Preview
1 Adam Feldman, Esq. (SBN: 333667)
Adam Feldman Law, APC
2 adam@adamfeldmanlaw.com
3 info@adamfeldmanlaw.com
5850 Canoga Avenue, Suite 400
4 Woodland Hills, CA 91367
T: 818-710-3833 | F: 818-710-3802
5
6 Attorney for Plaintiff:
Gabriela Anacona through
7 her guardian ad litem
Denisse Anacona Martinez
8
9 SUPERIOR COURT OF STATE OF CALIFORNIA
10 FOR THE COUNTY OF SANTA BARBARA
11
12 GABRIELA ANACONA through her guardian Case No.:
ad litem DENISSE ANACONA MARTINEZ, an
13 individual, COMPLAINT FOR DAMAGES:
14
1. MEDICAL NEGLIGENCE
15 Plaintiff, 2. ELDER ABUSE/NEGLECT
16 DEMAND FOR A JURY TRIAL
17 v.
[AMOUNT DEMANDED EXCEEDS $35,000]
18
DIGNITY HEALTH dba MARIAN REGIONAL
19 MEDICAL CENTER, AND DOES 1-100,
20 Inclusive,
21
Defendants.
22
23
24 Plaintiff, GABRIELA ANACONA (“Plaintiff”), hereby submits this Complaint for Damages
25 against Defendants, DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER, AND
26 DOES 1-50, Inclusive, and allege the following:
27 ///
28 ///
1
COMPLAINT FOR DAMAGES
1 THE PARTIES
2 1. At all relevant times, Plaintiff GABRIELA ANACONA was over the age of sixty-five
3 (65) (born on January 17, 1940) and was an “elder” within the meaning of California Welfare and
4 Institutions Code section 15610.27.
5 2. At all relevant times, Plaintiff was dependent on the care of her immediate family and
6 medical care providers. Plaintiff is exclusively a Spanish speaker. Plaintiff has been clinically diagnosed
7 with dementia. Plaintiff has a documented history of falls one of which was serious enough to warrant
8 surgical intervention for a spinal fracture attributed to said fall.
9 3. Due to mental incapacity, Plaintiff brings her claims by and through her guardian ad
10 litem, DENISSE ANACONA MARTINEZ.
11 4. DENISSE ANACONA MARTINEZ is a competent adult and at all times material hereto
12 the lawful daughter of Plaintiff.
13 5. Defendants DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER and
14 DOES 1-50 own and operate a hospital in Santa Maria California, County of Santa Barbra, doing
15 business as MARIAN REGIONAL MEDICAL CENTER (hereinafter referred to as “MRMC”) located
16 at 1400 E Church St Santa Maria, CA 93454. At all times relevant MRMC was subject to the
17 requirements of federal and state law regarding the operation of hospitals and accredited medical centers
18 operating in the State of California.
19 6. Defendant DIGNITY HEALTH is the licensee of MRMC and MRMC is part of the
20 Dignity Health network and its policies and procedures.
21 7. Plaintiff is ignorant of the true names and capacities of those Defendants sued here as
22 DOES 1 through 100 and for that reason has sued such Defendants by fictitious names. Plaintiff will
23 seek leave of the Court to amend the Complaint to identify said Defendants once their identities become
24 known.
25 8. Plaintiff is informed and believes and upon such information and belief alleges that at all
26 times herein mentioned, Defendants and each of them, were the agents, ostensible agents, servants,
27 employees, assistants, and/or consultants of their co-Defendants and were, as such, acting within the
28 course, scope, purpose and authority of said agency and employment; that each and every defendant as
2
COMPLAINT FOR DAMAGES
1 aforesaid, when acting as a principal, was negligent in the supervision, selection, hiring, proctoring,
2 granting of, reviewing and renewing staff privileges, of each and every other defendant as an agent,
3 servant, employee, assistant and/or consultant.
4 9. Plaintiff is informed and believes and upon such information and belief alleges that each
5 Defendant designated herein as a DOE was responsible, negligently, or in some other actionable
6 manner, for the events and happenings herein referred to, which proximately caused the injuries and
7 damages to Plaintiff as are hereinafter alleged.
8 JURISDICTION AND VENUE
9 10. This Court has personal jurisdiction over DIGNITY HEALTH dba MARIAN
10 REGIONAL MEDICAL CENTER (“MRMC”) AND DOES 1 to 100 because said Defendants were, at
11 all relevant times, doing business in the State of California, in the County of Santa Barbra, as set forth in
12 the paragraphs above, and as incorporated by reference here as though fully set forth herein. In the
13 course of engaging in such business, the conduct of each of the Defendants caused injury to Plaintiff as
14 set forth more fully below.
15 11. Venue in this judicial district is proper because Defendants named herein conduct
16 business in this district in a manner that has caused injury to Plaintiff as set forth more fully below.
17 12. Pursuant to CCP 364 Plaintiff provided notice of this lawsuit to all Defendants on
18 January 2, 2024, of this action, which extends the applicable statute of limitations by 90 days. An agent
19 of named Defendant DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER
20 (“MRMC”) signed the domestic return receipt that was returned to this Law Firm upon delivery of said
21 364 Letter.
22 GENERAL ALLEGATIONS
23 13. All the acts described herein constituted an ongoing practice and pattern of neglect and
24 abuse committed by Defendants.
25 14. Plaintiff, at the time of the alleged incident, was an 83 – year – old female. She was and
26 is exclusively a Spanish speaker with clinically diagnosed dementia.
27 ///
28 ///
3
COMPLAINT FOR DAMAGES
1 15. In the years leading up to this alleged incident, Plaintiff was living with her daughter and
2 son in law with her two grandchildren. In spite of her dementia, Plaintiff still played an active role in her
3 families’ lives cooking, playing, traveling, and spending quality time with her children and
4 grandchildren. She was still able to recognize her family members and live a meaningful life with those
5 she loved.
6 16. In addition to her dementia, Plaintiff had a prior medical history of falls, one of which
7 was so serious that she suffered an L4 burst fracture in 2020. She was treated for this burst fracture at
8 MRMC.
9 17. In 2021, Plaintiff suffered another fall while playing with her grandchildren that
10 aggravated her L4 burst fracture. She then presented to MRMC where physicians discovered that in
11 addition to her L4 burst fracture, Plaintiff had sustained T1, T2, and T6 compression fractures because
12 of this second fall. On August 2, 2021, Plaintiff underwent an L4 kyphoplasty for the L4 burst fracture
13 at MRMC.
