Filed 9/16/15 Mousavi v. Community Memorial Health System CA2/6 NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION SIX

MORVARID MARY MOUSAVI,

Plaintiff and Appellant
,

v.

COMMUNITY MEMORIAL HEALTH SYSTEM,
Defendant and Respondent. 2d Civil No. B255498 (Super. Ct. No. 56

- 2012

- 00418964

- CU

MM

- VTA) (Ventura County)

Morvarid Mary Mousavi sued Community Memorial Health System
, dba Community Memorial Hospital (CMH) an d others for injuries she purportedly sustained during and after a surgical procedure. CMH successfully demurred to all but the medical malpractice claim and moved for summary judgment. It submitted expert evidence that
its treatment was within the appli cable standard of care and did not cause Mousavi ' s claimed injuries. Mousavi offered no admissible expert e vidence in response. Concluding she had failed to raise a triable issue of material fact, the trial court granted summary judgment. We affirm.

F ACTUAL AND PROCEDURAL HISTORY
Mousavi consulted with Dr. Terry Cole, a b oard

- certified specialist in obstetrics and gynecology . He determined Mousavi suffered from uterine fibroids,
ovarian cysts and excessive menstrual bleeding

. Her past surgical histo ry included2

multiple caesarean sections, an ectopic pregnancy, bowel resection and abdominoplasty (tummy tuck).

Mousavi elected to have Dr. Cole perform a total abdominal hysterectomy
and right ovary removal. He made the initial incision to open the ab domen , but was unable to identify the pelvic structures due to extensive adhesions and scar tissue from
Mousavi ' s past surgeries . Because he could not safely remove the uterus and ovary at that point
, Dr. Cole requested Dr. James D. Woodburn ' s assistance. Dr. Woodburn performed extensive lysis of the adhesions and scar tissue to expose the pelvic structure

. Once this process was completed, Dr. Cole removed the uterus and ovary. Dr. Woodburn
closed the surgical wound without any reported complications

.

While recovering in the post

- anesthesia surgical care unit, Mousavi began yelling, acting out and complaining of intense pain. She repeatedly got out of bed unassisted so that she could leave the floor to smoke. Following an argument with her husband, Mousavi was found in a fetal position on the floor . She continued to yell at the
nurses and staff members. A CMH social worker was called in to assist her.

Notwithstanding her behavior, the nurses and support staff managed to
monitor Mousavi ' s vital signs and to follow a ll doctors ' orders, including pain medication
administration

. Two days after admission, Mousavi discharged herself against medical
advice. She returned to CMH that same evening and was seen by Dr. Alex Kowblansky in the emergency dep artment. The on

- call gynecologist, Dr. Michael Green, r e

- admitted
her for pain complaints

. She continued to yell and act out, causing Dr. Green to order a psychiatric consult. A few hours later, before she could be fully evaluated, Mousavi again dischar ged herself against medical advice. She took a taxi to another hospital, where she was diagnosed with a distal right ureter injury. She underwent a successful

ureter re

- implantation the next day.

Mousavi filed a first amended complaint a gainst CMH, Dr . Woodburn, Dr. Green, Dr. Kowblansky and several other defendants alleging (1) aggravated assault, (2) assault and battery of a high and aggravated nature, (3) false imprisonment, (4) fraud, (5) breach of duty, (6) gross negligence, (7) negligent and inte ntional infliction of emotion al3

distress and (8) medical malpractice. CMH demurred to all eight causes of action. The trial court sustained the demurrer as to all but the medical malpractice claim. The trial

court subsequently granted CMH ' s motion for s ummary judgment, concluding that CMH
had established that no triable issue of material fact exists as to both liability and causation, and that Mousavi cannot show that CMH breached the standard of care. 1
M ousavi appeals.
DISCUSSION

Mousavi , who is self

- represented, purports to appeal both the demurrer and summary judgment rulings , but her opening brief is confusing and disjointed in m ost respects. Mousavi does not address the claims that were dismissed on demurrer. Nor does she suggest how the compla int could be amended to correct the pleading
deficiencies. She also makes a number of factual and legal assertions without explaining their significance to the trial court ' s rulings or providing adequate supporting legal authority or citations to the reco rd

. In some instances, she simply poses a question (e.g.,

" Why is expert testimony required in this matter? " ) without offering any further explanation or discussion.

