{"id":525,"date":"2021-10-25T03:58:43","date_gmt":"2021-10-25T03:58:43","guid":{"rendered":"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\/?page_id=525"},"modified":"2022-05-03T01:06:14","modified_gmt":"2022-05-03T01:06:14","slug":"caci-500-medical-negligence-essential-factual-elements","status":"publish","type":"page","link":"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\/caci-500-medical-negligence-essential-factual-elements\/","title":{"rendered":"CACI 500 Medical Negligence\u2014Essential Factual Elements"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-ku5imtw5-b6013ba4c30909c569383af00ab20832\">\n#top .av-special-heading.av-ku5imtw5-b6013ba4c30909c569383af00ab20832{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-ku5imtw5-b6013ba4c30909c569383af00ab20832 .av-special-heading-tag 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itemprop=\"text\" ><ul>\n<li><a href=\"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\/\">CACI Jury Instructions Index<\/a><\/li>\n<li><a href=\"https:\/\/caci-fillable-forms.crowdsourcelawyers.com\/\">App: CACI Jury Instructions Fillable Forms Word Format<\/a><\/li>\n<\/ul>\n<\/div><\/section>\n<div  class='hr av-av_hr-91d7ccd583a503147498e120fee2ff9b hr-default  avia-builder-el-4  el_after_av_textblock  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-ku5iocjf-9ec9ef2107ff23e4ed152fe9216d9745\">\n#top .av_textblock_section.av-ku5iocjf-9ec9ef2107ff23e4ed152fe9216d9745 .avia_textblock{\nfont-size:20px;\n}\n<\/style>\n<section  class='av_textblock_section av-ku5iocjf-9ec9ef2107ff23e4ed152fe9216d9745 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h2 class=\"SS_Banner\">500\u00a0Medical Negligence\u2014Essential Factual Elements<\/h2>\n<hr \/>\n<p><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">Please see\u00a0CACI No.\u2002400,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Negligence\u2014Essential Factual Elements <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/span><\/span><\/p>\n<hr \/>\n<div class=\"SS_Note\">\n<h2 class=\"SS_HideShowSection SS_Expandable\"><\/h2>\n<div id=\"TRNotes_n_1\">\n<p><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">New September 2003; Revised December 2011, December 2015 <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<p><a href=\"https:\/\/crowdsourcelawyers.com\/\">Crowdsource Lawyers<\/a><\/p>\n<p><a href=\"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\">https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci<\/a><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\"><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<\/div>\n<\/div>\n<div class=\"SS_Note\">\n<h2 class=\"SS_HideShowSection SS_Expandable\">Directions for Use<\/h2>\n<div id=\"TRNotes_n_2\">\n<p>In medical malpractice or professional negligence cases, the word \u201cmedical\u201d or \u201cprofessional\u201d should be added before the word \u201cnegligence\u201d in the first paragraph of\u00a0CACI No.\u2002400. From a theoretical standpoint, medical negligence is still considered negligence. (See\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Flowers v. Torrance Memorial Hospital Medical Center<\/span>\u00a0(1994) 8 Cal.4th 992, 997\u2013998 [35 Cal.Rptr.2d 685, 884 P.2d 142].)<\/p>\n<p>Also give the appropriate standard-of-care instruction for the defendant\u2019s category of medical professional. (See\u00a0CACI No. 501,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Standard of Care for Health Care Professionals<\/span>,\u00a0CACI No. 502,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Standard of Care for Medical Specialists<\/span>,\u00a0CACI No. 504,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Standard of Care for Nurses<\/span>,\u00a0CACI No. 514,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Duty of Hospital.<\/span>)<\/p>\n<p>It is not necessary to instruct that causation must be proven within a reasonable medical probability based upon competent expert testimony. The reference to \u201cmedical probability\u201d in medical malpractice cases is no more than a recognition that the case involves the use of medical evidence. (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Uriell v. Regents of University of California<\/span>\u00a0(2015) 234 Cal.App.4th 735, 746 [184 Cal.Rptr.3d 79].) <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/p>\n<hr \/>\n<\/div>\n<\/div>\n<div class=\"SS_Note\">\n<h2 class=\"SS_HideShowSection SS_Expandable\">Sources and Authority<\/h2>\n<div id=\"TRNotes_n_3\">\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cProfessional Negligence\u201d of Health Care Provider Defined.\u00a0Code of Civil Procedure section 340.5,\u00a0Civil Code sections 3333.1\u00a0and\u00a03333.2.