South Hoover Hospital
(1976)
Lest it appear that it is the same event which causes both the one-year and three-year limitation periods to begin, we reiterate that the one-year period commences not merely upon discovery of the harm caused by the alleged wrongful act, but requires also “discovery of the malpractice.”
(Martinez
v.
County of Los Angeles
(1978)
Inasmuch as one of the grounds upon which the summary judgment herein was granted was that the action was “barred by the Statute of Limitations as set forth in Sections 340(3) and 340.5 of the Code of Civil Procedure . . . ,” the court apparently mistakenly reasoned that the
*665
relevant date which set the limitations periods in motion is August 1972, the date when defendant inserted the Daikon shield. However, in
Larcher
the Supreme Court differentiated between the “injury” and the “alleged wrongful act.” It stated that the word “injury,” as used in the
1970
version of section 340.5 to denote the start of the four-year limitation period, was a “word of art” which clearly referred to the “damaging effect” of the “alleged wrongful act” and not to the act itself.
{Id.,
at pp. 655-656, and fn. 11 on p. 656.) Likewise, in the 1975 amended version of section 340.5, it is the “injury” which sets in motion the three-year limitation period. “For our purposes here, the key holding of both
Sanchez
and
Larcher
is that ‘injury’ is not synonymous with ‘wrongful act.’ ”
(Bispo
v.
Burton
(1978)
At bench, plaintiff’s third amended complaint alleges that not until May 5, 1975, the date on which she consulted Dr. Michael Fahey, did she discover the cause of her injury. She further alleges facts to show that her failure to make an earlier discovery was reasonable and not through lack of due diligence in investigating or taking action. Such allegations are sufficient to satisfy the pleading requirements and raise the issue of belated discovery.
(Sanchez, supra,
pp. 106-107;
Dujardin
v.
Ventura County Gen. Hosp.
(1977)
Moreover, plaintiff’s action is likewise not barred by those sections merely because defendant’s affidavit and documentation in support of his motion for summary judgment show that he had seen plaintiff on only the one occasion in 1972 when he had inserted the Daikon Shield. Although plaintiff’s failure to file counteraffidavits admits the truth of defendant’s declaration
(Sanchez
v.
South Hoover Hospital, supra,
at p. 107;
Brewer
v.
Reliable Automotive Co.
(1966)
A defendant moving for summary judgment who cannot establish a complete defense has the burden of establishing that the plaintiff’s causes of action against him have no merit. He must make a factual showing negating the existence of all such causes of action on all theories embodied in the complaint. If he fails in that burden, summary judgment must be denied despite the lack of opposing declarations.
(Kelleher
v.
Empresa Hondurena de Vapores, S.A.
(1976)
“Applicable substantive law determines the facts necessaiy to support a particular theory of relief and hence the sufficiency of properly framed *667 factual statements in declarations to support a summary judgment.” {Ibid.)
The foundation of all liability for a person’s willful and negligent acts is Civil Code section 1714 which declares: “Everyone is responsible, not only for the result of his willful acts, but also for an injury occasioned to another by his want of ordinary care or skill in the management of his property or person, except so far as the latter has, willfully or by want of ordinary care, brought the injury upon himself. . .
Plaintiff alleges that: (1) defendant prescribed and inserted a Daikon Shield for temporary contraceptive purposes without proper investigation to determine its safety and (2) defendant failed to warn her that such Daikon Shield was a health hazard when he subsequently acquired actual knowledge of the danger. Charging willful misconduct in count one, plaintiff prayed for compensatory damages and exemplary damages on the ground that defendant was “guilty of oppression, fraud and malice . . charging negligent malpractice in count two, plaintiff prayed for compensatory damages only.
Defendant’s moving papers were sufficient to negate any charge that his conduct was either willfully or negligently wrongful when in 1972 he inserted the intrauterine device. He declared in his affidavit that “In August, 1972, the Daikon Shield was one of the most popular and acceptable intrauterine devices on the market. At the time it was lauded and believed to be one of the more safer [sic] and effective intrauterine devices available. It was not until approximately two years later that serious question as to its general safety was first raised and acknowledged in the general medical community; shortly thereafter it was withdrawn from the market.”
