Preview
ADR-106
George E. Clause, Esq. (S
BNe,88107)
AllORNEY OR PARTY WITI-IOUT ATTORNEYSlale Barnumt>er, anciaddress): FOR COURT USE ONLY
~ Brian M. Davies, Esq. (SBN 279728)
I !ayes Scott Bonino Ellingson Guslani Simonson & Clallse LLP
999 SkJwai
T EPH
Roag 5§~~ff.
NE NO.: - -9q0fi-edwood Cit~ CA, 94070
FAX NO. (Op. nal): ELECTRONICALLY
1---MAIL ADDRESS (Oplmnal):
Defendants
ATTORNEY FOR (Name).
F I L E D
Superior Court of California,
County of San Francisco
SUPERIOR COURT OF CALIFORNIA, COUNTY OF San Francisco
srREETADDREss,400 McAllister Street 07/30/2020
MAIi ING AllllH~SS. Clerk of the Court
San Francisco,
c1rv ANo z:1P cooE CA 94102 BY: SANDRA SCHIRO
BRANCH NAMf·Civic Center Collrthollse Deputy Clerk
PETITIONER: MARY AYERS
RESPONDENT: KAISER FOUNDATION HOSPITALS, et al.
PETITION TO [lJ CONFIRM D CORRECT D VACATE
CONTRACTUAL ARBITRATION AWARD
Jurisdiction (check all that apply):
D Action is a limited civil case
Amount demanded D does not exceed $10,000
D exceeds $10,000, but does not exceed $25,000
CASE NUMEJER:
[ZJ Action is an unlimited civil case (exceeds $25,000) CPF-20-51716 l
NOTICE: You may use this form to request that the court confirm, correct, or vacate an award in an arbitration conducted
pursuant to an agreement between the parties that is subject to Code of Civil Procedure section 1285 et seq. and that does
not involve an attorney-client fee dispute. If you are requesting court action after an attorney-client fee arbitration award,
please read Alternative Dispute Resolution form ADR-105, Information Regarding Rights After Attorney-Client Fee
Arbitration.
1. Petitioner and respondent. Petitioner (name each):
Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc., The Permanente Medical Group, Inc.,
Leslie Aiken, MD, Meaghan Lynch, MD, and Jacqueline Poggi, MD.
alleges and requests relief against respondent (name each):
Mary Ayers
2. Contractual arbitration. This petition requests the court to confirm, correct, or vacate an award in an arbitration conducted
according to an agreement between the parties that is subject to Code of Civil Procedure section 1285 et seq.
3. Pending or new action.
a. [ZJ A court case is already pending, and this is a petition filed in that action. (ff so, proceed to item 4.)
b. D This petition commences a new action. (If so, complete items 3b(1) through 3b(4).)
(1) Petitioner's capacity. Each petitioner named in item 1 is an individual,
D except petitioner (state name and complete one or more of the fol/owing):
(a)D is a corporation qualified to do business in California.
(b)D is an unincorporated entity (specify):
(c)D is a representative (specify),·
(d)D is (specify other capacity):
(2) Respondent's capacity, Each respondent named In item 1 is an individual,
D except respondent (state name and complete one or more of the following):
(a)D is a business organization, form unknown.
(b)D is a corporation.
(c)D is an unincorporated entity (specify):
(d)D is a representative (specify):
(e)D is (specify other capacity):
Page 1 of 3
Form ApprovelG & WTNDO\X! COVERINGS
778 BRANNAN ST
SA~ FRANCISCO, CA 94103
FACSIMILE TRANSMITTAL SHEET
_'PROM: LINDA B1-\RO:'JIA
COMPANY:
FAX ~UMBRR: TO'fAL NO. F P.AGES
f IY,.. f 5'1- 6'ff6f"INCLUDTNG COVER:
PHONE NUMBER: SE:-.JDER'S PHO~E/FAX
NUMBER:
415.863.3110/ 415.863.9561
RE: YOUR REPERTINCB NUMBER!
~URGENT â–¡ FOR REVIEW â–¡ PLE.ASE COMMENT â–¡ PLD
. .
T: •! 1 s. i,,,;,;1 I I(\
... , ,i I 5, 11r,,;,9,,r<1
lr.:N .\ l'I l~N 1\ 1.1\1,lNDR(i\l.Y ,\ I HH),C(~ M
Enrollment form Pia a:ie prInt gr Ii' pe I~ bl ll~ t lnK n11 ty-. Sve Inw,uc Uans ~n papu 16 bela re rom~ Iel Ing 111·I! to nn. M.itB 3 t.apy hir ynurrucard~-
ro be coompleted by EMPLOYER 0 New grnup ~ccount ~Existing group accol.Jnr
If_lf-1' 'o JJ ftf,. 0J-.1'ruDs J:r.1c.... OOO(bbf/763 _Lb__j_£ J
'),0 0
Company name~ Group nurnber Date coverage to be effective ..
Ecnrollment unit Pla.n selectiOI' Emplol1ee d.iss!f1cetion (if applic.i!;,le)
/1tJ. p.~me E,
Ernployet> -
_fr f..J 1)6 P-I:o,,J _J_;____!_$_;.21.
Date of hire
EnrQllment rea$0n,. (Pfl!:ase chec;:k oni,.)
â–¡ New 9ro1.1p ZICCOtint JiilN<2w hire Cl Open enrollment -full timG ___J-------.J~-
Q Part time to
0 Lo5s of coverage ____}__,/,-~- uOther Evel"lt date _ ___j.,.__/_ _ _
Tc b1o1 completed by EMPLOYEE
~ Are you now or have; you ever been a member of, or received cim~ from, Kalsr::-r Permanente il'l Cail'fornla?
â–¡ Yss);' No
If ~o, under v.1hat medical record number (if known)"? Former/Maiden name?
_.81'.1de13:o~lk1~ f_ (J~-7_~- '?~ (J ~ E:.r,..~·s L~
Name (La!.~. First, MI)• $oci~I Secunty nurnber * F>rderred ~okeri or written l,inguage (optiOni.1I>
4-IS _J)v..b.oc=R_,
Home !!ddres:;'"
A\J~ _
Apt no,
0~F~c..t'.Sco
City
CA
State
9rlic
ZIP
~...J2..J 7 a Gender" D M)(F
L},( c; .. g 1~~751-l 1-f S- 15<,;s ,. 3 II o
Daw of l;,irth• Home phone• Work phone
/
m:J Family informatic;m Ne?-\
0 SpQU~e I D~t!:! of birth"
tJ Pomesi:ic pi!rtn/r
GendiN" jsoci:itl Security no.*
â–¡ M â–¡ F
N~me (Last, fir.t, Ml) Medic.ii reeord no. (if known)
â–¡ Child O Studerrt. JDate of birth"
Go!nder•· Social $0curity no.w
OM â–¡ F
rim, Ml)
Nilrne (LElst, Medical record no. (if known)
â–¡ Chile;!
□ Student I Dat~ of birth•
Gender* Social 5ecuri1y no,*
LIM â–¡ F
Nome (Last, Fir!.t, Ml) Medical record no. (if known) ·-
0 O,ild tl Student j Date of birth~
Gender"
(las,;, First,
N,..,me MI)
Iâ–¡ IYl â–¡ F Sod.ii Security no,*
Medical record no, (if knDwn)
Will you pe .edding additional dependents?
0 Vgs)f No Add any additional depend~n-t:£
ml page 15.
