Justia Professional Malpractice & Ethics Opinion Summaries

Articles Posted in California Courts of Appeal
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Following a preliminary hearing, petitioner Dr. Sanjoy Banerjee was charged in an information with two counts of presenting a false or fraudulent health care claim to an insurer (a form of insurance fraud, counts 1-2), and three counts of perjury (counts 3-5). The superior court denied Banerjee’s motion to dismiss the information as unsupported by reasonable or probable cause. Banerjee petitioned for a writ of prohibition to direct the superior court to vacate its order denying his Penal Code section 995 motion and to issue an order setting aside the information. The Court of Appeal issued an order to show cause and an order staying further proceedings on the information, pending the Court's resolution of the merits of Banerjee’s petition. The State filed a return, and Banerjee filed a traverse. The State argued the evidence supported a strong suspicion that Banerjee committed two counts of insurance fraud and three counts of perjury, based on his violations of Labor Code section 139.3(a) between 2014 and 2016. During that period, Banerjee billed a workers’ compensation insurer for services he rendered to patients through his professional corporation and through two other legal entities he owned and controlled. The insurance fraud charges are based on Banerjee’s 2014-2016 billings to the insurer through the two other entities. The perjury charges were based on three instances in which Banerjee signed doctor’s reports, certifying under penalty of perjury that he had not violated “section 139.3.” Banerjee argued: (1) the evidence showed he did not violate the statute's referral prohibition; (2) even if he did not comply with section 139.3(e), the “physician’s office” exception to the referral prohibition applied to all of his referrals to his two other legal entities; and (3) the patient disclosure requirement of section 139.3(e), the referral prohibition of section 139.3(a), and the physician’s office exception to the referral prohibition were unconstitutionally vague. The Court of Appeal concluded: (1) Banerjee did not violate section 139.3(a) by referring his patients to his two other legal entities; and (2) the evidence supported a strong suspicion that Banerjee specifically intended to present false and fraudulent claims for health care benefits, in violation of Penal Code section 550(a)(6), by billing the workers’ compensation insurer substantially higher amounts through his two other legal entities than he previously and customarily billed the insurer for the same services he formerly rendered through his professional corporation and his former group practice. Thus, the Court granted the writ as to the perjury charges but denied it as to the insurance fraud charges. View "Banerjee v. Super. Ct." on Justia Law

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Plaintiff Sayedeh Sahba Amjadi appealed the dismissal entered after a settlement was entered by her attorney on her behalf and over her objection with defendant Jerrod West Brown, and appealed an order denying her subsequent motion to vacate the judgment. The settlement was entered by plaintiff’s attorney pursuant to a provision in the attorney’s contingent fee agreement, which purported to grant the attorney the right to accept settlement offers on the client’s behalf in the attorney’s “sole discretion,” so long as the attorney believed in good faith that the settlement offer was reasonable and in the client’s best interest. The Court of Appeal determined such a provision violated the Rules of Professional Conduct and was void to the extent it purported to grant an attorney the right to accept a settlement over the client’s objection. Accordingly, the Court held the settlement to be void and reversed the resulting judgment. The Court also referred plaintiff’s former attorneys to the State Bar for potential discipline, as required by law and by Canon 3D(2) of the Code of Judicial Ethics. View "Amjadi v. Brown" on Justia Law

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Plaintiff Brian Exline appealed an order granting defendant Lisa Gillmor’s special motion to strike under California's anti-SLAPP law. Exline filed a complaint against Gillmor alleging that, during her terms serving as a councilmember and then as the mayor of the City of Santa Clara (the City), Gillmor violated the Political Reform Act of 1974 (the Act) by failing to disclose on Form 700 filings her interest in, and income she received from, an entity known as Public Property Advisors. Exline argued his lawsuit was not subject to challenge under Code of Civil Procedure section 425.16 because it fell within the public interest exemption codified at section 425.17 (b). He contended the trial court erred by concluding that an exception to that exemption, set forth in section 425.17(d)(2) applied and rendered the exemption inapplicable. The Court of Appeal held the exception applied to completion of the Form 700, and the complaint in this case was therefore subject to the anti-SLAPP law. View "Exline v. Gillmor" on Justia Law

