Woodland Hills personal injury attorney Barry P. Goldberg is asked this question with great frequency— what happens when you are injured at a health care facility? It is not uncommon for patients to fall while at the hospital for unrelated ailments. The injuries can be extremely serious and life threatening particularly if the patient is already suffering from another ailment.
The medical facilities always contend that the alleged injury is subject to MICRA protections, including the shortened statute of limitations applicable to medical professionals. Being subject to MICRA has other detrimental qualities, including limited damages and reduced attorney fees. The question usually boils down to whether everything done at a medical facility is related to the delivery of professional medical care.
An example of some of the problems encountered in these cases is highlighted by the recent case of Johnson v. Open Door Community Health Centers (September 11, 2017). In that case, Ms. Johnson tripped of a scale that was blocking the exit pathway after she had concluded her examination at the facility. She suffered very serious injuries. She filed suit more than one year after the accident. The trial court granted a motion for summary judgment on the ground that the Medical Injury Compensation Reform Act’s (MICRA) (Code Civ. Proc., § 340.5) one-year statute of limitations for professional negligence blocked the suit. The court applied the standard set forth in Flores v. Presbyterian Intercommunity Hosp. (2016) 63 Cal.4th 75 (Flores).
Ms. Johnson appealed and disputed that alleged negligence occurred in the rendering of professional services she was not injured in the course of obtaining medical treatment, by equipment used to diagnose and treat medical conditions.
Code of Civil Procedure section 340.5 governs actions against health care providers for professional negligence, allowing only one year from the earlier of the date a plaintiff discovered or reasonably should have discovered his injury, or three years from the injury, to file suit. It defines “‘[p]rofessional negligence’ ” as “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.” (Code Civ. Proc., § 340.5 (2).)
As admitted by our Supreme Court in Flores, the precise boundary between the duties owed by a healthcare provider to the general public and those it owes to its patients, i.e., whether negligence occurs in the course of “ ‘rendering. . . professional services,’ ” can be difficult to ascertain. In Flores, after assessing plaintiff’s condition, the plaintiff’s doctor ordered the rails on her hospital bed raised. (Id. at 79.) When plaintiff attempted to exit her bed, one of the rails collapsed, causing her to fall and be injured. (Id.) The Supreme Court considered whether alleged negligence “in the use or maintenance of hospital equipment or premises qualifies as professional negligence” subject to section 340.5. (Id. at 84.)
The Supreme Court concluded that, for the purposes of MICRA, “professional services” are not limited to those activities requiring the application of medical skill and training. (Id. at 84.) Injury-causing conduct that requires no special skill may nonetheless occur in the rendering of professional services, for example, when a janitor accidentally bumps a patient’s ventilator; a hospital employee accidentally serves a patient food that is not part of the patient’s medically-prescribed diet; or hospital staff fails to adequately secure a violently coughing patient awaiting a diagnosis. (Id. 85-86.) Though sweeping the floor, serving food, or strapping a gurney do not require medical training, they may nonetheless affect the quality of a patient’s medical care. Thus, the court declined to adopt a narrow rule limiting “professional services” to only those tasks requiring medical skill and training. (Id. 85.)
On the other hand, negligence in performing the duties that hospitals owe to all users—including personnel and visitors—simply by virtue of operating a facility that is open to the public” are not included in MICRA. (Flores at p. 86, emphasis added.) The Supreme Court rejected the notion that MICRA’s one-year statute of limitations should “apply to a visitor’s action for injuries resulting from a custodian’s negligence in leaving a broom on a hallway floor, or a doctor’s action against the hospital for failure to place a warning sign on a wet, recently mopped floor.” (Id.) Otherwise, contrary to the intent of the Legislature, section 340.5 would become “an all-purpose rule covering essentially every form of ordinary negligence that happens to occur on hospital property.” (Id.)
As stated in Johnson:
The Supreme Court counsels us to “draw a distinction between the professional obligations of hospitals in the rendering of medical care to their patients and the obligations hospitals have, simply by virtue of operating facilities open to the public, to maintain their premises in a manner that preserves the well-being and safety of all users.” (Flores, supra, 63 Cal.4th at p. 87.) Were a chair in a hospital waiting room to collapse, the resulting claim would be subject to the two-year statute of limitations, not section 340.5’s shorter statute, because “the hospital’s duty with respect to that chair is no different from that of any other home or business with chairs in which visitors may sit.” (Id. at p. 89.) By contrast, the plaintiff in Flores was injured due to the breach of a duty owed only to patients: As she conceded, hospital staff failed to competently carry out her doctor’s order to raise the rails on her bed. Flores, supra, 63 Cal.4th at p. 89.) The hospital’s negligent use or maintenance of the rails was “integrally related to her medical diagnosis and treatment.” (Ibid.) [“When a doctor or other health care professional makes a judgment to order that a hospital bed’s rails be raised in order to accommodate a patient’s physical condition and the patient is injured as a result of the negligent use or maintenance of the rails, the negligence occurs ‘in the rendering of professional services’. . .”].)
In reversing the summary judgment, the Court of Appeal pointed out that unlike the plaintiff in Flores, who was injured during the provision of medical care, through the breach of a duty owed only to patients, Johnson was injured after her care was completed, allegedly as a result of a breach of duties owed generally to all visitors to the Open Door clinic. Although she tripped on medical equipment coincidentally used as part of her earlier medical treatment, she does not allege that Open Door’s failure to properly maintain the scale affected the quality of her medical treatment. She was weighed without incident. Had she alleged the improper placement of the scale caused her to fall off the scale and injure herself, MICRA might apply. Had she alleged that Open Door’s failure to properly calibrate the scale resulted in inaccurate information and inappropriate medical care, any resulting claim would almost certainly be subject to MICRA. However, she alleges that Open Door’s placement of the scale posed a tripping hazard, implicating Open Door’s duty to all users of its facility, including patients, employees, and other invitees, to maintain safe premises. (Flores at 87-88.)
If you or a loved one was injured at a medical facility, it is very important to document the injury immediately and consult with an experienced personal injury trial attorney. The medical facilities will invariably attempt to tie the accident to the delivery of medical care. However, if it was an accident that could have happened to any user of the facility, a regular negligence action is probably available outside of MICRA restrictions.