Chow v. Leyba CA2/7 ( 2022 )


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  • Filed 4/19/22 Chow v. Leyba CA2/7
    NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS
    California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions
    not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion
    has not been certified for publication or ordered published for purposes of rule 8.1115.
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    SECOND APPELLATE DISTRICT
    DIVISION SEVEN
    LINDSEY CHOW,                                              B307432
    Plaintiff and                                     (Los Angeles County
    Appellant,                                        Super. Ct. No. BC648838)
    v.
    MA LEYBA et al.,
    Defendants and
    Respondents.
    APPEAL from a judgment of the Superior Court of
    Los Angeles County, Monica Bachner, Judge. Affirmed.
    Lindsey Chow, in pro. per., for Plaintiff and Appellant.
    William Chow, in pro. per., for Defendant and Respondent.
    La Follette, Johnson, DeHaas, Fesler & Ames, Janee M.
    Tomlinson and David J. Ozeran for Defendants and Respondents.
    _____________________
    Henry Chow was brought to the emergency room at
    St. Vincent Medical Center on October 31, 2015, where he was
    treated and then admitted to the hospital. He died on
    November 6, 2015, one day after his son, William Chow, agreed to
    make his father a DNR (do not resuscitate) patient. On
    January 31, 2017 Susan Chan Chow, Henry Chow’s wife, and
    Lindsey Chow,1 his daughter, filed this wrongful death and
    survival action, alleging medical negligence and related tort
    claims. Ultimately, following a series of demurrers and amended
    pleadings, as well as Susan’s death, the trial court granted
    St. Vincent’s motion for summary judgment and entered
    judgment in favor of St. Vincent finding Lindsey, who was
    representing herself, had failed to demonstrate a triable issue of
    fact whether St. Vincent had failed to meet the standard of care
    in treating Henry or St. Vincent’s care was the cause of Henry’s
    injury or death. We affirm.
    FACTUAL AND PROCEDURAL BACKGROUND
    1. Henry Chow’s Hospitalization and Death
    Henry, 77 years old, was brought to the St. Vincent
    emergency room on October 31, 2015 complaining of shortness of
    breath and chest pain.2 He was given an electrocardiogram and
    intubated for respiratory distress. After intubation Henry
    experienced severe bradycardia and suffered cardiac arrest. He
    1      We hereafter refer to members of the Chow family by their
    first names to avoid repetition.
    2     Our description of Henry’s hospitalization and the events
    preceding his death is based on St. Vincent’s separate statement
    of undisputed material facts in support of its motion for summary
    judgment. None of these facts was disputed in Lindsey’s separate
    statement in opposition to the motion.
    2
    was revived through administration of cardiopulmonary
    resuscitation (CPR). Henry was then transferred to a
    catheterization laboratory where an intra-aortic balloon catheter
    was inserted and angioplasty attempted.
    The catheterization laboratory determined Henry had
    “[s]evere multiple vessel coronary artery disease,” and his
    medical history showed diabetes, acute kidney failure, acute
    respiratory failure and aspiration pneumonia. A preliminary
    cardiac consultation performed on October 31, 2015 concluded
    Henry’s prognosis was “very poor”: “Mr. Chow has had [a]
    massive myocardial infarction. He has multivessel heavily
    calcified coronary stenosis and is presently in cardiogenic shock.”
    Henry was transferred to the intensive care unit, where he
    remained until his death on November 6, 2015. During that time
    he was seen by a variety of medical specialists, including
    nephrology, cardiology, pulmonology and infectious disease
    physicians.
    On November 5, 2015 an emergency “code blue” was called
    for Henry. CPR was again administered, and he was given
    three rounds of epinephrine. Henry regained a weak pulse. He
    was returned to a ventilator and treated once more with
    vasopressors. Following the code blue, Dr. Tao Nguyen, the
    hospitalist who had responded, discussed Henry’s situation with
    William. William agreed to make Henry a DNR patient and
    signed the appropriate form. The DNR order instructed health
    care providers to allow a natural death and provide a comfort-
    focused treatment. Henry died on November 6, 2015. The final
    diagnosis was acute myocardial infarction, cardiogenic shock,
    acute kidney injury, diabetes mellitus, acute diastolic heart
    failure, aspiration pneumonia and sepsis.
