Zeddrick F. White v. United States Government et al
Filing
58
POST-TRIAL FINDINGS OF FACT AND CONCLUSIONS OF LAW signed by Judge Manuel L. Real. (lom)
1
2
3
4
5
6
7
8
9
10
SANDRA R. BROWN
Acting United States Attorney
DOROTHY A. SCHOUTEN
Assistant United States Attorney
Chief, Civil Division
ROBYN-MARIE LYON MONTELEONE
Assistant United States Attorney
Chief, General Civil Section
RICHARD M. PARK (SBN 236173)
Assistant United States Attorney
Room 7516, Federal Building
300 North Los Angeles Street
Los Angeles, California 90012
Tel: (213) 894-3275
Fax: (213) 894-7819
Email: richard.park@usdoj.gov
Attorneys for Defendant
United States of America
11
UNITED STATES DISTRICT COURT
12
CENTRAL DISTRICT OF CALIFORNIA
13
14
ZEDDRICK F. WHITE
15
16
Plaintiff,
v.
17
UNITED STATES OF AMERICA,
18
Defendant.
19
20
21
22
23
24
25
26
27
28
Case No. CV 16-06348 R (KSx)
POST-TRIAL FINDINGS OF FACT
AND CONCLUSIONS OF LAW
Trial: August 8, 2017 at 10:00 a.m.
Location: Roybal Federal Building and
U.S. Courthouse
255 East Temple Street
Courtroom 880
Los Angeles, CA 90012
Honorable Manuel L. Real
United States District Judge
The Court conducted the trial of the above-captioned action on August 8, 2017;
1
2
heard the entirety of Plaintiff’s evidence; admitted into evidence Defendant’s trial
3
exhibits 1-26; heard Defendant’s motion for judgment on partial findings pursuant to
4
Rule 52(c) of the Federal Rules of Civil Procedure; Plaintiff’s opposition thereto; and
5
granted such motion. As instructed by the Court, Defendant United States hereby
6
submits the following Proposed Post-Trial Findings of Fact and Conclusions of Law.
7
A proposed Judgment has been submitted under separate cover.
8
I.
9
FINDINGS OF FACT
1.
On January 20, 2015, Plaintiff visited the West Los Angeles facility of the Veterans Affairs Greater
10
Los Angeles Health Care System (“West LA VA”) to receive treatment for urinary frequency. Plaintiff saw a VA
11
primary care physician, who conducted a clinical examination and routine laboratory
12
testing.
13
2.
Later that same day, Plaintiff’s primary care physician informed him
14
about his abnormal laboratory results and requested that Plaintiff visit the Emergency
15
Department at the West LA VA for follow up testing and treatment.
16
3.
Plaintiff’s initial laboratory results revealed that he had high levels of
17
creatinine (measurements of toxins in the blood), which indicates poor kidney
18
function.
19
4.
At the Emergency Department, Plaintiff underwent additional clinical
20
evaluation, laboratory testing, and a kidney ultrasound to determine the etiology of his
21
kidney problems. This workup indicated that Plaintiff had Vitamin D toxicity
22
(extremely high levels of Vitamin D in blood) and hypercalcemia (excessive amount
23
of calcium in blood). Plaintiff was diagnosed with acute renal failure and acute
24
kidney injury. He was admitted to the West LA VA hospital as an inpatient.
25
5.
Plaintiff revealed to VA healthcare providers that he consumed a Vitamin
26
D supplement, multivitamin, workout supplement, and various herbal supplements in
27
the months prior to the Emergency Department visit.
28
1
1
6.
Taking excessive amounts of supplements containing Vitamin D can
2
raise calcium levels and cause hypercalcemia. When hypercalcemia is present, a
3
person’s kidneys must work harder to filter the blood, which can cause excessive thirst
4
and frequent urination. Hypercalcemia can damage the kidneys and limit their ability
5
to cleanse blood and eliminate fluid.
6
7
8
9
10
11
12
7.
Physicians from the Nephrology Department of West LA VA consulted
with the VA medical staff regarding Plaintiff’s renal issues.
8.
During his hospital admission, Plaintiff received an intravenous saline
solution and calcitonin medication to address his hypercalcemia.
9.
On January 21, 2015, Plaintiff was also subject to a full renal workup to
determine the cause of his acute kidney injury.
10.
As part of the full renal workup, Plaintiff underwent a chest x-ray and
13
was tested for a number of conditions that are known to have a damaging effect on
14
kidney function, including Hepatitis B, Hepatitis C, Syphilis, and HIV.
15
16
17
18
19
11.
Patients with acute kidney injuries are routinely tested for HIV because
the virus itself can damage the kidneys.
12.
A VA healthcare provider explained the nature of the full renal workup
and obtained Plaintiff’s consent to complete the workup.
13.
On January 22, 2015, VA healthcare providers conducted a renal biopsy
20
to obtain more information regarding Plaintiff’s acute kidney injury. Plaintiff
21
consented to the renal biopsy.