Defendant’s attorney in his affidavit stated that he had been involved in numerous cases involving the Daikon Shield and asserted, “I can certify to the court that it was not until some time in the middle of 1974 that the Daikon Shield fell into question and shortly thereafter withdrawn from the market.” Defendant in his affidavit further declared that the device had been inserted “without incident,” and that he thereafter provided plaintiff with a copy of the manufacturer’s “package insert” which described the Daikon Shield and potential problems and complications. His affidavit also set forth his credentials in obstetrics and gynecology and declared that his conduct was within the standard of practice in the community.
*668
“[I]t is settled that an opponent’s failure to file counteraffidavits admits the truth of the movant’s affidavit. [Citation.]”
(Sanchez
v.
South Hoover Hospital, supra,
18 Cal.Sd 93, 107.) Although under well established rules governing summary judgment motions, the affidavits of the moving party are to be strictly construed, and those of the opponent liberally construed, nevertheless, the party opposing a motion for summary judgment which is supported by affidavits or declarations sufficient to sustain the motion (or partial grant of the motion) has the burden of showing that triable issues of fact exist. “The purpose of the summary procedure is to penetrate through evasive language and adept pleading and ascertain the existence or absence of triable issues.”
(Chern
v.
Bank of America
(1976)
Moreover, defendant’s declaration in his affidavit that “I had no reason to and in fact did not bear any malice, reckless disregard or desire to harm Ms. Tresemer,” was sufficient to negate any charge of malice, in the absence of counteraffidavits. The substantive law applicable to a claim for exemplary damages is contained in Civil Code section 3294 which provides that “In an action for the breach of an obligation not arising from contract, where the defendant has been guilty of oppression, fraud, or malice, express or implied, the plaintiff, in addition to the actual damages, may recover damages for the sake of example and by way of punishing the defendant.” “The cases interpreting section 3294 make it clear that in order to warrant the allowance of punitive damages the act complained of must not only be wilful in the sense of intentional, but it must also be accompanied by aggravating circumstances, amounting to malice. The malice required implies an act conceived in a spirit of mischief or with criminal indifference towards the obligations owed to others. There must be an intent to vex, annoy or injure. Mere spite or ill will is not sufficient; and mere negligence, even gross negligence is not sufficient to justify an award of punitive damages. [Citations.]” (Italics omitted;
Ebaugh
v.
Rabkin
(1972)
We turn now to plaintiff’s theory of recovery, based on the proposition that defendant had a duty to warn her of the dangerous effects of the Daikon Shield when, subsequent to its insertion, he obtained actual knowledge of its hazards, and that his failure to do so amounted to negligence or willful, wanton and reckless disregard for the consequences. We note primarily that if there is such duty to warn, defendant’s conclusory declaration in his affidavit that “at all times pertinent my conduct was within the standard of practice in this community,” unsupported by further factual averments, is not sufficient to negate the allegation that such duty was breached.
(Colby
v.
Schwartz
(1978)
If there was here no duty to warn plaintiff, then defendant was “free to act [or fail to act] in careless disregard of [her] life and safety.”
(Tarasoff
v.
Regents of University of California
(1976)
“. . . As stated in
Dillon
v.
Legg
(1968)
A court’s conclusion that defendant owes plaintiff a duty of care is “[only an] ‘expression of the sum total of those considerations of policy which lead the law to say that the particular plaintiff is entitled to protection.’ (Prosser, Law of Torts (4th ed. 1971) pp. 325-326.) Any number of considerations may justify the imposition of duty in particular circumstances, including the guidance of history, our continually refined concepts of morals and justice, the convenience of the rule, and social judgment as to where the loss should fall. (Prosser,
Palsgraf Revisited
(1953) 52 Mich.L.Rev. 1, 15.) While the question whether one owes a duty to another must be decided on a case-by-case basis, every case is governed by the rule of general application that all persons are required to use ordinary care to prevent others from being injured as the result of their conduct.
(Hilyar
v.
Union Ice Co.
(1955)
It has been held in numerous cases that the duty of adequate warning by the manufacturer of an ethical drug (available only upon prescription) is discharged by its warning of hazards to doctors.
(Fogo
v.
Cutter Laboratories Inc.
