The Court of Appeal of the State of California Fifth Appellate District (“California Appellate Court”) held in its unpublished opinion filed on January 31, 2022 that the trial court erred in dismissing a father’s lawsuit against a hospital and Donor Network West for intentional infliction of emotional distress regarding their handling of his daughter’s death in the hospital and the donation of her organs.
The trial court found that the complaint failed as a matter of law because the plaintiff did not allege (1) intentional conduct primarily directed at him or (2) reckless conduct in his presence.
The Underlying Facts
The plaintiff and his ex-wife had a daughter, Brittany, who was admitted to the hospital with a strangulation injury on November 17, 2017. For a few days after Brittany’s admission, the hospital’s medical staff told the father that Brittany was alive and had a chance of survival. The father was committed to keeping her alive. He felt that Brittany’s strangulation was not an accident and suspected foul play.
During this time the defendants decided that Brittany’s organs should be donated. The defendants intentionally concealed from the father that they intended to remove Brittany’s organs and tissue without his authorization. Brittany’s medical records confirm the defendants’ conclusion that it was not appropriate to tell the father about the plan for organ removal until after Brittany’s organs had been taken.
Six days after admission, the hospital medical staff told the father that Brittany was brain dead. The father told the hospital’s medical staff and Brittany’s mother that he objected to withdrawing life support measures and to the removal of Brittany’s organs or tissue because he wanted to preserve any evidence of foul play. He wanted an autopsy performed and he believed that operating on Brittany to obtain organs or tissue would cause any autopsy results to be inaccurate. The father’s objections to withdrawing the life support measures became so vociferous that the hospital staff called for security personnel and police personnel, effectively threatening to have him ejected from the hospital. He was given three minutes to say goodbye to his daughter and leave the hospital.
The father refused to consent to the donation of Brittany’s organs or tissue. Furthermore, Brittany had never signed any instructions regarding the donation of her organs or tissues after death. Thus, the father contended that he and Brittany’s mother, as the surviving parents, possessed co-equal rights to determine the disposition of Brittany’s remains. The father alleged that both defendants were aware that he suspected foul play in Brittany’s death and that he did not want her body disturbed before an autopsy was performed.
After Brittany’s death on November 24, 2017, despite the father’s expressed objections, Donor Network West extracted some of her organs and tissue at the hospital, with the hospital’s assistance. The father alleged that the defendants wrongfully designated Brittany’s mother as the sole decision maker for the donation and therefore the defendants’ harvesting of Brittany’s organs and tissue was done unlawfully, without proper and effective legal authorization or valid permission of both parents. The father alleged that the defendants knew that he, as Brittany’s father, had a legal right to determine the disposition of Brittany’s remains and that he objected to any donation of her organs.
Intentional Infliction Of Emotional Distress
The elements of a cause of action for intentional infliction of emotional distress are (1) extreme and outrageous conduct by the defendant with the intention of causing, or reckless disregard of the probability of causing, emotional distress; (2) the plaintiff’s suffering severe or extreme emotional distress; and (3) actual and proximate causation of the emotional distress by the defendant’s outrageous conduct.
Extreme And Outrageous Conduct
The first element consists of two components: the defendant must engage in extreme and outrageous conduct and must have a culpable state of mind, either intentional or reckless. Extreme and outrageous conduct exists when the conduct is so extreme as to exceed all bounds of that usually tolerated in a civilized community. Mere insults, indignities, threats, annoyances, petty oppressions or other trivialities are not actionable outrageous conduct. Deprivation of a statutory right, in and of itself and without additional conduct, is insufficient to be extreme and outrageous. However, conduct not objectively “extreme and outrageous” may become so where a defendant acts in the face of knowledge that a plaintiff is peculiarly susceptible to emotional distress, by virtue of age, or some physical or mental condition or idiosyncrasy.
A culpable state of mind exists when a defendant engages in outrageous conduct with either the intention of causing, or reckless disregard of the probability of causing, emotional distress. It is not enough that the conduct be intentional and outrageous: it must be intentional conduct directed at the plaintiff, or conduct in reckless disregard of the plaintiff’s interests, in the presence of a plaintiff of whom the defendant is aware is present.
The plaintiff argued on appeal that the conduct in question was more than the actual harvesting of Brittany’s organs—it also included the defendants secretly deciding to recover and donate Brittany’s organs without obtaining his consent, effectively ejecting him from the hospital when he objected to any organ recovery and donation, and proceeding with removing and donating Brittany’s organs and tissue over his objections.
