Pages Menu
Categories Menu

Posted by on Jun 6, 2016 in Publications |

California Supreme Court Strengthens Protections of MICRA

California Supreme Court Strengthens Protections of MICRA

In a pair of recent cases, Winn v. Pioneer Medical Group, Inc. and Flores v. Presbyterian Intercommunity Hospital, the California Supreme Court issued decisions strengthening the position of hospitals and medical professionals across the state by bringing some more clarity to the breadth and scope of MICRA. Before looking into these cases, however, let’s take a step back to better understand their impact.

In 1975, California passed the Medical Injury Compensation Reform Act, commonly referred to now as “MICRA,” with the intention of lowering medical malpractice insurance premiums by decreasing the potential tort liability of medical professionals – in other words, to make it cheaper to practice medicine by making medical lawsuits cost less. One of the ways that MICRA accomplished this goal was by capping the amount of non-economic damages (e.g. a damage award for pain and suffering) recoverable in a medical malpractice case to $250,000. This meant, and still means, that a person injured by a medical professional is largely limited to recovering economic losses, such as loss of wages and costs of medical care, as even extensive pain and suffering is capped at $250,000. As you might imagine, plaintiff attorneys across the state were, shall we say, less than thrilled at the passage of this law and have since set about finding ways to try and circumvent the MICRA limits..

One of the main ways that plaintiff attorneys have attempted to circumvent MICRA is by trying to frame their cases as being outside of “professional negligence.” Although the body of case law interpreting this term is large and somewhat complex, the short version is that MICRA only protects medical providers when they are providing medical care. So if Dr. Joe hits Sally with his car, he doesn’t get to claim the protections of MICRA simply because he’s a doctor – only if Dr. Joe hurts Sally while he’s providing her with medical care does Sally’s claim against him become subject to MICRA.

The effort by plaintiff attorneys to bring their cases outside of professional negligence has resulted in a number of approaches, including one in which elder abuse is alleged – e.g. that the doctor withheld medical care from an elderly patient – and another in which the injury is framed as a regular tort, such as a slip and fall, that simply happened to take place in a medical setting – e.g. the plaintiff was injured because the bed railings weren’t installed properly. Until recently, whether such claims were affected by MICRA was something of a grey area, with a variety of courts applying a variety of tests to try and decide whether a particular incident was covered by MICRA or not. Today, however, things are now much more black and white.

Through Winn, the Court definitively limited the ability of plaintiff attorneys to allege elder abuse in conjunction with a medical malpractice claim, holding that a medical malpractice claim does not arise to the level of elder abuse “unless the defendant health care provider had a substantial caretaking or custodial relationship, involving ongoing responsibility for one or more basics needs, with the elder patient.” And through Flores, the Court held that negligence in maintaining hospital equipment or premises can still qualify as professional negligence if the acts or omissions were “necessary or otherwise integrally related to the medical treatment and diagnosis of the patient.”

By way of these two decisions, then, the California Supreme Court has substantially curbed two of the ways that plaintiff attorneys routinely attempt to circumvent the protections of MICRA by ensuring that routine medical malpractice claims cannot be readily transformed into something more – i.e. an elder abuse claim – or into something less – i.e. a simple slip and fall – so as to escape the protections of MICRA. In so holding, the California Supreme Court made clear its intent to clarify and reinforce the protections that MICRA offers to healthcare professionals in their provision of medical care to the residents of California.


If you’re involved in a lawsuit or risk management and have any questions regarding current or potential legal issues, we would urge you to contact an attorney as soon as possible to obtain advice, guidance and representation. At Baker, Keener & Nahra, we have the experience, skill, and drive to get the best possible results for our clients, no matter the size of the case or the scope of the problem. So if we can be of any assistance to you, please contact us and let us know how we can help.