14 18. A kyphoplasty is a minimally invasive procedure used to treat vertebral compression
15 fractures and unstable burst fractures by inflating a balloon to restore bone height then injecting bone
16 cement into the vertebral body. This type of procedure and the recovery associated with it is generally
17 less difficult to tolerate for dependent adults than surgical options that require metal hardware to be
18 implanted into the spine.
19 19. After this surgery, Plaintiff made a full recovery and returned to her everyday life with
20 her family. Once she recovered, Plaintiff was still able to perform most of her activities of daily living
21 including dressing herself, cooking meals with her daughter, bending over to play with her
22 grandchildren, and ambulating freely throughout her family’s home.
23 20. On February 4, 2023, Plaintiff suffered an unwitnessed fall at home where during her fall,
24 her back struck a wall. She began to feel pain in the same region of her lumbar spine that she
25 experienced before her kyphoplasty surgery in 2021. She communicated her pain to her daughter and
26 son in law after this fall who then took Plaintiff for an evaluation at MRMC.
27 21. When Plaintiff presented at MRMC on February 4, 2023, post fall, she complained of
28 bilateral hip pain and an inability to ambulate.
4
COMPLAINT FOR DAMAGES
1 22. An X-ray of her pelvis showed no new fractures. Plaintiff was discharged home with
2 Norco and Lidocaine topical patches and instructed to follow up with her primary care physician Dr.
3 Desmond in the next few days. Additionally, the imaging of Plaintiff’s pelvis and low back performed
4 on February 4, 2023, did not show any injuries to her right hip or femur.
5 23. Plaintiff’s pain did not subside in the days following February 4, 2023. Her family,
6 concerned, ultimately brought Plaintiff back to MRMC with worsening pain and limited ability to
7 ambulate. Plaintiff had not had any relief using oral and topical pain management options.
8 24. Upon presentation to MRMC on February 7, 2023, Plaintiff complained of low back pain,
9 pelvic pain, and difficulty ambulating. Her vital signs were within normal limits. She had a normal chem
10 panel and CBC.
11 25. Rather than a second X-ray, staff at MRMC decided to perform a CT scan of Plaintiff’s
12 pelvis. This CT came back negative for any fractures or internal injuries.
13 26. MRMC staff also performed a CT scan of Plaintiff’s lumbosacral spine. This CT scan
14 demonstrated a new finding of a left L3 inferior endplate region compression fracture with 20%
15 vertebral body height loss and resulting mild central canal and bilateral foraminal stenosis. There was
16 also her prior L4 burst fracture deformity and moderate right central canal stenosis. Neurosurgery was
17 contacted.
18 27. MRMC staff ultimately decided to admit Plaintiff for observation. Plaintiff was then
19 admitted in the early morning hours of February 8, 2023, into the care and custody of MRMC.
20 28. Plaintiff’s daughter DENISSE ANACONA MARTINEZ went on record with MRMC
21 personnel to ensure that her mother’s care team was aware of Plaintiff’s dementia diagnosis and the
22 language barrier. Indeed, Plaintiff’s medical records maintained by MRMC reflect her dementia
23 diagnosis and language barrier.
24 29. Once admitted, imaging studies, and intake interviews with Plaintiff’s family were
25 conducted, at 5:26am on February 8, 2023, Dr. John Newlander assessed Plaintiff where he stated, “I
26 suspect she will require less than 2 midnights hospitalization. She is a full code with a fair prognosis.”
27
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5
COMPLAINT FOR DAMAGES
1 30. One of the tools that MRMC uses to assess patient specific needs upon admission, is the
2 Johns Hopkins Fall Risk Assessment. This fall assessment is geared toward reducing the chances of a
3 patient fall while admitted. The Assessment results in each patient receiving a numeric score.
4 31. Numeric scores are calculated as low (<6), moderate (6-13), or high fall risk (>13). The
5 highest numeric score a patient can receive is a 28 meaning they are categorized as an extremely fall
6 risk.
7 32. Upon admission, Plaintiff received a JHFRA score of 28.
8 33. According to MRMC’s policies and procedures, patients who are classified as high fall
9 risks require extra precautions to prevent against foreseeable harm caused by a fall. Some of these
10 preventions include but are not limited to: (1) the application of fall mats, (2) moving the patient closer
11 to the nurses POD, (3) activating the bed and chair alarms, (4) use of the Avasure virtual nurse system,
12 and (5) for nurses to remain within the arms-length of patients when toileting. None of these precautions
13 were taken.
14 34. Plaintiff was tagged with a “Fall Risk” wrist band and placed in a hospital room away
15 from the nearest nursing POD with a “Fall Risk” label on the door no larger than a name tag.
16 35. On the night of February 9, 2023, different MRMC personnel provided Plaintiff’s family
17 with conflicting versions of events. Based on the testimony given under penalty of perjury to an
18 investigator sent to MRMC by the California Department of Public Health during a June 13, 2023,
19 investigation, a registered nurse was assigned to care for Plaintiff on February 9, 2023. RN1 admitted
20 the following:
21 • She was aware that Plaintiff was a high fall risk.
22 • She observed Plaintiff seated on the edge of her bed with her legs dangling over the edge.
23 • She observed that Plaintiff was visibly agitated and refused redirection to lay back into
24 bed.
25 • She was unable to secure Plaintiff into bed.
26 • She left Plaintiff unattended despite knowing she was a high fall risk.
27 • When she returned to the unattended plaintiff, she found her on the floor complaining of
28 severe leg pain.
6
COMPLAINT FOR DAMAGES
1 • She admitted to seeing Plaintiff’s leg clearly deformed and extremely swollen.
2 36. This preventable fall resulted in Plaintiff suffering a proximal femoral diaphysis oblique
3 fracture of the right hip. Ortho was contacted immediately, and Plaintiff was taken in for an emergency
4 open reduction and internal fixation (“ORIF”) of her right subtrochanteric femur fracture in the early
5 morning hours on February 10, 2023, by Dr. Kistler.