    3
    2. Lindsey’s Lawsuit
    Lindsey and Susan, representing themselves, filed their
    original complaint on January 31, 2017, asserting causes of
    action for wrongful death, medical malpractice, negligence,
    “survival” (a claim under Code of Civil Procedure section 377.30
    for damages suffered by Henry before his death) and false
    imprisonment arising from Henry’s hospitalization and death.
    Their principal allegation was that care had been improperly
    withdrawn from Henry, who was allowed to die. Lindsey and
    Susan named as defendants Ma Leyba, a nurse who provided
    care for Henry; Dr. Nguyen; St. Vincent; and Verity Health
    System of California, a nonprofit health care organization that
    operated St. Vincent, among other hospitals.
    After demurrers by the defendants to some, but not all, of
    the causes of action were sustained with leave to amend, Lindsey
    and Susan filed a first amended complaint, which added
    additional causes of action for elder abuse and intentional and
    negligent infliction of emotional distress. St. Vincent, Verity
    Health and Leyba’s demurrers to the negligence and survival
    causes of action were sustained without leave to amend. The
    elder abuse and intentional infliction of emotional distress causes
    of action were struck as improperly added without leave of court.
    Demurrers to other causes of action were sustained with leave to
    amend.
    The second amended complaint alleged causes of action for
    wrongful death, medical malpractice, negligent infliction of
    emotional distress and false imprisonment. St. Vincent, Verity
    Health and Leyba’s demurrers to the cause of action for false
    imprisonment were sustained without leave to amend.
    4
    Demurrers to other causes of action were once again sustained
    with leave to amend.
    On January 31, 2018 Lindsey and Susan moved for leave to
    amend their complaint to include a claim for punitive damages
    and new causes of action for medical battery, malfeasance and
    violation of informed consent. The court denied the motion.
    On February 16, 2018 Lindsey and Susan filed
    amendments to their pleading naming eight physicians and
    nurses in place of Doe defendants, and on February 23, 2018 filed
    a third amended complaint alleging causes of action for wrongful
    death, medical malpractice, negligent infliction of emotional
    distress, false imprisonment and survival. New demurrers and
    motions to strike were filed. The court struck the false
    imprisonment cause of action against St. Vincent, Verity Health
    and Leyba. To the extent other demurrers were sustained,
    Lindsey and Susan were given leave to amend.
    On March 23, 2018 Lindsey and Susan named William as a
    nominal defendant in place of Doe 9.
    On May 29, 2018 Lindsey and Susan filed a fourth
    amended complaint (the operative pleading) with four causes of
    action: wrongful death, medical malpractice, negligent infliction
    of emotional distress and survival. St. Vincent demurred to the
    cause of action for negligent infliction of emotional distress. The
    other defendants demurred to all the causes of action. All
    defendants moved to strike the causes of action for medical
    malpractice and survival on the ground Susan, Henry’s successor
    in interest, could not maintain those causes of action in propria
    persona. While the demurrers and motions to strike were
    pending, Lindsey and Susan moved for leave to file a fifth
    amended complaint to add a number of new causes of action,
    5
    including intentional torts and violation of religious freedom.
    The court denied the motion.
    On June 17, 2019, following Susan’s death several months
    earlier, Lindsey moved to substitute herself as Henry’s successor
    in interest.3 The defendants opposed the motion, arguing a self-
    represented party who is not an attorney cannot appear as
    successor in interest and could not maintain Henry’s survival and
    medical malpractice causes of action. The motion was denied
    without prejudice on July 22, 2019 (permitting the substitution if
    Lindsey retained an attorney).
