Flores v. Presbyterian Intercommunity Hospital

Filed 5/5/16

IN THE SUPREME COURT OF CALIFORNIA

CATHERINE FLORES, )

)

Plaintiff and Appellant, )

) S209836

v. )

) Ct.App. 2/3 B235409

PRESBYTERIAN INTERCOMMUNITY )

HOSPITAL, )

) Los Angeles County

Defendant and Respondent. ) Super. Ct. No. VC058225

____________________________________)

A personal injury action generally must be filed within two years of the

date on which the challenged act or omission occurred. (Code Civ. Proc., § 335.1

(section 335.1).) A special statute of limitations applies, however, to actions “for

injury or death against a health care provider based upon such person’s alleged

professional negligence.” (Code Civ. Proc., § 340.5 (section 340.5).) Unlike most

other personal injury actions, professional negligence actions against health care

providers must be brought within “three years after the date of injury or one year

after the plaintiff discovers, or through the use of reasonable diligence should have

discovered, the injury, whichever occurs first.” (Ibid.)

Plaintiff in this case is a hospital patient who was injured when one of the

rails on her hospital bed collapsed. The rail had been raised according to doctor’s

orders following a medical assessment of her condition. Plaintiff sued the

hospital, claiming that it negligently failed to inspect and maintain the equipment.

The question presented is whether her claim is governed by the special limitations

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period in section 340.5 or instead by the usual two-year statute of limitations for

personal injury actions. Because plaintiff’s injury resulted from alleged

negligence in the use and maintenance of equipment needed to implement the

doctor’s order concerning her medical treatment, we conclude that plaintiff’s

claim sounds in professional, rather than ordinary, negligence. Therefore, as the

trial court correctly ruled, the action is governed by the special limitations period

in section 340.5 rather than the two-year statute of limitations under section 335.1.

I.

On March 5, 2009, plaintiff Catherine Flores, a patient at defendant

Presbyterian Intercommunity Hospital (PIH Health) in Whittier, was attempting to

get up from her hospital bed when the latch on the bedrail failed and the rail

collapsed, causing her to fall to the floor. Just under two years later, on March 2,

2011, she filed suit against PIH Health, stating causes of action for general

negligence and premises liability. She alleged that defendant had “failed to use

reasonable care in maintaining [its] premises,” “failed to take reasonable

precautions to discover and make safe a dangerous condition on the premises,”

and “failed to give Plaintiff a reasonable and adequate warning of a dangerous

condition so Plaintiff could have avoided foreseeable harm.” Flores claimed she

suffered injury as a result.

PIH Health demurred to the complaint. It argued that the complaint was

governed by section 340.5’s statute of limitations for suits alleging professional

negligence, that Flores had discovered the injury when she fell out of her hospital

bed, and that the complaint was untimely because it was filed more than one year

thereafter. In her briefs and argument in opposition to the demurrer, Flores

disputed that her claim arose from professional negligence. She acknowledged

that a doctor had made a “medical decision” to order that the rails on her bed be

raised, following a “medical assessment” of her condition. But, she argued, “the

2

rendition of professional services ended when Defendant medically assessed

Plaintiff’s condition and medically determined to raise the sidewalls on her bed.”

PIH Health’s alleged negligent conduct, she argued, was therefore “clearly

ordinary, and not professional, negligence,” and was therefore subject to the

ordinary two-year limitations period for personal injury actions (§ 335.1). The

trial court agreed with PIH Health, sustained the demurrer without leave to amend,

and dismissed the lawsuit. Flores appealed.

The Court of Appeal reversed, ordering the trial court to reinstate the

complaint. The Court of Appeal held that PIH Health’s alleged failure to use

reasonable care in maintaining its premises and its alleged failure to take

reasonable precautions to make a dangerous condition safe “sounds in ordinary

negligence because the negligence did not occur in the rendering of professional

services.”

We granted PIH Health’s petition for review.

II.

A.

For most of the 20th century, medical malpractice claims were subject to

the same one-year limitations period that applied to other personal injury claims.

