Valadez v. Sutter Health Memorial Hospital Los Banos

• Court: District Court, E.D. California
• Decided: July 7, 2025
• Docket: 1:22-cv-00263
• Status: Unknown

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 Olivia Valadez, successor in interest to the 11 | Estate of Eric Valadez, No. 1:22-ev-00263 KIM EPG 12 Plaintiff, ORDER 13 V. 14 | Sutter Health Memorial Hospital Los Banos, et 15 al., 16 Defendants. 17 Olivia Valadez alleges Sutter Health Memorial Hospital Los Banos and DOES 1-20! 18 | (collectively the Hospital) violated federal and California laws when it negligently allowed her 19 | son Eric Valadez (Valadez) to escape the hospital, after which he committed suicide. Both parties 20 | bring partial motions for summary judgment. As part of her motion, plaintiff requests the court 21 | take judicial notice of the California Department of Public Health Licensing and Certification’s 22 | (DHLC) 2021 Deficiencies Report on the Hospital. Defendants move to strike plaintiffs 23 | additional statement of facts in support of her motion for summary judgment. As described more 24 | fully below, the court grants in part and denies in part plaintiff's motion for 25 | ///I/

' Valadez named DOES 1-20 as defendants as well, but has not moved to substitute named individuals in their stead. The court thus dismisses all DOE defendants without prejudice. See Fed. R. Civ. P. 4(m) (providing for dismissal if a defendant not served within 90 days after complaint filed); see also Fed. R. Civ. P. 10(a) (complaint must “name all the parties”).

1 summary judgment, grants in part and denies in part the Hospital’s motion for summary 2 judgment, grants plaintiff’s request for judicial notice and grants the Hospital’s motion to strike. 3 I. PROCEDURAL BACKGROUND 4 Plaintiff filed suit against the Hospital on March 3, 2022. See Compl., ECF No. 2. 5 Plaintiff alleges the Hospital violated the Emergency Medical Treatment and Active Labor Act 6 (EMTALA), 42 U.S.C. § 1395dd, by failing to screen and by failing to stabilize Valadez when it 7 treated him on March 21-22, 2021, Compl. ¶¶ 26–34; the Americans with Disabilities Act (ADA), 8 42 U.S.C. §§ 12181–12189, id. ¶¶ 17–25; California’s Unruh Civil Rights Act (Unruh Act), Cal. 9 Civ. Code § 51, id. ¶¶ 35–45, and California’s Disabled Person’s Act (CDPA), Cal. Civ. Code 10 §54, id. ¶¶ 46–56. Plaintiff also alleges the Hospital committed negligence per se. Id. ¶¶ 57–66. 11 Plaintiff seeks general and special damages, statutory damages, punitive damages, injunctive 12 relief and attorneys’ fees. See id. (Prayer for Relief). 13 Both parties have moved for partial summary judgment on all plaintiff’s claims except her 14 negligence per se claim. See Def.’s Mot. Summ. J., ECF No. 46; Pl.’s Mot. Summ. J., ECF No. 15 57. The Hospital argues it did not violate EMTALA because it properly screened Valadez and 16 because Valadez left the Hospital before the Hospital could transfer him and therefore 17 EMTALA’s stabilization requirement was inapplicable. See Def.’s Mem. at 11–14, ECF No. 47.2 18 The Hospital also argues plaintiff’s ADA, Unruh Act and CDPA claims fail as a matter of law 19 because plaintiff argues only that Valadez received poor care for his psychiatric disability and not 20 because he was denied access to a public accommodation. See id. at 14–17. Meanwhile plaintiff 21 claims it is undisputed the Hospital violated EMTALA by providing an incorrect screening of 22 Valadez’s suicidal ideation, and the Hospital failed to stabilize Valadez by not giving him 23 medication, by not properly supervising him and by placing him in a dangerous hallway. See 24 Pl.’s Mem. at 17–23, ECF No. 57-1. Plaintiff also argues it is undisputed the Hospital failed to 25 accommodate Valadez’s disability, mostly through its poor medical treatment on March 21–22, 2 Pages cited here are those applied at the top right by the CM/ECF system with the exception of deposition transcripts. The court cites depositions to the original page numbers of the deposition transcript. 1 2021, and thus violated Title III of the ADA. See id. at 13–16. Plaintiff further argues that 2 because the Hospital violated the ADA it also violated the Unruh Act and the CDPA. See id. at 3 23–26. 4 Both motions are fully briefed. See Def.’s Mem; Pl.’s Opp’n, ECF No. 72; Def.’s Reply, 5 ECF No. 83; Pl.’s Mem; Def.’s Opp’n, ECF No. 61; Pl.’s Reply, ECF No. 80. In addition to her 6 motion for summary judgment, plaintiff asks the court take judicial notice of the DHLC’s 2021 7 report on the Hospital. See Req. Jud. Notice, ECF No. 58. The Hospital opposes plaintiff’s 8 request. See Def.’s Response, ECF No. 62. As part of her motion for summary judgment, 9 plaintiff also has submitted an additional statement of undisputed material facts with her reply 10 brief. See ECF No. 81. The Hospital requests the court strike this filing, see Def.’s Mot. Strike, 11 ECF No. 82, arguing it violates this court’s local rules as well as the Federal Rules of Civil 12 Procedure, see id. at 1–3. 13 On October 11, 2024, this case was reassigned to the undersigned. See Order, ECF No. 14 86. On May 8, 2025, the court heard oral argument on the pending summary judgment motions. 15 Jeremy Dobbins appeared for plaintiff. See Mins. Mot. Hr’g, ECF No. 92. Aaron Schultz 16 appeared for the Hospital. See id. At hearing, the court directed the parties to file supplemental 17 briefing on Harmon v. Uintah Basin Medical Center, No. 20-0669, 2021 WL 2532826 (D. Utah 18 June 21, 2021), a case the court identified as being relevant to plaintiff’s EMTALA duty to 19 stabilize claim, see id. Both parties have submitted their supplemental briefs and the court has 20 submitted the matters, which it resolves here. See Pl.’s Suppl. Br., ECF No. 93; Def.’s Suppl. Br., 21 ECF No. 94. 22 II. CLARIFYING THE RECORD: OBJECTIONS, JUDICIAL NOTICE 23 The parties have both submitted evidence in support of their motions and in opposition to 24 their opponent’s motion. The court first resolves several disputes regarding these submissions. 25 First, the Hospital has raised several objections in addition to making its motion to strike based on 26 plaintiff’s submitted statements of facts. See Def.’s Reply at 4–5; Def.’s Opp’n at 7–9; Def.’s 27 Mot. Strike. Second, plaintiff has requested the court take judicial notice of the DHLC’s 2021 28 Deficiencies Report on the Hospital in support of its motion for summary judgment. See Req. 1 Jud. Notice. Third, the Hospital has made evidentiary objections to almost all of plaintiff’s 2 submitted evidence both in opposition to the Hospital’s motion for summary judgment and in 3 support of her own motion for summary judgment. See Def.’s Objs. Pl.’s Mot. Summ. J. (Objs. 4 No. 1), ECF No. 65; Def.’s Objs Pl.’s Opp’n Def.’s Mot. Summ. J. (Objs. No. 2), ECF No. 84. 5 The court addresses each dispute in turn. 6 A. Local Rule 260 7 Under Federal Rule of Civil Procedure 56, litigants who move for or oppose summary 8 judgment must cite “particular parts of materials in the record” to show specific facts are 9 disputed, undisputed or cannot be proved, as the case may be. See Fed. R. Civ. P. 56(c)(1). This 10 district’s local rules implement that rule by requiring a separate statement proposing undisputed 11 facts. See E.D. Cal. L.R. 260(a). The separate statement must “cite the particular portions” of the 12 record that establish each proposed fact as “undisputed.” Id. The opposing party must then 13 respond to each proposed fact on the list and either admit or deny the fact is undisputed. See 14 E.D. Cal. L.R. 260(b). If the opposing party contends the fact is disputed, it must cite “the 15 specific particular portions” of the record showing the fact is disputed. Id. 16 The Hospital makes two objections arguing plaintiff did not abide by Local Rule 260. 