Tonti v. Naficy CA4/3 ( 2023 )


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  • Filed 1/23/23 Tonti v. Naficy CA4/3
    NOT TO BE PUBLISHED IN OFFICIAL REPORTS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 This opinion has not been certified for publication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
    FOURTH APPELLATE DISTRICT
    DIVISION THREE
    ALISON TONTI,
    Plaintiff and Appellant,                                           G060814
    v.                                                            (Super. Ct. No. 30-2019-01116243)
    K. MITCHELL NAFICY,                                                     OPI NION
    Defendant and Respondent.
    Appeal from a judgment and orders of the Superior Court of Orange
    County, Theodore R. Howard, Judge. Affirmed in part, reversed in part, and remanded.
    Medvei Law Group and Sebastian M. Medvei for Plaintiff and Appellant.
    Peterson Bradford Burkwitz, Thomas Bradford and Gil Burkwitz for
    Defendant and Respondent.
    *                  *                  *
    INTRODUCTION
    This appeal arises from a judgment in favor of defendant Dr. K. Mitchell
    Naficy following orders sustaining demurrers and an order granting summary judgment.
    In December 2018, plaintiff Alison Tonti received substance abuse treatment at a
    residential detoxification facility operated by codefendant Capo By The Sea, Inc. (Capo).
    According to Tonti, she was not examined by Naficy prior to receiving a drug
    prescription given to ease her anticipated withdrawal symptoms. Tonti alleges that days
    later, she lost consciousness as a result of the drug and suffered a substance abuse
    relapse. Shortly thereafter, she withdrew from Capo and filed the underlying lawsuit
    against Naficy, Capo, and a Capo staff member, asserting three claims against Naficy.
    Relevant to this appeal, Naficy filed successful demurrers against Tonti’s
    claims for violation of the unfair competition law (UCL) (Bus. & Prof. Code, § 17200 et
    1
    seq.) and willful misconduct. Naficy then filed a motion for summary judgment (MSJ)
    against Tonti’s remaining medical malpractice claim. In support, Naficy submitted
    Tonti’s medical records and a declaration of a proposed expert witness who presented
    opinions based on the records. In her opposition to the MSJ, Tonti asserted evidentiary
    objections to the records, arguing they were hearsay and not properly authenticated. The
    trial court overruled the objections and granted the MSJ.
    Tonti asserts the trial court erroneously sustained Naficy’s demurrers and
    incorrectly overruled her objections to the admissibility of her medical records. We
    conclude Tonti has shown one of the demurrers was erroneously sustained and agree her
    medical records lacked proper authentication to support Naficy’s MSJ. We affirm the
    court’s order sustaining Naficy’s demurrer to Tonti’s original complaint willful
    misconduct claim, reverse the court’s order sustaining Naficy’s demurrer to Tonti’s
    amended complaint UCL claim, reverse the grant of summary judgment, and remand this
    matter for further proceedings.
    1
    All further undesignated statutory references are to the Business & Professions
    Code.
    2
    2
    FACTUAL BACKGROUND
    In December 2018, Tonti admitted herself to Capo to receive residential
    substance detoxification services for a fee of $10,000. A Capo staff member that Tonti
    has designated in her complaint as “Jeff Doe” drove Tonti there. Relevant to her claims
    against Naficy, Tonti asserts that upon arriving at Capo, she “did not meet with any
    doctors, and did not have any kind of examination by a licensed health care professional.”
    Tonti alleges that, notwithstanding the lack of an examination, she received
    prescriptions for medication treatments known as “taper[s],” which she explains are
    “designed to ease a [substance abuse disorder] patient through detoxification and into
    abstinence . . . by using medications to alleviate and control the severe pain from
    withdrawals associated with detoxification and abstinence.”
    Tonti asserts that after she complained about her first taper treatment, Doe
    called Naficy who, without examining Tonti, prescribed for the next treatment “a 30-day
    protocol of [b]enzodiazepine.” Because she had no direct line of communication to
    Naficy, Tonti told Doe she “did not feel comfortable taking [the b]enzodiazopene as part
    of [her treatment] because her past experience with it had led to unfortunate side effects.”
    Notwithstanding, Doe “required [Tonti] to continue with the [b]enzodiaz[e]p[i]ne
    protocol,” according to her allegations.