~ !S,aiser .foun~n.H~alth PlaQ, m.s.....,'lmXfils~aMTI..t5! lnsY(~...QITJf!an;v ArbltratiP...b...MreJ:ment.;_
I understand that (~ept for Small C\eims Court ca~, claims subject to e Medicaiv appMls proi:l:"dure, ar,d, if I am enroUed
in a g~up that is subject to ERISA, certain beneftt-related disp~tes) any dispute betw,;,en rnysett, my he\rs., r~lative5 1 or Qther
associated partie~ on the ,;me h.iricl end K::iiser Foundation Health Plan1 Inc. (KFHP), Kai~er Permanent~ Insurance Company
(KPIC), any contracted health ,are provider$, administrators, or other associa\r,!d parties on the other hand, for alleged
violation of any dut)• arising out of or related to membership in KFHP or coverage- by KPIC, indudin9 any dalm for medie811
or hospital rnalpractic:e (a claim that medical sl!l'\lk:es were u!'lneC'A!!ttary or u0$uthorized or werv improperly, negligently, or
incornpetent!y rendered), for premises llabiht:y, or relating to the coyerage for,
or delivery of, s;ervil)!! or Items, irrespective of
l~gal theory, must be decided by binding arbitration under CallforMia law and not by lawsuit or rQSOrt to court i=rocei;~, except
ar. t1pplicable law providi!s for judic:ial review of arbitration ptoceedlngs. I agree to give up our right to a jury trial encl 1;1ccept
the use of bindin9 arbitration. I understt1ncl that th.i full arbitretio;in provi$ibn i!o l:Or,t:ain.id in the Evidence of Coverage and io
the Ce iflr;ate of lns1.1rance.
X /t!ilntrwes)
Date*
-•, 13
Covered California's online enrollment system
HOUSEHOLD CASE ID
APPLICATION (CASE ID 5004993160)
HEAD OF HOUSEHOLD Mary A Ayers
APPLICATION CREATED DATE 12/18/2014
APPLICATION SUBMIT DATE 03/22/2018
APPLICATION STATUS SUBMITTED
APPLICATION SOURCE SAWS
LAST MODIFIED DATE 04/03/2018
ENROLLMENT INFORMATION
INSURER NAME Kaiser
PLAN NAME Bronze 60 HMO
BENEFIT EFFECTIVE DATE 01/01/2015
BENEFIT END DATE 12/31/2015
ENROLLMENT STATUS Confirmed
ENROLLMENT ID 2621142
CREATED TIMESTAMP 12/18/2014 12:59:39 AM
ELECTRONIC SIGNATURE
CREATED BY USER ID deanand marysf
CREATED BY USER NAME Mary Anderson Ayers
CREATED BY USER ROLE Individual
ESIGNATURE NAME ENTERED Mary Anderson Ayers
ESIGNATURE DATE 12/18/2014 12:59:39 AM
AGREED TO BINDING ARBITRATION Yes
6/13/2018 9:10:45 AM
This message, together with any attachments, is intended only for the use of the individual(s) or entity whom it is addressed.
It may contain information that is confidential and prohibited from disclosure. If you are not the intended recipient, you are
Hereby notified that any dissemination or copying of this message and/or any attachment Is strictly prohibited. If you have
Received this message in error, please notify the original sender immediately by telephone or by return email and delete this
Message, along with any attachments
from vour comouter. Thank vou.
Page 1
1. Wireframes for Esignature\
1.1. Sign Application
The user provides an eSignature in this step.
COl/ltfiD
t,;. \
.'t!~· ,.
'.>; _;_ ! Esp:aiirn I Q
Logc.,t
i
; 1 Provide eSignature
r,::. ~ut
(.!;('-~~ a;, r,:ir·H..';\~ :-l :·L, Jn;
feJd lhi.:.• (lC~•:1 ,1:~:.1 ~ ~ . j 1.:•.H_l:'
,u',!' µl!•;.~::·.tl j,:lei•t1r,:.;(tJ-'"
-,i11 1 r
ll'..._ 1 1]l.),, I ~h-~
1'.-:
your P:U ,"-!,-J '"''!••:,~,-, yn;_:
(•'::11,:,1',tt1 •·r, -r
, - -i;:·,\: 1:•_. !_q,'.1n\· VJ!•pfl ~•,:;: t !-'_,-., \--'!l-~f, •'r".:.~"! ~;-:, "/'."'\'
..._: . _, •; w~- ...-.!··:,,,1 ~i\~.>
i\;:i(i.'?
i-
th:.:· t(~-·~··1 ,1n;i
11~._id
o~e,(, J:W:'. h.'1 ··~
,~j( (·."•t1s'J,lni•."'.~,.
-~·'
-_
l agree:
~~~.
To file a fecle,.a! incomi! tax rel urn "" 01 b?.l'o1e lhP. due d11te (or lhe •~•
, g ex:tens1111!5 of
lo clam, Lhe AdY;anc<,d Pwrn1urn Tax C1ed« (APTG), ,,J',\,,
,ru:i\\~.;,).lou~
To ,~;><>fl th~ng~s I¢ C=1~d C~hfornia it.al affecl rh~'@ l.'l!'.fnd
address, TilQs~ chang~s coo:d all'oct tho pans and A" \,gJblo:<;i\ ,:J;,
""'11 qu~~'¼9:~ 'l!'-'tW
I c~n110I swi\th p<3fl$ au\sid~ ol 1ht Opf'll En•o!Jp.:-nf
1!!~,11' Same ol tile
his''lff«- 3dopt,on of a child,
qualif',;ng l,fo e,1cm~ srt1 a f'(\tman~nl movoJh~',~111ls i~' '.Ji:c::.:U.ci-~., pjans
0
'}1"i',:i''
maniag<- or do!Tl<'s!lc l"'flnersh,p ·1;;:ci¾'"
'"_,~
I
- -~.;,;.:.~1,.:_"'.,
Binding Arbltratlon·Agd,•emi:.nt: , !O
:r;;j,c,
,_;~:;~,~'.:-
~-"-,,'"'.., ,_
,_-y. "; -
11,JNl~t,;t~nd th, ~, ,'' • ,1_jk.;;;, rul11t lot I tsor.in9 dl~p'llNIU f111!4, I Foatrw,at. a.mm!
:[Va!Jdatlar, . e:l•ffltlllt
' lbquln,dl llLl!lln,;,.; Rurt; Valldl!lt!Cll1
I
•Tppe Ot!,icrfptlcn ,. T.VPe ·~ptkln I
I ,
Cl>n1•nt ITitle NIA Ollfllay Text Pro'tlde .slgnahffll g Text Field Yes Displays eSign11un1 1h11 -
haa entared n•a
----·
2
I
l Cor,tantI Vas
1n,i;1rue1lr:,n 1¢, rl'il
Oiff!l~y TC!9e: Redirm back~ the cmrt
·------
...-.
J NA
t Thi1 lhoold b4- in
I Elothan(ile r\/s
Di&lll8'fli laid 1"'1 «in be translated aod C.lrt
[ .Agreemen1
1h11 conlent c.intiQured bj slates
manage.men! 12 8ut10n SulJo,111, ~ NA When select.d, ~ follov.i11g QCCU~: nla
t l.y5tffl1 so !NI 11 &S,,;inature' OhKiw lo see lhral 1 ha'tll read and agnN! lo...•
i canbeupdaled i;h;(lc box i!i ch!!cked.
