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Julian v. Mission Community Hospital

California Court of Appeals, Second District, Seventh Division

May 2, 2017

KATIA JULIAN, Plaintiff and Appellant,
MISSION COMMUNITY HOSPITAL et al., Defendants and Respondents.

         APPEAL from a judgment of the Superior Court of Los Angeles County No. LC100529 Frank J. Johnson, Judge. Affirmed.

          Law Office of Gary Brown and Gary Brown for Plaintiff and Appellant.

          Cole Pedroza, Kenneth R. Pedroza, E. Todd Chayet; Reback, McAndrews, Kjar, Warford & Stockalper, Thomas F. McAndrews and Tracy D. Hughes for Defendants and Respondents Mission Community Hospital and Deanco Healthcare, LLC.

          Bonne, Bridges, Mueller, O'Keefe & Nichols, David J. O'Keefe, Thomas M. O'Neil, Michael Vincent Ruocco and Gary Dennis for Defendant and Respondent Abdul Shirazi, M.D.

          Lynberg & Watkins, Gary A. Bacio and Christopher P. Bates for Defendants and Respondents Los Angeles Unified School District, Los Angeles Unified School Police, Libier Valencia, Yvonne Miranda, Elizabeth Lara, Jose Cardenas, and Robert Taylor.

          SEGAL, J.


         This action arises out of a series of events that began at a Los Angeles middle school, where Katia Julian taught mathematics, and ended at Mission Community Hospital, where Julian was involuntarily detained for mental health evaluation and treatment. After her release, Julian sued the Los Angeles Unified School District (LAUSD), the Los Angeles Unified School Police (LAUSP), and five individual police officers (collectively, the school defendants) who detained her and helped transport her to the hospital. She alleged the school defendants did not have probable cause under Welfare and Institutions Code section 5150 to detain her.[1] Julian also sued the hospital (Mission Community Hospital), its owner (Deanco Healthcare, LLC), and the physician who treated her there (Dr. Abdul Shirazi) (collectively, the hospital defendants), alleging they lacked probable cause to continue to detain her and to admit her to the hospital where she spent one night before she was released the next day.

         Julian's operative third amended complaint sought monetary damages for various alleged violations of the Lanterman-Petris-Short Act (section 5000 et seq.) (the Act) and of her civil rights under the federal and state constitutions. The trial court sustained the hospital defendants' demurrers to Julian's third amended complaint and granted the school defendants' motion for summary judgment.

         We conclude there is no private right of action for the violations of the Act Julian alleged. We also conclude the school district and the school police are immune from liability under Title 42 United States Code section 1983 (section 1983), the individual officers are entitled to qualified immunity, the hospital and physician are not state actors for purposes of Julian's section 1983 claims, most of the provisions of the California Constitution Julian invoked do not create causes of action for damages, and Julian failed to state a claim for violations of those provisions that might provide such a cause of action. Finally, because the hospital defendants are not state actors for purposes of section 1983, they cannot be liable for Julian's alleged violations of the California Constitution. Therefore, we affirm.


         A. The School Police Detain Julian

         On May 1, 2012 Julian attended a mathematics department meeting in a classroom at the middle school where she taught.[2] Julian claimed that at the end of the meeting another teacher “physically assaulted” her by grabbing her hand as she tried to close the door to the classroom. Julian reported the alleged assault to the school's principal, Nidia Castro, who told Julian she would report the incident to the school police. Julian asked Castro not to report the incident to the school police because, as Castro knew, Julian had “a severe nervous reaction” to the school police stemming from earlier incidents. Castro also knew Julian had a “seizure disorder that was exacerbated by extreme stress.”