6 37. It has been nearly a full year since this fall, and Plaintiff has not been able to return home.
7 38. Plaintiff has lost nearly twenty pounds, suffered numerous UTIs, has been separated from
8 her daughter, her son in law, and her grandchildren. Her existence has been permanently altered by the
9 negligence of MRMC staff.
10 FIRST CAUSE OF ACTION
11 Medical Negligence
12 GABRIELA ANACONA through her guardian ad litem DENISSE ANACONA MARTINEZ
13 v.
14 DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER, AND DOES 1-100
15 39. Plaintiff hereby incorporates the allegations asserted in the paragraphs above as though
16 fully set forth below.
17 40. Each of the Defendants to this cause of action owed Plaintiff a duty to comply with the
18 prevailing standards of care in providing medical services to Plaintiff while she was admitted to MRMC
19 which include, but are not limited to, careful observation, care, and treatment of health conditions and
20 the protection from known health and safety hazards such as falls.
21 41. MRMC and DOES 1 to 100 breached their duties of care to Plaintiff by failing to
22 adequately care plan, monitor, observe, protect, and/or provide services to Plaintiff. Specifically,
23 MRMC and DOES 1 to 100 failed to use ordinary skill and care during the observation and treatment of
24 Plaintiff upon presentation to MRMC. Specifically, MRMC and DOES 1 to 100 failed to construct a
25 care plan suitable for the safe monitoring and observation of Plaintiff. Further, MRMC and DOES 1 to
26 50, neglected Plaintiff while clearly agitated and in a compromised state resulting in a completely
27 preventable fall.
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7
COMPLAINT FOR DAMAGES
1 42. MRMC’s numerous and repeated failures caused Plaintiff life-altering past and future
2 physical, mental, emotional, and financial damages as a result of the negligence of MRMC and DOES 1
3 to 50.
4 SECOND CAUSE OF ACTION
5 Elder Abuse – Neglect
6 GABRIELA ANACONA through her guardian ad litem DENISSE ANACONA MARTINEZ
7 v.
8 DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER, AND DOES 1-100
9 43. Plaintiff hereby incorporates the allegations asserted in the paragraphs above as though
10 fully set forth below.
11 44. As defined by the Elder Abuse and Dependent Adult Civil Protection Act ("Elder Abuse
12 Act"), "abuse of an elder or dependent adult'' is either: "a) physical abuse, neglect, financial abuse,
13 abandonment, isolation, abduction or other treatment with resulting physical harm or pain or mental
14 suffering," or "b) the deprivation by a care custodian of goods or services that are necessary to
15 avoid physical harm or mental suffering." Welf. & Inst. Code §15610.07.
16 45. The Elder Abuse Act defines "neglect" as "the negligent failure of any person having the
17 care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person
18 in a like position would exercise." "Neglect includes, but is not limited to, all of the following: (1)
19 Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter; (2) Failure to
20 provide medical care for physical and mental health needs ...; (3) Failure to protect from health
21 and safety hazards; (4) Failure to prevent malnutrition or dehydration." Welf. & Instit Code §
22 15610.57(b). (Emphasis added).
23 46. Plaintiff was at all times relevant to the events giving rise to this cause of action an
24 “elder” as that term is defined in Welfare and Institutions Code. Plaintiff was 83 years-old when she
25 presented on February 7, 2023, to MRMC emergency department.
26 47. At all times relevant to this action, MRMC and DOES 1 to 100 were "care custodians"
27 within the meaning of California Welfare & Institutions Code section 15610.l7 because each Defendant
28 to this cause of action were charged with providing necessary medical services, hydration, medication,
8
COMPLAINT FOR DAMAGES
1 nutrition, safety, and protection from known health and safety hazards including fall prevention while
2 Plaintiff was admitted as an inpatient to MRMC. In fact, Plaintiff was dependent on MRMC for all
3 activities of daily living from February 7, 2023, until her discharge post ORIF to Marian Extended Care
4 Center.
5 48. More specifically, Defendants MRMC and DOES 1 to 100, all knew that Plaintiff was at
6 a high risk for falls, and that she required interventions including patient specific care planning, the
7 application of fall mats, moving the patient’s room closer to the nurses POD, activating the bed and
8 chair alarms, the use of the Avasure virtual nurse system, and for nurses to remain within the patients
9 arm length when toileting. Defendants MRMC and DOES 1 to 100, all knew that Plaintiff did not speak
10 English, and had clinically diagnosed dementia so it would be foreseeable that she could not interpret
11 any instructions in English or understand the authority of a nurse attempting to give her directions.
12 49. MRMC and DOES 1 to 100 neglected Plaintiff within the meaning of Welfare and
13 Institutions Code section 15610.57 in numerous respects. MRMC woefully neglected Plaintiff by failing
14 to protect her from known health and safety hazards such as falls. This neglect includes, but is not
15 limited to, the following:
16 • Failure to protect from falls, a known health and safety hazards;
17 • Failed to care plan to address Plaintiff’s risk for falls while under the care and custody of
18 MRMC staff;
19 • Withholding necessary language assistance to ensure a patient with dementia, who did not
20 speak English, could be communicated with;
21 • Withholding the necessary staff to ensure Plaintiff was attended to by failing to schedule staff
22 as appropriate to meet plaintiffs’ needs;
23 • Withholding floor mats from plaintiffs’ bedside to prevent injury from falls;
24 • Withholding admission to a room closer to the nurses POD;
25 • Withholding the use of bed and chair alarms despite advanced knowledge of plaintiffs’ high
26 fall risk;
27 • Withholding the use of the Avasure virtual nurse system even though it was available;
28 • Failing to remain within the patients arm length when toileting; and
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COMPLAINT FOR DAMAGES
1 • Failed to observe Plaintiff to protect her from known health and safety hazards while she was
2 under the care and custody of MRMC and DOES 1 to 100.
