Medical Malpractice & Professional Negligence in California

Medical Malpractice & Professional Negligence in California

The legal landscape governing patient injury in California is defined by the concept of professional negligence, commonly known as medical malpractice.

This body of law is designed to hold healthcare providers accountable when their care falls below the acceptable standard, resulting in patient harm.

However, this pursuit of accountability is highly complex, governed by strict procedural rules, specialized evidentiary requirements, and the controversial limitations of the Medical Injury Compensation Reform Act (MICRA).

The foundation of every malpractice claim rests on proving four key elements:

1. Duty of Care: A legal obligation created by the existence of a doctor-patient relationship, requiring the provider to act as a reasonably competent medical professional would under similar circumstances.
2. Breach of Duty: The provider’s negligent act or omission to act—the failure to meet the standard of care.
3. Causation: The breach must be the proximate cause (a substantial factor) of the patient's injury.
4. Damages: The patient must suffer actual, quantifiable harm (e.g., physical injury, financial loss).

For a comprehensive look at the general legal framework governing accident and injury claims in the state, see the California Personal Injury Law Guide 2025

The Standard of Care Across Different Specialties

The requirement to meet the standard of care applies to all licensed healthcare professionals, though the specific duty is tailored to the practice area.

California law defines this duty under the Civil Jury Instructions for Medical Negligence (CACI 501), which state that a provider must use the level of skill, knowledge, and care that other reasonably careful professionals in the same field would use under similar circumstances.

1. Diagnostic Errors: Misdiagnosis and Delayed Diagnosis Claims in California

Diagnostic failure is a prime example of negligence. A provider is liable if they fail to employ the differential diagnosis process that a reasonably prudent doctor would use, leading to a misdiagnosis (the wrong condition) or a delayed diagnosis (a correct diagnosis made too late).

In cases like a missed cancer diagnosis, the patient's claim rests on proving that timely intervention would have resulted in a significantly better outcome, a concept often referred to as "loss of a chance."

2. Procedural Negligence: Surgical Errors and Birth Injuries

These claims involve tangible errors during invasive procedures:

• Surgical Errors: Patient Rights in California: These include mistakes such as wrong-site surgery, anesthesia errors, damage to internal organs or nerves, or, notoriously, leaving a foreign body (e.g., a sponge or instrument) inside the patient. These are often clear deviations from the standard of care.
• Birth Injury Lawsuits in California: Catastrophic injuries during labor and delivery, such as cerebral palsy, hypoxic-ischemic encephalopathy (HIE), or Erb’s palsy, are frequently the subject of these lawsuits. Negligence often involves the delayed recognition of fetal distress, the improper handling of a difficult delivery, or mismanagement of the mother's pre-existing conditions, which results in permanent injury to the child.

3. Non-Physician Professional Negligence

Professional negligence laws extend beyond physicians and surgeons:

• Medication and Pharmacy Error Lawsuits in California: Errors involve prescribing the wrong drug or dose, failing to check for harmful drug interactions, or dispensing the incorrect medication at the pharmacy. These cases often involve negligence by multiple parties (prescribing doctor, nurse, and pharmacist).
• Dental Malpractice Claims in California: The standard of care for a dentist involves using the skill and knowledge expected of a reasonably careful dentist in the same community. Claims often stem from unnecessary procedures, nerve injuries during oral surgery (e.g., implant placement or wisdom tooth extraction), failure to diagnose oral diseases, or improperly administered anesthesia.
• Psychiatric Malpractice and Mental Health Provider Liability: The duty of care for mental health providers (psychiatrists, psychologists, and therapists) is highly specialized. Claims often focus on a failure to prevent self-harm or suicide, breach of confidentiality, improper sexual conduct with a patient, or gross mismanagement of psychotropic medication, demonstrating a breach of the professional standard of care for a mental health setting.

Jurisdictional Overlap: Nursing Homes and Elder Abuse

Nursing Home Abuse and Neglect in California cases present a critical overlap between medical malpractice and California’s powerful Elder Abuse and Dependent Adult Civil Protection Act (EADACPA).

• Medical Malpractice vs. Elder Abuse: Claims based purely on negligent medical treatment (e.g., a doctor's error in prescribing medicine) are subject to MICRA's restrictions. However, claims based on egregious neglect or abuse (e.g., developing severe pressure ulcers (bedsores) due to reckless inattention, malnutrition, dehydration, or failure to assist with hygiene) can often be litigated under EADACPA, Welf. & Inst. Code §15657.
• Enhanced Remedies: A finding of recklessness, oppression, fraud, or malice under EADACPA allows the patient (or their estate) to pursue enhanced remedies, including uncapped non-economic damages, attorneys' fees and costs, and in some cases, punitive damages, which are not capped by MICRA. This distinction is crucial to maximizing recovery for vulnerable adults.