I! 11 is not. dl~p'.ays -
, p~llytr, messag~ neirt to iL
~
5
t
-·-··-·-·
,1Cor.1en1
Corrran1
ea¢hGlil!C.
ISim-Titfe Y•
Yes
T&ld HCliOn 1¢1'
·---· ,.,.
Oi&plar, r • Binding Arbitration AQraem1mt
Display blndl1111 11rbitratkln ai;rttment
n'a I
tf enrollmentcnplaySignaiuraPIN " True,
v;d~es, llile PIN by ifj\f'gking AHBX PIN
Vo~d1t10,1 li:ito1a1'1t (lNU $3],.
B,inding At1.111r!\lion \
lf responH from int~e = Valid, con1inue lo #4.
Aorcernenl I
I If !i!Sl)Clnse from interface = 1n,,.afr.l, dlSplay "The
I Pl•~H niler :io !he tupp,IIM Plrbltradon I PiN you enlel'Ed does llOl mMc.11 file one ftll" your
l11ng1.i;tlil• fQr lhe app!IAl:II• v;llldlt:, perioc!. i
I ilt,;,:!M.rnL.
I
Checks lo IOI) lhPl"" eSlslniiluri: n,mc hui:I
6 Alk)o1'1$ useno
; Tv;xt F~ld YIIS · DIIPf,D~ tw;t ficald for r.ltgnati.m:i
Ml If 1115 nol. di:,p'.n-.·a em=- 111esn1111
teen tnlerl)d.
I
I
✓
lnp!.11 esigM~~
ror1M
I
I
11ext to it
Ir U,,:rn:: i,rct no crroffl ;iind lhe PIN ii 'l'Dlld,
I a!)ftell'\0111$, I Olsplays lhs oonilrrn•tian ~ -
7 cnect l:i1e lhll11/lo Aq~ 1'o The Binding Arbllllltloo Agr!1'K1Bnl pta~leE! and H~ Ille st•tus ID '1'11nding•,
user ~ t'l\!td ;sru:I L~s an e¥ent to lhe aVffll~ for ll1tl enioflm11<1t
i '-'9rOlldlOlh¢ where l'l'lflt_1ype = 0-:21 (
111r,ft. Initial
.\ blncmg arb~ralrOn Eitr:olln>cmO and C','Onl•..'-00 = EG (Scr,clil
! l)gr=i,nl
-, .. ,~-----,-· ........ _,_,...,_ Sah1c:tion.
lo ! Texi Field Yes
U~,r onblra ltle Di~uyed if conn;ivs\'.ltJorl ~ng Chocb lo
,l
ir
U,e global •conf,g\lf'illlCCl Vllluo lor ti-.: s.late =
PIN numb~r g,,vQn er.ccllmentdd.plalSignil'llJraPIN "True.
seQd'hlld Calrlami11, imrokc AH8X lnti;;mict" (IND 20) to
i \o1hem durlrq PIN II Hod onrollm11nt dll1a ID AHBX
I ;KOOUnl$81uplo
,I Toolbp: lo'"1en ltletll!ll di~'(I 1he ~.ilng f
lli.llhl\lnllcale t11e
; user.
10c(Up v.hicll lbauld be configurable by SIBie:
I! Tho UIIC!tl" ta lhan 'ilU\Qmatk:ill'lty lâ– loon IQ a
;1
Yw M! up a p0TVDnal ldcntifil;:aliorl numbor (?!N) e~rollfOOl'll C 1o your ac,ec,urtl
IM"lllro1et IL
~ Covered California
\ i;·- '}
COVERED
E-Signature Report from Enrollment
Covered California's online enrollment system
HOUSEHOLD CASE ID
APPLICATION (CASE ID 5004993160)
HEAD OF HOUSEHOLD Mary A Ayers
APPLICATION CREATED DATE 12/1B/2014
APPLICATION SUBMIT DATE 03/22/2018
APPLICATION STATUS SUBMITTED
APPLICATION SOURCE SAWS
LAST MODIFIED DATE 04/03/2018
ENROLLMENT INFORMATION
INSURER NAME Kaiser
PLAN NAME Bronze 60 HMO
BENEFIT EFFECTIVE DATE 01/01/2016
BENEFIT END DATE 12/31/2016
ENROLLMENT STATUS Confirmed
ENROLLMENT ID 4162100
CREATED TIMESTAMP 11/18/2015 10:18:22 AM
ELECTRONIC SIGNATURE
CREATED BY USER ID exchange@ghix.com
CREATED BY USER NAME Excahnge Adrnin Il
CREATED BY USER ROLE Admin
ESIGNATURE NAME ENTERED Mary Ayers
ESIGNATURE DATE 11/18/2015 10:18:22 AM
AGREED TO BINDING ARBITRATION Yes
6/13/2018 9:28:23 AM
This message, together with any attachments, is intended only for the use of the individual(s) or entity whom it is addressed.
It may contain information that is confidential and prohibited from disclosure. If you are not the intended recipient, you are
Hereby notified that any dissemination or copying of this message and/or any attachment is strictly prohibited, If you have
Received this message in error, please notify the original sender immediately by telephone or by return email and delete this
Message, alona with any attachments, from your computer. Thank vou.
Page 1
1. Wireframes for Esignatur~
1.1. Sign Application
The user provides an eSignature in this step.
! OllliM'Cti31 i Help
.:~·.:-.,·:c,•• '.',,·.-~•: 1-i'.1(1 2<:-':,,Jc
IQ
L°'lJsc~1 ; fap31iol
1
: 1 Provide eSignature
{~t~.:,.J •':LJt r ;.1 :~ct :~
7 . r~ l' J :;1
(: ~i'i \ (.''.~ ~, 1_•.· (.> ~: :, ·: Yi~ H do't~j t61gnici~v t 1 ;t. \ht
ti, ~\:I ! (1:J: pe:::. ·:,.· ..•! 1,;!~ :· tr Li.;,;;:;.,-:. •1 _,mt~•·
y,'<·,,
\',i:, ...:n
>~--~u!·~ r:,,--:,:;,·, P?!J irnd
f_,•;1!,1.1•.,·1~fJ1~', 1:
l'!j~J'-1 /-.iii' h.,-.J~::.::., c~.A1:l~·t€,Jc.i:)):.l
~LH(1 ,1.t;-:-·~.-1 :-,~l
~-t.1,..; Jltl
;":'",,'•,-,i":.':,
, l I a,g,e·ti \-l~:~r\t ;:
fo f.le ;i federal mcom.i la, re-lurn on or b,;fore lh~ due ,fate fer lhe r;,1ufi'(()i).cli,1~g e:<:1ens1~ of
,,,.{f:':?l~--
lo claim 1h~ Ad',a11c.ed Pram,um fax Cr~d,I (APTC). \~ 7 }l'.~
· fo r~p,1rt tbang~~ lo C('J;•t>led c~Morni'4 1hal 3~{'CI my el,g;bi'i\'i'io~
r,1C~1r-.~:-J'lt>ut-~~a'':;,ieiild
addrc~, ,-·.-c,,
Th~ s~ ciiJfl9(', co~:d affocL Lh~ i:-tarls a"d l1PtC~~nllich f 11.Ji,'i)'Jig,~o/, t:':',.
_,.
