Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_17-cv-02265/USCOURTS-cand-3_17-cv-02265-3/pdf.json

Nature of Suit Code: 362
Nature of Suit: Medical Malpractice
Cause of Action: 28:1331 Fed. Question

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

RONALD TURNER,

Plaintiff,

v.

UNITED STATES, et al.,

Defendants.

Case No. 17-cv-02265-WHO 

ORDER GRANTING MOTION FOR 

SUMMARY JUDGMENT

Re: Dkt. Nos. 65, 76

INTRODUCTION

Plaintiff Ronald Turner alleges that after he met with defendant Dr. Tracie Rivera at 

Eureka Community Based Outpatient Clinic (“Eureka CBOC”), a medical clinic operated by the 

United States Department of Veterans Affairs (“United States” or “VA”), Dr. Rivera negligently 

disclosed Turner’s confidential medical information to his supervisor and the police, resulting in a 

worsening of Turner’s medical condition, loss of employment, and humiliation. He brings this 

action against Dr. Rivera, Locumtenens.com, LLC (“Locumtenens”), and LT Medical, LLC for 

medical malpractice under California law and against the United States under the Federal Tort 

Claims Act (“FTCA”), 28 U.S.C. §§ 1346, 2671 et seq. The United States moves for summary 

judgment on the FTCA claim, arguing that because Dr. Rivera was not a United States employee 

during her time at Eureka CBOC, the United States cannot be held liable for her actions. Because 

I conclude that, for the purposes of the FTCA, Dr. Rivera was an independent contractor, I 

GRANT the United States’s motion for summary judgment. 

BACKGROUND

Turner alleges that Dr. Rivera negligently disclosed his confidential health information to 

his employer and the police. See generally Second Amended Complaint (“SAC”) (Dkt. No. 80). 

At the time of the alleged disclosure, Dr. Rivera was working at the Eureka CBOC pursuant to a 

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contract between the United States and Locumtenens. Declaration of Julie Bibb Davis ISO United 

States’s Motion for Summary Judgment, Ex. A (Dkt. No. 65-2). The contract outlined the United 

States’s requirements for the contract psychiatrist position, which would be filled by 

Locumtenens, as well as the obligations of Locumtenens as a party to the contract. These terms 

included a list of general duties for the contract psychiatrist at Eureka CBOC, id. at 4, and the 

obligations of Locumtenens as to said psychiatrist, id. at 10. Further, the contract required that 

Locumtenens provide the psychiatrist with workers compensation, professional liability insurance, 

income tax withholding, and Social Security payments. Id. Concerning the relationship between 

the United States and the psychiatrist, the contract explicitly states that the hired psychiatrist 

would be an independent contractor and that the United States “may evaluate the quality of 

professional and administrative services provided, but retains no control over the medical, 

professional aspects of services rendered (e.g., professional judgments, diagnosis for specific 

medical treatment).” Id. at 13.

Prior to bringing this action, Turner filed an administrative tort claim with the United 

States, which was denied because the United States determined that Dr. Rivera was an 

independent contractor. First Amended Complaint, Ex. A (Dkt. No. 1). Turner subsequently 

brought this action in the Northern District of California, and the United States moves for 

summary judgment. 

LEGAL STANDARD

Summary judgment on a claim or defense is appropriate “if the movant shows that there is 

no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of 

law.” Fed. R. Civ. P. 56(a). In order to prevail, a party moving for summary judgment must show 

the absence of a genuine issue of material fact with respect to an essential element of the nonmoving party’s claim, or to a defense on which the non-moving party will bear the burden of 

persuasion at trial. See Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Once the movant has 

made this showing, the burden then shifts to the party opposing summary judgment to identify 

“specific facts showing there is a genuine issue for trial.” Id. The party opposing summary 

judgment must then present affirmative evidence from which a jury could return a verdict in that 

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party’s favor. Anderson v. Liberty Lobby, 477 U.S. 242, 257 (1986). 