    After beginning the benzodiazepine taper, Tonti asserts she had an episode
    where she “blacked out” and during that time obtained heroin, relapsing into substance
    abuse. Tonti alleges she was transferred to a lower security location by Capo and
    unsuccessfully demanded to be returned to a residential facility. “[F]earing another
    relapse,” she “cease[d] enrollment with” Capo and unsuccessfully demanded a refund.
    2
    The factual allegations discussed are limited to the issues material to our
    disposition of this appeal.
    3
    Tonti alleges that if Naficy had “conducted a non-negligent work up” that
    included “an inquiry into [Tonti]’s particular substance sensitivities . . . Naficy would
    have discovered that [Tonti] ha[d a] very low tolerance for [the Benzodiazepine] as it is
    outside the scope of the typical substances related to” Tonti’s substance abuse disorder.
    She alleges the defendants “engaged in a conspiracy, common enterprise, and common
    course of conduct, the purpose of which is and was to engage in the violations of law
    alleged.” She seeks restitution of the $10,000 she paid to Capo, compensatory and
    punitive damages, and declarative as well as injunctive relief.
    PROCEDURAL HISTORY
    In Tonti’s original and amended complaint, she alleges six causes of action
    against various defendants: (1) professional negligence; (2) negligence; (3) “intentional
    conduct”; (4) breach of contract; (5) intentional misrepresentation; and (6) violation of
    the UCL. Only three of the claims were alleged against Naficy: professional negligence,
    “intentional conduct,” and violation of the UCL.
    Tonti’s claims for “intentional conduct” and violation of the UCL were
    eliminated at the pleadings stage of litigation. Specifically, the trial court sustained
    Naficy’s first demurrer against the two claims with leave to amend.
    In her amended complaint, Tonti only reasserted professional negligence
    and violation of the UCL against Naficy, adding some factual specificity for the latter.
    Naficy filed a second demurrer, against the UCL claim, that the trial court sustained.
    Although leave to amend was again granted, Tonti failed to do so and proceeded against
    Naficy on the professional negligence claim only.
    Five months later, in May 2021, Naficy filed an MSJ on Tonti’s
    professional negligence claim. In support, he filed a declaration by proposed expert
    witness Dr. Darryl J. Ballin, who specialized in “addiction medicine.” Ballin presented
    opinions supporting Naficy’s positions on the applicable standard of care, causation, and
    4
    damages claimed, including his opinion that the taper prescription Tonti relies on did not
    cause the “‘black out’” episode she claims to have suffered. The opinions were based on
    Naficy’s presentation of Tonti’s medical records purportedly documenting her treatments
    received through Naficy’s practice and Capo which had been filed in the trial court.
    Naficy presented defense discovery verifications as the foundations for the records.
    Tonti’s opposition to the MSJ included written evidentiary objections to
    Ballin’s declaration as well as hearsay and foundation objections to the presented medical
    records. The trial court overruled Tonti’s objections, citing Evidence Code section 720
    and Shugart v. Regents of University of California (2011) 
    199 Cal.App.4th 499
     (Shugart).
    The court granted Naficy’s MSJ and entered judgment. Tonti timely appealed.
    DISCUSSION
    As noted, Tonti challenges the trial court’s rulings on Naficy’s demurrers
    and the MSJ. We first review the MSJ rulings, then Tonti’s challenges to the demurrer
    rulings.
    I.      THE MOTION FOR SUMMARY JUDGMENT
    A. Standard of Review
    We review a summary judgment motion ruling de novo for whether any
    triable issue of material fact exists. (Wiener v. Southcoast Childcare Centers, Inc. (2004)
    
    32 Cal.4th 1138
    , 1142.) The moving party bears the initial burden of production to make
    a prima facie showing that no triable issue of material fact exists. (Aguilar v. Atlantic
    Richfield Co. (2001) 
    25 Cal.4th 826
    , 850.) Only if the moving party carries this burden
    does it shift to the opposing party, to show a triable issue of material fact exists. (Ibid.)
    Because an MSJ grant implements a drastic result, we strictly construe the moving
    party’s papers and evidence, with all doubts on the propriety of granting summary
    judgment resolved against the moving party. (Hamburg v. Wal-Mart Stores, Inc. (2004)
    5
    
    116 Cal.App.4th 497
    , 502 [papers]; City of Vista v. Robert Thomas Securities, Inc. (2000)
    
    84 Cal.App.4th 882
    , 886 [evidence].)
