Doe v. Sutherland Healthcare Solutions CA2/7 ( 2021 )


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  • Filed 12/6/21 Doe v. Sutherland Healthcare Solutions CA2/7
    NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS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    has not been certified for publication or ordered published for purposes of rule 8.1115.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
    SECOND APPELLATE DISTRICT
    DIVISION SEVEN
    A. DOE et al.,                                                       B297712
    Plaintiffs and Appellants,                                  (Los Angeles County
    Super. Ct. Nos.
    v.                                                          BC539436,
    BC539844, BC542556)
    SUTHERLAND HEALTHCARE
    SOLUTIONS, INC. et al.,
    Defendants and Respondents.
    APPEAL from a judgment of the Superior Court of
    Los Angeles County, Ann I. Jones, Judge. Reversed and
    remanded with directions.
    Nelson & Fraenkel, Gretchen M. Nelson, Gabriel S.
    Barenfeld; Kabateck, Brian Kabateck, Anastasia K. Mazzella;
    Genie Harrison Law Firm, Genie Harrison; Righetti Glugoski,
    Matthew Righetti; Law Offices of Kevin T. Barnes and Gregg
    Lander for Plaintiffs and Appellants.
    Baker & Hostetler, Teresa C. Chow, Matthew C. Baisley,
    Paul Karlsgodt and Casie Collignon for Defendant and
    Respondent Sutherland Healthcare Solutions, Inc.
    Jones Day, Daniel J. McLoon, David J. Feder; Office of the
    Los Angeles County Counsel, Brian T. Chu and Brandi M. Moore
    for Defendant and Respondent County of Los Angeles.
    __________________________
    Following the theft of eight computers from an office of
    Sutherland Healthcare Solutions, Inc., a company that provides
    billing and payment processing services to hospitals including
    those operated by the County of Los Angeles, six affected
    individuals sued Sutherland and the County for violations of the
    Confidentiality of Medical Information Act (CMIA) (Civ. Code,
    § 56 et seq.)1 and negligence in a putative class action lawsuit,
    alleging their confidential medical and personally identifiable
    information had been compromised. Their complaint sought
    statutory damages for the CMIA violation, as provided in
    sections 56.36, subdivision (b), and 56.101, subdivision (a), and,
    as actual damages for negligence, the value of the lost
    information and the cost of credit monitoring services and
    enhanced security measures undertaken by certain plaintiffs.
    The trial court granted Sutherland and the County’s
    motion for summary judgment, ruling as to the CMIA claim that
    plaintiffs’ circumstantial evidence was insufficient to create a
    triable issue that the confidential nature of the plaintiffs’ medical
    information had been breached by an unauthorized individual, as
    required by the Third District’s decision in Sutter Health v.
    1     Statutory references are to this code unless otherwise
    stated.
    2
    Superior Court (2014) 
    227 Cal.App.4th 1546
    , 1555 (Sutter Health)
    and this court’s decision in Regents of University of California v.
    Superior Court (2013) 
    220 Cal.App.4th 549
    , 570 (Regents), and as
    to the negligence cause of action that plaintiffs had not presented
    evidence they had suffered actual damages or that potentially
    cognizable damages had been caused by the theft of the
    computers. The court also ruled that plaintiffs had failed to
    properly allege the County had violated a mandatory duty
    imposed by statute and that the County was immune from
    liability for common law negligence.
    We reverse the judgment, affirming the order of summary
    adjudication as to the CMIA cause of action but reversing as to
    the negligence claim. On remand plaintiffs may renew their
    motion for leave to amend the complaint, which was denied by
    the trial court while the summary judgment motion was pending.
    FACTUAL AND PROCEDURAL BACKGROUND
    1. The Theft of Sutherland Computers Containing
    Confidential Information
    a. Sutherland’s data handling practice
    For Sutherland to perform its billing and payment
    processing services, the County electronically transmitted patient
    data to Sutherland, which stored the information on a secure
    shared drive. Sutherland employees who worked with the data
    emailed documents, including spreadsheets, containing the
    personal health and personally identifiable information of
    individuals treated at county facilities. The computers at
    Sutherland’s Torrance office were configured to save a cache of all
    emails sent and received by the computer user. As a result, every
    hard drive had a file containing all emails and attachments sent
    3
    and received at that computer. Some employees also stored
    documents on their computers’ hard drive.
    The network server at Sutherland’s Torrance office was
    encrypted. Access to individual computers required a username
    and password, but information stored on those computers was not
    encrypted. Although the degree of difficulty was debated by the
    parties’ experts, it was undisputed that it was feasible for
    someone with the proper skillset to access the data on the
    password-protected computers.
    b. The burglary
    In the evening of February 5, 2014 someone entered
    Sutherland’s Torrance office and stole eight desktop computers.
    The stolen computers were among nearly 80 in the office and
    were spread throughout the 9,000 square foot facility. Six of the
    stolen computers were used by higher-level employees. Several of
    the individuals whose computers were taken admitted at
    deposition that they kept their passwords in a folder on their
    hard drives and had downloaded patient medical records and
    personally identifiable information onto their hard drives.
    The hard drives in the eight stolen desktop computers
    contained files that included medical information or personally
    identifiable information for more than 340,000 patients at county
    health care facilities. Following the theft Sutherland sent
    notification letters to more than 300,000 patients.2 Law
    2     The notice advised the stolen computers “contained
    personal information including your first and last name, Social
    Security number, and billing information. In addition, the stolen
    computers may have included your date of birth, address,
    diagnoses and other medical information.” “Because of the type
    of personal information involved,” the notice continued, “we
    4
    enforcement (the Torrance Police Department, the Los Angeles
    Police Department, the FBI and the Secret Service) investigated
    the theft and identified several suspects, but no arrests were
    made or charges filed. The stolen computers have not been
    recovered.
    2. The Lawsuits
    The first class action lawsuit arising from the February 5,
    2014 burglary was filed against Sutherland in March 2014. On
    September 25, 2014 three lawsuits were consolidated, and,
    pursuant to stipulation, on October 31, 2014 a consolidated
    amended class action complaint was filed by Mario Cazarin, John
    Galliano, Tanikka Harasim, Oswald Robinson, Tu Kamon and
    Damon English against Sutherland and the County, asserting
    causes of action for violation of CMIA, negligence and violations
    of section 1798.81.5, failure to provide reasonable security
    procedures and practices with respect to California residents’
    personal information, and section 1798.82, failure to provide
    notice regarding a breach of security regarding California
    residents’ personal information. Each of the six plaintiffs had
    received Sutherland’s notice of the computer thefts.
    Following a partially successful demurrer, plaintiffs on
    May 11, 2015 filed the operative consolidated second amended
    class action complaint, alleging causes of action for violation of
    CMIA and negligence against both Sutherland and the County
    encourage you to take steps to protect yourself from identity
    theft. We are offering credit monitoring services [that] will
    include: 12 months of credit monitoring, a $20,000 insurance
    reimbursement policy, Healthcare Identity Protection Toolkit™,
    exclusive educational materials and access to fraud resolution
    representatives.”
    5
    and violation of section 1798.82 against Sutherland. Plaintiffs
    sought actual damages and/or statutory damages for violation of
    CMIA and actual damages for the failure to protect their medical
    and personally identifiable information in the other two causes of
    action.
    After another pleading challenge, the court sustained the
    demurrer to the cause of action under section 1798.82 with leave
    to amend and overruled the demurrer to the CMIA and
    negligence claims.3 Plaintiffs did not amend further, and the
    section 1798.82 cause of action is not at issue in this appeal.
