Opinion

Foster v. Kaweah Delta Medical Center CA5

Court
California Court of Appeal
Filed
Apr 26, 2021
Status
Unpublished
Cited by
0 cases
Authority
More cited than 15.4%

The opinion

Filed 4/26/21 Foster v. Kaweah Delta Medical Center CA5

NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for

publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication

or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIFTH APPELLATE DISTRICT

RICKY TYRONE FOSTER,

F080927

Plaintiff and Appellant,

(Super. Ct. No. VCU280726)

v.

KAWEAH DELTA MEDICAL CENTER, ORDER MODIFYING OPINION

AND DENYING REHEARING

Defendants and Respondents.

[NO CHANGE IN JUDGMENT]

THE COURT:

It is ordered that the opinion filed herein on March 30, 2021, be modified as

follows:

1. On page 20, insert the following heading and paragraphs after the second

paragraph beginning “Based on the contents” and immediately before the

“DISPOSITION”:

4. Equitable Estoppel

Foster’s petition for rehearing contends his state law medical

malpractice cause of action is not time barred because Kaweah is equitably

estopped from asserting the limitations of the claim statute. Foster

contends Kaweah’s acts and omissions, including the failure to respond to

his request for information about an appeal, hindered or prevented his filing

of a timely claim under the Government Claims Act. As explained below,

we conclude Foster is unable to plead and prove the reasonable reliance

element of equitable estoppel in a manner that justifies his failure to present

a timely claim and his failure to seek leave to file a late claim.

“Generally speaking, four elements must be present in order to apply

the doctrine of equitable estoppel: (1) the party to be estopped must be

apprised of the facts; (2) he must intend that his conduct shall be acted

upon, or must so act that the party asserting the estoppel had a right to

believe it was so intended; (3) the other party must be ignorant of the true

state of facts; and (4) he must rely upon the conduct to his injury.”

(Driscoll v. City of Los Angeles (1967) 67 Cal.2d 297, 305 (Driscoll); J.M.

v. Huntington Beach Union High School Dist. (2017) 2 Cal.5th 648, 656.)

A plaintiff’s reliance upon the defendant’s conduct must be reasonable

under the circumstances. (Santos v. Los Angeles Unified School Dist.

(2017) 17 Cal.App.5th 1065, 1076.)

The doctrine of equitable estoppel may be applied against a public

entity where justice and right require it. (Driscoll, supra, 67 Cal.2d at p.

305.) Thus, “a public entity may be estopped from asserting the limitations

of the claims statute where its agents or employees have prevented or

deterred the filing of a timely claim by some affirmative act.” (John R. v.

Oakland Unified School Dist. (1989) 48 Cal.3d 438, 445, italics added.)

First, we recognize Bermudez’s letter may have caused Foster to

believe he needed to submit a claim or complaint to the Medical Board to

comply with the claim presentation requirements of the Government

Claims Act. The December 28, 2018 letter from the Medical Board stating

his “complaint is closed” would have constituted written notice of the

rejection of his claim for purposes of Government Code section 911.6. If

that rejection is treated as the rejection of a claim deemed by estoppel to

have been properly submitted under the Government Claims Act, then

Foster would have had six months to file his lawsuit. (Gov. Code, § 945.6,

subd. (a).) That six-month period expired on June 28, 2019. Consequently,

even with the benefit of equitable estoppel, Foster’s September 2019

complaint would not have been timely filed. As a result, if Kaweah is

equitably estopped from asserting the complaint to the Medical Board was

not the presentation of a claim for purposes of the Government Claims Act,

Foster still did not timely file his lawsuit within six months after the

Medical Board rejected his complaint.

Second, we consider the question of how long Foster could

reasonably rely on Kaweah’s failure to respond to his request for

information about pursuing an appeal. Foster waited about two months

2.

before he submitted a complaint to the Medical Board. Thus, it is

reasonable to infer from Foster’s actions that he relied on Kaweah’s letter

and its statement regarding information about an appeal for two months.

Because this appeal comes to us at the pleading stage, we infer Foster could

allege that two-month reliance period was reasonable. The two-month

delay, however, would not have affected the time Foster took to file his

lawsuit after receiving the Medical Board’s rejection notice in December

2018. In other words, any misrepresentation by Kaweah would not have

reasonably caused Foster to delay in filing his lawsuit after the Medical

Board rejected his complaint.

Third, Foster’s equitable estoppel theory does not address other

mandatory procedural requirements of the Government Claims Act and

provide an excuse for not complying with those requirements. When a

claim is not timely presented, Government Code section 911.4, subdivision

(a) requires the claimant to submit a written application to the public entity

for leave to present a late claim. Next, if the public entity denies such an

application, the claimant’s last recourse is to petition the superior court for

relief from the claim presentation requirement. (J.M. v. Huntington Beach

Union High School Dist., supra, 2 Cal.5th at pp. 653–656.) A petition for

relief from the claim filing requirements “shall be filed within six months

after the application to the board [for leave to file a late claim] is denied or

deemed to be denied pursuant to Section 911.6.” (§ 946.6, subd. (b).)

Foster’s theory of equitable estoppel does not explain how affirmative acts

by Kaweah reasonably prevented him from completing these required steps.

