Appellate Updates

Sgaraglino v. County of Ventura (June 8, 2026, B348978) __ Cal.App.5th __, 2026 WL 1657823

Anthony Sgaraglino was involuntarily detained for psychiatric care at Ventura County Medical Center under Welfare and Institutions Code section 5150. He was discharged after a physician determined he no longer met the criteria for continued hospitalization. Sgaraglino committed suicide the next day. His parents sued Ventura County for wrongful death, alleging negligence or gross negligence in releasing him despite indications he was unsafe to discharge. The County moved for summary judgment, asserting immunity under section 5113. The Sgaraglinos argued section 5113 does not apply to gross negligence claims, but they filed no responsive separate statement—only a doctor’s declaration opining that Anthony should not have been released given his history of mental illness and suicidal ideation. The trial court granted the motion, finding section 5113 barred any claim that the release fell below the standard of care. The Sgaraglinos appealed.

The Court of Appeal affirmed, holding that section 5113 grants psychiatric facilities immunity for releasing patients after a section 5150 involuntary detention. The court explained that the Lanterman-Petris-Short Act, which governs involuntary detention of persons with mental illness, was enacted to end inappropriate, indefinite, and involuntary commitment. Immunity furthers the Act’s goals. Recognizing the tension between safety and freedom, the Legislature imposed time limits on involuntary detentions and immunized psychiatric facilities and their personnel from liability for release decisions. Section 5113 provides that a facility “shall not be civilly or criminally liable for any action by a person released at or before the end of a period for which the person was admitted.” On its face, section 5113 protects the County from liability for Sgaraglino’s post-release actions, and the statute contains no exception for gross negligence. Because the Sgaraglinos did not dispute in a responsive separate statement that Anthony no longer met the criteria for continued hospitalization, the doctor’s declaration was irrelevant. Arguing the release did not meet the medical standard of care is the very argument section 5113 forecloses.

J.M. v. Illuminate Education, Inc. (May 14, 2026, No. S286699) __ Cal.5th __, 2026 WL 1340681

J.M., a minor, attended school in a district that contracted with Illuminate Education to store student data, including medical information such as dyslexia screening results, to help the district meet students’ educational needs. After Illuminate discovered someone without authority had access to its databases, J.M. brought a class action against Illuminate for violating the Confidentiality of Medical Information Act (“CMIA”) (Civ. Code, § 56 et seq.) and the Customer Records Act (“CRA”) (Civ. Code, § 1798.80 et seq.). J.M. alleged that, following the data breach, he had received solicitations from third parties based on the information he provided to the school district. The trial court dismissed the complaint for failure to state a claim, ruling that J.M. had not adequately alleged Illuminate was a “provider of health care,” “contractor,” or “administrator” under the CMIA, or that it “own[ed] or license[d]” the breached data, or that it otherwise owed J.M. a duty under the CRA. The Court of Appeal reversed, holding that both statutes embraced Illuminate’s platform and that the trial court abused its discretion by denying leave to amend. The Supreme Court granted review and reversed.

The Supreme Court held that J.M. failed to state a CMIA claim because Illuminate did not maintain confidential information for use by a health care provider. Examining the statute’s text and legislative history, the Court concluded the CMIA covers only businesses that maintain medical information for the purpose of medical diagnosis or treatment. J.M. alleged that Illuminate’s platform provides educators, students, and parents access for educational planning and evaluation, not medical care. Because J.M. failed to allege that Illuminate made medical information available to healthcare providers for the purpose of diagnosing or treating a medical condition, the CMIA did not apply to Illuminate’s services.

The Supreme Court also clarified the standard for failure-to-preserve claims under the CMIA: a plaintiff need not allege that medical information was actually viewed by an unauthorized third party. Instead, a plaintiff need only allege a significant risk of unauthorized access to or use of the information, disapproving Regents of the University of California v. Superior Court (2013) 220 Cal.App.4th 549, Sutter Health v. Superior Court (2014) 227 Cal.App.4th 1546, and Vigil v. Muir Medical Group (2022) 84 Cal.App.5th 197.