22
14.
The renal biopsy did not show evidence of chronic kidney disease.
23
15.
Following the biopsy, VA healthcare providers continued to provide
24
intravenous fluids to improve Plaintiff’s creatinine levels and medication for his
25
hypercalcemia.
26
16.
27
HIV positive.
On January 24, 2015, Plaintiff was informed by VA healthcare providers that he tested
28
2
1
2
3
17.
The same day, following the disclosure of Plaintiff’s HIV status, Plaintiff
left the hospital against medical advice.
18.
Although VA healthcare providers strongly encouraged him to stay in the
4
hospital, knowing that Plaintiff was determined to leave, they advised him to drink
5
ample amounts of fluid, eat a low calcium diet, and take the prescription steroid
6
Prednisone for his hypercalcemia.
7
19.
Before leaving the hospital Mr. White was “informed of the risk involved
8
and released the attending physician and the hospital from all responsibility and any ill
9
effect which may result [sic] from their action.”
10
20.
Upon leaving the hospital, Mr. White “was not angry” and “felt he had
11
been provided overall good care, but had many personal things going on that he could
12
not explain.”
13
14
15
16
17
21.
Prior to his departure from the hospital, Plaintiff’s creatinine levels were
substantially lower.
22.
VA healthcare providers instructed Plaintiff to follow-up with the VA
Nephrology Department and the VA HIV clinic at the West LA VA.
23.
At all times during his hospital admission from January 20 – 24, 2015,
18
Plaintiff was appropriately treated by VA healthcare providers for his acute kidney
19
injury.
20
21
22
24.
Between January 26 to March 5, 2015, VA healthcare providers called
Plaintiff and left voicemail messages asking him to schedule an appointment.
25.
On January 30, 2015, Plaintiff’s primary care physician sent him a letter
23
reminding him of a nephrology appointment on February 4, 2015, informing him that
24
she made a request to an infectious diseases HIV specialist for a consultation, and
25
asking him to make a primary care appointment.
26
26.
After leaving against medical advice on January 24, 2015, Plaintiff never
27
returned to the West LA VA for any medical treatment at all, including any follow up
28
for his acute kidney injury or for his HIV condition.
3
27.
1
2
Each VA healthcare provider was acting within the course and scope of
his or her employment when treating Plaintiff.
28.
3
On or about March 4, 2015, Plaintiff filed an administrative tort claim
4
(Standard Form-95) against the Department of Veterans Affairs in the amount of
5
Fifty-Thousand Dollars ($50,000) claiming he was tested for HIV without his consent
6
and for misdiagnosing kidney failure.
29.
7
Defendant’s retained expert in internal medicine and nephrology, Dr.
8
Stuart Friedman, opined that VA healthcare providers at all times met the applicable
9
standard of care and provided appropriate treatment. He also opined that VA
10
healthcare providers did not breach the standard of care in diagnosing and treating
11
Plaintiff for kidney injury. See Trial Ex. 26.
30.
12
The Court finds that Dr. Friedman is appropriately credentialed and
13
qualified to provide expert medical opinion. The Court further finds that his expert
14
opinions as set forth in his report are credible.
15
31.
Plaintiff presented no expert witness testimony in support of his claims.
16
32.
The Court further finds that Plaintiff’s testimony was inadequate to set
17
forth a prima facie case of medical negligence or to establish any of the claims made
18
in his complaint.
19
33.
Any finding of fact deemed to be a conclusion of law is hereby
20
incorporated into Conclusions of Law.
21
II.
22
CONCLUSIONS OF LAW
1.
In an action brought pursuant to the Federal Tort Claims Act (“FTCA”),
23
28 U.S.C. § 2671 et seq., the law of the place where the allegedly negligent act
24
occurred governs the substantive law applied. See 28 U.S.C. §§ 1346(b).
25
2.
To have a cognizable claim under the FTCA, the claim must arise from
26
the negligent or wrongful act of a government employee acting within the scope of his
27
or her employment “under circumstances where the United States, if a private person,
28
would be liable to the claimant in accordance with the law of the place where the act
4
1
or omission occurred.” 28 U.S.C. § 1346(b); Dalehite v. United States, 346 U.S. 15,
2
73 S.Ct. 936, 97 L.Ed. 1427 (1953).
3
4
5
3.
California law applies to the instant suit because the acts or omissions at
issue in this suit occurred at the West LA VA in Los Angeles, California.
4.
Under the FTCA, the United States is liable for money damages in the
6
same manner and to the same extent as a private individual under like circumstances,
7
but shall not be liable for interest prior to judgment or for punitive damages. 28
8
U.S.C. § 2674.
9
5.
10
11
Under the FTCA, Plaintiff’s damages, if any, are limited to the amount
claimed administratively. See 28 U.S.C. §2675(b).
6.