(See Code Civ. Proc., former § 340, subd. (3), added by Stats. 1905, ch. 258, § 2,

p. 232; Neel v. Magana, Olney, Levy, Cathcart & Gelfand (1971) 6 Cal.3d 176,

181 (Neel); Gopaul v. Herrick Memorial Hosp. (1974) 38 Cal.App.3d 1002, 1005

(Gopaul).) But courts had held that in professional malpractice cases, unlike in

ordinary personal injury actions, the limitations period did not begin to run “until

the plaintiff discovered his injury, or through the use of reasonable diligence,

should have discovered it.” (Stafford v. Shultz (1954) 42 Cal.2d 767, 776; see

Sanchez v. South Hoover Hospital (1976) 18 Cal.3d 93, 96-97; Huysman v. Kirsch

(1936) 6 Cal.2d 302.)

3

In 1970, the Legislature codified this delayed discovery rule in former

section 340.5, which then applied to any action against specified medical

professionals, or hospitals employing such professionals, “based upon such

person’s alleged professional negligence . . . or for error or omission in such

person’s practice.” (§ 340.5, as added by Stats. 1970, ch. 360, § 1, p. 772.) In

such cases, the Legislature provided that the statute of limitations was one year

from the date on which the plaintiff discovered or should have discovered the

injury, but was subject to an outer limit of four years after the date of injury.

(Ibid.) The new law was intended “to retain the substance of the common law

discovery rule, while modifying its ‘open-ended’ operation.” (Sanchez v. South

Hoover Hospital, supra, 18 Cal.3d at p. 98.)

Five years later, the Legislature amended section 340.5 to its present

version as part of the Medical Injury Compensation Reform Act (MICRA)

(Stats. 1975, 2d Ex. Sess. 1975-1976, chs. 1, 2, pp. 3949-4007), a wide-ranging

statutory scheme designed to reduce the cost of medical malpractice insurance “by

limiting the amount and timing of recovery in cases of professional negligence”

(Western Steamship Lines, Inc. v. San Pedro Peninsula Hospital (1994) 8 Cal.4th

100, 111; see Stats. 1975, 2d Ex. Sess. 1975-1976, ch. 2, § 12.5, p. 4007 [preamble

to MICRA]). MICRA amended section 340.5 to shorten the outer limitations

period from four years to three. It expanded the coverage of the provision to

include not only actions against medical professionals and hospitals “as . . .

employer[s]” of such persons (Code Civ. Proc., former § 340.5), but also actions

against “ ‘[h]ealth care provider[s],’ ” generally, which it defined to include any

licensed “clinic, health dispensary, or health facility” (§ 340.5, subd. (1)). Finally,

and as particularly relevant here, it amended the description of covered claims,

stating that the special limitations period applies to “an action for injury or death

against a health care provider based upon such person’s alleged professional

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negligence.” (§ 340.5.) MICRA also supplied, for the first time, a definition of

the term “professional negligence”: “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.” (§ 340.5, subd. (2).)1

For many years after MICRA’s enactment, its special limitations provisions

were relevant only in cases involving delayed discovery; in all other cases, the

one-year statute of limitations corresponded to the usual one-year statute of

limitations for personal injury actions. In 2002, however, the Legislature enacted

section 335.1, which established a two-year limitations period for most tort actions

alleging personal injury or death.2 Because all parties agree that Flores was aware

1 An identical definition appears in several other provisions of MICRA:

Civil Code section 3333.1 (evidence of collateral source payments allowed and

subrogation by a collateral source precluded in professional negligence actions);

Civil Code section 3333.2 (noneconomic damages in professional negligence

actions capped at $250,000); Code of Civil Procedure section 364 (plaintiffs in

professional negligence actions must give 90-day notice of intent to sue); Code of

Civil Procedure section 667.7 (judges in professional negligence actions

authorized to provide for periodic payments of future damages); and Business and

Professions Code section 6146 (limiting contingent fees in professional negligence

actions). We have said that, “[t]o ensure that the legislative intent underlying

MICRA is implemented, . . . the scope of conduct afforded protection under

MICRA provisions (actions ‘based on professional negligence’) must be

determined after consideration of the purpose underlying each of the individual

statutes.” (Central Pathology Service Medical Clinic, Inc. v. Superior Court

(1992) 3 Cal.4th 181, 192.)

2 The legislative findings accompanying the enactment of section 335.1

indicate that the Legislature was particularly concerned that, under the previous

one-year statute of limitations, “residents of California who were victims of the

(Footnote continued on next page.)