The California Appellate Court stated: “we conclude that [the father’s] broader conception of the conduct at issue is correct; the physical removal and donation of Brittany’s organs is not the only conduct relevant to a determination of “extreme and outrageous” … The complaint alleges that they engaged in such deprivation at a particularly vulnerable point for [the father]: the impending death of his daughter, and in a particularly egregious way: by barring [him] from being physically present with his daughter as she faced death … there is authority for the proposition that actions on the part of defendants may be “taken alone, or considered together as part of a course of conduct” by a reviewing court evaluating them for their qualitative measure … Moreover, there are examples of conduct occurring over a prolonged period of time, and encompassing a series of acts, which have been held to constitute “extreme and outrageous” conduct.”
The California Appellate Court stated: “[The father] alleges that defendants knew that he was vehemently opposed to the removal and donation of Brittany’s organs because [he] vociferously asserted his statutory rights to object to such removal and donation. [The father] further alleges that Hospital and Donor Network nevertheless removed and donated Brittany’s organs several days thereafter in spite of [the father’s] asserted statutory rights. We conclude such an alleged course of conduct is no less egregious under the circumstances than the examples cited above and is sufficient to constitute “extreme and outrageous conduct” for purposes of stating a claim for intentional infliction of emotional distress … the actions of Hospital and Donor Network alleged by [the father] occurred over several days, and deprived [him] of his asserted statutory rights to object to the harvesting of his daughter’s organs, at a time of apparent emotional distress and vulnerability for [the father]. This conduct by Hospital and Donor Network satisfies the requirement of “extreme or outrageous” conduct necessary to constitute the first element of a claim for intentional infliction of emotional distress.”
The requisite state of mind exists when a defendant engages in outrageous conduct with either (1) the intention of causing emotional distress or (2) a reckless disregard of the probability of causing emotional distress. The father alleged in his complaint that (1) defendants’ plan or scheme included intentionally concealing the fact they intended to remove Brittany’s organs and tissue without his authorization and (2) the plan and related concealment were done with the intent to deprive him of his legal rights and to cause him emotional injury. The California Appellate Court stated: “we apply the general rule that a plaintiff is required to plead only ultimate facts … and conclude that [the father’s] allegations that defendants intended to cause him emotional distress adequately alleges sufficient intentional conduct for purposes of stating a claim for intentional infliction of emotional distress … Defendants’ argument that [the father] did not allege intentional conduct primarily directed at him fails because it perceives the outrageous conduct as consisting only of the harvesting of organs and tissue from Brittany, and that conduct was primarily directed at Brittany’s body. This argument fails because it does not consider the full scope of defendants’ conduct … the relevant conduct includes (1) defendants’ secret plan to harvest organs and tissue without [the father’s] permission, (2) their ignoring his objections to any organ removal, (3) ejecting him, in effect, from the hospital, and (4) completing their plan by harvesting organs and tissue. A sufficient portion of this course of conduct was directed towards [the father] and his statutory rights to satisfy “[t]he requirement that the defendant’s conduct be directed primarily at the plaintiff” … not every act in an outrageous course of conduct need be directed at the plaintiff.”
The California Appellate Court stated: “At the very least the alleged actions of Hospital and Donor Network were undertaken with little or no apparent thought or sensitivity to their likely impact on [the father], who was strenuously objecting to them specifically. [The father] was present and aware that Hospital and Donor Network were working to disregard his asserted rights to object to the harvesting of Brittany’s organs: [the father] had to be present and defendants had to be aware of his presence in order to constructively eject him from the hospital. Such an apparent lack of thought or sensitivity constitutes reckless disregard in the context of a claim for intentional infliction of emotional distress, and [the father’s] presence and defendants’ awareness of that presence at the time is manifest … [The father’s] complaint therefore alleges a sufficient recklessness on the part of Hospital and Donor Network, and knowing presence of [the father], even if he was not physically present at the time of the removal of Brittany’s organs.”
With regard to Defendant Donor Network, the California Appellate Court stated: “The complaint alleges that Hospital and Donor Network acted as one another’s agents, and that they were both aware that [the father] suspected foul play in Brittany’s death, and that they were both aware that [the father] did not want Brittany’s organ’s harvested. [The father’s] claim, in essence, is that Hospital and Donor Network worked together with one another as a joint venture to knowingly deprive [the father] of his statutory rights to object to the donation of Brittany’s organs. Agency is an ultimate fact for pleading purposes and is properly alleged simply by stating one defendant is the agent of a codefendant … at least for pleading purposes, the allegations of the complaint are sufficient to establish a principal-agency relationship between Hospital and Donor Network and are sufficient to establish knowledge on the part of Donor Network of [the father’s] objections to the harvesting of Brittany’s organs.”
The California Appellate Court held: “In sum, [the father’s] complaint adequately alleges all the elements of a cause of action for intentional infliction of emotional distress against each defendant. Therefore, the demurrers should have been overruled as to that cause of action.”
Source O’Connor v. Fresno Community Hospital And Medical Center, F080109.
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