Consequently, Foster’s theory of equitable estoppel is not sufficient

to excuse his compliance with the claim presentation requirements of the

Government Claims Act and render his complaint timely within the statutes

of limitation.

There is no change in the judgment.

Appellant’s petition for rehearing filed on April 13, 2021, is hereby denied.

FRANSON, Acting P.J.

WE CONCUR:

PEÑA, J.

3.

SMITH, J.

4.

Filed 3/30/21 Foster v. Kaweah Delta Medical Center CA5 (unmodified opinion)

NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for

publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication

or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIFTH APPELLATE DISTRICT

RICKY TYRONE FOSTER,

F080927

Plaintiff and Appellant,

(Super. Ct. No. VCU280726)

v.

KAWEAH DELTA MEDICAL CENTER, OPINION

Defendant and Respondent.

THE COURT*

APPEAL from a judgment of the Superior Court of Tulare County. Bret D.

Hillman, Judge.

Ricky Tyrone Foster, in pro. per., for Plaintiff and Appellant.

Salinas Law Group, Inc., and Richard S. Salinas for Defendant and Respondent.

-ooOoo-

Appellant Ricky Tyrone Foster, a self-represented prison inmate, sued Kaweah

Delta Health Care District (Kaweah) and alleged Kaweah was deliberately indifferent to

his serious medical condition, inadequately trained its personnel, and failed to properly

* Before Franson, Acting P.J., Peña, J. and Smith, J.

diagnose and treat his seven broken ribs. Kaweah filed a demurrer, contending Foster

failed to allege compliance with, or an excuse from complying with, the claim

presentation requirements of the Government Claims Act (Gov. Code, § 810 et seq.) and

Foster’s action was time-barred under the statute of limitations applicable to medical

malpractice actions (Code Civ. Proc., § 340.5). The trial court sustained the demurrer

without leave to amend. Foster appealed.

Foster’s complaint stated a cause of action under the federal Civil Rights Act, 42

United States Code section 1983 (section 1983),1 and the principles set forth in Monell v.

Department of Social Services (1978) 436 U.S. 658 (Monell) and City of Canton v.

Harris (1989) 489 U.S. 378 (Harris). The claim presentation requirements of the

Government Claims Act do not apply to causes of action under section 1983. Therefore,

any failure by Foster to comply with those requirements is not a valid ground for

sustaining the demurrer to his section 1983 cause of action.

The statute of limitations applicable to Foster’s section 1983 cause of action is the

two-year period applied to personal injury actions. (§ 335.1.) As an inmate serving a life

sentence with the possibility of parole, Foster is eligible for the two-year tolling period

set forth in section 352.1, subdivision (a). Furthermore, the exception contained in

subdivision (b) of section 352.1 does not apply to federal civil rights causes of action

under section 1983. As a result, the combination of sections 335.1 and 352.1 allowed

Foster to file his federal cause of action within four years after it accrued. Here, Foster

easily meets the deadline as his ribs were broken in August 2017 and his lawsuit was

filed in 2019. Consequently, Foster’s section 1983 cause of action is not barred by the

statute of limitations.

We therefore reverse the judgment of dismissal.

1 Except for section 1983, all unlabeled statutory references are to the Code of Civil

Procedure.

2.

FACTS

In 1994, Foster was convicted of various serious offenses relating to a carjacking.

(People v. Foster (1995) 34 Cal.App.4th 766, 768.) The jury found Foster used a firearm

during the commission of the offenses. Foster “was sentenced to a total unstayed prison

term of life with the possibility of parole plus 12 years.” (Id. at p. 769.) In 1995, we

affirmed Foster’s conviction and sentence. (Id. at p. 776.) The details about Foster’s

sentence are relevant to the application of section 352.1, which tolls the running of the

statute of limitations for up to two years for certain inmates.

On August 6, 2017, Foster was held by the California Department of Corrections

and Rehabilitation at the Corcoran State Prison. Foster, who is black, was involved in a

fight with prisoners classified as “Other.” Foster received some superficial injuries and

was restrained on a hospital gurney. While he was strapped to the gurney, prison

officials allowed an “Other” prisoner who had been involved in the fight to attack the

defenseless Foster. Foster alleges the prison officials allowed the attack as retaliation for

Foster filing inmate grievances against prison officials and participating in an Internal

Affairs investigation of prison officials. During the attack, the gurney fell over and

Foster landed on top of a metal box, which he alleges caused him great pain.

Plaintiff was transported to Kaweah Delta Medical Center, a hospital in Visalia

operated by Kaweah. At the hospital, Foster was seen by defendant Kenny Derkang Lee,

M.D., and a C.T. scan and x-rays were taken. Foster was told that no fractures were

found on the chest x-rays or the C.T. scan. Foster was experiencing a great deal of chest

pain and demanded a second medical opinion. Dr. Lee denied this request, despite

Foster’s chest being noticeably swollen, his difficulty in breathing, and his crying from

the pain.