    Following argument the trial court sustained St. Vincent’s
    demurrer to the cause of action for negligent infliction of
    emotional distress with leave to amend as to Lindsey and without
    leave to amend as to Susan. St. Vincent’s motion to strike the
    claim for punitive damages was granted. St. Vincent’s motion to
    strike the medical malpractice and survival causes of action
    based on Lindsay’s self-represented status was denied on the
    ground she still had the option of retaining counsel to pursue
    those claims on Henry’s behalf. The demurrers of all other
    defendants as to all causes of action were sustained without leave
    to amend. Lindsey elected not to further amend.
    3     The lawsuit was stayed between September 10, 2018 and
    July 19, 2019 as a result of bankruptcy proceedings involving
    St. Vincent and Verity Health. Granting relief from the
    automatic stay, the bankruptcy court stated, “The State Court is
    the forum best suited to adjudicate Movants’ claims, which all
    arise under non-bankruptcy law. Further, the State Court is
    already intimately acquainted with this matter, having ruled
    upon multiple Demurrers and Motions to Strike filed by the
    Debtors.”
    6
    On November 26, 2019 St. Vincent, the only defendant still
    in the lawsuit, filed its answer to the fourth amended complaint,
    responding to the remaining causes of action for wrongful death,
    medical malpractice and survival. (The answer noted the causes
    of action for negligent infliction of emotional distress and false
    imprisonment, alleged in the fourth amended complaint, had
    been dismissed by the court.)
    3. St. Vincent’s Motion for Summary Judgment
    St. Vincent moved for summary judgment on January 29,
    2020, contending the medical care and treatment provided Henry
    met the standard of care and did not cause injury to him or his
    death. St. Vincent submitted with its motion the declaration of
    Andrew Wachtel, M.D., a board certified physician in internal
    medicine and pulmonary disease.
    Dr. Wachtel explained he had reviewed Henry’s medical
    records from St. Vincent beginning with Henry’s arrival at the
    hospital on October 31, 2015 and opined the care and treatment
    Henry received in the emergency room met the standard of care:
    “The medical issues he presented with were properly and timely
    addressed, and proper medical interventions were undertaken.
    Furthermore, no act or omission on the part of hospital personnel
    while Mr. Chow was in the emergency room caused or
    contributed to his death on November 6, 2015.” After describing
    Henry’s treatment in the catheterization laboratory and the ICU
    following his transfer from the emergency room, Dr. Wachtel
    further opined that Henry “received extensive and appropriate
    care during his stay in the ICU.” Dr. Wachtel then opined that,
    following the code blue on November 5, 2015, administration of
    CPR, use of epinephrine and placement of Henry back on a
    ventilator, “it was apparent that Mr. Chow was going to die, and
    7
    nothing could be done to save him.” “[I]t was appropriate and
    within the standard of care,” according to Dr. Wachtel, “for
    Dr. Nguyen to issue the DNR order upon obtaining Mr. Chow’s
    son’s consent, and for the hospital staff to carry out that order,
    which it did appropriately and within the standard of care.”
    Summarizing his views, Dr. Wachtel opined, “[T]he medical
    staff at St. Vincent Medical Center met the standard of care in
    the medical treatment rendered to the decedent.” In addition, he
    declared, “[t]o a reasonable medical probability, no act or
    omission on the part of hospital personnel or any medical
    provider caused Mr. Chow’s condition to decline or his death.” He
    concluded his declaration by stating, “[T]o a reasonable medical
    probability, the placing of Mr. Chow on a DNR did not cause his
    death, because to a reasonable medical probability, he was going
    to die shortly after the November 5, 2015 Code Blue regardless of
    whether he was on a DNR or not. In other words, Mr. Chow had
    reached the end of his life, and to a reasonable medical
    probability further resuscitative efforts were not going to extend
    his life.”
    Citing Landeros v. Flood (1976) 
    17 Cal.3d 399
     and Sanchez
    v. South Hoover Hospital (1976) 
    18 Cal.3d 93
    , St. Vincent argued,
    because it had submitted an expert declaration opining that it
    had met the standard of care when treating Henry and that to a
    reasonable medical probability placing him on a DNR did not
    cause his death, it was entitled to summary judgment unless
    Lindsey filed an expert declaration in opposition contradicting
    that opinion.