To prove medical malpractice under California law, Plaintiff must
12
establish: (1) the duty of VA healthcare providers to use such skill, prudence, and
13
diligence as other members of their profession commonly possess and exercise; (2)
14
that VA healthcare providers breached that duty; (3) a proximate causal connection
15
between the negligent conduct and the resulting injury; and (4) actual loss or damage
16
resulting from the VA healthcare providers’ negligence. See, e.g., Hanson v. Grode,
17
76 Cal. App. 4th 601, 606 (1999); Gami v. Mullikin Med. Ctr., 18 Cal. App. 4th 870,
18
877 (1993) (reciting elements of medical negligence claim).
19
7.
As a general rule, the testimony of an expert witness is required in every
20
professional negligence case to establish (i) the applicable standard of care, (ii)
21
whether that standard was met or breached by defendant, and (iii) whether any breach
22
of the standard of care by defendant caused the plaintiff’s damages. See Scott v.
23
Raybrer, 185 Cal. App. 4th 1535, 1542 (Cal. App. 2d Dist. 2010) (citing Flowers v.
24
Torrance Memorial Hospital Medical Center, 8 Cal. 4th 992, 1001 (1994).
25
8.
“The standard of care in a medical malpractice case requires that medical
26
service providers exercise . . . that degree of skill, knowledge and care ordinarily
27
possessed and exercised by members of their profession under similar circumstances.”
28
Barris v. County of Los Angeles, 20 Cal. 4th 101, 108 n.1 (1999).
5
9.
1
Thus, a physician breaches the standard of care only if the physician’s
2
action is “[a] deviation from the standard of care that his peers consider appropriate in
3
the situation.” Burgess v. Superior Ct., 2 Cal. 4th 1064, 1081 (1992).
10.
4
The burden of proof with respect to all elements of his claims rests with
5
Plaintiff who must demonstrate to a reasonable degree of medical probability that the
6
VA healthcare providers breached the applicable standard of care and thereby caused
7
injury based upon competent expert testimony. See Vasquez v. Residential
8
Investments, Inc., 118 Cal. App. 4th 269, 288 (2004); Bromme v. Pavitt, 5 Cal. App.
9
4th 1487, 1489 (1992) (citing Jones v. Ortho Pharmaceutical Corp., 163 Cal. App. 3d
10
396, 402-403 (1985)).
11.
11
12
“A tort is a legal cause of injury only when it is a substantial factor in
producing the injury.” Soule v. GM Corp., (1994) 8 Cal. 4th 548, 572.
12.
13
Under California Civil Jury Instruction (“CACI”) 430: A substantial
14
factor in causing harm is a factor that a reasonable person would consider to have
15
contributed to the harm. It must be more than a remote or trivial factor. It does not
16
have to be the only cause of the harm. [Conduct is not a substantial factor in causing
17
harm if the same harm would have occurred without that conduct.] CACI 430 (2010).
13.
18
19
Plaintiff did not meet his burden of proof on any element of any claim
presented in his complaint.
14.
20
West LA VA staff provided appropriate medical care for Plaintiff’s acute
21
kidney injury and ordered appropriate testing to determine the cause of such injury.
22
Their conduct met the applicable standard of care at all times relevant to this case.
15.
24
25
Plaintiff consented to the care and treatment given to him at the West LA
16.
23
Dr. Friedman, Defendant’s expert nephrologist, provided credible
VA.
26
testimony that VA healthcare providers acted within the standard of care in diagnosing
27
or treating Plaintiff for his kidney injury.
28
6
1
17.
Plaintiff did not present any opinion by a treating physician or expert
2
witness that any VA healthcare provider breached the standard of care in diagnosing
3
or treating Plaintiff for his kidney injury.
4
5
6
7
8
9
10
18.
Plaintiff did not present any opinion by a treating physician or expert
witness that Plaintiff acquired HIV during his VA hospital admission.
19.
To a reasonable degree of medical probability, Plaintiff could not have
contracted HIV during his inpatient care at the West LA VA.
20.
No act or omission by any VA healthcare provider breached the
applicable standard of care. No act or omission by any VA healthcare provider was
the legal cause of any injury to Plaintiff.
11
21.
The United States did not breach any duty owed to Plaintiff.
12
22.
The United States did not cause any of the injuries alleged by Plaintiff.
13
23.
Under Rule 52(c) of the Federal Rules of Civil Procedure, Defendant is
14
entitled to judgment on partial findings because Plaintiff was fully heard during a
15
nonjury trial and did not establish that VA healthcare providers breached any duty or
16
caused any of the injuries alleged by Plaintiff.
17
18
24.
Any conclusion of law deemed to be a finding of fact is hereby
incorporated into Findings of Fact.
19
20
Dated: August 14, 2017.
21
22
23
24
_______________________________________
HONORABLE MANUEL L. REAL
UNITED STATES DISTRICT COURT JUDGE
25
26
27
28
7
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?