Articles Posted in Personal Injury

It is worth noting that situations similar to those described in this wrongful death case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, UC Davis Medical Center, Mercy, Methodist, or Sutter.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this personal injury action and its proceedings.)

In contrast, in our case, the analysis is not burdened by the policy favoring arbitration. Instead, there are at least two strong public policies weighing against the clause’s enforceability that must be taken into account: one disfavoring exculpatory provisions in hospital admission agreements purporting to limit liability without clear explanation to the patient; and another favoring the availability of essential medical services to all patients in order to serve the public interest. See Id.

See also, Randas v. YMCA of Metropolitan Los Angeles (1993) 17 Cal. App. 4th 158, 161-162 (Explaining, “…the hospital patient contract clearly falls within the category of agreements affecting the public interest” while distinguishing releases signed by participants in sports or recreational activities, because “… athletic or recreational activities, however enjoyable or beneficial, are not essential, as a hospital is to a patient” [citing Tunkl, supra at 92]); see also Health Net of California, Inc. v. Dept. Of Health Services (2003) 113 Cal. App. 4th 224, 237 (wherein the court, citing Tunkl, concluded that “… an exculpatory clause that is part of a transaction that provides managed health care for Medi-Cal beneficiaries affects the public interest.”); City of Santa Barbara v. Superior Court (2007) 41 Cal. 4th 747, 762. (See Part 7 of 9.)

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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It is worth noting that situations similar to those described in this wrongful death case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, UC Davis Medical Center, Mercy, Methodist, or Sutter.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this personal injury action and its proceedings.)

Perhaps nowhere is the import of these principles more apparent than in the context of the hospital emergency room (ER). California law has long held that especially where, as here, a patient arrives at the ER in a condition impaired by a serious injury or illness, hospital admission forms purporting to circumscribe the hospital’s liability constitute adhesion contracts. As the California Supreme Court recognized in Tunkl v. Board of Regents (1963) 60 Cal. 2d 92, 93 The would-be patient is in no position to reject the proffered agreement, to bargain with the hospital, or in lieu of agreement to find another hospital.

The admission room of a hospital contains no bargaining table where, as in a private business transaction, the parties can debate the terms of their contract. As a result, we cannot but conclude that the instant agreement manifested the characteristics of the so-called adhesion contract … ” Id at 102; see also Wheeler, supra, 63 C.A.3d at 357 (wherein the court, relying on Tunkel, held that a hospital’s standard printed “Conditions of Admission” constitutes an adhesion contract, especially because a patient being admitted to a hospital is in no position to debate his or her terms of admission).

Significantly, while the admission agreement in Tunkl involved a clause purporting to waive liability, Wheeler involved an arbitration clause-a provision freighted with public policy concerns favoring its application.

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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It is worth noting that situations similar to those described in this wrongful death case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, UC Davis Medical Center, Mercy, Methodist, or Sutter.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this personal injury action and its proceedings.)

The Consent to Admission Form, or at least the “Independent Contractor” provision, constitutes an unenforceable adhesion contract.

The evidence of record established these facts as undisputed:

1. The admission form signed by Mr. Hall at Universal contained a provision characterizing Universal physicians as independent contractors, which was located approximately two-thirds down from the top of the document.

2. This independent contractor provision was in the same small print as the rest of the document, was not in bold type, highlighted, or in any way emphasized or set apart from the rest of the text so as to draw the reader’s notice. Absolutely no evidence was offered suggesting that Mr. Hall’s attention was drawn to this provision in any way, either in writing or orally.

3. Mr. Hall was required to sign the form in order to receive admission and treatment at Universal, and had little if any bargaining power under the circumstances (which he was incapable of exercising at that time, even if it existed).

A contract of adhesion has been defined as ” … a standardized contract, which, imposed and drafted by the party of superior bargaining strength, relegates to the subscribing party only the opportunity to adhere to the contract or reject it.” Bruni v. Didion (4th App. Dist. 2008) 160 Cal. App. 4th 1272, 1289. Stated another way, ” … a contract of adhesion is a standardized contract drafted by the party with stronger bargaining power, such that the weaker party has no choice other than to accept it or reject it.” Id at 1291.

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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It is worth noting that situations similar to those described in this wrongful death case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, UC Davis Medical Center, Mercy, Methodist, or Sutter.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this personal injury action and its proceedings.)