17 First, the Hospital argues plaintiff violated Local Rule 260 because she failed to file a separate 18 statement of disputed facts in opposition to the Hospital’s motion for summary judgment. See 19 Def.’s Reply at 4–5. Second, the Hospital argues plaintiff violated Local Rule 260 in her 20 statement of undisputed facts for her motion for summary judgment because her listed facts do 21 not fully encompass all the facts plaintiff relies on in her memorandum of points and authorities 22 in support of summary judgment. See Def.’s Opp’n at 7–9. As to the first objection, Local Rule 23 260 does not require parties in opposition to submit statements of disputed facts, see E.D. Cal. 24 L.R. 260(b), so plaintiff did not violate Local Rule 260 by omitting one. As to the second 25 objection, the court has had no problem finding the evidence cited by the plaintiff in her motion 26 for summary judgment and the Hospital has been able to respond to plaintiff’s facts in its own 27 opposition. Thus, even if plaintiff’s statement of facts is deficient, the Hospital is not prejudiced. 28 The Hospital’s objections in this respect are overruled. 1 Perhaps in a belated attempt to remedy her statement of facts, plaintiff has submitted an 2 additional statement of facts to support her motion for summary judgment. See Pl.’s Add’l Stmt. 3 Undisp. Facts. The Hospital has moved to strike this filing, arguing it does not abide by the local 4 rules of this district or by the Federal Rules of Civil Procedure. See Def.’s Mot. Strike at 1–2. As 5 the Hospital points out, Local Rule 260(a) allows the moving party for summary judgment to file 6 a statement of undisputed facts. See id. at 2 (citing E.D. Cal. L.R. 260(a)). Local Rule 260(b) 7 allows the party opposing summary judgment the opportunity to file a separate statement of 8 disputed facts. See id. (citing E.D. Cal. L.R. 260(b)). The local rules do not allow the moving 9 party to file an additional statement of facts in their reply brief. The Hospital would be 10 prejudiced by this filing as it has not had an opportunity to dispute plaintiff’s additional statement 11 of facts. The court grants the Hospital’s motion to strike the additional statement of facts. 12 B. Judicial Notice 13 A judicially noticed fact is a “fact that is not subject to reasonable dispute.” Fed. R. Evid. 14 201(b). A fact is not subject to reasonable dispute if it is generally known or if it can be 15 accurately and readily determined from sources whose authority cannot reasonably be questioned. 16 See id. The court must take judicial notice “if a party requests it and the court is supplied with the 17 necessary information.” Id. 201(c)(2). Regarding the nature of the documents covered by 18 plaintiff’s request, “[j]udicial notice is appropriate for [such] records and ‘reports of 19 administrative bodies,’” because their authority usually cannot reasonably be questioned. Grant 20 v. Aurora Loan Servs., 736 F. Supp. 2d 1257, 1263 (N.D. Cal. 2010) (quoting United States v. 21 14.02 Acres of Land More or Less in Fresno County, 547 F.3d 943, 955 (9th Cir. 2008)). 22 The court takes judicial notice of the existence of the DHLC’s 2021 Deficiencies Report 23 of the Hospital. As plaintiff points out, the report was completed by a California agency and is 24 available online; there is no reason to question its authenticity.3 However, as the Hospital points 25 out, the report contains hearsay, especially the interviews embedded within it, and plaintiff has 3 See http://www.cdph.ca.gov/Programs/CHCQ/LCP/CalHealthFind/Pages/ASPEN_FEDERAL_2567. aspx?EventID=GJH011 (last accessed June. 11, 2025). 1 not made any attempt to show what if any exception might apply to allow in some of the report’s 2 contents. Def.’s Response at 2–3. Further, while the court finds that while plaintiff almost 3 certainly could transform at least some of the DHLC’s interviews and conclusions based on those 4 interviews into admissible evidence at trial, as currently presented certain details of the report 5 involving the care of Valadez are inadmissible. The interview content has not been confirmed 6 through deposition testimony that would allow the court to treat that content as undisputed 7 evidence. See Req. Jud. Notice Ex. A (DHLC Rep.) at 17–24. The court thus takes judicial 8 notice of the existence of the report, that the conclusions rest on interviews conducted with the 9 Hospital’s staff in April 2021, and that the report investigated Valadez’s stay at the hospital. The 10 court, however, does not take judicial notice of the interview content embedded in the report or 11 any conclusions based on such interviews because as currently constituted it is hearsay and 12 subject to dispute. 13 C. Objections 14 The Hospital makes three other types of objections in both its objections to plaintiff’s 15 opposition to the Hospital’s motion for summary judgment and in its opposition to plaintiff’s 16 motion for summary judgment. First, the Hospital objects to specific statements in the 17 declarations of plaintiff’s three experts: Drs. Mill and Ramirez and Nurse Branch as well as their 18 entire declarations. See Objs. No. 1 at 2–5, 7–13; Objs. No. 2 at 2–3, 5–7. Second, the Hospital 19 separately objects to the DHLC’s 2021 Deficiencies Report on the Hospital, which the plaintiff 20 has submitted as evidence both in support of her opposition to the Hospital’s motion for summary 21 judgment and in support of her own motion for summary judgment. See Objs. No. 1 at 5–6; Objs. 22 No. 2 at 3–4. Finally, the Hospital objects to plaintiff’s submission of Valadez’s medical records 23 as evidence in support of her motion for summary judgment. See Objs. No. 1 at 6, 14. 24 The court overrules all of the Hospital’s objections to plaintiff’s expert declarations. The 25 primary objection is that the experts are relying on inadmissible evidence to form their opinions. 26 See Objs. No. 1 at 2 (arguing Dr. Mills’ report is inadmissible because he relied on inadmissible 27 evidence to form opinion) (citing Gretzler v. Stewart, 112 F.3d 992, 1003 (9th Cir. 1997) 28 (discussing an old Arizona rule of evidence)). This contention flies in the face of Federal Rule of 1 Evidence 703, which explicitly allows experts to rely on inadmissible evidence “[i]f experts in the 2 particular field would reasonably rely on those kinds of facts or data in forming an opinion on the 3 subject . . . .” Fed. R. Evid. 703. The Hospital also argues the experts are relying on speculation 4 in forming their opinions, see Objs. No. 1 at 4–5, and that plaintiff cannot introduce facts into 5 evidence through an expert report, see, e.g., Def.’s Opp’n at 18–24 (citing In re Citric Acid Litig., 6 191 F.3d 1090, 1102 (9th Cir. 1999) (noting “an expert report cannot be used to prove the 7 existence of facts set forth therein”)). The experts cannot establish facts for plaintiff solely 8 through their declarations. However, their opinions based upon reliable data is admissible. All 9 three experts ground their opinions on an examination of Valadez’s medical records, the most 10 important of which have been submitted as evidence by both the Hospital and plaintiff, the exact 11 type of record an expert may examine to evaluate the quality of Valadez’s treatment. See Mills 12 Decl. at 9; Ramirez Decl. at 15; Branch Decl. at 23. 