5

of her injury at the time it occurred, the question in this case is whether her claim

is subject to the two-year statute of limitations under section 335.1, in which case

her claim was timely, or the one-year statute of limitations under section 340.5, in

which case it was not.

B.

As our courts have long recognized, “the dividing line between ‘ordinary

negligence’ and ‘professional malpractice’ may at times be difficult to place . . . .”

(Gopaul, supra, 38 Cal.App.3d at p. 1007.) Over time, the Courts of Appeal have

drawn the line differently in cases involving alleged negligence in the use or

maintenance of hospital equipment or premises.

In Gopaul, the court considered the proper characterization of such a claim

under the law as it existed before the enactment of section 340.5. (See Gopaul,

supra, 38 Cal.App.3d at p. 1005, fn. *.) The plaintiff in Gopaul was a hospital

patient, later diagnosed with bronchial pneumonia, who fell from a gurney during

a coughing fit while left unattended. The specific question before the court was

whether the plaintiff was entitled to the benefit of the judge-made “discovery rule”

for cases of professional malpractice. The Gopaul court held that the rule did not

apply. The court explained that not every negligent act by a professional is an act

of professional negligence: “No reasonable person would suggest that

‘professional malpractice’ was the cause of injury to a patient from a collapsing

(Footnote continued from previous page.)

terrorist actions of September 11, 2001, must prematurely choose between

litigation and federal remedies, while residents of other states have more than

twice as long to pursue their remedies.” (Stats. 2002, ch. 448, § 1, subd. (c),

p. 2522.) The perhaps unintentional effect of the legislation was to create a longer

limitations period for ordinary negligence actions than for professional negligence

actions not involving delayed discovery of the injury.

6

chair in a doctor’s office, or to a client from his attorney’s negligent driving en

route to the court house, or to a hospital patient from a chandelier falling onto his

bed.” (Gopaul, supra, 38 Cal.App.3d at p. 1006.) Rather, the court held,

professional malpractice occurs only when “the negligence occurred within the

scope of the ‘skill, prudence, and diligence commonly exercised by practitioners

of [the] profession.’ ” (Id. at p. 1007, quoting Neel, supra, 6 Cal.3d at p. 188.)

After MICRA was enacted, the Court of Appeal in Murillo v. Good

Samaritan Hospital (1979) 99 Cal.App.3d 50 (Murillo) took a different approach.

In Murillo, the court considered the application of section 340.5, as amended by

MICRA, to a hospital patient’s claim that she fell from her hospital bed while

sedated after hospital employees negligently left the rails of her bed down during

the night. Relying on Gopaul, the hospital argued that the patient’s claim sounded

in ordinary negligence rather than professional negligence, and thus was not

subject to the delayed discovery rule of section 340.5. The Murillo court

disagreed. Under section 340.5, it reasoned, “the test is not whether the situation

calls for a high or a low level of skill, or whether a high or low level of skill was

actually employed, but rather the test is whether the negligent act occurred in the

rendering of services for which the health care provider is licensed.” (Murillo,

supra, 99 Cal.App.3d at p. 57.) The court explained that “the professional duty of

a hospital . . . is primarily to provide a safe environment within which diagnosis,

treatment, and recovery can be carried out. Thus if an unsafe condition of the

hospital’s premises causes injury to a patient, as a result of the hospital’s

negligence, there is a breach of the hospital’s duty qua hospital.” (Id. at pp. 56-

57.) Because the patient’s claim in that case involved the “hospital’s duties to

recognize the condition of patients under its care and to take appropriate measures

for their safety,” the court concluded the claim was “squarely one of professional

negligence.” (Id. at p. 56; see Bellamy v. Appellate Department (1996) 50

7

Cal.App.4th 797, 806-808 (Bellamy) [applying the Murillo test and concluding

that section 340.5 applied to a patient’s claim that she was injured when hospital

employees negligently failed to set a brake on a rolling X-ray table or to hold the

table in place]; see also Flowers v. Torrance Memorial Hospital Medical Center

(1994) 8 Cal.4th 992, 999, 1002, fn. 6 [noting that Gopaul and Murillo reached

contrary results, but declining to decide which was correct].)