On August 9, 2017, Kaweah discharged Foster and he was returned to Corcoran

State Prison, where he was placed in administrative segregation. The appellate record

includes reports generated by California Correctional Health Care Services for

3.

examinations of Foster. The August 29, 2017 report from Corcoran State Prison states

six x-rays of Foster’s “chest and rib cage were acquired” and showed a minimally

displaced right 10th rib fracture. The report for x-rays taken during an October 9, 2017

exam at Calipatria State Prison showed “[h]ealing bilateral rib fractures are present with

fractures of the anterior arch of the right fourth through seventh ribs and fractures of the

anterior arcs of the left fourth through sixth ribs.” The report for x-rays taken during a

December 4, 2017 exam at Calipatria State Prison stated: “Healed/healing right-side rib

fractures with no new deformity identified. Known left-sided rib fractures are not a

conspicuous on the present exam, suggestive of healed deformity.” After the heading

labeled “IMPRESSION,” the report stated: “Chronic fracture deformities with no acute

osseous abnormality.”

Office of Patient Experience

Miriam Y. Bermudez of Kaweah’s Office of Patient Experience sent Foster a letter

dated May 25, 2018, which began: “This 2nd letter is in follow-up to the letter sent to you

on 03/29/2018. We apologize that you were disappointed with our physicians care during

your hospital stay. Your concerns were forwarded to the Medical Staff Office for

review.” The letter informed Foster that two of Kaweah’s radiologists had conducted a

review and reported that (1) no fractures were found evident on the chest x-ray and (2)

the C.T. scan showed very subtle irregularities of the right anterior lateral fourth and fifth

ribs that could represent subtle incomplete or healing fractures. The letter concluded that

the abnormalities referred to in Foster’s letter were not found in the x-rays and scan done

during Foster’s August hospital stay.

The letter also informed Foster of his right to file a formal complaint with the

Medical Board of California and provide telephone numbers and the mailing address of

the board’s “Central Complaint Unit.” The last sentence of the letter stated: “If you are

not satisfied with our response, please contact me within 20 days of this letter in order to

4.

file an appeal.” Although Foster wrote to Bermudez, he received no further

communications from Kaweah.

Medical Board of California

Because he received no appeal assistance from Bermudez, Foster submitted a

complaint about Dr. Lee’s treatment to the Medical Board of California in July 2018. In

August 2018, the Medical Board sent Foster an initial letter acknowledging receipt of his

complaint and a second letter stating he needed to complete and sign certain forms

authorizing the release of medical information. In October 2018, the Medical Board sent

Foster a letter stating it had received all the records required for its review and those

documents had been forwarded to a medical consultant for review. On December 28,

2018, the Medical Board sent Foster a letter stating it had completed its review of his

complaint against Dr. Lee and it was “unable to meet the burden of proof required to

pursue administrative action.” Accordingly, the letter stated Foster’s “complaint is

closed.”

Tulare County’s Board of Supervisors

On September 20, 2019, Foster filed a claim with the Board of Supervisors of the

County of Tulare. On October 4, 2019, the County’s Risk Management Division sent

Foster a formal denial of his claim. The cover letter stated “the County of Tulare is not

an appropriate defendant” because Dr. Lee was not a County employee and the County

has no jurisdiction over Kaweah. The letter also advised Foster that if he pursued

litigation against the County it might seek attorney fees and sanctions against him.

PROCEEDINGS

On September 10, 2019, Foster signed a pleading titled “CIVIL RIGHTS

COMPLAINT BY A PRISONER.” Nothing in the record shows when Foster delivered

the complaint to prison officials for mailing to the Tulare County Superior Court. On

October 7, 2019, Foster’s complaint was filed by the court.

5.

A section in the preprinted complaint addressed administrative remedies. Item 5.d

asked: “If you did not submit or appeal a request for administrative relief at any level,

briefly explain why you did not.” On the line that followed, Foster typed, “defendant’s

are not prison official’s, and my injury’s/case is against a public hospital.” In the next

item, Foster typed: “I filed both: 1.) Medical Board Claim; and 2.) Tort Claim. as my

claim’s are not prison related per-se. Board of Supervisor.”

In December 2019, Kaweah filed a demurrer, contending Foster failed to allege

compliance with, or an excuse from complying with, the claim presentation requirements

of the Government Claims Act (Gov. Code, § 810 et seq.). Kaweah also asserted the

action was time-barred under the statute of limitations applicable to medical malpractice

actions (Code Civ. Proc., § 340.5).

On January 28, 2020, after opposition and reply papers were filed, the trial court

held a hearing on the demurrer. Foster and defense counsel appeared by CourtCall.

After hearing argument, the court took the matter under submission. On January 29,

2020, the trial court signed and filed a four-page “RULING ON DEFENDANT’S

DEMURRER” sustaining Kaweah demurrer to Foster’s complaint without leave to

amend. On February 13, 2020, the court filed an order dismissing the case with

prejudice. In March 2020, Foster filed a timely appeal.

In October 2020, after Foster filed his opening brief, this court sent the parties a

briefing letter directing them to address 13 questions enumerated in the letter. After the

respondent’s brief and appellant’s reply brief were filed, we sent a second briefing letter

asking Kaweah to address five specific questions in a sur-reply brief.

