Medical Battery Claims Give California Patients Greater Recourse

Filing a lawsuit for medical malpractice is sometimes the only way to address an injury sustained during a medical procedure. When the injury and provider conduct meet certain criteria, patients may have experienced not just medical malpractice but also medical battery. In California, the damages available may exceed the state’s statutory limits under the California Medical Injury Compensation Reform Act of 1975, or MICRA.

A medical procedure at a University of California teaching hospital last year, during which lidocaine and formaldehyde were placed next to each other, is an example of this. Lidocaine is used for local pain management; formaldehyde is a preservative used in mortuaries. Yet these two fluids ended up next to each other during the procedure, and formaldehyde was mistakenly injected into the patient, resulting in profound injuries.

This mistake arguably constituted medical battery. It also highlights procedural reforms that health-care providers should consider implementing to prevent these errors from happening again.

Statutory MICRA Limits

When patients experience an adverse outcome in a medical setting, they may consider whether a medical negligence claim is appropriate. In California, medical malpractice “occurs when a patient is harmed by a doctor or other medical professional who fails to competently perform his or her medical duties” within the applicable standard of care.

California passed legislation to revise MICRA in 2022, increasing the non-economic damage cap for cases initiated on or after Jan. 1, 2023. The revision increased the limits of non-economic damages from $250,000 to $350,000 for non-death cases and $500,000 for death cases. According to the statute, non-economic damages will progressively increase each year over the next 10 years. This includes wrongful death cases.

But in cases of catastrophic harm at the hands of providers, MICRA’s caps leave patients with insufficient funds to cover future medical expenses, long-term care, and other economic and emotional damages.

Patients may not know there may be recourse beyond negligence when a provider’s care isn’t simply a failure to meet the standard of care. Medical battery includes procedures conducted without patient consent or unauthorized physical contact.

In cases of proven medical battery, harmed patients aren’t subject to the MICRA caps. Juries can decide whether patients deserve financial compensation for medical battery—the damages for which can exceed the MICRA limits because there is no statutory limit on non-economic harm.

Malpractice Versus Battery

The difference between medical negligence and medical battery in California is the patient’s consent (or lack thereof) to the procedure and the physician’s role in causing the patient harm.

First, battery can occur when a doctor performs a medical procedure without consent or the patient consents to one procedure, but a substantially different medical procedure is performed. In the University of California case, a patient agreed to a medical procedure that would involve the use of lidocaine. The patient didn’t consent to be injected with formaldehyde, a substance that isn’t even contemplated or used in the specific procedure. Thus, a jury may conclude that the circumstances match California’s definition of medical battery.

Second, the medical providers’ conduct must have played a significant role in the patient’s injuries. Here, the providers removed the formaldehyde from its original packaging, which included the warning “hazardous,” and placed it in an identical specimen cup next to the lidocaine. Neither was alleged to be properly labeled.

Removing the toxic formaldehyde from its well-labeled bottle was a deliberate choice by the providers that contributed to the patient’s catastrophic injuries. Notably, the medical provider didn’t need to have an intent to harm the patient for the latter to prove medical battery.

Possible Reforms

Health-care providers should consider updating policies and procedures to prevent medical battery. Opportunities for reform include:

• Mandatory consent and verification checks. Providers can implement mandatory two-step consent verification processes before every procedure, having both the doctor and a nurse verify the patient’s consent and the scope of the procedure.
• Increased training on patient autonomy and consent. Providers and other medical professionals should receive regular training on the requirements and importance of patient consent, as well as the health system’s policies for upholding consent. Policies are only effective if they are consistently adhered to.
• Clear labeling and medical handling policies. Medication handling protocols must be revisited and tightened to prevent errors. Such policies could include color-coded labeling systems to distinguish hazardous substances from approved medications, physical separation of hazardous and non-hazardous substances, and mandatory verification by two health-care professionals before administering any medication.

Medical battery claims allow injured patients to make a claim without the statutory limits of MICRA, which often limit damages and don’t provide the money to care for a patient who has suffered from a catastrophic error. Medical battery also pushes institutions to take responsibility and revise their training and procedures to prevent catastrophic events.

This article does not necessarily reflect the opinion of Bloomberg Industry Group, Inc., the publisher of Bloomberg Law and Bloomberg Tax, or its owners.

Author Information

June P. Bashant is a partner at Rouda Feder Tietjen & McGuinn in San Francisco, focusing on catastrophic injuries, product liability, and wrongful death litigation.

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