I wnno1 ~w•lch ftllnl• 01,:,id,; c:! 11,e Ope,~ l:".r110Jff',,}ni-P'~t,t;,ol~sJ'f:~1-I', ~ q,.,.;l;f/n{i-1if~ "Mn\
Scm,; of the
qua:,fying life ,;,cnl$ .,r~ J. Jl(Orm~ncnl fl\(11'1) 11,a(r~ult:. in k4iq,':t9;1&,·, pbn,;
hi,\t-. e>r')dop!ion of a child.
rn3rn3Se
01dom:?sllc p,annersh,~ --,. :;;;,~'.", .
.-:·_:,-::s·'--~
-• Bindrng Arbitration Agr~ment: B Print
I UI\Ofl$l;md I -.tutu {01 re.ct,vig di1pu1~s
C(d1Mm. J(!lriniStralCneil~n
I 1Con1ent (Title NIA Display Text: Prow:ie eSigna!Ure nla Q I
Text Field fYes
Ol~Jar.1 ll!lei
, eS,,Jni~ ;
n'a
Oisplays eS1gna1Wre lhe u~r )1,111 er,1ered
2 jeoo1ent Yes
ln~lruc1i01' !)Cf Di~-Pl'-'.Y Tex• To ~dlouL re~d the agreement
r\!a
!
!
I
i,S~!UfellllO !,ere or,d enter your pc:~l klen1mc..~tion I 1 The field is set to T od:ay's date, Display only.
a,11reemt'!ll nelds nu,nbet (PIN) and eSigniJl.....e in ltlc &PQD:$
10 ~nts lhe agreement "1tlen p,e,i;~ed wa
bc,l<;,,t bd>;w/. When you o:inkt yoor PIN .iJld e.SO.ni11ure, Print Allows 1he 1F,;er to
: NA
a maans yau are ,ura abaUI the h.eallh ln...,rsnoa prin4 the- tllfT!la and i
l¼!r eement
piat,s you rnose and t>ave read an 1he term!I 11100 Bul.1on • <:ortditloos I
i ilgl'eEtffi&n1.
j .
l
c.:mdtt1ooa
!Goetl h,,¢11 •o Ht!:!
fNA
~-
11 Bu11on RE.cn p,age
7 Ct-.e<:lmo~
Chec:kbOX to Ye-s nra
Cti${)1ay ~ x 3nd l!Otl l 1!3'-e Read And Creates the en(cilmen1 rWl!rnti::>n ,iclling
,_
Ch~lo
Selection.
II lhc g,loool ronfiQIJCollioo value Jor l~ ~all!: =
PIN number gNr
·14 the purpose of proving prior b.m acts pursuant to .California Evid¢nce Cod~ §1101 {b) to establish
15 a common design or plan was denied.
16 On October23~2019, Claimantserved aMotionT-0 StayProceedirigs Until Deceniber:9,.
17 · 2019, At Hobart Buildinig, 582 Market Street, San Francisco, 'To AdmitClaimanf''S Exh:ibit 1\,
18 Parts 1 To 10, AsStipulated Medic;tl Records And To Order Issue Sanctions (sic) Against
19 Respondents Qn Liability For Providing False Medical R.ecord Binders To Arbifrator And To
20 Order A Mistrial. On October 24, 2019, Respondents objected. Claimant's ¢otion was denied.
21 On November 12, 2019. Claimai;1t moved for Reconsideration ofthe Arbitrator's
22 November 1:2.., 2019Decision0f'':Bad Acts" and to Take JudiciaLNoticeofthe California
23 Department of Managed Health Care Report of Juµe 12,2017 and To Take Judicial Notice dfthe
24
Page4of46
Ayers v. Kaiser - Decision
l Kn6x-Keene Act, Health & SafotyCode § 1340 et seq. On November 19, 2019, Claimant filed
2 an Amended Motion for Reconsideration of the Arbitrator's November 12, 2019 Decision Of
3 "'Bad Acts" and to Take Judicial Notice of the California Department of Managed Health Care
4 Report of June 12, 2017 and To Take Judicial Notice of the Knox-Keene Act, Health & .Safety
5 Code § 1340 et seq. Based on New Facts and Upon Evidence Code §452 (C). Respondent
6 objected.
7 On December 2, 2019, the Arbitrator ruled that the prior Arbitrator's Ruling Re
8 Claimant'·s Motion Pursuant to California Evidence Code§ 1101 and § 1280 to Admit DMHC
9 Reports, Drs. Bun-ough's and Water's Testimony re Prior Bad Acts is Amended with the deleHo
10 of the reference to the Settlement Agreement. Claimant's request for the Arbitrator to take
11 judicial notice of the Knox-Keene Act, Health and Safety Code §1340 et seq., was granted.
12 Claimant's request for the Arbitrator to take judicial notice of the California Department of
13 Managed Health Care Report of June 12, 2017 was granted, exclusive of its contents and
14 pursuant to the limitations imposed above. Claimant's request for reconsideration ofthe
15 admissibility of the contents 2017 DHMC report regarding the "Bad Acts" was denied.
16 Respondent's request for sanctions was denied.
17 On November 15, 2019, Claimant moved to '"Reopen'' Claimant's Casc-in-Chiefln the
18 Interest of Judgment (sic). Respondents objected. On December 2, 2019, Claimant's motion to
19 re-open her casc-in-chiefin order to have Dr. Burroughs testify on the issue ofthe preservation
.20 and/or altetation of electronic medicalrecords was granted. Claimant's motion to =re-open her
21 case-in..;chi.efin order to submit a certified copy of the DMHG of2017 was denied.
22 Claimant.asserted that the original fee waiver applies to the cost of Reporter's transcript
23 · of the proceedings and requests a copy be provided to her &t no cost Respohdents opposed that
24
Page 5 of 46
Ayers v. Kaiser - Decision
1 request. On January 23, 2020, Claimant's. motion was denied, with the provision that if
2 Respondents refer to the transcript in argument or in their brief, they shall supply a copy of that
3 excerpt to Claimant
4 Closing Arguments were heard on February 28, 2020. The case was deemed closed on
5 March 6, 2020 based upon the submission of the final transcripts reet,'ived. The deadline for the
6 Arbjtration Award is April 17, 2020.
7 On March 2, 2020, Claimant's "Motion to Dismiss" and/or Motion for a Mistrial was
8 denied.
9 On April 7, 2020, Claimant served a Motion to Disqualify Arbitrator Per Code of Civil
10 Procedure §128L91(d). On April 8, 2020, Claimant's motion was denied,
11 On April 13, 2020, Claimant served a second Motion to Disqualify Arbitrator Pursuant to
12 CCP§ 1281.91 (D), CCP§l 70.1, CCR§J.8(6)(2). That motion was denied on.April 14,2020.
13 II
14 Factual Background
15 On February 23, 2016. Claimant and her husband, Dean Ayers (hereafter ''Husband''),
16 were assaulted by several individuals near their home in San Francisco, Claimant was struck in
17 the face and thrown to the ground. She was knocked unconscious. When the police came, she
18 was rushed to the neurosurgery ward of San Francisco General Hospital (SFGH_). The diagnosis
19 was: subarachnoid hemorrhage (SAD), along the left temporal lobe, right parietal scalp
20 hematoma, right parietal and temporal bone fracture, right si,heroid fracture and bilateral
2I nondisplaced nasaJ fractute. Claimant's husband, also suffered a broken bone in his leg/ankle.
