Simms v. Bear Valley Cmty. Healthcare Dist.

• Decision Date: 28 June 2022
• Docket Number: E075184
• Citation: 80 Cal.App.5th 391,295 Cal.Rptr.3d 710
• Parties: Timothy SIMMS, Plaintiff and Appellant, v. BEAR VALLEY COMMUNITY HEALTHCARE DISTRICT, Defendant and Respondent.
• Court: California Court of Appeals Court of Appeals

80 Cal.App.5th 391

295 Cal.Rptr.3d 710

Timothy SIMMS, Plaintiff and Appellant,

v.BEAR VALLEY COMMUNITY HEALTHCARE DISTRICT, Defendant and Respondent.

E075184

Court of Appeal, Fourth District, Division 2, California.

Filed June 28, 2022

Timothy Simms, in pro. per., for Plaintiff and Appellant.

Kramer, DeBoer & Keane, Kathleen A. Stosuy, Deborah O. DeBoer, San Francisco, and Karla M. Meier, Indian Wells, for Defendant and Respondent.

OPINION

RAPHAEL, J.

Plaintiff and appellant Timothy Simms wants to bring a medical malpractice lawsuit against defendant and respondent Bear Valley Community Healthcare District (Bear Valley). Representing himself, he appeals from a judgment denying his petition under Government Code ¹ section 946.6, in which he sought relief from the requirement in the Government Claims Act (§ 810 et seq.) that he timely present a claim to Bear Valley before bringing a suit for damages. We reverse the judgment, finding that Simms does not require relief from the claim presentation requirement because he in fact submitted a timely claim, and the trial court erred by ruling he had not done so. Although Simms's claim was deficient in certain respects, its submission triggered a statutory duty for Bear Valley to notify Simms of the defects, and the failure to notify him waived any defense as to the claim's sufficiency. As such, Simms should be permitted to file a complaint.

In so ruling, we take sides in a split of California appellate authority that has remained unresolved for decades. This split concerns whether petitioners seeking judicial relief from claim requirements under section 946.6 may assert that they did present the public entity with a timely claim, or whether that argument may be raised only by filing suit and alleging compliance with claim requirements. We see no sound reason why a petitioner should not be able to raise actual compliance in a section 946.6 petition, or why the adjudicating court should be precluded from deciding that a submitted claim was compliant if there are no disputed issues of fact that need to be left for a jury's determination.

BACKGROUND

Bear Valley is a local health care district organized under Health and Safety Code section 32000 et seq. On December 8, 2017, Simms was injured in a fall and sought treatment at Bear Valley's emergency room. In December 2017 and January 2018, Simms went to appointments with several Bear Valley medical providers to obtain additional treatment for continuing pain from his injuries.

Simms was not satisfied with his experience at the follow-up appointments. On two occasions—December 26, 2017, and January 26, 2018—he verbally "file[d] a grievance" with Bear Valley, complaining that the providers who saw him had the perception that he was trying to obtain drugs on false pretenses and thus were refusing to investigate and treat his ongoing, chronic pain. Bear Valley responded to these complaints with a letter dated January 30, 2018, explaining what the providers had observed about Simms's behavior during three visits. Several appointments in March and April 2018 also did not meet Simms's expectations. On April 24, 2018, Bear Valley sent Simms a "formal notice" that Bear Valley would "no longer serve as [his] primary care provider due to unresolved differences in treatment/care philosophy between providers and patient."

Simms sent Bear Valley a May 13, 2018 letter framed as a response to the January 30, 2018 letter. (According to Simms, he had been out of town and had not yet received the April 24, 2018 notice when he sent his May 13 response.) In the May 2018 letter, Simms detailed his experiences and denied any "drug seeking" behavior. He stated that being "treated like a criminal by a couple of [Bear Valley] Providers" had "added to" his chronic pain and given him "a tremendous amount of stress, anxiety, and severe mental anguish." Simms expressed dissatisfaction not only with the efforts of the Bear Valley providers to help him control his "chronic pain," including refusal to renew his medications or transition

him to different medications that would work better, but also with their failure to order additional scans to investigate the source of his pain. He demanded that all references to "drug seeking behavior" be removed from his medical records. Simms also asked for a "written apology" from a particular Bear Valley doctor "for his unprofessionalism, gross negligence and defamatory comments ... which have now spread throughout all of [Bear Valley]." Simms threatened that if he "continue[d] to be defamed, harassed, mistreated and ignored by [Bear Valley]" he would "take [his] concerns to a higher level" by "filing a lawsuit for restitution." Bear Valley did not respond to the letter.

