Milner v. Regents of U.C. CA4/1

California Court of Appeal·Decided April 11, 2013·No. D060037·Unpublished

Opinion

Filed 4/11/13 Milner v. Regents of U.C. CA4/1 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE

STATE OF CALIFORNIA

LARRY D. MILNER, SR., D060037 Plaintiff and Appellant,

v. (Super. Ct. No. 37-2008-00078431-

CU-PO-CTL)

THE REGENTS OF THE UNIVERSITY OF CALIFORNIA,

Defendant and Respondent.

APPEAL from a judgment of the Superior Court of San Diego County, Luis R.

Vargas, Judge. Reversed.

Plaintiff and appellant, Larry D. Milner, Sr. (Plaintiff) sued defendant and respondent, The Regents of the University of California (the Regents) on medical malpractice theories arising out of the death of his 29-year-old son, Larry Milner, Jr. ("Larry Jr."), who was hospitalized at the Regents' University of California San Diego Medical Center and being treated for a variety of medical problems. Since Plaintiff was

representing himself in the trial court and was out of the country on military deployment after he filed his complaint, the court granted several continuances of the trial date. The month before trial, the court denied a summary judgment motion by the Regents, after Plaintiff supplied a declaration about causation of harm from a retained expert medical witness.

At trial call, the Regents obtained judgment on their motion for nonsuit, following the trial court's granting of their motion in limine that disallowed any late designation of Plaintiff's expert medical witness. (Code Civ. Proc., § 2034.720; all further statutory references are to the Code of Civil Procedure unless otherwise specified.) Without that expert being designated, Plaintiff could not address at trial the element of causation of injury from the alleged medical negligence. (Jennings v. Palomar Pomerado Health Systems, Inc. (2003) 114 Cal.App.4th 1108, 1118 (Jennings).)

Plaintiff challenges the resulting judgment, contending it was an abuse of discretion for the trial court to exclude his expert from testifying. He argues that his "delay in designating that expert was, at most, an honest mistake and was not unreasonable under controlling law," specifically, section 2034.720. Plaintiff relies on that section to argue that "other, more appropriate alternatives existed to address the Regents' objection to Dr. [Stephen L.] Fischer's testimony at trial," such as imposition of terms and conditions for permitting the late designation (§ 2034.720, subd. (d)), since the Regents had become aware of the content of Dr. Fischer's proposed testimony at trial, through the summary judgment proceedings.

Plaintiff consequently argues the trial court erred in granting the Regents' nonsuit motion, since Plaintiff could presumably have presented sufficient expert opinion and nonexpert evidence from which a trier of fact could have found causation of the harm from the actions or inactions of the Regents.

We agree with Plaintiff that given the Regents' advance knowledge of the identity of Plaintiff's expert witness and his views, and in light of the difficulty evidenced in the record about Plaintiff's problems in navigating trial procedure, the trial court abused its discretion in excluding the expert testimony, since there was no showing of undue prejudice to the Regents in allowing a late designation conditioned on a reasonable process for deposition. On this record, it was inconsistent for the trial court to end the case in this manner when it had previously exercised its discretion to allow continuances, to attempt to settle the case, and otherwise to accommodate the needs of Plaintiff in representing himself. The trial court did not adequately apply the statutory criteria in section 2034.720, the nonsuit was unwarranted, and we reverse the judgment.

FACTUAL AND PROCEDURAL BACKGROUND A. Larry Jr.'s Illness and Medical Care Larry Jr. suffered from numerous ailments, including lupus, anemia, and congestive heart failure. In August 2006, he had received a kidney transplant and was required to take immunosuppressive medications to prevent rejection of the organ. This type of medication is known by physicians to make a patient more susceptible to opportunistic infections.

In January 2007, Larry Jr. was being treated for such an infection by the Regents'

staff, and he was admitted to the hospital and given broad spectrum antibiotics. After a period of time, he was discharged to a skilled nursing facility for continued antibiotic treatment. During treatment, he was given a chest x-ray that revealed a 4.l cm. mass in his lung, suggesting there was a growth or neoplasm there.

During February 2007, Larry Jr. was receiving antibiotics and being monitored by Regents' physicians. He went to the infectious disease clinic on February 20, 2007 for further tests and evaluation and the doctors diagnosed anemia-related side effects from the powerful antibiotics he had received. The next day, after he was readmitted to the hospital, another chest x-ray showed there was a 10 cm. lung mass, where the smaller one had been. A radiology report comparing the two x-rays indicated that the size of that mass was "unchanged."

Larry Jr. soon became sicker and was moved to the hospital's critical care unit (CCU). He was suffering from compromised breathing and limited heart function. He had a heart attack and was later pronounced dead.

At autopsy, the pathologist determined the cause of death to be septic shock, secondary to a "disseminated zygomycosis infection" (a large fungal infection) in the lung and heart tissues, and a background bacterial infection. This type of large fungal infection will normally be fatal unless aggressive treatment is quickly initiated through the introduction of anti-fungal medications. Immunocompromised patients whose immune systems have been further depressed through recent antibiotic use are particularly vulnerable to such infections.

B. Litigation and Trial Continuances; Regents' Expert Designation Acting in propria persona, Plaintiff filed his medical malpractice complaint against the Regents in February 2008. In April 2009, he obtained counsel, who filed a first amended complaint (FAC) alleging wrongful death, in that Larry Jr. suffered from a deadly fungal lung infection, which was not properly diagnosed, monitored, or treated by his health care providers. Plaintiff alleged that the knowledge gained by the Regents' staff members about this patient's medical history, including the compromised nature of his immune system, imposed upon them a heightened obligation to timely diagnose and actively treat the presence of a rapidly growing fungal infection in his lung. The Regents filed an answer and discovery began. At a hearing on March 23, 2010, the court set a trial date of September 24, 2010, along with other calendar dates. The expert witness exchanges were scheduled for July 16 and July 30, 2010.

During much of the litigation, Plaintiff was employed as an active duty naval officer and was deployed in the South Pacific. Plaintiff had difficulty retaining counsel to pursue the case in his absence, which he blamed upon the complexity of the case and the financial limitations on recovery posed by medical malpractice regulations. In April 2010, the Regents filed a summary judgment motion and obtained a hearing date. The Regents complied with the original expert designation date, and identified their expert as Dr. Gonzalo R. Ballon-Landa, who is an internist with a subspecialty in infectious disease, who has been in private practice as an infectious disease consultant since 1983.

At hearings in June and September 2010, Plaintiff's counsel sought to withdraw and the court told Plaintiff he needed to retain a new attorney by the end of October 2010.

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