22 During her two day stay at SFGH, neurosurgeons conducted an assessment. Claimant's Glasgow
23· Coma Scale was a score of 14 out of 15 which was deemed a mild.Traumatic Brain Injury. Two
24
Page 6 of46
Ayers v. Kaiser -Decision
1 CT scans showed fractures and slight intracranial bleeding, but neurological consults determined
2 that no surgical treatment was necessary, and she was transferred to the Kaiser Foundation
3 Hospital in San Francisco upon her condition stabilizing. The SfGHrecord ne>ted that Claimant
4 had a prior history of fib
Preview
ADR-106 George E. Clause, Esq. (S BNe,88107) AllORNEY OR PARTY WITI-IOUT ATTORNEYSlale Barnumt>er, anciaddress): FOR COURT USE ONLY ~ Brian M. Davies, Esq. (SBN 279728) I !ayes Scott Bonino Ellingson Guslani Simonson & Clallse LLP 999 SkJwai T EPH Roag 5§~~ff. NE NO.: - -9q0fi-edwood Cit~ CA, 94070 FAX NO. (Op. nal): ELECTRONICALLY 1---MAIL ADDRESS (Oplmnal): Defendants ATTORNEY FOR (Name). F I L E D Superior Court of California, County of San Francisco SUPERIOR COURT OF CALIFORNIA, COUNTY OF San Francisco srREETADDREss,400 McAllister Street 07/30/2020 MAIi ING AllllH~SS. Clerk of the Court San Francisco, c1rv ANo z:1P cooE CA 94102 BY: SANDRA SCHIRO BRANCH NAMf·Civic Center Collrthollse Deputy Clerk PETITIONER: MARY AYERS RESPONDENT: KAISER FOUNDATION HOSPITALS, et al. PETITION TO [lJ CONFIRM D CORRECT D VACATE CONTRACTUAL ARBITRATION AWARD Jurisdiction (check all that apply): D Action is a limited civil case Amount demanded D does not exceed $10,000 D exceeds $10,000, but does not exceed $25,000 CASE NUMEJER: [ZJ Action is an unlimited civil case (exceeds $25,000) CPF-20-51716 l NOTICE: You may use this form to request that the court confirm, correct, or vacate an award in an arbitration conducted pursuant to an agreement between the parties that is subject to Code of Civil Procedure section 1285 et seq. and that does not involve an attorney-client fee dispute. If you are requesting court action after an attorney-client fee arbitration award, please read Alternative Dispute Resolution form ADR-105, Information Regarding Rights After Attorney-Client Fee Arbitration. 1. Petitioner and respondent. Petitioner (name each): Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc., The Permanente Medical Group, Inc., Leslie Aiken, MD, Meaghan Lynch, MD, and Jacqueline Poggi, MD. alleges and requests relief against respondent (name each): Mary Ayers 2. Contractual arbitration. This petition requests the court to confirm, correct, or vacate an award in an arbitration conducted according to an agreement between the parties that is subject to Code of Civil Procedure section 1285 et seq. 3. Pending or new action. a. [ZJ A court case is already pending, and this is a petition filed in that action. (ff so, proceed to item 4.) b. D This petition commences a new action. (If so, complete items 3b(1) through 3b(4).) (1) Petitioner's capacity. Each petitioner named in item 1 is an individual, D except petitioner (state name and complete one or more of the fol/owing): (a)D is a corporation qualified to do business in California. (b)D is an unincorporated entity (specify): (c)D is a representative (specify),· (d)D is (specify other capacity): (2) Respondent's capacity, Each respondent named In item 1 is an individual, D except respondent (state name and complete one or more of the following): (a)D is a business organization, form unknown. (b)D is a corporation. (c)D is an unincorporated entity (specify): (d)D is a representative (specify): (e)D is (specify other capacity): Page 1 of 3 Form ApprovelG & WTNDO\X! COVERINGS 778 BRANNAN ST SA~ FRANCISCO, CA 94103 FACSIMILE TRANSMITTAL SHEET _'PROM: LINDA B1-\RO:'JIA COMPANY: FAX ~UMBRR: TO'fAL NO. F P.AGES f IY,.. f 5'1- 6'ff6f"INCLUDTNG COVER: PHONE NUMBER: SE:-.JDER'S PHO~E/FAX NUMBER: 415.863.3110/ 415.863.9561 RE: YOUR REPERTINCB NUMBER! ~URGENT □ FOR REVIEW □ PLE.ASE COMMENT □ PLD . . T: •! 1 s. i,,,;,;1 I I(\ ... , ,i I 5, 11r,,;,9,,r<1 lr.:N .\ l'I l~N 1\ 1.1\1,lNDR(i\l.Y ,\ I HH),C(~ M Enrollment form Pia a:ie prInt gr Ii' pe I~ bl ll~ t lnK n11 ty-. Sve Inw,uc Uans ~n papu 16 bela re rom~ Iel Ing 111·I! to nn. M.itB 3 t.apy hir ynurrucard~- ro be coompleted by EMPLOYER 0 New grnup ~ccount ~Existing group accol.Jnr If_lf-1' 'o JJ ftf,. 0J-.1'ruDs J:r.1c.... OOO(bbf/763 _Lb__j_£ J '),0 0 Company name~ Group nurnber Date coverage to be effective .. Ecnrollment unit Pla.n selectiOI' Emplol1ee d.iss!f1cetion (if applic.i!;,le) /1tJ. p.~me E, Ernployet> - _fr f..J 1)6 P-I:o,,J _J_;____!_$_;.21. Date of hire EnrQllment rea$0n,. (Pfl!:ase chec;:k oni,.) □ New 9ro1.1p ZICCOtint JiilN<2w hire Cl Open enrollment -full timG ___J-------.J~- Q Part time to 0 Lo5s of coverage ____}__,/,-~- uOther Evel"lt date _ ___j.,.__/_ _ _ Tc b1o1 completed by EMPLOYEE ~ Are you now or have; you ever been a member of, or received cim~ from, Kalsr::-r Permanente il'l Cail'fornla? □ Yss);' No If ~o, under v.1hat medical record number (if known)"? Former/Maiden name? _.81'.1de13:o~lk1~ f_ (J~-7_~- '?~ (J ~ E:.r,..~·s L~ Name (La!.~. First, MI)• $oci~I Secunty nurnber * F>rderred ~okeri or written l,inguage (optiOni.1I> 4-IS _J)v..b.oc=R_, Home !!ddres:;'" A\J~ _ Apt no, 0~F~c..t'.Sco City CA State 9rlic ZIP ~...J2..J 7 a Gender" D M)(F L},( c; .. g 1~~751-l 1-f S- 15<,;s ,. 3 II o Daw of l;,irth• Home phone• Work phone / m:J Family informatic;m Ne?-\ 0 SpQU~e I D~t!:! of birth" tJ Pomesi:ic pi!rtn/r GendiN" jsoci:itl Security no.