         That evening Castro received a text message from Julian's close friend, Jackie Ibrahim, another teacher at the school who had been discussing with Julian some recent changes at the school. The message read, “Wow I finally convinced Katia to stay and now you throw me this curve ball--it seems the situation changes each day... you really got our hopes up and now you are going back on what you said. I want to throw up and Katia wants to slit her wrists.” Castro responded, “I am concerned about the line ‘Katia wants to slit her wri[s]ts' do I need to send someone to her? Are you with her? Will she be okay? This entire process has been very chaotic and has not been easy for me either. Just hang in there.” Ibrahim informed Castro she was with Julian, and Castro took no further action at that time.

         The following morning Castro met with Julian on an unrelated matter and recorded in her notes that they had “a very relaxed, friendly conversation.” Despite Julian's request that Castro not report the alleged assault to the school police, Castro believed “a report needed to be made, ” so she sought advice from a superior who suggested she speak with someone in the office of crisis counseling. Castro explained to the crisis counselor that she knew she had a responsibility to address Julian's claim of a physical assault but wanted to be sensitive to her fear of the school police. Castro also explained she needed to be “extra sensitive” in light of Ibrahim's text stating that Julian wanted to slit her wrists. The crisis counselor reminded Castro of her “responsibility for employee safety” and advised her to follow the guidelines governing workplace violence.

         Castro reported the alleged assault to Officer Libier Valencia, a school police officer assigned to the middle school, even though Castro knew Julian disliked Officer Valencia. While Castro was discussing the situation with Officer Valencia, the crisis counselor, Karen Miller, called Castro with additional questions about Julian. During this conversation, Castro and Officer Valencia revealed that Julian had scratches on her forearms Julian had told Castro were caused by her cats and that Julian had expressed a need for “revenge” against yet another teacher who had crossed her. All of the participants in this conversation agreed they needed additional information from Julian about the alleged assault, and, because Castro and Officer Valencia knew Julian would not want to speak to Officer Valencia, they requested another officer question Julian. Sergeant Robert Taylor, Officer Valencia's superior officer, eventually arrived to question her.

         Before questioning Julian, Sergeant Taylor called Miller for more information. Miller told Sergeant Taylor she was concerned about Julian's mental stability because Julian had recently lost a different lawsuit against the school district and had told her best friend she was going to “slit her wrists.” Miller impressed upon Sergeant Taylor that Julian might be suicidal. Sergeant Taylor requested additional officers for backup, including Officers Yvonne Miranda, Elizabeth Lara, and Jose Cardenas.

         Aware of Julian's previous encounters with Officer Valencia, Sergeant Taylor and Castro agreed that Castro would make initial contact with Julian and explain to her Sergeant Taylor was there to interview her about the alleged assault. The other officers remained in a conference room nearby while Castro approached Julian with Sergeant Taylor behind her. Castro told Julian the officer was there to “take her report.” In response, Julian ran down the hallway and placed herself between a student desk and a copier. She told Sergeant Taylor she did not want to talk to him, began crying and screaming, and dropped or slid to the floor with her back against the wall. Another school administrator came out of her office, told Castro she had seen Julian do something similar before, and offered to take Julian into her office so she could calm down. Castro declined her offer because Julian continued screaming “get away from me” and Castro did not know at whom Julian was screaming.

         According to Castro's notes, which Julian submitted in opposition to the school defendants' motion for summary judgment (and which the parties refer to as the “Castro timeline”), Sergeant Taylor asked Julian to “calm down” and told her “she [w]as safe.” Julian began “screaming even louder.” As Officer Valencia approached, Julian continued screaming, “Get away from me.” Castro crouched down in front of Julian and told her she would not leave her alone with the officers and they would not harm her, while Sergeant Taylor remained four or five feet away. Julian told Castro she was afraid Sergeant Taylor was going to hurt her, and Castro told her that “all he wanted was to get her statement regarding her allegations of physical assault.” Julian said Sergeant Taylor “was [taking] her freedom away.” Castro asked Sergeant Taylor to leave her alone with Julian, but he said he could not do that. Sergeant Taylor stated that, “due to [Julian's] state and reactions, he was going to call paramedics, ” at which point Julian yelled she had done nothing wrong and continued to scream “leave” and “get away from me.”

