Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_15-cv-00477/USCOURTS-caed-2_15-cv-00477-0/pdf.json

Nature of Suit Code: 446
Nature of Suit: Americans with Disabilities Act - Other
Cause of Action: 42:12101 Americans with Disabilities Act

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UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF CALIFORNIA 

KELLY ALEXANDER, an individual, 

DONALD PORTER, an individual, 

Plaintiffs, 

v. 

HUSSAM KUJOK, an individual; 

HUSSAM KUJOK, M.D., INC.; MARK 

DEBRUIN, an individual; DEBRUIN 

MEDICAL CENTER, A.P.C.; GILBERT 

MARTINEZ, an individual; FAMILY 

MEDICINE AND AMBULATORY CARE 

CENTERS, INC.; DHEERAJ KAMRA, 

an individual; CAPITOL INTERNAL 

MEDICINE ASSOCIATES; THOMAS 

A. DEL ZOTTO, an individual; 

ROBERT W. LARSEN, an individual; 

and DOES 1 through 10 inclusive, 

Defendants. 

No. 2:15-cv-00477-MCE-CKD 

MEMORANDUM AND ORDER 

Through this lawsuit, Plaintiffs Kelly Alexander and Donald Porter (“Plaintiffs” 

unless otherwise noted) seek damages and injunctive relief under the Americans with 

Disabilities Act of 1990, 42 U.S.C. § 12101, et seq. (“ADA”). The jurisdiction of this court 

is premised on federal question jurisdiction in accordance with 28 U.S.C. § 1331. In 

addition to their federal claims under the ADA, Plaintiffs also assert pendant state law 

claims under 1) California’s Unruh Civil Rights Act, California Civil Code § 51, et seq.; 

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2) California’s Disabled Persons Act, California Civil Code § 54, et seq.; 3) California’s 

Bane Act, California Civil Code § 52.1; and 4) common law negligence claims. Finally, 

Plaintiffs also assert a cause of action for violation of the Rehabilitation Act, 29 U.S.C. 

§ 794. Presently before the Court are motions to dismiss brought by all six 

doctors/medical entities being sued as Defendants: 1) Hussam Kujok M.D. and his 

medical practice, Hussam Kujok, M.D., Inc. (collectively “Dr. Kujok”); 2) Mark Debruin 

and his medical practice, Debruin Medical Center A.P.C. (“Dr. Debruin”); 3) Gilbert 

Martinez and his practice, Family Medicine and Ambulatory Care Centers, Inc. 

(“Dr. Martinez”); 4) Dheeraj Kamra and his practice, Capitol Internal Medicine Associates 

(“Dr. Kamra”); 5) Thomas A. Del Zotto (“Dr. Del Zotto”); and 6) Robert W. Larsen 

(“Dr. Larsen”). 

All six doctors argue that Plaintiffs lack standing to pursue ADA claims because 

they have no intent to return for further treatment, and that absent such intent subject 

matter jurisdiction under Federal Rule of Civil Procedure 12(b)(1)1

 is lacking. 

Alternatively, Defendant physicians argue that Plaintiffs’ claims fail to state a viable claim 

against them in any event, and that dismissal under Rule 12(b)(6) is therefore 

appropriate. Finally, Dr. Larsen argues that Plaintiffs’ prayer for punitive damages 

should be stricken inasmuch as no such damages are authorized by any of the claims 

asserted by Plaintiffs in this lawsuit. 

For the reasons set forth below, Defendants’ Motions to Dismiss are GRANTED in 

part and DENIED in part.2

 Dr. Larsen’s Motion to Strike the punitive damage allegations 

is DENIED. 

/// 

/// 

 1

 All further references to “Rule” or “Rules” are to the Federal Code of Civil Procedure unless 

otherwise noted. 

2

 Having determined that oral argument was not of material assistance, the Court ordered this 

Motion submitted on the briefing in accordance with Local Rule 230(g). 

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BACKGROUND3

Plaintiffs, who are both profoundly deaf, use American Sign Language ("ASL") as 

their primary means of communication. Both are on SSI and their Medi-Cal coverage 

was assigned to the Hills Medical Group, a large consortium of some 3,800 physicians. 

When their primary physician, Mark Moody, retired, both Plaintiffs needed to find a new 

doctor within the Hills Group. Plaintiffs Alexander and Porter were initially referred for 

that purpose to Drs. Kujok and Martinez, respectively. 

