Hu Yan, App/cr-resp. v. Pleasant Day Adult Family Home, Inc., Et Ano, Res/cr-app.

Court of Appeals of Washington·Decided December 16, 2013·No. 68976-2·Unpublished

Opinion

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

HU YAN, individually and as Personal Representative of the Estate of GUIZHEN No. 68976-2-1 YAO, deceased, o

DIVISION ONE «T3

Appellant/Cross Respondent, f.~) | —)

UNPUBLISHED OPINION R 'o

c.

PLEASANT DAY ADULT FAMILY HOME, INC., P.S., a domestic corporation, YU CHEN YIN and unknown JOHN DOES,

Respondents/Cross Appellants. FILED: December 16, 2013

Appelwick, J. — Yao died after falling during her stay at a private adult family home, Pleasant Day, run by Yin. Yao's husband, Yan, sued Yin and Pleasant Day for negligence, neglect of a vulnerable adult, and breach of contract. Yin asserted that Yao's family, the DSHS, and Yao's healthcare providers were comparatively negligent in causing her death. The jury returned a defense verdict. Yan challenges allowance of the affirmative "empty chair" defenses, the allowance of expert testimony, failure of health care providers to report neglect, and dismissal of his breach of contract claim. We affirm.

FACTS

Guizhen Yao suffered from Parkinson's disease and a rare form of frontal lobe dementia. The Department of Social and Health Services (DSHS) provided an in-home caregiver for her three hours each day. However, by 2008, Yao's symptoms included recurring panic attacks, hallucinations, delusions, irritability, aggravation, stumbling, fear of falling, and violent, exit-seeking behavior. Her elderly husband, Hu Yan, could no longer care for her due to his own frail condition.

In late spring 2008, Yao's husband and daughter, Janney Gwo, met with Yao's primary care provider, Advanced Registered Nurse Practitioner (ARNP) Eleanor Lee, to discuss placement options for Yao. Lee believed Yao required a level of care that could be provided only at a skilled nursing facility. Yao's doctor, Soo Borson, also recommended that Yao be placed in a skilled nursing home, preferably one with a locked dementia unit. Skilled nursing facilities provide 24-hour care by licensed staff, while adult family homes typically have only one or two caregivers who provide more limited care.

On June 4, 2008, DSHS case manager Debbie Ho prepared a significant change assessment for Yao's transfer to a care facility. The assessment did not disclose Yao's discharge from adult day care for behavioral issues, that another skilled nursing facility rejected Yao, or that her doctors recommended she be placed in a skilled nursing facility.

Lee also prepared a letter on June 8, 2008 outlining Yao's treatment and care needs. She emphasized the complexity of Yao's medical conditions and the behavioral issues the facility would have to address. She recommended that Yao be placed in a "very skillful adult family home who is comfortable managing dementia with extremely difficult behaviors, or a skilled nursing facility with plenty of experienced staff." Lee faxed the letter to Ho on June 11, 2008, intending it to be delivered to the facility selected by Yao's family.

In late June 2008, Gwo and Yan met with Yu Chen Yin, owner of Pleasant Day

Adult Family Home and primary caregiver for the facility.1 Pleasant Day is privately run and Yin is authorized to have up to six residents at one time. Yao's family expressed

interest in Pleasant Day, because Yin speaks Chinese. Before admitting Yao as a resident, Yin reviewed a copy of the DSHS assessment of Yao's medical condition. However, neither Yao's family nor DSHS gave Lee's letter to Yin. Nor did Yin know of Yao's exit-seeking behavior.

During June 2008, Lee advised Yao's family several times against placing Yao at Pleasant Day, insisting she go to a skilled nursing facility. However, Yao's family made the ultimate decision to place her at Pleasant Day. Gwo signed the required forms for Yao to be admitted at Pleasant Day and affirmed that she was Yao's representative. Yao appointed Gwo and Yan to be her healthcare agents.

Yao moved in to Pleasant Day on July 7, 2008. That same day, Yao had a severe panic attack and Yin wrote in her chart notes, '"Can't keep Yao's safety.'" Lee visited Pleasant Day the next day to discuss ways to handle Yao's panic attacks. Yin expressed concern that the placement was not a good fit, because Yao's condition was too severe for an adult family home setting. However, Lee told Yin that Yao might need two weeks to get used to the new environment, attributing her behavior to transfer trauma. Yin also asked Yao's family to move her to another facility, but they did not do so.

1 Lee wrote that Yin had one helper from 7 a.m. to 7 p.m., but otherwise did the rest of the work at Pleasant Day.

Yao fell for the first time on the morning of July 19 or July 20. Later that day, Yao escaped from Pleasant Day and fell again. Yin reported these falls to Lee and Yao's family. Lee visited again on July 21. She provided Yin a copy of her June 8 letter and medication log. Yin stressed that Yao needed more supervision and her medical condition was beyond Pleasant Day's capabilities. Lee told Yin that Yao still needed more time to adjust to the new environment.

On August 1, August 16, and August 20, Yao again sustained falls inside and outside Pleasant Day. She suffered multiple injuries to her face and body as a result. After the August 1 fall, Lee visited and acknowledged that Yao should be transferred to a skilled nursing facility.

On August 5, Yin called Gwo to tell her the family needed to move Yao out of Pleasant Day as soon as possible, because she could not keep Yao safe. Yao's medical team met that same day to discuss Yao's care and voiced concern about her actively deteriorating medical condition. They thought an adult family home placement was inappropriate, but were unwilling to place her in the hospital until a bed became available in a skilled nursing facility. No one passed these concerns on to Yin. Rather, they informed her only that Yao was waitlisted for a skilled nursing facility and she needed to stay at Pleasant Day until a bed opened.

Then, on August 30, 2008, Yao escaped from Pleasant Day and fell again, this time fracturing her jaw. Yin called Yao's family, who took her to the hospital. Yao died in the hospital on September 14, 2008 as a result of her injuries from the fall.

Yan sued Pleasant Day and Yin for negligence, neglect of a vulnerable adult, and breach of contract resulting in personal injury and wrongful death. The trial court dismissed Yan's breach of contract claim on Yin's motion. The parties filed several other motions in limine, only a few of which are pertinent to this appeal, and are addressed in turn below. At trial, Yin argued that Yao's family, DSHS, and Yao's healthcare providers were empty chair defendants, comparatively negligent for Yao's injury and death. The jury returned a defense verdict. Yan appeals.

DISCUSSION

Yan makes several arguments on appeal. He contends that the trial court erred in denying his motion to strike Yin's empty chair and comparative negligence affirmative defenses. He argues that the trial court abused its discretion in admitting expert testimony that Yin's conduct and care provided to Yao did not constitute neglect. Similarly, Yan argues that the trial court erred in denying his motion to exclude evidence that Yao's healthcare providers and a DSHS investigator did not find or report neglect. He asserts that the trial court erred in dismissing his breach of contract claim. Yin also cross appeals and argues that the trial court erred as a matter of law in limiting her CR 68 costs award to expenses allowed in RCW 4.48.010.

I. Yin's Affirmative Defenses

Yan argues that the trial court erred in denying his motion to dismiss Yin's empty chair and comparative negligence affirmative defenses to the negligence claim. The

alleged empty chairs were DSHS, Gwo, and Yan.2 There are two issues on appeal: (1) Did DSHS have a special relationship with Yao and thereby owe a duty to protect her

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Hu Yan, App/cr-resp. v. Pleasant Day Adult Family Home, Inc., Et Ano, Res/cr-app., (Wash. Ct. App. 2013).

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