Flowers v. Torrance Memorial Hospital Medical Center

• Decision Date: 05 December 1994
• Docket Number: No. S033331,S033331
• Citation: 8 Cal.4th 992,35 Cal.Rptr.2d 685,884 P.2d 142
• Court: California Supreme Court
• Parties: , 884 P.2d 142 Darlene FLOWERS, Plaintiff and Appellant, v. TORRANCE MEMORIAL HOSPITAL MEDICAL CENTER, et al., Defendants and Respondents

Page 685

35 Cal.Rptr.2d 685

8 Cal.4th 992, 884 P.2d 142

Darlene FLOWERS, Plaintiff and Appellant, v. TORRANCE MEMORIAL HOSPITAL MEDICAL CENTER, et al., Defendants and Respondents.

No. S033331.

Supreme Court of California

Dec. 5, 1994.

Gittler & Wexler, Gittler, Wexler & Bradford, Harlan L. Bransky, Los Angeles, Robert M. Moss, Santa Monica, and Ronald P. Kaplan, Los Angeles, for plaintiff and appellant.

Robert R. Huskinson, Manhattan Beach, Horvitz & Levy, David M. Axelrad, S. Thomas Todd and David S. Ettinger, Encino, for defendants and respondents.

Catherine I. Hanson and Gregory M. Abrams, San Francisco, as amici curiae on behalf of defendants and respondents.

ARABIAN, Justice.

In this case, we consider the distinction between "ordinary" and "professional" negligence and conclude that with respect to questions of substantive law they comprise essentially one form of action. Apart from statutory considerations, characterizing misfeasance as one type of negligence or the other generally only serves to define the standard of care applicable to the defendant's conduct. Accordingly, we reverse the decision of the Court of Appeal holding that the same alleged breach of duty can give rise to distinct causes of action for "ordinary" as well as "professional" negligence.

FACTUAL AND PROCEDURAL HISTORY

This case began Christmas Eve 1986 when plaintiff Darlene Flowers (plaintiff) was admitted to the emergency room of defendant Torrance Memorial Hospital Medical Center (the hospital) complaining of bladder pain. She was assisted onto a gurney by defendant Nurse Mary Elizabeth Osborne (Osborne) to await further medical attention, at which time Osborne raised only the far side railing. While awaiting treatment, plaintiff apparently fell asleep. When she awoke, she attempted to roll over but instead fell off the gurney and sustained injury to her back and arm.

Plaintiff subsequently filed suit against the hospital and Osborne (collectively, defendants) alleging causes of action for "general negligence" and "premises liability." Defendants moved for summary judgment based on the declaration of their expert, who had extensive experience in emergency room practice in the general locale of the hospital. He stated that "[i]t is not and was not at the time of the accident the standard of practice in emergency rooms in this locality to necessarily put the rails up on gurneys for patients" such as plaintiff, who "was not elderly or confused, was not inebriated or medicated, was not a small child, and was not otherwise the kind of patient needing the rails put up. Furthermore, she was in considerable pain and not likely to fall asleep." Plaintiff countered with evidence from her own medical expert that the hospital's emergency room policy and procedure manual required The trial court granted summary judgment in favor of defendants after finding that the declaration of plaintiff's expert witness was defective in several respects. Hence, defendants' evidence as to the applicable standard as well as their exercise of due care stood unrebutted, and no triable issue of material fact remained as to their negligence. The court denied plaintiff's motion for reconsideration.

"[b]oth side rails ... to be up on a patient lying on a guerney [sic ]...." In response, defendants argued that plaintiff's witness had misinterpreted the policy and procedure manual, which did not so require, and that he had relied on a provision in an orientation packet applicable only to children.

In a divided opinion, the Court of Appeal reversed. Although the majority agreed that defendants had negated any "professional negligence," they found the pleadings "broad enough to encompass a theory of liability for ordinary as well as professional negligence" because the manner of her injury did not involve a breach of duty to provide professional skill or care. ¹ (See Gopaul v. Herrick Memorial Hosp. (1974) 38 Cal.App.3d 1002, 1007, 113 Cal.Rptr. 811; see also Neel v. Magana, Olney, Levy, Cathcart & Gelfand (1971) 6 Cal.3d 176, 188, 98 Cal.Rptr. 837, 491 P.2d 421; but see Murillo v. Good Samaritan Hospital (1979) 99 Cal.App.3d 50, 56-57, 160 Cal.Rptr. 33.) Relying in part on Gopaul v. Herrick Memorial Hosp., supra, 38 Cal.App.3d 1002, 113 Cal.Rptr. 811, the court concluded that summary judgment was not proper in light of defendants' failure to address this alternative theory of liability. The dissenting justice disagreed that the pleadings or the facts raised any claim other than one for professional negligence.