3 50. Despite MRMC and DOES 1 to 50’s knowledge of Plaintiff’s cognitive status, language
4 barrier, susceptibility to falls, and high fall risk status, MRMC and DOES 1 to 100 repeatedly withheld
5 the necessary services to ensure Plaintiff was adequately attended to and in so doing failed to protect
6 Plaintiff from known health and safety hazards such as falls in violation of Welfare and Institutions
7 Code section 15610.57. MRMC and DOES 1 to 100’s conduct signified a pattern of withholding care for
8 Plaintiff as demonstrated by the aforementioned failures of MRMC and its staff.
9 51. Even with the change of nursing staff over the hours and days that Plaintiff was under the
10 care and custody of MRMC and DOES 1 to 100, multiple nurses, agents, and staff members of all
11 defendants recklessly allowed Plaintiff to remain in a hyper vulnerable position ultimately leading to a
12 foreseeable and preventable fall. This repeated withholding of care and the failure to intervene and
13 protect Plaintiff against known health and safety hazards such as falls demonstrates a top-down system
14 failure in MRMC’s training and supervision of its nurses, agents, and staff.
15 52. MRMC and DOES 1 to 100 continuously and recklessly, maliciously, and fraudulently,
16 made the decision to withhold from Plaintiff the most basic level of care she required to prevent
17 foreseeable falls even though all Defendants were aware of her fall risk status. Plaintiff had a
18 documented history of falls including a fall serious enough to cause multiple spinal burst fractures.
19 Indeed, Plaintiff previously underwent an L4 kyphoplasty to repair her burst fracture at MRMC. Plaintiff
20 then presented to MRMC in February of 2023 for an unwitnessed fall at home causing her pain serious
21 enough to impair her ability to walk. She was not admitted but sent home with pain medication. Plaintiff
22 then presented to MRMC two days later with continued and worsening pain as a result of this
23 unwitnessed fall. After CT imaging revealed an adjacent level burst fracture and neuro was consulted, it
24 was determined that surgical intervention was not warranted but Plaintiff would be admitted for two
25 nights for the sole purpose of observation. She had a fair prognosis. Upon admission, Plaintiff was rated
26 a 28 out of 28 on the Johns Hopkins Fall Risk Assessment Scale meaning she was the highest level of
27 fall risk possible and required all additional safety measures to prevent a foreseeable fall. Additionally,
28 Plaintiff was known to be Spanish speaking with clinically diagnosed dementia meaning she was unable
10
COMPLAINT FOR DAMAGES
1 to head verbal warnings as a cognitively intact, and English-speaking elder may be. Plaintiff was marked
2 as a fall risk with a bright yellow “fall-risk” wrist band to make it apparent to all MRMC nurses, agents,
3 and staff that Plaintiff required additional safety measures and care. Plaintiff’s room was also marked
4 with a “fall-risk” label to alert any and all MRMC nurses, agents, and staff, that the occupant of this
5 room required additional safety measures and care.
6 53. Despite all of this, MRMC and DOES 1 to 100 withheld necessary safety measures from
7 Plaintiff. Not a single defendant nurse, agent, or staff member recognized the need to intervene in any
8 way. Even with the knowledge that Plaintiff required patient specific care planning, the application of
9 fall mats, moving the patient’s room closer to the nurses POD, activating the bed and chair alarms, the
10 use of the Avasure virtual nurse system, and for nurses to remain within the patients arm length when
11 toileting, MRMC and DOES 1 to 100 withheld this care during Plaintiffs admission leading up to the
12 fall. Then, with the ability to intervene an MRMC nurse admitted to a representative of the California
13 Department of Public Health, that after visualizing Plaintiff sitting at the edge of her bed with her legs
14 dangling off the side this nurse claims she tried to coax Plaintiff back into bed. This nurse used forceful
15 English commands that further agitated Plaintiff. This Nurse described Plaintiff as being at the edge of
16 her bed in a visibly agitated state. She then claims that she made the choice to leave the room with
17 Plaintiff in this compromised position. When the nurse returned to the room several minutes later,
18 Plaintiff was found on the floor with her right thigh visibly deformed from her broken femur. These
19 actions were reckless in that MRMC and DOES 1 to 50 consciously disregarded all available
20 information and safety requirements allowing Plaintiff to suffer a catastrophic fall.
21 54. The withholding of care set forth above amounts to a pattern and practice of neglect done
22 with a conscious disregard of the safety of Plaintiff. These actions are malicious, reckless, oppressive,
23 and indeed fraudulent given the conflicting testimony and stories presented to the CDPH investigator
24 and Plaintiffs’ responsible parties. To add insult to injury, when Plaintiff’s daughter DENISSE
25 ANACONA MARTINEZ, was made aware of her mother’s fall and the need for surgery, she asked an
26 MRMC nurse on staff that evening, how this fall could have happened. The MRMC nurse responded
27 with the phrase, “shit happens” and provided no substantive explanation for how this fall occurred.
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11
COMPLAINT FOR DAMAGES
1 55. MRMC and DOES 1 to 100 caused physical and mental harm to Plaintiff. Through the
2 flagrant disregard by MRMC and DOES 1 to 100’s conduct caused Plaintiff to suffer extreme physical,
3 mental, and emotional pain and suffering.
4 PRAYER
5 Wherefore, Plaintiff prays for judgment as follows:
6 1. For general damages, including past and future pre-death pain and suffering, according to
7 proof;
8 2. For past and future special damages, according to proof;
9 3. For attorney’s fees as to the Second Cause of Action according to proof;
10 4. For costs of suit incurred herein;
11 5. For prejudgment interest;
12 6. For punitive and exemplary damages as to the Second Cause of Action according to proof;
13 and
14 7. For other such relief as the Court deems just and proper.
15
16 Dated: January 29, 2024 ADAM FELDMAN LAW, APC
17
By:_______________________________
18 Adam Feldman, Esq.
19 Attorney for Plaintiff:
GABRIELA ANACONA through her
20 guardian ad litem DENISSE ANACONA
MARTINEZ
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COMPLAINT FOR DAMAGES
1 DEMAND FOR TRIAL BY JURY
2 1. Plaintiff hereby demands a trial by jury as to all claims and causes of action.
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4 Dated: January 29, 2024 ADAM FELDMAN LAW, APC
5
6 By:_______________________________
Adam Feldman, Esq.