DISCUSSION

I. DEMURRERS AND STANDARD OF REVIEW

Kaweah’s demurrer raised two grounds. First, Kaweah asserted Foster had failed

to allege facts sufficient to state a cause of action because he failed to allege an essential

6.

element—namely, compliance with the claims presentation requirements of the

Government Claims Act. Second, Kaweah contended Foster’s medical malpractice cause

of action was barred by the applicable statute of limitations. In light of these contentions,

we consider the principles addressing how each of these grounds may be raised by

demurrer and the corresponding standard of appellate review.

A. Grounds for Demurrer

1. Failure to Plead a Cause of Action

A complaint must contain “[a] statement of the facts constituting the cause of

action, in ordinary and concise language.” (Code Civ. Proc., § 425.10.) The facts needed

to properly plead a cause of action are referred to as the essential elements of the cause of

action. The essential elements are determined by the substantive law that defines the

cause of action. (Weil & Brown, Cal. Practice Guide: Civil Procedure Before Trial (The

Rutter Group 2020) ¶ 6:121, p. 6-36.) The facts needed to satisfy these elements are the

facts upon which liability depends. (Id. ¶ 6:123, p. 6-38.) Generally, when a cause of

action falls within the scope of the Government Claims Act, submission of a claim is a

condition precedent to maintaining a tort action and, thus, compliance is treated as an

essential element of the cause of action. (State of California v. Superior Court (2004) 32

Cal.4th 1234, 1239–1240.)

When a complaint “does not state facts sufficient to constitute a cause of action,” a

defendant may raise that objection by filing a demurrer. (Code Civ. Proc., § 430.10,

subd. (e).) Determining whether a pleading alleges facts sufficient to constitute a cause

of action is a question of law. (Neilson v. City of California City (2005) 133 Cal.App.4th

1296, 1305.)

Appellate courts reviewing an order sustaining a general demurrer independently

determine whether the pleading “alleges facts sufficient to state a cause of action under

any legal theory.” (McCall v. PacifiCare of Cal., Inc. (2001) 25 Cal.4th 412, 415.)

7.

Appellate courts “give the complaint a reasonable interpretation, reading it as a whole

and its parts in their context.” (City of Dinuba v. County of Tulare (2007) 41 Cal.4th 859,

865.) The demurrer is treated as admitting all material facts properly pleaded, but does

not admit the truth of contentions, deductions or conclusions of law. (Ibid.) The

pleader’s contentions or conclusions of law are not controlling because appellate courts

are obligated to independently decide questions of law without deference to the legal

conclusions of the pleader or the trial court. (Gutierrez v. Carmax Auto Superstores

California (2018) 19 Cal.App.5th 1234, 1242.)

2. Statute of Limitations Defense

The grounds listed in section 430.10 are not the only bases for a demurrer. Under

section 430.30, subdivision (a), when “any ground for objection to a complaint …

appears on the face thereof, or from any matter of which the court is required to or may

take judicial notice, the objection on that ground may be taken by a demurrer to the

pleading.” The statute of limitations, while characterized as an affirmative defense, also

is a “ground for objection to a complaint” for purposes of section 430.30 and, therefore,

may be raised in a demurrer. (Cochran v. Cochran (1998) 65 Cal.App.4th 488, 493.)

Generally, an order sustaining a demurrer on statute of limitations grounds is

subject to independent review on appeal. (Committee for Green Foothills v. Santa Clara

County Bd. of Supervisors (2010) 48 Cal.4th 32, 42.) The untimeliness of the lawsuit

must clearly and affirmatively appear on the face of the complaint and matters judicially

noticed before an appellate court will affirm an order sustaining the demurrer. (Ibid.)

Allegations in the complaint showing the claim might be barred are not enough.

(Marshall v. Gibson, Dunn & Crutcher (1995) 37 Cal.App.4th 1397, 1403.)

B. Leave to Amend

A trial court’s decision to sustain a demurrer without leave to amend is subject to

review for an abuse of discretion. “[I]t is an abuse of discretion to sustain a demurrer

8.

without leave to amend if the plaintiff shows there is a reasonable possibility any defect

identified by the defendant can be cured by amendment.” (Aubry v. Tri–City Hospital

Dist. (1992) 2 Cal.4th 962, 967.) The plaintiff has the burden of demonstrating a

reasonable possibility of curing the defect. (Blank v. Kirwan (1985) 39 Cal.3d 311, 318.)

In making the required demonstration, a plaintiff is not limited to the matters

presented to the trial court. Code of Civil Procedure section 472c, subdivision (a)

provides: “When any court makes an order sustaining a demurrer without leave to amend

the question as to whether or not such court abused its discretion in making such an order

is open on appeal even though no request to amend such pleading was made.” In City of

Stockton v. Superior Court (2007) 42 Cal.4th 730, the Supreme Court interpreted this

statute to mean: “The issue of leave to amend is always open on appeal, even if not

raised by the plaintiff.” (Id. at p. 746, citing Aubry v. Tri-City Hospital Dist., supra, 2

Cal.4th at p. 971.)

II. SECTION 1983 CAUSE OF ACTION

Section 1983 states, in pertinent part, “Every person who, under color of any

statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of

Columbia, subjects, or causes to be subjected, any citizen of the United States or other

person within the jurisdiction thereof to the deprivation of any rights, privileges, or

immunities secured by the Constitution and laws, shall be liable to the party injured in an

action at law, suit in equity, or other proper proceeding for redress ....”