    Sutherland and the County answered the complaint on
    October 28, 2015.
    3. The Motion for Leave To Amend
    In September 2017, approximately five months after
    Sutherland and the County moved for summary judgment,
    plaintiffs sought leave to amend their complaint to add claims
    against Sutherland for breach of contract (as third party
    beneficiaries) and for violation of the unfair competition law
    (UCL) (Bus. & Prof Code, § 17200 et seq.). In support of their
    request plaintiffs argued the new causes of action related to the
    same general facts alleged in the operative complaint but added
    allegations based on evidence obtained from documents recently
    produced by the County and Sutherland, specifically the
    contracts between the County and Sutherland and documents
    “evidencing the County’s promises to Plaintiffs and Class
    members related to the confidentiality of collected patient
    3     The court sustained the demurrer as to all of English’s
    causes of action against the County based on his failure to file a
    timely prelawsuit claim under the Government Claims Act.
    6
    information which, in large part, form the basis for the
    additional causes of action against Sutherland in the Proposed
    Third Amended Complaint.”
    Sutherland and the County opposed the motion, arguing
    plaintiffs had unreasonably delayed in seeking leave to amend,
    they would be severely prejudiced if amendment were allowed,
    and the proposed amendments were futile. The trial court denied
    the motion in a three-page ruling on October 4, 2017, finding the
    additional discovery plaintiffs stated had alerted them to the
    existence of their new claims “was substantially available—either
    as part of the public record or as part of the documents produced
    to plaintiffs in 2015—over a year and a half ago.”
    The court ruled delay without a valid showing of excuse
    was a significant factor in considering a motion for leave to
    amend and could be a sufficient reason without more to deny the
    motion. In addition, the court found amendment at that point in
    the case would significantly prejudice defendants. The court
    pointed out that a motion for summary judgment had been filed
    by defendants and significant discovery had taken place,
    including “a considerable amount of discovery [by plaintiffs] in
    order to oppose that motion.” Permitting the amendment would
    likely lead to another demurrer and then a new motion for
    summary judgment, preceded by additional discovery. “Such a
    delay is not only unjustified but would reopen much of the
    concluded discovery and significantly impair the case
    management plan that has been structured by this court for over
    two years. While there is no trial date set, the potentially
    dispositive motions are set for early next year. Additional causes
    of action would preclude [that] hearing . . . from going forward in
    a timely fashion.”
    7
    Finally, without definitively deciding the issue, the court
    indicated skepticism about the merits of at least the contract
    claim in light of express language in the pertinent agreements
    excluding third party beneficiaries.
    4. The Motion for Summary Judgment or, Alternatively,
    Summary Adjudication
    In April 2017 Sutherland and the County moved for
    summary judgment and in January 2018 filed an amended
    motion. On the CMIA claim, defendants asserted as to four of the
    six plaintiffs there was no medical information contained in the
    data that might be accessed from the stolen computers, and as to
    two of the plaintiffs the stored medical information was not
    private or confidential because their conditions were publicly
    observable. Most significantly, contending it was inherently
    speculative to conclude the motivation for the computer theft was
    to mine and sell the data the computers may have contained,
    Sutherland and the County argued plaintiffs could not prove
    confidential medical information on the stolen computers had
    been viewed by any unauthorized person, as required by Sutter
    Health, supra, 
    227 Cal.App.4th 1546
     and Regents, supra,
    
    220 Cal.App.4th 549
     to establish a CMIA claim for the negligent
    release of confidential information.
    Emphasizing there was no direct evidence that stolen
    medical information had been accessed, Sutherland and the
    County argued the circumstantial evidence proffered by plaintiffs
    (evidence indicating the probable motivation for the burglary was
    to steal medical information and one of the named plaintiffs and
    others affected by the burglary had reported attempts at identity
    theft after the incident), while arguably sufficient to survive a
    demurrer, as the trial court had held, was insufficient to create a
    8
    triable issue of fact on summary judgment. In support
    Sutherland and the County submitted a report from
    Dr. Marcus K. Rogers, an expert in investigating cybercrimes,
    stating, as the lower boundary of the true total, an estimated
    7 percent of the United States population 16 years or older is a
    victim of identity theft. Using that estimate, 23,709 of the
    338,700 patients whose information was contained on the stolen
    computers were likely to have been victims of identity theft
    unrelated to the Sutherland computer theft. Yet, according to
    Sutherland and the County’s expert, there were only eight
    reported separate instances of attempted fraud by persons whose
    data were contained on the stolen Sutherland systems. The
    Sutherland and County expert also opined that, if someone were
    to become a victim of financial fraud or identity theft through the
    use of information taken from the computer systems, it would be
    completely coincidental that medical information pertaining to a
    particular individual was viewed, and it would depend on the
    proximity of one person’s information to another person’s
    information in a particular file.
    A second defense expert, Dr. Thomas Holt, opined that,
    even if cyber criminals had obtained the data stored on the stolen
    computers, the format of the medical information contained in
    the local files and the lack of value that cyberhackers attach to
    medical information made it unlikely that unauthorized persons
    would have viewed, mined, obtained or sold the medical
    information. Rather, the personally identifiable information that
    was also contained in the local files was far more valuable and far
    less time-consuming to mine than the medical information.
    As for the negligence claim, Sutherland and the County did
    not dispute the allegation Sutherland had failed to act reasonably
    9
    to protect confidential medical information or personally
    identifiable information stored on the stolen desk top computers,
    but argued none of the plaintiffs could prove cognizable damages:
    “Either they claim no concrete losses at all, or they claim losses
    that the law does not recognize as damages.” Only one of the
    plaintiffs alleged a specific loss of money (something less than
    $60 attributed to an unrecognized credit card charge in 2015),
    and he was unable to provide any information that would tie it to
    the Sutherland theft. Expenses for credit monitoring services to
    mitigate a risk of future harm, Sutherland and the County
    argued, were insufficient to qualify as cognizable injury in a
    negligence claim; and personal time spent reviewing information
    related to the theft did not constitute actual harm. In addition,
    they contended, given the prevalence of identity theft resulting
    from the many recent large scale data breaches that had occurred
    throughout the country, plaintiffs could not prove actual
    causation between the several instances of attempted fraud or
    identity theft reported by individuals whose information was on
    the stolen computers (only one of which involved a named
    plaintiff) and the Sutherland burglary.
    Finally, the County argued there is no common law
    governmental tort liability in California. As such, the County
    asserted, it is immune from liability for common law negligence.
    5. Plaintiffs’ Opposition and Defendants’ Reply
    In their opposition papers plaintiffs argued the stolen data
    contained confidential medical information as to all six of them.
    As to the four described by defendants as without medical
    information in the stolen computers, plaintiffs argued each had
    “CPT” (current procedural terminology) codes in his or her data,
    alphanumerics assigned to every task and service a medical
    10
    practitioner may provide a patient, which are used by insurers to
    determine reimbursement amounts. A CPT code can be entered
    into an internet search engine to determine the procedure and/or
    diagnosis and thus constitutes medical information within the
    meaning of CMIA, they argued. As to the other two plaintiffs,
    plaintiffs disputed the extent to which they openly discussed
    their medical conditions and argued the visibility of a condition
    alone is insufficient to constitute a waiver of confidentiality of all
    medical information about the condition.