Judgments are presumed correct and it is the appellant ' s burden to affirmatively demon strate error. ( Denham v. Superior Court (1970) 2 Cal.3d 557, 564; Hernandez v. California Hospital Medical Center (2000) 78 Cal.App.4th 498, 502.) That
Mousavi is self

- r epresented does not change this burden. ( Dowden v. Superior Court (1999) 73 Cal.App. 4th 126, 129

- 130 ; Nwosu v. Uba (2 004) 122 Cal.App.4th 1229, 1246

- 1247 .) We are not required to examine undeveloped claims or to make arguments for the parties. ( Paterno v. State of California (1999) 74 Cal.App.4th 68, 106 ; Kim v. Sumitomo
Bank (1993) 17 Cal.App.4th 974, 979 [appellate court not required to consider points not supported by citation to authorities or record].)

1 The trial court also granted motions for summary judgment filed by Drs. Woodburn and Green. We aff irmed the summary judgment in Dr. Woodburn's favor. ( Mousavi v. Woodburn (Oct. 1, 2014, B251529) [nonpub. opn.].) Her two appeals from the summary judgment in Dr. Green's favor were dismissed for failure to file opening briefs. ( Mousavi v. Green (May 12 , 2015, B259296); Mousavi v. Green (Mar. 26, 2015, B258195).) CMH is the only respondent in this a ppeal.4 Although we could affirm the summary judgment on the basis that Mousavi
has failed to present understandable, persuasive or suppo rted arguments on appeal, we are mindful that important rights are at stake

. (See Cal

. Rules of C ourt , rule 8.204(a)(1); see Duarte v. Chino Community Hospital (1999) 72 Cal.App.4th 849, 856

- 857

. ) We
therefore have examined the record for evidentiary and legal support for the summary judgment

. Standard of Review

We review the trial court ' s decision granting summary judgment de novo ( Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 860), applying the same three

step analysis required of the tri al court. ( Bono v. Clark (2002) 103 Cal.App.4th 14 09,
1431

- 1432.) After identifying the issues framed by the pleadings, we determine whether the moving party has established facts justifying judgment in its favor. If the moving party has carried its ini tial burden, we then decide whether the opposing party has
demonstrated the existence of a triable issue of material fact. ( Id. at p. 1432.) We strictly construe the moving party ' s evidence and liberally construe the opposing party ' s evidence

. ( Binder v . Aetna Life Ins. Co. (1999) 75 Cal.App.4th 832, 838

- 839

. ) A triable
issue of material fact exists if the evidence would allow a reasonable trier of fact to find the underlying fact in favor of the party opposing the motion in accordance with the applicab le standard of proof. ( Aguilar , at p. 850.) Medical Malpractice Claim To prove a medical malpractice claim, the plaintiff must establish the applicable standard of care and a breach of that standard. ( Hanson v. Grode (1999) 76 Cal.App.4th 601, 607 ; Powe ll v. Kleinman (2007) 151 Cal.App.4th 112, 122 ( Powell )

. )

" Because the standard of care in a medical malpractice case is a matter ' peculiarly within the knowledge of experts ' [citation], expert testimony is required to ' prove or disprove
that the defendan t performed in accordance with the standard of care ' unless the negligence is obvious to a layperson. " ( Johnson v. Superior Court (2006) 143 Cal.App.4th 297, 305.) Similarly, "' [c]ausation must be proven within a reasonable medical probability based upon competent expert testimony.

. . . '" ( Dumas v. Cooney5

(1991) 235 Cal.App.3d 1593, 1603 ; Bromme v. Pavitt (1992) 5 Cal.App.4th 1487, 1498 [ competent expert testimony necessary to establish negligent conduct caused patient ' s injury].) A medical malpractice defendant who supports a summary judgment motion with applicable expert declarations "' . . . is entitled to summary judgment unless the plaintiff comes forward with conflicting expert evidence. '" ( Munro v. Regents of University of California (1989) 215 C al.App.3d 977, 984

- 985; Powell, supra, 151 Cal.App.4th at p. 123.) CMH ' s moving papers offered the declarations of Robert T. Goldweber, M.D. (emergency medicine), Michael J. Gitlin, M.D. (psychiatry), James Dunn, M.D. (surgery) and Margaret Cote, R.N. (nu rsing) to establish that the care and treatment provided by CMH met the standard of care and did not cause or contribute to her alleged injuries. Mousavi responded by (1) requesting a stay pending her appeal of the summary judgment in Dr. Woodburn ' s favor or additional time to oppose the motion, (2) objecting to all of CMH ' s evidence and (3) submitting the declaration of Janet Blok Scott, R.N., a nurse from Arkansas. Mousavi did not submit a separate statement in opposition or any evidence other than Nurs e Scott ' s declaration.