(1977)
Prosser noted that “[i]n the determination of the existence of a duty, there runs through much of the law a distinction between action and inaction. In the early common law one who injured another by a positive, affirmative act, was held liable without any great regard even for his fault. But the courts were far too much occupied with the more flagrant forms *672 of misbehavior to be greatly concerned with one who merely did nothing, even though another might suffer harm because of his omission to act..... [H] Liability for nonfeasance was therefore slow to receive recognition in the law.” (Law of Torts, § 56, pp. 338-339.)
In discussing the duty to aid a person in peril, Prosser further noted at page 342 that “[w]here the original danger is created by innocent conduct, involving no fault on the part of the defendant, it was formerly the rule that no [duty to maké a reasonable effort to give assistance and avoid any further harm] arose; but this appears to have given way, in recent decisions, to a recognition of the duty to take action, both where the prior innocent conduct has created an unreasonable risk of harm to the plaintiff, and where it has already injured him. . . . This process of extension has been slow, and marked with extreme caution; but there is reason to think that it may continue until it approaches a general holding that the mere knowledge of serious peril, threatening death or great bodily harm to another, which an identified defendant might avoid with little inconvenience, creates a sufficient relation, recognized by every moral and social standard, to impose a duty of action. [1] Where the duty is recognized, it is agreed that it calls for nothing more than reasonable care under the circumstances.” (Italics added.)
A cay.se of action is stated for failure to warn plaintiff. This would arise by virtue of a confidential relationship between doctor and patient. It is not a malpractice cause of action in the commonly understood sense but rather a malpractice action from the imposed continuing status of physician-patient where the danger arose from that relationship. It is also a cause of action for common negligence. The statute of limitations of section 340.5 would not apply even though the basic “injury” resulted from a medical treatment for it is a separate duty to act which is involved. Certainly the use of summary judgment is inappropriate under such circumstance. It is our conclusion that not only has a cause of action been stated, but that triable issues of fact remain, despite defendant’s declarations.
The judgment is reversed.
Ashby, J., and Hastings, J., concurred.
A petition for a rehearing was denied December 12, 1978, and respondent’s petition for a hearing by the Supreme Court was denied January 17, 1979. Clark, J., was of the opinion that the petition should be granted.
Notes
Dr. De Lara provided this date in his affidavit in support of his separate motion for summary judgment which appears as part of our record on appeal.
Code of Civil Procedure section 340.5 provides as follows: “In an action for injury or death against a health care provider based upon such person’s alleged professional negligence, the time for the commencement of action shall be three years after the date of *664 injury or one year after the plaintiff discovers, or through the use of reasonable diligence should have discovered, the injury, whichever occurs first. In no event shall the time for commencement of legal action exceed three years unless tolled for any of the following: (1) upon proof of fraud, (2) intentional concealment, or (3) the presence of a foreign body, which has no therapeutic or diagnostic purpose or effect, in the person of the injured person. [H] Actions by a minor shall be commenced within three years from the date of the alleged wrongful act except that actions by a minor under the full age of six years shall be commenced within three years or prior to his eighth birthday whichever provides a longer period. Such time limitation shall be tolled for minors for any period during which parent or guardian and defendant’s insurer or health care provider have committed fraud or collusion in the failure to bring an action on behalf of the injured minor for professional negligence. [H] For the purposes of this section: [II] (1) ‘Health care provider’ means any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or licensed pursuant to the Osteopathic Initiative Act, or the Chiropractic Initiative Act, or licensed pursuant to Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code, and any clinic, health dispensary, or health facility, licensed pursuant to Division 2 (commencing with Section 1200) of the Health and Safety Code. ‘Health care provider’ includes the legal representatives of a health care provider; [H] (2) ‘Professional negligence’ means a negligent act or omission to act by a health care provider in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death, provided that such services are within the scope of services for which the provider is licensed and which are not within any restriction imposed by the licensing agency or licensed hospital.” (Added by Stats. 1970, ch. 360, § 1, p. 772, Amended by Stats. 1975, Second Ex. Sess., ch. 1, § 25, p. 3969; Stats. 1975, Second Ex. Sess., ch. 2, § 1.192, p. 3991, urgency, eff. Sept. 26, 1975, operative Dec. 12, 1975.)
The tolling provisions apply only to the three-year limitation period of Code of Civil Procedure section 340.5.
(Sanchez, supra,
at pp. 99-100;
Gray
v.
Reeves
(1977)
“California has recognized various degrees of negligence which invoke various legal consequences but as was stated in
Donnelly
v.
Southern Pacific Co.,