On summary judgment, the Court draws all reasonable factual inferences in favor of the 

non-movant. Id. at 255. In deciding a motion for summary judgment, “[c]redibility 

determinations, the weighing of the evidence, and the drawing of legitimate inferences from the 

facts are jury functions, not those of a judge.” Id. However, conclusory and speculative testimony 

does not raise genuine issues of fact and is insufficient to defeat summary judgment. See 

Thornhill Publ’g Co., Inc. v. GTE Corp., 594 F.2d 730, 738 (9th Cir.1979).

DISCUSSION

The United States moves for summary judgment on the ground that Dr. Rivera was an 

independent contractor while employed at Eureka CBOC, meaning that the United States is not 

liable under the FTCA. Mot. at 3-6 (Dkt. No. 65). The FTCA provides a limited waiver of the 

United States’s sovereign immunity, allowing the government to be sued “for injury or loss of 

property, or personal injury or death caused by the negligent or wrongful act or omission of any 

employee of the Government while acting within the scope of his office or employment.” 28 

U.S.C. § 1346(b)(1). It is the exclusive remedy for torts committed by federal employees during 

the course and scope of their employment. 28 U.S.C. § 2679(b)(1); see Brandes v. United States, 

783 F.2d 895, 896 (9th Cir. 1986) (“The FTCA does not, however, entirely waive the sovereign 

immunity of the United States: the federal government may only be held liable for damages 

caused by the negligent or wrongful act or omission of a government employee.”); see also United 

States v. Orleans, 425 U.S. 807, 813 (1971) (noting that the FTCA only extends to government 

employees and was “never intended . . . to reach employees or agents of all federally funded 

programs that confer benefits on people”). 

Whether an individual is a government employee for purposes of the FTCA is a question 

of federal law. Brandes, 783 F.2d at 896; see Logue v. United States, 412 U.S. 521, 528 (1973). 

In determining whether an individual is an independent contractor or an employee, courts analyze 

the degree of control government officials exercise over the performance of the individual. See 

Logue, 412 U.S at 527–28. The test is “not whether the [contractor] receives federal money and 

must comply with federal standards and regulations, but whether its day-to-day operations are 

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supervised by the Federal Government.” Orleans, 425 U.S. at 815.

The Ninth Circuit considered the question of whether a private physician on contract at a 

government facility was a government employee for the purposes of the FTCA in Carrillo v. 

United States, 5 F.3d 1302 (9th Cir. 1993). The doctor in Carrillo was employed by Pediatric 

Providers but worked in a pediatrics clinic at Madigan Army Medical Clinic (“Madigan”) pursuant 

to a contract between Pediatric Providers and Madigan. In affirming the district court’s 

conclusion that the doctor was an independent contractor, the Ninth Circuit noted that, although 

Madigan regulated the doctor’s administrative duties and hours, “neither Madigan nor any other 

agency of the federal government had any control over [his] practice of medicine.” Id. at 1305. 

The doctor, therefore, was not a government employee under the FTCA.

Based on the record in this case, I conclude that, for the purposes of the FTCA, Dr. Rivera 

was an independent contractor. Like the doctor in Carrillo, Dr. Rivera was employed pursuant to 

an agreement between the United States and a contractor, Locumtenens. See Davis Decl., Ex. A. 

Locumtenens had an agreement with the United States to provide a psychiatrist for mental health 

services at Eureka CBOC. Id. at 3. The contract explicitly stated that the hired psychiatrist would 

be an independent contractor. Id. at 13 (“[P]rofessional services rendered by [Locumtenens] or its 

health-care providers are rendered in its capacity as an independent contractor.”). It required that 

Locumtenens provide Dr. Rivera with workers compensation, professional liability insurance, 

income tax withholding, and Social Security payments. Id., Ex. A at 10. It states that while the 

United States “may evaluate the quality of professional and administrative services provided,” it 

“retains no control over the medical, professional aspects of services rendered (e.g., professional 

judgments, diagnosis for specific medical treatment).” Id. Further, the United States did not pay 

Dr. Rivera’s salary and her timesheets were submitted to and approved by Locumtenens. Davis 

Decl., Ex. B (Dkt. No. 65-3).1

 

1

Turner points to the Ninth Circuit’s decision in Edison v. United States, 822 F.3d 510 (9th Cir. 

