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CA appeal court: Personal injury plaintiffs can't claim all hospital expenses, just because they visited ER once

NORTHERN CALIFORNIA RECORD

Wednesday, December 4, 2024

CA appeal court: Personal injury plaintiffs can't claim all hospital expenses, just because they visited ER once

State Court
Webp ca stanley mosk library and courthouse third district appeal

The Stanley Mosk Library and Courthouse, home of the California Third District Court of Appeal, Sacramento | Tony Webster from Minneapolis, Minnesota, United States, CC BY-SA 2.0 <https://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons

A California state appeals panel has ruled a Sacramento court wrongly applied a California law governing hospital liens, saying courts can't use the law to force personal injury defendants to pay any and all medical bills charged by a hospital, simply because a patient may have used that hospital's emergency room one time.

In the ruling, a three-justice panel of the California Third District Court of Appeal ordered a new trial to determine a proper award for medical expenses, potentially sharply reducing a $4.9 million award granted by a Sacramento County jury to a man who suffered injuries in a low-speed vehicle crash caused by bees nine years ago.

The Nov. 25 ruling came as the latest step in a years-long court fight in the lawsuit brought by plaintiff David Yaffee against truck driver Joseph Skeen and Skeen's then-employer, KLS Transportation Inc. The lawsuit was also defended by KLS' insurer, National Liability & Fire Insurance Company, a Berkshire Hathaway insurance company, based in Stamford, Connecticut.


California Third District Appellate Justice Harry E. Hull Jr. | Ballotpedia

The lawsuit landed in Sacramento County Superior Court in November 2016, as Yaffee sought millions of dollars in damages for injuries he claimed to have suffered as a result of a low-speed crash when his Acura car was rear-ended by a 26-foot box truck driven by Skeens in 2015.

According to court documents and reporting posted by Jury Verdict Alert, Skeens testified he was stopped at a red light behind Yaffee's vehicle, when bees entered the cab of his box truck. He testified he proceeded to attempt to swat the bees and shoo them out of his vehicle, when he said his foot slipped off the brake pedal, causing his truck to move forward and strike the back end of Yaffee's car at no more than 5 mph.

Yaffee, however, testified he still suffered significant back injuries, ulimately resulting in surgery. Despite the low speed at which the crash occurred, Yaffee said the significant size and weight imabalance between his car and Skeens' truck still caused him to suffer injuries and the full extent of those injuries were not known for some time.

According to court documents, Yaffee's car was towed following the crash and a friend drove hiim home. 

According to court documents, Yaffee said he began feeling a "burning sensation in his back and neck," and within hours the pain, tingling and other symptoms in his back and lower extremities allegedly worsened and continued to worsen over the ensuing days and weeks. Yaffee visited a doctor at UC Davis Medical Center, where he was examined, given the painkiller naproxen and a muscle relaxer and sent home. 

The pain, however, continued to worsen, Yaffee said, ultimately resulting in months of treatments leading to surgery and the implantation of an electrical stimulating device to relieve chronic pain.

He also was unable to continue in his job, according to court documents, suffering lost income and career opportunities.

For their part, Skeens and his co-defendants asserted Yaffee's physical ailments were the result of a preexisting condition, and not a direct result of the crash.

After a nine-day trial in 2022, a jury sided with Yaffee, awarding him nearly $3.3 million in damages, including $993,000 for past medical expenses and $685,993 for future medical expenses, or a total medical expenses award of nearly $1.68 million.

The court later also awarded Yaffee costs and prejudgment interest worth nearly $1.65 million more.

The Sacramento County Superior Court judge denied the defendants' request to either overturn the verdict or grant a new trial, prompting appeal.

On appeal, the Third District Appellate justices upheld the verdict overall, including Yaffee's claims for lost income and other non-medical related losses and costs.

However, the justices said the Sacramento Court will need to hold a new trial to properly calculate how much Yaffee should receive for past and future medical expenses.

The decision was authored by Justice Harry E. Hull. Justices Elena J. Duarte and Stacy Boulware Eurie concurred in the ruling.

In rejecting the jury's $993,000 award for past medical expenses, the appellate justices said the Sacramento County judge and attorneys for both parties relied on a faulty interpretation of California's Hospital Lien Act (HLA).

The law, which originated in the 1960s, was amended by California state lawmakers in 1992 specifically to address the problems faced by hospitals in collecting fees for service from uninsured patients receiving care at their emergency departments.

Under the language adopted at that time, lawmakers allowed hospitals to apply liens on patients for unpaid bills stemming from "emergency and ongoing medical or other services."

The Sacramento court interpreted the law to allow Yaffee to seek compensation for all of his past medical expenses charged by UC Davis.

Justice Hull and his colleagues, however, said that interpretation is faulty.

Hull said the law limits a hospital's authority to impose liens under the HLA only to expenses racked up by patients between the time they present for care at a hospital's emergency department and when they are discharged.

"The HLA does not apply so broadly as to also include services UC Davis provided plaintiff after the emergency room staff discharged him...," Hull wrote.

"... It does not include all future services the patient may receive from the hospital related to the underlying injury that led to the emergency treatment."

Further, Hull and his colleagues agreed the legislative history behind the 1992 changes to the HLA backed up their findings.

"The history does not reflect a Legislative intention that every service offered by a hospital and its affiliates in perpetuity be reimbursed under the HLA so long as at some point the hospital provides emergency services for a condition caused by the injury," Hull wrote.

To hold otherwise, Hull said, would "eviscerate" a landmark 2011 California state Supreme Court decision, known as Howell v Hamilton Meats & Provisions, which established how courts can calculate damages for medical expenses in personal injury cases.

The Third District ordered the Sacramento County Superior Court to hold a new trial to calculate proper damages for past medical expenses under the Howell guidance.

The appellate court also ordered a recalculation of future medical expenses. 

Hull and his colleagues agreed with the defendants that the award granted to Yaffee by the jury doesn't hold up under the evidence.

Particularly, the justices rejected the jury's decision to allow Yaffee to receive $300,000 for possible implantation of the electrical stimulating device.

The justices said "testimony established no meaningful degree of certainty that a permanent stimulator eventually would be used or useful. The evidence established only that a trial to determine whether plaintiff was a likely candidate for the treatment was in the future anticipated."

The justices said their ruling should not be read to say Yaffee isn't entitled to any awards for past and future medical expenses, but rather that he should receive potentially significantly lesser amounts to be determined at trial.

Because they tossed the medical expenses awards, the justices also overturned the prejudgment interest award, saying that will also need to be recalculated by the Sacramento court based on any new awards for medical expenses.

In all, the justices ordered the court to recalculate more than $3.3 million of the original $4.9 million amount the Sacramento court had ordered defendants to pay.

Yaffee has been represented by attorneys John N. Demas, Brad A. Schultz and C. Athena Roussos, of the Demas Law Group, of Sacramento.

Defendants are represented in the case by attorneys Susan A. Kidwell and Rory S. Miller, of Locke Lord, of Los Angeles; and  Stephen W. Robertson, of the firm of Martenson Hasbrouck & Simon, of Sacramento.

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