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Plaintiff filed suit against his criminal defense attorney for legal malpractice after he entered a plea of guilty to federal tax charges in United States District Court. Plaintiff alleged his attorney, Martin Schainbaum, negligently advised him to sign "closing agreements" by which he agreed to pay civil tax fraud penalties as part of the disposition of his criminal case. Plaintiff contended that but for Schainbaum's negligence, he would not have agreed to that obligation.The Court of Appeal found that the trial court properly sustained the demurrer without leave to amend because plaintiff failed to plead actual innocence, a necessary element of his cause of action for legal malpractice arising out of a criminal proceeding.The court explained that the civil penalties arose out of the criminal prosecution, as did any alleged legal malpractice attributable to Schainbaum. Furthermore, plaintiff was required to allege actual innocence. Under Coscia v. McKenna & Cuneo (2001) 25 Cal.4th 1194, 1200, plaintiff was required to obtain exoneration of his guilt as a prerequisite to proving actual innocence in his malpractice action against his former criminal defense counsel, which he failed to do so. Therefore, the demurrer was properly sustained and the court affirmed the judgment. View "Genis v. Schainbaum" on Justia Law

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Plaintiff Rodney Davis, a physician assistant, learned to perform liposuction under the guidance of a physician. Davis grew dissatisfied with the physician for whom he worked, so he decided to establish a new practice. To do so, Davis needed a physician to serve as his supervising physician. Davis found Dr. Jerrell Borup, who had been an anesthesiologist for 18 years, but who had not practiced medicine for 12 years. Before meeting Davis, Borup had never performed liposuction or other surgery. Borup agreed to serve as “Medical Director,” although he would never perform a procedure at the new practice. Borup’s role, in practice, consisted of reviewing charts. Davis, who gave himself the title of “Director of Surgery,” would perform all of the liposuction procedures. Davis opened his practice, Pacific Liposculpture, in September 2010. In 2015, the Physician Assistant Board (the Board) filed an accusation accusing Davis of, among other things, the unlicensed practice of medicine, gross negligence, repeated negligent acts, and false and/or misleading advertising. An administrative law judge (ALJ) found the Board’s accusations were established by clear and convincing evidence, and recommended the revocation of Davis’s license. The Board adopted the ALJ’s findings and recommendations. Davis filed a petition for a writ of administrative mandamus seeking, inter alia, a writ compelling the Board to set aside its decision. The trial court denied the petition. On appeal, Davis argued the ALJ erred in finding that he committed the various acts alleged, and that the findings were not supported by substantial evidence. He further claimed that the discipline imposed constituted a manifest abuse of discretion. Finding no reversible error, the Court of Appeal affirmed. View "Davis v. Physician Assistant Board" on Justia Law

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D.C. was employed by Applied, 1996-2008, and claimed three industrial injuries: a specific injury to her neck and right upper extremity in 2001, a specific injury to her neck and both upper extremities in 2005, and a cumulative trauma injury to her neck, both upper extremities, and psyche ending on her last day working. D.C. claimed her injuries were due to the constant use of a computer keyboard. In 2006, she developed a pain disorder, anxiety, and depression, which she claimed were compensable consequences of her physical injuries. She later claimed that she was sexually exploited by Dr. Massey, the physician primarily responsible for the treatment of her industrial injuries. D.C. was diagnosed with PTSD. Applied's workers’ compensation carriers disputed liability for her psychiatric injuries.A workers’ compensation judge found that all of D.C.’s injury claims were industrial; awarded D.C. 100 percent permanent disability (PD) based on her PTSD alone; found no apportionment; and concluded that the insurers were jointly and severally liable for that award since Dr. Massey treated all three of her industrial injuries. The Workers’ Compensation Appeals Board generally affirmed.The court of appeal concluded there was substantial evidence of repeated exposure to injury-causing events and new injuries after 2005 that supported the finding of cumulative trauma ending in 2008. D.C. met her burden of proving that her PTSD was a compensable consequence injury that resulted from the treatment for her industrial injuries and that her employment was a contributing cause; as a matter of law, a patient cannot consent to sexual contact with her physician. The court rejected several challenges to the sufficiency of the evidence. The 100 percent PD award must be annulled as based on an incorrect legal theory, the alternative path theory. View "Applied Materials v. Workers' Compensation Appeals Board" on Justia Law

