Business Law

San Antonio Regional Hospital v. Superior Court (Musharbash) (May 3, 2024, E082481) Cal.App.5th [2024 WL 2720256]

San Antonio Regional Hospital v. Superior Court (Musharbash) (May 3, 2024, E082481) ___Cal.App.5th ___ [2024 WL 2720256], certified for publication May 28, 2024

Nurse anesthetist not competent to provide expert opinion on neurosurgical treatment decisions.

Joseph Musharbash sued San Antonio Regional Hospital after his adult son (Michael) died at the hospital while being treated for a traumatic brain injury.  Musharbash alleged the hospitalā€™s surgical delay caused Michaelā€™s death.  He also alleged the hospitalā€™s nursing staff negligently failed to monitor Michael, to inform his doctors of his deteriorating status, and to advocate for earlier surgery.  The hospital moved for summary judgment, based in part on the declarations of two doctors who opined that Michael had received adequate treatment.  In opposition, Musharbash submitted an expert declaration from a nurse anesthetist who opined there was a negligent delay in Michaelā€™s medical treatment, which caused his death.  The trial court denied the hospitalā€™s summary judgment motion, finding that the nurseā€™s declaration created triable issues regarding standard of care and causation.  The hospital filed a writ petition challenging the superior courtā€™s denial of summary judgment.

The Court of Appeal granted the hospitalā€™s petition and directed the trial court to enter a new order granting summary judgment in the hospitalā€™s favor.  The court held that the nurse anesthetist was unqualified to provide expert testimony on the standard of care and causation issues.  The court explained that nothing in the nurseā€™s declaration ā€œestablishe[d] that her experience as a nurse anesthetist or trauma unit nurse gave her the specialized knowledge required to opine on the standard of care applicable to an intensive care unit neurosurgeon deciding whether a severe traumatic brain injury requires immediate surgical intervention, or whether the standard of care was breached.ā€  Similarly, her declaration did not show she was competent to opine on causation.  While she might have been qualified to testify whether the hospitalā€™s nursing staff properly monitored and reported on Michaelā€™s status, she was not competent to testify regarding whether the nurseā€™s alleged negligence affected the neurosurgeonā€™s treatment decisions.

The bulletin describing this appellate decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson, Peder K. Batalden, and Lacey Estudillo at the appellate firm Horvitz & Levy LLP, and is republished with permission.

For more information regarding this bulletin, please contact H. Thomas Watson, Horvitz & Levy LLP, at 818-995-0800 or

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