* □ M □ F N~me (Last, fir.t, Ml) Medic.ii reeord no. (if known) □ Child O Studerrt. JDate of birth" Go!nder•· Social $0curity no.w OM □ F rim, Ml) Nilrne (LElst, Medical record no. (if known) □ Chile;! □ Student I Dat~ of birth• Gender* Social 5ecuri1y no,* LIM □ F Nome (Last, Fir!.t, Ml) Medical record no. (if known) ·- 0 O,ild tl Student j Date of birth~ Gender" (las,;, First, N,..,me MI) I□ IYl □ F Sod.ii Security no,* Medical record no, (if knDwn) Will you pe .edding additional dependents? 0 Vgs)f No Add any additional depend~n-t:£ ml page 15. ~ !S,aiser .foun~n.H~alth PlaQ, m.s.....,'lmXfils~aMTI..t5! lnsY(~...QITJf!an;v ArbltratiP...b...MreJ:ment.;_ I understand that (~ept for Small C\eims Court ca~, claims subject to e Medicaiv appMls proi:l:"dure, ar,d, if I am enroUed in a g~up that is subject to ERISA, certain beneftt-related disp~tes) any dispute betw,;,en rnysett, my he\rs., r~lative5 1 or Qther associated partie~ on the ,;me h.iricl end K::iiser Foundation Health Plan1 Inc. (KFHP), Kai~er Permanent~ Insurance Company (KPIC), any contracted health ,are provider$, administrators, or other associa\r,!d parties on the other hand, for alleged violation of any dut)• arising out of or related to membership in KFHP or coverage- by KPIC, indudin9 any dalm for medie811 or hospital rnalpractic:e (a claim that medical sl!l'\lk:es were u!'lneC'A!!ttary or u0$uthorized or werv improperly, negligently, or incornpetent!y rendered), for premises llabiht:y, or relating to the coyerage for, or delivery of, s;ervil)!! or Items, irrespective of l~gal theory, must be decided by binding arbitration under CallforMia law and not by lawsuit or rQSOrt to court i=rocei;~, except ar. t1pplicable law providi!s for judic:ial review of arbitration ptoceedlngs. I agree to give up our right to a jury trial encl 1;1ccept the use of bindin9 arbitration. I understt1ncl that th.i full arbitretio;in provi$ibn i!o l:Or,t:ain.id in the Evidence of Coverage and io the Ce iflr;ate of lns1.1rance. X /t!ilntrwes) Date* -•, 13 Covered California's online enrollment system HOUSEHOLD CASE ID APPLICATION (CASE ID 5004993160) HEAD OF HOUSEHOLD Mary A Ayers APPLICATION CREATED DATE 12/18/2014 APPLICATION SUBMIT DATE 03/22/2018 APPLICATION STATUS SUBMITTED APPLICATION SOURCE SAWS LAST MODIFIED DATE 04/03/2018 ENROLLMENT INFORMATION INSURER NAME Kaiser PLAN NAME Bronze 60 HMO BENEFIT EFFECTIVE DATE 01/01/2015 BENEFIT END DATE 12/31/2015 ENROLLMENT STATUS Confirmed ENROLLMENT ID 2621142 CREATED TIMESTAMP 12/18/2014 12:59:39 AM ELECTRONIC SIGNATURE CREATED BY USER ID deanand marysf CREATED BY USER NAME Mary Anderson Ayers CREATED BY USER ROLE Individual ESIGNATURE NAME ENTERED Mary Anderson Ayers ESIGNATURE DATE 12/18/2014 12:59:39 AM AGREED TO BINDING ARBITRATION Yes 6/13/2018 9:10:45 AM This message, together with any attachments, is intended only for the use of the individual(s) or entity whom it is addressed. It may contain information that is confidential and prohibited from disclosure. If you are not the intended recipient, you are Hereby notified that any dissemination or copying of this message and/or any attachment Is strictly prohibited. If you have Received this message in error, please notify the original sender immediately by telephone or by return email and delete this Message, along with any attachments from vour comouter. Thank vou. Page 1 1. Wireframes for Esignature\ 1.1. Sign Application The user provides an eSignature in this step. COl/ltfiD t,;. \ .'t!~· ,. '.>; _;_ ! Esp:aiirn I Q Logc.,t i ; 1 Provide eSignature r,::. ~ut (.!;('-~~ a;, r,:ir·H..';\~ :-l :·L, Jn; feJd lhi.:.• (lC~•:1 ,1:~:.1 ~ ~ . j 1.:•.H_l:' ,u',!' µl!•;.~::·.tl j,:lei•t1r,:.;(tJ-'" -,i11 1 r ll'..._ 1 1]l.),, I ~h-~ 1'.-: your P:U ,"-!,-J '"''!••:,~,-, yn;_: (•'::11,:,1',tt1 •·r, -r , - -i;:·,\: 1:•_. !_q,'.1n\· VJ!•pfl ~•,:;: t !-'_,-., \--'!l-~f, •'r".:.~"! ~;-:, "/'."'\' ..._: . _, •; w~- ...-.!··:,,,1 ~i\~.> i\;:i(i.'? i- th:.:· t(~-·~··1 ,1n;i 11~._id o~e,(, J:W:'. h.'1 ··~ ,~j( (·."•t1s'J,lni•."'.~,. -~·' -_ l agree: ~~~. To file a fecle,.a! incomi! tax rel urn "" 01 b?.l'o1e lhP. due d11te (or lhe •~• , g ex:tens1111!5 of lo clam, Lhe AdY;anc<,d Pwrn1urn Tax C1ed« (APTG), ,,J',\,, ,ru:i\\~.;,).lou~ To ,~;><>fl th~ng~s I¢ C=1~d C~hfornia it.al affecl rh~'@ l.'l!'.fnd address, TilQs~ chang~s coo:d all'oct tho pans and A" \,gJblo:<;i\ ,:J;, ""'11 qu~~'¼9:~ 'l!'-'tW I c~n110I swi\th p<3fl$ au\sid~ ol 1ht Opf'll En•o!Jp.:-nf 1!!~,11' Same ol tile his''lff«- 3dopt,on of a child, qualif',;ng l,fo e,1cm~ srt1 a f'(\tman~nl movoJh~',~111ls i~' '.Ji:c::.:U.ci-~., pjans 0 '}1"i',:i'' maniag<- or do!Tl<'s!lc l"'flnersh,p ·1;;:ci¾'" '"_,~ I - -~.;,;.:.~1,.:_"'., Binding Arbltratlon·Agd,•emi:.nt: , !O :r;;j,c, ,_;~:;~,~'.:- ~-"-,,'"'.., ,_ ,_-y. "; - 11,JNl~t,;t~nd th, ~, ,'' • ,1_jk.;;;, rul11t lot I tsor.in9 dl~p'llNIU f111!4, I Foatrw,at. a.mm! :[Va!Jdatlar, . e:l•ffltlllt ' lbquln,dl llLl!lln,;,.; Rurt; Valldl!lt!Cll1 I •Tppe Ot!,icrfptlcn ,. T.VPe ·~ptkln I I , Cl>n1•nt ITitle NIA Ollfllay Text Pro'tlde .slgnahffll g Text Field Yes Displays eSign11un1 1h11 - haa entared n•a ----· 2 I l Cor,tantI Vas 1n,i;1rue1lr:,n 1¢, rl'il Oiff!l~y TC!9e: Redirm back~ the cmrt ·------ ...-. J NA t Thi1 lhoold b4- in I Elothan(ile r\/s Di&lll8'fli laid 1"'1 «in be translated aod C.lrt [ .Agreemen1 1h11 conlent c.intiQured bj slates manage.men! 12 8ut10n SulJo,111, ~ NA When select.d, ~ follov.i11g QCCU~: nla t l.y5tffl1 so !NI 11 &S,,;inature' OhKiw lo see lhral 1 ha'tll read and agnN! lo...