         While waiting for the ambulance to arrive, Julian reached for her phone inside a small bag beside her. Not knowing what Julian was reaching for, Sergeant Taylor approached, knelt down, and turned Julian around to handcuff her. Julian resisted, and Sergeant Taylor called the other officers to assist. Officer Miranda attempted to control the growing crowd of students, employees, and parents in the area. Julian continued to scream, struggled with the officers, and complained after she had been handcuffed that her back hurt. Julian asked Castro to take her phone from her bag and call her attorney, but Castro was unable to call him before the ambulance arrived.

         When the paramedics arrived, they attempted to move Julian to a gurney, but she resisted and said to Castro, “Do you see what they are doing to me?” Another administrator told Julian to cooperate, but Castro noted the more the paramedics asked Julian to calm down “the angrier she became.” Eventually the paramedics secured Julian on a gurney and transported her to Mission Community Hospital, approximately one block from the school.

         B. The Hospital Detains Julian

         Upon arriving at the hospital, Julian continued “to thrash and try to slide off the [g]urney.” Officer Valencia gave the hospital a completed Application for 72-Hour Detention for Evaluation and Treatment form pursuant to section 5150. The application stated Julian “went out of control, throwing herself to the floor” when the school police contacted her about a criminal investigation, and Julian “made statements to [an]other school staff member that she wanted to cut her wrist.” The section 5150 application further stated: “She has 6 to 8 cuts on the right & left wrist. Mrs. Julian came into a crawling position and was screaming out of control.” The document concluded, “Based upon the above information it appears that there is probable cause to believe that [Julian] is, as a result of mental disorder[, a] danger to... herself [and a] danger to others.” Julian calmed down after approximately 15 minutes in the hospital, and the paramedics asked the officers to remove the handcuffs.

         Dr. Daniel Moghadam initially examined Julian. Julian alleged he ignored the “cat scratches” on her arms, failed to investigate her seizure disorder, and “erroneously accepted” the information in the section 5150 form from the school police. Dr. Moghadam transferred Julian to the Behavioral Health Unit. Julian alleged the hospital held her there an “unnecessarily long time, ” and she never received a proper examination by a qualified individual designated by the hospital pursuant to the Welfare and Institutions Code. Instead, she alleged, Dr. Shirazi, who was not a board certified psychiatrist or designated by the hospital to detain persons with possible mental disorders, telephonically ordered Julian's detention for up to 72 hours and “illegally prescribed anti-psychotic medications” without examining her or obtaining her informed consent.

         Although the chronology of events in Julian's allegations is unclear, she appears to have alleged that, after her detention, another doctor, “who was not qualified to do an assessment and yet improperly diagnosed an acute psychosis, noted but did not investigate a seizure disorder, and also failed to notice the lack of cuts on her arms.” After Julian spent the night in the hospital, Dr. Shirazi personally examined her the next day and released her. Julian alleged, “Had the hospital protocol required the physician to undertake a careful examination of [her]... [she] would have been rejected as a detainee.”

         C. Julian Sues the School Defendants and the Hospital Defendants

         Julian sued the school defendants and the hospital defendants for violations of the Act, violations of her civil rights under section 1983 and the California Constitution, false imprisonment, intentional infliction of emotional distress, and medical negligence. The trial court sustained demurrers by all of the defendants, and Julian eventually filed the operative third amended complaint. That complaint did not include causes of action for intentional infliction of emotional distress or medical negligence.[3]

         The school defendants answered the third amended complaint and filed a motion for summary judgment or in the alternative summary adjudication. The hospital defendants demurred again.