Finally, the Supreme Court held Illuminate was not a proper CRA defendant. J.M. provided his personal information to the school district, not to Illuminate, and therefore was not Illuminate’s customer. The Supreme Court remanded for the lower courts to determine whether to grant J.M. leave to amend.

Tulare Medical Center Property Owners Association v. Valdivia (Apr. 7, 2026, No. F089334) ___ Cal.App.5th ___, 2026 WL 946380

In 1991, a public hospital district adopted and recorded CC&Rs for the Tulare Medical Center common interest development that prohibited certain land uses, including “abortion clinic.” Many years later, when a family planning provider that offered abortion services sought to lease a unit in the development, the Tulare Medical Center Property Owners Association sought to enforce the prohibition and moved for a preliminary injunction. The defendants opposed the motion, arguing the CC&Rs use restriction violated the Unruh Civil Rights Act and the California Constitution. The trial court denied a preliminary injunction, and the Association appealed.

The Court of Appeal affirmed on two grounds. First, the court held that the compelling interest test applied because a government entity had adopted the CC&Rs, but the Association failed to demonstrate a compelling interest justifying the prohibition. The court reasoned that the restriction interfered with the fundamental right to reproductive freedom under Article I, sections 1 and 1.1 of the California Constitution. Second, applying Civil Code section 53 and the framework from Harris v. Capital Growth Investors XIV (1991) 52 Cal.3d 1142 and Koebke v. Bernardo Heights Country Club (2005) 36 Cal.4th 824, the court concluded that the decision to have an abortion is fundamental to a person’s identity, beliefs, and self-definition, and therefore qualifies as a protected characteristic under the Unruh Act. Because the CC&Rs indirectly limited the use of real property based on a protected characteristic, section 53 voided the prohibition. The court emphasized that this result does not compel any landowner to rent to an abortion provider; it simply prevents this restriction from binding subsequent owners.

Fresenius Medical Care Orange County, LLC v. Bonta,___ F.4th ___, 2026 WL 934331 (9th Cir. Apr. 7, 2026)

Dialysis providers Fresenius Medical Care and DaVita, patients with end-stage renal disease (ESRD), and the American Kidney Fund (AKF) sued to enjoin enforcement of California Assembly Bill 290 (AB 290), which the Legislature enacted to prevent dialysis providers from profiting off patients who receive charitable assistance to pay private health insurance premiums. The challenged provisions: (1) cap the rate at which providers who donate to charities can be reimbursed by insurers (Reimbursement Cap); (2) require charities offering health insurance premium assistance to disclose patient names to insurers (Patient Disclosure Requirement); (3) prohibit charities from conditioning charitable assistance on certain patient eligibility factors (Financial Assistance Restriction); (4) require charities that receive donations from providers to inform patients of all health coverage options (Coverage Disclosure Requirement); and (5) allow affected entities a safe harbor to seek an updated advisory opinion before the law takes effect (Safe Harbor Provision). In a summary judgment ruling, the district court upheld the Reimbursement Cap, Coverage Disclosure Requirement, and Safe Harbor Provision, but ruled the Patient Disclosure Requirement and Financial Assistance Restriction violate the First Amendment.

The Ninth Circuit affirmed in part and reversed in part, holding that the first three provisions violate the First Amendment. The Reimbursement Cap violates providers’ associational right to donate to mission-driven charities. The Patient Disclosure Requirement violates AKF’s associational rights, as well as those of its patients, by compelling charities to divulge patient identities. The Financial Assistance Restriction violates AKF’s expressive association rights by limiting its right to associate with whom it chooses. The court found that all three provisions failed “exacting scrutiny”—the standard for regulations burdening First Amendment rights—because none was narrowly tailored to serve the state’s asserted interest. The Reimbursement Cap was not narrowly tailored to California’s legitimate interest in preventing distortion of insurance risk pools because the State could have achieved that goal by directly regulating reimbursement rates; the Patient Disclosure Requirement failed because California justified it as a means of effectuating the now-unconstitutional Reimbursement Cap; and the Financial Assistance Restriction was not narrowly tailored to achieve California’s legitimate state interest in protecting vulnerable populations from abusive practices. The court concluded that the Coverage Disclosure Requirement does not violate the First Amendment because it is permissible compelled commercial speech and is reasonably related to the State’s interest in preventing consumer deception. However, the court held that the unconstitutional provisions cannot be severed from the Coverage Disclosure Requirement because the Legislature would not have enacted it as a standalone measure. Finally, the court concluded that the challenges to the Safe Harbor Provision were moot.