    B. MSJ Expert Evidence Case Law
    As noted, Tonti’s opposition to Naficy’s MSJ included evidentiary
    objections to Ballin’s declaration and the presentation of Tonti’s medical records on
    which Ballin’s opinions rested. Among the grounds were hearsay objections that shifted
    to Naficy the burden of establishing a foundation for a hearsay exception.
    The parties correctly agree that without properly admitted medical records
    an expert witness’s medical opinions based on those records have no evidentiary value.
    (Garibay v. Hemmat (2008) 
    161 Cal.App.4th 735
    , 743 (Garibay) [“‘Although experts
    may properly rely on hearsay in forming their opinions, they may not relate the out-of-
    court statements of another as independent proof of the fact’”].) Accordingly, the
    threshold issue for our review is whether the medical records were properly “placed
    before the [trial] court by the moving party.” (Shugart, supra, 199 Cal.App.4th at
    p. 505.)
    We review the trial court’s overruling of Tonti’s evidentiary objections for
    abuse of discretion. (Reid v. Google, Inc. (2010) 
    50 Cal.4th 512
    , 535.) Specifically, we
    “measure[] the evidence presented to the trial court against the range of options permitted
    by the established legal criteria. [Citation.] The scope of the trial court’s discretion is
    limited by the governing law, and an action that ‘“‘transgresses the confines of the
    applicable principles of law’”’ constitutes an abuse of discretion. [Citation.] [¶] The
    trial court’s factual findings are reviewed under the substantial evidence standard while
    the trial court’s legal conclusions are reviewed de novo. [Citation.]” (Cornerstone
    Realty Advisors, LLC v. Summit Healthcare REIT, Inc. (2020) 
    56 Cal.App.5th 771
    , 789.)
    Generally, we affirm or reverse based on the correctness of the result and not its reasons.
    (See Whyte v. Schlage Lock Co. (2002) 
    101 Cal.App.4th 1443
    .)
    6
    As noted, the trial court’s ruling on the admissibility of the medical records
    included citations to Evidence Code section 720 and Shugart, supra, 199 Cal.App.4th at
    pages 506-507. At the outset, we note that Evidence Code section 720 does not bear on
    the admissibility of Tonti’s medical records because that section is about expert
    qualifications and not the admissibility of materials an expert can rely on for presenting
    opinions.
    We review Shugart, supra, 
    199 Cal.App.4th 499
    , for grounds on which the
    records were properly admitted. There, an employer of a doctor and another physician
    moved for summary judgment against claims of medical negligence asserted by plaintiffs,
    a patient and a spouse. The defendants submitted “properly authenticated” copies of the
    patient’s medical records as well as declarations of experts who opined the physician’s
    services met the standard of care and did not cause the injuries claimed. (Id. at pp. 503,
    506.) In opposition, the plaintiffs submitted a declaration by their own expert
    challenging both points. (Id. at pp. 503-504; see Cobbs v. Grant (1972) 
    8 Cal.3d 229
    ,
    236 [unless “medical question resolvable by common knowledge,” expert evidence
    required].)
    The trial court granted the defendants’ summary judgment motions. It
    concluded the declaration of the plaintiffs’ expert lacked evidentiary value because the
    expert had failed to refer to or attach the materials he relied on to form his opinions and
    because the plaintiffs did not otherwise “separately set forth any of the medical history
    of” the patient plaintiff. (Shugart, supra, 199 Cal.App.4th at pp. 504-505.)
    The appellate court reversed, holding the plaintiffs’ expert’s opinions had
    not lacked a proper foundation. (Shugart, supra, 199 Cal.App.4th at p. 505.) The
    appellate court pointed out the opinions relied in part on medical records that had already
    been properly authenticated as part of the defendant physician’s moving papers. (Id. at
    pp. 505-506.) In other words, Shugart’s driving rationale on the admissibility of MSJ
    7
    evidence is that there is no need for a party to properly authenticate medical records that
    have already been deemed so by the trial court. (Id. at p. 506.)
    The Shugart court contrasted its evidentiary record from the record in
    Garibay v. Hemmat (2008) 
    161 Cal.App.4th 735
     (see Shugart, supra, 199 Cal.App.4th at
    pp. 505-506), a case on which Tonti relies in this appeal. The Garibay appellate court
    reversed a summary judgment granted in favor of a medical malpractice defendant.