Although the Court of Appeal in this case recited Murillo’s rule that the

governing test “ ‘is whether the negligent act occurred in the rendering of services

for which the health care provider is licensed’ ” (italics omitted), the court

disagreed with what it characterized as “Murillo’s dictum that a negligently

maintained, unsafe condition of a hospital’s premises which causes injury to a

patient falls within professional negligence.” The court emphasized that the

“critical inquiry is whether the negligence occurred in the rendering of

professional services.” The court concluded that “Flores’s complaint, which

alleged she was injured ‘when the bed rail collapsed causing plaintiff to fall to the

ground,’ sounds in ordinary negligence” because the inspection and maintenance

of hospital equipment and premises does not constitute “the rendering of

professional services.”

III.

As this case comes to us, the central point of dispute is whether negligence

in the use or maintenance of hospital equipment or premises qualifies as

professional negligence subject to the special statute of limitations in section

340.5. We begin, as in all cases of statutory interpretation, by examining the text

of the statute. The definition of “professional negligence” in section 340.5 has

four elements: (1) “a negligent act or omission to act by a health care provider in

the rendering of professional services,” (2) “which act or omission is the

proximate cause of injury or wrongful death,” (3) “provided that such services are

8

within the scope of services for which the provider is licensed,” and (4) “which are

not within any restriction imposed by the licensing agency or licensed hospital.”

(§ 340.5, subd. (2).) The parties do not dispute that three of the four elements are

satisfied in this case. The controversy centers on the meaning of the first element,

whether the negligent act or omission occurred “in the rendering of professional

services.”

Flores urges us to interpret the phrase “professional services” to mean

“services involving a job requiring a particularized degree of medical skill.” In

her view, because the maintenance of hospital equipment and premises requires no

“specialized education, training or skill” it cannot qualify as negligence “in the

rendering of professional services (§ 340.5).” PIH Health, drawing on Murillo,

counters that, under section 340.5, “the test is not whether the situation calls for a

high or a low level of skill, or whether a high or low level of skill was actually

employed, but rather the test is whether the negligent act occurred in the rendering

of services for which the health care provider is licensed.” (Murillo, supra, 99

Cal.App.3d at p. 57.) As amici curiae supporting the hospital point out, the

statutory and regulatory licensing requirements for hospitals include general

premises safety and maintenance requirements. (See, e.g., Cal. Code Regs., tit. 22,

§ 70837, subd. (a) [“The hospital shall be clean, sanitary and in good repair at all

times. Maintenance shall include provision and surveillance of services and

procedures for the safety and well-being of patients, personnel and visitors.”].)

According to PIH Health, any failure to use reasonable care in maintaining its

equipment or premises occurs in the rendering of services for which it is licensed,

and therefore sounds in professional, rather than ordinary, negligence.

In our view, neither party accurately captures the meaning of section 340.5:

Flores’s proposed rule is too narrow, while PIH Health’s proposed rule is too

broad. Flores is, of course, correct that the term “professional services,” as it

9

relates to members of a profession, ordinarily is used to refer to “ ‘services . . .

which can be judged against the skill, prudence, and diligence commonly

possessed’ ” by other members of the profession. (Lee v. Hanley (2015) 61

Cal.4th 1225, 1237 (Lee), quoting Quintilliani v. Mannerino (1998) 62

Cal.App.4th 54, 64; see Gopaul, supra, 38 Cal.App.3d at p. 1007 [the test for

determining the existence of “professional malpractice” is “whether the negligence

occurred within the scope of the ‘skill, prudence, and diligence commonly

exercised by practitioners of his profession’ ”].) Flores is also correct that in the

health care context, the relevant professional service is medical care: that is, the

medical diagnosis and treatment of patients. But this does not mean that section

340.5 applies only to those specific tasks that require advanced medical skills and

training. A medical professional or other hospital staff member may commit a

negligent act in rendering medical care, thereby causing a patient’s injury, even

where no particular medical skills were required to complete the task at hand. A

hospital’s negligent failure to prevent a patient from becoming separated from an

oxygen ventilator, for example, occurs in the “rendering of professional services”

(§ 340.5, subd. (2)), “regardless of whether separation was caused by the ill-

considered decision of a physician or the accidental bump of a janitor’s broom”