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Jensen was charged as a coconspirator in a felony indictment alleging a scheme under which members of the Santa Clara County Sheriff’s Department issued hard-to-obtain concealed firearms permits in exchange for substantial donations to an independent expenditure committee supporting the reelection campaign of Sheriff Smith. Jensen is a sheriff’s department captain identified as the individual within the sheriff’s department who facilitated the conspiracy. Jensen unsuccessfully moved to disqualify the Santa Clara County District Attorney’s Office from prosecuting him, alleging that that office leaked grand jury transcripts to the press days before the transcripts became public which created a conflict of interest requiring disqualification. He also joined in codefendant Schumb’s motion to disqualify the office due to Schumb’s friendship with District Attorney Rosen and Rosen’s chief assistant, Boyarsky.The court of appeal rejected Jensen’s arguments for finding a conflict of interest requiring disqualification: the grand jury transcript leak, Schumb’s relationships with Rosen and Boyarsky, and a dispute between Rosen and Sheriff Smith about access to recordings of county jail inmate phone calls. The trial court could reasonably conclude Jensen did not demonstrate that the district attorney’s office was the source of the leak. Jensen himself does not have a personal relationship with Rosen or Boyarsky. The trial court could reasonably conclude that Jensen did not establish a conflict of interest based on the existence of a dispute between the district attorney and the elected official with supervisory power over Jensen. View "Jensen v. Superior Court" on Justia Law

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Schumb was charged as a coconspirator in a felony indictment alleging a quid pro quo scheme in which members of the Santa Clara County Sheriff’s Department issued hard-to-obtain concealed firearms permits in exchange for substantial monetary donations to the reelection campaign of Sheriff Smith. Schumb is an attorney with a history of fundraising for elected officials; he accepted the donations as a treasurer of an independent expenditure committee supporting Sheriff Smith’s reelection. Schumb is a friend of Rosen, the elected Santa Clara County District Attorney, and previously raised funds for Rosen’s campaigns.Schumb unsuccessfully moved to disqualify the Santa Clara County District Attorney’s Office from prosecuting him, arguing that his friendships with Rosen and Rosen’s chief assistant, Boyarsky, created a conflict of interest making it unlikely Schumb would receive a fair trial. Schumb asserted that he intends to call Rosen and Boyarsky as both fact and character witnesses at trial and. despite their personal connections to the case, neither Rosen nor Boyarsky made any effort to create an ethical wall between themselves and the attorneys prosecuting the case. The court of appeal vacated and directed the lower court to enter a new order disqualifying the Santa Clara County District Attorney’s Office in Schumb's prosecution. View "Schumb v. Superior Court" on Justia Law

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Plaintiff and his medical corporation appeal from the trial court's order of his motion for a preliminary injunction against CVS. In June 2020, CVS stopped filling plaintiff's prescriptions for controlled substances for his patients, citing concerns about his prescribing patterns. The trial court denied the injunction on several grounds, including the conclusion that plaintiff should have first sought relief from the California State Board of Pharmacy (Board).The Court of Appeal affirmed the trial court's conclusion, which was based on the doctrine of exhaustion of administrative remedies, on the alternative, but closely related ground under the doctrine of primary jurisdiction. In this case, the Board has primary jurisdiction to consider the particular statutory obligations underlying plaintiff's injunction motion. The court concluded that the trial court correctly recognized that an order requiring CVS to honor particular prescriptions would involve judgments concerning the statutory obligations of pharmacists that the Board is both expected and equipped to resolve. Furthermore, the Board is also empowered to issue an abatement order, if warranted, that would perform the equivalent role of an injunction in providing the relief that plaintiff seeks. Accordingly, the trial court reasonably ruled that plaintiff should first seek relief from the Board before pursuing his claims in court. View "Bradley v. CVS Pharmacy, Inc." on Justia Law

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Appellant Sekayi White was an incarcerated and self-represented plaintiff who filed suit after his criminal defense lawyer, respondent Michael Molfetta, failed to respond to repeated requests for his case file. Having exhausted all avenues of direct state appeal of his conviction, White wanted to use the file to help him prepare petitions for collateral habeas relief. Molfetta received White’s letters, but believed he was prohibited from producing the file because it included protected materials. Instead of explaining the problem directly to his former client and producing the unprotected parts of the file, Molfetta effectively ignored the letters. Molfetta produced the file, minus protected materials, only after being ordered to do so by the trial judge in the underlying litigation here. By the time of the production, White’s deadline to file a federal petition for writ of habeas corpus had expired; his petition in the state court was also denied. White sued to recoup the money he spent reconstructing the file, later asking for emotional distress damages. He got neither. The Court of Appeal affirmed the trial court’s judgment in Molfetta’s favor, “but we publish in the hope the embarrassment we feel about the case can lead to improvement. … absent a miscarriage of justice (of which we have no evidence here) our moral and professional assessments, however deeply felt, cannot create a cause of action in tort. As explained herein, we must agree with the trial court: White failed to adequately plead and prove injury from Molfetta’s wrongful behavior.” View "White v. Molfetta" on Justia Law