13 Second, the court sustains the Hospital’s objection to plaintiff’s use of the DHLC 14 Deficiencies Report to support plaintiff’s motion for summary judgment on the same grounds as 15 it sustained the Hospital’s objections to plaintiff’s request for judicial notice of the same report: 16 that plaintiff cannot use specific statements from the interviews within the report to support her 17 motion for summary judgment. See Objs No.1 at 5–6. However, plaintiff may rely on the 18 existence of the report as a whole to support her opposition to the Hospital’s motion for summary 19 judgment, given that the Hospital’s objections to the DHLC report relate only to a portion of its 20 form: that in its current state the report contains hearsay. But “to survive summary judgment, a 21 party does not necessarily have to produce evidence in a form that would be admissible at trial, so 22 long as the party satisfies the requirements of Federal Rules of Civil Procedure 56.” Fraser v. 23 Goodale, 342 F.3d 1032, 1036–37 (9th Cir. 2003). The court thus denies the Hospital’s objection 24 to the DHLC report to the extent plaintiff offers it in opposition to the Hospital’s motion for 25 summary judgment. See Objs. No. 2 at 3–4. 26 Third, the Hospital objects to plaintiff’s submission of Exhibits F and H in support of her 27 motion for summary judgment. See Objs. No. 1 at 6, 14. Exhibit F is Valadez’s medical records 28 from the Hospital. See Pl.’s Stmt. of Evid. Ex. F (Pl.’s Med. Recs.) at 142–205, ECF No. 57-3. 1 Exhibit H is Valadez’s medical records from Merced County. See Pl.’s Stmt. of Evid Ex. H at 2 214–29. At oral argument, the Hospital conceded that Exhibit F is identical to Valadez’s Sutter 3 Health medical records, which the Hospital submitted as authenticated evidence in support of its 4 own motion for summary judgment; the Hospital dropped this objection. See Def.’s Ex. B (Def.’s 5 Med. Recs.) at 40, ECF No. 51. As to Valadez’s medical records from Merced County, the 6 Hospital argues Valadez has failed to authenticate them under Federal Rule of Evidence 901(a)– 7 (b). See Objs. No. 1 at 14. The court sustains this objection for purposes of plaintiff’s motion for 8 summary judgment; as a moving party, as plaintiff needs to produce evidence in admissible form 9 but plaintiff has not authenticated the Merced County records. See generally Pl.’s Stmt. of Evid 10 Ex. H. See Orr v. Bank of Am., 285 F.3d 764, 773 (9th Cir. 2002) (“Authentication is a ‘condition 11 precedent to admissibility’ and this condition is satisfied by ‘evidence sufficient to support a 12 finding that the matter in question is what proponent claims.’”) (quoting Fed. R. Evid.901(a)). 13 III. UNDISPUTED AND DISPUTED FACTS 14 Unless specified below, the court construes the following facts as being undisputed. 4 The 15 tragic events underlying this case began on Sunday, March 21, 2021, at a church in Dos Palos, 16 California. See Pl.’s Stmt. of Evid. Ex. G (Ambulance Rep.) at 209; Pl.’s Stmt. of Evid. Ex. F 17 (Pl.’s Med. Recs.) at 148. Eric Valadez was there attending church with his extended family. See 18 Pl.’s Med. Recs. at 148. Unfortunately for Valadez, he experienced an emergency medical 19 episode: he began to behave in ways that threatened himself and, with a knife, cut a 4-centimeter 20 abrasion on his neck. See id.; Def.’s Med. Recs. at 6. His family contacted emergency medical 21 services, and the Dos Palos Police Department, upon hearing what had happened at the church, 22 placed Valadez on a psychiatric hold at 2:10 p.m. See Ambulance Rep. at 209. Under California 23 law, a psychiatric hold, or “5150 hold,” allows the relevant county, upon probable cause, to take a 24 person into custody if that person is experiencing a “mental health disorder” who is “a danger to 4 The court has compared the parties’ respective statements of fact and the underlying record and reviewed the relevant deposition transcripts. See Def.’s Stmt. Undisp. Mat. Facts (Def.’s SUMFs), ECF No. 48; Pl.’s Opp’n Def.’s SUMFs, ECF No. 74; Pl.’s Stmt. Undisp. Mat. Facts (Pl.’s SUMFS), ECF No. 57-2; Def.’s Opp’n Pl.’s SUMFs, ECF No. 63; Def.’s Stmt. Add’l Facts, ECF No. 64; Pl.’s Reply Def.’s Stmt. Add’l Facts, ECF No. 79; Def.’s Exs. A–C, ECF Nos. 50–52; Pl.’s Stmts. of Evid., ECF Nos. 57-3, 73; Pl.’s Exs. I–K, ECF Nos. 59–59-2; Req. 1 others, or to themselves”; the period of custody can last up to 72 hours, for purposes of 2 “assessment, evaluation, and crisis intervention.” Cal. Welf. & Inst. Code § 5150(a). 3 Valadez arrived by ambulance to Los Banos Memorial Hospital at 2:56 p.m. and was 4 admitted to the emergency department. Def.’s Med. Recs. at 2. The Hospital recorded his 5 “arrival complaint” as “suicidal ideation.” See id. The Hospital “roomed” Valadez in the 6 emergency department hallway at 2:59 p.m., only three minutes after he arrived at the facility, 7 and the Hospital does not claim it attempted in any way to restrain him. Def.’s Med. Recs. at 2. 8 At 3:09 p.m. nurse Anil Biviyodavid completed the initial triage on Valadez. See Def.’s 9 Med. Recs. at 2. Biviyodavid also conducted the Columbia-Suicide Severity Rating Scale—a 10 standard screening device for section 5150 patients—and found Valadez was at “No Risk” of 11 suicide. See Pl.’s Med. Recs. at 175. Valadez submits expert deposition testimony that 12 Biviyodavid’s screening was inappropriate or incomplete because his “No Risk” score was 13 incorrect. See Pl.’s Stmt. of Evid. Ex. B (Mills Decl.) at 10. 14 At 4 p.m., Valadez was assigned to the care of Dr. James Saunders, who evaluated 15 Valadez’s “superficial abrasion” on his neck as well as his other vitals and also took a blood test. 16 See Pl.’s Med. Recs. at 152. Saunders prescribed no medication for Valadez. See id. He also 17 cleared Valadez “pending tele psychiatry” evaluation and left his disposition “to be determined in 18 conjunction with telepsych.” Def.’s Med. Recs. at 6. Valadez tested positive for alcohol and 19 opiate use. See Pl.’s Med. Recs. at 153. Valadez then waited for a psychiatric evaluation in the 20 hallway while nurses occasionally checked up on him. See id. at 156–57. At 7:00 p.m. the care 21 of Valadez shifted from Saunders to Dr. Jasmine Mahesri, who also did not prescribe Valadez any 22 medication. See id. at 159. 23 The psychiatrist, Dr. Hetal Kanaiyalal Brahmbhatt, finally consulted with Valadez over 24 the phone around 11 p.m. and issued a diagnosis minutes later. See id. at 168. Brahmbhatt found 25 Valadez to be “scared, paranoid, [and] hypervigilant during the interview.” Id. She evaluated 26 Valadez’s suicide risk as being “high.” Id. at 167. She ordered Valadez to be “on [a] 5150 hold 27 and admitted to the psych hospital for further stabilization and recovery.” Id. at 168. She also 28 prescribed Risperdal, an anti-psychotic medication, as well as Zoloft. Id. There is, however, no 1 evidence the Hospital ever gave this medication to Valadez. Just after midnight, early on 2 March 22, 2021, Merced County placed another 5150 hold on Valadez, who remained in the 3 hallway at the Hospital while he awaited transfer to the psychiatric hospital. See id. at 188–91. 