 Plaintiff Alexander was told by Dr. Kujok's office in April of 2014 that they were no 

longer accepting new patients once told she needed an ASL interpreter. Plaintiff's 

insurance agent then called and was ultimately told that Dr. Kujok was not willing to 

provide interpreting services. 

Following Dr. Kujok’s refusal to provide medical treatment with the aid of an ASL 

interpreter, Plaintiff Alexander sought care from several other Hills Physician Group 

doctors. In July of 2014, she was accepted as a patient by Dr. Debruin and scheduled 

an initial appointment on July 28, 2014. Dr. Debruin’s office informed Plaintiff that they 

would not schedule an interpreter. Although his staff later told Plaintiff that they would 

make the necessary arrangements, when Alexander presented for her initial visit she 

was told that no interpreter had been ordered. During the course of his evaluation, 

Dr. Debruin told Alexander that she could communicate well and didn't need an 

interpreter. When Dr. Debruin suggested they use notes, Alexander explained that ASL 

is not English and is not directly translatable. According to Plaintiff, particularly when 

technical terms are involved, use of ASL is critical for purposes of accurate 

communication. Dr. Debruin's insistence that Plaintiff could in that event communicate in 

writing caused Alexander to leave his office. 

Plaintiff Alexander was subsequently referred to a third potential primary care 

 3

 The facts in this section are drawn, in some cases verbatim, from the allegations as set forth in 

Plaintiffs’ First Amended Complaint. 

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doctor, Dr. Kamra. Although Kamra’s office staff originally advised Plaintiff that an ASL 

interpreter would be provided, when she arrived for her appointment no interpreter was 

present. Plaintiff went ahead and saw Dr. Kamra anyway because the foot injury she 

was suffering from had already been exacerbated by delay occasioned by the abovedescribed interpreter issues. Alexander therefore felt she needed immediate attention 

and could not wait to reschedule. According to Plaintiff, her communication was 

impeded without an interpreter and Dr. Kamra failed to correctly note Plaintiff’s allergy to 

iodine. 

Dr. Kamra did refer Plaintiff to a podiatrist, Dr. Del Zotto, to evaluate a foreign 

body in her left foot. Dr. Del Zotto told Plaintiff, however, that his business partner, 

Dr. Larsen, refused to provide interpreting services and that she would have to go to a 

different podiatrist. Plaintiff’s appointment with Dr. Del Zotto was accordingly cancelled. 

As a result of the conduct of the above-described physicians, Plaintiff Alexander 

claims that she encountered almost a year’s delay in obtaining treatment for her foot 

condition which both exacerbated her physical discomfort and caused emotional 

distress. 

 The history recounted by the other Plaintiff, Porter, is similar though not as 

extensive. Dr. Martinez did initially provide a sign language interpreter at his initial 

intake visit with Plaintiff Porter on April 29, 2014. When Martinez realized Plaintiff Porter 

was watching the interpreter, Porter claims that Martinez “grabbed” Porter’s face and 

stated “don’t look at her, look at me. You can read my lips.” Porter at that point 

explained that he needed to look at the interpreter to understand what Dr. Martinez was 

saying. While Porter continued to see Dr. Martinez, after his third appointment, Porter 

claims that Dr. Martinez refused and/or failed to continue to provide a sign language 

interpreter, despite Porter’s claim he could not understand what Dr. Martinez told him by 

lip reading alone. Porter alleges that Dr. Martinez' staff hung up on him repeatedly 

when he called through a relay operator service once the operators explained they were 

calling on behalf of a deaf person. Porter further alleges that Dr. Martinez’ office was 

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prohibited from communicating with him by text message, even though that was an 

effective way to schedule appointments, which resulted in Porter being required to drive 

to Dr. Martinez’ office and schedule his appointments in person. 

Although Plaintiff Alexander never actually saw Dr. Martinez, she claims that 

when she learned about Dr. Martinez’ conduct from plaintiff Porter she cancelled her 

own appointment with Martinez since she believed “there was a substantial likelihood 

she would suffer the same discriminatory treatment if she was examined by Martinez.” 

FAC at ¶ 36. 

 Given these circumstances, Plaintiffs have sued the six doctors enumerated 

above. All six doctors have now filed similar, and in some instances virtually identical, 

motions to dismiss under Rules 12(b)(1) and 12(b)(6). 