On July 11, 2019, Simms sent Bear Valley a letter framed as a "90-Day Notice of Intent to Sue as required by California Code of Civil Procedure § 364." The notice was addressed to the same Bear Valley employee as his May 2018 letter. In the notice, Simms stated that he intended to file a medical malpractice lawsuit against Bear Valley. He represented that on "July 18, 2018 and September 13, 2018" he received results of MRI scans ordered by his new health care provider, scans that Bear Valley providers had "refused to do." The scans revealed spinal injuries from Simms's December 2017 fall that Bear Valley had failed to diagnose, "result[ing] in further physical damage ... coupled with an unnecessary delay of safe and proper treatment causing irreparable damage" to his neck and back "which has resulted in recommended surgeries to avoid paralysis." Simms also complained of "severe withdrawal symptoms" due to Bear Valley providers’ "refusal to provide continued care and/or prescribe [him] medications [he] had been taking for two years (or prescribe a safe withdrawal plan)."

Bear Valley treated Simms's July 11, 2019 letter as a claim under the Government Claims Act and responded with a "Notice of Return of Late Claim." The notice stated that Simms's claim was being returned "because it was not presented within six months after the event or occurrence as required by law." As required by statute, the notice informed Simms that his "only recourse" was to apply for leave to present a late claim. (See § 911.3, subd. (a).)

On July 30, 2019, Simms applied for leave to present a late claim. Bear Valley denied the application on August 20, 2019. As required by statute, the denial notice informed Simms that if he wished "to file a court action on this matter," he must "first petition the appropriate court for an order relieving [him] from the provisions of Government Code Section 945.4 (claim presentation requirement). See Government Code Section 946.6." (See § 911.8, subd. (b).)

On November 18, 2019, Simms petitioned the trial court for an order relieving him from the claim presentation requirement. Simms's proposed claim, framed as a letter to Bear Valley, is similar to his July 11, 2019 letter to Bear Valley and his proposed claim attached to his July 30, 2019 application for leave to present a late claim, except that the stated dates when he received MRI scan results are "October 13, 2018 and October 27, 2018" instead of the July and September dates. After a January 10, 2019, hearing, the trial court denied the petition, finding that Simms's May 2018 letter "did not comply with the requirements of [the Government Claims Act] so as to be deemed either a claim or a defective claim," and that he had failed to demonstrate that he was entitled to relief from the requirement of presenting a timely claim.

DISCUSSION

Simms contends that the trial court abused its discretion in several ways. The argument that we find dispositive is that his May 2018 letter should have been treated by Bear Valley as a claim, even if a defective one, and that by failing to do so, Bear Valley waived any defense based on insufficiency of the claim. It follows, in Simms's view, that the trial court should have allowed him to proceed with a lawsuit alleging causes of action encompassed by that claim against Bear Valley. We agree.

Before turning to this analysis, however, we must first address a threshold matter. For decades, there has been an unresolved split of authority as to whether a plaintiff who files a section 946.6 petition seeking relief from the claim presentation requirement may assert that he actually submitted a timely claim, or whether that argument may be raised only by filing a lawsuit in which the complaint alleges compliance with the claim presentation requirement.

(Compare, e.g., Ngo v. County of Los Angeles (1989) 207 Cal.App.3d 946, 951–952, 255 Cal.Rptr. 140 ( Ngo ) [must be raised in a complaint alleging compliance] and Rason v. Santa Barbara City Housing Authority (1988) 201 Cal.App.3d 817, 827-828, 247 Cal.Rptr. 492 ( Rason ) [same] with Santee v. Santa Clara County Office of Education (1990) 220 Cal.App.3d 702, 711, 269 Cal.Rptr. 605 ( Santee ) [may be addressed in a claim-relief proceeding] and Reyes v. County of Los Angeles (1988) 197 Cal.App.3d 584, 593-594, 243 Cal.Rptr. 35 [same].) Our division of the Court of Appeal has not considered the issue in a published opinion.

In our view, cases like Santee take the better approach. The purpose of the claim requirement is to provide the public entity with sufficient information to avoid needless litigation. ( City of San Jose v. Superior Court (1974) 12 Cal.3d 447, 455, 115 Cal.Rptr. 797, 525 P.2d 701 [purpose is "to provide the public entity sufficient information to enable it to adequately investigate claims and to settle them, if appropriate, without the expense of litigation"].) The Ngo approach multiplies legal proceedings unnecessarily, effectively requiring claimants who dispute a public entity's determination of timeliness to pursue the dual track of both (1) filing a civil lawsuit alleging compliance and (2) applying for relief first from the public agency under section 911.4 and then, if denied, from the court under ...