4 It is undisputed the Hospital was required to transfer Valadez because the Hospital does 5 not possess “an in-patient psychiatric unit and is not equipped to provide in-patient care for 6 patients placed on an involuntary psychiatric hold, or for whom in-patient treatment is 7 recommended.” Johnson Decl. ¶ 2, ECF No. 52. Patients like Valadez, it says, are always 8 “transferred to a facility licensed to provide in-patient psychiatric care.” Id. In other words, the 9 Hospital only provides emergency care for individuals like Valadez: ordinary, long-term care is 10 provided only after the patient has been transferred to another facility. See id. 11 Just before Merced County placed the second 5150 hold, Valadez’s condition worsened. 12 See Pl.’s Med. Recs. at 157–58. At 11:56 p.m., an emergency room nurse reported Valadez 13 attempted to call his mother and sister, questioned why the psychiatrist knew details about his 14 personal life, and presented as paranoid. See id. at 157–58. At 12:47 a.m., a registered nurse by 15 the name of Mariana Salas reported the following: 16 Heard sound of something fallen. Both security and [Valadez] 17 nowhere to be found. Noticed fire extinguisher glass broken with 18 broken glass on the floor. Security returned a few minutes later. Per 19 security [Valadez] was pacing hallway and had hit the glass on the 20 extinguisher door twice before breaking it and fleeing the hospital. 21 Per the security guard [Valadez] did have a piece of glass on hand 22 when he fled. Los Banos Police Department was called and notified 23 of [Valadez’s] elopement. 24 Pl.’s Med. Recs. at 163; Def.’s Med. Recs. at 13. The Los Banos police were unable to locate 25 Valadez on March 22, 2021. Several days later, on March 27, 2021, a Los Banos resident found a 26 man hanging from a railing on a boat in his backyard. The man was later identified as Valadez, 27 and his death was ruled a suicide. See Def.’s Mem. at 4; Pl.’s Mem. at 9. 28 As noted above, plaintiff has submitted declarations from three expert witnesses who 29 examined Valadez’s medical records for his stay at Los Banos Hospital. See Pl.’s Stmt. of Evid. 30 Exs. B–D. The Hospital, while objecting on evidentiary grounds to these declarations, see supra 1 Part II.C, has not rebutted plaintiff’s experts’ opinions with its own expert declarations. Dr. Barry 2 Mills, a board-certified psychiatrist and licensed physician in California, submits the Hospital 3 failed to provide one-to-one observation, restrict Valadez to a safe room, or to even administer 4 Valadez psychiatric medication. See Pl.’s Stmt. of Evid. Ex. B (Mills Decl.) at 10–11. Dr. Mills 5 noted the presence of alcohol and opiates in Valadez’s system “significantly increased his risk of 6 imminent danger.” Id. at 10. Further, while Valadez met the criteria for involuntary medication, 7 the Hospital did not order involuntary medication to be administered to him. See id. The 8 Hospital also did not keep Valadez away from dangerous sharp objects like the glass that encased 9 the fire extinguisher. See id. Dr. René Ramirez, a board-certified emergency medicine physician, 10 submits the Hospital failed in its care for Valadez because it neglected to provide him with 11 “physical and chemical restraints” as a way to stabilize his condition and prevent him from 12 committing self-harm. Pl.’s Stmt. of Evid. Ex. C (Ramirez Decl.) at 14. According to 13 Dr. Ramirez, patients on 5150 holds “should immediately be placed under the strictest of 14 monitoring conditions” to assure “safety for themselves and others.” Id. at 20. Ramirez noted the 15 Hospital failed to appreciate the “severity of [Valadez’s] acute decompensated state” and also 16 noted the presence of opiates and alcohol in Valadez’s system, which the Hospital had 17 documented early on in Valadez’s stay. See id. Meanwhile Dan Branch, a registered nurse in 18 California with 15 years’ experience, submits Valadez was not provided a safe environment for 19 someone in his condition given that the hallway had a glass-encased fire extinguisher and was 20 near an exit. See Pl.’s Stmt. of Evid. Ex. D (Branch Decl.) at 23–24. Branch also submits 21 Valadez should not have been able to walk down the hallway on his own. See id. All three 22 experts submit the Hospital’s failure to provide Valadez adequate care contributed to his death. 23 See Mills Decl. at 10–11; Ramirez Decl. at 20; Branch Decl. at 24. 24 IV. LEGAL STANDARD 25 To succeed on summary judgment, a party must show “there is no genuine dispute as to 26 any material fact and [they are] entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). A 27 dispute is “genuine” if “a reasonable jury could return a verdict for the nonmoving party.” 28 Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A fact is “material” if it “might affect 1 the outcome of the suit under the governing law.” Id. “[M]ere allegation and speculation do not 2 create a factual dispute for purposes of summary judgment.” Nelson v. Pima Cmty. Coll., 83 F.3d 3 1075, 1081–82 (9th Cir. 1996) (citing Witherow v. Paff, 52 F.3d 264, 266 (9th Cir. 1995)). The 4 court views the record in the light most favorable to the non-moving party and draws reasonable 5 inferences in their favor. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587– 6 88 (1986); Adickes v. S.H. Kress & Co., 398 U.S. 144, 157 (1970). “[t]rial courts should act . . . 7 with caution in granting summary judgment . . . [and] the trial court may . . . deny summary 8 judgment in a case where there is reason to believe that the better course would be to proceed to a 9 full trial.” Anderson, 477 U.S. at 255. 10 V. ANALYSIS 11 A. EMTALA (Claim Two)5 12 Congress enacted EMTALA to prevent Medicare-participating hospitals from refusing to 13 care for, or “dumping,” unwanted emergency room patients. See Baker v. Adventist Health, Inc., 14 260 F.3d 987, 993 (9th Cir. 2001). It is undisputed the Hospital is subject to EMTALA’s 15 requirements. The statute mandates two requirements: first, hospitals must provide an 16 “appropriate medical screening examination within the capability of the hospital’s emergency 17 department, including ancillary services routinely available to the emergency department.” 18 42 U.S.C. § 1395dd(a). Second, if the “hospital determines that the individual has an emergency 19 medical condition, the hospital must provide either . . . such further medical examination and such 20 treatment as may be required to stabilize the medical condition or . . . for transfer of the individual 21 to another medical facility . . . .” 42 U.S.C. § 1395dd(b). Plaintiff alleges the Hospital failed both 22 to screen and stabilize Valadez. 23 1. Duty to Screen 24 The Hospital would be liable under EMTALA if it had failed to abide by its own 25 screening procedures when it treated Valadez. See Baker, 260 F.3d at 993. It would violate 5 The court takes plaintiff’s claims out of order as it finds plaintiff’s ADA, Unruh Act and CDPA Act claims all allege Valadez was deprived of an accommodation based on his disability; they are related claims and should be addressed in the order set forth below. 1 EMTALA if it did not provide a screening of Valadez “comparable to that offered to other 2 patients with similar symptoms.” Jackson v. East Bay Hosp., 246 F.3d 1248, 1255 3 (9th Cir. 2001). However, EMTALA’s duty to screen requirement is not a substitute for medical 4 malpractice, as EMTALA does not “impose on hospitals a national standard of care in screening 5 patients.” Eberhardt v. City of Los Angeles, 62 F.3d 1253, 1258 (9th Cir. 1995). The standard of 6 care—whether or not the screen performed by the Hospital was done correctly—is instead the 7 province of state tort law. See id. However, if a screen is “so cursory that it is not ‘designed to 8 identify acute and severe symptoms that alert the physician of the need for immediate medical 9 attention to prevent serious bodily injury,’” the Hospital may have failed in its duty to screen 10 Valadez. Jackson, 246 F.3d at 1256 (quoting Eberhardt, 62 F.3d at 1257). 