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Estate of Ursua v. Alameda County Medical Center

November 9, 2005



The opinion of the court was delivered by: Bernard Zimmerman United States Magistrate Judge

Plaintiffs, the estate and family of Dr. Erlinda Ursua, filed this action pursuant to 42 U.S.C. § 1983 against defendant Alameda County Medical Center (the "Medical Center"), alleging a violation of Dr. Erlinda Ursua's Fourteenth Amendment rights. They also sued Alameda County (the "County") and ABC Security Service, Inc. ("ABC") for negligence.*fn1 Now before me is the County's motion for summary judgment. For a full description of the material facts, see the Order Granting Defendant Alameda County Medical Center's Motion for Summary Judgment.

In response to plaintiffs' claim, the County has asserted design immunity under California Government Code § 830.6. Design immunity is a complete affirmative defense to plaintiff's negligence claim. If the County demonstrates it is entitled to design immunity, recovery may be denied regardless of the evidence presented relating to a defective design. Bane v. State of California, 208 Cal. App. 3d 860, 866 (1989). Whether a public body is entitled to design immunity is a question of law for the court to decide. Mozzetti v. City of Brisbane, 67 Cal. App. 3d 565, 573 (1977).

The three elements of design immunity are: (1) the causal relationship between the design and the accident; (2) the discretionary approval of the design prior to construction; and (3) substantial evidence supporting the reasonableness of the design. Hefner v. County of Sacramento, 197 Cal. App. 3d 1007, 1014 (1988). The County bears the burden of establishing all of the elements. Mozzetti, 67 Cal. App. 3d at 574.

Plaintiffs and the County agree on the first element of design immunity; there was a causal relationship. Plaintiff contends that the defective design of the John George Psychiatric Pavilion (the "JGPP"), in particular, the isolation of Room B18 (also known as Room 1319), where Dr. Ursua conducted the history and examination of Pavon, contributed to Dr. Ursua's death (Joint Statement of Undisputed Facts ("UF") 16-17). The second element is also established. It is undisputed that the Board of Supervisors of Alameda County approved as recommended the design of the JGPP, which included the location and placement of Room B18 and the presence of the panic button in Room B18, by resolution R-89-123 (UF 20; Wilson Decl., Exh. A, Summary Action Minutes at 3).

Plaintiffs dispute the County has satisfied the third element of design immunity, that substantial evidence supports the reasonableness of the design.*fn2 Plaintiffs argue that the County must show the architects or other decision-makers specifically discussed and approved the safety and location of Room B18. I disagree. Requiring discussion and consideration of the safety of each room in the JGPP to show reasonableness of the design is not only impractical, it runs counter to the rationale behind design immunity.

As for plaintiffs' arguments regarding the substantial evidence of the reasonableness of the design, I focus on two points. First, the presence of panic buttons in the rooms is evidence that the architects did consider staff safety, as well as other objectives of staffing, space and cost efficiencies and effective treatment, in designing the building.

Second, the Court can find no authority to support plaintiffs' contention that substantial evidence of reasonableness must include evidence that the specific risks of which plaintiffs now complain were considered. Most design immunity cases, in fact, seem to defer to the judgment and approval of the public body or municipality without any requirements on the detail, form and substance of approval or reasonableness. See Bay Area Rapid Transit Dist. v. Superior Court, 46 Cal. App. 4th 476 (1996); Higgins v. State of California, 54 Cal. App. 4th 177 (1997). Where the courts have denied the defense of design immunity, some violation of guidelines or standards existed. See Hernandez v. Dept. of Transportation, 114 Cal. App. 4th 476 (2004)(involving a design that violated Caltrans' own guardrail-installation guidelines); Levin v. State of California, 146 Cal. App. 3d 410 (1983)(reversing summary judgment because a steep embankment slope was not reflected in the design plan and did not conform to the state's own standards).*fn3

In the instant case, multiple agencies approved the design of the JGPP. The County's Department of Public Works reviewed and approved the proposed plans showing the placement of Room B18 and the panic button in Room B18 (UF 22; Wilson Decl., Exh. A, Public Works Agency Letter). After the approval of the Board of Supervisors, the Office of Statewide Health Planning and Development, the Office of the State Architect and the State Fire Marshall approved the JGPP plans (Nash Decl. ¶ 4). There is no evidence that the County violated any laws, codes or regulations in designing the JGPP. The design "did not violate any existing standard of care" and "[t]here are no federal or state codes, regulations or standards which dictate the placement of an exam room in a facility such as JGPP or prohibit the configuration which was designed in this case" (UF 23-24).

Moreover, the issue is not whether the design could be found to be unreasonable, but "whether there is any reasonable basis on which a reasonable public official could initially have approved the design" (emphasis in original). Compton v. City of Santee, 12 Cal. App. 4th 591, 597 (1993). Assuming there is a foundation for the reasonableness of a design, the public body should get the benefit of the defense of design immunity. See Cameron v. State of California, 7 Cal. 3d 318, 326 (1972)("[T]o permit reexamination in tort litigation of particular discretionary decisions where reasonable men may differ as to how the discretion should be exercised would create too great a danger of impolitic interference with the freedom of decision-making by those public officials in whom the function of making such decisions has been vested.") The legislature is clear; the courts are not to reweigh reasonable decisions made by public bodies which approved the design. Bane, 208 Cal. App. 3d at 866. The County has established the third element of design immunity. Substantial evidence of the reasonableness of the design of the JGPP exists.*fn4

Because Alameda County has satisfied its burden and established that it is entitled to the defense of design immunity, IT IS ORDERED that its motion for summary judgment is GRANTED.

Dated: November ...

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