Prescott v. Rady Children's Hosp.-San Diego

• Citation: 265 F.Supp.3d 1090
• Decision Date: 27 September 2017
• Docket Number: Case No.: 16–cv–02408–BTM–JMA
• Parties: Katharine PRESCOTT, an individual, and Katharine Prescott, on behalf of Kyler Prescott, a deceased minor, Plaintiff, v. RADY CHILDREN'S HOSPITAL–SAN DIEGO, Defendant.
• Court: U.S. District Court — Southern District of California

265 F.Supp.3d 1090

Katharine PRESCOTT, an individual, and Katharine Prescott, on behalf of Kyler Prescott, a deceased minor, Plaintiff,
v.
RADY CHILDREN'S HOSPITAL–SAN DIEGO, Defendant.

Case No.: 16–cv–02408–BTM–JMA

United States District Court, S.D. California.

Signed September 27, 2017

Eileen Regina Ridley, Alan R. Ouellete, Foley and Lardner LLP, San Francisco, CA, Kathryn Anna Shoemaker, Foley & Lardner, Los Angeles, CA, for Plaintiff.

Julie Renee Dann, Marilyn R. Moriarty, Lewis Brisbois Bisgaard & Smith, LLP, San Diego, CA, for Defendant.

ORDER GRANTING IN PART AND DENYING IN PART DEFENDANT'S MOTION TO DISMISS AND DENYING DEFENDANT'S MOTION TO STAY

Barry Ted Moskowitz, Chief Judge

Before the Court are Defendant Rady Children's Hospital, San Diego's ("RCHSD") motion to dismiss and motion to stay. (ECF No. 9, 15.) The Court discusses each below.

I. BACKGROUND

Plaintiff Katharine Prescott brought this action against RCHSD on behalf of herself, and on behalf of Kyler Prescott, her deceased minor son. (ECF No. 1 ("Compl.").) RCHSD is a nonprofit healthcare organization affiliated with the University of California, San Diego School of Medicine that receives federal and state assistance. (Compl. ¶ 20–22.) Mr. Prescott

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alleges that RCHSD "advertises its expertise in treating transgender and gender noncomforming children and adolescents through its Gender Management Clinic...." (Id. at ¶ 23.) "RCHSD held itself out and warranted itself to the public as competent, careful, and experienced in the care and treatment of patients, particularly transgender patients and those with gender dysphoria¹ ." (Id.) Additionally, RCHSD's website states that transgender youth "deserve to have a medical home at Rady Children's Hospital—San Diego." (Id.)

Kyler was assumed to be female at birth. (Id. at ¶ 29.) However, at the age of ten Kyler began exhibiting signs that he was a boy. (Id.) At the age of twelve, due to increasing gender dysphoria, Kyler began engaging in self-harming behaviors. (Id.) When Kyler was thirteen, he told Ms. Prescott that he was a boy. (Id. at ¶ 30.) As Kyler entered puberty, his gender dysphoria significantly worsened and he continued to engage in severe self-harming behaviors. (Id.) Concerned about his mental health, Kyler's parents and then-therapist focused their therapy sessions on helping him cope with his gender dysphoria and depression. (Id.) When Kyler was thirteen, with the support of his parents, he socially transitioned² to living life as a boy. (Id. at ¶ 34.) At fourteen Kyler began seeing Darlene Tando, an expert in providing therapy to transgender youth. (Id.) In September 2014, Kyler's endocrinologist, a physician in the Gender Management Clinic at RCHSD, approved him for puberty-delaying medication. (Id. at ¶ 35.) In October 2014, Kyler received his first treatment. (Id.)

Despite the positive effects Kyler's transition had on his mental health, he still experienced depression and gender dysphoria. (Id. at ¶ 36.) For a transgender person with gender dysphoria, being referred to by the wrong gender pronoun is often incredibly distressing. (Id. at ¶ 37.) For Kyler, being misgendered caused him psychological distress. (Id. at ¶ 38.) This led Kyler to withdraw from his charter school and instead participate in a private independent study. (Id.)

On April 5, 2015, Ms. Prescott took Kyler to the Sam S. and Rose Stein Emergency Care Center of RCHSD because of his suicidal thoughts related to gender dysphoria and to treat his self-inflicted lacerations. (Id. at ¶ 39.) In the early morning of April 6, 2015, Kyler was admitted to RCHSD's Child and Adolescent Psychiatry Services ("CAPS") unit on a Cal. Welf. & Inst. Code section 5150 hold for psychiatric inpatient care. (Id.) The RCHSD and CAPS staff was informed by Ms. Prescott of Kyler's male identity and "his need to be referred to exclusively with male gender pronouns." (Id. at ¶ 40.) Kyler's medical records reflected his legal name and gender change. (Id. at ¶ 40.) His male gender identity was also denoted on his RCHSD medical wrist bracelet. (Id.) Upon intake, the RCHSD staff assured Ms. Prescott "that Kyler's sex and gender identity would be respected and affirmed"

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and that "all staff would refer to Kyler with male gender pronouns and would otherwise treat him as a boy." (Id. at ¶ 41.)