(Taylor v. United States (9th Cir. 1987) 821 F.2d 1428, 1432). If a doctor has

determined that a hospitalized patient’s medical needs require a special diet, and

the patient is injured because a hospital employee negligently gives the patient the

wrong food, the hospital has inflicted injury in the rendering of professional

services to the patient. And if hospital staff place a violently coughing patient on a

gurney for X-rays, and the patient falls to the ground after the staff negligently

10

leave her unsecured while the film is developed, the hospital has caused injury in

the rendering of professional services to the patient, even though fastening straps

requires no special skill. (See Bellamy, supra, 50 Cal.App.4th 797.)3

We thus agree with PIH Health (and by extension, with the Murillo court)

to this extent: Under section 340.5, “the test is not whether the situation calls for a

high or a low level of skill, or whether a high or low level of skill was actually

employed . . . .” (Murillo, supra, 99 Cal.App.3d at p. 57.) But we disagree with

the remainder of the hospital’s proposed rule. In our view, a hospital’s negligent

act or omission does not qualify as negligence “in the rendering of professional

services” (§ 340.5, subd. (2)) merely because it violates a state licensing

requirement to maintain the premises in “good repair” (Cal. Code Regs., tit. 22,

§ 70837, subd. (a)). Such a rule would collapse the first (“a negligent act or

omission . . . in the rendering of professional services”) and third (“within the

scope of services for which the [health care] provider is licensed”) parts of the

statutory definition, thereby essentially reading out of the statute the independent

requirement that the negligent act or omission must occur “in the rendering of

professional services.” (§ 340.5, subd. (2).) It would thus sweep in not only

negligence in performing the duties that hospitals owe to their patients in the

rendering of medical diagnosis and treatment, but 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. (Cal. Code Regs.,

tit. 22, § 70837, subd. (a).) It would mean, for example, that section 340.5 would

3 To the extent Gopaul, supra, 38 Cal.App.3d 1002, reached a contrary

conclusion under the law as it existed before the 1970 enactment of section 340.5,

it sheds no light on the proper interpretation of the operative provisions of the

statute currently in force.

11

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.

The rule PIH Health urges would, in short, transform section 340.5’s

special rule for professional negligence — i.e., negligence in the rendering of

medical care to patients — into an all-purpose rule covering essentially every form

of ordinary negligence that happens to occur on hospital property. Had the

Legislature intended to craft such a rule, it certainly could have done so. But it

chose instead to write a narrower rule, both to cabin the operation of the delayed

discovery rule that had formerly applied in professional malpractice cases and to

address “skyrocketing malpractice premium costs . . . resulting in a potential

breakdown of the health delivery system.” (Stats. 1975, 2d Ex. Sess. 1975-1976,

ch. 2, § 12.5, p. 4007 [preamble to MICRA].) Neither purpose would be served by

extending the special limitations period of section 340.5 to cases involving

ordinary negligence that happen to occur on hospital property.4 The rule PIH

Health urges would, in short, extend section 340.5 well beyond its intended scope.

The text and purposes underlying section 340.5 instead require us to draw a

distinction between the professional obligations of hospitals in the rendering of

4 Indeed, at the time MICRA was enacted, such an expansion could well

have been counterproductive. As noted above, the limitations periods established

in section 340.5 as amended by MICRA (one year when the injury was or should

have been immediately discovered; three years when discovery of the injury was

delayed; and in some circumstances subject to tolling) were in all circumstances

equal to or longer than the limitations period in actions for ordinary negligence

(one year in all cases). To the extent that MICRA reflected legislative concerns

about open-ended limitations periods and skyrocketing malpractice rates, those

concerns would have counseled against treating a garden-variety negligence claim

as a claim for professional negligence, since doing so could only work to lengthen

— not shorten — the applicable limitations period.

12

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. Our recent decision in Lee,

supra, 61 Cal.4th 1225, lends support to this conclusion. The question in that case

concerned section 340.5’s neighboring provision imposing a one-year statute of

limitations for “[a]n action against an attorney for a wrongful act or omission,

other than for actual fraud, arising in the performance of professional services.”

