The California Medical Association (CMA), through its Amicus Curiae Committee, with the valuable support of the American Medical Association (AMA) Litigation Center, has filed a brief with the California Supreme Court in an important case that draws the line between medical malpractice and elder abuse claims, Winn v. Pioneer Medical Group. In the brief, CMA and AMA explain why the appellate court decision, if left standing, would eviscerate the long-standing protections and effective purpose of California’s Medical Injury Compensation Reform Act (MICRA).
The case involves an 83 year-old-women who received care at Pioneer Medical Group in Cerritos in 2000. Several health professionals treated her for onychomycosis, which limits mobility and indirectly impairs peripheral circulation.
In 2007, she was diagnosed with peripheral vascular disease by a Pioneer family physician. The patient’s condition deteriorated and she visited Pioneer Medical Group at least seven more times during the next two years complaining of various ailments associated with peripheral vascular disease. She was admitted to a hospital with gangrene in 2009 and her right leg was amputated. She died from blood poisoning in 2010.
In 2011, Cox’s daughters filed suit against Pioneer Medical Group and several staff members alleging professional negligence and elder abuse. The plaintiffs said the medical group’s failure to refer Cox to a vascular specialist constituted neglect and abuse under the Elder Abuse Act.
Pioneer contended it was not liable for elder abuse because its physicians treated the woman as an outpatient and liability for elder abuse by definition requires assumption of custodial obligations. The group argued the alleged conduct could only constitute professional negligence, not elder abuse.
A lower court ruled in favor of Pioneer and threw the elder abuse claim out. The plaintiffs appealed the decision to the California Second Appellate District Court. CMA, through its Amicus Committee, filed an amicus brief and participated in oral argument before the Court of Appeal. The appeals court reversed the ruling and sent the case back to the lower court, allowing the elder abuse claim against the medical group to move forward. Pioneer Medical Group asked the California Supreme Court to review the appellate court decision. The Supreme Court granted that request.
CMA’s brief, filed together with the AMA, argues that claims based on a physician’s decision about whether a patient, including an elderly outpatient, needs a certain type of medical care fall within the parameters of professional negligence and are governed by MICRA, not the Elder Abuse Act.
CMA's brief with the AMA sets forth how this appeal is a veiled attempt to reclassify acts of professional negligence in order to circumvent MICRA and invoke the heightened remedies available under the Elder Abuse Act. The restrictive effect that such reclassification would have on access to care for the elderly, and the expansive effect it would have on malpractice insurance costs for health care providers, is significant. CMA's brief asks the Supreme Court to reject such reclassification and to state with certainty that claims based on a health care provider's decision as to an appropriate course of treatment cannot, through artful pleadings, be recast as claims for elder abuse, as doing so threatens to undermine the carefully crafted provisions of MICRA.
CMA told the court that allowing plaintiffs to seek enhanced remedies for elder abuse based on such conduct would conflict with the provisions of MICRA, which limit plaintiffs' remedies in an action based on that same conduct. Since the law cannot both enhance and limit remedies based on the same conduct, for the Elder Abuse Act and MICRA to coexist, allegations of elder abuse and professional negligence must be mutually exclusive. Therefore, the use of the Elder Abuse Act to extract additional damages or higher settlements in cases involving professional negligence is a misuse of the act that should not be allowed.
Click here to read the brief.
Contact: CMA's legal information line, (800) 786-4262 or firstname.lastname@example.org.