STANDARD 

A. Motion to Dismiss for Lack of Standing 

Where a plaintiff lacks standing to bring a claim, courts lack jurisdiction to hear 

that claim, and a motion to dismiss under Rule 12(b)(1) is appropriate. Ballentine v. 

United States, 486 F.3d 806, 810 (3d Cir. 2007). 

 B. Motion to Dismiss for Failure to State a Viable Claim 

On a motion to dismiss for failure to state a claim under Rule 12(b)(6), all 

allegations of material fact must be accepted as true and construed in the light most 

favorable to the nonmoving party. Cahill v. Liberty Mut. Ins. Co., 80 F.3d 336, 337-38 

(9th Cir. 1996). Rule 8(a)(2) “requires only ‘a short and plain statement of the claim 

showing that the pleader is entitled to relief’ in order to ‘give the defendant fair notice of 

what the . . . claim is and the grounds upon which it rests.’” Bell Atl. Corp. v. Twombly, 

550 U.S. 544, 555 (2007) (quoting Conley v. Gibson, 355 U.S. 41, 47 (1957)). A 

complaint attacked by a Rule 12(b)(6) motion to dismiss does not require detailed factual 

allegations. However, “a plaintiff's obligation to provide the grounds of his entitlement to 

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relief requires more than labels and conclusions, and a formulaic recitation of the 

elements of a cause of action will not do.” Id. (internal citations and quotations omitted). 

A court is not required to accept as true a “legal conclusion couched as a factual 

allegation.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 

555). “Factual allegations must be enough to raise a right to relief above the speculative 

level.” Twombly, 550 U.S. at 555 (citing 5 Charles Alan Wright & Arthur R. Miller, 

Federal Practice and Procedure § 1216 (3d ed. 2004) (stating that the pleading must 

contain something more than “a statement of facts that merely creates a suspicion [of] a 

legally cognizable right of action”)). 

Furthermore, “Rule 8(a)(2) . . . requires a showing, rather than a blanket 

assertion, of entitlement to relief.” Twombly, 550 U.S. at 555 n.3 (internal citations and 

quotations omitted). Thus, “[w]ithout some factual allegation in the complaint, it is hard 

to see how a claimant could satisfy the requirements of providing not only ‘fair notice’ of 

the nature of the claim, but also ‘grounds' on which the claim rests.” Id. (citing Wright & 

Miller, supra, at 94, 95). A pleading must contain “only enough facts to state a claim to 

relief that is plausible on its face.” Id. at 570. If the “plaintiffs . . . have not nudged their 

claims across the line from conceivable to plausible, their complaint must be dismissed.” 

Id. However, “[a] well-pleaded complaint may proceed even if it strikes a savvy judge 

that actual proof of those facts is improbable, and ‘that a recovery is very remote and 

unlikely.’” Id. at 556 (quoting Scheuer v. Rhodes, 416 U.S. 232, 236 (1974)). 

 A court granting a motion to dismiss a complaint must then decide whether to 

grant leave to amend. Leave to amend should be “freely given” where there is no 

“undue delay, bad faith or dilatory motive on the part of the movant, . . . undue prejudice 

to the opposing party by virtue of allowance of the amendment, [or] futility of the 

amendment . . . .” Foman v. Davis, 371 U.S. 178, 182 (1962); Eminence Capital, LLC v. 

Aspeon, Inc., 316 F.3d 1048, 1052 (9th Cir. 2003) (listing the Foman factors as those to 

be considered when deciding whether to grant leave to amend). Not all of these factors 

merit equal weight. Rather, “the consideration of prejudice to the opposing party . . . 

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carries the greatest weight.” Id. (citing DCD Programs, Ltd. v. Leighton, 833 F.2d 183, 

185 (9th Cir. 1987)). Dismissal without leave to amend is proper only if it is clear that 

“the complaint could not be saved by any amendment.” Intri-Plex Techs. v. Crest Group, 

Inc., 499 F.3d 1048, 1056 (9th Cir. 2007) (citing In re Daou Sys., Inc., 411 F.3d 1006, 

1013 (9th Cir. 2005); Ascon Props., Inc. v. Mobil Oil Co., 866 F.2d 1149, 1160 (9th Cir. 

1989) (“Leave need not be granted where the amendment of the complaint . . . 

constitutes an exercise in futility . . . .”)). 