(Code Civ. Proc., § 340.6, subd. (a) (section 340.6(a)).) We acknowledged in that

case that the “statutory text does not by itself make clear whether the phrase

‘arising in the performance of professional services’ limits the scope of section

340.6(a) to legal malpractice claims or covers a broader range of wrongful acts or

omissions that might arise during the attorney-client relationship.” (Lee, supra, 61

Cal.4th at p. 1233.) We therefore proceeded to examine the Legislature’s purpose

in enacting section 340.6(a) in 1977: “to ‘reduce[] the cost of legal malpractice

insurance’ and ‘limit[] the open-endedness’ of the various limitations periods,” as

well as to avoid evasion of the statute through artful pleading. (Lee, supra, 61

Cal.4th at p. 1234.) In light of the concerns that motivated its enactment, we

concluded that section 340.6(a) is properly read to apply to claims that “depend on

proof that an attorney violated a professional obligation in the course of providing

professional services.” (Lee, supra, 61 Cal.4th at pp. 1236-1237.)

In so holding, we rejected the argument that section 340.6(a) applies “to all

forms of attorney misconduct, except actual fraud, that occur during the attorney-

client relationship or entail the violation of a professional obligation.” (Lee,

supra, 61 Cal.4th at p. 1238.) Section 340.6(a), we explained, does not cover

“services unrelated to the practice of law, such as concert promotion,” or a

“garden-variety theft” that “occurs while the attorney and the victim are discussing

the victim’s legal affairs.” (Lee, supra, 61 Cal.4th at p. 1237.) Further, we

13

explained, the statute does not “necessarily apply whenever a plaintiff’s

allegations, if true, would entail a violation of an attorney’s professional

obligations,” because the “obligations that an attorney has by virtue of being an

attorney are varied and often overlap with obligations that all persons subject to

California’s laws have.” (Id. at p. 1238 [offering as an example the professional

rules barring sexual battery in the context of the attorney-client relationship].) The

question, we said, is “whether the claim, in order to succeed, necessarily depends

on proof that an attorney violated a professional obligation as opposed to some

generally applicable nonprofessional obligation.” (Ibid.)

Although Lee concerned a different statute of limitations, its analysis of the

similarly worded statute of limitations governing actions against attorneys is

instructive. Just as an attorney’s obligations “often overlap with obligations that

all persons subject to California’s laws have” (Lee, supra, 61 Cal.4th at p. 1238),

so do the obligations of hospitals. And just as an attorney’s breach of a generally

applicable obligation to avoid stealing from or physically harming his or her

clients does not fall within section 340.6(a), so too, we conclude, an injury

resulting from a hospital’s breach of a generally applicable obligation to maintain

its equipment and premises in a safe condition does not fall within section 340.5.

Rather, the special statute of limitations for professional negligence actions against

health care providers applies only to actions alleging injury suffered as a result of

negligence in rendering the professional services that hospitals and others provide

by virtue of being health care professionals: that is, the provision of medical care

to patients.

Consistent with these considerations, we conclude that whether negligence

in maintaining hospital equipment or premises qualifies as professional negligence

depends on the nature of the relationship between the equipment or premises in

question and the provision of medical care to the plaintiff. A hospital’s negligent

14

failure to maintain equipment that is necessary or otherwise integrally related to

the medical treatment and diagnosis of the patient implicates a duty that the

hospital owes to a patient by virtue of being a health care provider. Thus, if the

act or omission that led to the plaintiff’s injuries was negligence in the

maintenance of equipment that, under the prevailing standard of care, was

reasonably required to treat or accommodate a physical or mental condition of the

patient, the plaintiff’s claim is one of professional negligence under section 340.5.

But section 340.5 does not extend to negligence in the maintenance of equipment

and premises that are merely convenient for, or incidental to, the provision of

medical care to a patient. Arguably every part of a hospital’s plant would satisfy

such a standard, since the medical care of patients is, after all, the central purpose

for which any hospital is built. (See Murillo, supra, 99 Cal.App.3d at p. 57.)

Even those parts of a hospital dedicated primarily to patient care typically contain

numerous items of furniture and equipment — tables, televisions, toilets, and so

on — that are provided primarily for the comfort and convenience of patients and

visitors, but generally play no part in the patient’s medical diagnosis or treatment.

Although a defect in such equipment may injure patients as well as visitors or

staff, a hospital’s general duty to keep such items in good repair generally overlaps

with the “obligations that all persons subject to California’s laws have” (Lee,

supra, 61 Cal.4th at p. 1238), and thus will not give rise to a claim for professional

negligence. If, for example, a chair in a waiting room collapses, injuring the

person sitting in it, 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.

