Hulbert v. Cross

CourtCalifornia Court of Appeal
DecidedJune 11, 2021
DocketC090663
StatusPublished

This text of Hulbert v. Cross (Hulbert v. Cross) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hulbert v. Cross, (Cal. Ct. App. 2021).

Opinion

Filed 6/11/21 CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA THIRD APPELLATE DISTRICT (Shasta) ----

DARREN HULBERT, C090663

Plaintiff and Appellant, (Super. Ct. No. 190446)

v.

RICHARD CROSS,

Defendant and Respondent.

APPEAL from a judgment of the Superior Court of Shasta County, Stephen H. Baker, Judge. Reversed with directions.

Darren Hulbert, in pro. per., for Plaintiff and Appellant.

Leonard & Lyde, D. Marc Lyde and Michael G. Gallert for Defendant and Respondent.

1 Plaintiff Darren Hulbert, a self-represented indigent inmate, appeals from a judgment of dismissal in a medical malpractice action in which he asserts a single cause of action for medical negligence against defendant, Richard Cross, M.D. Dr. Cross performed a radial head resection and arthroplasty on Hulbert’s right elbow. Hulbert alleges that Dr. Cross negligently failed to tighten a screw in the implant, which resulted in the screw coming loose and damaging Hulbert’s elbow joint, cartilage, and surrounding tissue. To help establish his claim, Hulbert filed a motion for appointment of legal counsel and a medical expert. The trial court denied the motion and subsequently found that Hulbert could not rebut the declaration of Dr. Cross’s medical expert without providing medical expert evidence of his own. On this basis, the trial court granted Dr. Cross’s motion for summary judgment. On appeal, Hulbert contends (1) he was deprived of meaningful access to the courts because the trial court denied him the assistance of a medical expert while requiring a medical expert to establish a triable issue of material fact, (2) the trial court failed to exercise its discretion by considering all of the remedies available to ensure that he had meaningful access to the courts, (3) the trial court erred in determining there was no triable issue of material fact because the loose screw itself did not prove medical negligence, (4) the trial court erred in refusing to appoint legal counsel, (5) Dr. Cross did not provide informed consent prior to the procedure, (6) the declaration by Dr. Cross’s medical expert was insufficient to overcome a presumption of negligence because Dr. Cross’s operation notes failed to show compliance with the implant manufacturer’s instructions. We conclude that the trial did not properly exercise informed discretion with respect to ensuring access to the courts when it denied Hulbert’s motion for appointment of a medical expert. The trial court’s statement that it lacked authority to appoint legal counsel requires remand to allow the trial court to consider and clarify which remedies

2 are appropriate in this case to protect Hulbert’s right to meaningful access to the court. Accordingly, we reverse and remand with further instructions. FACTUAL AND PROCEDURAL HISTORY

Action for Medical Malpractice In July 2018, Hulbert filed a complaint that alleged a single cause of action for medical malpractice. An amended complaint was filed in March 2019. The medical malpractice cause of action alleged the following: In March 2016, Dr. Cross performed a radial head resection and arthroplasty on Hulbert’s right elbow at the Shasta Regional Medical Center. Dr. Cross selected the manufacturer and type of implant, a “Biomet 44 x 14 mm radial head with a stem press fit.” After the procedure, Dr. Cross signed an operation report describing his actions during the surgery. The operation report fails to note whether Dr. Cross inspected the implant, checked the set screw to ensure it was tightened properly, or indicate that he had tightened the screw at all. After surgery, a screw came loose and lodged in Hulbert’s elbow joint. This caused severe pain and damage to Hulbert’s elbow joint, cartilage, and surrounding tissue. During the pendency of the action, Hulbert continued to experience severe pain. Motion for Summary Judgment In February 2019, Dr. Cross filed a motion for summary judgment on grounds that he did not breach the appropriate standard of care and that Hulbert had not established causation. In support of the motion, Dr. Cross argued that the alleged medical cause of Hulbert’s injuries does not entail the type of conduct that is within the common knowledge of laymen. Dr. Cross asserted that medical expert testimony is required. To this end, Dr. Cross introduced the declaration of orthopedic surgeon, Thomas G. Sampson. Dr. Sampson reviewed the medical history and treatment of Hulbert and opined as follows:

3 “A. Dr. Cross met the applicable standard of care in all aspects of his care and treatment of [Hulbert], including his pre-op care. He provided [Hulbert] with the appropriate conservative care for the radial head fracture. When that was unsuccessful, Dr. Cross assessed [Hulbert] with failed conservative care, and correctly considered a radial head arthroplasty. “B. On March 16, 2016, after obtaining [Hulbert’s] consent, Dr. Cross appropriately performed the radial head resection and arthroplasty of the radial head. He appropriately placed a Biomet 44 x 14 mm radial head with stem press fit. Intra-articular visualization of the radial articular surfaces revealed displaced fractures with chondrolysis of the radial head, which were resected with a sagittal saw and removed. The canal of the proximal radius was broached and definitive stem and head were appropriately impacted into place. Trial reduction appeared to restore normal anatomy. The elbow joint was stable, achieving full range of motion. “C. The outcomes of radial head arthroplasty are varied and failure may occur in the absence of negligence. In this case, there was dissociation of the set screw and loosening of the stem of the component observed in the subsequent surgery, which are both based on mechanical stresses on the implant and not implantation technique. It is my opinion to a degree of medical probability that Dr. Cross met all requirements of the standard of care when implanting the radial head arthroplasty.” Hulbert filed a handwritten memorandum of points and authorities in opposition to summary judgment. Hulbert noted that Dr. Cross’s postoperative notes failed to state that he checked to ensure that the set screw was properly tightened. Hulbert further noted that Dr. Cross “failed to caution [him] as to any risk of mechanical stress or the potential of the set screw [becoming] loose.” On the issue of the screw, Hulbert asserted that there are implants available that do not include the use of a set screw. On these bases, Hulbert argued that Dr. Cross had been negligent.

4 Hulbert also argued that Dr. Cross’s expert witness declaration is “vague, speculative, and lacks factual basis.” Hulbert pointed out that the declaration did not provide a basis for concluding that Dr. Sampson is familiar with elbow implants, their components, or specifically the Biomet implant used in this case. Dr. Sampson’s declaration neither describes the “varied results” that can result from elbow implants nor what sort of “mechanical stresses” could have caused the injury. Hulbert also argued a lack of consent in that he was not properly advised of the risks of the particular implant chosen. In a separate statement of disputed facts, Hulbert asserted that Dr. Cross did not ensure that he properly tightened the set screw and did not provide Hulbert a choice of implants. Hulbert also asserted it was undisputed that there are implants that do not require a screw, only Dr. Cross could have foreseen the risk of the screw coming loose, and the screw – by definition – needed to be tightened and checked as part of the operation. Hulbert also argued that he needed to be able to cross-examine Dr. Sampson about his declaration.

Motion for Appointment of Legal Counsel and Medical Expert In April 2019, Hulbert filed a motion for court appointment of legal counsel and a medical expert.

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Hulbert v. Cross, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hulbert-v-cross-calctapp-2021.