Source: https://www.advocatemagazine.com/article/2017-november/appellate-reports-2
Timestamp: 2019-04-20 06:14:16+00:00

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Who needs to know about this case? Lawyers litigating Elder-abuse cases.
Why it’s important: Holds that a hospital’s substantial impairment of an elderly patient’s right to autonomy can constitute actionable “neglect” within the Elder Abuse Act.
Synopsis: Decedent Anthony Carter, who was 78 years old and experiencing confusion, was admitted to St. Mary Medical Center. He named Maxine Stewart, a registered nurse, as his representative to make health-care decisions under a written durable power of attorney.
The hospital and Carter’s doctors planned to perform a surgery on Carter to implant a pacemaker. Stewart refused to consent and canceled the surgery. After this refusal, the doctor asked St. Mary’s risk-management department to convene an ethics committee meeting to consider the case. The committee concluded that Stewart’s status as Carter’s designee could be voided if she refused to consent to life-saving surgery. Neither Carter nor Stewart was informed of the committee meeting, nor of its decision before the surgery. The surgery went forward without prior notice to Stewart. Carter’s doctors signed the consent form for the procedure, purportedly on Carter’s behalf. During the surgery Carter went into cardiac arrest and suffered a hypoxic event, causing brain damage. He required acute skilled nursing care until his death six weeks later.
Stewart filed suit against the hospital and Carter’s doctors. St. Mary moved for summary adjudication of several of the claims alleged. It argued the elder-abuse claim failed because holding an ethics committee meeting about Stewart’s power of attorney over Carter could not amount to reckless neglect within the meaning of the Elder Abuse Act. The fraudulent concealment claim, St. Mary contended, failed because a hospital owes no fiduciary duty to a patient, and the medical-battery claim was allegedly insufficient because the hospital itself did not perform the surgery and the doctors who performed the surgery were not hospital employees. The trial court granted the motion in favor of St. Mary on these claims, and Stewart filed a writ petition. Granted.
The Appellate Court held that St. Mary’s relationship with Carter was a custodial one. The type of relationship the Act contemplates is “a robust caretaking or custodial relationship ‒ that is, a relationship where a certain party has assumed a significant measure of responsibility for attending to one or more of an elder’s basic needs that an able-bodied and fully competent adult would ordinarily be capable of managing without assistance.” This test was met here.
St. Mary argued that the court should evaluate the custodial nature of the relationship on a task-by-task view, and that convening the ethics committee to construe Carter’s power of attorney was not custodial conduct. The court rejected this approach, noting that St. Mary cited no authority allowing or even encouraging a court to assess care and custody status on a task-by-task basis, and that the prevailing case law’s focus on the extent of dependence by a patient on a health-care provider rather than on the nature of the particular activities that comprised the patient-provider relationship counsels against adopting such an approach.
In addition, by proceeding with the surgery without the patient’s consent, or the consent of his designee, the hospital was potentially subject to a claim for medical battery under Cobbs v. Grant (1972) 8 Cal.3d 229, 239-240 [recognizing battery claim against doctor for performing an operation to which the patient had not consented].
The court also held that a reasonable jury could find St. Mary “fail[ed] to protect [Carter] from health and safety hazards” (Welf. & Inst. Code, § 15610.57, subd. (b)(3)) by authorizing the surgery in the way it did. Stewart’s medical-ethics expert described the process used by the hospital as a “sham,” and said that the hospital should have obtained a court order to perform the surgery. The requirement to obtain a court order is designed to prevent the patient from being exposed to the very abuse that occurred in this case.