    As to Sutherland and the County’s primary argument that
    plaintiffs could not establish a CMIA violation, plaintiffs insisted
    it was a reasonable inference from the circumstantial evidence
    that the stolen data had been improperly viewed or otherwise
    accessed by unauthorized individuals. First, plaintiffs argued it
    was a reasonable inference (not mere speculation) the computers
    had been stolen because of the value on the black market of the
    data they contained. Plaintiffs provided evidence the estimated
    value of the individual computers was between $300 and $500.
    (The Torrance Police Department estimated the total value of the
    stolen hardware, which included two monitors in addition to the
    eight computers, at $4,104.) The medical information and
    personally identifiable information were valued at between $10
    and $500 per individual patient on the black market.4 In
    4     In a declaration submitted with their opposition papers,
    plaintiffs’ expert James Van Dyke explained consumers’
    personally identifiable information “remains of high value to
    identity criminals.” Although he stated costs range from under
    $10 to over $400 depending on quality, citing the Identity Theft
    Resources Center, he declared, on average, a criminal can
    purchase personally identifiable information from another
    criminal on the black market for somewhere between 12 and
    11
    addition, plaintiffs noted that none of the computer cables or
    other accessories, except for two monitors, had been taken, nor
    were the computers taken closest to the door used to enter the
    facility, suggesting it was not the value of the equipment taken
    that motivated the thief. They also quoted from the search
    warrant affidavit of a district attorney’s office investigator that
    the stolen computers were an “ideal source of PII [personally
    identifiable information] for the purposes of tax fraud or many
    other identity theft or fraud schemes.” The investigator also
    opined the computers had been specifically targeted.
    Second, plaintiffs provided expert evidence refuting any
    suggestion it would be difficult to access unencrypted data on the
    stolen computers. Third, plaintiffs pointed to 10 known incidents
    of identity fraud or attempted identity theft by individuals
    affected by the security breach, including use of social security
    numbers to open fraudulent credit accounts, which they described
    as “close in time” to the Sutherland breach; and their
    cybersecurity expert, Christopher Tarbel, opined, to a reasonable
    degree of certainty, that the stolen data had been viewed and
    accessed by cybercriminals.
    As to the negligence claim, plaintiffs argued they were
    entitled to recover the value of the personal information stolen
    from them (analogizing to the valuation of stolen access card
    account information in criminal cases to determine whether the
    theft is a felony or misdemeanor) and contended expenses
    incurred for credit monitoring and enhanced home security were
    also recoverable. Whether those damages were caused by
    16 dollars. He continued, “Estimates for health records range
    from $10 to $50 per individual.”
    12
    Sutherland and the County’s negligence, they asserted, was a
    factual issue that was not properly decided on summary
    judgment. Finally, as to the County, plaintiffs argued their
    negligence claims were based on the County’s breach of its
    statutory obligations under CMIA.
    Concurrently with their opposition papers plaintiffs filed
    numerous (and detailed) evidentiary objections to Sutherland and
    the County’s evidence, including to the declarations of Dr. Rogers
    and Dr. Holt, the two defense experts.
    In their reply memorandum Sutherland and the County
    emphasized that only 10 (approximately) of the nearly 400,000
    individuals given notice of the theft of the Sutherland computers
    had alleged any attempted fraud or identity theft and none of
    those reports involved the misuse of medical information.
    Plaintiffs’ circumstantial evidence, they argued, was at most
    speculation about how the information on the stolen computers
    might have been misused. All plaintiffs actually established was
    that it was technologically feasible for an unauthorized
    individual to break into the computers, the medical and personal
    data were more valuable on the black market than the hardware
    stolen, and the computers may have been specifically selected by
    the thief on some basis other than convenience. Quoting this
    court’s Regents decision, they continued, “[T]he only conclusion
    supported by the record is that ‘no one (except perhaps the thief)
    knows what happened . . . ,’ and therefore Plaintiffs cannot prove
    their ‘medical records were, in fact, viewed by an unauthorized
    individual.”
    13
    6. The Court’s Ruling
    Following oral argument on December 10, 2018, the court
    on December 19, 2018 issued a 14-page ruling, granting
    Sutherland and the County’s motion.5 The court first found as to
    three of the plaintiffs (Galliano, Harasim and English) there were
    no CPT codes or other medical information pertaining to them in
    the stolen computers. Accordingly, the court granted the motion
    for summary adjudication as to the CMIA cause of action as to
    those three plaintiffs. Although there were CPT codes in the data
    concerning Kamon, the court agreed with Sutherland and the
    County that Kamon had presented no evidence her CPT codes
    disclosed confidential medical information. On that basis the
    court granted summary adjudication on the CMIA claim against
    Kamon.
    Accepting Sutherland and the County’s argument that a
    visible medical condition precluded a CMIA claim, the court also
    granted summary adjudication on that cause of action as to
    Cazarin notwithstanding the presence of confidential medical
    information concerning him within the data on the stolen
    computers.
    In addition, as to Cazarin and the sixth plaintiff, Robinson,
    the court ruled their contention that anyone had actually viewed
    their confidential medical information required “layers of
    speculation.” The court wrote, “At best, Plaintiffs have shown a
    5     The court overruled all 123 of plaintiffs’ objections to
    defendants’ evidence. As to objections 1-59 and 62-90 the court
    stated, “These are not objections to specific evidence. Rather,
    these are objections to facts set forth in Defendants’ separate
    statement.” No other explanation was given for overruling those
    objections or for any of the other objections.
    14
    possibility that the password-protected (albeit unencrypted)
    confidential medical information on the stolen computers was
    viewed.” But, the court ruled, quoting Sutter Health, supra,
    227 Cal.App.4th at page 1558, “that is not the standard.” The
    court concluded plaintiffs had not presented evidence from which
    a trier of fact could reasonably infer the computers were targeted
    for their data. In addition, observing that proof of an actual
    breach of confidentiality is required, not merely accessibility of
    the data, the court noted that none of the limited incidents of
    identity theft (or attempted identity theft) had involved Cazarin
    or Robinson and thus did not assist in demonstrating a triable
    issue of fact regarding the “actually viewed” element of their
    CMIA claim. Accordingly, the court granted the motion for
    summary adjudication of the CMIA claim as to Cazarin and
    Robinson.
    Turning to the negligence claim, the court agreed with
    Sutherland and the County that plaintiffs had failed to present
    evidence of actual damages. The court rejected the contention
    the value of the stolen information is recoverable, pointing out
    that section 3336, cited by plaintiffs, pertains to the measure of
    damages for conversion, not negligence. The court then
    acknowledged that credit monitoring services can constitute
    actual damages in an action for failure to protect confidential
    personal information, but ruled plaintiffs had failed to show the
    required logical and temporal connection between the decision to
    purchase those services and the alleged breach, noting there had
    been no showing that any suspicious activity related to plaintiffs
    involved the type of information contained on the stolen
    computers. The court also found plaintiffs’ proof of causation
    insufficient to raise a triable issue, explaining that four of the
    15
    plaintiffs had not been the victims of any attempted fraudulent
    activity and the cause of the incidents involving the other two
    plaintiffs was “purely speculative.” The court granted summary
    adjudication on the negligence claim on both of those grounds.
    With regard to the negligence claim against the County,
    the court ruled, to the extent based on a violation of a mandatory
    duty imposed by CMIA, it was duplicative of the CMIA claim. No
    other statute creating a mandatory duty allegedly breached by
    the County was properly pleaded in the operative complaint.
    Accordingly, summary adjudication on the negligence claim was
    granted as to the County for this additional reason.