B. Motion to Strike 

Rule 12(f) provides that a district court “may strike from a pleading an insufficient 

defense or any redundant, immaterial, impertinent, or scandalous matter.” “The function 

of a Rule 12(f) motion to strike is to avoid the expenditure of time and money that must 

arise from litigating spurious issues by dispensing with those issues prior to trial. . . .” 

Whittlestone, Inc. v. Handi-Craft, 618 F.3d 970, 974 (9th Cir. 2010). 

ANALYSIS 

A. Rule 12(b)(1) Motions to Dismiss 

As indicated above, standing is a jurisdictional issue, deriving from the 

requirement that an actionable case or controversy be present. Doe No. 1 v. Reed, 

697 F.3d 1235, 1238 ( 9th Cir. 2012). Standing must accordingly be “likely” as opposed 

to merely “speculative” so that the claimed injury is redressable by a favorable court 

decision. Lujan v. Defenders of Wildlife, 504 U.S. 555, 561 (1992). The only relief 

available to private parties under the ADA is injunctive relief; monetary damages may 

not be recovered. See 42 U.S.C. § 12188; Jairath v. Dyer, 154 F.3d 1280, 1283 n.7 

(11th Cir. 1998). Where injunctive relief is sought, a plaintiff must establish a 

reasonable likelihood of further violations. National Wildlife Federation v. Burlington 

Northern R.R., Inc., 23 F.3d 1508, 1511. ( 9th Cir. 1994) 

/// 

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 In the context of a plaintiff seeking injunctive relief under the ADA, this means that 

Plaintiff here must demonstrate a “significant possibility of future harm.” Vogel v. Rite 

Aid Corp., 992 F. Supp. 2d 998, 1008 (C.D. Cal. 2014). Defendants claim Plaintiffs lack 

standing to assert injunctive relief under the ADA because they cannot show any 

likelihood of ever returning for further care to the physicians who allegedly failed to 

accommodate their disability, and consequently cannot qualify for an injunction curbing 

further harm. Despite this requirement that future harm be identified, the ADA 

nonetheless makes it clear that a plaintiff need not engage in the “futile gesture” of 

attempting to return to a physician if the plaintiff already knows that reasonable 

accommodations will not be provided: 

Nothing in this section shall require a person with a disability 

to engage in a futile gesture if such person has actual notice 

that a person or organization covered by this title does not 

intend to comply with its provisions. 

42 U.S.C. § 12188(a)(1). 

This is consistent with the view that standing under remedial statutes, like the 

ADA, should be interpreted as broadly as permissible under the Constitution. See, e.g., 

Trafficante v. Metropolitan Life Ins. Co., 409 U.S. 205, 211-12 (1972). 

The “futile gesture” exception applies squarely to the circumstances of this matter. 

Given the barriers to effective accommodation both Plaintiffs already experienced, they 

were not required to resort to what would be the futile act of attempting to return to the 

same physicians who had already refused to facilitate effective communication on their 

part. Moreover, and in any event, Court further notes that while Plaintiffs allege they 

switched to a higher priced Medi-Cal provider that allowed them to choose physicians 

not affiliated with Hills Medical Group, they also claim they may not be able to afford that 

added cost in the long run and consequently may have to return to the Hills network and 

encounter the same denial of services. See FAC, ¶¶ 68-70. Plaintiffs accordingly 

reason that this eventuality may ultimately force them to return to Defendants for care 

despite their attempt to avoiding having to do so at the present time. 

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Under either alternative, and given the ADA’s broad scope as a remedial statute, 

the Court finds that Plaintiffs have standing to assert their ADA claims against 

Defendants herein. The only exception is with respect to Plaintiff Alexander’s claims 

against Dr. Martinez. Alexander never saw Dr. Martinez in the first place and 

consequently did not personally encounter a denial of “full and equal treatment because 

of her disability,” as needed to assert any ADA claim in the first instance. Wilson v. Pier 

1 Imps. (US), Inc., 439 F Supp. 2d 1054, 1067 (E.D. Cal. 2006); Molski v. Hitching Post I 

Rest., Inc., 2005 WL 3952248 at *3 (C.D. Cal. 2005). While Alexander claims she was 

dissuaded from doing so by Porter’s experience with Dr. Martinez, any indirect harm in 

that regard is insufficient to confer standing for Alexander to assert her First Cause of 