Miller v. City of Portland (9th Cir. 2017) 868 F.3d 846. Miller brought a claim against the City under 42 U.S.C. § 1983 alleging that the City’s police department had violated her 4th Amendment rights. The City served her with a Rule 68 Offer of Judgment for $1,000 and reasonable attorney’s fees. Miller accepted and sought fees in the district court. The City argued that because the amount of the settlement was de minimis, she was not entitled to a fee award. The district court denied the motion on that basis. Reversed. Rule 68 offers are analyzed under ordinary contract-law principles, and plaintiffs are entitled to rely on the plain language of the offers they accept. The district court erred in applying the legal standard under 42 U.S.C. § 1988 for determining whether a prevailing plaintiff is entitled to a fee award, because the offer here plainly stated that it included an award of reasonable fees. Accordingly, the case was remanded for the court to determine the reasonable amount of fees.
Plaintiffs, two Hispanic LAPD officers, were involved in a fatal shooting of an African-American man, who was unarmed and autistic. After the shooting the officers were kept out of the field, and were instead assigned to various jobs that did not require a field certification. They continued to receive their full salaries, but were no longer eligible to receive a 2-3 percent “field bonus.” They sued the LAPD for unlawful discrimination under the FEHA and prevailed in a jury trial, with each officer receiving roughly $2 million. The City appealed. Reversed.
The officers’ main evidence was a comparison of how they were treated with how two white officers were treated after a similar shooting incident, in which the victim was Hispanic, and not African American. At trial, the officers had argued that the disparate treatment was based, in large part, on the race of the victim.
Salyers v. Metropolitan Life Insurance Company (9th Cir. 2017) __ F.3d __.
Plaintiff Salyers was a nurse employed by Providence Health. When she first applied for dependent life insurance coverage on her spouse, Gary Wolk, she elected only $20,000 in coverage. Because of this low amount, no evidence of insurability was required under Providence’s ERISA plan. Although Salyers elected only $20,000 in coverage, Providence mistakenly entered $500,000 into its system, and deducted premiums for that amount of coverage for several years. No request of insurability was made by Providence or the plan insurer, MetLife, even though evidence of insurability was required.
In 2014, Salyers increased the coverage on Wolk to $250,000. Although Salyers did not provide a statement of health or evidence of insurability, as the plan documents said was required, Salyers’s premiums were adjusted to reflect the $250,000 in coverage. Ten days after the new coverage was effective, Wolk died. MetLife paid only $30,000 – the maximum amount that the plan documents allowed for coverage without evidence of insurability. The district court entered judgment in favor of MetLife. Reversed.
The Ninth Circuit adopted a federal common-law rule concerning agency, applicable to ERISA claims, which held that Providence was acting as MetLife’s agent, and therefore information made known to Providence by plan beneficiaries is imputed to MetLife, the principal. The court had no trouble concluding that Providence had apparent authority, and perhaps even implied actual authority, to enforce the evidence-of-insurability requirement on MetLife’s behalf.
A plan participant would have reasonably believed that Providence did not collect evidence of insurability of its own accord but on MetLife’s behalf. Providence’s direct interaction with plan participants, coupled with MetLife’s failure to engage with Salyers about evidence of insurability, suggested that Providence had apparent authority on the collection of evidence of insurability.
Providence knew or should have known that Salyers’s 2014 coverage election required evidence of insurability, because Providence’s system showed $250,000 in coverage. Despite having not received evidence of insurability from Salyers in 2014 or earlier, Providence began deducting premiums from Salyers’s paycheck every two weeks between September 2013 and February 2014, in amounts corresponding to $500,000 in coverage for 2013 and $250,000 for 2014. Plus, just five days after Gary’s death, having still not received evidence of insurability, Providence sent a letter to Salyers confirming coverage of $250,000.
The deductions of premiums, MetLife and Providence’s failure to ask for a statement of health over a period of months, and Providence’s representation to Salyers that she had $250,000 in coverage were collectively “so inconsistent with an intent to enforce” the evidence of insurability requirement as to “induce a reasonable belief that [it] ha[d] been relinquished.” Accordingly, MetLife waived the evidence of insurability requirement, and it cannot contest coverage on that basis.

References: v. 
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