11 It is undisputed the Hospital screened Valadez almost immediately after he arrived. Nurse 12 Biviyodavid screened Valadez and noted in Valadez’s medical records use of the Columbia- 13 Suicide Severity Rating Scale as a part of the screen. See Pl.’s Med. Recs. at 175. Plaintiff does 14 not argue this was the incorrect screening device for section 5150 patients. Plaintiff also does not 15 argue that, if administered properly, the Columbia-Suicide Severity Rating Scale would not be so 16 cursory as to effectively be incapable of identifying Valadez’s symptoms. See Jackson, 246 F.3d 17 at 1256. Further, the Hospital points out plaintiff has provided no evidence of disparate 18 treatment. See Def.’s Opp’n at 24. 19 Instead, plaintiff argues nurse Biviyodavid simply checked a box that he used the 20 Columbia-Suicide Severity Rating Scale but did not actually screen Valadez properly. Plaintiff 21 bases this argument on Biviyodavid’s making a mistake when he declared Valadez was not a 22 suicide risk. Pl.’s Mem. at 19–20; Pl.’s Opp’n at 9–10. Plaintiff also provides expert testimony 23 from Dr. Mills who suggests the screen was incomplete based on the mistakes he believes 24 Biviyodavid made. See Mills Decl. at 10; Mills Dep. at 15–16 (“I mean, I – they scored [The 25 Columbia-Suicide Severity Rating Scale] very wrong I think someone just put – checked that they 26 did it and didn’t really do it.”). But Mills’ only opinion for why the screen was incomplete was 27 that Biviyodavid came to the wrong conclusion regarding Valadez’s risk of self-harm. See Mills 28 Dep. at 15–16. Mills’ belief that the screen was not done is speculative and speculation alone 1 cannot establish a dispute of material fact. See Nelson, 83 F.3d at 1081–82 (citing Witherow, 2 52 F.3d at 266). Plaintiff did not, for example, depose Biviyodavid or provide any other factual 3 basis from which a reasonable factfinder could infer Biviyodavid did not use the Columbia- 4 Suicide Severity Rating Scale to assess Valadez. 5 Further, plaintiffs’ own expert, Dr. Ramirez, seemed to suggest in his deposition the 6 Hospital initially screened Valadez when he stated, “So the patient was – it seemed like he was 7 screened in the initial screening exam, even the nurse note[d] on the intake, one of the 8 questionnaires I recall stuck out to me was this patient presented with a suicidal gesture . . . .” 9 Ramirez Dep. at 22. Upon further questioning regarding whether Valadez had an appropriate 10 screening exam, Ramirez responded, “He had an initial screening exam, and then he did not have 11 an appropriate stabilization.” Id. at 22–23. Pressed again on the question of screening, Ramirez 12 stated, “The patient was screened and within that screening it was uncovered that the patient did 13 not feel safe going home, that he presented for a suicidal gesture, and the ER doctor also agreed 14 that the patient was a danger to himself.” Id. at 23. Dr. Ramirez also suggested in his deposition 15 the Hospital should have conducted a new screen when Valadez’s symptoms deteriorated after 16 11 p.m. on March 21, 2021. See id. at 32. 17 Nothing, however, in the statutory text of EMTALA suggests a patient needs to be 18 screened twice. As the Hospital points out, plaintiff is really asking the court to apply a national 19 standard of care for screening and punish the Hospital because of Biviyodavid’s alleged 20 negligence in misdiagnosing Valadez’s condition, something EMTALA does not require. See 21 Def.’s Opp’n at 19 (citing Jackson, 246 F.3d at 1248). While Biviyodavid appears to have made 22 a mistake by stating Valadez was not a suicide risk at the time of screening, the Hospital was 23 otherwise on actual notice—from the time Valadez arrived up to the time he fled—that Valadez 24 was at risk of self-harm. See Def.’s Med. Recs. at 2; Pl.’s Med. Recs. at 167–68. The Hospital 25 had no need to rescreen Valadez when his condition worsened as at that point he had received a 26 full diagnosis from a psychiatrist, Dr. Brahmbhatt. See Pl.’s Med. Recs. at 167–68. In short, 27 there is no undisputed evidence to support the conclusion the initial screen of Valadez was a 28 determinative problem. Instead, the problem with the care Valadez received arguably lay with 1 the Hospital’s failure to stabilize Valadez before transferring him. The court turns to the 2 Hospital’s duty to stabilize. 3 2. Duty to Stabilize 4 EMTALA requires the Hospital, when it determines a patient like Valadez has an 5 emergency medical condition, to provide either “such further medical examination and such 6 treatment as may be required to stabilize the medical condition, or . . . for transfer of the 7 individual to another medical facility.” 42 U.S.C. § 1395dd(b)(1)(A)–(B). But in order to 8 transfer a patient under EMTALA, the Hospital must first stabilize the patient; thus EMTALA 9 generally requires stabilizing emergency care. See 42 U.S.C. § 1395dd(c)(1). “Stabilization” is 10 defined as providing “such medical treatment of the condition as may be necessary to assure, 11 within reasonable medical probability that no material deterioration of the condition is likely to 12 result from or occur during the transfer of the individual from a facility . . . .” 13 42 U.S.C. § 1395dd(e)(3)(A). 14 To succeed on a failure to stabilize claim, plaintiff ultimately must show, first, Valadez 15 had an emergency condition, and, second, the Hospital had actual knowledge of Valadez’s 16 emergency condition. See Eberhardt, 62 F.3d at 1259 (“[T]he hospital’s duty to stabilize the 17 patient does not arise until the hospital first detects an emergency medical condition.”). Third, 18 plaintiff must also show the Hospital’s failure to stabilize took place during emergency or 19 observational care and not after Valadez had been transitioned to inpatient care. See Bryant v. 20 Adventist Health Sys./West, 289 F.3d 1162, 1167 (9th Cir. 2002) (“We hold that the stabilization 21 requirement normally ends when a patient is admitted for inpatient care.”); see also Bryan v. 22 Rectors and Visitors of Univ. of Va., 95 F.3d 349, 352 (4th Cir. 1996) (EMTALA only covers 23 stabilizing treatment “in connection with a possible transfer” and not “long-term care within the 24 system”). And fourth, plaintiff must show the Hospital did not provide medical treatment 25 necessary to assure a material deterioration was unlikely to result from a transfer. See 26 42 U.S.C. § 1395dd(e)(3)(A). 27 As to the fourth element, this court agrees with a sister district judge that EMTALA’s duty 28 to stabilize includes proper monitoring and restraint of psychiatric patients suffering from suicidal 1 ideation.6 In Harmon v. Uintah Basin, for example, the complaint alleged plaintiff suffered from 2 suicidal ideation and was admitted to a hospital for observational purposes. 