Sobalvarro v. Vibra Health Care (March 26, 2026, A168792) __ Cal.App.5th __, 2026 WL 850431

Jessica Sobalvarro was admitted to Kentfield Hospital to recover from a paralyzing stroke that left her unable to speak. Kentfield’s nursing staff provided intimate care for Sobalvarro, including bathing and toileting, and a male nursing assistant provided much of that care. Throughout her stay, Sobalvarro’s family and friends observed her crying and appearing sad. After sufficiently regaining her speech, Sobalvarro sued Kentfield, its corporate parent (Vibra Health Care), and the male nurse. She pleaded claims for dependent adult abuse, negligence, battery, and assault, alleging the male nurse had sexually assaulted her. Although the jury found the male nurse was not liable, it nonetheless found Kentfield and Vibra negligent for violating the Patients’ Bill Right of Rights (Cal. Code Regs., tit. 22, § 72527 et seq.) and awarded $1 million in noneconomic damages. The trial court granted JNOV for defendants, ruling that causation could not be established once the jury exonerated the male nurse. Sobalvarro appealed.

The Court of Appeal reversed, holding that substantial evidence supported the jury’s liability finding. The court explained that, because it was undisputed that Sobalvarro would have opted for care by a female nurse had Kentfield given her that choice, the jury could infer that some of her distress stemmed from “receiving daily intimate care, while paralyzed and unable to move or speak, over a lengthy period from a male nurse, contrary to her wishes, and as a direct result of Kentfield’s negligence” in failing to give her the option of female nursing care.

Wright v. WellQuest Elk Grove, LLC (Mar. 18, 2026, No. C105070) __ Cal.App.5th __[2026 WL 762409]

An elderly dementia patient was admitted to a memory care facility. The facility was informed that she was a wanderer who required supervision to prevent her from leaving the premises. Three days after admission, the patient was found alone and unresponsive outside in extreme heat. She died four days later. The decedent’s family sued the facility for elder neglect, negligence, fraud, tort per se, wrongful death, and negligent infliction of emotional distress. The facility moved to compel arbitration and to stay court proceedings based on an agreement signed by the decedent’s niece. The trial court denied both motions. In pertinent part, the court ruled that some claims in the lawsuit could not be compelled to arbitration, creating the possibility of conflicting rulings by an arbitrator and trial judge, which is a discretionary basis for denying arbitration under state law. (Code Civ. Proc., § 1281.2, subd. (c)). The facility appealed, asserting that section 1281.2, subdivision (c), was preempted by the parties’ express choice to invoke the Federal Arbitration Act (FAA) in their arbitration agreement.

The Court of Appeal affirmed. The parties’ agreement required arbitration “in accordance with” or “pursuant to” the FAA. The Court of Appeal found this language inadequate to express a preference to be governed by the FAA’s procedural provisions, even if the FAA’s substantive provisions might apply. And because the FAA’s procedural provisions did not apply, state procedural law applied by default, including section 1281.2, subdivision (c), on which the trial court had relied. In reaching this conclusion, the court disagreed with Rodriguez v. American Technologies, Inc. (2006) 136 Cal.App.4th 1110, which held otherwise.