Stanhope was among the authority relied on by the Fourth Appellate District Court in Mejia at 1448, 1454-1459, wherein the Mejia court noted that this rule applies with greater force in cases where the plaintiff-patient is seen in the emergency room, emphasizing its agreement with “…the Stanhope holding that emergency room patients cannot be expected to inquire as to whether treating physicians are independent contractors.” Mejia involved a plaintiff whose broken neck was allegedly misdiagnosed by ER physicians, resulting in paralysis. Surveying the law of other jurisdictions, the court observed, ” …because it is commonly believed that hospitals are the actual providers of care, ostensible agency can be readily inferred whenever someone seeks treatment at a hospital.” Id at 1456. The Court concluded California law should be interpreted consistently with this majority view.

Alternatively, if Mr. Hall signed the “Consent to Admission” form after receiving a dose of Dilaudid, an opiate-based narcotic, it may be presumed that his judgment was impaired, particularly given the long duration of his severe pain prior to receiving the medication and his declining vital signs. Either way, this dying man could not be held responsible to analyze a legal document he was required to sign in order to receive treatment to ease his misery, as a matter of law. See Mejia, supra, 99 Cal. App. 4th at 1454, 1458-1459.

The application of this general principle-that patients who enter a medical facility under circumstances indicating that they are unable to effectively consider and accept the terms of an agreement they must sign in order to be admitted should not be bound by its terms-has been applied in a broad range of situations. It extends even to patients who are not in pain, medicated, or seeking admission on an emergency basis.

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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It is worth noting that situations similar to those described in this wrongful death case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, UC Davis Medical Center, Mercy, Methodist, or Sutter.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this personal injury action and its proceedings.)

THE PHYSICIANS WHO DEALT WITH MR. HALL AT UNIVERSAL WERE OSTENSIBLE AGENTS OF THE HOSPITAL, AS A MATTER OF LAW

A. Because he was gravely ill and in severe pain, Mr. Hall lacked the capacity to validly execute a contract, purporting to contain a waiver of rights.

The evidence of record has established these facts as undisputed:

1. Mr. Hall signed the Universal admission form at about the same time he was admitted to the hospital floor on August 11,2008, which the records indicate was approximately 10:30 p.m.

2. At that time of his admission, Mr. Hall had been suffering pain he reported to be 9 – 10/10 for nearly 2 1/2 hours.

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

3. Mr. Hall’s Universal chart indicates that at approximately 10:30 p.m., he was finally given an intravenous dose of two to three milligrams of Dilaudid (with the usual dose ranging from one to two milligrams when so administered). Dilaudid is a narcotic pain reliever that takes immediate effect when given intravenously, and which may impair thinking and judgment.

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It is worth noting that situations similar to those described in this wrongful death case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, UC Davis Medical Center, Mercy, Methodist, or Sutter.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this personal injury action and its proceedings.)

Plaintiffs’ Motion for Directed Verdict Against Universal Memorial Hospital, Inc. on Ostensible Agency Issue
INTRODUCTION

Plaintiffs hereby move that the Court determine, as a matter of law, that the Universal Hospital Conditions of Admission form signed by Decedent David Hall, Jr. is an unenforceable with respect to the provision therein stating the physicians attending to him are independent contractors.

The motion is based on two distinct reasons: (1) Because Mr. Hall lacked the responsibility and capacity to validly execute a binding agreement acknowledging such legal relationships and concurrently waiving his rights at the time he signed it; and (2) because the Form constitutes an unenforceable adhesion contract. Accordingly, Plaintiffs respectfully request that the Court remove the agency issue from consideration by the jury, rule that the clause at issue is void and has no legal effect herein as a matter of law, and further rule that all physicians who attended Mr. Hall during his stay at Universal are declared to be ostensible agents of the hospital, as a matter of law. In addition, Plaintiffs request that the Court instruct the jury that the Universal physicians were ostensible agents of the hospital, as a matter of law. (See Part 2 of 9.)

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this brain injury case and its proceedings.)

Mr. Santoro’s Damages are Straightforward and Largely Undisputed

Defendants suggest that plaintiffs damages evidence will be highly complex and note that there were numerous doctors who treated plaintiff during the months he was hospitalized at Sacramento Medical Center, Mercy and the rehabilitation facilities. However, plaintiff’s damages evidence will be streamlined, straightforward and largely undisputed.