<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cThe elements of a cause of action for medical malpractice are: (1) a duty to use such skill, prudence, and diligence as other members of the profession commonly possess and exercise; (2) a breach of the duty; (3) a proximate causal connection between the negligent conduct and the injury; and (4) resulting loss or damage.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Lattimore v. Dickey<\/span>\u00a0(2015) 239 Cal.App.4th 959, 968 [191 Cal.Rptr.3d 766].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cThe court\u2019s use of standard jury instructions for the essential elements of negligence, including causation, was appropriate because medical negligence is fundamentally negligence.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Uriell, supra<\/span>, 234 Cal.App.4th at p. 744\u00a0[citing Directions for Use to this instruction].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cSection 340.5 defines \u2018professional negligence\u2019 as \u2018a negligent act or omission by a health care provider in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death, provided that such services are\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">within the scope of services for which the provider is licensed<\/span>\u00a0and which are not within any restriction imposed by the licensing agency or licensed hospital.\u2019 The term \u2018professional negligence\u2019 encompasses actions in which \u2018the injury for which damages are sought is directly related to the professional services provided by the health care provider\u2019 or directly related to \u2018a matter that is an ordinary and usual part of medical professional services.\u2019 \u2018[C]ourts have broadly construed \u201cprofessional negligence\u201d to mean negligence occurring during the rendering of services for which the health care provider is licensed.\u2019\u2009\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Arroyo v. Plosay<\/span>\u00a0(2014) 225 Cal.App.4th 279, 297 [170 Cal.Rptr.3d 125], original italics, internal citations omitted.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cWith respect to professionals, their specialized education and training do not serve to impose an increased duty of care but rather are considered additional \u2018circumstances\u2019 relevant to an overall assessment of what constitutes \u2018ordinary prudence\u2019 in a particular situation.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Flowers<\/span>,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">supra<\/span>, 8 Cal.4th at pp. 997\u2013998.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cSince the standard of care remains constant in terms of \u2018ordinary prudence,\u2019 it is clear that denominating a cause of action as one for \u2018professional negligence\u2019 does not transmute its underlying character. For substantive purposes, it merely serves to establish the basis by which \u2018ordinary prudence\u2019 will be calculated and the defendant\u2019s conduct evaluated.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Flowers, supra<\/span>, 8 Cal.4th at p. 998.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cThe Medical Injury Compensation Reform Act (MICRA) contains numerous provisions effecting substantial changes in negligence actions against health care providers, including a limitation on noneconomic damages, elimination of the collateral source rule as well as preclusion of subrogation in most instances, and authorization for periodic payments of future damages in excess of $ 50,000. While in each instance the statutory scheme has altered a significant aspect of claims for medical malpractice, such as the measure of the defendant\u2019s liability for damages or the admissibility of evidence, the fundamental substance of such actions on the issues of duty, standard of care, breach, and causation remains unaffected.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Flowers<\/span>,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">supra<\/span>, 8 Cal.4th at p. 999.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cOn causation, the plaintiff must establish \u2018it is more probable than not the negligent act was a cause-in-fact of the plaintiff\u2019s injury.\u2019 \u2018\u2009\u201cA possible cause only becomes \u2018probable\u2019 when, in the absence of other reasonable causal explanations, it becomes more likely than not that the injury was a result of its action.\u201d\u2009\u2019 \u2018[C]ausation in actions arising from medical negligence must be proven within a reasonable medical probability based on competent expert testimony, i.e., something more than a \u201c50-50 possibility.