• i canbeupdaled i;h;(lc box i!i ch!!cked. I! 11 is not. dl~p'.ays - , p~llytr, messag~ neirt to iL ~ 5 t -·-··-·-· ,1Cor.1en1 Corrran1 ea¢hGlil!C. ISim-Titfe Y• Yes T&ld HCliOn 1¢1' ·---· ,.,. Oi&plar, r • Binding Arbitration AQraem1mt Display blndl1111 11rbitratkln ai;rttment n'a I tf enrollmentcnplaySignaiuraPIN " True, v;d~es, llile PIN by ifj\f'gking AHBX PIN Vo~d1t10,1 li:ito1a1'1t (lNU $3],. B,inding At1.111r!\lion \ lf responH from int~e = Valid, con1inue lo #4. Aorcernenl I I If !i!Sl)Clnse from interface = 1n,,.afr.l, dlSplay "The I Pl•~H niler :io !he tupp,IIM Plrbltradon I PiN you enlel'Ed does llOl mMc.11 file one ftll" your l11ng1.i;tlil• fQr lhe app!IAl:II• v;llldlt:, perioc!. i I ilt,;,:!M.rnL. I Checks lo IOI) lhPl"" eSlslniiluri: n,mc hui:I 6 Alk)o1'1$ useno ; Tv;xt F~ld YIIS · DIIPf,D~ tw;t ficald for r.ltgnati.m:i Ml If 1115 nol. di:,p'.n-.·a em=- 111esn1111 teen tnlerl)d. I I ✓ lnp!.11 esigM~~ ror1M I I 11ext to it Ir U,,:rn:: i,rct no crroffl ;iind lhe PIN ii 'l'Dlld, I a!)ftell'\0111$, I Olsplays lhs oonilrrn•tian ~ - 7 cnect l:i1e lhll11/lo Aq~ 1'o The Binding Arbllllltloo Agr!1'K1Bnl pta~leE! and H~ Ille st•tus ID '1'11nding•, user ~ t'l\!td ;sru:I L~s an e¥ent to lhe aVffll~ for ll1tl enioflm11<1t i '-'9rOlldlOlh¢ where l'l'lflt_1ype = 0-:21 ( 111r,ft. Initial .\ blncmg arb~ralrOn Eitr:olln>cmO and C','Onl•..'-00 = EG (Scr,clil ! l)gr=i,nl -, .. ,~-----,-· ........ _,_,...,_ Sah1c:tion. lo ! Texi Field Yes U~,r onblra ltle Di~uyed if conn;ivs\'.ltJorl ~ng Chocb lo ,l ir U,e global •conf,g\lf'illlCCl Vllluo lor ti-.: s.late = PIN numb~r g,,vQn er.ccllmentdd.plalSignil'llJraPIN "True. seQd'hlld Calrlami11, imrokc AH8X lnti;;mict" (IND 20) to i \o1hem durlrq PIN II Hod onrollm11nt dll1a ID AHBX I ;KOOUnl$81uplo ,I Toolbp: lo'"1en ltletll!ll di~'(I 1he ~.ilng f lli.llhl\lnllcale t11e ; user. 10c(Up v.hicll lbauld be configurable by SIBie: I! Tho UIIC!tl" ta lhan 'ilU\Qmatk:ill'lty l■loon IQ a ;1 Yw M! up a p0TVDnal ldcntifil;:aliorl numbor (?!N) e~rollfOOl'll C 1o your ac,ec,urtl IM"lllro1et IL ~ Covered California \ i;·- '} COVERED E-Signature Report from Enrollment Covered California's online enrollment system HOUSEHOLD CASE ID APPLICATION (CASE ID 5004993160) HEAD OF HOUSEHOLD Mary A Ayers APPLICATION CREATED DATE 12/1B/2014 APPLICATION SUBMIT DATE 03/22/2018 APPLICATION STATUS SUBMITTED APPLICATION SOURCE SAWS LAST MODIFIED DATE 04/03/2018 ENROLLMENT INFORMATION INSURER NAME Kaiser PLAN NAME Bronze 60 HMO BENEFIT EFFECTIVE DATE 01/01/2016 BENEFIT END DATE 12/31/2016 ENROLLMENT STATUS Confirmed ENROLLMENT ID 4162100 CREATED TIMESTAMP 11/18/2015 10:18:22 AM ELECTRONIC SIGNATURE CREATED BY USER ID exchange@ghix.com CREATED BY USER NAME Excahnge Adrnin Il CREATED BY USER ROLE Admin ESIGNATURE NAME ENTERED Mary Ayers ESIGNATURE DATE 11/18/2015 10:18:22 AM AGREED TO BINDING ARBITRATION Yes 6/13/2018 9:28:23 AM This message, together with any attachments, is intended only for the use of the individual(s) or entity whom it is addressed. It may contain information that is confidential and prohibited from disclosure. If you are not the intended recipient, you are Hereby notified that any dissemination or copying of this message and/or any attachment is strictly prohibited, If you have Received this message in error, please notify the original sender immediately by telephone or by return email and delete this Message, alona with any attachments, from your computer. Thank vou. Page 1 1. Wireframes for Esignatur~ 1.1. Sign Application The user provides an eSignature in this step. ! OllliM'Cti31 i Help .:~·.:-.,·:c,•• '.',,·.-~•: 1-i'.1(1 2<:-':,,Jc IQ L°'lJsc~1 ; fap31iol 1 : 1 Provide eSignature {~t~.:,.J •':LJt r ;.1 :~ct :~ 7 . r~ l' J :;1 (: ~i'i \ (.''.~ ~, 1_•.· (.> ~: :, ·: Yi~ H do't~j t61gnici~v t 1 ;t. \ht ti, ~\:I ! (1:J: pe:::. ·:,.· ..•! 1,;!~ :· tr Li.;,;;:;.,-:. •1 _,mt~•· y,'<·,, \',i:, ...:n >~--~u!·~ r:,,--:,:;,·, P?!J irnd f_,•;1!,1.1•.,·1~fJ1~', 1: l'!j~J'-1 /-.iii' h.,-.J~::.::., c~.A1:l~·t€,Jc.i:)):.l ~LH(1 ,1.t;-:-·~.-1 :-,~l ~-t.1,..; Jltl ;":'",,'•,-,i":.':, , l I a,g,e·ti \-l~:~r\t ;: fo f.le ;i federal mcom.i la, re-lurn on or b,;fore lh~ due ,fate fer lhe r;,1ufi'(()i).cli,1~g e:<:1ens1~ of ,,,.{f:':?l~-- lo claim 1h~ Ad',a11c.ed Pram,um fax Cr~d,I (APTC). \~ 7 }l'.~ · fo r~p,1rt tbang~~ lo C('J;•t>led c~Morni'4 1hal 3~{'CI my el,g;bi'i\'i'io~ r,1C~1r-.~:-J'lt>ut-~~a'':;,ieiild addrc~, ,-·.-c,, Th~ s~ ciiJfl9(', co~:d affocL Lh~ i:-tarls a"d l1PtC~~nllich f 11.Ji,'i)'Jig,~o/, t:':',. _,. I wnno1 ~w•lch ftllnl• 01,:,id,; c:! 11,e Ope,~ l:".r110Jff',,}ni-P'~t,t;,ol~sJ'f:~1-I', ~ q,.,.;l;f/n{i-1if~ "Mn\ Scm,; of the qua:,fying life ,;,cnl$ .,r~ J. Jl(Orm~ncnl fl\(11'1) 11,a(r~ult:. in k4iq,':t9;1&,·, pbn,; hi,\t-. e>r')dop!ion of a child. rn3rn3Se 01dom:?sllc p,annersh,~ --,. :;;;,~'.", . .-:·_:,-::s·'--~ -• Bindrng Arbitration Agr~ment: B Print I UI\Ofl$l;md I -.tutu {01 re.ct,vig di1pu1~s C(d1Mm. J(!lriniStralCneil~n I 1Con1ent (Title NIA Display Text: Prow:ie eSigna!Ure nla Q I Text Field fYes Ol~Jar.1 ll!lei , eS,,Jni~ ; n'a Oisplays eS1gna1Wre lhe u~r )1,111 er,1ered 2 jeoo1ent Yes ln~lruc1i01' !)Cf Di~-Pl'-'.Y Tex• To ~dlouL re~d the agreement r\!a ! ! I i,S~!UfellllO !,ere or,d enter your pc:~l klen1mc..