Action under the ADA against Dr. Martinez. Additionally, because Alexander’s Second 

and Third Causes of Action against Dr. Martinez, for violations of the Unruh Act and the 

California Disabled Persons Act, are expressly premised on Alexander’s ability to make 

a claim under the ADA, those claims fail as against Dr. Martinez. Because the 

Rehabilitation Act is predicated on the same actual denial of services because of 

disability, Plaintiff’s Sixth Cause of Action fails to the extent it is directed to Dr. Martinez 

as well. See Duvall v. County of Kitsap, 260 F.3d 1124, 1135 ( 9th Cir. 2001). Finally, 

since Plaintiff’s Fourth Cause of Action for negligence against Dr. Martinez is also 

premised on breaches of duties owed under the ADA, Unruh Act and the Disabled 

Persons Act, it too fails. See FAC, ¶¶ 95-97. 

B. Rule 12(b)(6) Motions to Dismiss 

 On a substantive basis, Defendants' 12(b)(6) arguments present factual issues 

beyond the pleadings not amenable to disposition by way of a motion to dismiss. Some 

of the Defendant physicians claim, for example, that they offered acceptable alternatives 

to Plaintiff’s request for an ASL interpreter, such as communicating by note or by lip 

reading. The fact remains, however, that Plaintiffs allege in their complaint that any 

accommodations that may have been offered were not sufficient, since their ability to 

understand either spoken or written English is compromised. Plaintiff Alexander told 

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Dr. Debruin that she had to have an ASL interpreter to communicate effectively, and 

could not understand him without one, either orally or in writing. FAC, ¶¶ 45, 50-52. 

Plaintiff Porter similarly told Dr. Martinez that he could not understand medical 

terminology without an interpreter when Martinez grabbed his face and told Porter that 

he should be looking at him and reading his lips. Id. at ¶¶ 33-34. Dr. Kamra refused to 

provide ASL interpreting services to Plaintiff Alexander, which she claims “directly and 

negatively impacted the quality of care provided” and resulted in the incorrect 

documentation of Alexander’s medical allergies and omitting her allergy to iodine. Id. at 

¶ 59. 

Accepting Plaintiffs’ allegations as true, as we must in evaluating a motion to 

dismiss, Plaintiffs claim they were excluded from meaningful participation in their medical 

treatment because, to the extent Defendants were willing to offer any accommodation 

measures, they were insufficient to facilitate effective communication. 

The regulations implementing Title III of the ADA unequivocally require places of 

public accommodation to “furnish appropriate auxiliary aids and services . . . to ensure 

effective communication with individuals with disabilities.” 28 C.F.R. 36.303(c)(1). The 

test is not whether any auxiliary aid was offered but whether that aid would be sufficient 

to permit effective communication. Case law provides no definition of what constitutes 

effective communication. To the contrary, any such determination is a question of fact 

which cannot be resolved at this juncture. On the basis of the pleadings, Plaintiff has 

asserted that any accommodation offered was inadequate. 

Plaintiffs have also alleged that they were excluded from treatment altogether 

because of their disability. Dr. Kujok allegedly refused to see Alexander at all once he 

was informed she was deaf and needed as ASL interpreter. Id. at ¶¶ 29-31. 

Dr. Martinez purportedly refused to allow Plaintiff Porter to even use a relay operator, or 

to communicate by way of text message in scheduling an appointment. Id. at ¶¶ 42-43. 

Dr. Del Zotto informed Plaintiff Alexander that because his office refused to provide the 

requested ASL interpreter she would need to get treatment from a different podiatrist. 

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Id. at ¶ 64. Plaintiffs therefore also claim that they were prevented from seeking care 

altogether, even aside from whether accommodations offered in the course or providing 

care were adequate. 

