Ortega v. Emanuel Medical Center CA5 ( 2021 )


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  • Filed 5/25/21 Ortega v. Emanuel Medical Center CA5
    NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS
    California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for
    publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication
    or ordered published for purposes of rule 8.1115.
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    FIFTH APPELLATE DISTRICT
    CESAR ORTEGA,
    F079329
    Plaintiff and Appellant,
    (Super. Ct. No. CV-18-001199)
    v.
    EMANUEL MEDICAL CENTER,                                                               OPINION
    Defendant and Respondent.
    THE COURT*
    APPEAL from a judgment of the Superior Court of Stanislaus County. Stacy P.
    Speiller, Judge.
    Bravo Law Office and Joseph K. Bravo for Plaintiff and Appellant.
    Dummit, Buchholz & Trapp, Daniela P. Stoutenburg and Thomas M. Gray for
    Defendant and Respondent.
    -ooOoo-
    *        Before Hill, P.J., Smith, J. and De Santos, J.
    Cesar Ortega (plaintiff) filed this medical malpractice action alleging defendant,
    Emanuel Medical Center (EMC), misdiagnosed his condition, resulting in injury.
    Plaintiff appeals from the judgment entered after EMC’s motion for summary judgment
    was granted, on the ground the statute of limitations had run before plaintiff filed his
    complaint or gave notice of intent to sue. We conclude the undisputed material facts
    demonstrated plaintiff’s action was untimely and affirm the judgment.
    FACTUAL AND PROCEDURAL BACKGROUND
    In early December 2016, plaintiff’s primary care provider diagnosed him with
    acute sinusitis, cough, and a vitamin D deficiency, and ordered a chest X-ray; the X-ray
    findings were consistent with pneumonia. Two days later, plaintiff went to the
    emergency department at EMC, where he was diagnosed with pneumonia and prescribed
    antibiotics. Plaintiff’s primary care provider continued to treat him for pneumonia
    through January 2017. On January 31, 2017, plaintiff received the results of a CT scan
    from his primary care provider; the diagnosis was a mass of the lung. On February 7,
    2017, plaintiff’s primary care provider diagnosed probable metastatic lung cancer and
    referred plaintiff to an oncologist. Plaintiff underwent a biopsy and surgical placement of
    a lifeport; the pathology report from the biopsy showed plaintiff had a fungal infection.
    On February 27, 2017, the oncologist informed plaintiff he did not have cancer, he had a
    lung infection; an assistant in that office told plaintiff a big mistake was made regarding
    the CT scan. On March 14, 2017, Dr. David Olson, an infectious disease physician,
    diagnosed plaintiff with valley fever, and discussed with him the pathophysiology of the
    fungal infection and the lifelong therapy that would be necessary.
    On March 19, 2018, plaintiff served EMC with a notice of intent to sue, pursuant
    to Code of Civil Procedure section 364.1 Ninety-one days thereafter, on June 18, 2018,
    1       All further statutory references are to the Code of Civil Procedure unless otherwise
    indicated.
    2.
    plaintiff filed his complaint against EMC and others (collectively defendants), alleging
    one cause of action for medical malpractice. He alleged he saw defendants for diagnosis
    and treatment, but defendants misdiagnosed him with pneumonia, when the proper
    diagnosis was valley fever. Plaintiff was unnecessarily hospitalized and treated for
    pneumonia, delaying proper treatment for valley fever. Plaintiff alleged he was injured
    thereby and sought to recover damages.
    EMC filed a motion for summary judgment, asserting plaintiff’s action was barred
    by the statute of limitations.2 Plaintiff’s opposition disputed only a portion of one of the
    30 facts set out in EMC’s separate statement of undisputed material facts. Plaintiff also
    offered a separate statement of 16 additional facts he contended raised triable issues of
    material fact on the statute of limitations issue. The trial court granted EMC’s motion
    and entered judgment in its favor. Plaintiff appeals.