    (Garibay, supra, 161 Cal.App.4th at pp. 743-744.) The “main issue on appeal [was]
    whether an expert medical witness’s declaration, setting forth facts of the surgery
    performed on plaintiff Garibay based on the expert witness’s review of hospital and
    medical records which were not properly before the court, was sufficient to meet the
    burden of the production of evidence required of the party moving for summary
    judgment.” (Id. at p. 740.) The Garibay appellate court concluded the defense expert
    declaration was insufficient because the records had not been authenticated and therefore
    had been erroneously admitted. (Id. at pp. 741-743.)
    C. Tonti’s Hearsay Objection Is Well Taken
    In this case, in contrast to Shugart, Naficy does not claim any prior trial
    court ruling that found Tonti’s medical records properly authenticated; nor do we discern
    any. Instead, this case is directly analogous to the threshold issue in Garibay: whether
    the moving party properly authenticated medical records to satisfy their initial burden of
    production to support their MSJ.
    As in Garibay, we look to Evidence Code section 1271, known as the
    business records exception to the hearsay rule. It states: “Evidence of a writing made as
    a record of an act, condition, or event is not made inadmissible by the hearsay rule when
    offered to prove the act, condition, or event if: [¶] (a) The writing was made in the regular
    course of a business; [¶] (b) The writing was made at or near the time of the act,
    condition, or event; [¶] (c) The custodian or other qualified witness testifies to its identity
    8
    and the mode of its preparation; and [¶] (d) The sources of information and method and
    time of preparation were such as to indicate its trustworthiness.”
    As noted, in this case, Ballin’s expert declaration relied on two challenged
    medical records of Tonti regarding treatments received from Naficy’s practice and Capo.
    The records were submitted with respective discovery response verifications by Naficy
    and the owner of Capo, verifying the defendants’ responses to discovery requests for
    production of documents and things, as required by Code of Civil Procedure section
    2031.250. Consistent with the requirements of that discovery statute, the verifications
    both assert that “[t]he matters stated in the foregoing documents are true of [the
    signatory’s] own knowledge except as to those matters which are stated on information
    and belief, and as to those matters [they believe] to be true.” Critically, there is no
    assertion in either verification specifying that their corresponding records were “made in
    the regular course of a business” or “at or near the time of the act, condition, or event”
    recorded, as required by the business records exception to the hearsay rule (Evid. Code, §
    1271) and we do not infer these points (City of Vista v. Robert Thomas Securities, Inc.,
    
    supra,
     84 Cal.App.4th at p. 886 [moving party’s evidence strictly construed]).
    Naficy’s appellate briefing does not discuss Evidence Code section 1271 or
    address Tonti’s reliance on Garibay. None of his case law citations, bereft of discussion,
    address the hearsay objection at issue in Garibay and this appeal.
    Based on the record and briefing, we conclude Tonti has met her burden to
    show the trial court erroneously admitted the medical records on which Naficy’s expert
    based his opinions because there was an insufficient factual showing that an exception to
    the hearsay rule was satisfied. It follows that Naficy’s “summary judgment motion failed
    to meet its burden of production, and thus did not shift that burden to [Tonti].” (Garibay,
    supra, 161 Cal.App.4th at p. 743.)
    Accordingly, because Naficy as the party moving for summary judgment
    failed to meet his initial burden, summary judgment should not have been granted despite
    9
    Tonti’s failure to present an expert declaration opposing Ballin’s opinions on the merits.
    (See Garibay, supra, 161 Cal.App.4th at p. 741 [“‘In professional malpractice cases,
    expert opinion testimony is required to prove or disprove that the defendant performed in
    accordance with the prevailing standard of care [citation], except in cases where the
    negligence is obvious to laymen. [Citation.]”].) Given our conclusion, we need not
    consider the parties’ other MSJ contentions.
    II.   THE DEMURRER RULINGS
    Next, Tonti contends the trial court erred in sustaining Naficy’s demurrers
    to Tonti’s third cause of action in her original complaint, for “intentional conduct,” and
    sixth cause of action in her amended complaint, for violation of the UCL. Tonti asserts
    the third cause of action should have survived “[f]or the same reasons as the [UCL]
    claim,” so we begin our review with the sixth cause of action.