Where, as here, a moving party makes the required prima facie evidentiary showing, the failure to file a responsive separate statement may, in the court ' s discretion, constitute a sufficient ground for granting the motion. (Code C iv. Proc., § 437 c , subd. (b)(3); Oldcastle Precast, Inc. v. Lumbermens Mut. Cas. Co. (2009) 170 Cal.App.4th 554, 568; Batarse v. Service Employees Int ernat. Union
, Local 1000 (2012) 209 Cal.App.4th 820, 831

- 833.) Although the trial court discussed and co uld have invoked this rule, it exercised its discretion to resolve the motion on the evidence presented.

The standard of care in medical malpractice cases is the reasonable degree of skill, knowledge an d care ordinarily possessed and exercised by member s of the medical profession under similar circumstances. ( Mann v. Cracchiolo (1985) 38 Cal.3d 18, 36; see Evid. Code, § 720, subd. (a).) The test for determining familiarity with the standard of care is knowledge of similar conditions. ( Sinz v. Owens (1 949) 33 Cal.2d6

749, 756; see Avivi v. Centro Medico Urgente Medical Center (2008) 1 59 Cal.App.4th 463, 470.) Mousavi did not present any expert evidence on the standard of care for physicians. Nurse Scott opined in her declaration that CMH violated the standard of care for nurses in an acute care setting by failing to assess and appropriately respond to
Mousavi ' s complaints of pain and to certain critical laboratory results . She state d that

" [t]hese failures on the part o f [CMH] resulted in a failure t o identify and treat postoperatively anemia and acute renal failure from an obstructed disconnected ureter. "

Respondents contend that Nurse Scott ' s declaration is insufficient to demonstrate the existence of a triable issue of material fact. We agree. First, it d id not establish that Nurse Scott is familiar with the standard of care for nursing in this community. She is licensed in Arkansas but has never been licensed in California. She also has not worked in an acute care hospital setting since 1976

. Second, her declaration
offer ed nothing more than her ultimate conclusions

. " [A]n expert ' s opinion rendered without a reasoned explanation of why the underlying facts lead to the ultimate conclusion has no evidentiary value because an expert opinion is worth no more than the
reasons and facts on which it is based. " ( Powell , supra, 15 1 Cal.App.4th at p. 123, citations and internal quotes omitted; see Evid. Code, §§ 801, 802, 803; Kelley v. Trunk (1 998) 66 Cal.App.4th 519, 523.) Finally, Nurse Scott ' s declaration neglected to lay the foundation for her qualif

ications to state an opinion as to causation. (See Bromme v.
Pavitt , supra, 5 Cal.App.4th at p. 1498.) For these reasons, Mousavi ' s medical malpractice claim fails as a matter of law. 2

Mousav i contends the trial court should have invoked its authority under
Evidence Code section 730 to appoint an expert to respond to CMH ' s expert evidence.
Mousavi ' s opposition did not request appointment of an expert ; nor did she raise the issue
at the hearin g on the motion. Consequently, the issue was waived. (See Ventura v. ABM

2 Mousavi suggests that Drs. Cole, Woodburn and Green are the " ostensible agents" of CMH and that CMH is liable for their actions on that basis. M ousavi did not, however, present any evidence or reasoned argument on this issue.7

Industries Inc orporated (2012) 212 Cal.App.4th 258, 265 [failure to seek ruling from trial court forfeited issue on appeal].)

The trial c ourt also did not abuse its discretion by denying Mousavi ' s requests to stay the motion for summary judgment or to otherwise extend the time for her to oppose it. She filed no declaration supporting either request and made no showing that a stay would be appropriate or that a continuance would r esult in the receipt of facts essential to opposing the motion. (See Ace American Ins. Co. v. Walker (2004) 121 Cal.App.4th 1017, 1023; Combs v. Skyriver Communications, Inc. (2008) 159 Cal.App.4th 1242, 1269

- 1270.) We conclude the motion was properly gr anted.
DISPOSITION The judgment is affirmed. Respondent shall recover its costs on appeal.
NOT TO BE PUBLISHED

.

PERREN, J. We concur:

GILBERT, P. J.

YEGAN, J.8 Mark Borrell, Judge
Superior Court County of Ventura

__________________ ____________

Morvarid Mary Mousavi, in pro. per., for Plaintiff and Appellant. Clinkenbeard, Ramsey, Spackman & Clark, LLP, Barbara A. Carroll
, for
Defendant and Respondent.