2021 WL 2532826, 3 at *1. While being observed, the plaintiff’s condition worsened. Id. The hospital then attempted 4 to transfer him to a better qualified care facility. Id. The hospital did not give the patient 5 stabilizing medication, but instead transported him by private vehicle accompanied not by a 6 person trained in managing a suicidal person but instead by “one able-bodied person, an 80-year- 7 old woman, and a man who was and is paraplegic.” Id. The plaintiff, who was neither sedated 8 nor restrained, attempted suicide by jumping out of the moving car while it was travelling 65 9 miles per hour on the highway. Id. He survived, but with severe and permanent injuries. Id. The 10 district court, in denying a motion to dismiss, found the plaintiff had a plausible claim under 11 EMTALA’s duty to stabilize requirement because the hospital allegedly did not give the plaintiff 12 stabilizing care and did not properly monitor the plaintiff. Id. at *6-7. The court finds the 13 reasoning of the district court in Harmon persuasive because, absent proper monitoring and 14 restraint, a patient suffering from suicidal ideation is at high risk of attempted self-harm and 15 likely to experience a material deterioration in medical condition. See 42 U.S.C. 16 § 1395dd(e)(3)(A). 17 In its supplemental briefing, the Hospital argues Harmon differs from the case at bar 18 because the type of harm the court addressed in that case arises “when a patient is actually 19 transferred.” Def.’s Suppl. Brief at 2. While recognizing the distinction in factual circumstances, 20 the court is not persuaded those differences matter for the principle the court in Harmon 21 articulates: that the duty to stabilize includes requiring hospital staff to monitor and restrain a 22 patient suffering from suicidal ideation pending completion of transfer. 23 Applying the law related to stabilization, for the first element, the parties do not dispute 24 Valadez had an emergency condition. See Eberhardt, 62 F.3d at 1257–59 (applying EMTALA 6 The court also takes judicial notice on its own motion of the Office of Inspector General’s 2017 investigation of and settlement with Covenant Medical Center in Waterloo, Iowa over alleged EMTALA violations including discharging a woman experiencing thoughts of suicidal ideation and failing to restrain another patient whose mind was “disturbed,” allowing him to elope and eventually die from exposure. See https://oig.hhs.gov/fraud/enforcement/iowa- hospital-settles-case-involving-a-patient-dumping-allegations/ (accessed June 13, 2025). 1 stabilization requirement to a psychiatric condition); see also 42 C.F.R. § 489.24(b)(1) (listing 2 psychiatric disturbances as an example of an emergency medical condition under EMTALA). 3 For the second element, the parties also do not dispute the Hospital was aware of Valadez’s 4 emergency condition. He arrived on a 5150 hold with complaints of suicidal ideation and a self- 5 inflicted knife wound on his neck. See Def.’s Med. Recs. at 2. Another 5150 hold was placed 6 after 11 p.m., after the treating psychiatrist evaluated him as a having a high suicide risk. See 7 Pl.’s Med. Recs. at 167–68. For the third element, it also is undisputed the Hospital did not 8 provide Valadez “inpatient care.” See Bryant, 289 F.3d at 1167. The Hospital has submitted it 9 did not have the facilities or expertise to provide long-term care. See Johnson Decl. ¶ 2. Valadez 10 either only received emergency care at the Hospital or some type of observational care and 11 neither one exempts the Hospital from EMTALA’s stabilization requirements. See Harmon, 12 2021 WL 2532826, at *5–6 (collecting authority on observational care under EMTALA). Further 13 the parties do not dispute Valadez was going to be transferred to a psychiatric hospital, as 14 required. See Pl.’s Med. Recs. at 168. Thus, the Hospital indisputably had a duty to stabilize 15 Valadez until it transferred him. 16 For the fourth element, the court finds it is undisputed the Hospital failed to provide 17 stabilizing care to Valadez. The court makes this finding using Valadez’s medical records and 18 Valadez’s three unrebutted expert reports evaluating his medical records. The Hospital placed 19 Valadez, who was suffering from suicide ideation and who had committed self-harm with a knife 20 less than an hour before his arrival, in a hallway containing a glass-encased fire extinguisher. See 21 Def.’s Med. Recs. at 2, 13; Pl.’s Med. Recs. at 163. Further, the Hospital placed Valadez in the 22 hallway, in spite of two 5150 holds and a diagnosis by its own psychiatrist that he presented a 23 high risk of self-harm and harm to others. See Def.’s Med. Recs. at 2; Pl.’s Med. Recs. at 167–68. 24 There is no evidence Valadez received medicine to stabilize his condition even though 25 Dr. Brahmbhatt prescribed Valadez Risperdal and Zoloft. See Pl.’s Med. Recs. at 168. There is 26 undisputed evidence his condition worsened during his stay at the Hospital. See Pl.’s Med. Recs. 27 at 157–58. There is no evidence Valadez was restrained at any point during his stay. Further, a 28 security guard monitoring Valadez allowed him to pace the hallway even after a second 5150 1 hold had been placed on him for suicide ideation. See Def.’s Med. Recs. at 13; Pl.’s Med. Recs. 2 at 163. Examining these facts, three experts opine the Hospital did not supervise Valadez 3 properly and placed him in a dangerous hallway that made it likely he would commit self-harm. 4 See generally Mills Decl.; Ramirez Decl.; Branch Decl. Plaintiff’s experts submit the Hospital 5 should have provided psychiatric medication and possibly physical restraints to keep Valadez safe 6 especially as the Hospital knew Valadez had opiates and alcohol in his system, which made his 7 psychiatric condition even more unstable. See generally Mills Decl., Ramirez Decl., Branch 8 Decl. The Hospital, meanwhile, has not provided any of its own expert testimony that might 9 rebut or counter plaintiff’s experts. 10 Finally, the court finds there is no dispute of material fact as to causation. Dr. Mills, after 11 evaluating Valadez’s medical records, has opined that “[a]bsent immediate, appropriate 12 intervention, the potential for a poor outcome of this patient was quite foreseeable.” Mills Decl. 13 at 10. Mills concluded the Hospital’s “denial of access to adequate psychiatric care, caused 14 [Valadez’s] injury and death.” Id. at 11. Dr. Ramirez, similarly, after evaluating Valadez’s 15 medical records, opined the “denial of access to psychiatric care and emergency treatment in this 16 case caused the elopement from the hospital and untimely death of [Valadez].” Ramirez Decl. at 17 20. Nurse Branch, after evaluating the same medical records, opined that “Valadez’s desire for 18 self-harm and subsequent elopement was foreseeable and preventable in my opinion.” Branch 19 Decl. at 24. Branch concluded “[t]he lack of any treatment to stabilize his condition and the 20 inability of the staff to provide Mr. Valadez a safe and secure environment directly contributed to 21 his death.” Id. These three experts’ opinions, in short, makes it more likely than not Valadez’s 22 injury was a result of the Hospital’s failure to stabilize him. See Jennings v. Palomar Pomerado 23 Health Sys., Inc., 114 Cal. App. 4th 1108, 1118 (2003) (plaintiff must produce “evidence from 24 which reasonable [people] may conclude that it is more probable that the event was caused by the 25 defendant than it was not” (quoting Osborn v. Mem’l Blood Bank, 5 Cal. App. 4th 234, 253 26 (1992) (alterations in original)). 