         Following a hearing on the demurrers and the motion for summary judgment, the trial court granted the school defendants' motion for summary judgment. With regard to Julian's first cause of action for violations of the Act, the court ruled the school defendants were immune from liability because they properly exercised their authority to place Julian on a 72-hour hold. In particular, the court stated Julian's “behavior was bizarre and the [school defendants] are not required to make a definitive prognosis of [Julian's] mental health” before detaining her. With regard to Julian's civil rights claims, the court found the school defendants enjoyed qualified immunity and “undisputed supporting evidence supported the actions of the [school defendants'] authority under the law” to detain Julian. The court also found the school defendants were immune from liability for civil rights violations under the California Constitution pursuant to Government Code section 821.6. Counsel for Julian abandoned the false imprisonment cause of action by acknowledging it was “no longer viable.”

         On the demurrers by the hospital defendants, the court ruled the third amended complaint failed to state facts sufficient to constitute causes of action. The court found the third amended complaint was not significantly different from the “prior iterations of the complaint.” With regard to the cause of action for statutory violations, the court stated “the pleading suffers from the same shortcomings as that in the [second] amended complaint without new facts or law presented.”[4] On Julian's causes of action for civil rights violations, the court ruled the complaint failed “to show how Dr. Shirazi, or the hospital, acted under the color of law or had any role in violating [Julian's] civil rights.” Julian again conceded her cause of action for false imprisonment was not viable and withdrew it. The court sustained the demurrers without leave to amend.[5] Julian timely appealed from the ensuing judgment.


         A. 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.' [Citation.] We review a grant of summary judgment de novo and decide independently whether the facts not subject to triable dispute warrant judgment for the moving party as a matter of law. [Citations.] The evidence must be viewed in the light most favorable to the nonmoving party.” (Samara v. Matar (2017) 8 Cal.App.5th 796, 802-803; see Code Civ. Proc., § 437c, subd. (c); Biancalana v. T.D. Service Co. (2013) 56 Cal.4th 807, 813; Drexler v. Petersen (2016) 4 Cal.App.5th 1181, 1188.) “A triable issue of material fact exists where ‘the evidence would allow a reasonable trier of fact to find the underlying fact in favor of the party opposing the motion in accordance with the applicable standard of proof.'” (Jade Fashion & Co., Inc. v. Harkham Industries, Inc. (2014) 229 Cal.App.4th 635, 643.) We may affirm a summary judgment if it is correct on any of the grounds asserted in the trial court, regardless of the trial court's stated reasons. (Grebing v. 24 Hour Fitness USA, Inc. (2015) 234 Cal.App.4th 631, 637.)

         We review the trial court's order sustaining the hospital defendants' demurrers de novo. (See Eckler v. Neutrogena Corp. (2015) 238 Cal.App.4th 433, 438; Lewis v. Safeway, Inc. (2015) 235 Cal.App.4th 385, 390-391.) In so doing, we exercise our “‘independent judgment about whether the complaint states a cause of action as a matter of law.'” (Eckler, at p. 438.) We assume the truth of all properly pleaded facts, but we do not assume the truth of contentions, deductions, or conclusions of fact or law. (Lyles v. Sangadeo-Patel (2014) 225 Cal.App.4th 759, 764; see Eckler, at p. 438.) We review questions of statutory interpretation de novo. (John v. Superior Court (2016) 63 Cal.4th 91, 95; Even Zohar Const. & Remodeling, Inc. v. Bellaire Townhouses, LLC (2015) 61 Cal.4th 830, 837.)

         “‘If a demurrer is sustained, we exercise our independent judgment on whether a cause of action has been stated as a matter of law, regardless of reasons stated by the trial court. [Citation.] We affirm if the trial court's decision was correct on any theory.'” (Schermer v. Tatum (2016) 245 Cal.App.4th 912, 923; see Ivanoff v. Bank of America, N.A. (2017) 9 Cal.App.5th 719, 732, fn. 2 [“appellate court must affirm if the trial court's decision to sustain the demurrer was correct on any theory”].)