    A. Standard of Review
    “‘In reviewing an order sustaining a demurrer, we examine the operative
    complaint de novo to determine whether it alleges facts sufficient to state a cause of
    action under any legal theory.’” (Mathews v. Becerra (2019) 
    8 Cal.5th 756
    , 768.) “[W]e
    give the complaint a reasonable interpretation” and, outside of issues not implicated
    3
    here, “we treat the demurrer as an admission by [the] defendant[] of all material facts
    properly pled in [the] plaintiff[’s] complaint — but not logical inferences, contentions, or
    conclusions of fact or law.” (Winn v. Pioneer Medical Group, Inc. (2016) 
    63 Cal.4th 148
    , 152.) “[W]hen a demurrer is sustained with leave to amend, but the plaintiff elects
    3
    Complaint allegations can be refuted by attached exhibits (Nolte v. Cedars-Sinai
    Medical Center (2015) 
    236 Cal.App.4th 1401
    , 1406 (Nolte).) and judicial notice (Evans
    v. City of Berkeley (2006) 
    38 Cal.4th 1
    , 6).
    10
    not to amend, it is presumed on appeal that the complaint states the strongest case
    possible.” (Ram v. OneWest Bank, FSB (2015) 
    234 Cal.App.4th 1
    , 10 (Ram).)
    “‘[A]lthough we use a de novo standard of review . . . , we do not transform
    into a trial court . . . . Instead, the appellant must frame the issues for us, show us where
    the superior court erred, and provide us with the proper citations to the record and case
    law.’” (Crawley v. Alameda County Waste Management Authority (2015) 
    243 Cal.App.4th 396
    , 404 (Crawley); Baldwin v. AAA Northern California, Nevada & Utah
    Ins. Exchange (2016) 
    1 Cal.App.5th 545
    , 549 [The “[a]ppellant bears the burden of
    demonstrating that the trial court erred”].)
    B. UCL Principles
    California’s UCL provides limited civil remedies for unfair competition,
    which it defines as “any unlawful, unfair or fraudulent business act or practice.” (Bus. &
    4
    Prof. Code, § 17200; see De La Torre v. CashCall, Inc. (2018) 
    5 Cal.5th 966
    , 993 [UCL
    is “broad in scope, . . . limited in remedies”].) Relevant to this appeal, the UCL’s
    “unlawful” prong requires a prima facie showing of three essential elements: (1) specific
    unlawful conduct (Munson v. Del Taco, Inc. (2009) 
    46 Cal.4th 661
    , 676), (2) a business
    course of conduct (see Podolsky v. First Healthcare Corp. (1996) 
    50 Cal.App.4th 632
    ,
    653), and (3) that as a result the defendant obtained plaintiff’s money or property
    (Kwikset Corp. v. Superior Court (2011) 
    51 Cal.4th 310
    , 322). “[T]he UCL ‘“borrows”’
    rules set out in other laws and makes violations of those rules independently actionable”
    (Zhang v. Superior Court (2013) 
    57 Cal.4th 364
    , 369), generally independent of whether
    the borrowed law otherwise allows a private cause of action (see id. at p. 369).
    C. The Demurrer to the UCL Claim Was Improperly Sustained
    4
    All further undesignated statutory references are to the Business & Professions
    Code.
    11
    Tonti asserts in her appellate briefing that Naficy violated the corporate
    practice of medicine (§ 2400), Health and Safety Code sections 11150, 11154, 11217.5,
    and committed medical malpractice, including failing to obtain Tonti’s informed consent.
    Tonti failed to assert some of the grounds in the trial court so her UCL claim can stand in
    this appeal based on theories of violating: (1) the corporate practice of medicine; (2) &
    (3) Health and Safety Code sections 11150 and 11154; and (4) a failure to obtain Tonti’s
    informed consent. Because we conclude Tonti sufficiently alleged facts for the first
    theory, we do not reach conclusions about the remaining three theories.
    “In general, under California’s long-standing ‘policy . . . against [the]
    corporate practice of the learned professions,’ for-profit corporations ‘may not engage in
    the practice of ... medicine.’ [Citation.] The ban on the corporate practice of medicine
    generally precludes for-profit corporations — other than licensed medical corporations —
    from providing medical care through either salaried employees or independent
    contractors. [Citations.] . . . [T]he ban on the corporate practice of medicine ‘is intended
    to ameliorate “the evils of divided loyalty and impaired confidence” which are thought to
    be created when a corporation solicits medical business from the general public and turns
    it over to a special group of doctors, who are thus under lay control. [Citation.]’”
