James v. St. Elizabeth Community Hospital

• Decision Date: 16 November 1994
• Docket Number: No. C017726,C017726
• Court: California Court of Appeals Court of Appeals
• Parties: Kay H. JAMES, Plaintiff and Appellant, v. ST. ELIZABETH COMMUNITY HOSPITAL et al., Defendants and Respondents. Civ.

Page 372

35 Cal.Rptr.2d 372

30 Cal.App.4th 73

Kay H. JAMES, Plaintiff and Appellant, v. ST. ELIZABETH COMMUNITY HOSPITAL et al., Defendants and Respondents.

Civ. No. C017726.

Court of Appeal, Third District, California.

Nov. 16, 1994.

[30 Cal.App.4th 75] Rolland L. Papendick, Red Bluff, for plaintiff and appellant.

Steven R. Enochian, Mark D. Norcross and Moss & Enochian, Redding, for defendants and respondents.

DAVIS, Associate Justice.

In this medical malpractice case arising out of an emergency room visit, plaintiff Kay James appeals from a judgment of nonsuit in favor of defendants St. Elizabeth Community Hospital and Christopher Louisell, M.D. Nonsuit was granted after plaintiff's expert was deemed unqualified to testify under Health and Safety Code section 1799.110, subdivision (c). (All further undesignated section references are to the Health and Safety Code.) Section 1799.110, subdivision (c) states: "(c) In any action for damages involving a claim of negligence against a physician and surgeon providing emergency medical coverage for a general acute care hospital emergency department, the court shall admit expert medical testimony only from physicians and surgeons who have had substantial professional experience within the last five years while assigned to provide emergency medical coverage in a general acute care hospital emergency department. For purposes of this section, 'substantial professional experience' shall be determined by the custom and practice of the manner in which emergency medical coverage is provided in general acute care hospital emergency departments in the same or similar localities where the alleged negligence occurred."

The issue is whether section 1799.110, subdivision (c) (hereafter, subdivision (c)) applies whenever an emergency room physician treats a patient in a general acute care hospital emergency department, or whether subdivision (c) applies only when such a physician performs "emergency medical services" (as defined in section 1799.110, subd. (b)) in such an emergency department. We hold that subdivision (c) applies whenever an emergency room physician treats a patient in a general acute care hospital emergency department.

FACTUAL AND PROCEDURAL BACKGROUND

In 1989 plaintiff sued Dr. Louisell, alleging that he failed to properly treat her fractured Plaintiff testified to the following: On July 19, 1988, plaintiff injured her left ring finger moving boxes at work. Later that day, plaintiff visited a nearby clinic and was told that her finger was not broken. A clinic doctor applied a splint consisting of a "tongue depressor type piece of wood" and tape. The splint held the plaintiff's middle and ring fingers straight. During the night, plaintiff's ring finger swelled; as her engagement and wedding rings tightened, the pain increased.

ring finger when she sought care at St. Elizabeth Community Hospital's (St. Elizabeth) emergency room. It is undisputed that Dr. Louisell is an emergency room physician and that St. Elizabeth's emergency room is within a general acute care hospital emergency department. Defendants moved for nonsuit after opening statements. The court did not rule on the motion at that time, and the trial proceeded.

The next day, plaintiff returned to the clinic to have her rings removed. The clinic doctor did not have ring removal equipment. Plaintiff then went to the sheriff's department. The sheriff's deputies also declined to remove plaintiff's rings because "they were afraid they were gonna hurt me."

At approximately 6:30 p.m., plaintiff went to St. Elizabeth's emergency room. The emergency room personnel removed plaintiff's rings. Plaintiff felt immediate relief. Dr. Louisell requested to further examine plaintiff, and she consented. Dr. Louisell ordered X-rays. After reading the X-rays, Dr. Louisell informed plaintiff that her left ring finger had a small break on the knuckle.

Dr. Louisell and a nurse reapplied the same wooden splint plaintiff had been given the day before. Dr. Louisell instructed plaintiff to leave the splint on for three to four weeks and to then see her own doctor. ¹ About four weeks later, plaintiff saw her physician. When the physician removed the splint, plaintiff was unable to bend her fingers. Plaintiff underwent extensive physical therapy for approximately a year, and her attorney claimed in his opening statement that plaintiff still suffers residual effects.