         B. The Lanterman-Petris-Short Act

         The Legislature enacted the Act in 1967 to govern the involuntary commitment of mentally disordered persons. (Stats. 1967, ch. 1667, § 36, p. 4074; State Dept. of Public Health v. Superior Court (2015) 60 Cal.4th 940, 952; Coburn v. Sievert (2005) 133 Cal.App.4th 1483, 1492.) One of the purposes of the Act is to provide “prompt evaluation and treatment of persons with mental health disorders or impaired by chronic alcoholism.” (§ 5001, subd. (b).) This purpose “reflects the unfortunate reality that mental illness in its most acute form can pose a danger to the individuals themselves or others that requires immediate attention. To achieve this purpose, a number of [the] Act['s] provisions allow a person to be removed from the general population in order to be civilly committed based on a probable cause determination made by a mental health or law enforcement professional, and then to challenge the civil commitment within a reasonable time afterwards.” (Cooley v. Superior Court (2002) 29 Cal.4th 228, 253-254.)

         The Act safeguards the rights of the involuntarily committed through judicial review. (See § 5001; Sorenson v. Superior Court (2013) 219 Cal.App.4th 409, 423.) For example, the Act limits involuntary commitment to successive periods of increasingly longer duration, beginning with a 72-hour detention for evaluation and treatment. (§ 5150; Sorenson, at p. 423.) Commitments longer than the initial 72-hour detention require a certification hearing before an appointed hearing officer to determine whether there is probable cause for confinement, unless the detainee has filed a petition for writ of habeas corpus. (§§ 5256, 5256.1, 5262, 5270.15, 5275, 5276; see Sorenson, at pp. 423-424.) A 180-day commitment requires a court order. (§ 5301.)

         Section 5150, the statute primarily at issue in this case, allows law enforcement officers and various medical professionals to bring an individual to an appropriate facility for assessment, evaluation, and treatment for up to 72 hours where there is “‘probable cause to believe that the person is, as a result of mental disorder, a danger to others, or to himself or herself, or gravely disabled.'” (Jacobs v. Grossmont Hospital (2003) 108 Cal.App.4th 69');">108 Cal.App.4th 69, 74;see Coburn, supra, 133 Cal.App.4th at p. 1493.) “A broad range of personnel-including peace officers, members of the staff of the evaluation facility, designated members of a mobile crisis team, and other professional persons designated by the county-can initiate the placement of a mentally disordered person for the 72-hour evaluation.” (Coburn, at p. 1493; see Ford v. Norton (2001) 89 Cal.App.4th 974, 979.)

         When a peace officer takes a person into custody under section 5150 and presents that person to a facility designated by the county for evaluation and treatment, the officer must provide a written application describing the circumstances that brought the person's condition to the officer's attention and stating the officer “has probable cause to believe that the person is, as a result of a mental health disorder, a danger to others, or to himself or herself, or gravely disabled.” (§ 5150, subd. (e).) In determining whether there is probable cause, a person authorized to make that determination may consider “available relevant information about the historical course of the person's mental disorder” (§ 5150.05, subd. (a)) and “shall not be limited to consideration of the danger of imminent harm” (§ 5150, subd. (b)).[6]