The Limits of Recovery: MICRA and Damage Caps

The Medical Injury Compensation Reform Act (MICRA) of 1975 has long been the defining and most controversial aspect of medical malpractice litigation in California.

Its primary intent was to stabilize malpractice insurance rates by limiting large jury awards.

MICRA and Damage Caps in California Medical Malpractice Cases

The AB 35 Modernization (Effective 2023): Assembly Bill 35 addressed the injustice of the cap remaining stagnant for nearly 50 years. It created three separate tracks for non-economic damages with different starting caps and annual increases:

1. Non-Death Cases: The cap starts higher (e.g., $350,000 in 2023) and increases by $40,000 annually until it reaches $750,000 in 2033.
2. Wrongful Death Cases: The cap starts higher (e.g., $500,000 in 2023) and increases by $50,000 annually until it reaches $1,000,000 in 2033.
3. Multiple Defendants: AB 35 permits a separate cap against three distinct categories of defendants (e.g., one cap against a negligent physician and a separate cap against a negligent hospital/institution), potentially allowing for a higher total recovery in complex cases.

After 2033, the caps will be subject to a 2% annual adjustment for inflation, a critical change absent from the original law.

Procedural Hurdles and Statute of Limitations

In addition to proving negligence, a plaintiff must clear strict procedural hurdles, most notably the Statute of Limitations.

Under California Code of Civil Procedure § 340.5, medical malpractice claims have a shorter filing window compared to other personal injury actions.

The Strict Time Limits

The general rule for filing a medical malpractice lawsuit is the earlier of:

1. One year after the plaintiff discovers, or through reasonable diligence should have discovered, the injury; OR
2. Three years after the date the injury occurred.

Key Exceptions:

• Fraud or Intentional Concealment: If the healthcare provider fraudulently hid the malpractice, the three-year limit is waived, and the patient has one year from the date of discovery to file.
• Foreign Objects: If a foreign body that has no therapeutic or diagnostic purpose (like a surgical sponge) is left in the patient, the three-year limit does not apply; the plaintiff has one year from the date of discovery to file the claim.
• Minors: For a minor under the age of six, the lawsuit must be filed within three years of the injury or before their eighth birthday, whichever provides a longer period. For minors aged six and older, the three-year clock is the general rule.

Emerging Legal Challenges in Modern Healthcare

The expansion of healthcare technology presents new challenges to the traditional definition of the standard of care.

Telemedicine Malpractice: Emerging Issues in California

The dramatic rise of telehealth has created a novel legal frontier.

Crucially, the standard of care for a provider conducting a remote visit is the same as an in-person visit. Telemedicine Malpractice claims often involve:

• Failure to Refer: A provider is negligent if they fail to recognize the limitations of a remote exam and do not refer the patient for necessary in-person care.
• Misdiagnosis: Errors in diagnosis caused by the inability to perform a hands-on physical exam or by poor video/audio quality.
• Jurisdictional Complexity: When the patient and provider are in different states, determining the proper court and applicable state law becomes a significant legal challenge.

In summary, Medical Malpractice in California is a complex area of law where the patient’s right to compensation for professional negligence is rigorously tested.

Success requires proving a breach of the medical standard of care, establishing a causal link to the injury, navigating a complex statute of limitations, and managing the significant limitations imposed on recovery by the evolving MICRA laws.

People Also Ask (FAQs)

What qualifies as medical malpractice in California?
Medical malpractice occurs when a healthcare provider breaches the standard of care owed to a patient, and that breach directly causes injury. This includes misdiagnosis, surgical mistakes, medication errors, and negligent aftercare.

How does MICRA affect medical malpractice cases in California?
The Medical Injury Compensation Reform Act (MICRA) limits non-economic damages in malpractice claims. Under AB 35 (effective 2023), caps are increasing gradually through 2033, with higher limits for wrongful death cases.

Can I sue for a misdiagnosis in California?
Yes. Misdiagnosis or delayed diagnosis can be malpractice if a reasonably competent doctor would have identified the condition earlier. The patient must prove that earlier treatment would likely have prevented harm.

What are examples of surgical malpractice in California?
Common examples include wrong-site surgery, anesthesia errors, nerve damage, or leaving foreign objects inside the patient. These clear deviations from the standard of care can support malpractice claims.

Are nursing home negligence claims considered medical malpractice?
Not always. If the harm stems from medical negligence (like a medication error), MICRA applies. If it involves elder abuse or neglect under California’s Elder Abuse and Dependent Adult Civil Protection Act (EADACPA), victims may recover enhanced damages beyond MICRA limits.

Does California recognize telemedicine malpractice?
Yes. The standard of care is the same as for in-person care. Telemedicine malpractice may involve misdiagnosis, failure to refer for in-person treatment, or jurisdictional issues when provider and patient are in different states.

What is the statute of limitations for medical malpractice in California?
Patients must generally file within one year of discovering the injury or three years from the date of injury, whichever comes first. Exceptions apply for fraud, concealment, foreign objects, or minors.