\u201d\u2009\u2019 \u2018[T]he evidence must be sufficient to allow the jury to infer that in the absence of the defendant\u2019s negligence, there was a reasonable medical probability the plaintiff would have obtained a better result.\u2019\u2009\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Belfiore-Braman v. Rotenberg<\/span>\u00a0(2018) 25 Cal.App.5th 234, 247 [235 Cal.Rptr.3d 629], internal citations omitted.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cThat there is a distinction between a reasonable medical \u2018probability\u2019 and a medical \u2018possibility\u2019 needs little discussion. There can be many possible \u2018causes,\u2019 indeed, an infinite number of circumstances which can produce an injury or disease. A possible cause only becomes \u2018probable\u2019 when, in the absence of other reasonable causal explanations,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">it becomes more likely than not that the injury was a result of its action<\/span>. This is the outer limit of inference upon which an issue may be submitted to the jury.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Jennings v. Palomar Pomerado Health Systems, Inc.<\/span>\u00a0(2003) 114 Cal.App.4th 1108, 1118 [8 Cal.Rptr.3d 363], original italics, internal citations omitted.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cThe rationale advanced by the hospital is that \u2026 if the need for restraint is \u2018obvious to all,\u2019 the failure to restrain is ordinary negligence.\u2009\u2026 [T]his standard is incompatible with the subsequently enacted statutory definition of professional negligence, which focuses on whether the negligence occurs in the rendering of professional services, rather than whether a high or low level of skill is required. [Citation.]\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Bellamy v. Appellate Dep\u2019t of the Superior Court<\/span>\u00a0(1996) 50 Cal.App.4th 797, 806\u2013807 [57 Cal.Rptr.2d 894].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201c[E]ven in the absence of a physician-patient relationship, a physician has liability to an examinee for negligence or professional malpractice for injuries incurred during the examination itself.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Mero v. Sadoff<\/span>\u00a0(1995) 31 Cal.App.4th 1466, 1478 [37 Cal.Rptr.2d 769].) <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<\/div>\n<\/div>\n<h2 class=\"SS_Heading\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\"><span class=\"SS_ib\" data-housestyle=\"EMPHASIS_ib\">Secondary Sources<\/span><\/span><\/h2>\n<div>6 Witkin, Summary of California Law (11th ed. 2017) Torts, \u00a7\u00a7\u20091066\u20131068, 1071, 1072<\/div>\n<div>California Tort Guide (Cont.Ed.Bar 3d ed.) \u00a7\u20099.65<\/div>\n<div>3 Levy et al.,\u00a0California Torts, Ch. 30,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">General Principles of Liability of Professionals<\/span>, \u00a7\u200930.11,\u00a0Ch. 31,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Liability of Physicians and Other Medical Practitioners<\/span>, \u00a7\u200931.01\u00a0(Matthew Bender)<\/div>\n<div>17\u00a0California Forms of Pleading and Practice, Ch. 209,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Dentists<\/span>, \u00a7\u2009209.15\u00a0(Matthew Bender)<\/div>\n<div>27\u00a0California Forms of Pleading and Practice, Ch. 295,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Hospitals<\/span>, \u00a7\u00a7\u2009295.13,\u00a0295.43\u00a0(Matthew Bender)<\/div>\n<div>36\u00a0California Forms of Pleading and Practice, Ch. 415,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Physicians: Medical Malpractice<\/span>, \u00a7\u2009415.11\u00a0(Matthew Bender)<\/div>\n<div>17\u00a0California Points and Authorities, Ch. 175,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Physicians and Surgeons<\/span>, \u00a7\u2009175.20 et seq.\u00a0(Matthew Bender)<\/div>\n<div class=\"SS_Note\">\n<div id=\"TRNotes_n_3\"><\/div>\n<\/div>\n<\/div><\/section>\n<div  class='hr av-reqs5-c3f7e368360b0bfa358d56a8424e4a6b hr-default  avia-builder-el-6  el_after_av_textblock  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jwg2l-2f494011adfd87ce722029f334201378\">\n#top .av_textblock_section.av-jwg2l-2f494011adfd87ce722029f334201378 .avia_textblock{\nfont-size:22px;\n}\n<\/style>\n<section  class='av_textblock_section av-jwg2l-2f494011adfd87ce722029f334201378 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><a href=\"https:\/\/crowdsourcelawyers.com\/\">CrowdSourceLawyers.com<\/a><\/p>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-525","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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