    In her opposition papers Lindsey contended St. Vincent
    personnel had caused Henry’s death by unlawfully unplugging
    his life support without his consent and against his desire, which
    8
    she characterized as murder and euthanasia, as well as elder
    abuse. Lindsey submitted her own declaration, stating she was
    in Henry’s room on the morning of November 6, 2015 and saw
    nurse Leyba sitting 12 to 20 feet away from Henry, not providing
    services, while Henry was gasping for air, unable to breathe. The
    ventilator was unplugged, the heart monitor removed and all
    alarms were turned off. According to Lindsey, her father’s eyes
    were full of terror and fear.
    4. The Trial Court’s Ruling
    Before turning to the merits of St. Vincent’s motion, the
    trial court overruled Lindsay’s objection to Dr. Wachtel’s expert
    witness declaration, explaining, “[I]t appears to be an objection to
    his conclusion that ‘no act or omission’ caused the death on the
    grounds that such a declaration is not based on personal
    knowledge.”4
    Based on Dr. Wachtel’s opinions, the court found
    St. Vincent had submitted competent evidence that its medical
    personnel had not breached a duty of care or caused Lindsey
    damages or Henry’s death, carrying its initial burden on
    summary judgment. Lindsey, in contrast, failed to carry her
    burden. “Plaintiff failed to submit admissible competent evidence
    creating a triable issue of fact as to Defendant’s submitted
    evidence that Defendant met the standard of care and that
    Defendant’s care of Decedent was not the cause of Decedent’s
    injury or death.” Emphasizing that Lindsey did not submit an
    expert declaration controverting the opinions of Dr. Wachtel and
    4      The court also noted that Lindsey’s objection violated
    California Rules of Court, rule 3.1354(b) because it was included
    within her opposition memorandum, rather than having been
    filed separately.
    9
    ruling inapplicable the “common knowledge” exception to the
    general requirement that expert testimony is needed in medical
    malpractice cases, the court found Lindsey’s declaration did not
    constitute competent evidence: “Plaintiff’s arguments in
    opposition that Defendant’s treatment of Decedent constituted
    ‘intentional murder’ as opposed to negligence, whether conduct of
    Defendant’s staff caused Decedent’s death, and arguments
    relating to the DNR order and taking Decedent off the ventilator
    are irrelevant to her burden in opposing Defendant’s motion for
    summary judgment, for which she must submit expert testimony
    in support of her assertions.”
    Judgment was entered in favor of St. Vincent on July 24,
    2020. On the same date, but in a separate document, judgment
    was entered in favor of Verity Health and various individual
    defendants. William was dismissed from the action on July 24,
    2020 for failure to prosecute pursuant to Code of Civil Procedure
    section 583.240, subdivision (a)(1).
    Lindsey filed a timely notice of appeal, which appears to be
    limited to the judgment entered in favor of St. Vincent.
    DISCUSSION
    1. Standard of Review
    A motion for summary judgment is properly granted only
    when “all the papers submitted show that there is no triable
    issue as to any material fact and that the moving party is entitled
    to a judgment as a matter of law.” (Code Civ. Proc., § 437c,
    subd. (c).) A defendant may bring a motion on the ground the
    plaintiff cannot prove one of the required elements of the case or
    there is a complete defense to the action. (Code of Civ. Proc.,
    § 437c, subds. (o)(1), (2) & (p)(2); Aguilar v. Atlantic Richfield Co.
    (2001) 
    25 Cal.4th 826
    , 849.)
    10
    To carry its initial burden when the motion is directed to
    the plaintiff’s case rather than an affirmative defense, the
    defendant must present evidence that either negates an element
    of the plaintiff’s cause of action or shows that the plaintiff does
    not possess, and cannot reasonably obtain, evidence necessary to
    establish at least one element of the cause of action. (Aguilar v.
    Atlantic Richfield Co., 
    supra,
     25 Cal.4th at pp. 853-854.) Only
    after the defendant carries that initial burden does the burden
    shift to the plaintiff “to show that a triable issue of one or more
    material facts exists as to the cause of action or a defense
    thereto.” (Code Civ. Proc., § 437c, subd. (p)(2).)
