Yun Hee So v. Sook Ja Shin
212 Cal. App. 4th 652, 151 Cal. Rptr. 3d 257, 2013 WL 28785 (2013)
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Rule of Law:
A health care provider's tortious conduct undertaken for personal benefit, rather than for the purpose of delivering professional medical services, does not constitute 'professional negligence' under Code of Civil Procedure section 340.5. Whether a patient consented to post-procedural interactions and whether a provider's conduct is 'extreme and outrageous' are typically factual questions that cannot be decided on demurrer if sufficiently pleaded.
Facts:
- On September 30, 2008, Yun Hee So was admitted to Hollywood Presbyterian Medical Center for a dilation and curettage (D&C) procedure following a miscarriage.
- During the D&C, anesthesiologist Dr. Sook Ja Shin administered insufficient anesthesia, causing So to awaken and experience pain and discomfort.
- After the procedure, in the recovery room, So asked Dr. Shin why she had awakened, causing Dr. Shin to become visibly upset and raise her voice.
- Dr. Shin then left the room and returned with a container filled with So's blood and tissue (including potential fetal remains).
- Dr. Shin gestured menacingly with the container, bringing it within inches of So's face and motioned as if to drop it in her lap, stating that So could see it was 'only blood' and therefore could not have experienced pain.
- So nearly fainted, screamed at Dr. Shin to get away, and realized the container held parts of her dead baby.
- Dr. Shin, realizing her anger, approached So, touched her hands, arms, and shoulders, and later returned to ask So to keep the incident quiet and not report it to the hospital, offering to buy her dinner or refund the anesthesia cost.
- At the time, Dr. Shin was facing potential termination by her medical group or the hospital and feared So's report.
Procedural Posture:
- On August 11, 2010, Yun Hee So (plaintiff) filed an initial action.
- On January 6, 2011, plaintiff filed the operative first amended complaint against Dr. Sook Ja Shin, HP Anesthesia Medical Group, and Hollywood Presbyterian Medical Center, asserting causes of action for negligence, intentional infliction of emotional distress, and assault and battery.
- Dr. Shin, the hospital, and the medical group demurred to the second (intentional infliction of emotional distress) and third (assault and battery) causes of action.
- The trial court (court of first instance) sustained the demurrers to the second and third causes of action, finding insufficient allegations of outrageous conduct, unconsented touching, and vicarious liability.
- On April 15, 2011, the hospital and Dr. Shin moved for judgment on the pleadings regarding the first cause of action (negligence), which the medical group joined.
- The trial court granted the motions for judgment on the pleadings, concluding the alleged acts occurred "in the rendering of professional services" and were time-barred under Code of Civil Procedure section 340.5 (one-year statute of limitations for professional negligence).
- On June 1, 2011, the trial court entered judgment for Dr. Shin, the hospital, and the medical group.
- On June 13, 2011, the trial court entered a subsequent judgment for Dr. Shin.
- Plaintiff timely appealed from the judgment to the California Court of Appeal.
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Issue:
1. Does conduct by a health care provider, allegedly for the provider's personal benefit (e.g., to prevent a negative report) rather than for a legitimate medical purpose, constitute 'professional negligence' subject to the one-year statute of limitations under Code of Civil Procedure section 340.5? 2. Can a plaintiff adequately plead assault and battery against a health care provider if the alleged offensive contact occurs post-procedure and is not consented to, even if the patient consented to the initial medical procedure? 3. Do allegations of a health care provider's aggressive and intimidating behavior towards a vulnerable patient in a recovery room, involving graphic medical materials and attempts to silence the patient, sufficiently plead 'extreme and outrageous conduct' for a claim of intentional infliction of emotional distress? 4. Is a hospital's alleged direct negligence in hiring and retaining an unfit doctor, and failing to safeguard an incapacitated patient, considered 'professional negligence' under Code of Civil Procedure section 340.5?
Opinions:
Majority - Suzukawa, J.
No, conduct by a health care provider undertaken for the provider's personal benefit, rather than for the purpose of delivering health care, does not constitute 'professional negligence' subject to the one-year statute of limitations under Code of Civil Procedure section 340.5. The court reasoned that 'professional negligence' requires the negligent act to occur 'in the rendering of professional services,' meaning it must be directly related to and an ordinary part of medical services, provided by the health care provider acting in its capacity as such. The plaintiff alleged Dr. Shin's actions were intended to persuade So not to report the incident, thus acting for Dr. Shin's own benefit and not for the patient's medical care. Citing Atienza v. Taub, the court distinguished misconduct not aimed at treatment from professional negligence. Therefore, the negligence claim against Dr. Shin and the vicarious liability claim against the medical group and hospital were not time-barred by section 340.5's one-year limit for professional negligence, and the two-year ordinary negligence statute of limitations applied, making the August 2010 filing timely. Yes, a hospital's alleged direct negligence in hiring and retaining an unfit doctor, and failing to safeguard an incapacitated patient, is considered 'professional negligence' under Code of Civil Procedure section 340.5. The court reasoned that competent selection and review of medical staff, and providing inpatient care with reasonable diligence in safeguarding patients, are professional services for which a hospital is licensed. Therefore, plaintiff's direct negligence claim against the hospital was properly dismissed as time-barred under the one-year professional negligence statute of limitations. No, a plaintiff can adequately plead assault and battery if the alleged offensive contact occurs post-procedure and is not consented to, even if initial consent was given for the medical procedure. The court explained that while consent to surgery includes postoperative care, not all postoperative contact constitutes care. The complaint alleged Dr. Shin interacted with So to defend her competence and prevent a report, not to provide medical care, and that So expressly told Dr. Shin to get away from her. Citing Kaplan v. Mamelak, the court held that whether alleged conduct was within the scope of a patient's consent is a factual question, not suitable for decision on demurrer. No, allegations of a health care provider's aggressive and intimidating behavior towards a vulnerable patient in a recovery room, involving graphic medical materials and attempts to silence the patient, are sufficient to plead 'extreme and outrageous conduct' for a claim of intentional infliction of emotional distress. The court stated that there is no bright-line standard for 'outrageous conduct,' making it usually a question of fact. Analogizing to Bundren v. Superior Court, where a hospital's debt collection practices towards a vulnerable patient were found potentially outrageous, the court concluded that a reasonable juror could find Dr. Shin's actions (forcing a recently miscarried patient to view fetal remains, while angry and attempting to silence her) to be extreme and outrageous, especially given So's vulnerable state in the recovery room.
Analysis:
This case clarifies the distinction between "professional negligence" (governed by the shorter MICRA statute of limitations) and ordinary negligence or intentional torts in the medical context. It emphasizes that conduct, even by a medical professional during a patient interaction, is only professional negligence if undertaken for the purpose of delivering medical care. Actions for a doctor's personal benefit, or those that are clearly outside the scope of consented medical treatment, are treated differently. This decision protects patients from having intentional tort claims or non-medical negligence claims summarily dismissed under the strict medical malpractice statute of limitations, potentially increasing the types of actionable claims against healthcare providers in California.
