Along for the Ride: Non-Patients May be Subject to MICRA’s Limitations

In Lopez v. American Medical Response West (2023) Cal.Rptr.3d (2023 WL 2518511), the California Court of Appeal, First Appellate District, affirmed a lower holding that the one-year statute of limitations under professional negligence applies to both a patient and a non-patient who had been riding in an ambulance driven by a medical professional when it collided into another vehicle during an emergency transportation.

The Lopez trial court held that the Medical Injury Compensation Reform Act (MICRA) statute of limitations for professional negligence applied to both the patient and non-patient, superseding the extended limitations permitted under a general negligence claim. Secondarily, the court rejected plaintiffs’ position that their complaint was filed timely, based on their subsequent notice letter under Code Civ. Proc. § 364. This appeal followed the trial court decision.

Generally, a personal injury action must be filed within two years of the date on which the challenged act or omission occurred. Code Civ. Proc. § 335.1. But a special one-year statute of limitations applies for injury or death against a health care provider when a claim involves alleged professional negligence. Code Civ. Proc. § 340.5. MICRA expanded Section 340.5 by designating that a claim for professional negligence will be subject to the one-year statute of limitations.

The California Supreme Court established nuances of professional negligence limitations in Flores v. Presbyterian Intercommunity Hospital (2016) 63 Cal.4th 75, when a patient was injured after a hospital bed rail collapsed. Flores held that an injury claim is controlled by professional negligence limitations when the use or maintenance of medical equipment or premises was the cause of injury while medical care was being provided to the patient. A subsequent appellate decision in Nava v. Saddleback Memorial Medical Center (2016) 4 Cal.App.5th 285 held that the transfer of a patient in the hospital on a gurney was integrally related to the medical treatment or diagnosis, and, therefore, the injury occurred in the rendering of such professional services.

The Lopez case involved Emergency Medical Technicians (EMTs) who were rendering professional services to a patient while transporting him and his non-patient son in an ambulance, and while en route, that ambulance collided with another vehicle due to the EMTs’ negligence. Both the patient and non-patient were injured from the EMTs’ use of that equipment integrally related to the patient’s medical diagnosis and treatment (i.e., the ambulance being used to accommodate the father’s transportation for furthering medical treatment).

Although MICRA applies to negligent acts or omissions in the rendering of professional services, it does not require the services to have been performed for the plaintiff. Cal. Civ. Proc. Code § 340.5. Accordingly, regardless of whether the EMTs performed any professional services to the patient or his son, the use of the ambulance was reasonably required to accommodate the patient’s condition. This put the EMTs’ actions squarely under the direction of Section 340.5. Lopez illustrated that a third party, such as the non-patient son in this case, can be subject to the same MICRA limitations when that person is injured and is similarly situated as the patient. Here, both the patient and his son were in the same ambulance and injured in the same way. Lopez was carefully narrow for this set of facts and did not extend its holding to other examples of third parties not as similarly situated.

Thus, Lopez accurately affirmed that the defendant’s motion for summary judgment was properly granted because the plaintiffs had not filed their complaint until 14 months after the incident occurred.

Flores highlighted MICRA’s purpose – “to reduce the cost of medical malpractice insurance by limiting the amount and timing of recovery in cases of professional negligence.” Flores at 231-32 (quoting 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]).

Any concerns about Lopez extending into unintended liability scenarios are unfounded and only entertained if we expect the courts to disregard such policy rationale and common sense as to the nature of multiple plaintiffs similarly situated in a claim. Lopez provides a specific example of a patient and non-patient both inside of an ambulance at the same time, each injured in the same collision caused by the same events and circumstances. Even if the father and son had been represented by independent counsel and filed their claims separately, a court would be obligated to merge the two litigation matters for efficiency’s sake.

Lopez does not attempt to reach alternate scenarios where, for example, an injured third-party not inside of an ambulance is struck by an ambulance driven negligently by a professional in the course of treating or transporting a patient. Such a case would certainly be distinguishable from Lopez and worthy of a unique examination. It extends even farther into the realm of hypothetical delusion to think that Lopez somehow will impose MICRA’s limitations to a third-party who is injured by an ambulance that was not being driven for purposes of medical care or by one not being driven by a medical professional. None of these scenarios would be in line with the holding in Lopez, involving the operation of a vehicle being “reasonably required to treat or accommodate a physical or mental condition of the patient.”

Overall, Lopez provides helpful clarification without broad implications.

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March 29, 2023