California Supreme Court Chief Justice Patricia Guerrero
SAN FRANCISCO - The California Supreme Court says lower courts were wrong to find a state law gave greater protections from lawsuits to ambulance operators involved in “run of the mill” traffic crashes.
Chief Justice Patricia Guerrero wrote the unanimous opinion, filed July 31, overturning a lower court's decision.
The ruling resolves a Medical Injury Compensation Reform Act question that began under Santa Clara County Superior Court Judge Christopher Rudy and proceeded to the California Sixth District Appellate Court.
According to Guerrero, the underlying incident was a January 2018 incident in which a truck driven by Francisco Gutierrez on a state highway was struck from behind by a ProTransport-1 ambulance driven by Uriel Tostado, an emergency medical technician.
According to court records, a second EMT was attending to the patient being transported between hospitals.
Gutierrez sued in January 2020 to seek compensation for neck and back injuries and property damage. In arguing for summary judgment, the defendants contended MICRA lawsuits must be filed within one year of the incident. But Gutierrez insisted his complaint was a general negligence lawsuit, giving him two years to sue. Judge Rudy ruled against Gutierrez, finding Tostado was a licensed health career provider rendering professional medical services, meaning the one-year MICRA limit applied.
After a split Sixth District panel affirmed the summary judgment ruling, Guerrero appealed to the state’s top court. There, the unanimous ruling aligned with the appellate dissent’s position that MICRA, enacted in the mid-1970s, wasn’t intended to cover what amounted to a “run-of-the-mill traffic accident.”
A key phrase in MICRA, according to Guerrero, is “professional negligence,” which she said the court had already examined in its 2016 opinion, Flores v. Presbyterian Intercommunity Hospital, regarding a patient injured in a fall from a hospital bed. In that case, the court held “professional services” can include acts that don’t require special skills provide they fall within the context of rendering medical care, while also noting that understanding shouldn’t cover “any services performed by a health care provider within the scope of licensure, observing that this interpretation would collapse” a definition of professional negligence.
The 2016 court delineated between medical services provided to patients and the operating of a facility open to the public, using the example of a visitor injured when stepping on a broom left on a hallway floor or slipping on a wet floor where no warning sign was present. As such, a vital concern in discussing cases involving MICRA protections is “the nature of the relationship between the equipment or premises in question and the provision of medical care to the plaintiff.”
Although Flores didn’t examine the context of a plaintiff who wasn’t a patient of a defending medical provider, Guerrero wrote, other earlier cases “strongly suggest that there must be a nexus between the provision of medical care and the resulting injury.”
To address potential ambiguity, the court analyzed the purpose and legislative intent of MICRA, including and beyond that discussed in Flores, noting “the manifest purpose of the legislation was to reduce costs associated with medical malpractice,” and branding that goal as one of “specific aims and accordingly limited reach.”
Guerreo reasoned, “the fundamental question is whether the plaintiff’s claim for negligence involves a violation of professional obligations, as opposed to the breach of a duty owed to the public generally.”
With that framework, the court ruled Gutierrez’s complaint is not subject to MICRA’s limitations. He alleged no negligence with respect to diagnosis or treatment, just that “defendants were negligent in their failure to obey traffic laws applicable to all drivers on the road,” Gurrero wrote, not unlike a Flores example of a collapsing waiting room chair.
“Even if we assume the patient in this case was receiving medical services during the ambulance transport, there are no allegations suggesting that professional negligence in rendering those services was the proximate cause of plaintiff’s injuries,” Guerrero wrote.
Although the appellate majority expressed concern about the potential for two plaintiffs involved in the same vehicle collision to be subject to different statutory limitations, the Supreme Court agreed with the dissent and said such an outcome “is neither unworkable nor inherently unfair. A more obvious unfairness would result from defendants’ proposed rule; that is, health care provider defendants would be afforded greater protection against an array of lawsuits than other types of defendants merely due to their identity as health care providers.”
Guerrero noted concerns about plaintiffs artfully pleading claims to avoid limitations and said courts would retain the ability to make decisions based on the substance of complaints, “not the terminology the plaintiff chooses to employ.”
The court remanded the complaint to the appellate court for further proceedings. It also rejected the holdings in two earlier cases, Canister v. Emergency Ambulance Service, a 2008 Fourth District Appellate Court ruling, and the 2023 Fifth District decision Lopez v. American Medical Response. The former involved a police officer injured while riding in an ambulance with a patient, the latter involved a son injured while his father, the patient, was being transported.
Gutierrez is represented by Southwest Legal Group, the Ehrlich Law Firm and the Law Offices of Clinton Ehrlich.
Consumer Attorneys of California filed a support brief for Gutierrez through Ikuta Hemesath.
Tostado is represented by Manning & Kass, Ellrod, Ramirez, Trester, with support briefs from the California Medical, Dental and Hospital associations through Cole Pedroza.
Upon request of the Supreme Court, the office of Attorney General Rob Bonta filed a support brief for Insurance Commissioner Ricardo Lara.