First, as noted above, plaintiff intends to call only one doctor from Sacramento Medical Center and one from Mercy, each of whom will explain the nature and extent of Mr. Santoro’s head injury and the surgical procedures they performed. A third doctor, Dr. X from Children’s Hospital, will explain the tendon release he performed on Mr. Santoro’s legs. This is a very straightforward procedure. None on this testimony will be lengthy. While Mr. Santoro’s injury was severe, none of the testimony about the injury or his treatment is particularly complex or difficult to understand. And, as noted, there is little dispute about the nature and extent of Mr. Santoro’s injury – it is pretty clear cut. There is little disagreement among the parties’ medical experts. The only other medical experts will be a neurologist, a neuropsychologist and a life care planner.

Thus, defendants’ concern about complexity or an extensive number of witnesses regarding damages will not materialize in reality. A single trial will be efficient and take far less court and juror time than a two-phase trial.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this brain injury case and its proceedings.)

Ends of Justice/Prejudice

Defendants speculate that a single trial may confuse the liability issues or result in prejudice in that a jury might look past liability. However, defendants cite no empirical evidence suggesting that trying liability and damages in a single trial would cause any prejudice to defendants. Certainly the fact that Mr. Santoro suffered a severe injury is no reason to bifurcate. Serious injury cases are tried in the courts of Sacramento County and other counties routinely without bifurcation and with no evidence of prejudice to defendants.

Jurors are routinely instructed they must find liability before considering damages and they appear to do so with little problem. Defendants offer speculation, but no evidence to the contrary. Further, as discussed above, the jury in this case would be aware of the seriousness of the injury in the liability phase in any event. The issue will be discussed in voir dire, as will many issues relating to Mr. Santoro’ injury and damages, for there is only one opportunity to voir dire the jury before it is empaneled. See Bly-Magee v. Budget Rent-A-Car 24 Cal.App.4th 318, 332-344 (1994).

Further, the fact that Mr. Santoro suffered a fractured skull, a severe brain injury and was in a coma for weeks, etc. will be admissible on the amount of force used, to show that the amount of force used was unreasonable and excessive. Similarly, Mr. Santoro’s injury must be discussed to some extent by medical professionals to explain to the jury why Mr. Santoro’s memory loss is so extensive and, importantly, that his inability to recall any part of this incident is real and not feigned.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this brain injury case and its proceedings.)

B. Economy and Efficiency

The above discussion highlights the fact that far from promoting economy and efficiency, bifurcation would add significantly to the time and expense of litigating this case and would add significantly to the logistical difficulties of scheduling and re-scheduling witnesses, including experts, some of whom will have to testify twice.

In terms of economy, there is little question that a second trial will occur in this matter, particularly given the fact that comparative fault will apply. Given the number of procedures and training guidelines violated by Officer Doe and the extreme amount of force he applied to Mr. Santoro under very benign circumstances, it is most unlikely that a jury would not assign some percentage of fault to Officer Doe, if not a substantial percentage.

Not only would a second trial require several witnesses to testify twice, second opening statements, closing arguments, jury instructions and jury deliberations would be necessary. This would extend this trial well beyond the time necessary to conduct a single trial. This would not serve the goal of judicial economy at all. A single trial will not be much longer than a bifurcated liability phase, particularly since there is very little dispute among the experts about Mr. Santoro’s damages. Indeed, the defense neuropsychologist has recently testified that Mr. Santoro has greater deficits and will need more care during his life than plaintiffs expert.

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(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this brain injury case and its proceedings.)

A. CONVENIENCE OF WITNESSES

As mentioned, plaintiff intends to call one of the neurosurgeons who treated him at Sacramento Medical Center and another who treated him at Mercy. Both of these surgeons performed operations on Mr. Santoro at different times and for different reasons. Both will testify about the extent and severity of the head injury Mr. Santoro sustained, as well as the fact that an extreme amount of force was required to cause this level of injury.

This evidence is a critical piece of plaintiff’s proof in the liability phase. One of plaintiffs causes of action is for battery by Officer Doe. The crux of this claim is whether the force used by the officer was unreasonable or excessive under the circumstances. See, e.g., CACI Instruction No. 1305; Edson v. City of Aneheim, 63 Cal.App.4th 1269, 1272 [in action for battery against a police officer, plaintiff has burden of proving unreasonable force by the officer].

The nature and extent of the injury, as well as testimony about the amount of force that would be necessary to cause such an injury, is relevant and admissible on this issue.

Of course, both of these doctors will have additional testimony on the issue of damages. Bifurcation would therefore require that both testify twice, which would be highly inconvenient and unnecessarily expensive.

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