Theories of Liability & Common Defenses

A medical professional is liable for deviation from the standard of care applicable to practitioners in the same or similar circumstances. The standard is established through expert testimony from a qualified physician in the same specialty. MICRA (CCP § 340.5) imposes a three-year / one-year limitations period and its own procedural requirements distinct from ordinary negligence.

Cobbs v. Grant (1972) 8 Cal.3d 229 established that a physician must disclose all information material to a patient's decision about proposed treatment, including risks, alternatives, and the consequences of non-treatment. Breach occurs when the physician withholds information a reasonable patient would have considered material to the decision, and the undisclosed risk in fact caused harm.

When the nature of the injury permits an inference of negligence without direct evidence of breach — a surgical instrument left inside the patient, an operation on the wrong body part, or burns from a warming device — the doctrine of res ipsa loquitur allows the jury to infer breach. The inference applies when: (1) the event is the kind that does not ordinarily occur without negligence; (2) the instrumentality was in the defendant's exclusive control; and (3) the plaintiff did not voluntarily contribute.

In skilled-nursing and long-term care cases, plaintiffs increasingly plead elder abuse under the Elder Abuse and Dependent Adult Civil Protection Act. Section 15657 provides uncapped non-economic damages, attorneys' fees, and pain-and-suffering recovery for the decedent — remedies unavailable under MICRA. The threshold is recklessness (Delaney standard), not ordinary negligence, but this is regularly met in understaffing and pressure-wound cases.

Hospitals can be liable for negligent credentialing of independent-contractor physicians, or under ostensible agency where the patient reasonably believed the treating physician was a hospital employee. Mejia v. Community Hospital of San Bernardino (2002) 99 Cal.App.4th 1448 holds that a hospital's right to control a physician's work — even under an independent-contractor label — can establish actual agency and full vicarious liability.

Defective medical devices — implants, surgical instruments, drug delivery systems — can generate strict products liability claims alongside malpractice claims against the implanting physician. Federal preemption under 21 U.S.C. § 360k bars parallel state-law claims against FDA-approved Class III devices, but express and implied preemption are vigorously contested and courts often allow manufacturing-defect claims to proceed.