A. Foster’s Complaint

Foster’s 11-page complaint consisted of a preprinted form with blanks filled in by

typewriter and seven additional typed pages. On its first page, Foster marked a box

indicating the court had jurisdiction over the action pursuant to “28 U.S.C. § 1343(a); 42

U.S.C. § 1983.” In a part of the complaint labeled “INTRODUCTION,” Foster stated:

“This is a civil rights action which is seeking money damage’s and declaratory judgment

9.

under 42 U.S.C. § 1983.” The same paragraph referred to a deliberate indifference to a

serious medical condition, mistreatment, an unnecessary and wanton infliction of pain,

unprofessional medical misconduct, “all in violation of the Eighth and Fourteenth

Amendment to the United States Constitution.” The heading for the first and only cause

of action included the following: “(42 U.S.C.§ 1983, 8th Amendment to the U.S.

Const.)” Under that heading, Foster described many acts as violations of “the 8th

amendment of the United States Constitution” and stated Kaweah’s “wrongful actions

herein are in violation of 42 U.S.C.§ 1983 because they have intentionally and

prejudicially deprived plaintiff of rights, benefits and privileges secured by the United

States Constitution.”

Foster’s complaint includes many references to section 1983 and violations of his

constitutional rights. Giving his “complaint a reasonable interpretation, reading it as a

whole and its parts in their context,” there is no doubt that Foster was attempting to state

a civil rights cause of action under section 1983. (City of Dinuba v. County of Tulare,

supra, 41 Cal.4th at p. 865; see Genesis Environmental Services v. San Joaquin Valley

Unified Air Pollution Control Dist. (2003) 113 Cal.App.4th 597, 599–600 [complaint that

made no reference to § 1983 alleged sufficient facts to state a cause of action under that

statute for a violation of the equal protection clause; Fifth Dist. reverses judgment of

dismissal].)

B. The Demurrer

Kaweah’s demurrer and supporting papers did not mention section 1983. As a

result, Kaweah did not address whether a section 1983 cause of action is subject to the

claim presentation requirements of the Government Claims Act. Also, it did not address

which statute of limitations applies to a section 1983 cause of action.

Like Kaweah’s demurrer, the trial court’s four-page ruling did not mention section

1983. The court identified Foster’s legal theory by stating: “This is a medical negligence

10.

action against defendant Kaweah … based on … Foster’s contention that he was injured

as a result of the failure of Kaweah … to properly diagnose and treat broken ribs that

[Foster] sustained on or about August 6, 2017, in an altercation at Corcoran State Prison.”

The trial court concluded the claim for medical negligence was subject to the

Government Claims Act and determined Foster did not properly allege compliance with

the act’s claim presentation requirements or an excuse for his noncompliance. The court

also concluded the lawsuit was untimely under the one-year statute of limitations for

medical malpractice action set forth in section 340.5. In concluding the lawsuit was

untimely, the court determined the two-year tolling provision in section 352.1,

subdivision (a) did not apply to Foster for two independent reasons. First, Foster was

serving a life sentence and was not eligible for tolling. Second, under section 352.1,

subdivision (b), the two-year tolling provision does not apply to an action brought against

a public entity for which a claim must be presented in accordance with the Government

Claims Act. The court determined Kaweah was such a public entity and, thus, Foster

could not rely on the tolling provision in section 352.1.

C. Issues Raised in this Appeal

Because Kaweah’s demurrer and the trial court’s ruling ignored Foster’s federal

civil rights claim, our October 2020 letter of briefing instructions asked the parties to

address the following questions: (1) “Is Foster’s civil rights cause of action under 42

U.S.C. section 1983 for deliberate indifference to a serious medical need subject to the

claim presentation requirements of the Government Claims Act?” (2) Does the two-year

tolling period in section 352.1 apply to a federal civil rights cause of action or, more

specifically, does the exception in subdivision (b) of section 352.1 prevent the tolling

provision from applying to Foster’s civil rights cause of action? (3) For purposes of

“section 1983, is Kaweah … a ‘person’ that can be held liable under the statute for a civil

11.

rights violation?” The respondent’s brief filed by Kaweah addressed each of these

questions.

1. Claim Presentation Requirements Do Not Apply

Kaweah responded to the first question by stating Foster’s cause of action under

section 1983 was not subject to the claim presentation requirements of the Government

Claims Act. We agree. Section 1983 actions are not subject to the Government Claims

Act. (California Correctional Peace Officers Assn. v. Virga (2010) 181 Cal.App.4th 30,

38.) Consequently, any failure to comply with the act’s claim presentation requirements

does not bar Foster’s section 1983 cause of action. In other words, compliance with the

Government Claims Act is not an essential element of a federal civil rights claim.

2. Tolling of Statute of Limitations

In its respondent’s brief, Kaweah argued, without citation to any case law, that the

trial court correctly determined the two-year tolling provision in section 352.1 did not

apply because Foster’s lawsuit was against a public entity. (§ 352.1, subd. (b).)

Subsequently, Kaweah filed a sur-reply brief conceding that “Foster is entitled to the

benefit of two-years tolling provided in [section] 352.1 because his life sentence is not

without the possibility of parole.”