7 Attorney for Plaintiff:
GABRIELA ANACONA through her
8 guardian ad litem DENISSE ANACONA
9 MARTINEZ
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COMPLAINT FOR DAMAGES
Preview
1 Adam Feldman, Esq. (SBN: 333667) Adam Feldman Law, APC 2 adam@adamfeldmanlaw.com 3 info@adamfeldmanlaw.com 5850 Canoga Avenue, Suite 400 4 Woodland Hills, CA 91367 T: 818-710-3833 | F: 818-710-3802 5 6 Attorney for Plaintiff: Gabriela Anacona through 7 her guardian ad litem Denisse Anacona Martinez 8 9 SUPERIOR COURT OF STATE OF CALIFORNIA 10 FOR THE COUNTY OF SANTA BARBARA 11 12 GABRIELA ANACONA through her guardian Case No.: ad litem DENISSE ANACONA MARTINEZ, an 13 individual, COMPLAINT FOR DAMAGES: 14 1. MEDICAL NEGLIGENCE 15 Plaintiff, 2. ELDER ABUSE/NEGLECT 16 DEMAND FOR A JURY TRIAL 17 v. [AMOUNT DEMANDED EXCEEDS $35,000] 18 DIGNITY HEALTH dba MARIAN REGIONAL 19 MEDICAL CENTER, AND DOES 1-100, 20 Inclusive, 21 Defendants. 22 23 24 Plaintiff, GABRIELA ANACONA (“Plaintiff”), hereby submits this Complaint for Damages 25 against Defendants, DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER, AND 26 DOES 1-50, Inclusive, and allege the following: 27 /// 28 /// 1 COMPLAINT FOR DAMAGES 1 THE PARTIES 2 1. At all relevant times, Plaintiff GABRIELA ANACONA was over the age of sixty-five 3 (65) (born on January 17, 1940) and was an “elder” within the meaning of California Welfare and 4 Institutions Code section 15610.27. 5 2. At all relevant times, Plaintiff was dependent on the care of her immediate family and 6 medical care providers. Plaintiff is exclusively a Spanish speaker. Plaintiff has been clinically diagnosed 7 with dementia. Plaintiff has a documented history of falls one of which was serious enough to warrant 8 surgical intervention for a spinal fracture attributed to said fall. 9 3. Due to mental incapacity, Plaintiff brings her claims by and through her guardian ad 10 litem, DENISSE ANACONA MARTINEZ. 11 4. DENISSE ANACONA MARTINEZ is a competent adult and at all times material hereto 12 the lawful daughter of Plaintiff. 13 5. Defendants DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER and 14 DOES 1-50 own and operate a hospital in Santa Maria California, County of Santa Barbra, doing 15 business as MARIAN REGIONAL MEDICAL CENTER (hereinafter referred to as “MRMC”) located 16 at 1400 E Church St Santa Maria, CA 93454. At all times relevant MRMC was subject to the 17 requirements of federal and state law regarding the operation of hospitals and accredited medical centers 18 operating in the State of California. 19 6. Defendant DIGNITY HEALTH is the licensee of MRMC and MRMC is part of the 20 Dignity Health network and its policies and procedures. 21 7. Plaintiff is ignorant of the true names and capacities of those Defendants sued here as 22 DOES 1 through 100 and for that reason has sued such Defendants by fictitious names. Plaintiff will 23 seek leave of the Court to amend the Complaint to identify said Defendants once their identities become 24 known. 25 8. Plaintiff is informed and believes and upon such information and belief alleges that at all 26 times herein mentioned, Defendants and each of them, were the agents, ostensible agents, servants, 27 employees, assistants, and/or consultants of their co-Defendants and were, as such, acting within the 28 course, scope, purpose and authority of said agency and employment; that each and every defendant as 2 COMPLAINT FOR DAMAGES 1 aforesaid, when acting as a principal, was negligent in the supervision, selection, hiring, proctoring, 2 granting of, reviewing and renewing staff privileges, of each and every other defendant as an agent, 3 servant, employee, assistant and/or consultant. 4 9. Plaintiff is informed and believes and upon such information and belief alleges that each 5 Defendant designated herein as a DOE was responsible, negligently, or in some other actionable 6 manner, for the events and happenings herein referred to, which proximately caused the injuries and 7 damages to Plaintiff as are hereinafter alleged. 8 JURISDICTION AND VENUE 9 10. This Court has personal jurisdiction over DIGNITY HEALTH dba MARIAN 10 REGIONAL MEDICAL CENTER (“MRMC”) AND DOES 1 to 100 because said Defendants were, at 11 all relevant times, doing business in the State of California, in the County of Santa Barbra, as set forth in 12 the paragraphs above, and as incorporated by reference here as though fully set forth herein. In the 13 course of engaging in such business, the conduct of each of the Defendants caused injury to Plaintiff as 14 set forth more fully below. 15 11. Venue in this judicial district is proper because Defendants named herein conduct 16 business in this district in a manner that has caused injury to Plaintiff as set forth more fully below. 17 12. Pursuant to CCP 364 Plaintiff provided notice of this lawsuit to all Defendants on 18 January 2, 2024, of this action, which extends the applicable statute of limitations by 90 days. An agent 19 of named Defendant DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER 20 (“MRMC”) signed the domestic return receipt that was returned to this Law Firm upon delivery of said 21 364 Letter. 22 GENERAL ALLEGATIONS 23 13. All the acts described herein constituted an ongoing practice and pattern of neglect and 24 abuse committed by Defendants. 25 14. Plaintiff, at the time of the alleged incident, was an 83 – year – old female. She was and 26 is exclusively a Spanish speaker with clinically diagnosed dementia. 27 /// 28 /// 3 COMPLAINT FOR DAMAGES 1 15. In the years leading up to this alleged incident, Plaintiff was living with her daughter and 2 son in law with her two grandchildren. In spite of her dementia, Plaintiff still played an active role in her 3 families’ lives cooking, playing, traveling, and spending quality time with her children and 4 grandchildren. She was still able to recognize her family members and live a meaningful life with those 5 she loved. 6 16. In addition to her dementia, Plaintiff had a prior medical history of falls, one of which 7 was so serious that she suffered an L4 burst fracture in 2020. She was treated for this burst fracture at 8 MRMC. 9 17. In 2021, Plaintiff suffered another fall while playing with her grandchildren that 10 aggravated her L4 burst fracture. She then presented to MRMC where physicians discovered that in 11 addition to her L4 burst fracture, Plaintiff had sustained T1, T2, and T6 compression fractures because 12 of this second fall. On August 2, 2021, Plaintiff underwent an L4 kyphoplasty for the L4 burst fracture 13 at MRMC. 14 18. A kyphoplasty is a minimally invasive procedure used to treat vertebral compression 15 fractures and unstable burst fractures by inflating a balloon to restore bone height then injecting bone 16 cement into the vertebral body. This type of procedure and the recovery associated with it is generally 17 less difficult to tolerate for dependent adults than surgical options that require metal hardware to be 18 implanted into the spine. 