    7. The Motion To Seal Portions of the Ruling
    On February 14, 2019, nearly two months after the court’s
    ruling granting the motion for summary judgment, plaintiffs filed
    an unopposed application to seal portions of the court’s order
    referring to “Plaintiffs’ confidential and private medical
    information protected by the Court’s Stipulated Protective
    Order.” The court granted the motion in part, redacting
    information regarding Robinson from the public filing, but
    otherwise denied the motion. In its minute order the court
    explained, “[W]hile Plaintiffs ‘continue to believe’ that their
    medical information is private and confidential [fn. omitted], the
    Court agreed with Defendants’ argument that the medical
    information of Plaintiffs (except Plaintiff Oswald Robinson) on
    the stolen computers was not confidential based on facts
    identified on page 5 of its Order. Those facts are critical to the
    Court’s ruling, and the right of public access to the basis for the
    Court’s ruling prevails.”
    Judgment was entered on March 12, 2019. Plaintiffs filed a
    timely notice of appeal.
    16
    DISCUSSION
    1. Standard of Review
    A motion for summary judgment is properly granted only
    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.” (Code Civ. Proc., § 437c,
    subd. (c).) We review a grant of summary judgment de novo
    (Samara v. Matar (2018) 
    5 Cal.5th 322
    , 338) and, viewing the
    evidence in the light most favorable to the nonmoving party
    (Regents of University of California v. Superior Court (2018)
    
    4 Cal.5th 607
    , 618), decide independently whether the facts not
    subject to triable dispute warrant judgment for the moving party
    as a matter of law. (Hampton v. County of San Diego (2015)
    
    62 Cal.4th 340
    , 347; Schachter v. Citigroup, Inc. (2009) 
    47 Cal.4th 610
    , 618.) “Circumstantial evidence is just as good as direct
    evidence to create a triable issue of fact.” (Hussey-Head v. World
    Savings & Loan Assn. (2003) 
    111 Cal.App.4th 773
    , 780.)
    2 Governing Law: CMIA
    As defined by CMIA, “‘Medical information’ means any
    individually identifiable information, in electronic or physical
    form, in possession of or derived from a provider of health care,
    health care service plan, pharmaceutical company, or contractor
    regarding a patient’s medical history, mental or physical
    condition, or treatment.” (§ 56.05, subd. (j).)6 “This definition
    6     Section 56.05, subdivision (j), defines “Individually
    identifiable” for purposes of CMIA as meaning that “the medical
    information includes or contains any element of personal
    identifying information sufficient to allow identification of the
    individual, such as the patient’s name, address, electronic mail
    address, telephone number, or social security number, or other
    17
    does not encompass demographic or numeric information that
    does not reveal medical history, diagnosis, or care. . . . [¶] . . .
    [T]he mere fact that a person may have been a patient at the
    hospital at some time is not sufficient.” (Eisenhower Medical
    Center v. Superior Court (2014) 
    226 Cal.App.4th 430
    , 435.) In
    addition, “[c]onfirmation that a person’s medical record exists
    somewhere is not medical information as defined under the
    CMIA.” (Id. at p. 436.)
    CMIA prohibits health care providers and related entities
    from disclosing medical information regarding a person without
    authorization in certain specified instances (§ 56.10) and imposes
    a duty on health care providers who create, maintain or dispose
    of medical information to do so in a manner that preserves the
    confidentiality of that information (§ 56.101, subd. (a)). Any
    provider who negligently creates, maintains or disposes of
    medical information is subject to the remedies and penalties
    “provided under subdivisions (b) and (c) of Section 56.36”
    (§ 56.101, subd. (a)), which include actual damages suffered by
    the patient or nominal damages of $1,000 (§ 56.36,
    subd. (b)(1), (2)).
    The private cause of action to enforce the duty imposed by
    section 56.101, subdivision (a), requires “pleading, and ultimately
    proving, that the confidential nature of the plaintiff’s medical
    information was breached as a result of the health care provider’s
    negligence.” (Regents, supra, 220 Cal.App.4th at p. 570; accord,
    Sutter Health, supra, 227 Cal.App.4th at p. 1555 [“without an
    actual confidentiality breach, a health care provider has not
    violated section 56.101 and therefore does not invoke the remedy
    information that, alone or in combination with other publicly
    available information, reveals the individual’s identity. ”
    18
    provided in section 56.36”].) That is, although a patient need not
    plead and prove the health care provider engaged in some
    affirmative conduct leading to an unauthorized third party’s
    access to confidential medical information (Regents, at p. 565 &
    fn. 12), more than loss of possession of records containing the
    confidential medical information must be shown. (Sutter Health,
    at p. 1557 [“[i]t is the medical information, not the physical
    record (whether in electronic, paper, or other form), that is the
    focus of [CMIA]”]; Regents, at p. 570 [“more than an allegation of
    loss of possession by the health care provider is necessary to state
    a cause of action for negligent maintenance or storage of
    confidential medical information”].)
    3. Plaintiffs Failed To Demonstrate Triable Issues of Fact
    as to Whether Their Confidential Medical Information
    Was Improperly Viewed or Otherwise Accessed
    Acknowledging there is no direct evidence the
    confidentiality of the stolen medical information had been
    breached, plaintiffs argue on appeal it is a reasonable inference
    from the circumstantial evidence they proffered in opposition to
    the motion for summary judgment—the apparent targeting of the
    eight computers, the thief’s decision not to steal other types of
    equipment (other than two monitors), the far greater black
    market value of the confidential data on the computers than the
    value of the stolen hardware, the unencrypted nature of those
    data, the relative ease with which they could be accessed, and at
    least 10 incidents of identity theft close in time to the incident—
    that the confidential medical information had been viewed or
    otherwise accessed by the thief or other unauthorized individuals,
    creating a triable issue of fact on that essential element of their
    CMIA cause of action.
    19
    Sutherland and the County dispute the significance of this
    inference, arguing it is only one of several possibilities and thus
    insufficient to defeat summary judgment, quoting Leslie G. v.
    Perry & Associates (1996) 
    43 Cal.App.4th 472
    , 483 (Leslie G.),
    which held, “Where, as here, the plaintiff seeks to prove an
    essential element of her case by circumstantial evidence, she
    cannot recover merely by showing that the inferences she draws
    from those circumstances are consistent with her theory. Instead,
    she must show that the inferences favorable to her are more
    reasonable or probable than those against her.” It may have just
    been a “smash and grab” burglary, Sutherland and the County
    argue. Or it may have been a scheme of corporate sabotage
    intended to persuade the County to move the lucrative contract
    for patient billing and payment services to one of Sutherland’s
    competitors based on Sutherland’s demonstrated lack of security.
    And even if the computers were targeted, the motivation may
    have been the personally identifiable information they contained,
    such as social security numbers, rather than medical
    information. Each of these alternate theories, Sutherland and
    the County posit, are consistent with certain of the facts known
    about the burglary.
    Sutherland and the County’s assertion that it is the role of
    the trial court on summary judgment—or this court when
    conducting its de novo review—to determine which of several
    reasonable but conflicting inferences is more probable directly
    conflicts with Code of Civil Procedure section 437c,
    subdivision (c), which provides, “[S]ummary judgment shall not
    be granted by the court based on inferences reasonably deducible
    from the evidence if contradicted by other inferences or evidence
    that raise a triable issue as to any material fact.” Indeed, as
    20
    Justice Miriam Vogel, the author of Leslie G., explained in
    rejecting an expansive interpretation of that decision several
    years later in Hussey-Head v. World Savings & Loan Assn.,
    supra, 111 Cal.App.4th at page 780, citing and quoting Saelzler v.
