Court Opinion

ID: 9638576
Source: CourtListenerOpinion
Date Created: 2023-08-22 15:47:42.139737+00
Date Added: 2024-06-11T18:10:08.029694
License: Public Domain

ALMA L. LÓPEZ, Chief Justice,
dissenting.
I agree with the majority that Suresh’s report was not sufficient to show that she was qualified to opine that the standard of care applicable to a urologist would require a urologist to diagnose preeclampsia. I disagree, however, that Suresh’s report was insufficient to meet the requirements of 4590i with regard to Sepulveda’s negligence in failing to monitor the fetus. Sur-esh’s report states that the nurse “voiced concern about' the fetal [heart rate monitoring] strip and fetal decelerations.” The nurse accompanied the patient to the operating room and “again voiced concern over the patient’s fetal strip.” Suresh further notes, “In preeclampsia, the fetus is at increased risk owing to marginal placental function which may become inadequate in the presence of increased uterine activity. Pre-operatively, there was evidence of uterine contractions and fetal decelerations and despite the nurse voicing her concerns — electronic fetal monitoring and surveillance was abandoned on the patient’s arrival to the operating room.” Suresh states that Sepulveda’s actions in “ignoring fetal well being also demonstrates substandard medical care.”
The majority contends that because Sur-esh “never alleges that the fetus would have survived if properly monitored during surgery had preeclampsia remained undiagnosed,” Suresh’s opinion “fails to establish ‘the causal relationship between [the breach] and the injury.’ ” However, Suresh states in her report that the “standard of care would have been to monitor uterine contractions and have continuous reading of [the fetal heart rate] by a qualified individual during the perianesthetie and preoperative period and to have arrangements for a stat cesarean section if the need arose.” Thus, Suresh opines on causation because if the standard of care had been met, and the fetal heart rate had been monitored, a stat cesarean section could have been performed to save the *685fetus if the need arose. The failure to monitor the heart rate led to the failure to perform the stat cesarean section, thereby preventing the fetus from surviving.
Accordingly, I believe Suresh’s report adequately summarizes the breach of the applicable standard of care with regard to the monitoring of the fetus and sets forth the causal relationship between the breach and the inability of the fetus to survive. Because the majority holds to the contrary, I respectfully dissent from this portion of the majority’s opinion.