    We review a grant of summary judgment de novo (Samara
    v. Matar (2018) 
    5 Cal.5th 322
    , 338) and, viewing the evidence in
    the light most favorable to the nonmoving party (Regents of
    University of California v. Superior Court (2018) 
    4 Cal.5th 607
    ,
    618), decide independently whether the facts not subject to
    triable dispute warrant judgment for the moving party as a
    matter of law. (Hampton v. County of San Diego (2015)
    
    62 Cal.4th 340
    , 347; Schachter v. Citigroup, Inc. (2009) 
    47 Cal.4th 610
    , 618.)
    2. Medical Negligence and the Need for Expert Testimony
    “Generally, ‘negligence’ is the failure to exercise the care a
    reasonable person would exercise under the circumstances.
    [Citation.] Medical negligence is one type of negligence, to which
    general negligence principles apply.” (Massey v. Mercy Medical
    Center Redding (2009) 
    180 Cal.App.4th 690
    , 694.) “The elements
    of a medical malpractice claim are: ‘“‘(1) the duty of the
    professional to use such skill, prudence, and diligence as other
    members of his profession commonly possess and exercise;
    (2) a breach of that duty; (3) a proximate causal connection
    11
    between the negligent conduct and the resulting injury; and
    (4) actual loss or damage resulting from the professional’s
    negligence.’”’” (Avivi v. Centro Medico Urgente Medical Center
    (2008) 
    159 Cal.App.4th 463
    , 468, fn. 2.) “Both the standard of
    care and [a defendant’s] breach must normally be established by
    expert testimony in a medical malpractice case.” (Id. at p. 467.)
    “Because the standard of care in a medical malpractice case
    is a matter ‘peculiarly within the knowledge of experts’ [citation],
    expert testimony is required to ‘prove or disprove that the
    defendant performed in accordance with the standard prevailing
    of care’ unless the negligence is obvious to a layperson.” (Johnson
    v. Superior Court (2006) 
    143 Cal.App.4th 297
    , 305; accord,
    Landeros v. Flood, 
    supra,
     17 Cal.3d at p. 410 [“‘[t]he standard of
    care against which the acts of a physician are to be measured is a
    matter peculiarly within the knowledge of experts; it presents the
    basic issue in a malpractice action and can only be proved by
    their testimony [citations], unless the conduct required by the
    particular circumstances is within the common knowledge of the
    layman’”].)5 Similarly, “‘[c]ausation must be proven within a
    5      The Supreme Court in Flowers v. Torrance Memorial
    Hospital Medical Center (1994) 
    8 Cal.4th 992
    , 1001, discussed a
    medical malpractice plaintiff’s need for expert testimony to
    oppose summary judgment and the obvious-to-a-layperson
    (common knowledge) exception to that requirement: “‘“The
    standard of care against which the acts of a physician are to be
    measured is a matter peculiarly within the knowledge of experts;
    it presents the basic issue in a malpractice action and can only be
    proved by their testimony [citations], unless the conduct required
    by the particular circumstances is within the common knowledge
    of the layman.” [Citations.]’ [Citations.] The ‘common
    knowledge’ exception is principally limited to situations in which
    the plaintiff can invoke the doctrine of res ipsa loquitur, i.e.,
    12
    reasonable medical probability based upon competent expert
    testimony.’” (Dumas v. Cooney (1991) 
    235 Cal.App.3d 1593
    , 1603;
    see Scott v. Rayhrer (2010) 
    185 Cal.App.4th 1535
    , 1542 [“[a]s a
    general rule, the testimony of an expert witness is required in
    every professional negligence case to establish the applicable
    standard of care, whether that standard was met or breached by
    the defendant, and whether any negligence by the defendant
    caused the plaintiff’s damages”]; see also Bromme v. Pavitt (1992)
    
    5 Cal.App.4th 1487
    , 1492-1493 [“a plaintiff who alleges a
    when a layperson ‘is able to say as a matter of common
    knowledge and observation that the consequences of professional
    treatment were not such as ordinarily would have followed if due
    care had been exercised.’ [Citations.] The classic example, of
    course, is the X-ray revealing a scalpel left in the patient’s body
    following surgery. [Citation.] Otherwise, ‘“expert evidence is
    conclusive and cannot be disregarded.”’” (Fn. omitted.)