We agree that the two-year tolling afforded to certain prisoners by section 352.1

applies to Foster’s section 1983 cause of action. The statutory text creating the tolling

provision reads: “If a person entitled to bring an action, mentioned in Chapter 3

(commencing with Section 335), is, at the time the cause of action accrued, imprisoned

on a criminal charge, or in execution under the sentence of a criminal court for a term

less than for life, the time of that disability is not a part of the time limited for the

commencement of the action, not to exceed two years.” (§ 352.1, subd. (a), italics

added.) This court has interpreted the statutory phrase “for a term less than for life” to

mean only sentences for life without the possibility of parole. (Brooks v. Mercy Hospital

12.

(2016) 1 Cal.App.5th 1, 7.) Because Foster was sentenced to a prison term of life with

the possibility of parole, he is eligible for tolling under section 352.1, subdivision (a).

Thus, the trial court erred by ignoring Foster’s allegation that he “is serving life with the

possibility of parole.” In addition, it misconstrued the statute when it determined the

statute of limitations was extended for up to two years only “when the inmate is serving a

non-life sentence.”

The trial court adopted two independent grounds for concluding tolling was not

available. Accordingly, we also must consider the second ground, which raises the legal

question of whether the exception set forth in subdivision (b) of section 352.1 applies to

causes of action brought under section 1983. The statutory text in question reads: “This

section does not apply to an action against a public entity or public employee upon a

cause of action for which a claim is required to be presented in accordance with [the

Government Claims Act].” (§ 352.1, subd. (b).) As concluded earlier, a section 1983

theory of liability is not “a cause of action for which a claim is required to be presented in

accordance with [the Government Claims Act].” (§ 352.1, subd. (b).) Accordingly, the

exception does not apply to Foster’s section 1983 causes of action. (See Ellis v. City of

San Diego (9th Cir. 1999) 176 F.3d 1183, 1190 [state law claims were untimely because

two-year tolling under § 352.1 did not apply, but federal civil rights claim was timely];

Jones v. Blanas (9th Cir. 2004) 393 F.3d 918, 927 [§ 1983 claims are governed by the

forum state’s statute of limitations for personal injury claims, including state law

regarding tolling; § 352.1 does not cover civil detainees]; Martinez v. Gomez (9th Cir.

1998) 137 F.3d 1124.)

Consequently, the statute of limitations applicable to Foster’s section 1983 cause

of action was tolled for two years pursuant to section 352.1, subdivision (a). When this

two-year period is added to the two-year statute of limitations for personal injury claims

(§ 335.1), Foster’s section 1983 claim, which relates to his August 2017 hospital visit,

13.

was timely when it was filed in 2019. Thus, we join in Kaweah’s sur-reply brief’s

conclusion that the section 1983 cause of action was timely filed.

3. Kaweah Is a “Person” Under Section 1983

In its respondent’s brief, Kaweah conceded it is a local government entity and,

thus, qualifies as a “person” that can be held liable under section 1983 for a civil rights

violation. Kaweah argued a local government entity is liable under section 1983 only

when its “policy or custom … inflicts the injury” (Monell, supra, 436 U.S. at p. 694) and

Foster’s complaint was deficient because it did not allege any official policy or custom of

Kaweah had caused his injury. In Perry v. County of Fresno (2013) 215 Cal.App.4th 94,

this court concluded four conditions must be satisfied to establish government liability

under Monell: “The plaintiff must establish that: (1) the plaintiff was deprived of a

constitutional right; (2) the government entity had a policy; (3) this policy amounted to

deliberate indifference to the plaintiff’s constitutional right; and (4) the policy was the

moving force behind the constitutional violation.” (Perry, supra, at pp. 105–106.)

Foster’s reply brief argued the failure to train was at the heart of his complaint and

a failure to train can qualify as the policy or custom referred to in Monell. Foster

supported this argument by citing Harris, supra, 489 U.S. 378. In that case, the United

States Supreme Court stated, “we agree with the court below that a city can be liable

under § 1983 for inadequate training of its employees.” (Id. at p. 388.) The court went

on to state: “We hold today that the inadequacy of police training may serve as the basis

for § 1983 liability only where the failure to train amounts to deliberate indifference to

the rights of the persons with whom the police come into contact.” (Ibid.) The court

determined a failure to provide adequate training may be said to represent a policy of

local government when, “in light of the duties assigned to specific officers or

employees[], the need for more or different training is so obvious, and the inadequacy so

likely to result in the violation of constitutional rights, that the policymakers of the [local

14.

government] can reasonably be said to have been deliberately indifferent to the need.”

(Id. at p. 390.)

Based on the positions taken the respondent’s brief and the appellant’s reply brief,

our December 2020 briefing letter asked Kaweah:

“[W]hat test or standard is used to determine whether a plaintiff has alleged

sufficient facts to state a section 1983 claim against a local government

entity based on a failure to train that constitutes deliberate indifference?

