Medical Malpractice vs. General Negligence under California Law

By Alex Stein

In its recent decision, Flores v. Presbyterian Intercommunity Hosp., 369 P.3d 229 (Ca. 2016), the California Supreme Court has sharpened the critical distinction between “medical malpractice” and general negligence.

Under California statute, a plaintiff’s ability to file a medical malpractice suit expires in one year after the accrual of the cause of action. The statute tolls this period for two additional years, provided that the plaintiff files the suit within one year after he discovers the injury or could reasonably have discovered it. Cal. Code Civ. Proc. § 340.5 (providing that suits for medical malpractice must be filed “three years after the date of injury or one year after the plaintiff discovers, or through the use of reasonable diligence should have discovered, the injury, whichever occurs first.”). For other personal injury suits, the limitations period is “two years of the date on which the challenged act or omission occurred.” Cal. Code Civ. Proc. § 335.1.

In the case at bar, the plaintiff was injured when one of the rails on her hospital bed collapsed.

The rail had been raised pursuant to an order made by the plaintiff’s physician following a medical assessment of her condition. The plaintiff sued the hospital under the general negligence theory in the hopes to benefit from a two-year limitations period set by section 335.1. The California Supreme Court, however, categorized the suit as alleging medical malpractice because the plaintiff’s injury resulted from the “alleged negligence in the use and maintenance of equipment needed to implement the doctor’s order concerning her medical treatment.”

This categorization relied on Murillo v. Good Samaritan Hosp., 99 Cal.App.3d 50, 57 (Cal.App. 1979)—a decision in which California’s Court of Appeals explained that the test for distinguishing between general negligence and medical malpractice “is not whether the situation calls for a high or a low level of skill, or whether a high or low level of skill was actually employed, but rather …. whether the negligent act occurred in the rendering of services for which the health care provider is licensed.”

In tune with this decision, the Court set up the “integral relationship’ test. Specifically, it ruled that “A hospital’s negligent failure to maintain equipment that is necessary or otherwise integrally related to the medical treatment and diagnosis of the patient implicates a duty that the hospital owes to a patient by virtue of being a health care provider.” Suits complaining about violations of any such duty therefore must be filed within the timeframe of Cal. Code Civ. Proc. § 340.5.

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About Alex Stein

Alex Stein is a Professor of Law at Brooklyn Law School. Before joining Brooklyn, Alex was a Professor of Law at Cardozo Law School (2004-2016) and served for more than a decade at the Hebrew University of Jerusalem Faculty of Law (1991-2004). He also held visiting professorial appointments at Alabama, Columbia, Miami, and Yale Law Schools. In Fall 2016, he visited Harvard Law School, where he taught Torts and a seminar on Medical Malpractice. Alex's specialty areas include Torts, Medical Malpractice, Evidence, as well as general legal theory and economic analysis of law. He authors three books, An Analytical Approach to Evidence (with Ronald J. Allen et al.) (6th ed. 2016); Foundations of Evidence Law (2005) and Tort Liability under Uncertainty (2001, with Ariel Porat), and over sixty articles of which many have appeared in leading journals. Alex was one of the founding editors of Theoretical Inquiries in Law and is on the editorial board of the International Journal of Evidence & Proof. In 2013, he launched an e-journal STEIN on Medical Malpractice, http://www.steinmedicalmalpractice.com, that covers all significant developments in medical malpractice laws across the United States. He graduated from the Hebrew University of Jerusalem and earned a Ph.D. from the University of London.