Sanchez v. Kern Emergency Medical Transportation Corporation
COURT OF APPEAL, FIFTH APPELLATE DISTRICT (February 6, 2017)
An expert opinion filed in opposition to a summary judgment must be based on admissible evidence. In Sanchez v. Kern Emergency Medical Transportation Corporation, Plaintiff sustained an injury to his head while playing in a high school football game. The standby paramedic assessed plaintiff using the Glasgow Coma Scale and gave him the highest possible scores based on his responses. Nevertheless, the paramedic advised plaintiff to go to the hospital and called for a backup transport ambulance. The crew of the transport ambulance applied spinal precautions and transported plaintiff to the hospital 31 miles away. Forty-six minutes elapsed from the time plaintiff was first assessed by the paramedic to the time he arrived at the hospital. Plaintiff received a CT scan upon arrival which revealed a subdural hematoma, drugs were administered to reduce the brain swelling, and plaintiff underwent surgery to relieve a brain hemorrhage. At some point in time, plaintiff suffered a posterior artery stroke.
Plaintiff sued Kern Emergency Medical Transportation Corporation (“Kern”), among others, for his injuries. Plaintiff alleged that Kern was grossly negligent in the care and treatment it rendered to him, failed to properly assess him and failed to recognize he had sustained a traumatic brain injury that required immediate, urgent transport to a trauma center. Plaintiff alleged the delay in transport made his brain injury worse.
Kern moved for summary judgment asserting there was no evidence to support plaintiff’s allegations of gross negligence or causation of any damages. Kern supported its motion by submitting evidence that any delay caused by using two ambulances was only 2 ½ minutes which did not harm plaintiff or increase his injuries. Kern also submitted evidence that the delay, even if found to be 30 minutes, could not have caused plaintiff harm because the medical literature indicates there is no evidence such a brief delay in treatment correlates with a worse outcome. Kern submitted declarations from expert witnesses addressing the issues of breach of duty and causation.
When a plaintiff claims negligence in the medical context, the plaintiff must present evidence from an expert that the defendant breached his or her duty to the plaintiff and that the breach caused the injury to the plaintiff. Powell v. Kleinman (2007) 151 Cal.App.4th 112, 123.When a defendant moves for summary judgment and supports his motion with expert declarations that his conduct fell within the community standard of care, he is entitled to summary judgment unless the plaintiff comes forward with conflicting expert evidence. Id.
Plaintiff submitted a declaration from neurological surgery expert witness, Dr. Fardad Mobin, in support of his opposition to the motion. Dr. Mobin opined that had plaintiff been transported immediately upon initial contact by the paramedic, there would have been a decrease in brain swelling and pressure because the administration of drugs would have occurred much sooner. Dr. Mobin only referenced the 46 minutes which elapsed between plaintiff’s first contact with the paramedics and his arrival at the hospital and failed to set forth any other relevant time periods in his declaration relating to the alleged delay that caused plaintiff’s injuries to worsen.
The defense raised a number of objections to Dr. Mobin’s declaration arguing that the opinions expressed were conclusory, speculative, failed to consider undisputed facts in the record, and failed to address statements made by defense experts that refuted those opinions. The trial court sustained the objections to Dr. Mobin’s declaration and granted Kern’s motion for summary judgment on the grounds that plaintiff failed to present any admissible evidence contesting Kern’s evidence that any delay in transport to the hospital did not make plaintiff’s condition worse. Plaintiff appealed.
The Court of Appeal affirmed the trial court’s ruling finding that the trial court did not abuse its discretion in sustaining the objections to Dr. Mobin’s declaration. The Court found that Dr. Mobin’s declaration failed to demonstrate his opinions were based on matters that experts reasonably rely on in forming such opinions and failed to include a reasoned explanation connecting the factual predicates to the ultimate conclusion.
The Court noted that Dr. Mobin referred generally to a delay in transport but failed to define the delay referred to in forming his opinions and failed to address that time was properly spent on assessment by the paramedics and application of spinal precautions. The Court also noted that Dr. Mobin failed to address medical literature presented by defense experts that a moderate delay in treatment could not have affected plaintiff’s outcome. The court found that Dr. Mobin had no factual basis for concluding that the delay in transporting plaintiff to the hospital exacerbated his injuries suffered on the football field.
The Court of Appeal found that plaintiff failed to raise a triable issue of material fact on the issue of causation, and the trial court’s ruling granting Kern’s motion for summary judgment was upheld.
An expert opinion filed in opposition to a summary judgment motion does not need to be as extensive as those offered in support, but it still must be adequately supported to be admissible evidence. An expert’s opinion based on assumptions of fact without evidentiary support or on speculative or conjectural factors has no evidentiary value and may be excluded from evidence.
For a copy of the complete decision, see: Sanchez v. Kern Emergency Medical Trans.