    (People v. Cole (2006) 
    38 Cal.4th 964
    , 970-971 (Cole); see Physicians and Surgeons:
    Information Pertaining to the Practice of Medicine, Med. Bd. Cal.,
    https://www.mbc.ca.gov/Licensing/Physicians-and-Surgeons/Practice-Information/
    [“This section of the law is intended to prevent unlicensed persons from interfering with,
    or influencing, the physician’s professional judgment”].)
    Relevant here, the same Medical Practice Act that enacted section 2400 in
    1980, also enacted a statute that presently provides in relevant part as follows: “[A]ny
    person who practices or attempts to practice, or who holds himself or herself out as
    practicing . . . [medicine] without having at the time of so doing a valid, unrevoked, or
    unsuspended certificate . . . is guilty of a public offense.” (§ 2052, subd. (a); see Stats.
    12
    5
    1980, c. 1313, pp. 4449, 4494, § 2.) In 2002, the Legislature modified the statute and in
    relevant part added the following provisions: “Any person who conspires with or aids or
    abets another to commit any act described in subdivision (a) is guilty of a public offense.
    . . . [¶] . . . The remedy provided in this section shall not preclude any other remedy
    provided by law.” (§ 2052, subds. (b) & (c); Stats. 2002, ch. 1085, § 14.)
    On the factual allegations for her UCL claim, Tonti summarizes in her
    briefing that Naficy “set[] up a medical practice where [he wa]s paid by Capo to sign off
    on prescriptions, based on a pre-arranged program with Capo, without incurring the time
    and expense of seeing the patients first, thus, entirely alleviating himself of the duty to
    exercise professional judgment and skill and instead delegating that role to Capo and its
    nonmedical employees.” In her amended complaint, Tonti alleges that “Naficy allowed
    himself to be employed and directed by” Capo, prescribed drugs to Tonti when she “was
    not under [] Naficy’s care,” and did so without an appropriate medical examination of
    Tonti. Tonti also alleges the Capo staff member “Jeff Doe . . . was for all intents and
    purposes [Tonti’s unlicensed] health care provider” and that when Doe called Naficy and
    advised “further medication was needed,” Naficy prescribed the benzodiazepine without
    exercising independent judgment.
    A reasonable reading of Tonti’s allegations shows her UCL claim is based
    on a theory that Naficy was complicit in what Tonti asserts was a failure to provide
    promised “residential detoxification services” by a for-profit corporation. Naficy claims
    no exception to the corporate practice ban (see, e.g., § 2411 [ban exception for HMO’s])
    and Tonti alleges she was deprived of the $10,000 she paid to Capo for promised services
    because, “fearing another relapse,” she was effectively given no choice but to leave Capo,
    5
    “‘Person’ means any individual, partnership, corporation, limited liability
    company, or other organization, or any combination thereof, except that only natural
    persons shall be licensed under this chapter [including section 2052].” (§ 2032.)
    13
    based on a chain of events triggered by a “black out” episode caused by Naficy’s
    6
    purportedly unlawful prescription.
    Without considering the probability of whether Tonti will be able to prove
    her factual allegations (Nolte, supra, 236 Cal.App.4th at p. 1406; see Code Civ. Proc., §
    589 [demurrers raise questions of law]), we conclude those allegation are sufficient to
    support her theory for a UCL claim because, taken as true, they may reasonably support a
    conclusion that Naficy sufficiently assisted or encouraged a violation of California’s “ban
    on the corporate practice of medicine” (Cole, 
    supra,
     38 Cal.4th at p. 970; see also
    Steinsmith v. Medical Board (2000) 
    85 Cal.App.4th 458
     [restoring medical board’s
    citation against physician for “aiding the unlicensed practice of medicine”]; and CACI
    No. 3610)). For these reasons, the demurrer to Tonti’s sixth cause of action in her
    amended complaint should not have been sustained.
    D. Tonti Has Not Shown the Demurrer to Her Willful Misconduct Claim Was Improperly
    Sustained
    Finally, Tonti contends the trial court erroneously sustained Naficy’s first
    demurrer to Tonti’s original complaint third cause of action which is labeled “intentional
    conduct” but urged by Tonti to assert a cause of action for “willful misconduct.” As
    noted, Tonti did not amend her allegations for the claim even though the court granted
    leave to do so. (See Ram, supra, 234 Cal.App.4th at p. 22, fn. 3 [“A reviewing court
    normally ‘resolve[s] all ambiguities and uncertainties raised by the demurrer against’ the
    plaintiffs when, as here, a demurrer is sustained with leave to amend and the plaintiffs
    choose not to amend”].)