19 19. After this surgery, Plaintiff made a full recovery and returned to her everyday life with 20 her family. Once she recovered, Plaintiff was still able to perform most of her activities of daily living 21 including dressing herself, cooking meals with her daughter, bending over to play with her 22 grandchildren, and ambulating freely throughout her family’s home. 23 20. On February 4, 2023, Plaintiff suffered an unwitnessed fall at home where during her fall, 24 her back struck a wall. She began to feel pain in the same region of her lumbar spine that she 25 experienced before her kyphoplasty surgery in 2021. She communicated her pain to her daughter and 26 son in law after this fall who then took Plaintiff for an evaluation at MRMC. 27 21. When Plaintiff presented at MRMC on February 4, 2023, post fall, she complained of 28 bilateral hip pain and an inability to ambulate. 4 COMPLAINT FOR DAMAGES 1 22. An X-ray of her pelvis showed no new fractures. Plaintiff was discharged home with 2 Norco and Lidocaine topical patches and instructed to follow up with her primary care physician Dr. 3 Desmond in the next few days. Additionally, the imaging of Plaintiff’s pelvis and low back performed 4 on February 4, 2023, did not show any injuries to her right hip or femur. 5 23. Plaintiff’s pain did not subside in the days following February 4, 2023. Her family, 6 concerned, ultimately brought Plaintiff back to MRMC with worsening pain and limited ability to 7 ambulate. Plaintiff had not had any relief using oral and topical pain management options. 8 24. Upon presentation to MRMC on February 7, 2023, Plaintiff complained of low back pain, 9 pelvic pain, and difficulty ambulating. Her vital signs were within normal limits. She had a normal chem 10 panel and CBC. 11 25. Rather than a second X-ray, staff at MRMC decided to perform a CT scan of Plaintiff’s 12 pelvis. This CT came back negative for any fractures or internal injuries. 13 26. MRMC staff also performed a CT scan of Plaintiff’s lumbosacral spine. This CT scan 14 demonstrated a new finding of a left L3 inferior endplate region compression fracture with 20% 15 vertebral body height loss and resulting mild central canal and bilateral foraminal stenosis. There was 16 also her prior L4 burst fracture deformity and moderate right central canal stenosis. Neurosurgery was 17 contacted. 18 27. MRMC staff ultimately decided to admit Plaintiff for observation. Plaintiff was then 19 admitted in the early morning hours of February 8, 2023, into the care and custody of MRMC. 20 28. Plaintiff’s daughter DENISSE ANACONA MARTINEZ went on record with MRMC 21 personnel to ensure that her mother’s care team was aware of Plaintiff’s dementia diagnosis and the 22 language barrier. Indeed, Plaintiff’s medical records maintained by MRMC reflect her dementia 23 diagnosis and language barrier. 24 29. Once admitted, imaging studies, and intake interviews with Plaintiff’s family were 25 conducted, at 5:26am on February 8, 2023, Dr. John Newlander assessed Plaintiff where he stated, “I 26 suspect she will require less than 2 midnights hospitalization. She is a full code with a fair prognosis.” 27 28 5 COMPLAINT FOR DAMAGES 1 30. One of the tools that MRMC uses to assess patient specific needs upon admission, is the 2 Johns Hopkins Fall Risk Assessment. This fall assessment is geared toward reducing the chances of a 3 patient fall while admitted. The Assessment results in each patient receiving a numeric score. 4 31. Numeric scores are calculated as low (<6), moderate (6-13), or high fall risk (>13). The 5 highest numeric score a patient can receive is a 28 meaning they are categorized as an extremely fall 6 risk. 7 32. Upon admission, Plaintiff received a JHFRA score of 28. 8 33. According to MRMC’s policies and procedures, patients who are classified as high fall 9 risks require extra precautions to prevent against foreseeable harm caused by a fall. Some of these 10 preventions include but are not limited to: (1) the application of fall mats, (2) moving the patient closer 11 to the nurses POD, (3) activating the bed and chair alarms, (4) use of the Avasure virtual nurse system, 12 and (5) for nurses to remain within the arms-length of patients when toileting. None of these precautions 13 were taken. 14 34. Plaintiff was tagged with a “Fall Risk” wrist band and placed in a hospital room away 15 from the nearest nursing POD with a “Fall Risk” label on the door no larger than a name tag. 16 35. On the night of February 9, 2023, different MRMC personnel provided Plaintiff’s family 17 with conflicting versions of events. Based on the testimony given under penalty of perjury to an 18 investigator sent to MRMC by the California Department of Public Health during a June 13, 2023, 19 investigation, a registered nurse was assigned to care for Plaintiff on February 9, 2023. RN1 admitted 20 the following: 21 • She was aware that Plaintiff was a high fall risk. 22 • She observed Plaintiff seated on the edge of her bed with her legs dangling over the edge. 23 • She observed that Plaintiff was visibly agitated and refused redirection to lay back into 24 bed. 25 • She was unable to secure Plaintiff into bed. 26 • She left Plaintiff unattended despite knowing she was a high fall risk. 27 • When she returned to the unattended plaintiff, she found her on the floor complaining of 28 severe leg pain. 6 COMPLAINT FOR DAMAGES 1 • She admitted to seeing Plaintiff’s leg clearly deformed and extremely swollen. 2 36. This preventable fall resulted in Plaintiff suffering a proximal femoral diaphysis oblique 3 fracture of the right hip. Ortho was contacted immediately, and Plaintiff was taken in for an emergency 4 open reduction and internal fixation (“ORIF”) of her right subtrochanteric femur fracture in the early 5 morning hours on February 10, 2023, by Dr. Kistler. 