Plaintiffs’ allegations are sufficient to state ADA claims as alleged in their First 

Cause of Action. In addition, because Second and Third Causes of Actions, for violation 

of the Unruh and Disabled Persons Acts, are predicated on the ADA violations, and 

since Defendants’ arguments in contending that Plaintiffs cannot state a viable claim 

mirror their arguments with regard to the ADA claim, Defendants’ challenges to the 

Second and Third Causes of Action also fail.4

 

With respect to the Fourth Cause of Action for negligence, that claim is also 

predicated on the statutory violations as set forth in the prior causes of action. Plaintiffs 

have properly pled negligence in that regard. A negligence claim premised on alleged 

statutory duties requires only that the plaintiff plead violation of a statute, ordinance or 

regulation, that the violation proximately caused injury of the sort the enactment was 

designed to prevent, and that plaintiff is within the class of persons for whose protection 

the enactment at issue was adopted. Coppola v. Smith, 935 F. Supp. 2d 993, 1017 

(E.D. Cal. 2013). While a number of Defendants argue that the standards applicable to 

professional negligence should apply, the Court disagrees. Although Defendants herein 

are physicians, they are being sued here as the owners and operators of places of public 

accommodation, rather than because of their status as doctors per se. Therefore the 

professional negligence standards applicable to malpractice are not the proper yardstick 

by which to measure the viability of Plaintiffs’ negligence claims. 

/// 

 4

 The Court notes that some of the Defendants have alleged that the Disabled Persons Act is 

limited to instances where physically disabled individuals are denied access to some public site or service 

because of their service. In the Court’s view, however, hearing loss is no less of a physical impairment 

than mobility barriers which would preclude physical access due to other disabilities. Significantly, too, 

because the Disabled Persons Act specifically states that violations of the ADA qualify as violations of the 

Act (at Cal. Civ. Code § 54(c)) and since there is no question that the ADA protects claims like those made 

by Plaintiffs herein, any argument otherwise would run counter to the express terms of the Act. 

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Plaintiffs’ Sixth Cause of Action5

 alleges violation of the Rehabilitation Act on 

grounds that Section 504 of that Act prohibits any disabled person from being excluded 

from participation, due to his or her disability, from any program or activity receiving 

federal financial assistance. Plaintiffs contend that the Rehabilitation Act applies 

because their Medi-Cal coverage is jointly funded with both state and federal dollars. 

Defendants’ main challenge to the Rehabilitation Act claim rests with their assertion that 

the implementing regulations of the Act are limited with regard to the provision of 

“appropriate auxiliary aids to persons with impaired sensory manual, or speaking skills” 

to funding recipients employing fifteen or more persons. 45 C.F.R. § 84.52(d). Because 

the operative First Amended Complaint is silent with respect to whether any of the 

Defendants have the requisite number of employees, Defendants contend that the 

Rehabilitation Act fails to apply. 

 Contrary to Defendants’ argument, however, this is not a case only about 

whether appropriate auxiliary aids have been provided. Instead, it is more fundamentally 

about allegations that Plaintiffs were denied access to Defendants’ facilities altogether 

because of Defendants’ refusal to provide reasonable accommodations. In general 

terms, the Rehabilitation Act prohibits “denying a qualified handicapped person [health, 

welfare and social services] on the basis of their handicap.” 45 C.F.R. § 84.52(a)(1). A 

violation of that overarching provision, as Plaintiffs correctly point out, has no minimum 

employee requirement. Given the broad scope to which remedial provisions like those 

contained in the Rehabilitation Act are entitled, the Court cannot focus solely on the 

narrower question of auxiliary aids when Plaintiffs have in effect claimed that they were 

denied access altogether to Defendants’ facilities due to their failure to make any 

reasonable accommodation. 

Certain Defendants also argue that because Medi-Cal is a state as opposed to 

federal program, Defendants receiving monies from Medi-Cal do not actually receive 

 5

 The Fifth Cause of Action, for violation of California’s Bane Act (Cal. Civ. Code § 52.1), is limited 

to claims made by Plaintiff Porter against Dr. Martinez and has not been challenged by Dr. Martinez in his 

Motion to Dismiss. 

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federal dollars even though Medi-Cal itself does. See, e.g., Dr. Kamra Motion, ECF 

No. 23-1, 9:23-28. Defendants accordingly argue that in the absence of direct federal 

financial assistance, any liability under the Rehabilitation Act is not triggered. This 

argument lacks merit. Medi-Cal is California’s Medicaid program, and Medicare and 

Medicaid payments have been widely interpreted as federal financial assistance when 

raised in the context of Section 504 litigation, like this case, brought against healthcare 

entities receiving such payments on behalf of individuals receiving health services. See. 

e.g., United States v. Baylor Univ. Med. Ctr. 736 F.2d 1039, 1042 ( 5th Cir. 1983) 

(Medicare and Medicaid payments to a hospital’s inpatient and emergency services 

program constituted federal financial assistance under Section 504); Doe v. Centinela 

Hospital, 1988 WL 81776 (C.D. Cal. 1988) (residential alcohol and drug rehabilitation 

program which received Medicare funds for treatment of some patients was a recipient 

of federal financial assistance under the Rehabilitation Act). 