    DISCUSSION
    I.     Standard of Review
    Summary judgment is properly granted when “all the papers submitted show that
    there is no triable issue as to any material fact and that the moving party is entitled to a
    judgment as a matter of law.” (§ 437c, subd. (c).) “Since summary judgment involves
    pure matters of law, we review a grant of summary judgment de novo. [Citations.] In
    undertaking our independent review of the evidence submitted, we apply the same three-
    step analysis as the trial court. First, we identify the issues framed by the pleadings.
    Next, we determine whether the moving party has established facts justifying judgment in
    its favor. Finally, if the moving party has carried its initial burden, we decide whether the
    opposing party has demonstrated the existence of a triable, material fact issue.” (Chavez
    v. Carpenter (2001) 
    91 Cal.App.4th 1433
    , 1438.) We consider all the evidence
    2       The motion was captioned as a motion for summary adjudication. Because it sought
    adjudication in EMC’s favor of the single cause of action alleged in the complaint, it was
    actually a motion for summary judgment, and we will refer to it as such.
    3.
    presented, except that which the trial court properly excluded. (Merrill v. Navegar, Inc.
    (2001) 
    26 Cal.4th 465
    , 476.) “ ‘We liberally construe the evidence in support of the party
    opposing summary judgment and resolve doubts concerning the evidence in favor of that
    party.’ ” (Yanowitz v. L’Oreal USA, Inc. (2005) 
    36 Cal.4th 1028
    , 1037.)
    II.    Application of the Three-step Analysis
    Plaintiff contends the trial court failed to conduct the three-step analysis used in
    ruling on motions for summary judgment. He asserts the trial court looked only at the
    allegations of the unverified complaint and did not cite any undisputed material facts
    supporting its conclusion that, when plaintiff was diagnosed with valley fever, he was on
    inquiry notice that EMC’s diagnosis of pneumonia may have been incorrect.
    “ ‘A defendant has the initial burden to show that undisputed facts support
    summary judgment based on the application of an affirmative defense.’ [Citations.] ‘The
    statute of limitations operates in an action as an affirmative defense.’ [Citation.] ‘ “[T]he
    question of when there has been a belated discovery of the cause of action, especially in
    malpractice cases, is essentially a question of fact,” ’ and ‘ “[i]t is only where reasonable
    minds can draw but one conclusion from the evidence that the question becomes a matter
    of law.” ’ ” (Drexler v. Petersen (2016) 
    4 Cal.App.5th 1181
    , 1188–1189 (Drexler).)
    “ ‘[W]here the uncontradicted facts established through discovery are susceptible of only
    one legitimate inference, summary judgment is proper.’ ” (Id. at p. 1189.)
    The trial court looked to the complaint to frame the issues to be addressed: the
    complaint alleged EMC misdiagnosed plaintiff by failing to diagnose valley fever. The
    trial court expressly found EMC “met its initial burden of showing that the complaint is
    time-bar[r]ed because plaintiff failed to file it within a year of being diagnosed with
    valley fever.” Implicitly it found the valley fever diagnosis was sufficient to put plaintiff
    on inquiry notice that the pneumonia diagnosis may have been wrong. The dates of the
    4.
    valley fever diagnosis, service of plaintiff’s notice of intent to sue,3 and the filing of the
    complaint were included in EMC’s separate statement of undisputed material facts and
    were not disputed by plaintiff.
    Plaintiff disputed only a portion of one of the undisputed material facts presented
    by defendant. He presented an additional 16 facts, which he contended raised triable
    issues of material fact regarding the timeliness of his action; the evidence plaintiff cited
    in support of his additional facts was his own declaration. The trial court overruled
    EMC’s objections to plaintiff’s declaration. Because the trial court expressly overruled
    the objections, it presumably considered plaintiff’s additional facts in ruling on the
    motion and found them insufficient to raise a triable issue of material fact on the statute
    of limitations issue. Thus, we cannot say from its ruling that the trial court failed to apply
    the three-step analysis.
