Case Number: BC509153    Hearing Date: September 08, 2014    Dept: 93

Superior Court of California
County of Los Angeles
Department 93

HRACHIK MARSIGH STEPANIAN,

Plaintiff(s),
v.

S.V. ARIATHURAI, M.D., et al.,

Defendant(s). Case No.: BC509153

Hearing Date: September 8, 2014

[TENTATIVE] ORDER RE:
DEFENDANTS HAGOP DIKRANIAN, M.D. AND ARMEN DIKRANIAN, M.D.’S MOTION FOR SUMMARY JUDGMENT

Defendants Hagop Dikranian, M.D. (sued as Doe 1) and Armen Dikranian, M.D.’s Motion for Summary Judgment is GRANTED.

Discussion

Plaintiff’s Complaint alleges a single claim for medical malpractice. Plaintiff alleges that moving Defendants “negligently performed the radiation therapy treatment that caused [Plaintiff] injuries.” (Complaint ¶¶5, 14-17.) Moving Defendants move for summary judgment on the basis that they did not breach any standard of care in treating Plaintiff, and did not cause or contribute to his injuries. (Motion, p. 1:14-17.)

Professional Negligence

Whenever the plaintiff claims negligence in the medical context, the plaintiff must present evidence from an expert that the defendant breached his or her duty to the plaintiff and that the breach caused the injury to the plaintiff. (Munro v. Regents of University of California (1989) 215 Cal.App.3d 977.) “‘California courts have incorporated the expert evidence requirement into their standard for summary judgment in medical malpractice cases. When a defendant moves for summary judgment and supports his motion with expert declarations that his conduct fell within the community standard of care, he is entitled to summary judgment unless the plaintiff comes forward with conflicting expert evidence.’” (Id. at pp. 984-85.)

(Powell v. Kleinman (2007) 151 Cal.App.4th 112, 123.)

Here, moving Defendants present the declaration of Richard Shapiro, M.D., who is board-certified in urology and qualified to render an expert opinion on the standard of care required of urologists in this medical community. (Motion, Shapiro Decl. (“Shapirp Decl.”) ¶2.) In reaching his expert opinion, Dr. Shapiro reviewed the following: pertinent medical records of Plaintiff from Dikranian Urology, Herach Yadegarian, M.D., Armen Kassabian, M.D., Mansoor Karamooz, M.D., Temple Community Hospital, Glendale Memorial Hospital, Glendale Cancer Treatment Center, Glendale Adventist Medical Center, Central Neuro Diagnostics and The Oncology Institute of Hope and Innovation; the Complaint; Plaintiff’ss responses to Special Interrogatories, Set 1; and Plaintiff’s deposition transcript. (Shapiro Decl. ¶3.)

Plaintiff was diagnosed with prostate cancer in 2009. (UMF 1, Motion, Exh. E (“Stepanian Depo.”), pp. 6:13-20, 8:24-9:4.); Exh. F (“Dikranian Urology Records”), pp. 82, 109; Exh. G (“Harach Yadegarian, M.D. Records”), p. 38; Exh. H (“Armen Kassabian, M.D. Records”), pp. 24-27; Exh. I (“Glendale Cancer Treatment Center Records”), pp. 4, 46-48; Shapiro Decl. ¶3a.) Following treatment in 2011, Plaintiff presented to Defendant Hagop Dikranian on March 30, 2012. (UMFs 5-6, Dikranian Urology Records, pp. 28, 82-83, 109; Shapiro Decl. ¶3f; Dikranian Decl. ¶¶3-4.) Defendant Hagop Dikranian recommended radiation therapy as an additional mode of treatment for Plaintiff’s recurrent prostate cancer. (UMF 7, Dikranian Urology Records, pp. 28, 82-83, 109; Shapiro Decl. ¶3g; Dikranian Decl. ¶4.) Plaintiff began a course of local radiation therapy at Glendale Cancer Treatment Center from May 2, 2012 to June 20, 2012. (UMFs 13-14, Glendale Cancer Treatment Center Records, p. 52; Shapiro Decl. ¶¶3m-3n.) There were some symptoms noted during the course of treatment, including some right lower extremity edema. (UMF 14, Glendale Cancer Treatment Center Records, p. 52; Shapiro Decl. ¶3n.) Plaintiff returned to see Defendant Hagop Dikranian on or about August 29, 2012 at which time it was noted that he had marked edema of the suprapubic area, genitalia and lower extremities. (UMF 15, Dikranian Urology Records, p. 28; Shapiro Decl. ¶3o.) Defendant Hagop Dikranian prescribed Lasix, a diuretic to treat the edema, and recommended Plaintiff restart Lupron and Casodex. (UMF 15, Dikranian Urology Records, p. 28; Shapiro Decl. ¶3o.)

Dr. Shapiro opines that Defendant Hagop Dikranian at all times acted within the appropriate standard of care. (UMFs 18, 20, 22, 24, Shapiro Decl. ¶¶4b, 4e, 4f, 4h.) Defendant Hagop Dikranian was not responsible for determining whether Plaintiff was an appropriate candidate for radiation therapy, determining the proper radiation dosage, administering the radiation therapy, or responding to any side effects that arose from the radiation therapy. (UMF 23, Shapiro Decl. ¶4g.) Defendant Hagop Dikranian had no control over the radiation therapy, so to a reasonable degree of medical certainty, he did not cause or contribute to Plaintiff’s lower extremity edema. (UMFs 31-34, Shapiro Decl. ¶¶5f-5i.) Dr. Shapiro’s expert opinion carries Defendant Hagop Dikranian’s initial burden of proof regarding his compliance with the standard of care and that he did not cause or contribute to Plaintiff’s injuries.

Defendant Armen Dikranian was not involved in the initial evaluation of Plaintiff, the recommendation that he consider radiation therapy after seeing a specialist, or the referral to Dr. Ariathurai for consideration of radiation treatment. (UMF 25, Dikranian Urology Records, pp. 28, 82, 83, 109, 128, 129; Glendale Cancer Treatment Center Records, p. 117; Shapiro Decl. ¶4i; Dikranian Decl. ¶¶4-7.) Defendant Armen Dikranian had no involvement with Plaintiff’s care and treatment prior to his radiation therapy. (UMF 25, Dikranian Urology Records, pp. 28, 82, 83, 109, 128, 129; Glendale Cancer Treatment Center Records, p. 117; Shapiro Decl. ¶4i; Dikranian Decl. ¶¶4-7.) Dr. Shapiro opines that Defendant Armen Dikranian at all times acted within the appropriate standard of care. (UMF 26, Shapiro Decl. ¶4j.) Defendant Armen Dikranian also had no control over Plaintiff’s radiation treatment and did not cause or contribute to his injuries. (UMFs 36-37, Shapiro Decl. ¶¶5j-5k.) Dr. Shapiro’s expert opinion carries Defendant Armen Dikranian’s initial burden of proof regarding his compliance with the standard of care and that he did not cause or contribute to Plaintiff’s injuries.

The burden now shifts to Plaintiff to create a triable issue of fact regarding moving Defendants’ compliance with the standard of care and whether they caused or contributed to his injuries. As the motion is unopposed, however, no such triable issues of fact exist. Therefore, moving Defendants have demonstrated that Plaintiff cannot prove the existence of necessary elements of his medical malpractice claim.

Moving Defendants are ordered to give notice.

DATED: September 8, 2014
_________________________
Hon. Gail Ruderman Feuer
Los Angeles Superior Court