27 The Hospital makes four arguments for why the court should either grant it summary 28 judgment on plaintiff’s duty to stabilize claim or deny plaintiff’s motion for summary judgment 1 on the same claim. First, the Hospital argues none of the evidence plaintiff has submitted is 2 admissible. See Def.’s Opp’n at 16–24. The court has addressed this argument above, and finds 3 otherwise, in relevant part. See supra Part II.C. Second, the Hospital argues the court can only 4 evaluate EMTALA’s stabilization requirements if a patient is transferred or discharged. Def.’s 5 Mem. at 11. Third, the Hospital argues it provided Valadez stabilizing treatment. See id. at 13– 6 14. And fourth, the Hospital argues plaintiff has failed to show causation linking the Hospital’s 7 alleged failure to stabilize to Valadez’s death. See id. at 14. The court addresses the last three 8 arguments below. 9 The court finds the Hospital’s second argument unconvincing. The Hospital effectively 10 asks the court to create, in essence, a “dump in the hallway” carve out to EMTALA’s stabilization 11 requirement. The Hospital did not discharge Valadez, and it did not manage to transfer him 12 before he escaped. Because the Hospital was not discharging or transferring Valadez at the time 13 he fled the premises, the Hospital argues it cannot be held liable for failing to stabilize him. See 14 id. at 11. This argument ignores the plain language of EMTALA, which requires hospitals to 15 provide either stabilizing care or a transfer provided the patient is stabilized. See 42 U.S.C. 16 § 1395dd(b)(1)(A)–(B). As the Ninth Circuit has noted, quoting the Fourth Circuit’s decision in 17 Bryant: 18 The stabilization requirement is . . . defined entirely in connection 19 with a possible transfer and without reference to the patient’s long- 20 term care within the system. It seems manifest to us that the 21 stabilization requirement was intended to regulate the hospital’s care 22 of the patient only in the immediate aftermath of the act of admitting 23 her for emergency treatment and while it considered whether it 24 would undertake longer term full treatment or instead transfer the 25 patient to a hospital that could and would undertake that treatment. 26 Bryant, 289 F.3d at 1167 (quoting Bryan, 95 F.3d at 352). Here, the Hospital effectively admits it 27 gave Valadez only emergency care in the less than 24 hours after it admitted him with suicidal 28 ideation on a 5150 hold and before a planned transfer. See Johnson Decl. ¶ 2. Its failure to 29 stabilize Valadez then, falls well within the emergency treatment time frame during which 30 EMTALA requires stabilization as envisioned by the courts in both Bryant and Bryan, given that 31 the care was “in connection with a possible transfer.” See Bryant, 289 F.3d at 1167 (quoting 1 Bryan, 95 F.3d at 352) (noting stabilization is required “in the immediate aftermath of the act of 2 admitting [a patient] for emergency treatment and while it considered whether it would undertake 3 longer term full treatment or instead transfer the patient to a hospital that could and would 4 undertake that treatment”). Until Valadez was transferred or discharged, the Hospital was 5 required to provide stabilizing care. See id. 6 The Hospital’s third and fourth arguments are also unavailing. The Hospital argues it 7 provided stabilizing care because Valadez was “placed on a 5150 hold and monitored.” Def.’s 8 Mem. at 13; see also Def.’s Opp’n at 26 (“The undisputed facts show that [Valadez] was 9 monitored regularly while at [the Hospital] while awaiting transfer.”). But the Hospital has not 10 provided any expert report to substantiate this position, and the undisputed evidence supports the 11 opposite conclusion. Valadez’s three experts also concluded he was not monitored effectively. 12 See generally Mills Decl.; Ramirez Decl.; Branch Decl. Any reasonable factfinder would 13 conclude, as a consequence of undisputed facts regarding the Hospital’s treatment, Valadez’s 14 condition would have been reasonably likely to deteriorate during the transfer. Under these 15 circumstances, it is obvious Valadez could have engaged in serious self-harm by cutting himself 16 with the fire extinguisher case’s glass or seriously injuring himself in an attempt to escape. As in 17 Harmon, Valadez did not receive stabilizing medication as the Hospital’s psychiatrist prescribed 18 and was not supervised properly or restrained. See Harmon, 2021 WL 2532826, at *6. Fourth, 19 the Hospital has provided no evidence to rebut plaintiff’s three experts who all concluded the 20 Hospital’s failure to provide stabilizing emergency care caused Valadez’s suicide. 21 In sum, the court grants the Hospital’s motion for summary judgment on plaintiff’s 22 EMTALA claim on the theory it failed to screen Valadez. The court denies the Hospital’s motion 23 for summary judgment on plaintiff’s EMTALA claim on the theory the Hospital failed to stabilize 24 Valadez. The court denies plaintiff’s motion for summary judgment on her EMTALA claim on 25 the theory the Hospital failed to screen Valadez. The court grants plaintiff’s motion for summary 26 judgment on her EMTALA claim on the theory the Hospital failed to stabilized Valadez. 27 ///// 28 ///// 1 B. ADA (Claim One) 2 To prove a violation of Title III of the ADA, plaintiff must show (1) Valadez was 3 disabled; (2) the Hospital is a private entity that operates a place of public accommodation; and 4 (3) the Hospital denied public accommodations on account of Valadez’s disability. Arizona ex 5 rel. Goddard v. Harkins Amusement Enters. Inc., 603 F.3d 666, 670 (9th Cir. 2010) (citing Molski 6 v. M.J. Cable, Inc., 481 F.3d 724, 730 (9th Cir. 2007)). Plaintiff must also show the Hospital 7 denied Valadez access because of his disability in light of the Ninth Circuit’s pronouncement that 8 “the ADA prohibits discrimination because of disability, not inadequate treatment for disability.” 9 See Simmons v. Navajo County, 609 F.3d 1011, 1022 (9th Cir. 2010), overturned in part on other 10 grounds, Castro v. County of Los Angeles, 833 F.3d 1060 (9th Cir. 2016) (en banc) (citing Bryant 11 v. Madigan, 84 F.3d 246, 249 (7th Cir. 1996) (“The ADA does not create a remedy for medical 12 malpractice.”)). 13 The Hospital does not dispute Valadez was disabled within the meaning of the ADA and 14 the Hospital does not dispute it is a place of public accommodation under the ADA. See Def.’s 15 Mem. at 15; Def.’s Opp’n at 12–13. The dispute rests on the third element of the ADA claim: 16 whether the Hospital denied public accommodations on account of Valadez’s psychiatric 17 disorder. 18 Plaintiff argues the Hospital’s treatment of Valadez violated Title III of the ADA because 19 it did not hold him in a quiet or safe room designed to protect patients suffering from suicidal 20 ideation, did not provide him with one-on-one care, and did not give him medication that would 21 have alleviated his illness. Pl.’s Mem. at 15; Pl.’s Reply at 4–5. The Hospital argues that even 22 taking all these facts as true, plaintiff’s ADA claim fails because the ADA does not create liability 23 for medical malpractice claims: in other words, a plaintiff has an actionable ADA claim when he 24 is denied access to accommodations based on disability, not when he is negligently treated for the 25 disability. Def.’s Mem. at 15 (citing Simmons, 609 F.3d at 1022). 26 The court agrees plaintiff has no actionable ADA claim. As the Hospital notes, almost 27 everyone admitted for medical treatment can claim some kind of disability. Def.’s Opp’n at 13. 