    Even if, as plaintiff contends, the trial court failed to use the three-step analysis in
    ruling on the motion and failed to cite the undisputed material facts supporting its ruling,
    those shortcomings alone do not constitute grounds for reversal. When a trial court
    grants a motion for summary judgment, it must, “by written or oral order, specify the
    reasons for its determination. The order shall specifically refer to the evidence proffered
    in support of and, if applicable, in opposition to the motion that indicates no triable issue
    exists.” (§ 437c, subd. (g).) On appeal, however, we review the trial court’s ruling de
    novo, conducting our own three-step analysis and determining independently whether the
    moving party is entitled to summary judgment. The trial court’s “failure to perform its
    statutory duty [to provide a statement of the reasons for its determination] does not
    3       Section 364 requires a plaintiff to give at least 90 days’ notice of intent to file an action
    for medical malpractice and provides that, if the notice is served within 90 days of the expiration
    of the applicable statute of limitations, the limitation period is extended 90 days from service of
    the notice. (§ 364, subds. (a), (d).) These provisions have been interpreted to toll the statute of
    limitations for 90 days when the notice of intent to sue is provided in the last 90 days of the
    limitation period. (Russell v. Stanford University Hospital (1997) 
    15 Cal.4th 783
    , 786–791.)
    5.
    automatically result in reversal. We need only determine whether the record establishes
    the [moving parties’] entitlement to summary judgment in their favor.… ‘We are not
    confined, in considering the granting of the summary judgment, to the sufficiency of the
    stated reasons. It is the validity of the ruling which is reviewable and not the reasons
    therefor.’ ” (Ruoff v. Harbor Creek Community Assn. (1992) 
    10 Cal.App.4th 1624
    ,
    1627–1628.) “The [trial] court’s stated reasons for granting summary judgment are not
    binding on us because we review its ruling, not its rationale.” (Walker v. Countrywide
    Home Loans, Inc. (2002) 
    98 Cal.App.4th 1158
    , 1168.) Even if the trial court made its
    ruling for the wrong reasons, if its ruling is correct on any theory, it will be affirmed.
    (Curcini v. County of Alameda (2008) 
    164 Cal.App.4th 629
    , 637.)
    Consequently, because we review the trial court’s ruling de novo, the question is
    not whether the trial court failed to apply the three-step analysis, but whether the result it
    reached was correct on the merits, regardless of its analysis.
    III.   Accrual of a Cause of Action
    A.     Standards for accrual and late discovery
    A plaintiff must bring a claim within the limitations period after accrual of the
    cause of action. (§ 312.) Generally, a cause of action accrues “when the cause of action
    is complete with all of its elements,” including the wrongful act and the resulting harm.
    (Norgart v. Upjohn Co. (1999) 
    21 Cal.4th 383
    , 397.) The most important exception to
    the accrual rule is the discovery rule, which postpones accrual until the plaintiff
    discovers, or has reason to discover, the cause of action. (Ibid.) The discovery rule “may
    be expressed by the Legislature or implied by the courts.” (Ibid.)
    The statute of limitations applicable to medical malpractice actions is found in
    section 340.5, which provides: “In an action for injury or death against a health care
    provider based upon such person’s alleged professional negligence, the time for the
    commencement of action shall be three years after the date of injury or one year after the
    plaintiff discovers, or through the use of reasonable diligence should have discovered, the
    6.
    injury, whichever occurs first.” (§ 340.5.) The general rule applies to the three-year
    period, which runs from the date of injury. (Ibid.) The discovery rule applies to the one-
    year period, and postpones accrual until “the plaintiff discovers, or through the use of
    reasonable diligence should have discovered, the injury.” (Ibid.) The action must be
    filed within both time periods in order to be timely. (Rose v. Fife (1989) 
    207 Cal.App.3d 760
    , 767–768.) EMC’s motion for summary judgment contended the plaintiff’s action
    was barred because it was not filed within the one-year period.
    “[T]he term ‘injury,’ as used in section 340.5, means both ‘a person’s physical
    condition and its “negligent cause.” ’ ” (Gutierrez v. Mofid (1985) 
    39 Cal.3d 892
    , 896.)
