Susan Chen And Naixiang Lian v. Kate Halamay, Md.

Court of Appeals of Washington·Decided February 10, 2020·No. 76929-4·Unpublished

Opinion

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

SUSAN CHEN as parents and natural guardians of J.L., a minor, No. 76929-4-I and L.L., a minor, and NAIXIANG LIAN, as parents and natural (Consolidated with No. 78829-9-I) guardians of J.L., a minor, and L.L., a minor, DIVISION ONE

Appellants,

UNPUBLISHED OPINION

V.

KATE HALAMAY, M.D., and ALLEGRO PEDIATRICS (previously known as Pediatric Associates), FILED: February 10, 2020

Respondents.

LEACH, J. — Pro se litigants Susan Chen and Naixiang Lian, as parents and guardians of J.L. and L.L.1 (collectively Chen), appeal the summary judgment dismissal of their lawsuit against Dr. Kate Halamay and Allegro Pediatrics and the subsequent denials of their motion for reconsideration and motion to vacate. Chen claims that questions of fact exist about whether Dr. Halamay acted negligently or in bad faith by reporting Chen to Child Protective Services (CPS) for suspected child abuse and that numerous procedural irregularities justify reversal. Because Chen fails to establish error, we affirm.

1 We grant Chen’s motion to use initials to refer to their minor children.

No. 76929-4-1/2

FACTS

In August 2012, Chen brought her two-year-old son, J.L., to Allegro Pediatrics, expressing concerns that he might have autism. Staff members provided referrals for speech therapy, a hearing assessment, and evaluations at the Seattle Children’s Hospital autism clinic and the Kindering Center. In October 2012, Allegro staff attempted to follow up with J.L.’s parents to check the status of his progress, as it did not appear that J.L. had been seen at the autism clinic or at Kindering. But they were unable to reach the family.

On November 15, 2012, a physical therapist at Seattle Children’s Hospital assessed J.L. as having some characteristics of a child on the autism spectrum. The therapist recommended additional therapy and follow-up with the Kindering Center and faxed her treatment notes to Allegro. J.L.’s family subsequently moved to Oregon for several months before returning to Washington. While in Oregon, they took J.L. to Dr. John Green.

On August 31, 2013, Chen again brought J.L. to Allegro, where he was seen for the first time by Dr. Halamay. Shortly before this visit, laboratory tests ordered by Dr. Green and performed at Seattle Children’s Hospital indicated abnormal kidney function. Chen reported that J.L. was exhausted, urinating more than usual, and was interested only in eating meat. After consulting with a nephrology fellow, Dr. Halamay provided Chen with an urgent referral order to Seattle Children’s Hospital nephrology clinic. On September 5, 2013, Chen took J.L. to the nephrology clinic. The doctor indicated that J.L.’s lab results appeared to be improving and that the prior abnormal results may have

No. 76929-4-1/3

been obtained at a time that J.L. was dehydrated given his history of diarrhea and inability to access fluids.” The clinic recommended repeat lab tests in three weeks, with follow-up at the nephrology clinic if needed.

Chen brought J.L. for a second visit with Dr. Halamay on September 16, 2013.

Chen stated that J.L. was very gassy, sometimes has a “stiff” stomach, and cries a lot. Although J.L.’s gastroenterologist had recommended constipation medication and stool studies, Chen did not think J.L. was constipated and did not have the studies done. Dr. Halamay ordered lab tests, instructed Chen to refrain from restricting J.L from fluids, and provided a referral to Seattle Children’s Hospital for further neurodevelopmental evaluation.

On September 19, 2013, J.L.’s speech therapist, Jennifer Dierenfeld, contacted Dr. Halamay to seek more information about the family. Dierenfeld expressed concern that J.L. has “extreme sensory dysregulation” and cries inconsolably” during sessions. She stated that Chen “becomes extremely frustrated” when J.L. cries and “even threw an object during one of the sessions.” Dierenfeld further stated that another therapist observed Chen “raise her hand toward [J.L.] but did not actually hit him.” Given this information, Dr. Halamay planned to recommend to Chen that they enter social and behavioral therapy and further evaluate J.L.’s sensory issues.

On September 23, 2013, Dr. Halamay called Chen to discuss J.L.’s lab results and her recommendations. Chen was “extremely concerned” about J.L.’s thyroid lab values and requested an urgent referral to Dr. Kietter, a pediatric endocrinologist, which Dr. Halamay provided. Dr. Halamay also discussed Dierenfeld’s concerns about the

No. 76929-4-1/4

need for sensory and behavioral therapy, but Chen declined. Dr. Halamay asked Chen to bring J.L for a follow-up visit in the next one to two weeks.

Three days later, Dr. Halamay spoke with a gastroenterology physician’s assistant at Seattle Children’s Hospital who opined that J.L. should be further evaluated for abdominal distension and gas issues. Because Chen said she did not want J.L. to be seen by Seattle Children’s Hospital, Dr. Halamay referred J.L. to Swedish Medical Center and asked Chen to make a follow-up appointment for J.L. at Allegro within the next week.

At J.L.’s third visit with Dr. Halamay, on October 7, 2013, Chen reported that J.L.

continued to have abdominal pain and gas which had by then been present for six weeks. Chen declined Dr. Halamay’s recommendations for J.L. to participate in development or behavioral therapies or to be seen by the Seattle Children’s Hospital gastroenterology clinic. Dr. Halamay again recommended that Chen take J.L. to Swedish Medical Center as an alternative, but Chen said she preferred to take J.L. to Dr. Arthur Krigsman, a pediatric gastroenterologist in Texas. Chen asked Dr. Halamay to order a “page-long list of tests” that had allegedly been requested by Dr. Krigsman, some of which Dr. Halamay had never heard of. Given her unfamiliarity with Dr. Krigsman and the tests, Dr. Halamay declined. She offered to order an X-ray to check J.L.’s stool burden, but Chen declined.

On October 19, 2013, J.L. saw Dr. Roberta Winch, another pediatrician at Allegro. Chen reported that J.L. was tired, sweaty, and had swelling in his knees and feet. Dr. Winch examined J.L. She determined that he had abdominal pain and

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distension requiring immediate evaluation at the Seattle Children’s Hospital emergency department. After “significant persuasion,” Chen agreed to take J.L. there immediately. However, Chen and J.L. did not show.

The following day, an Allegro nurse called Chen to check on J.L. Chen stated that she did not take J.L. to the emergency department because her other child was sick but agreed to schedule a follow-up appointment for J.L. if necessary. That afternoon, Chen took J.L. to the Seattle Children’s Bellevue urgent care clinic. There, providers recommended that he be seen at the Seattle Children’s Hospital emergency department. Chen became upset and left the clinic with J.L. against medical advice.

Later that evening, Chen took J.L. to the Seattle Children’s Hospital emergency department. There, providers noted that J.L. seemed irritable, tired, and limp, with a distended abdomen and critically abnormal lab results. After further testing and consultation, providers allowed J.L. to return home on the condition that Chen promptly follow up on J.L.’s nephrology, gastroenterology, and endocrinology treatment orders.

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