The Rule of Nichols v. Alghannam is that the MICRA statute of limitations (Code Civ. Proc. § 340.5) applies to professional negligence claims even when a physician allegedly lacks proper hospital staff privileges, under circumstances where the complaint fails to allege specific restrictions on the scope of the provider's practice beyond professional conduct standards.
Appeal from judgment after demurrer sustained without leave to amend in Superior Court, Yuba County.
Defendant Appellant was Muhammad Alghannam, M.D. — the pain management physician who allegedly treated Sandra Robinson at Rideout hospital without proper staff privileges.
Plaintiff Respondent was Lori Nichols, Randy Robinson, Darren Robinson, and Michelle Robinson — adult children of Sandra Robinson who died from fentanyl overdose following surgery.
The suit sounded in professional negligence and elder abuse. Cross-claims were not applicable.
The key substantive facts leading to the suit were: Sandra Robinson had an implanted Medtronic fentanyl pump managed by Alghannam. After Sandra underwent hernia surgery at Rideout hospital in July 2018, she continued receiving fentanyl through the pump and self-administering additional doses through an actuator. Hospital staff observed changes in Sandra's mental status, but the actuator was not removed. Sandra died from fentanyl overdose on August 4, 2018. Alghannam allegedly treated Sandra at Rideout without valid staff privileges, failed to turn off the pain pump as requested by Dr. Fahey, and treated Sandra without obtaining valid consent.
The procedural result leading to the Appeal: The trial court sustained Alghannam's demurrer to the fifth amended complaint without leave to amend, ruling that plaintiffs' negligence causes of action were time-barred under Code of Civil Procedure section 340.5 and their elder abuse claim failed to allege conduct qualifying as elder abuse.
The key question(s) on Appeal: 1. Whether Code of Civil Procedure section 340.5 (MICRA) applies to claims against a physician allegedly practicing without proper hospital staff privileges 2. Whether the statute of limitations was tolled for intentional concealment 3. Whether claims relate back to the original complaint under section 474 4. Whether the complaint adequately alleged elder abuse
The Appellate Court held that MICRA's definition of "professional negligence" applies even when a physician allegedly lacks hospital staff privileges, where the complaint fails to specify restrictions on the scope of practice beyond professional conduct standards, and that plaintiffs failed to adequately plead intentional concealment, relation back, or elder abuse with the required culpability.
The case is inapplicable when a plaintiff can specifically allege that a physician rendered services falling within actual restrictions on the scope of practice imposed by a licensing agency or hospital (beyond mere professional conduct violations), or when a plaintiff can adequately plead intentional concealment with specific affirmative acts by the defendant.
The case leaves open what specific types of hospital-imposed restrictions would remove conduct from MICRA's definition of "professional negligence," and whether different factual allegations regarding lack of staff privileges might support a different outcome.
Counsel
For Appellant: Nicholas R. Deal and Glenn A. Ellis (admitted pro hac vice)
For Respondent: Cole Pedroza, Kenneth R. Pedroza, Nathan J. Novak; Low McKinley & Salenko, Steven M. McKinley, and George E. Washington
Amicus curiae: [None identified]