Unreported / Non-Citable
Background
Carlos S. Lopez II served three tours of duty in the Middle East, sustained a traumatic brain injury, and was honorably discharged in 2009. After his discharge, Lopez received medical care from the Department of Veterans Affairs in Los Angeles. He suffered from service-related post-traumatic stress disorder. In May 2018, VA doctors prescribed gabapentin—an anticonvulsant sometimes used for pain management—to treat his back pain.
A few weeks later, Lopez visited a VA walk-in clinic reporting frequent nightmares he could not distinguish from reality, difficulty sleeping, and recurring thoughts that he was a “bad person” capable of “doing awful things.” Five days after that visit, Lopez committed suicide. His parents sued the United States under the Federal Tort Claims Act (FTCA), alleging VA medical staff were professionally negligent. After a three-day bench trial in the Central District of California, the district court found for the government.
The Court’s Holding
The Ninth Circuit affirmed in an unpublished memorandum disposition. The court addressed five issues raised by the plaintiffs and rejected each one.
First, the court held that the district court applied the correct standard of care under California medical malpractice law, which requires physicians to exercise the degree of skill and care ordinarily possessed by members of their profession under similar circumstances. The plaintiffs argued that VA doctors should be held to a heightened standard because veterans face elevated suicide risk, but their own expert never testified to such a heightened standard—only that the VA providers should have been more attentive to Lopez’s specific risk factors. Without supporting expert evidence, the argument failed.
Second, the court found no clear error in the district court’s decision to credit defense witnesses. Lopez’s treating neurologists testified they had a practice of discussing medication side effects and likely did so with Lopez. Although they did not document that specific conversation, the testimony was coherent and facially plausible, which under Anderson v. Bessemer City makes reversal on credibility grounds virtually impossible. The court also upheld the district court’s reliance on the VA psychologist’s testimony, which was corroborated by contemporaneous clinical notes.
Key Takeaways
- Under the FTCA, California’s standard of care for medical malpractice applies to negligence claims against VA medical staff in California—there is no judicially created “heightened” standard for treating veterans, even given their elevated suicide risk.
- Plaintiffs asserting a specialized or heightened standard of care must present expert testimony establishing that standard; a general argument about patient population risk is insufficient.
- In a bench trial, a district court’s decision to credit a witness whose testimony is coherent and facially plausible is entitled to strong deference and “can virtually never be clear error” unless contradicted by extrinsic evidence.
- The absence of documentation of a specific conversation does not automatically render a provider’s testimony about that conversation incredible, particularly when the provider establishes a general practice of having such conversations.
Why It Matters
This case is a cautionary tale for FTCA medical malpractice plaintiffs in California, particularly in cases involving veteran suicide. The Ninth Circuit’s ruling makes clear that even compelling facts—a combat veteran with PTSD prescribed a drug with known psychiatric side effects who then commits suicide—are not enough to overcome a district court’s factual findings after a bench trial. Plaintiffs must present targeted expert testimony that precisely defines the standard of care they wish the court to apply, rather than relying on policy arguments about heightened risk.
For California practitioners handling medical malpractice claims against federal facilities, the decision reinforces the importance of expert preparation: an expert must do more than opine that a doctor should have acted differently. The expert must articulate a concrete, recognized standard of care that applies in the specific clinical setting at issue. The case also highlights the steep clear-error standard that appellate courts apply to bench-trial credibility findings, making robust trial-level advocacy essential.