    Advanced Group 400 (2001) 
    25 Cal.4th 763
    , 767, all that is
    necessary for a plaintiff opposing summary judgment is to “create
    a reasonable inference” the defendant violated the statute at
    issue, since, “to prevail by summary judgment, the moving party
    must establish that ‘“under no hypothesis is there a material
    issue of fact that requires the process of trial.”’” (Accord,
    Savaikie v. Kaiser Foundation Hospitals (2020) 
    52 Cal.App.5th 223
    , 229-230 [“‘[g]enerally, when conflicting inferences can be
    reasonably drawn from the evidence, a triable issue of fact is
    deemed to exist’”]; Pierson v. Helmerich & Payne Internat.
    Drilling Co. (2016) 
    4 Cal.App.5th 608
    , 627 [same].)
    The deficiency in plaintiffs’ CMIA proof is not their failure
    to create triable issues of fact concerning the motivation for the
    burglary and the likelihood some of the stolen medical
    information was viewed or otherwise accessed, but their lack of
    evidence that plaintiffs’ confidential medical information was
    compromised. The private cause of action for negligent release of
    confidential medical information created by sections 56.36,
    subdivision (b), and 56.101, subdivision (a), like the right of
    privacy itself, “is purely a personal one.” (See Regents, supra,
    220 Cal.App.4th at p. 563 & fn. 6.) A patient may sue for
    statutory damages for a breach of confidentiality only if the
    compromised information “concern[ed] him or her.” (§ 56.36,
    subd. (b); see Regents, at p. 563 [“[a]t the very least, the
    information potentially compromised as a result of the negligent
    conduct must relate to the individual initiating the action”].)
    21
    Plaintiffs do not challenge the trial court’s ruling that no
    confidential medical information concerning Galliano, Kamon or
    English was stored on the stolen computers. Although they have
    not made the same express concession regarding Harasim and
    contest the trial court’s finding that she waived any
    confidentiality because an aspect of her medical condition was
    publicly visible—an issue we need not address—they have not
    argued the trial court erred in its additional finding that there
    were no CPT codes or other confidential medical information
    concerning her on the stolen computers. As to these four
    plaintiffs, then, the court’s order granting summary adjudication
    of the CMIA cause of action must be affirmed.
    What about Cazarin and Robinson, the remaining
    two plaintiffs? As discussed, data on the stolen computers
    included information (medical information, personally
    identifiable information or both) for more than 340,000 patients
    at county health care facilities. According to plaintiffs, after
    eliminating duplications, there were approximately 460,000
    unique documents stored on the eight computers. No single
    document or discrete set of documents contained all relevant
    patient information.
    Even if plaintiffs’ circumstantial evidence supports the
    reasonable inference that the confidentiality of some of those
    patients’ medical information was breached following the theft,
    there is no evidentiary basis—reasonable or otherwise—for
    inferring that the confidential medical records of Cazarin or
    Robinson were among them. As the trial court emphasized, none
    of the approximately 10 incidents of identity theft or attempted
    identity fraud arguably linked to the Sutherland burglary
    involved either Cazarin or Robinson. While it is certainly true, as
    22
    plaintiffs contend, that being a victim of identity fraud is not an
    element of a CMIA claim—the confidential medical information
    need only be viewed or accessed, not used—evidence that one
    type of confidential information had been accessed and used
    would have supported an inference other aspects of that patient’s
    stolen data had been viewed, as well. Plaintiffs identified
    nothing else in the record that would permit a jury to find that
    records specific to Cazarin or Robinson were among those opened
    or actually viewed following the theft of the computers, assuming
    any records were.
    Ultimately, then, the argument that Cazarin’s and
    Robinson’s CMIA claims survive summary judgment depends on
    the contention the circumstantial evidence created a reasonable
    inference, and thus a triable issue, not only that some of the
    confidential medical information on the stolen computers was
    viewed but that all of it was. As to this inference, too, there is no
    evidentiary basis. To the contrary, defendants’ experts opined
    that a criminal who intended to mine the stolen information for
    sale would likely have employed an automated process that
    targeted specific types of data and would limit any manual
    review to spot checking to assist that process. The volume of
    data and variety of attachments, they explained, would have
    made it infeasible for anyone to manually view all the data even
    if the contents of the hard drives were accessed.7 Plaintiffs did
    7       On appeal plaintiffs contend the trial court’s “blanket”
    overruling of all 123 of its objections to defendants’ evidence with
    little or no explanation was an abuse of discretion. Citing
    primarily Nazir v. United Airlines, Inc. (2009) 
    178 Cal.App.4th 243
    , they assert such a ruling affords no meaningful basis for
    review and could be treated as a failure to rule at all. They may
    be correct. But if plaintiffs intended that we disregard on appeal
    23
    not dispute that overall assessment, contesting only the degree of
    difficulty in viewing unencrypted data on a password protected
    computer while essentially agreeing a manual review of all data
    would be unnecessary to effect the data theft. Evidence that
    suggests data might have been transferred through an
    automated process from one set of computers to another without
    some indication all the data were viewed, directly or indirectly,
    falls short of creating a triable issue whether the confidentiality
    of medical information personal to Carazin or Robinson was
    breached.8
    the evidence presented by defendants’ experts, it was their
    burden to renew their objections and present arguments that
    would support sustaining them. (See Reid v. Google, Inc. (2010)
    
    50 Cal.4th 512
    , 534 [“presumptively overruled objections can still
    be raised on appeal, with the burden on the objector to renew the
    objections in the appellate court”].) Their opening brief entirely
    fails to do that, and their reply brief is only minimally better.
    Accordingly, we consider defendants’ expert reports to this
    limited extent. (See People v. Tully (2012) 
    54 Cal.4th 952
    , 1075;
    Sweetwater Union High School Dist. v. Julian Union Elementary
    School Dist. (2019) 
    36 Cal.App.5th 970
    , 987.)
    8     Plaintiffs in their reply brief emphasize that in Regents,
    supra, 
    220 Cal.App.4th 549
    , we referred to “viewed or otherwise
    accessed,” not simply “viewed” and suggest, without elaboration,
    the “accessed” standard is somehow broader than “viewed” and
    that under this more expanded interpretation of CMIA Cazarin’s
    and Robinson’s claims survive. Plaintiffs misapprehend the
    import of that language. In Regents we rejected the argument a
    private cause of action under Civil Code sections 56.36,
    subdivision (b), and 56.101 requires pleading and proof of an
    affirmative disclosure by the health care provider. In doing so, we
    considered regulatory safeguards in the Health and Safety Code,
    enacted some years after the CMIA provisions at issue in the case,
    24
    4. Plaintiffs Established Triable Issues of Fact Regarding
    Actual Damages and Causation for Purposes of Their
    Negligence Claim
    To establish a prima facie case of negligence, a plaintiff
    must prove the defendant owed a duty to the plaintiff, the
    defendant breached that duty, and the defendant’s breach
    proximately caused the plaintiff damage. (Lockheed Martin Corp.
    v. Superior Court (2003) 
    29 Cal.4th 1096
    , 1106; Paz v. State of
    California (2000) 
    22 Cal.4th 550
    , 559.) In moving for summary
    judgment Sutherland and the County did not challenge plaintiffs’
    ability to prove duty or breach, arguing only that they lacked
    evidence of causation and damage. (See Jimenez v. Superior
    Court (2002) 
    29 Cal.4th 473
    , 483 [“‘appreciable, nonspeculative,
    present injury is an essential element of a tort cause of action’”].)