    6
    Our conclusions in this opinion should not be interpreted as views on the ultimate
    merits of the parties’ respective contentions, including legal issues that may be relevant in
    subsequent stages of this litigation. (See, e.g., § 2242 [on parameters for prescribing
    “dangerous drugs”].)
    14
    Tonti states the trial court’s ruling on the misconduct claim “set forth a
    completely correct analysis as to what the elements of the claim are” but she does not
    analyze the elements in her appellate briefing, nor does she present any supporting
    authority to demonstrate how they were satisfied by her complaint allegations. The
    court’s ruling Tonti endorses relied on Berkley v. Dowds (2007) 
    152 Cal.App.4th 518
    .
    That appellate court discussed the theory of willful misconduct in the context of elder
    abuse law in part as follows: “‘[W]illful misconduct’ is recognized . . . not [as] a separate
    tort, but simply “‘an aggravated form of negligence . . . Its pleading requirements are
    similar to negligence but stricter.’’’’’ (Id. at p. 526) “‘“[T]hree essential elements must
    be present to raise a negligent act to the level of wilful [sic] misconduct: (1) actual or
    constructive knowledge of the peril to be apprehended, (2) actual or constructive
    knowledge that injury is a probable, as opposed to a possible, result of the danger, and (3)
    conscious failure to act to avoid the peril. [Citations.]”’” (Id. at p. 528; see Perlin v.
    Fountain View Mgmt., Inc. (2008) 
    163 Cal.App.4th 657
     [holding violation of elder abuse
    statute “constitute[s] an independent cause of action”; opposite of conclusion in
    Berkley].)
    As noted, Tonti contends her willful misconduct claim should have
    survived “[f]or the same reasons” her UCL claim should have survived , without
    meaningful discussion. The sole factual issue she briefs is her general pleading allegation
    that Naficy issued her a prescription without an examination.
    There are two fundamental problems with Tonti’s reliance on UCL analysis
    for her attempt to satisfy the elements essential for willful misconduct liability. First is
    the obvious differences between the respective elements. For example, the UCL requires
    no showing of a defendant’s knowledge of probable injury to a plaintiff.
    The second problem is that Tonti’s third cause of action was alleged in her
    original complaint (and disposed of on Naficy’s first demurrer), whereas Tonti’s UCL
    claim allegations were thereafter elaborated in her amended complaint (and disposed of
    15
    on Naficy’s second demurrer). Particularly given that Tonti does not discuss the
    differences between the pleading iterations, her urging us to analyze the trial court’s first
    demurrer ruling on Tonti’s original third cause of action based on our analysis of her
    amended sixth cause of action does little to bridge the gap between her UCL violation
    theory and asserted theory of willful misconduct. Sufficiently pleaded facts for a UCL
    violation or practice of unauthorized corporate medicine do not necessarily demonstrate
    aggravated negligence. As to the sole factual issue mentioned in Tonti’s appellate
    briefing, prescription without examination, we are not presented with any specific
    complaint allegation that Naficy knew injury was probable and we do not infer the point
    given Tonti’s election not to amend her allegations. (See Ram, supra, 234 Cal.App.4th at
    p. 22, fn. 3.)
    In sum, we conclude that even assuming arguendo Tonti’s willful
    misconduct claim should be recognized as a valid cause of action, she has not carried her
    burden to show why the trial court erred in sustaining Naficy’s demurrer against it.
    (Crawley, supra, 243 Cal.App.4th at p. 404; see Cahill v. San Diego Gas & Electric Co.
    (2011) 
    194 Cal.App.4th 939
    , 956 [“‘We are not bound to develop appellants’ arguments
    for them’”].)
    16
    DISPOSITION
    The trial court’s June 18, 2020 order sustaining respondent’s demurrer to
    appellant’s original complaint third cause of action is affirmed. The court’s December
    10, 2020 order sustaining respondent’s demurrer to appellant’s amended complaint sixth
    cause of action is reversed. The court’s August 5, 2021 order granting summary
    judgment is also reversed. The matter is remanded for further proceedings consistent
    with this court’s opinion. Appellant is entitled to recover her costs on appeal.
    DELANEY, J.
    WE CONCUR:
    MOORE, ACTING P. J.
    GOETHALS, J.
    17