Additionally, with regard to Plaintiff Alexander’s attempt to obtain podiatric 

treatment from Defendant Del Zotto, Dr. Del Zotto and his alleged business partner, 

Defendant Larsen make some particular arguments that must be separately addressed. 

Defendant Del Zotto claims that he is an employee of a podiatric group owned by 

Defendant Larsen, and that as an employee he does not own or operate a place of 

public accommodation so as to incur liability under the ADA, or under Alexander’s other 

claims that rest upon her having established an ADA claim. Del Zotto includes a 

declaration to that effect and contends he had no authority to enact or amend policy. 

Del Zotto consequently alleges that Alexander cannot state a viable claim against him. 

The problem with Del Zotto’s argument is that it stems from matters outside the 

pleading; namely, the declaration he submits. Matters extraneous to the pleading should 

not be considered in the context of a motion to dismiss under Rule 12(b)(6), which with 

exceptions not relevant here must depend on the allegations made within the four 

corners of the complaint. See Standard Investment Chartered Inc. v. NASD, 

621 F. Supp. 2d 55, 66 (S.D. N. Y. 2007). Plaintiff’s First Amended Complaint alleges 

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just to the contrary in stating that “DEL ZOTTO provides medical services to patients 

who are members of the public.” FAC, ¶ 64. While the FAC does allege that Larsen, as 

the “business partner” in the office, was the individual who refused to provide the 

requested ASL interpreter to Plaintiff Alexander, nowhere does it indicate that Del Zotto 

was merely an employee. 

Both Del Zotto and Larsen also argue that they should be dismissed from Plaintiff 

Alexander’s Rehabilitation Act cause of action on grounds that podiatry services are not 

a covered benefit under California’s Med-Cal program pursuant to California Welfare and 

Institutions Code § 14131.10. That argument is also misplaced. Section 14131.10 

states only the Medi-Cal will not pay for optional podiatric services, and Plaintiff alleges 

that her foot injury did not entail such an “optional” treatment. In any event, whether or 

not the treatment Alexander required was optional or not requires a factual evaluation 

that cannot be resolved here. 

C. Motion to Strike 

As a final matter, Dr. Larsen asks the Court to strike Plaintiff’s prayer for punitive 

damages on grounds that no such damages are authorized under any of the causes of 

action pled by Plaintiffs in their complaint. Dr. Larsen accordingly contends that punitive 

damages are unavailable here as a matter of law, citing an Eighth Circuit decision, 

Tapley v. Lockwood Green Engineers, Inc., 502 F.2d 559, 560 ( 8th Cir. 1974) to 

support that proposition. 

While Dr. Larsen correctly points out that Plaintiffs failed to oppose his argument 

in that regard, the problem with the course he recommends is that it is directly contrary 

to applicable precedent in this circuit. In Whittlestone, Inc. v. Handi-Craft Co., 618 F.3d 

970 ( 9th Cir. 2010), the Ninth Circuit found that a Rule 12 motion is not available to 

strike legally inapplicable damage requests since an improper prayer is neither an 

“insufficient defense” nor a ”redundant, immaterial, impertinent or scandalous” so as to 

come within the express purview of Rule 12. Id. at 973-74, 76. Consequently this Court 

cannot grant Dr. Larsen’s Motion to Strike. 

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CONCLUSION 

For all the reasons set forth below, Dr. Martinez’ Motion to Dismiss (ECF No. 28) 

is GRANTED as to Plaintiff Alexander’s claims against Martinez in their entirety. 

Because Plaintiff Alexander essentially concedes that her claims against Martinez are 

not well taken, no leave to amend will be permitted. Dr. Martinez’ Motion to Dismiss is 

otherwise DENIED. The Motions to Dismiss brought on behalf of Drs. Del Zotto (ECF 

No. 22), Kamra (ECF No. 23); Kujok (ECF No. 26), Debruin (ECF No. 27), and Larsen 

(ECF No. 65) are DENIED. Plaintiff Larsen’s request that punitive damages be stricken 

from Plaintiffs’ FAC is also DENIED. 

IT IS SO ORDERED. 

Dated: January 20, 2016 

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