    Nothing in the trial court record would support a finding
    the proper treatment of a DNR patient with Henry’s multiple
    problems falls within this common knowledge exception to the
    need for expert testimony in a medical malpractice case.
    (See Bardessono v. Michels (1970) 
    3 Cal.3d 780
    , 792-793 [jury
    could rely on common knowledge where alleged malpractice did
    not involve a complex procedure, but rather a simple treatment
    for commonplace problem where untoward, extremely rare result
    occurred]; Davis v. Memorial Hospital (1962) 
    58 Cal.2d 815
    , 818
    [trial court erred in failing to instruct jury on res ipsa loquitur
    when it was matter of common knowledge that procedure is not
    ordinarily harmful in the absence of negligence]; see also Curtis
    v. Santa Clara Valley Medical Center (2003) 
    110 Cal.App.4th 796
    ,
    801 [“[t]he more complex or unusual the medical process, the
    more likely it is that expert testimony will be required to
    establish whether or not the injury was the result of
    negligence”].)
    13
    statutory cause of action for wrongful death arising from medical
    negligence must prove by reasonable medical probability based
    on competent expert testimony that a defendant’s acts or
    omissions were a substantial factor in bringing about the
    decedent’s death”].)
    “‘Whenever the plaintiff claims negligence in the medical
    context, the plaintiff must present evidence from an expert that
    the defendant breached his or her duty to the plaintiff and that
    the breach caused the injury to the plaintiff.’” (Sanchez v. Kern
    Emergency Medical Transportation Corp. (2017) 
    8 Cal.App.5th 146
    , 153.) A medical malpractice defendant who supports a
    summary judgment motion with applicable expert declarations
    “‘is entitled to summary judgment unless the plaintiff comes
    forward with conflicting expert evidence.’” (Munro v. Regents of
    University of California (1989) 
    215 Cal.App.3d 977
    , 985.)
    3. Lindsey Failed To Demonstrate a Triable Issue of
    Material Fact as to St. Vincent’s Breach of Duty, an
    Essential Element of Her Causes of Action
    In appellate briefs devoid of any citation to the record
    (see generally Cal. Rules of Court, rule 8.204(a)(1)(C) [any
    reference to a matter in the record must be supported by a
    specific citation]), Lindsey contends the motion for summary
    judgment was improperly granted because St. Vincent’s medical
    personnel committed a deliberate act of euthanasia (murder)
    outside the standard of care. Although we do not question the
    depth of Lindsey’s anguish over the death of her father, because
    she failed to present expert medical testimony in opposition to
    St. Vincent’s motion, her briefs fail to provide any ground for
    reversal of the trial court’s judgment.
    Lindsey advances four basic arguments in her briefs. First,
    asserting murder is not mere negligence, Lindsey contends her
    14
    declaration described deliberate acts intended to kill Henry
    (unplugging the ventilator, removing the heart monitor and
    turning off alarms); and she suggests, as a consequence, well-
    established rules governing medical malpractice cases are
    somehow inapplicable to her lawsuit. Lindsey’s argument
    misperceives the nature and elements of her causes of action for
    wrongful death and medical malpractice. (The survival action is
    simply Henry’s claim for malpractice.) As to each, the issue is not
    whether St. Vincent’s actions were deliberate or accidental—
    there is no dispute they were intentional—but whether they were
    performed in accordance with the applicable standard of care
    and, therefore, not tortious or otherwise wrongful.6 Dr. Wachtel
    testified they complied with that standard, based on his review of
    Henry’s medical records, as well as Dr. Wachtel’s own extensive
    training and experience. As discussed, absent an expert
    declaration contradicting Dr. Wachtel’s opinion, that evidence is
    conclusive; and the trial court was required to grant St. Vincent’s
    motion.