(See Connick v. Thompson (2011) 563 U.S. 51, 62 [a pattern of similar

constitutional violations by untrained employees that puts municipal

decisionmakers on notice that a new program is necessary]; City of Canton

v. Harris, supra, 489 U.S. 378, 390 [‘the need for more or different training

[was] so obvious’]; Shadrick v. Hopkins County (6th Cir. 2015) 805 F.3d

724, 737 [plaintiff’s ‘burden under § 1983 is to prove that [the defendant

entity’s] failure to train and supervise its ... nurses about the legal duty to

provide constitutionally adequate medical care amounted ‘to deliberate

indifference to the rights of persons with whom the [nurses] come into

contact” ’]; Segal v. City of New York (2d Cir. 2006) 459 F.3d 207, 219;

Long v. County of Los Angeles (9th Cir. 2006) 442 F.3d 1178, 1186 [three-

part test for establishing municipality’s liability under Monell]; Olsen v.

Layton Hills Mall (10th Cir. 2002) 312 F.3d 1304, 1318 [while a single

incident generally will not give rise to liability, deliberate indifference may

be found absent a pattern of unconstitutional behavior if a violation of

federal rights is a highly predictable or plainly obvious consequence of a

municipality’s action]. Please note that cases decided by summary

judgment or trial, addressing proof, will be less useful or persuasive than

cases decided at the pleading stage.)”

The briefing letter also asked Kaweah whether the allegations in Foster’s

complaint that referred to the failure to train adequately pleaded a claim against it for

failure to train its personnel. Kaweah’s sur-reply brief did not comply with our directions

to provide specific answers to these questions. Instead, Kaweah bypassed these questions

and stated it would answer Foster’s section 1983 claim for deliberate indifference to

medical needs, would “not contend that [Foster’s] Deliberate Indifference claim is

untimely,” and would not contend the section 1983 claim “has pleading deficits arising

from California’s Government Claims Act.”

15.

In light of Kaweah’s responses to our questions and Foster’s allegations that

Kaweah was deliberately indifferent in failing to train the doctor who treated him, we

conclude Foster adequately alleged a section 1983 cause of action based on a failure to

train that can be viewed as a policy or custom of Kaweah. (See Monell, supra, 436 U.S.

at p. 694 [policy or custom]; Harris, supra, 489 U.S. at p. 390 [failure to train].)

III. STATE LAW NEGLIGENCE CLAIM

A. General Principles Governing Statutes of Limitation

Statutes of limitation prescribe the length of time a plaintiff is given to bring suit

or be barred. (Aryeh v. Canon Business Solutions, Inc. (2013) 55 Cal.4th 1185, 1191

(Aryeh).) Generally, the limitations period “runs from the moment a claim accrues.”

(Ibid.; § 312 [action must be “commenced within the periods prescribed in this title, after

the cause of action shall have accrued”].) California follows the “ ‘last element’ ” accrual

rule, which provides the statute of limitations runs from the occurrence of the last

element essential to the cause of action. (Aryeh, supra, at p. 1191.) Our Supreme Court

has described the essential elements for statute of limitations purposes as “ ‘wrongdoing,

harm, and causation.’ ” (Ibid.)

The foregoing general rules are subject to various modifications and equitable

exceptions that affect the initial accrual of a cause of action, the subsequent running of

the limitations period, or both. (Aryeh, supra, 55 Cal.4th at p. 1192.) These exceptions

and modifications include the delayed discovery rule, equitable tolling, equitable

estoppel, the continuing violation doctrine, the theory of continuous accrual, and waiver.

(Ibid.)

In this case, Foster relies on the delayed discovery rule. That rule postpones the

accrual of a cause of action until the plaintiff discovers, or has reason to discover, the

cause of action. (Fox v. Ethicon Endo-Surgery, Inc. (2005) 35 Cal.4th 797, 807.) Thus,

the statute of limitations begins to run when the plaintiff has reason to suspect an injury

16.

and some wrongful cause, unless the plaintiff pleads and proves that a reasonable

investigation at that time would not have uncovered a factual basis for the particular

cause of action. (Id. at p. 803.)

B. Sections 340.5 and 352.1

Section 340.5 establishes the statute of limitations in medical malpractice lawsuits.

It reads in part: “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 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.” Under the plain

wording of the statute, the shorter of the two limitation periods determines whether the

action is timely filed. (Ngo v. County of Los Angeles (1989) 207 Cal.App.3d 946, 948.)

Stated another way, “[a] plaintiff in a medical malpractice action must satisfy the

requirements of both the one-year and the three-year limitations periods.” (Drexler v.

Petersen (2016) 4 Cal.App.5th 1181, 1189.)

The interplay between sections 340.5 and 352.1 was addressed by our Supreme

Court in Belton v. Bowers Ambulance Service (1999) 20 Cal.4th 928. The court

concluded that the two-year tolling for prisoners as provided in section 352.1 applies to

the one-year limitations period in section 340.5, but not to the three-year limitations

period in that section. (Belton, supra, at pp. 931–935.) Accordingly, a prisoner’s time to

sue a healthcare provider can be extended by his or her incarceration up to, but never

beyond, the maximum three-year deadline contained in section 340.5. In Belton, the

prisoner had filed his complaint more than one year after discovery of his cause of action,

17.

but within the three-year maximum period. Based on the tolling of section 340.5’s one-

year period pursuant to section 352.1, the court concluded the complaint was timely.