DISCUSSION

The Court of Appeal majority erroneously premised their result on a perceived conceptual distinction between "ordinary" and "professional" negligence, which in their view differentiates separate and independent theories of liability even when based on the same facts asserted by the same plaintiff. While this distinction may be relevant and necessary for purposes of statutory construction and application (cf. Central Pathology Service Medical Clinic, Inc. v. Superior Court (1992) 3 Cal.4th 181, 10 Cal.Rptr.2d 208, 832 P.2d 924 [construing "professional negligence" as used in Code Civ.Proc., § 425.13] ), it is misplaced in resolving a motion for summary judgment in which the question is whether the moving party has demonstrated or negated negligence as a matter of law. In the latter context, the nature of the alleged breach of duty affects only the determination of the appropriate standard of care, which otherwise remains constant irrespective of the terminology used to characterize it.

"[N]egligence is conduct which falls below the standard established by law for the protection of others against unreasonable risk of harm." (Rest.2d Torts, § 282.) Thus, as a general proposition one "is required to exercise the care that a person of ordinary prudence would exercise under the circumstances." ² (Polk v. City of Los Angeles (1945) 26 Cal.2d 519, 525, 159 P.2d 931; Rowland v. Christian (1968) 69 Cal.2d 108, 70 Cal.Rptr. 97, 443 P.2d 561; see Civ.Code, § 1714, subd. (a).) Because application of this principle is inherently situational, the amount of care deemed reasonable in any particular case will vary, while at the same time the standard of conduct itself remains constant, i.e., due care commensurate with the risk posed by the conduct taking into consideration all relevant circumstances. (Dalzell v. County of Los Angeles (1948) 88 Cal.App.2d 271, 276, 198 P.2d 554; Lasater v. Oakland Scavenger Co. (1945) 71 Cal.App.2d 217, 221, 162 P.2d 486.) " 'There are no "degrees" of care as a matter of law; there are only different amounts of care, as a matter of fact....' [Citation.]" (Donnelly v. Southern Pacific Co. (1941) 18 Cal.2d 863, 871, 118 P.2d 465.) "Persons dealing with dangerous instrumentalities involving great risk of harm must exercise a greater amount of care than persons acting in less responsible capacities, but the former are no more negligent than the latter for failing to exercise the required care. [Citation.]" (Ibid.; cf. Polk v. City of Los Angeles, supra, 26 Cal.2d at p. 535, 159 P.2d 931 [applying the same measure of the standard of care to the former rule of contributory negligence].)

With respect to professionals, their specialized education and training do not serve to impose an increased duty of care but rather are considered additional "circumstances" relevant to an overall assessment of what constitutes "ordinary prudence" in a particular situation. Thus, the standard for professionals is articulated in terms of exercising "the knowledge, skill and care ordinarily possessed and employed by members of the profession in good standing...." (Prosser & Keeton, Torts (5th ed. 1984) The Reasonable Person, § 32, p. 187.) For example, the law " 'demands only that a physician or surgeon have the degree of learning and skill ordinarily possessed by practitioners of the medical profession in the same locality and that he [or she] exercise ordinary care in applying such learning and skill to the treatment of [the] patient.' [Citation.]" (Huffman v. Lindquist (1951) 37 Cal.2d 465, 473, 234 P.2d 34, italics added.) Similarly, a hospital's "business is caring for ill persons, and its conduct must be in accordance with that of a person of ordinary prudence under the circumstances, a vital part of those circumstances being the illness of the patient and incidents thereof." (Rice v. California Lutheran Hospital (1945) 27 Cal.2d 296, 302, 163 P.2d 860, italics added; see also, e.g., Tarasoff v. Regents of Univ. of Cal. (1976) 17 Cal.3d 425, 438, 131 Cal.Rptr. 14, 551 P.2d 334 [psychotherapist "need only exercise 'that reasonable degree of skill, knowledge, and care ordinarily possessed and exercised by members of [that professional specialty] under similar circumstances.' "]; Gambert v. Hart (1872) 44 Cal. 542, 552 [same; attorneys]; Stuart v. Crestview Mut. Water Co. (1973) 34 Cal.App.3d 802, 811-812, 110 Cal.Rptr. 543 [same; engineers]; Montijo v. Swift (1963) 219 Cal.App.2d 351, 353, 33 Cal.Rptr. 133 [same; architects]; Lindner v. Barlow, Davis & Wood (1962) 210 Cal.App.2d 660, 665, 27 Cal.Rptr. 101 [same; accountants].)

Since the standard of care remains constant in terms of "ordinary prudence," it is clear that denominating a cause of action as one for "professional negligence" does not transmute its underlying character. For substantive purposes, it merely serves to establish the basis by which "ordinary prudence" will be calculated and the defendant's conduct evaluated. Nor does it distinguish a claim separate and independent from some other form of negligence. As to any given defendant, only one standard of care obtains under a particular set of facts, even if the plaintiff attempts to articulate multiple or alternate theories of liability. (Cf. Central Pathology Service Medical Clinic, Inc. v. Superior Court, supra, 3 Cal.4th at p. 192, 10 Cal.Rptr.2d 208, 832 P.2d 924; Rowland v. Christian, supra, 69 Cal.2d at pp....