    “Under the discovery rule, the statute of limitations begins to run when the plaintiff
    suspects or should suspect that [his] injury was caused by wrongdoing, that someone has
    done something wrong to [him].… [T]he limitations period begins once the plaintiff
    ‘ “ ‘has notice or information of circumstances to put a reasonable person on
    inquiry .…’ ” ’ [Citation.] A plaintiff need not be aware of the specific ‘facts’ necessary
    to establish the claim; that is a process contemplated by pretrial discovery. Once the
    plaintiff has a suspicion of wrongdoing, and therefore an incentive to sue, [he] must
    decide whether to file suit or sit on [his] rights. So long as a suspicion exists, it is clear
    that the plaintiff must go find the facts; [he] cannot wait for the facts to find [him].”
    (Jolly v. Eli Lilly & Co. (1988) 
    44 Cal.3d 1103
    , 1110–1111, fn. omitted.)
    B.     Late discovery of misdiagnosis
    Plaintiff argues that when a medical malpractice cause of action is based on
    misdiagnosis of the plaintiff’s disease or condition, the harm does not occur when a
    contradictory diagnosis is made, but “when the patient determines that they have received
    the appropriate medical treatment.” Although plaintiff discusses the Drexler case and
    apparently bases his argument on it, he cites nothing in that case supporting his
    interpretation of the rule.
    7.
    In Drexler, the plaintiff repeatedly consulted his primary care physician,
    Dr. David J. Petersen, about headaches and neck pain. (Drexler, supra, 4 Cal.App.5th at
    pp. 1184–1187.) Dr. Petersen diagnosed tension headaches. (Id. at p. 1184.) When the
    plaintiff asked to have an MRI performed, Dr. Petersen declined to order one. (Id. at
    p. 1185.) The plaintiff was referred to a neurologist when he complained of tingling in
    his fingers and arm pain, and was diagnosed with carpal tunnel syndrome. (Id. at
    pp. 1185–1186.) On January 15, 2011, plaintiff obtained his medical records, then
    consulted an attorney about suing both doctors for malpractice. (Id. at p. 1187.) The
    attorney said the plaintiff did not have a case. (Ibid.) In October 2012, the plaintiff
    complained to other medical providers of headaches and double vision but did not stay
    for an MRI because the line was too long. In January 2013, he complained of unsteady
    gait, progressive voice hoarseness, and difficulty swallowing that had occurred in the
    prior three months; an MRI at that time revealed a brain tumor. (Ibid.) Emergency
    surgery to remove the tumor resulted in serious injuries. (Ibid.)
    The plaintiff sued Dr. Petersen and the neurologist for negligent failure to
    diagnose, and delay in diagnosing, his brain tumor. (Drexler, supra, 4 Cal.5th at
    p. 1188.) The trial court granted the defendants’ motion for summary judgment on
    statute of limitations grounds, finding the one-year limitations period barred the
    plaintiff’s claim against the defendants; the plaintiff had a suspicion of Dr. Petersen’s
    wrongdoing by January 15, 2011, when he consulted an attorney, and a suspicion of the
    neurologist’s wrongdoing in 2010 when the neurologist diagnosed carpal tunnel
    syndrome. (Ibid.) The appellate court reversed the judgment. (Id. at p. 1198.)
    Although the court acknowledged “[t]he fact that [the plaintiff] contemplated
    suing [the defendants was] strong evidence that [the plaintiff] suspected the doctors had
    not properly diagnosed or treated his headaches,” “the one-year and three-year limitations
    periods did not begin to run until [the plaintiff] discovered his injury—that is, became
    aware of additional, appreciable harm from his preexisting condition—and, with respect
    8.
    to the one-year limitations period, also had reason to believe that injury was caused by
    the wrongdoing of” the defendants. (Drexler, supra, 4 Cal.5th at p. 1190.) The issue in
    the case was “not whether [the plaintiff] had actual or constructive knowledge of the
    doctors’ alleged wrongdoing, but when [the plaintiff] discovered his injury.” (Ibid.) The
    injury was “ ‘the damaging effect of the alleged wrongful act and not … the act itself.’ ”
    (Ibid.) Injury occurs when appreciable harm is first manifested, and it may become
    apparent before the ultimate harm or diagnosis. (Id. at pp. 1190–1191.) “ ‘Each case
    necessarily will turn on its own particular circumstance.’ ” (Id. at p. 1191.)