    6      To reiterate, breach of duty and causation are essential
    elements of a claim for medical negligence (malpractice).
    (See, e.g., Bushling v. Fremont Medical Center (2004)
    
    117 Cal.App.4th 493
    , 509 [a medical malpractice plaintiff “must
    show that defendants’ breach of the standard of care was the
    cause, within a reasonable medical probability, of his injury”].)
    Similarly, the elements of a wrongful death cause of action
    directed to a health care provider include “(1) a ‘wrongful act or
    neglect’ on the part of one or more persons that (2) ‘cause[s]’
    (3) the ‘death of [another] person’ [citation]—on legal theories of
    negligence and strict liability.” (Norgart v. Upjohn Co. (1999)
    
    21 Cal.4th 383
    , 390.)
    15
    Lindsey’s challenge to the admissibility of Dr. Wachtel’s
    declaration because he did not have personal knowledge of
    Henry’s treatment, relying instead on Henry’s medical records, is
    misplaced. “Expert opinion testimony may be based upon
    information furnished to the expert by others so long as the
    information is of a type reasonably relied upon by professionals in
    the relevant field.” (Olive v. General Nutrition Centers, Inc.
    (2018) 
    30 Cal.App.5th 804
    , 821; accord, Zuniga v. Alexandria
    Care Center, LLC (2021) 
    67 Cal.App.5th 871
    , 887; see Evid. Code,
    § 801, subd. (b) [expert opinion may be based on matter,
    including the expert’s experience, training and education,
    perceived by or personally known to the witness, “or made known
    to him at or before the hearing, whether or not admissible, that is
    of a type that reasonably may be relied upon by an expert in
    forming an opinion upon which the subject to which his testimony
    relates”].) Henry’s medical records were submitted with
    St. Vincent’s motion papers, authenticated by the custodian of
    medical records for St. Vincent, and properly before the trial
    court as business records within the meaning of Evidence Code
    section 1271. “They are the type of records on which medical
    experts may and do rely in order to give expert testimony in a
    medical malpractice case.” (Wicks v. Antelope Valley Healthcare
    Dist. (2020) 
    49 Cal.App.5th 866
    , 876; see Shugart v. Regents of
    University of California (2011) 
    199 Cal.App.4th 499
    , 506 [“The
    court found in its order of May 14, 2010, that the medical records
    in support of Dr. Warren’s motion were properly authenticated.
    Accordingly, the foundational facts and medical records on which
    Dr. Ostegard relied as stated in his declaration were before the
    court to support his expert opinion”].)
    16
    Lindsey also argues summary judgment should have been
    denied because the bankruptcy court, when lifting the automatic
    stay of the case imposed following Verity Health’s bankruptcy
    filing in September 2018, found her claims had merit. The
    bankruptcy court made no such finding, as the trial court
    explained when rejecting this same contention. The bankruptcy
    court noted that Lindsey and Susan alleged the debtors
    “euthanized Henry . . . as a cost-saving measure”—language that
    Lindsey quotes without indicating it was a description of her
    allegation—but ruled only that state court, not federal
    bankruptcy court, was the forum better suited to adjudicate
    Lindsey’s state law claims.
    Finally, Lindsey contends Henry’s death certificate, which
    stated the immediate cause of death was cardiogenic shock and
    acute myocardial infarction, established that Henry did not die
    from natural causes. But the meaning of those medical terms in
    the context of an evaluation of St. Vincent’s treatment and care of
    Henry, just as Lindsey’s claims that St. Vincent’s conduct
    violated various federal laws regarding euthanasia and
    constituted Medicare fraud, required expert testimony. In the
    absence of expert testimony, St. Vincent was entitled to summary
    judgment.
    17
    DISPOSITION
    The judgment is affirmed. St. Vincent is to recover its costs
    on appeal.
    PERLUSS, P. J.
    We concur:
    SEGAL, J.
    FEUER, J.
    18