    Effectively conflating those arguments, the trial court
    ruled, although under certain circumstances the costs incurred
    that expressly addressed “‘unlawful or unauthorized access to’”
    confidential medical information, as well as its unauthorized “‘use
    or disclosure.’” (See Regents, at p. 568.) The argument advanced
    was that “negligently release[ ]” in Civil Code section 56.36,
    subdivision (b), must mean more than permitting unauthorized
    “access to” because the Legislature used that term in the new
    regulatory protections when it meant it. Not so, we held. Nothing
    in those newer statutes or their legislative history indicated the
    Legislature in providing additional protections for confidential
    medical information intended to modify or displace existing
    private remedies for the negligent storage or disposal of such
    information, which did not require affirmative disclosures.
    (Regents, at p. 568) However, because the Legislature had used
    “access” to refer to the concept we held encompassed by
    “negligently released,” the statutory term at issue in Regents, we
    did as well.
    25
    for credit monitoring services were recoverable as damages in a
    data breach case (as it had concluded when overruling
    Sutherland and the County’s demurrer to the negligence cause of
    action), those costs did not qualify as actual damages here
    because plaintiffs had failed to present evidence there was a
    “‘logical and temporal connection between the decision to
    purchase credit monitoring services and the defendant’s alleged
    breach.’”
    We agree credit monitoring costs and other economic losses
    incurred to combat potential identity theft are recoverable as
    damages if the remaining elements of a negligence claim arising
    from the breach of confidentiality of medical or personally
    identifiable information have been proved.9 The right to recover
    the cost of periodic monitoring due to an increased risk of future
    injury created by a defendant’s negligent conduct is well-
    established in California tort law. In Potter v. Firestone Tire &
    Rubber Co. (1993) 
    6 Cal.4th 965
    , a case involving the illegal
    dumping of toxic water materials, the Supreme Court held
    expenditures for prospective medical testing and evaluation that
    would be unnecessary absent wrongful exposure are “‘detriment
    proximately caused’” by negligent disposal of toxic substances.
    (Id. at p. 1005.) Accordingly, the Court held, “[T]he cost of
    medical monitoring is a compensable item of damages where the
    proofs demonstrate, through reliable medical expert testimony,
    that the need for future monitoring is a reasonably certain
    consequence of a plaintiff’s toxic exposure and that the
    9    Although the stolen computers contained only Cazarin’s
    and Robinson’s confidential medical information, all six plaintiffs’
    personally identifiable information was among the data on the
    computers.
    26
    recommended monitoring is reasonable.” (Id. at p. 1009;10
    see Lockheed, supra, 29 Cal.4th at p. 1105 [“Potter simply
    specified for the medical monitoring context the traditional
    requirement that a plaintiff prove causation of damage. Thus,
    while in Potter we ‘ma[de] it clear that the monitoring must be
    “additional or different”’ than that previously required [citation],
    we just as clearly stated that ‘if additional or different tests and
    examinations are necessitated as a result of the toxic exposure
    caused by the defendant, then the defendant bears full
    responsibility for their costs’”].) It is an entirely appropriate
    application of the principles underlying Potter’s holding that the
    cost of prospective medical monitoring is cognizable injury in a
    negligence action to impose responsibility for the cost of credit
    monitoring services on defendants found liable for a data breach
    if plaintiffs prove causation.
    10     Expanding on its holding the Supreme Court stated, “In
    determining the reasonableness and necessity of monitoring, the
    following factors are relevant: (1) the significance and extent of
    the plaintiff’s exposure to chemicals; (2) the toxicity of the
    chemicals; (3) the relative increase in the chance of onset of
    disease in the exposed plaintiff as a result of the exposure, when
    compared to (a) the plaintiff’s chances of developing the disease
    had he or she not been exposed, and (b) the chances of the
    members of the public at large of developing the disease; (4) the
    seriousness of the disease for which the plaintiff is at risk; and
    (5) the clinical value of early detection and diagnosis. Under this
    holding, it is for the trier of fact to decide, on the basis of
    competent medical testimony, whether and to what extent the
    particular plaintiff’s exposure to toxic chemicals in a given
    situation justifies future periodic medical monitoring.” (Potter v.
    Firestone Tire & Rubber Co., supra, 6 Cal.4th at p. 1009.)
    27
    As the district court explained in Huynh v. Quora, Inc.
    (N.D.Cal. 2020) 
    508 F.Supp.3d 633
     in denying a motion for
    summary judgment in a putative class action asserting claims
    under California law for negligence and violation of the UCL
    following a data breach,11 although “California courts have not
    considered whether time and money lost to credit monitoring
    from the future threat posed by compromised PII are damages to
    support a negligence claim” (id. at p. 649), “courts confronting the
    issue in this Circuit have extended the toxic tort exception to
    data breach cases in which PII is compromised.” (Id. at p. 650.)
    The Huyn court cited decisions from the Northern District,
    Central District and Southern District of California before ruling,
    “[T]his Court agrees with Plaintiff that the time and money she
    spent on credit monitoring in response to the Data Breach is
    cognizable harm to support her negligence claim.” (Ibid.; accord,
    Schmitt v. SN Servicing Corp. (N.D.Cal., Aug. 9, 2021, No. 21-cv-
    3355-WHO) 2021 U.S.Dist. Lexis 149252, *18 [“t]he money and
    time plaintiffs spent on credit monitoring are both cognizable
    forms of harm”]; see Lewert v. P.F. Chang’s China Bistro, Inc.
    (7th Cir. 2016) 
    819 F.3d 963
    , 967 [plaintiffs’ alleged injuries—
    “the increased risk of fraudulent charges and identity theft they
    face because their data has already been stolen”—“are concrete
    enough to support a lawsuit”]; Galaria v. Nationwide Mutual Ins.
    11    Like Sutherland and the County, the defendant in Huynh
    v. Quora, Inc., supra, 
    508 F.Supp.3d 633
     moved for summary
    judgment because “[p]laintiff has not suffered identity theft and
    asserts that she has voluntarily attempted to repair any
    hypothetical threat of future harm by temporarily purchasing
    credit monitoring services and monitoring her accounts.” (Id. at
    p. 649.)
    28
    Co. (6th Cir. 2016) 
    663 Fed.Appx. 384
    , 388 [“[A]lthough it might
    not be ‘literally certain’ that Plaintiffs’ data will be misused
    [citation], there is a sufficiently substantial risk of harm that
    incurring mitigation costs is reasonable. Where Plaintiffs
    already know that they have lost control of their data, it would be
    unreasonable to expect Plaintiffs to wait for actual misuse—a
    fraudulent charge on a credit card, for example—before taking
    steps to ensure their own personal and financial security,
    particularly when Nationwide recommended taking these steps”];
    but see Tsao v. Captiva MVP Restaurant Partners, LLC (11th Cir.
    2021) 
    986 F.3d 1332
    , 1340, 1345 [explaining the Sixth, Seventh,
    Ninth and D.C. Circuits have all recognized a plaintiff can
    establish injury-in-fact based on the increased risk of identity
    theft following a data theft, while the Second, Third, Fourth and
    Eighth Circuits have declined to find standing on that theory,
    and concluding in the case before it the plaintiffs’ mitigation costs
    did not constitute actual injury: “Tsao cannot conjure standing
    here by inflicting injuries on himself to avoid an insubstantial,
    non-imminent risk of identity theft”].)
