Friday, February 3, 2017
C.A. Upholds Dismissal of Claim Against Ambulance Firm
Panel Says Medical Expert’s Opinions About Duty and Causation Lacked Foundation
By KENNETH OFGANG, Staff Writer
A Kern Superior Court judge did not err in tossing out a former high school football player’s claims that an ambulance company committed gross negligence by not transporting him fast enough to the hospital after a head injury, the Fifth District Court of Appeal has ruled.
The court yesterday certified for partial publication its Jan. 13 opinion upholding Judge Sidney Chapin’s order granting summary judgment to Kern Emergency Medical Transportation Corporation.
Abraham Sanchez Jr. suffered the injury during a 2009 game. His complaint alleged that the defendant, which provided standby ambulance service, should have realized how serious his condition was and taken him immediately to the hospital, rather than summoning a transport ambulance.
By the time Sanchez reached the hospital, he had suffered a subdural hematoma, or swelling of the brain.
In moving for summary judgment, the defendant noted that as an employer of paramedics and emergency medical technicians, it can only be held liable—under Health and Safety Code §1799.106—for gross negligence or bad faith. The company said its paramedic properly assessed Sanchez’s condition at the time, under the county’s criteria, and that his condition did not constitute a Code 3 (lights-and-siren) emergency until it deteriorated after he had been placed in the second ambulance.
In any event, the company said, the paramedic had to complete his assessment before the plaintiff was moved and the wait for a second ambulance added less than three minutes to the plaintiff’s arrival time at the hospital, and could not, according to relevant medical literature, have worsened the medical outcome.
The plaintiff’s opposition included a declaration from a neurosurgeon, Dr. Fardad Mobin, who opined that if the paramedic had ordered immediate transport, “there would have been a decrease in brain swelling, and thereby pressure, because the administration of Mannitol would have occurred much sooner.”
The defense raised a number of objections to the declaration. After sustaining some of those, Chapin concluded that the plaintiff “failed to proffer substantial, admissible evidence from which a trier of fact could find in his on a necessary element of causation of injury,” and granted summary judgment.
Presiding Justice Brad Hill, writing for the Court of Appeal, agreed with the trial judge.
He cited a number of problems with the declaration, starting with Mobin’s suggestion that Sanchez suffered ischemia—a restriction in blood supply to the tissues—because he was not brought to the hospital within the “golden hour” following the injury. The undisputed evidence, Hill said, was that Sanchez arrived at the hospital 48 minutes after the injury occurred.
Mobin’s assertion that delay in transport exacerbated the injury was conclusory and failed to address the medical literature cited by the defense experts, which suggested that delays of as much as 30 minutes have no impact on outcomes.
“Plaintiff did not refute defendant’s showing that Mobin’s opinions were based on assumptions of fact without evidentiary support or on speculative or conjectural factors,” Hill wrote. “Such expert opinions have no evidentiary value and may be excluded from evidence.”
The appellate panel also rejected Mobin’s claim that the transportation delay and blood pooling that resulted ultimately caused Sanchez to suffer a stroke that same night. That conclusion was contrary to medical research relied on by the defense experts, who said the exact timing of the stroke, which was diagnosed after brain scans days later, couldn’t be determined.
Mobin, Hill said, “provided no reasonable explanation supported by facts for his conclusion that the stroke resulted from brain herniation from the delay in transport.”
Sanchez was represented on appeal by Daniel Rodriguez, Joel T. Andreesen and Chantal Trujillo of Rodriguez & Associates, and Stuart B. Esner and Andrew N. Chang of Esner Chang & Boyer; the company’s lawyers were Matthew Banashek and Michael W. Irving of Sclar Adler LLP.
The case is Sanchez v. Kern Emergency Medical Transportation Corporation, F069843.
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