Despite knowing that Kyler was a "transgender boy in acute psychological distress," "nursing and other RCHSD staff repeatedly addressed and referred to Kyler as a girl, using feminine pronouns." (Id. at ¶ 43.) Kyler complained to his mother during his stay that the staff referred to him with feminine pronouns, which caused him extreme distress. (Id. at ¶ 44.) Kyler also reported that while the other children who were patients initially referred to him with male pronouns, after the RCHSD staff's repeated use of female pronouns, the children also began calling him "she." (Id.) After Kyler was discharged, he also told Ms. Prescott that one RCHSD employee told him, "Honey, I would call you ‘he,’ but you're such a pretty girl." (Id.) Every time Ms. Prescott observed staff calling Kyler "she," she reiterated that "it was essential to exclusively refer to Kyler with male gender pronouns, and that misgendering caused him serious harm." (Id. at ¶ 46.)

During Kyler's stay, Ms. Prescott called RCHSD numerous times to share Kyler's reports of misgendering and remind the staff of the need to refer to Kyler with male pronouns. (Id. at ¶ 46.) The Complaint alleges that in response, RCHSD blocked her number, "leaving her unable to call the CAPS unit, which had control over her son during his time of distress, as well as leaving her unable to solicit updates on Kyler's condition." (Id. at ¶ 47.) As a result of RCHSD staff's conduct, Kyler suffered severe emotional distress and harm, and Ms. Prescott was and continues to be traumatized by the experience. (Id.) Despite concerns over Kyler's continuing depression and suicidal thoughts, Kyler's medical providers concluded that he should be discharged early from the hold at RCHSD because of the staff's conduct. (Id. at ¶ 51.) On April 7, 2015, Kyler was discharged from RCHSD's facility. (Id. at ¶ 52.) After being discharged, Kyler continued to feel anxious and depressed as a result of RCHSD staff's treatment during his stay. (Id. at ¶ 53.) On May 18, 2015, Kyler died by suicide. (Id. at ¶ 54.)

Ms. Prescott now brings this action against RCHSD alleging numerous causes of action including violations of the Affordable Care Act § 1557, 42 U.S.C. § 18116 ("ACA"), California's Unruh Civil Rights Act, Cal. Civ. Code. § 51, California Government Code § 11135, California's Unfair Competition Law, Cal. Bus. & Prof. Code §§ 17200 et seq. ("UCL"), and California's Fair Advertising Law, Cal. Bus. & Prof. Code §§ 17500 et seq. ("FAL").

II. STANDARD

A. Motion to Dismiss

A motion to dismiss under Federal Rule of Civil Procedure 12(b)(6) should be granted only where a plaintiff's complaint lacks a "cognizable legal theory" or sufficient facts to support a legal claim. Balistreri v. Pacifica Police Dept. , 901 F.2d 696, 699 (9th Cir. 1988). When reviewing a motion to dismiss, the allegations of material fact in plaintiff's complaint are taken as true and construed in the light most favorable to the plaintiff. Parks Sch. of Bus., Inc. v. Symington , 51 F.3d 1480, 1484 (9th Cir. 1995). In deciding a motion to dismiss, a court may consider the facts alleged in the complaint, exhibits attached to the complaint, and documents whose authenticity is not questioned and upon which the plaintiff's complaint necessarily relies on, even if not physically attached to the complaint. Branch v. Tunnell , 14 F.3d 449, 454 (9th Cir. 1994).

Although detailed factual allegations are not required, factual allegations "must be

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enough to raise a right to relief above the speculative level." Bell Atlantic v. Twombly , 550 U.S. 544, 555, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). "A plaintiff's obligation to prove the ‘grounds’ of his ‘entitle[ment] to relief’ requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do." Id. "[W]here the well-pleaded facts do not permit the court to infer more than the mere possibility of misconduct, the complaint has alleged—but it has not show[n] that the pleader is entitled to relief." Ashcroft v. Iqbal , 556 U.S. 662, 679, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) (internal quotation marks omitted). Only a complaint that states a plausible claim for relief will survive a motion to dismiss. Id.

B. Motion to Stay

"A trial court may, with propriety, find it is efficient for its own docket and the fairest course for the parties to enter a stay of an action before it, pending resolution of independent proceedings which bear upon the case." Leyva v. Certified Grocers of Cal., Ltd. , 593 F.2d 857, 863 (9th Cir. 1979). The rule does not require that the issues in the independent proceeding be necessarily controlling of the action before the court. Id. 863–64. When deciding whether to stay a...