2016) to argue that, even if Dr. Rivera is not a government employee, the United States owed him 

a duty of care to protect his privacy pursuant to the Privacy Act of 1974 and the independent 

contractor exception, therefore, does not apply and the United States should be held liable for Dr. 

Rivera’s disclosure. Edison has no bearing on this case. It held that, because the plaintiffs were 

seeking to hold the government directly liable for its own inaction and not vicariously liabile for 

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Despite these undisputed facts, Turner argues that the United States controlled aspects of 

Dr. Rivera’s day-to-day practice such that she was an employee. Specifically, he points out that 

her hours were monitored by a government employee, that her patients were limited to those at the 

VA, that she discussed whether to disclose the information at issue regarding Turner with a team 

of government employees prior to making the disclosure of Turner’s private information, and that 

she could not bill for her services or refer patients outside of the VA. But the United States may 

“fix specific and precise conditions to implement federal objectives” without becoming liable for 

an independent contractor’s torts. United States v. Orleans, 425 U.S. 807, 816 (1971). There 

must be “substantial supervision over the day-to-day operations of the contractor in order to find 

that the individual was acting as a government employee.” Letnes v. United States, 820 F.2d 

1517, 1519 (9th Cir. 1987) (citation omitted). Turner fails to identify any evidence that suggests 

“substantial supervision” on the part of the United States. Instead, the evidence Turner highlights 

demonstrates the imposition of broad general parameters that were largely set by the contract 

between the United States and Locumtenens. This is not enough to establish that the United States 

had sufficient control over Dr. Rivera’s professional judgment to make her an employee of the 

United States.

Turner also argues that there is a dispute of fact over who employed Dr. Rivera. Turner 

states that while the United States argues that Dr. Rivera was a Locumtenens’s employee, 

Locumtenens has represented that another entity, LT Medical, LLC employed Dr. Rivera. Turner 

contends that the United States’s relationship with Dr. Rivera cannot be determined until he has 

discovery and possession of all of the relevant contracts and documents that led to Dr. Rivera 

working at Eureka CBOC. This is incorrect. Although there may be some dispute about which 

entity employed Dr. Rivera, a genuine issue does not exist concerning whether she was an 

employee of the United States. As discussed above, the evidence establishes that Dr. Rivera was 

an independent contractor of the United States, not an employee. That the other defendants also 

 

the actions of its independent contractors, the district court erred when concluding that the 

independent contractor exception prevented it from exercising jurisdiction over the case. Id. at 

518. Here, Turner seeks to hold the United States liable for the actions of Dr. Rivera. This type of 

vicarious liability was not addressed in Edison. 

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claim that Dr. Rivera was not their employee does not change her relationship with the United 

States. It also does not preclude summary judgment in the United States’s favor on Turner’s 

FTCA claim. 

Turner contends that because Dr. Rivera was not licensed in California when she treated

Turner, she should be considered an employee of the VA under California law. He argues that 

because Dr. Rivera was not licensed to practice when she saw him as a patient,she potentially 

violated California Business and Professional Code section 715(b) (providing that a doctor can 

practice in California without a license so long as, “[t]he person practicing a profession or 

rendering services does so solely pursuant to a contract with the federal government on a federal 

reservation or at any facility wholly supported and maintained by the United States government.”) 

In Turner’s view, because Dr. Rivera was not licensed, the plain meaning of the statute dictates 

that either Dr. Rivera had a contract with the United States, which would imply an employeremployee relationship, or she was in violation of this section, which would open up the United 

States to liability for negligently hiring Dr. Rivera. 

Section 715(b) does not support Turner. Dr. Rivera was practicing in California pursuant 

to the contract between the United States and Locumtenens, and was practicing at a federal facility 

(as allowed under the statute). No language in Section 715(b) requires that the practicing doctor 

be a party to the contract that forms the basis of the general licensing exception. This argument

does not create a material dispute of fact as to the relationship between Rivera and the United 

States. 