    “When a plaintiff brings a malpractice action based on the defendant’s failure to
    diagnose, or misdiagnosis of, a latent, progressive condition, identification of the ‘injury’
    is more difficult.” (Drexler, supra, 4 Cal.5th at p. 1192.) “ ‘[T]he injury is not the mere
    undetected existence of the medical problem at the time the physician failed to diagnose
    or treat the patient or the mere continuance of that same undiagnosed problem in
    substantially the same state. Rather, the injury is the development of the problem into a
    more serious condition which poses greater danger to the patient or which requires more
    extensive treatment.’ ” (Id. at p. 1193.) “[T]he plaintiff in such a case may discover the
    injury when the undiagnosed condition develops into a more serious condition, but before
    it causes the ultimate harm. [Citation.] With the worsening of the plaintiff’s condition,
    or an increase in or appearance of significant new symptoms, the plaintiff with a
    preexisting condition either actually (subjectively) discovers, or reasonably (objectively)
    should be aware of, the physical manifestation of his or her injury.” (Id. at p. 1194.)
    The defendants in Drexler argued the plaintiff suffered appreciable harm because
    his headaches became worse and he suffered additional symptoms at least by January
    2011. (Drexler, supra, 4 Cal.5th at p. 1195.) The plaintiff initially contended his injury
    did not manifest until his brain tumor was correctly diagnosed, but on appeal, conceded
    his increased symptoms in October 2012 may have commenced the one-year limitations
    period. (Id. at pp. 1195–1196.) His action was filed within one year of that date. (Id. at
    9.
    p. 1188.) The court found the evidence was not undisputed that the plaintiff discovered
    his injury more than one year before filing suit, and the defendants were not entitled to
    summary judgment. (Id. at p. 1197.)
    Thus, in Drexler, the plaintiff initially contended the statute of limitations
    commenced to run when the correct diagnosis was made, and subsequently conceded it
    may have commenced earlier, when his symptoms worsened. Nothing in Drexler
    supports an argument that the commencement of the limitations period in a misdiagnosis
    case is delayed until the plaintiff becomes satisfied that the subsequent diagnosis is
    correct.
    C.      EMC’s evidentiary showing
    EMC’s motion for summary judgment asserted plaintiff’s action was barred by the
    one-year limitations period, which begins to run when “the plaintiff discovers, or through
    the use of reasonable diligence should have discovered, the injury.” (§ 340.5.) The
    discovery “rule sets forth two alternate tests for triggering the limitations period: (1) a
    subjective test requiring actual suspicion by the plaintiff that the injury was caused by
    wrongdoing; and (2) an objective test requiring a showing that a reasonable person would
    have suspected the injury was caused by wrongdoing. [Citation.] The first to occur
    under these two tests begins the limitations period.” (Kitzig v. Nordquist (2000)
    
    81 Cal.App.4th 1384
    , 1391.) EMC’s motion for summary judgment sought to establish
    plaintiff’s action was barred under the objective test; EMC contended that, regardless of
    plaintiff’s actual suspicion or lack thereof, a reasonable person in his situation would
    have suspected his injury was caused by wrongdoing more than one year before he gave
    notice of his intent to sue.
    The undisputed facts and evidence presented by EMC in its motion for summary
    judgment indicated that, on December 3, 2016, a physician in EMC’s emergency
    department diagnosed plaintiff with pneumonia and prescribed antibiotics. His primary
    care provider continued with that diagnosis and treatment until January 31, 2017, when
    10.
    he diagnosed a mass of the left lung based on a CT scan. Plaintiff underwent a PET/CT
    scan; as a result, on February 7, 2017, he was diagnosed with lung cancer and referred to
    an oncologist. The oncologist agreed with the diagnosis. Plaintiff underwent a biopsy
    and placement of a lifeport in his chest for chemotherapy treatments. On February 27,
    2017, the oncologist told plaintiff, based on the biopsy results, that he had a fungal
    infection, not cancer. In the next two days, that diagnosis was repeated by plaintiff’s
    primary care provider and the surgeon who performed the biopsy. On March 14, 2017
    the infectious disease physician identified the fungal infection as valley fever and
    explained the necessary treatment.