    As for causation, a question of fact that generally cannot be
    decided on summary judgment (see State Dept. of State Hospitals
    v. Superior Court (2015) 
    61 Cal.4th 339
    , 353; Shih v. Starbucks
    Corp. (2020) 
    53 Cal.App.5th 1063
    , 1071), plaintiffs presented
    expert testimony concerning the increased risk of identity theft
    resulting from data theft and the steps breach victims should
    take to avoid identity theft as a result of data theft, including
    purchasing fraud protection programs and monitoring credit
    bureaus. They also submitted evidence they had incurred costs
    and suffered other forms of economic loss as a result of the data
    theft, including credit monitoring expenses. Moreover, following
    29
    the theft of the computers, “because of the type of personal
    information involved,” Sutherland “encourage[d]” all of the
    County health care patients affected by the incident, including
    plaintiffs, “to take steps to protect yourself from identity theft”
    by, among other things, subscribing for a one-year credit
    monitoring program it was providing, along with a $20,000
    insurance reimbursement policy. This evidence was more than
    sufficient to create a triable issue of fact concerning causation—
    the temporal and logical relationship between Sutherland and
    the County’s negligence and the actual damages allegedly
    suffered by plaintiffs.12
    5. The County Is Not Immune from a Negligence Claim
    Predicated on Its Breach of Duty To Preserve the
    Confidentiality of Medical Information
    There is no common law tort liability for public entities in
    California. “Under the Government Claims Act [citation],
    governmental tort liability must be based on statute.” (B.H. v.
    County of San Bernardino (2015) 
    62 Cal.4th 168
    , 179 (B.H.);
    see Gov. Code, § 815, subd. (a) [“[e]xcept as otherwise provided by
    statute: [¶] . . . [a] public entity is not liable for an injury,
    whether such injury arises out of an act or omission of the public
    entity or a public employee or any other person”].) Government
    Code section 815.6 provides one of the statutory exceptions to this
    12     It will be the trial court’s responsibility to instruct the jury
    concerning plaintiffs’ burden to prove the necessity for, and
    reasonableness of, the mitigation measures for which they seek
    recovery, translating into this context the five factors the
    Supreme Court identified in Potter v. Firestone Tire &
    Rubber Co., supra, 6 Cal.4th at page 1009 as relevant to the
    determination whether future periodic medical monitoring was
    justified. (See fn. 10.)
    30
    general rule of public entity immunity: “Where a public entity is
    under a mandatory duty imposed by an enactment that is
    designed to protect against the risk of a particular kind of injury,
    the public entity is liable for an injury of that kind proximately
    caused by its failure to discharge the duty unless the public
    entity establishes that it exercised reasonable diligence to
    discharge the duty.” (See Haggis v. City of Los Angeles (2000)
    
    22 Cal.4th 490
    , 499-500 [“section 815.6 provides that the public
    entity ‘is liable’ for an injury proximately caused by its negligent
    failure to discharge the duty”].)
    “Government Code section 815.6 has three elements that
    must be satisfied to impose public entity liability: (1) a
    mandatory duty was imposed on the public entity by an
    enactment; (2) the enactment was designed to protect against the
    particular kind of injury allegedly suffered; and (3) the breach of
    the mandatory statutory duty proximately caused the injury.
    Even when a duty exists, California has enacted specific
    immunity statutes that, if applicable, prevail over liability
    provisions.” (B.H., supra, 62 Cal.4th at p. 179.)
    In the factual background portion of the operative pleading,
    plaintiffs alleged under CMIA and the Health Insurance
    Portability and Accountability Act of 1966 (HIPAA) the County
    had a nondelegable and mandatory duty to take appropriate
    measures to protect the confidentiality of the medical records of
    patients treated at County facilities, which it violated in several
    specific ways. In the second cause of action for negligence
    plaintiffs incorporated those background allegations by reference
    and expressly alleged the County (and Sutherland) breached
    their duty of care to plaintiffs and members of the putative class
    31
    by failing to properly protect the medical records of the County’s
    health care patients.
    The trial court ruled those seemingly adequate allegations
    of liability were insufficient to overcome the County’s immunity
    because, to the extent based on CMIA, the negligence cause of
    action was duplicative of the CMIA claim and, to the extent based
    on Government Code section 815.6, plaintiffs had failed to allege
    that statute in the operative pleading. Neither rationale
    supports the court’s finding the County is immune.
    As to the first ground, the two causes of action are not
    identical. As discussed, to prove a violation of CMIA, plaintiffs
    needed to establish not only that the County was negligent in its
    creation, maintenance or storage of medical information, but also
    that the confidentiality of that information had been breached.
    In contrast, no proof of unauthorized access to the confidential
    information is required for the cause of action based on the
    County’s negligent breach of its mandatory duty to safeguard the
    medical information of the patients it served. Conversely, no
    actual damages need be proved in the CMIA cause of action;
    statutory damages would be available if any of the plaintiffs
    could prove a CMIA violation. Actual damages are an essential
    element of the negligence claim.13
    13    In supplemental responses to the County’s interrogatories
    served more than two years before the trial court heard the
    summary judgment motion, plaintiffs stated, subject to various
    objections, that they and the class members were seeking
    statutory damages available under CMIA without also
    identifying actual damages they may have suffered. In its reply
    memorandum in support of summary judgment, but not its
    moving papers, the County argued plaintiffs had forfeited their
    claim to credit monitoring services as damages. In granting
    32
    The trial court’s second ground for finding immunity was
    based on a misapplication of the general principle that, to assert
    liability under Government Code section 815.6 for breach of a
    mandatory duty, the plaintiff “‘“must specifically allege the
    applicable statute or regulation.”’” (Washington v. County of
    Contra Costa (1995) 
    38 Cal.App.4th 890
    , 896, quoting Brenneman
    v. State of California (1989) 
    208 Cal.App.3d 812
    , 817.) Although
    it is somewhat unclear from the opinion in Cerna v. City of
    Oakland (2008) 
    161 Cal.App.4th 1340
    , 1349-1350, the case the
    trial court cited to support its ruling, the requirement is that the
    plaintiff specifically identify the statute that created the
    mandatory duty—here CMIA and HIPAA, which plaintiffs
    expressly alleged—not that the pleading cite section 815.6.
    (See, e.g., In re Groundwater Cases (2007) 
    154 Cal.App.4th 659
    ,
    689 [“[a] plaintiff seeking to hold a public entity liable under
    Government Code section 815.6 must specifically identify the
    statute or regulation alleged to create a mandatory duty”]; Searcy
    v. Hemet Unified School Dist. (1986) 
    177 Cal.App.3d 792
    , 802
    [“[s]ince the duty of a governmental agency can only be created
    by statute or ‘enactment,’ the statute or ‘enactment’ claimed to
    establish the duty must at the very least be identified”].)
    Government Code section 815.6 is certainly “[t]he gateway to
    recovery.” (Washington, at p. 896.) But it is not the statute that
    creates the mandatory duty upon which plaintiffs seek recovery
    summary adjudication in favor of Sutherland and the County on
    the negligence cause of action, however, the trial court did not
    adopt that argument, ruling those expenses were too speculative
    to be recoverable as damages. We, likewise, do not consider this
    claim for actual damages forfeited.
    33
    and need not be identified in the complaint in order to be
    discussed when opposing a motion for summary judgment. 14
    In its brief in this court the County adds a third argument,
    contending, even if the CMIA and negligence causes of action are
    not duplicative and plaintiffs adequately pleaded CMIA as the
    statutory basis for the mandatory duty it breached, they are still
    asserting a common law tort claim (albeit one effectively for
    negligence per se), barred by governmental immunity, not a
    statutory claim authorized by Government Code section 815.6.