28 Under plaintiff’s ADA theory, almost every malpractice case could or would turn into an ADA 1 case. See id. While the cases the Hospital points to involve Title II ADA claims and not Title III 2 ADA claims, they are nevertheless persuasive as the court sees no reason why the Ninth Circuit 3 would allow a Title III ADA claim that is in effect a medical malpractice claim when it has barred 4 similar claims under Title II of the ADA. See, e.g., Simmons, 609 F.3d at 1022. Further, while 5 plaintiff argues the Hospital should have accommodated Valadez with a quiet room, medication, 6 and one-on-one supervision, see Pl.’s Mem. at 15, Pl.’s Reply at 4–5, she points to no cases or 7 administrative regulations that suggest the Hospital was required to provide such an 8 accommodation. 9 The court grants the Hospital’s motion for summary judgment on plaintiff’s ADA claim 10 and denies plaintiff’s motion for summary judgment on that claim. 11 C. Unruh Act (Claim Three) 12 California’s Unruh Act applies to business establishments “that offer to the public 13 ‘accommodations, advantages, facilities, privileges, or services.’” North Coast Women’s Care 14 Med. Grp., Inc. v. Sup. Ct., 44 Cal. 4th 1145, 1153 (2008) (quoting Cal. Civ. Code § 51(b)). Its 15 antidiscrimination provisions subject to liability anyone who “denies . . . or incites a denial, or 16 makes any discrimination or distinction contrary to [the Act].” Id. (quoting Cal. Civ. Code 17 § 52(a)). Proving a Title III ADA claim is sufficient to prove an Unruh Act claim, see Cal. Civ. 18 Code § 51(f), but even though plaintiff failed to show an ADA violation in this case, she can still 19 prove an Unruh Act claim by showing the Hospital intentionally discriminated against Valadez by 20 denying him public accommodations, see Minton v. Dignity Health, 39 Cal. App. 5th 1155, 1162 21 (2019) (quoting Koebke v. Bernardo Heights Country Club, 36 Cal. 4th 824, 854 (2005)). 22 The parties do not dispute that Valadez had a qualified disability under the Unruh Act. 23 And medical establishments like the Hospital who provide services to the public are considered 24 businesses for the purposes of the Unruh Act. See Leach v. Drummond Med. Grp. Inc., 144 Cal. 25 App. 3d 362, 370–71 (1983). Plaintiff relies solely on her contention the Hospital violated the 26 ADA to prove her Unruh Act claim. See Pl.’s Mem. at 25. As the court has found there is not a 27 disputed material fact that would allow plaintiff to bring her ADA claim against the Hospital to 28 trial, it also finds there is no disputed material fact that would allow plaintiff to bring her Unruh 1 Act to trial under this theory of liability. Further, as with her ADA claim, plaintiff has not cited 2 any cases or California regulations that would suggest the Hospital violated the Unruh Act by 3 failing to provide Valadez proper medical treatment. While plaintiff has provided evidence that 4 points to the Hospital’s negligence when treating Valadez, she has not provided sufficient 5 evidence to create a dispute of material fact that the Hospital intentionally discriminated against 6 Valadez. Cf. Minton, 39 Cal. App. 5th at 1162–64 (reversing demurrer after finding plaintiff’s 7 Unruh Act claim to be plausible, that hospital intentionally denied providing plaintiff 8 hysterectomy owing to his being a transgendered man). 9 The court grants the Hospital summary judgment on plaintiff’s Unruh Act claim and 10 denies plaintiff’s motion for summary judgment on that claim. 11 D. CDPA (Claim Four) 12 The CDPA provides “[i]ndividuals with disabilities or medical conditions have the same 13 right as the general public to the full and free use of . . . public buildings, medical facilities . . . 14 public facilities, and other public places.” Cal. Civ. Code § 54. CDPA claims can only be made 15 relating to a denial of physical access to a building and not to the denial of services. See Bax v. 16 Doctors Med. Ctr. of Modesto, Inc., 393 F. Supp. 3d 1000, 1011 (E.D. Cal. 2019); see also Fetter 17 v. Bonner, No. 12-2235, 2015 WL 164268, at *5 (E.D. Cal. Jan. 13, 2015); Wilkins-Jones v. 18 County of Alameda, 859 F. Supp. 2d 1039, 1054 (N.D. Cal. 2012). Here, plaintiff argues only 19 that Valadez was denied services: proper medication, a proper room based on his disability, and 20 proper supervision. See Pl.’s Mem. at 26. Plaintiff claims the Hospital violated the CDPA 21 because it also violated the ADA. See id. But, as noted above, the court has granted the Hospital 22 summary judgment on plaintiff’s ADA claim, and even if it had not, the ADA claim would still 23 need to involve the denial of physical access to a building if plaintiff’s CDPA claim were to 24 survive summary judgment. The only physical denial plaintiff alleges is the Hospital’s failure to 25 provide Valadez with a safe room. See Pl.’s Opp’n at 14; Pl.’s Reply at 4–5. Here as well 26 plaintiff has not provided the court with any case that would show the Hospital is required by the 27 CDPA to provide patients suffering from suicidal ideation a specific room as opposed to being 28 ///// 1 required to provide physical access to the building generally. As plaintiff has failed to allege 2 Valadez was denied physical access to a building or facility, her CDPA claim must fail. 3 The Hospital’s motion for summary judgment on plaintiff’s CDPA claim is granted and 4 plaintiff’s motion for summary judgment on that claim is denied. 5 VI. CONCLUSION 6 For the reasons provided above, the court: 7  With respect to clarifying the evidentiary record: 8 9 o Grants plaintiff’s request for judicial notice (ECF No. 58) as follows: the 10 court takes judicial notice of the existence of the report, but it does not take 11 judicial notice of the interviews embedded within the report or the 12 conclusions based on those interviews because as currently constituted they 13 contain hearsay and the specific statements within the report are disputable. 14 15 o Sustains the Hospital’s objection to plaintiff’s using the information 16 obtained from interviews in the DHLC report for her motion for summary 17 judgment. 18 19 o Sustains the Hospital’s objection to plaintiff’s using Valadez’s medical 20 records from Merced County to support her motion for summary judgment. 21 22 o Overrules the Hospital’s objections to plaintiff’s using the existence of the 23 DHLC report in opposition to the Hospital’s motion for summary 24 judgment. 25 o Overrules all of the Hospital’s other objections. 26 27 o Grants the Hospital’s motion to strike plaintiff’s submission of additional 28 material facts in support of her motion for summary judgment (ECF No. 29 82). 30  Grants the Hospital’s motion for summary judgment (ECF No. 46) on the 31 following claims: 32 o The plaintiff’s ADA claim (claim one). 33 o The plaintiff’s EMTALA claim on the theory the Hospital violated its duty 34 to screen (claim two). 35 o The plaintiff’s Unruh Act claim (claim three). 36 o The plaintiff’s CDPA claim (claim four). 1  Denies the Hospital’s motion for summary judgment on plaintiff’s EMTALA claim 2 on the theory the Hospital violated its duty to stabilize (ECF No. 46). 3  Grants plaintiff’s motion for summary judgment on her EMTALA claim on the 4 theory the Hospital failed to stabilize (claim two) (ECF No. 57). 5  Denies the remainder of plaintiff’s motion for summary judgment (ECF No. 57). 6  Dismisses all DOE defendants without prejudice. 7  A final pretrial conference is set for August 21, 2025. The parties shall meet and 8 confer and file a joint status report 7 days prior to the final pretrial conference 9 addressing all matters the court should consider in issuing the final pretrial order, 10 including whether they request referral to a magistrate judge to conduct a further 11 court-convened settlement. See E.D. Cal. L.R. 281–282; Fed R. Civ. P. 16. 12 This order resolves ECF Nos. 46, 57, 58, 82. 13 IT IS SO ORDERED. 14 DATED: July 2, 2025.