         Before admitting a person into a designated facility, “the professional person in charge of the facility or his or her designee shall assess the individual in person to determine the appropriateness of the involuntary detention.” (§ 5151.) “If, in the judgment of the professional person in charge of the facility designated by the county for evaluation and treatment [or other authorized individuals] the person cannot be properly served without being detained, the admitting facility shall require an application in writing stating the circumstances under which the person's condition was called to the [facility's] attention... and stating that [the facility] has probable cause [to detain the person].” (§ 5150, subd. (e).) “Once admitted to a facility for a 72-hour detention, the detainee ‘shall receive an evaluation as soon after he or she is admitted as possible.' (§§ 5152, subd. (a), 5008, subd. (a) [‘evaluation' defined].) In addition, the detainee ‘shall receive whatever treatment and care his or her condition requires for the full period that he or she is held.' (§ 5152, subd. (a).) A person subject to 72-hour detention can be released early, released after the lapse of 72 hours, certified for an additional 14 days of intensive treatment, or placed under the control of an appointed conservator. (§§ 5152, subds. (a) & (b), 5250.) An early release from a 72-hour commitment may occur ‘only if... the psychiatrist directly responsible for the person's treatment believes, as a result of his or her personal observations, that the person no longer requires evaluation or treatment.' (§§ 5152, subd. (a) [mentally disordered persons], 5172, subd. (a) [inebriated persons].)” (Coburn, supra, 133 Cal.App.4th at p. 1493; see Ford, supra, 89 Cal.App.4th at p. 979.)

         “Consistent with the goals of the [Act], the decision to detain a person involuntarily for 72 hours requires the careful exercise of judgment in evaluating whether, as a result of mental disorder, a person poses a danger to others, or to himself or herself.” (Jacobs, supra, 108 Cal.App.4th at pp. 75-76.) Section 5278 provides immunity to individuals who exercise this authority in accordance with the law. This immunity “allows individuals authorized to detain a person for 72-hour treatment and evaluation to make that decision without fear of exposure to criminal or civil liability.” (Jacobs, at p. 76.) “The prospect of liability for initiating a 72-hour hold would frustrate and impede the Legislature's intent to provide prompt evaluation and treatment for the mentally ill and to ensure public safety. Thus, the immunity of section 5278 necessarily applies to individuals or entities who make the decision to detain, when that decision is supported by probable cause.” (Ibid.; see Cruze v. National Psychiatric Services, Inc. (2003) 105 Cal.App.4th 48');">105 Cal.App.4th 48, 56 [section 5278 applies to individuals and entities].)

         C. The Act Does Not Create a Private Right of Action for the Violations Alleged by Julian

         Julian titled her first cause of action “Statutory Violations Against All Police and Physician and the Hospital Defendants.” In her the third amended complaint Julian listed a variety of alleged violations of the Act, including that the police officers “concocted a situation and falsely reported probable cause pursuant to [sections] 5150, 5157 and 5328, ” and she alleged the hospital defendants “failed to review the false statement of probable cause submitted by the police defendants and determine the obvious point that [Julian] did not meet the criteria for detention and should have been rejected immediately as required by [sections] 5150, 5150.05, and 5151.” Julian also alleged the hospital defendants failed to assess and evaluate her in accordance with sections 5150, subdivision (b), 5150.4, and 5152, subdivision (a), and failed to provide her with a written statement of her rights pursuant to section 5325. With regard to Dr. Shirazi, Julian alleged he should not have treated her because he was not designated by the hospital at that time to assess potential detainees, he failed to assess and evaluate her as soon as possible after her admission pursuant to sections 5150, subdivision (b), 5150.4, and 5152, subdivision (a), and he prescribed medication contrary to the requirements of sections 5325.2, 5326.2, 5326.5, 5327, and 5332.

         The hospital defendants argue the Act does not create a private right of action for these violations. The hospital defendants (and the school defendants), however, did not raise this issue in the trial court, and the trial court's order sustaining the hospital defendants' demurrers did not address it. We may nevertheless consider an issue raised for the first time on appeal “‘when [it] involves purely a legal question which rests on an uncontraverted record which could not have been altered by the presentation of additional evidence.'” (Noe v. Superior Court (2015) 237 Cal.App.4th 316, 335; accord, Sanowicz v. Bacal (2015) 234 Cal.App.4th 1027, 1042-1043; Kramer v. Intuit Inc. (2004) 121 Cal.App.4th 574, 578; see Ivanoff v. Bank of America, N.A., supra, 9 Cal.App.5th at p. 732, fn. 2 [“[a]lthough ...

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