C. The State Law Malpractice Cause of Action Was Time Barred

Foster’s complaint is reasonably interpreted as alleging federal cause of action for

violations of section 1983 and a state law cause of action for medical malpractice. The

medical malpractice action is the subject to the one-year and three-year limitations

periods set forth in section 340.5.

1. No Tolling

Foster contends his state law cause of action is timely because the limitations

period was tolled for two years by section 352.1. We disagree. The exception in

subdivision (b) of section 352.1 applies to the medical malpractice claim against Kaweah

because it is a public entity and the cause of action is one “for which a claim is required

to be presented in accordance with [the Government Claims Act].” (§ 352.1, subd. (b).)

Our briefing letter gave Foster an opportunity to address whether this exception applied

to his state law claim and Foster did not present a convincing argument for concluding

the malpractice claim against Kaweah was not subject to the exception. Most of his

arguments focused on his life sentence being one with the possibility of parole.

Consequently, while Foster got the benefit of the two-year tolling provision for his

federal claim, his state law cause of action against Kaweah does not qualify for tolling

because the exception in subdivision (b) of section 352.1 prevents it. A similar

conclusion about the application of section 352.1 to federal and state law claims was

reached in Ellis v. City of San Diego, supra, 176 F.3d at page 1190. In that case, the

federal civil rights claim was timely because of tolling under section 352.1 and the state

law claims were untimely because the tolling provision did not apply to them.

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2. Commencement

To calculate whether Foster’s medical malpractice cause of action was brought

within one year of discovery for purposes of section 340.5, we must identify the date the

lawsuit commenced. Normally that date is when the complaint was filed, which was

October 7, 2019, in this case. (See §§ 350 [action is commenced when the complaint is

filed], 411.10 [“civil action is commenced by filing a complaint with the court”].)

The general rule that a lawsuit commences with the filing of the complaint does

not apply to Foster because he was in prison and was representing himself. As a result,

we must apply California’s prison delivery rule to determine the commencement date.

Under that rule, “a civil complaint by a pro se prisoner litigant should be deemed filed

when it is delivered to prison authorities for forwarding to the superior court.” (Moore v.

Twomey (2004) 120 Cal.App.4th 910, 918; 43 Cal.Jur.3d (2019) Limitations of Actions §

128, pp. 219–220 [under prison mailbox rule, prisoner’s complaint is deemed filed when

delivered to prison authorities for forwarding to court].)

Here, the record does not show when Foster delivered his complaint to prison

authorities for mailing to the superior court. For instance, there is no mail log showing

the date it was received and mailed. This appeal comes to us at the pleading stage. The

facts for the application of a statute of limitations at that stage must clearly and

affirmatively appear on the face of the complaint and matters judicially noticed.

(Committee for Green Foothills v. Santa Clara County Bd. of Supervisors, supra, 48

Cal.4th at p. 42.) Applying this principle, we draw the inference most favorable to Foster

when construing his complaint and assume it was delivered to prison officials

immediately after Foster signed it, which he did twice. The date handwritten by each

signature is September 10, 2019.

Therefore, applying California’s prison delivery rule and pleading stage principles,

we deem Foster’s lawsuit was commenced on September 10, 2019, even though it was

not filed by the superior court until the next month. Based on this commencement date

19.

and the one-year limitations period in section 340.5, Foster’s medical malpractice claim

will be timely if he discovered that cause of action on or after September 10, 2018.

3. Discovery

Foster’s complaint clearly and affirmatively shows he discovered the wrongdoing,

injury and causation relevant to his medical malpractice cause of action before September

2018. Paragraph 14 of Foster’s complaint alleges he “wrote several letter’s to

defendant’s to complain about his mistreatment and the unprofessional care that he was

denied which On: May 25, 2018, a response was issued by … Bermudez, who sought to,

apologize for the unprofessional care denied to the plaintiff .…” Consistent with this

allegation, Foster’s appellate briefing indicates that, sometime in February 2018, he

received the December 4, 2017 x-ray report showing the extent of his injuries. As a

result, Foster contends he did not discover the failure to diagnose his broken ribs and

resulting injuries until February 2018.

Based on the contents of Foster’s complaint and his appellate briefs, we conclude

Foster discovered his medical malpractice claim sometime before May 25, 2018. This

discovery occurred more than one year before the deemed commencement date of

September 10, 2019. As a result, Foster’s medical malpractice claim against Kaweah is

barred by the one-year statute of limitations in section 340.5, which was not tolled

because of the exception in subdivision (b) of section 352.1.

DISPOSITION

The order dismissing the case with prejudice, filed February 13, 2020, is reversed.

Within 10 days of the issuance of remittitur, the trial court shall vacate its “RULING ON

DEFENDANT’S DEMURRER,” filed January 29, 2020, and enter a new order (1)

overruling the demurrer to the federal civil rights cause of action under 42 U.S.C. section

1983, (2) sustaining the demurrer to the state law medical malpractice cause of action

20.

without leave to amend, and (3) directing Kaweah to answer the federal civil rights cause

of action within 21 days of the filing of the remittitur in the superior court.

Appellant shall recover his costs on appeal. (Cal. Rules of Court, rule 8.278.)

21.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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