    The one-year limitations period commences when the plaintiff discovers both the
    physical manifestation of the injury and its negligent cause. (Rose v. Fife, supra,
    207 Cal.App.3d at p. 768.) “[N]o ‘injury’ occurs until there is some evident harm or
    detrimental effect.” (Marriage & Family Center v. Superior Court (1991)
    
    228 Cal.App.3d 1647
    , 1654.) This is not a case like Drexler, where the only physical
    manifestation of injury or detriment resulting from the alleged misdiagnosis was the
    worsening of the plaintiff’s condition or the appearance of new symptoms. The
    undisputed facts indicate that, after EMC diagnosed plaintiff with pneumonia, he
    continued to seek treatment for his complaints. He was subsequently diagnosed with
    possible cancer, subjected to surgery, then rediagnosed with valley fever. If, as plaintiff
    contends, EMC should have diagnosed valley fever in December 2016, then the
    unnecessary surgery and placement of a lifeport was a result of the misdiagnosis and a
    physical manifestation of injury or detriment resulting from it.
    As to the alleged negligent cause of plaintiff’s injury, a plaintiff “is charged with
    ‘presumptive’ knowledge of his negligent injury, and the statute commences to run, once
    he has ‘ “notice or information of circumstances to put a reasonable person on inquiry, or
    has the opportunity to obtain knowledge from sources open to his investigation.” ’ ”
    (Gutierrez v. Mofid, supra, 39 Cal.3d at pp. 896–897.) The facts indicate plaintiff was
    11.
    informed on February 7, 2017, by his primary care provider and on February 9, 2017, by
    his oncologist, that his diagnosis was probable metastatic lung cancer. That diagnosis
    was sufficient to put a reasonable person on notice that the previous diagnosis of
    pneumonia might have been erroneous. Plaintiff had the opportunity to question either
    physician about the reasons for the change in diagnosis and the accuracy of the EMC
    diagnosis. Thus, he had both the means and the opportunity to discover the alleged
    wrongdoing.
    Further, on February 27, 2017, and February 28, 2017, plaintiff saw his oncologist
    and his primary care provider, and each told him he did not have cancer. Based on the
    biopsy results, they diagnosed a fungal lung infection. On March 14, 2017, the infectious
    disease physician to whom plaintiff’s primary care provider had referred him, diagnosed
    the fungal lung infection as valley fever. Again, plaintiff had the opportunity to make
    inquiries of any of these physicians about the previous diagnoses, testing, and treatments,
    and to raise questions about the accuracy of the EMC diagnosis.
    In his reply brief, plaintiff seems to contend his uncertainty about whether the
    valley fever diagnosis was the final or correct diagnosis postponed commencement of the
    limitations period until his treatment for that condition resulted in improvement in his
    health, thereby confirming the diagnosis. He asserts “EMC’s position … that a different
    subsequent diagnosis, whether correct or not, starts the statute of limitations clock
    running” “mischaracterizes or ignores facts which would have caused a reasonable
    person … to withhold judgement [sic] or make further inquiry whether he had been
    correctly diagnosed with Valley Fever until the medical treatment he received …
    demonstrated that it was the correct diagnosis.” (Italics added.) Under the discovery
    rule, however, the statute of limitations commences to run before the patient gathers all
    the facts supporting his cause of action. (Jolly v. Eli Lilly & Co., 
    supra,
     44 Cal.3d at
    p. 1111 [a plaintiff need not be aware of the specific facts necessary to establish the claim
    in order for the statute of limitations to commence running].) The statute of limitations
    12.
    begins to run when the plaintiff has information of circumstances sufficient to put the
    plaintiff on inquiry. (Fox v. Ethicon Endo-Surgery, Inc. (2005) 
    35 Cal.4th 797
    , 807–
    808.) Plaintiff now seems to concede he was on inquiry at the time he was diagnosed
    with valley fever.