6 37. It has been nearly a full year since this fall, and Plaintiff has not been able to return home. 7 38. Plaintiff has lost nearly twenty pounds, suffered numerous UTIs, has been separated from 8 her daughter, her son in law, and her grandchildren. Her existence has been permanently altered by the 9 negligence of MRMC staff. 10 FIRST CAUSE OF ACTION 11 Medical Negligence 12 GABRIELA ANACONA through her guardian ad litem DENISSE ANACONA MARTINEZ 13 v. 14 DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER, AND DOES 1-100 15 39. Plaintiff hereby incorporates the allegations asserted in the paragraphs above as though 16 fully set forth below. 17 40. Each of the Defendants to this cause of action owed Plaintiff a duty to comply with the 18 prevailing standards of care in providing medical services to Plaintiff while she was admitted to MRMC 19 which include, but are not limited to, careful observation, care, and treatment of health conditions and 20 the protection from known health and safety hazards such as falls. 21 41. MRMC and DOES 1 to 100 breached their duties of care to Plaintiff by failing to 22 adequately care plan, monitor, observe, protect, and/or provide services to Plaintiff. Specifically, 23 MRMC and DOES 1 to 100 failed to use ordinary skill and care during the observation and treatment of 24 Plaintiff upon presentation to MRMC. Specifically, MRMC and DOES 1 to 100 failed to construct a 25 care plan suitable for the safe monitoring and observation of Plaintiff. Further, MRMC and DOES 1 to 26 50, neglected Plaintiff while clearly agitated and in a compromised state resulting in a completely 27 preventable fall. 28 7 COMPLAINT FOR DAMAGES 1 42. MRMC’s numerous and repeated failures caused Plaintiff life-altering past and future 2 physical, mental, emotional, and financial damages as a result of the negligence of MRMC and DOES 1 3 to 50. 4 SECOND CAUSE OF ACTION 5 Elder Abuse – Neglect 6 GABRIELA ANACONA through her guardian ad litem DENISSE ANACONA MARTINEZ 7 v. 8 DIGNITY HEALTH dba MARIAN REGIONAL MEDICAL CENTER, AND DOES 1-100 9 43. Plaintiff hereby incorporates the allegations asserted in the paragraphs above as though 10 fully set forth below. 11 44. As defined by the Elder Abuse and Dependent Adult Civil Protection Act ("Elder Abuse 12 Act"), "abuse of an elder or dependent adult'' is either: "a) physical abuse, neglect, financial abuse, 13 abandonment, isolation, abduction or other treatment with resulting physical harm or pain or mental 14 suffering," or "b) the deprivation by a care custodian of goods or services that are necessary to 15 avoid physical harm or mental suffering." Welf. & Inst. Code §15610.07. 16 45. The Elder Abuse Act defines "neglect" as "the negligent failure of any person having the 17 care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person 18 in a like position would exercise." "Neglect includes, but is not limited to, all of the following: (1) 19 Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter; (2) Failure to 20 provide medical care for physical and mental health needs ...; (3) Failure to protect from health 21 and safety hazards; (4) Failure to prevent malnutrition or dehydration." Welf. & Instit Code § 22 15610.57(b). (Emphasis added). 23 46. Plaintiff was at all times relevant to the events giving rise to this cause of action an 24 “elder” as that term is defined in Welfare and Institutions Code. Plaintiff was 83 years-old when she 25 presented on February 7, 2023, to MRMC emergency department. 26 47. At all times relevant to this action, MRMC and DOES 1 to 100 were "care custodians" 27 within the meaning of California Welfare & Institutions Code section 15610.l7 because each Defendant 28 to this cause of action were charged with providing necessary medical services, hydration, medication, 8 COMPLAINT FOR DAMAGES 1 nutrition, safety, and protection from known health and safety hazards including fall prevention while 2 Plaintiff was admitted as an inpatient to MRMC. In fact, Plaintiff was dependent on MRMC for all 3 activities of daily living from February 7, 2023, until her discharge post ORIF to Marian Extended Care 4 Center. 5 48. More specifically, Defendants MRMC and DOES 1 to 100, all knew that Plaintiff was at 6 a high risk for falls, and that she required interventions including patient specific care planning, the 7 application of fall mats, moving the patient’s room closer to the nurses POD, activating the bed and 8 chair alarms, the use of the Avasure virtual nurse system, and for nurses to remain within the patients 9 arm length when toileting. Defendants MRMC and DOES 1 to 100, all knew that Plaintiff did not speak 10 English, and had clinically diagnosed dementia so it would be foreseeable that she could not interpret 11 any instructions in English or understand the authority of a nurse attempting to give her directions. 12 49. MRMC and DOES 1 to 100 neglected Plaintiff within the meaning of Welfare and 13 Institutions Code section 15610.57 in numerous respects. MRMC woefully neglected Plaintiff by failing 14 to protect her from known health and safety hazards such as falls. This neglect includes, but is not 15 limited to, the following: 16 • Failure to protect from falls, a known health and safety hazards; 17 • Failed to care plan to address Plaintiff’s risk for falls while under the care and custody of 18 MRMC staff; 19 • Withholding necessary language assistance to ensure a patient with dementia, who did not 20 speak English, could be communicated with; 21 • Withholding the necessary staff to ensure Plaintiff was attended to by failing to schedule staff 22 as appropriate to meet plaintiffs’ needs; 23 • Withholding floor mats from plaintiffs’ bedside to prevent injury from falls; 24 • Withholding admission to a room closer to the nurses POD; 25 • Withholding the use of bed and chair alarms despite advanced knowledge of plaintiffs’ high 26 fall risk; 27 • Withholding the use of the Avasure virtual nurse system even though it was available; 28 • Failing to remain within the patients arm length when toileting; and 9 COMPLAINT FOR DAMAGES 1 • Failed to observe Plaintiff to protect her from known health and safety hazards while she was 2 under the care and custody of MRMC and DOES 1 to 100. 3 50. Despite MRMC and DOES 1 to 50’s knowledge of Plaintiff’s cognitive status, language 4 barrier, susceptibility to falls, and high fall risk status, MRMC and DOES 1 to 100 repeatedly withheld 5 the necessary services to ensure Plaintiff was adequately attended to and in so doing failed to protect 6 Plaintiff from known health and safety hazards such as falls in violation of Welfare and Institutions 7 Code section 15610.57. MRMC and DOES 1 to 100’s conduct signified a pattern of withholding care for 8 Plaintiff as demonstrated by the aforementioned failures of MRMC and its staff. 