Pomona Valley Hospital v. Kaiser Foundation Health (Feb. 27, 2026, A168669) ___ Cal.App.5th ___ [2026 WL 554484], ordered published March 13, 2026

Pomona Valley Hospital sued Kaiser Foundation Health Plan in quantum meruit to recover the unreimbursed reasonable value of emergency services Pomona Valley provided to Kaiser Health Plan members. Pomona Valley had provided emergency medical services to Kaiser Health Plan members under a contract that set the reimbursement rates for those services. After Kaiser Health Plan terminated the contract, it began paying Pomona Valley a lower amount that Kaiser Health Plan determined was the reasonable value for those services. Pomona Valley sued to recover the higher unreimbursed fair market value for its emergency care. A jury ruled in Pomona Valley’s favor, but the trial court conditionally granted Kaiser Health Plan’s motion for a new trial, ruling it had erred by admitting the expired contract as evidence of the services’ value. Pomona Valley accepted a remitted judgment in lieu of a new trial. Kaiser Health Plan then appealed, and Pomona Valley cross-appealed. 

The Court of Appeal reversed the order granting a new trial and vacated the amended judgment, holding the trial court correctly denied Kaiser Health Plan’s motion in limine to exclude evidence of the expired reimbursement contract. The court rejected Kaiser Health Plan’s argument that the contract was inadmissible because the contract provided that its terms would not be used as evidence regarding the reasonable and customary value of services under a minimum payment regulation. The court explained that the jury was asked to determine a distinct quantum meruit valuation issue, which requires a different valuation than the regulatory minimum payment. The court explained that the fair market value of medical services is properly measured by the price that a willing buyer would pay to a willing seller, assuming full knowledge of pertinent facts. The court noted that while “a wide variety of evidence” may bear on fair market value, evidence regarding the hospital’s alleged cost of providing the services is irrelevant and should be excluded.

Nichols v. Alghannam (Feb. 18, 2026, No. C100433) __ Cal.App.5th __ [2026 WL 456491]

Plaintiffs, the adult children of Sandra Robinson, sued Dr. Muhammad Alghannam, who managed Robinson’s implanted fentanyl pump, and others for professional negligence and elder abuse after Robinson’s death from a fentanyl overdose. Plaintiffs alleged that, after surgery for an unrelated health issue, Robinson’s surgeon failed to coordinate with Dr. Alghannam about her pump, ordered additional fentanyl without consulting Dr. Alghannam, and failed to act on observable changes in Robinson’s mental status. Plaintiffs further alleged the surgeon, knowing Dr. Alghannam lacked valid staff privileges at the hospital, “asked him to come in any way,” to conceal his failure to manage Robinson’s pain pump. Plaintiffs filed several iterations of their complaint, and first named Dr. Alghannam as a defendant nearly five years after Robinson’s death. Dr. Alghannam demurred to plaintiffs’ operative complaint on statute of limitations grounds and for failure to plead elder abuse. The trial court sustained the demurrer, and plaintiffs appealed.

The Court of Appeal affirmed. The court held that plaintiffs’ action was barred by MICRA’s three-year limitations period because plaintiffs’ action was for “professional negligence.” (Code Civ. Proc., § 340.5.) Plaintiffs argued that Dr. Alghannam’s postsurgical treatment of Robinson was not “professional negligence” because it fell outside the scope of what the hospital was licensed to do. Relying on Waters v. Bourhis (1985) 40 Cal.3d 424 and Lopez v. Ledesma (2022) 12 Cal.5th 848, the court disagreed and held that the statutory exclusion for services rendered “within any restriction imposed by” a hospital applies only when a provider acts outside the licensed scope of practice—not merely when violating hospital rules or professional standards. (An example would be a psychologist performing heart surgery.) Because plaintiffs’ complaint did not specify what staff privileges Dr. Alghannam lacked, or how he violated the hospital’s restrictions, plaintiffs failed to plead that Dr. Alghannam rendered services within “ ‘ “a limitation on the scope of a provider’s practice beyond simply the obligation to adhere to standards of professional conduct.” ’ ” The court further held the statute of limitations was not tolled because the complaint failed to allege that Dr. Alghannam engaged in affirmative acts of concealment. The court also rejected plaintiffs’ argument that their claims against Dr. Alghannam were timely because they related back to their original complaint. Even assuming a relation back, plaintiffs failed to serve Dr. Alghannam within three years of filing their original complaint. Finally, the court affirmed dismissal of the elder abuse claim, finding the complaint failed to allege a custodial relationship and that Dr. Alghannam acted with recklessness, oppression, fraud, or malice.