    A potential plaintiff “has reason to discover the cause of action when he has
    reason at least to suspect a factual basis for its elements. [Citation.] He has reason to
    suspect when he has ‘ “ ‘ “notice or information of circumstances to put a reasonable
    person on inquiry” ’ ” ’ [citation]; he need not know the ‘specific “facts” necessary to
    establish’ the cause of action; rather, he may seek to learn such facts through the ‘process
    contemplated by pretrial discovery’; but, within the applicable limitations period, he must
    indeed seek to learn the facts necessary to bring the cause of action in the first place—he
    ‘cannot wait for’ them ‘to find’ him and ‘sit on’ his ‘rights’; he ‘must go find’ them
    himself if he can and ‘file suit’ if he does.” (Norgart v. Upjohn Co., 
    supra,
     21 Cal.4th at
    p. 398.) Thus, when a patient has facts that would cause a reasonable person to suspect a
    misdiagnosis, he is put on inquiry, which triggers the statute of limitations and gives him
    one year to investigate and bring suit, if he chooses to do so. The investigation does not
    postpone accrual of the cause of action.
    Further, the statute of limitations is not triggered by a “correct” subsequent
    diagnosis, but by facts that would cause a reasonable person to suspect that the prior
    diagnosis was incorrect. Subsequent diagnoses, correct or not, may cast doubt on the
    accuracy of an initial diagnosis and cause a reasonable person to suspect the initial
    diagnosis was incorrect.
    The undisputed material facts demonstrate that, by February 27, 2017, and
    certainly no later than March 14, 2017, a reasonable person in plaintiff’s position would
    have had a suspicion that EMC failed to correctly diagnose his condition and that he had
    undergone an unnecessary biopsy as a result. Plaintiff did not serve his notice of intent to
    sue until March 19, 2018, more than one year later. Consequently, the trial court
    13.
    correctly concluded that EMC met its initial burden of showing that the one-year statute
    of limitations barred plaintiff’s action and EMC was entitled to judgment as a matter of
    law. The burden of production then shifted to plaintiff to make a prima facie showing of
    the existence of a triable issue of material fact. (Aguilar v. Atlantic Richfield Co. (2001)
    
    25 Cal.4th 826
    , 845.)
    D.     Plaintiff’s showing
    Plaintiff disputed only a portion of one of EMC’s undisputed material facts, which
    stated that, when plaintiff’s primary care provider diagnosed a mass of the lung on
    January 31, 2017, “[t]here was no longer any diagnosis of pneumonia. Plaintiff was
    informed that he likely had cancer, not pneumonia.” Plaintiff asserted: “At no time was
    there any statement made that there was no longer any diagnosis of pneumonia.”
    Plaintiff failed to cite any supporting evidence. Even disregarding the challenged
    statement, however, the undisputed facts presented by EMC were sufficient to carry its
    initial burden.
    In opposition to EMC’s motion for summary judgment, plaintiff filed a separate
    statement of 16 additional material facts he contended raised triable issues and precluded
    summary judgment. The supporting evidence for all of the facts was plaintiff’s
    declaration. Many of the additional facts simply repeated facts included by EMC in its
    separate statement concerning plaintiff’s medical care. Others denied that plaintiff
    suspected wrongdoing or misdiagnosis by EMC, denied that his doctors told him EMC
    erred in its diagnosis, claimed he knew of other instances in which doctors were unable to
    diagnose patients, and asserted he thought uncertainty in diagnoses was a regular part of
    medicine. These additional facts address the subjective portion of the discovery rule:
    whether plaintiff had actual knowledge or an actual suspicion that his injury was caused
    by wrongdoing. They do not address the alternative objective test of discovery, which
    was the basis of EMC’s motion and which focuses on whether a reasonable person would
    have suspected the injury was caused by wrongdoing. Consequently, the additional facts
    14.
    plaintiff presented were not material to EMC’s motion for summary judgment and did not
    raise a triable issue of material fact.
    DISPOSITION
    The judgment is affirmed. EMC is entitled to its costs on appeal.
    15.