Section 340.5’s special statute of limitations does not apply to a suit arising out of

such an injury.

15

IV.

In this case, Flores’s complaint alleges that she was injured when the latch

on the rail on her hospital bed malfunctioned. Flores further alleges that PIH

Health negligently failed to discover or repair the malfunctioning latch and

negligently failed to warn her that it was not working properly. Although Flores’s

complaint does not describe precisely the events that led to the decision to raise

her bedrail, we may consider factual concessions made in her briefs or at oral

argument. (See Hernandez v. City of Pomona (2009) 46 Cal.4th 501, 506, fn. 1.)

As noted, in her brief and argument opposing PIH Health’s demurrer, Flores

explained that a doctor had made a “medical decision” to order that the rails on her

bed be raised, that this order followed from a “medical assessment” of her

condition, and she was thereafter injured when, “while grasping [the] rail and

attempting to exit the bed, the siderail collapsed causing Plaintiff to fall to the

floor and injure herself.”

Flores thus alleges, in essence, that PIH Health failed to properly

implement the doctor’s order, which was based on a medical assessment of her

condition, that the rails on her bed be raised. Flores’s injuries therefore resulted

from PIH Health’s alleged negligence in the use or maintenance of equipment

integrally related to her medical diagnosis and treatment. 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” and therefore is professional

negligence for purposes of section 340.5. As a result, the trial court correctly

determined that section 340.5 was the applicable statute of limitations, and the

Court of Appeal erred in holding to the contrary.

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DISPOSITION

The judgment of the Court of Appeal is reversed.

KRUGER, J.

WE CONCUR:

CANTIL-SAKAUYE, C. J.

WERDEGAR, J.

CHIN, J.

CORRIGAN, J.

LIU, J.

CUÉLLAR, J.

17

See next page for addresses and telephone numbers for counsel who argued in Supreme Court.

Name of Opinion Flores v. Presbyterian Intercommunity Hospital

__________________________________________________________________________________

Unpublished Opinion

Original Appeal

Original Proceeding

Review Granted XXX 213 Cal.App.4th 1386

Rehearing Granted

__________________________________________________________________________________

Opinion No. S209836

Date Filed: May 5, 2016

__________________________________________________________________________________

Court: Superior

County: Los Angeles

Judge: Yvonne T. Sanchez

__________________________________________________________________________________

Counsel:

Edward W. Lloyd & Associates and Edward W. Lloyd for Plaintiff and Appellant.

Steven B. Stevens; Agnew & Brusavich and Tobin D. Ellis for Consumer Attorneys of California as

Amicus Curiae on behalf of Plaintiff and Appellant.

Fonda & Fraser, Fonda, Hester & Associates, Fonda & Associates, Peter M. Fonda, Kristen J. Heim and

Rachael C. Kogen for Defendant and Respondent.

Dummit Buchholz & Trapp, Craig S. Dummit and Darren W. Dummit for Stanford Hospital and Clinics,

Doctors Medical Center of Modesto, Doctors Hospital of Manteca, Community Hospital of Los Gatos,

Doctors Hospital of Lakewood, Los Alamitos Hospital and Medical Center, Garfield Medical Center,

Monterey Park Community Hospital, Valley Presbyterian Hospital, Integrated Healthcare Holdings, Prime

Healthcare Management, Inc., Memorial Health Services, Universal Health Services, Inc., Sharp

Healthcare and North American Health Care as Amici Curiae on behalf of Defendant and Respondent.

Cole Pedroza, Curtis A. Cole, Kenneth R. Pedroza and Matthew S. Levinson for California Medical

Association, California Dental Association and California Hospital Association as Amici Curiae on behalf

of Defendant and Respondent.

Counsel who argued in Supreme Court (not intended for publication with opinion):

Edward W. Lloyd

Edward W. Lloyd & Associates

2900 Adams Street, #C130

Riverside, CA 92504

(951) 656-1203

Peter M. Fonda

Fonda & Associates

11900 Olympic Boulevard, Suite 810

Los Angeles, CA 90064-1046

(310) 553-3320

Kenneth R. Pedroza

Cole Pedroza

2670 Mission Street, Suite 200

San Marino, CA 91108

(626) 431-2787