Turner also seemingly asserts that because neither the United States nor Dr. Rivera 

disclosed that she was an independent contractor, despite multiple opportunities to do so, both the 

United States and Dr. Rivera “represented her as an employee and/or at a minimum an agent of the 

[United States].” Turner suggests that, given such representations, the United States should be 

estopped from now arguing that Dr. Rivera was not an employee of the United States. But 

equitable estoppel is a doctrine that is rarely valid against the government. See Heckler v. Cmty.

Health Servs. of Crawford Cnty., Inc., 467 U.S. 51, 59–61 (1984) (explaining that the burden to 

assert equitable estoppel against in government is “heavy”). “In addition to the traditional 

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elements of estoppel, a party seeking to raise estoppel against the government must establish 

affirmative conduct going beyond mere negligence. Affirmative misconduct requires an 

affirmative misrepresentation or affirmative concealment of a material fact by the government. 

Carrillo, 5 F. 3d at 1306 (internal citations and quotations omitted). Turner identifies no evidence 

of any affirmative misrepresentations or concealment of a material fact by the government 

concerning Dr. Rivera’s employment status that resulted in harm against him. The United States 

is not estopped from asserting that Dr. Rivera was an independent contractor during her time at 

Eureka CBOC. 

Relatedly, Turner relies on Mejia v. Community Hospital of San Bernardino, 99 Cal. App. 

4th 1448, 1454-55 (2002), for the proposition that a failure to clearly identify who employs a 

physician makes a medical center liable for that physician’s conduct. But Mejia addresses 

California law of ostensible agency, which provides that, when considering a hospital’s vicarious 

liability for the acts of a physician working at the hospital, a physician is considered an agent 

(opening the hospital to liability based on the physician’s tortious actions) where a patient has no 

reason to think that the physician is not an agent of the hospital. 99 Cal. App. 4th at 1557. 

California’s law of ostensible agency is irrelevant to this Order. The FTCA provides the 

exclusive remedy for tortious claims against the United States; whether an individual is a 

government employee or an independent contractor under the FTCA is a question of federal law, 

not California law. See Logue, 412 U.S. at 528. 

Turner also implies that because Dr. Rivera consulted with several federal employees 

concerning whether to disclose Turner’s confidential information, the United States should be held 

liable for such disclosures. But Dr. Rivera’s consultation with government employees is not 

sufficient to impose liability onto the United States, especially given that the harm that Turner 

alleges—disclosure of his confidential information—stemmed from Dr. Rivera’s actions, not those 

of the federal employees with whom she consulted. That Dr. Rivera spoke with federal 

employees prior to making the disclosures that form the basis of the action does not change the 

fact that Dr. Rivera was not a government employee during her time at Eureka CBOC; it is her 

actions that are the basis of Turner’s lawsuit. As discussed above, the United States is not liable 

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for her actions as an independent contractor. 

In sum, there is no genuine issue of fact concerning whether Dr. Rivera was an employee 

of the United States during her employment at Eureka CBOC. There was no contract between the 

United States and Dr. Rivera. The contract between the United States and Locumtenens expressly 

stated that Dr. Rivera was considered an independent contractor and that the United States did not 

have any control over the medical, professional aspects of services rendered. That the United 

States placed broad conditions on Dr. Rivera’s employment does not mean that it exercised

“substantial supervision” over her professional decisions. Turner has not presented any evidence 

that disputes those facts. Accordingly, I conclude that, for the purposes of the FTCA, Dr. Rivera 

was a United States independent contractor during her time at Eureka CBOC. Summary judgment 

in the favor of the United States is appropriate.2 

CONCLUSION

For the reasons discussed above, I GRANT the motion for summary judgment of the 

United States. 

IT IS SO ORDERED.

Dated: July 10, 2018

William H. Orrick

United States District Judge

 

2

Turner filed an administrative motion to file under seal certain documents in support of his 

opposition to the United States’s motion for summary judgment. Dkt. No. 76. Per Local Rule 79-

5(e), as designating party, the United States was obligated to file a declaration establishing that all 

of the designated material is sealable within four days of the filing of the administrative motion to 

seal. It has failed to do so. I ORDER that the United States file the appropriate declaration within 

10 days of this Order, establishing a compelling justification for sealing the documents. If it fails 

to do so, the administrative motion to seal will be DENIED.

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