~tion I 1 The field is set to T od:ay's date, Display only. a,11reemt'!ll nelds nu,nbet (PIN) and eSigniJl.....e in ltlc &PQD:$ 10 ~nts lhe agreement "1tlen p,e,i;~ed wa bc,l<;,,t bd>;w/. When you o:inkt yoor PIN .iJld e.SO.ni11ure, Print Allows 1he 1F,;er to : NA a maans yau are ,ura abaUI the h.eallh ln...,rsnoa prin4 the- tllfT!la and i l¼!r eement piat,s you rnose and t>ave read an 1he term!I 11100 Bul.1on • <:ortditloos I i ilgl'eEtffi&n1. j . l c.:mdtt1ooa !Goetl h,,¢11 •o Ht!:! fNA ~- 11 Bu11on RE.cn p,age 7 Ct-.e<:lmo~ Chec:kbOX to Ye-s nra Cti${)1ay ~ x 3nd l!Otl l 1!3'-e Read And Creates the en(cilmen1 rWl!rnti::>n ,iclling ,_ Ch~lo Selection. II lhc g,loool ronfiQIJCollioo value Jor l~ ~all!: = PIN number gNr ·14 the purpose of proving prior b.m acts pursuant to .California Evid¢nce Cod~ §1101 {b) to establish 15 a common design or plan was denied. 16 On October23~2019, Claimantserved aMotionT-0 StayProceedirigs Until Deceniber:9,. 17 · 2019, At Hobart Buildinig, 582 Market Street, San Francisco, 'To AdmitClaimanf''S Exh:ibit 1\, 18 Parts 1 To 10, AsStipulated Medic;tl Records And To Order Issue Sanctions (sic) Against 19 Respondents Qn Liability For Providing False Medical R.ecord Binders To Arbifrator And To 20 Order A Mistrial. On October 24, 2019, Respondents objected. Claimant's ¢otion was denied. 21 On November 12, 2019. Claimai;1t moved for Reconsideration ofthe Arbitrator's 22 November 1:2.., 2019Decision0f'':Bad Acts" and to Take JudiciaLNoticeofthe California 23 Department of Managed Health Care Report of Juµe 12,2017 and To Take Judicial Notice dfthe 24 Page4of46 Ayers v. Kaiser - Decision l Kn6x-Keene Act, Health & SafotyCode § 1340 et seq. On November 19, 2019, Claimant filed 2 an Amended Motion for Reconsideration of the Arbitrator's November 12, 2019 Decision Of 3 "'Bad Acts" and to Take Judicial Notice of the California Department of Managed Health Care 4 Report of June 12, 2017 and To Take Judicial Notice of the Knox-Keene Act, Health & .Safety 5 Code § 1340 et seq. Based on New Facts and Upon Evidence Code §452 (C). Respondent 6 objected. 7 On December 2, 2019, the Arbitrator ruled that the prior Arbitrator's Ruling Re 8 Claimant'·s Motion Pursuant to California Evidence Code§ 1101 and § 1280 to Admit DMHC 9 Reports, Drs. Bun-ough's and Water's Testimony re Prior Bad Acts is Amended with the deleHo 10 of the reference to the Settlement Agreement. Claimant's request for the Arbitrator to take 11 judicial notice of the Knox-Keene Act, Health and Safety Code §1340 et seq., was granted. 12 Claimant's request for the Arbitrator to take judicial notice of the California Department of 13 Managed Health Care Report of June 12, 2017 was granted, exclusive of its contents and 14 pursuant to the limitations imposed above. Claimant's request for reconsideration ofthe 15 admissibility of the contents 2017 DHMC report regarding the "Bad Acts" was denied. 16 Respondent's request for sanctions was denied. 17 On November 15, 2019, Claimant moved to '"Reopen'' Claimant's Casc-in-Chiefln the 18 Interest of Judgment (sic). Respondents objected. On December 2, 2019, Claimant's motion to 19 re-open her casc-in-chiefin order to have Dr. Burroughs testify on the issue ofthe preservation .20 and/or altetation of electronic medicalrecords was granted. Claimant's motion to =re-open her 21 case-in..;chi.efin order to submit a certified copy of the DMHG of2017 was denied. 22 Claimant.asserted that the original fee waiver applies to the cost of Reporter's transcript 23 · of the proceedings and requests a copy be provided to her &t no cost Respohdents opposed that 24 Page 5 of 46 Ayers v. Kaiser - Decision 1 request. On January 23, 2020, Claimant's. motion was denied, with the provision that if 2 Respondents refer to the transcript in argument or in their brief, they shall supply a copy of that 3 excerpt to Claimant 4 Closing Arguments were heard on February 28, 2020. The case was deemed closed on 5 March 6, 2020 based upon the submission of the final transcripts reet,'ived. The deadline for the 6 Arbjtration Award is April 17, 2020. 7 On March 2, 2020, Claimant's "Motion to Dismiss" and/or Motion for a Mistrial was 8 denied. 9 On April 7, 2020, Claimant served a Motion to Disqualify Arbitrator Per Code of Civil 10 Procedure §128L91(d). On April 8, 2020, Claimant's motion was denied, 11 On April 13, 2020, Claimant served a second Motion to Disqualify Arbitrator Pursuant to 12 CCP§ 1281.91 (D), CCP§l 70.1, CCR§J.8(6)(2). That motion was denied on.April 14,2020. 13 II 14 Factual Background 15 On February 23, 2016. Claimant and her husband, Dean Ayers (hereafter ''Husband''), 16 were assaulted by several individuals near their home in San Francisco, Claimant was struck in 17 the face and thrown to the ground. She was knocked unconscious. When the police came, she 18 was rushed to the neurosurgery ward of San Francisco General Hospital (SFGH_). The diagnosis 19 was: subarachnoid hemorrhage (SAD), along the left temporal lobe, right parietal scalp 20 hematoma, right parietal and temporal bone fracture, right si,heroid fracture and bilateral 2I nondisplaced nasaJ fractute. Claimant's husband, also suffered a broken bone in his leg/ankle. 22 During her two day stay at SFGH, neurosurgeons conducted an assessment. Claimant's Glasgow 23· Coma Scale was a score of 14 out of 15 which was deemed a mild.Traumatic Brain Injury. Two 24 Page 6 of46 Ayers v. Kaiser -Decision 1 CT scans showed fractures and slight intracranial bleeding, but neurological consults determined 2 that no surgical treatment was necessary, and she was transferred to the Kaiser Foundation 3 Hospital in San Francisco upon her condition stabilizing. The SfGHrecord ne>ted that Claimant 4 had a prior history of fib