    Yet as the County recognizes elsewhere in its brief, this court
    upheld just such a cause of action for negligence against a public
    entity based on the doctrine of negligence per se in Alejo v. City of
    Alhambra (1999) 
    75 Cal.App.4th 1180
    , 1184, disapproved on
    another ground in B.H., supra, 62 Cal.4th at page 188, footnote 6.
    (See Lehto v. City of Oxnard (1985) 
    171 Cal.App.3d 285
    , 292
    [“Government Code section 815.6 applies to public entities the
    familiar rule of tort law that violation of a legislatively prescribed
    standard of care creates a rebuttable presumption of
    negligence”].) In sum, the trial court erred in granting the
    County’s motion for summary adjudication as to plaintiffs’
    negligence cause of action based on governmental immunity.
    14    The court in Cochran v. Herzog Engraving Co. (1984)
    
    155 Cal.App.3d 405
    , which the County cites in support of its
    contention the absence of a citation to Government Code
    section 815.6 in the operative pleading dooms plaintiffs’ claim,
    noted that, “[t]o state a cause of action against a public entity,
    every fact material to the existence of its statutory liability must
    be pleaded with particularity.” (Cochran, at p. 414, fn. 2.)
    Plaintiffs have done just that—pleading all facts material to their
    negligence claim.
    34
    6. On Remand Plaintiffs Should Have the Opportunity To
    Renew Their Motion for Leave To Amend
    We review the denial of a motion for leave to amend a
    complaint for abuse of discretion. (Branick v. Downey Savings &
    Loan Assn. (2006) 
    39 Cal.4th 235
    , 242 [leave to amend a
    complaint is entrusted to the sound discretion of the trial court];
    Foroudi v. The Aerospace Corp. (2020) 
    57 Cal.App.5th 992
    , 1000;
    Bettencourt v. Hennessy Industries, Inc. (2012) 
    205 Cal.App.4th 1103
    , 1111.) Although “[a] trial court has wide discretion to allow
    the amendment of pleadings, and generally courts will liberally
    allow amendments at any stage of the proceeding” (Falcon v.
    Long Beach Genetics, Inc. (2014) 
    224 Cal.App.4th 1263
    , 1280),
    unreasonable delay alone can justify denial of a motion for leave
    to amend. (Huff v. Wilkins (2006) 
    138 Cal.App.4th 732
    , 765
    [“‘“even if a good amendment is proposed in proper form,
    unwarranted delay in presenting it may—of itself—be a valid
    reason for denial”’”]; see P&D Consultants, Inc. v. City of
    Carlsbad (2010) 
    190 Cal.App.4th 1332
    , 1345; Record v. Reason
    (1999) 
    73 Cal.App.4th 472
    , 486-487; see also Green v. Rancho
    Santa Margarita Mortgage Co. (1994) 
    28 Cal.App.4th 686
    , 692
    [“[t]here is a platoon of authority to the effect that a long
    unexcused delay is sufficient to uphold a trial judge’s decision to
    deny the opportunity to amend pleadings, particularly where the
    new amendment would interject a new issue which requires
    further discovery”].)
    Here, the trial court denied plaintiffs’ motion based on both
    delay, finding that the newly discovered information should have
    been known much earlier notwithstanding plaintiffs’ argument to
    the contrary, and prejudice, due to the pendency of Sutherland
    and the County’s summary judgment motion and the impact of
    35
    an amendment on the timing for that motion, as well as the
    court’s case management plan. It would be difficult to conclude
    that ruling was an abuse of discretion: “[W]hen a plaintiff seeks
    leave to amend his or her complaint only after the defendant has
    mounted a summary judgment motion directed at the allegations
    of the unamended complaint, even though the plaintiff has been
    aware of the facts upon which the amendment is based, ‘[i]t
    would be patently unfair to allow plaintiffs to defeat [the]
    summary judgment motion by allowing them to present a
    “moving target” unbounded by the pleadings.’” (Falcon v. Long
    Beach Genetics, Inc., supra, 224 Cal.App.4th at p. 1280; accord,
    Melican v. Regents of University of California (2007)
    
    151 Cal.App.4th 168
    , 176.)
    The circumstances on remand will be far different from
    those existing when the court considered plaintiffs’ motion: The
    summary judgment motion has been resolved; the CMIA cause of
    action dismissed; and the nature of the damages at issue in the
    remaining negligence claim defined and limited. Whatever
    remained from the court’s original case management plan will
    need to be revised. Accordingly, to the extent plaintiffs continue
    to believe they have viable claims for breach of contract or
    violation of the UCL, they should be permitted to renew their
    motion for leave to amend. The trial court, of course, retains its
    discretion to grant or deny any such motion in light of the current
    procedural posture of the case.
    7. The Order Denying in Part the Motion To Seal Portions
    of the Trial Court’s December 19, 2018 Ruling Must Be
    Revised
    We agree with the trial court’s general observation that the
    considerations under California Rules of Court, rule 2.550(d) in
    36
    deciding whether to seal papers filed by the parties are not
    identical to those involved in determining whether to redact
    previously sealed material when referred to in a court order.
    Nonetheless, “medical records are constitutionally private and
    statutorily confidential.” (Oiye v. Fox (2012) 
    211 Cal.App.4th 1036
    , 1070.) A person’s medical history “‘falls within the zone of
    informational privacy protected’ by the state and federal
    Constitutions.” (Id. at p. 1068.) Accordingly, great care should
    be taken before disclosing in a court ruling previously sealed
    medical information concerning identifiable parties.
    With respect to Galliano, English and Kamon, the trial
    court ruled there was no confidential medical information
    concerning them on the stolen computers. Accordingly, there was
    no reason to describe their medical conditions in the ruling. As to
    Harasim, although the court also found no confidential medical
    information pertaining to her was contained on the stolen
    computers, it additionally ruled Harasim had publicly disclosed
    enough information about her medical condition to preclude a
    CMIA claim. Making the minimal redactions (less than a dozen
    words) requested on page 6 of the ruling would not interfere with
    a reader’s ability to understand the court’s analysis of this point
    as to Harasim. Similarly, the explanation that Carazin’s medical
    condition was visible to others and, therefore, not confidential,
    need not include a description of that condition. As for the court’s
    concern it ought not redact information it had found was not
    confidential, pending a decision in this court affirming the trial
    court’s ruling, Harasim and Carazin were entitled to have the
    information treated as confidential. And since we do not find it
    necessary to decide the issue, they remain entitled to that degree
    of privacy protection.
    37
    We agree with the trial court that the information plaintiffs
    requested be redacted on pages other than five and six of the
    ruling do not relate to medical information and properly remain
    part of the publicly filed ruling.
    DISPOSITION
    The judgment is reversed. On remand the trial court is to
    enter a new order granting the motion for summary adjudication
    as to the CMIA cause of action and denying the motion as to the
    negligence cause of action. The trial court is further ordered to
    seal the portions of its December 19, 2018 ruling that contain
    specific medical or health-related information concerning any of
    the plaintiffs.
    The parties are to bear their own costs on appeal.
    PERLUSS, P. J.
    We concur:
    SEGAL, J.
    FEUER, J.
    38
    

Document Info

Docket Number: B297712

Filed Date: 12/6/2021

Precedential Status: Non-Precedential

Modified Date: 12/6/2021