Berk v. Choy, 607 U.S. __, 2026 WL 135974 (Jan. 20, 2026, No. 24-440)

Harold Berk sued Dr. Wilson Choy for medical malpractice under Delaware law. Because Berk and Dr. Choy were citizens of different states, Berk sued in federal court based on diversity jurisdiction. Under Delaware law, a plaintiff must submit with his medical malpractice complaint an affidavit from a medical professional attesting to the suit’s merit. Del. Code Ann. tit. 18, § 6853(a)(1) (2025). Berk failed to submit the required affidavit and argued that section 6853 did not apply in federal court because it was inconsistent with the Rules of Decision Act and the Federal Rules of Civil Procedure (FRCP). The District Court disagreed and dismissed Berk’s lawsuit for failure to comply with Delaware’s affidavit law. The Third Circuit affirmed, then the Supreme Court granted certiorari.

The Supreme Court reversed, holding that Delaware’s affidavit requirement does not apply in federal court. The Court explained that when a plaintiff brings a state-law claim in federal court, the court “faces a choice-of-law problem: whether to apply state or federal law.” The Rules of Decision Act directs federal courts to apply state substantive law unless the Constitution, a treaty, or a statute states otherwise. 28 U.S.C. § 1652. The Rules Enabling Act, which authorizes the Supreme Court to adopt the FRCP and other uniform rules of procedure, provides for application of federal law. 28 U.S.C. § 2072. When a valid Federal Rule is on point, it displaces contrary state law even if it might qualify as substantive law under Erie R. Co. v. Tompkins, 304 U.S. 64 (1938). Applying these principles, the Court held that FRCP 8, which requires only a “short and plain statement of the claim showing that [plaintiff] is entitled to relief,” displaces Delaware’s affidavit of merit requirement. By requiring no more than a statement of the claim, Rule 8 establishes implicitly that evidence of the claim (like an affidavit) cannot be required. The Court reasoned that FRCP 12 reinforces this point by providing only one ground for dismissal on the merits—“failure to state a claim upon which relief can be granted”—while applying § 6853 would amount to another.

California does not have an affidavit of merit statute like the Delaware statute at issue in Berk. The application of Berk to California’s MICRA and other statutes is uncertain.

American Medical Response of Inland Empire v. County of San Bernardino (Dec. 18, 2025, D085716) __ Cal.App.5th __, 2025 WL 3787453

San Bernardino County initiated a competitive process to improve its emergency medical services (EMS) system and issued a request for proposal (RFP) to select a new exclusive EMS provider. Two parties responded: American Medical Response of Inland Empire (AMR) and Consolidated Fire Agencies (ConFire). AMR received the highest cumulative score from the proposal review committee, and ConFire earned the highest median score and the highest score from 3 of the 4 evaluators. The County found the proposals “substantially equivalent,” negotiated with both providers, and presented their proposals to the Board of Supervisors, which ultimately awarded the contract to ConFire. AMR sued the County. The trial court enjoined the County from implementing its contract with ConFire, ruling that the County had a ministerial duty under the RFP to negotiate solely with AMR, the County abused its discretion by deviating from the RFP, AMR was likely to prevail on the merits, and the balance of hardships favored imposing an injunction. The County and ConFire appealed.

The Court of Appeal reversed. The court explained that the Emergency Medical Services Act grants local EMS agencies such as the County broad, discretionary authority to institute competitive procurement processes. The court held that the RFP permitted the County to negotiate with more than one proposer, evaluate proposals based on flexible criteria that do not define “highest score” as a cumulative or median measure, and exercise discretion when determining which proposal furthers the public interest. The trial court thus erred by finding the County had a ministerial duty to negotiate solely with AMR. The trial court also erred by finding that the County abused its discretion. The court found AMR failed to show the County’s decision to select ConFire was irrational or disconnected from its goals to improve delivery of EMS, enhance EMS efficiencies, and integrate the coordination of EMS and fire services. Because AMR failed to show a likelihood of success on the merits, the balance of harms did not support issuing an injunction.