During recess, the judge addressed the defendants' nonsuit motion. Defendants argued that plaintiff did not have a qualified expert under subdivision (c) to maintain her action. Plaintiff conceded that her expert, Dr. Gordon Smith, did not qualify under subdivision (c). However, plaintiff argued that subdivision (c) did not apply to her case because subdivision (c) applies only if "emergency medical services" are rendered. The trial court concluded that Dr. Louisell rendered "emergency medical services" to plaintiff and therefore that subdivision (c) did apply. (In passing, the trial court recognized that subdivision (c) may also apply outside the "emergency medical services" context.) After deeming plaintiff's only expert unqualified under subdivision (c), the trial court granted the defendants' nonsuit motion.

DISCUSSION

The only issue on appeal involves the interpretation of subdivision (c).

Certain rules of statutory construction guide our interpretation. The basic objective of statutory interpretation is to ascertain and effectuate legislative intent. (Department of Fish & Game v. Anderson-Cottonwood Irrigation Dist. (1992) 8 Cal.App.4th 1554, 1562, 11 Cal.Rptr.2d 222.) "In determining intent, we look first to the words themselves." (Ibid.) "[W]e read the words of the statute according to their 'usual, ordinary, and common sense meaning' consistent with the statute's apparent purpose...." (Al-Sal Oil Co. v. State Bd. of Equalization (1991) 232 Cal.App.3d 969, 976, 283 Cal.Rptr. 843.)

"When the [statutory] language is clear and unambiguous, there is no need for construction. When the language is susceptible of more than one reasonable interpretation, [as it is here], we look to a variety of extrinsic aids....' " (Department of Fish & Game, supra, 8 Cal.App.4th at p. 1562, 11 Cal.Rptr.2d 222, quoting People v. Woodhead (1987) 43 Cal.3d 1002, 1007-1008, 239 Cal.Rptr. 656, 741 P.2d 154, citation reference omitted.) These extrinsic aids include the ostensible objects to be achieved, the legislative history, public policy, and the statutory scheme of which the statute is a part. (Ibid.) Finally, the "words [of a statute] should be interpreted to make them workable and reasonable ..., in accord with common sense and justice, and to avoid an absurd result." (See Halbert's Lumber, Inc. v. Lucky Stores, Inc. (1992) 6 Cal.App.4th 1233, 1239, 8 Cal.Rptr.2d 298.)

Subdivision (c) is part of section 1799.110 which reads in its entirety:

"(a) In any action for damages involving a claim of negligence against a physician and surgeon arising out of emergency medical services provided in a general acute care hospital emergency department, the trier of fact shall consider, together with all other relevant matters, the circumstances constituting the emergency, as defined herein, and the degree of care and skill ordinarily exercised by reputable members of the physician and surgeon's profession in the same or similar locality, in like cases, and under similar emergency circumstances.

"(b) For the purposes of this section, 'emergency medical services' and 'emergency medical care' means those medical services required for the immediate diagnosis and treatment of medical conditions which, if not immediately diagnosed and treated, could lead to serious physical or mental disability or death.[ ²

"(c) In any action for damages involving a claim of negligence against a physician and surgeon providing emergency medical coverage for a general acute care hospital emergency department, the court shall admit expert medical testimony only from physicians and surgeons who have had substantial professional experience within the last five years while assigned to provide emergency medical coverage in a general acute care hospital emergency department. For purposes of this section, 'substantial professional experience' shall be determined by the custom and practice of the manner in which emergency medical coverage is provided in general acute care hospital emergency departments in the same or similar localities where the alleged negligence occurred." (All further references to undesignated subdivisions will be to these subdivisions.) ³

The problem is that subdivision (c) uses the undefined term "emergency medical coverage" while subdivision (a) uses the defined term "emergency medical services."

Two competing theories have developed regarding the proper interpretation of subdivision (c). The Second District, in Jutzi v. County of Los Angeles (1987) 196 Cal.App.3d 637, 647, 242 Cal.Rptr. 74, noted that "emergency medical coverage" is "apparently synonymous" with "emergency medical services." Plaintiff urges us to adopt the Jutzi interpretation. Plaintiff argues that Dr. Louisell's alleged negligence did not arise out of "emergency medical services," as defined in subdivision (b). Plaintiff asserts that after her ring was removed, any "emergency" that may have existed was over, and Dr. Louisell was then providing routine services. Consequently, plaintiff maintains, since her action against Dr. Louisell does not arise out of "emergency medical services," subdivision (c) does not apply here.

Contrary to Jutzi, the Sixth District in Zavala v. Board of Trustees (1993) 16 Cal.App.4th 1755, 1762, 20 Cal.Rptr.2d 768, construed "emergency medical coverage" as having its own meaning. The Zavala court interpreted "coverage" as referring to a physician's "territory or field of activity." (Ibid.) The Zavala court noted that the common definition for "coverage" is different from "care" o...