9 51. Even with the change of nursing staff over the hours and days that Plaintiff was under the 10 care and custody of MRMC and DOES 1 to 100, multiple nurses, agents, and staff members of all 11 defendants recklessly allowed Plaintiff to remain in a hyper vulnerable position ultimately leading to a 12 foreseeable and preventable fall. This repeated withholding of care and the failure to intervene and 13 protect Plaintiff against known health and safety hazards such as falls demonstrates a top-down system 14 failure in MRMC’s training and supervision of its nurses, agents, and staff. 15 52. MRMC and DOES 1 to 100 continuously and recklessly, maliciously, and fraudulently, 16 made the decision to withhold from Plaintiff the most basic level of care she required to prevent 17 foreseeable falls even though all Defendants were aware of her fall risk status. Plaintiff had a 18 documented history of falls including a fall serious enough to cause multiple spinal burst fractures. 19 Indeed, Plaintiff previously underwent an L4 kyphoplasty to repair her burst fracture at MRMC. Plaintiff 20 then presented to MRMC in February of 2023 for an unwitnessed fall at home causing her pain serious 21 enough to impair her ability to walk. She was not admitted but sent home with pain medication. Plaintiff 22 then presented to MRMC two days later with continued and worsening pain as a result of this 23 unwitnessed fall. After CT imaging revealed an adjacent level burst fracture and neuro was consulted, it 24 was determined that surgical intervention was not warranted but Plaintiff would be admitted for two 25 nights for the sole purpose of observation. She had a fair prognosis. Upon admission, Plaintiff was rated 26 a 28 out of 28 on the Johns Hopkins Fall Risk Assessment Scale meaning she was the highest level of 27 fall risk possible and required all additional safety measures to prevent a foreseeable fall. Additionally, 28 Plaintiff was known to be Spanish speaking with clinically diagnosed dementia meaning she was unable 10 COMPLAINT FOR DAMAGES 1 to head verbal warnings as a cognitively intact, and English-speaking elder may be. Plaintiff was marked 2 as a fall risk with a bright yellow “fall-risk” wrist band to make it apparent to all MRMC nurses, agents, 3 and staff that Plaintiff required additional safety measures and care. Plaintiff’s room was also marked 4 with a “fall-risk” label to alert any and all MRMC nurses, agents, and staff, that the occupant of this 5 room required additional safety measures and care. 6 53. Despite all of this, MRMC and DOES 1 to 100 withheld necessary safety measures from 7 Plaintiff. Not a single defendant nurse, agent, or staff member recognized the need to intervene in any 8 way. Even with the knowledge that Plaintiff required patient specific care planning, the application of 9 fall mats, moving the patient’s room closer to the nurses POD, activating the bed and chair alarms, the 10 use of the Avasure virtual nurse system, and for nurses to remain within the patients arm length when 11 toileting, MRMC and DOES 1 to 100 withheld this care during Plaintiffs admission leading up to the 12 fall. Then, with the ability to intervene an MRMC nurse admitted to a representative of the California 13 Department of Public Health, that after visualizing Plaintiff sitting at the edge of her bed with her legs 14 dangling off the side this nurse claims she tried to coax Plaintiff back into bed. This nurse used forceful 15 English commands that further agitated Plaintiff. This Nurse described Plaintiff as being at the edge of 16 her bed in a visibly agitated state. She then claims that she made the choice to leave the room with 17 Plaintiff in this compromised position. When the nurse returned to the room several minutes later, 18 Plaintiff was found on the floor with her right thigh visibly deformed from her broken femur. These 19 actions were reckless in that MRMC and DOES 1 to 50 consciously disregarded all available 20 information and safety requirements allowing Plaintiff to suffer a catastrophic fall. 21 54. The withholding of care set forth above amounts to a pattern and practice of neglect done 22 with a conscious disregard of the safety of Plaintiff. These actions are malicious, reckless, oppressive, 23 and indeed fraudulent given the conflicting testimony and stories presented to the CDPH investigator 24 and Plaintiffs’ responsible parties. To add insult to injury, when Plaintiff’s daughter DENISSE 25 ANACONA MARTINEZ, was made aware of her mother’s fall and the need for surgery, she asked an 26 MRMC nurse on staff that evening, how this fall could have happened. The MRMC nurse responded 27 with the phrase, “shit happens” and provided no substantive explanation for how this fall occurred. 28 11 COMPLAINT FOR DAMAGES 1 55. MRMC and DOES 1 to 100 caused physical and mental harm to Plaintiff. Through the 2 flagrant disregard by MRMC and DOES 1 to 100’s conduct caused Plaintiff to suffer extreme physical, 3 mental, and emotional pain and suffering. 4 PRAYER 5 Wherefore, Plaintiff prays for judgment as follows: 6 1. For general damages, including past and future pre-death pain and suffering, according to 7 proof; 8 2. For past and future special damages, according to proof; 9 3. For attorney’s fees as to the Second Cause of Action according to proof; 10 4. For costs of suit incurred herein; 11 5. For prejudgment interest; 12 6. For punitive and exemplary damages as to the Second Cause of Action according to proof; 13 and 14 7. For other such relief as the Court deems just and proper. 15 16 Dated: January 29, 2024 ADAM FELDMAN LAW, APC 17 By:_______________________________ 18 Adam Feldman, Esq. 19 Attorney for Plaintiff: GABRIELA ANACONA through her 20 guardian ad litem DENISSE ANACONA MARTINEZ 21 22 23 24 25 26 27 28 12 COMPLAINT FOR DAMAGES 1 DEMAND FOR TRIAL BY JURY 2 1. Plaintiff hereby demands a trial by jury as to all claims and causes of action. 3 4 Dated: January 29, 2024 ADAM FELDMAN LAW, APC 5 6 By:_______________________________ Adam Feldman, Esq. 7 Attorney for Plaintiff: GABRIELA ANACONA through her 8 guardian ad litem DENISSE ANACONA 9 MARTINEZ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 13 COMPLAINT FOR DAMAGES