Introduction

Imagine being rear-ended by an ambulance and later finding your lawsuit thrown out because it was filed too late under a medical malpractice deadline. That was the legal hurdle Francisco Gutierrez faced after an ambulance hit his truck on a California highway.[i] The ambulance’s driver—an emergency medical technician (EMT) transporting a patient—argued California’s special medical malpractice time limit applied, requiring suits to be filed within one year, not the usual two years for injury claims.[ii] In Gutierrez, the California Supreme Court intervened to draw a sharp line: not every accident involving a health care provider is medical malpractice. The Court held that, because the EMT’s alleged negligence stemmed from ordinary driving duties owed to the public at large rather than from professional medical care of a patient, the suit was governed by the normal two-year statute of limitations for general negligence,[iii] not MICRA’s one-year deadline.[iv]

Corporate and legal stakeholders in the health care and insurance industries have been watching this case as a bellwether for liability boundaries. Gutierrez highlights that courts will not automatically extend MICRA’s protections to any incident involving health professionals. The ruling arrives amid ongoing efforts to balance patient protections with provider accountability. By reaffirming that MICRA’s special rules apply only when an injury is caused by a breach of professional obligations in providing medical care, the Supreme Court’s decision gives much-needed clarity. Hospitals, ambulance companies, and medical practitioners are on notice that if their alleged negligence falls outside the realm of treating a patient—for example, a traffic collision or other ordinary mishap—they will face the same legal standards and timelines as any other defendant.

Facts

On January 20, 2018, plaintiff Francisco Gutierrez was driving his pickup truck on a highway in Santa Clara County when an ambulance struck his vehicle from behind.[v] The ambulance was operated by ProTransport-1 and driven by Uriel Tostado, a licensed EMT, who was transporting a patient between medical facilities.[vi] Gutierrez sustained neck and back injuries in the crash. On January 7, 2020—nearly two years after the accident—he filed a personal injury lawsuit against Tostado and his employer, framing it as a general negligence motor vehicle action seeking damages for his injuries.[vii] Importantly, Gutierrez was not a patient of the EMT or ambulance service; he was a third-party motorist injured in a roadway collision.

The defendants moved for summary judgment, arguing that Gutierrez sued too late. They contended that the claim was essentially one of medical professional negligence, so MICRA’s statute of limitations applied.[viii] By comparison, ordinary personal injury claims in California have a two-year limitations period.[ix] Since Gutierrez filed just shy of the two-year mark but well past one year from the accident, the defense argued the action was time-barred under MICRA’s one-year rule.[x]

The trial court agreed with the defendants, granting summary judgment on the basis that Tostado was a health care provider rendering professional services at the time of the crash. The appellate court affirmed in a split opinion, reasoning that MICRA “is not limited to suits by patients or to recipients of medical services” if the negligence occurs during professional services.[xi] A dissent countered that MICRA was never intended to reach “run-of-the-mill traffic accidents” and warned the majority’s approach stretched MICRA unpredictably.[xii] The Supreme Court granted review.

Analysis

The Supreme Court began by reiterating the principle that the applicable statute of limitations depends on “the nature of the right sued upon.”[xiii] MICRA’s statute of limitations applies only to actions “based upon [a health care provider’s] professional negligence”[xiv] defined as “a negligent act or omission to act by a health care provider in the rendering of professional services.”[xv]

Relying on its prior decision in Flores v. Presbyterian Intercommunity Hospital (2016) 63 Cal.4th 75, the Court emphasized that MICRA applies only when the negligence arises from professional obligations in the rendering of medical care to patients.[xvi] In Flores, a patient injured by a defective hospital bed rail could invoke MICRA because the rail’s position had been prescribed by her doctor, making the equipment “integrally related” to medical treatment.[xvii] But the Court warned that not all mishaps in medical settings qualify—for instance, if a visitor is injured by a chair in a waiting room, that is an ordinary negligence claim.[xviii]

Applying those principles, the Court in Gutierrez unanimously concluded that MICRA did not apply. Gutierrez’s claim arose from Tostado’s alleged failure to obey traffic laws – a duty “owed simply by virtue of being a driver,” not “by virtue of being a health care provider.”[xix] As the Court explained, “plaintiff’s claim sounds in general negligence and falls outside of MICRA’s scope.”[xx]

The Court also disapproved earlier appellate rulings, such as Canister v. Emergency Ambulance Service, Inc. (2008) 160 Cal.App.4th 388 and Lopez v. American Medical Response West (2023) 89 Cal.App.5th 336, to the extent they suggested MICRA applies whenever injuries occur “during the rendering of services.”[xxi] The Court instead aligned with Aldana v. Stillwagon (2016) 2 Cal.App.5th 1, which held MICRA inapplicable when a paramedic caused a car accident driving a supervisor’s truck, because driving in that context was not integrally related to medical treatment.[xxii] Ultimately, the Supreme Court reversed the Court of Appeal and reinstated Gutierrez’s lawsuit under the two-year general negligence statute of limitations.[xxiii]

Takeaways for Clients

• Not every mishap involving a health professional is “medical malpractice.” The Gutierrez decision makes clear that MICRA’s special protections kick in only when a provider’s alleged negligence is part of providing medical care to a patient.[xxiv] If the incident stems from a more generic duty (like driving safely, maintaining safe premises, etc.), it will be treated as an ordinary negligence claim—with the longer filing deadline and no MICRA damage caps. Clients should carefully analyze the nature of any claim against a healthcare provider to determine the true basis of the duty involved.
• Healthcare organizations must mind their “ordinary” duties. Hospitals, ambulance companies, and medical employers should recognize that they can be held to standard negligence rules for incidents outside the core of medical treatment. In practice, this means activities like patient transport, vehicle operation, facility upkeep, or other non-medical tasks won’t enjoy MICRA’s one-year statute of limitations or other malpractice liability limits. Robust risk management is needed in these areas: for example, enforce safe driving policies for ambulance drivers and ensure general liability insurance is in place, since malpractice insurance may not cover auto accidents.
• For defense counsel: tread carefully in invoking MICRA. After Gutierrez, courts are likely to scrutinize attempts to apply MICRA to fact patterns that don’t squarely involve a breach of professional medical standards. Simply because a defendant has a medical license or the accident happened in a healthcare context does not automatically bring the case under MICRA. The focus will be on what the defendant was doing (and what duty was owed) at the time of the alleged negligence. Lawyers defending health providers should assess whether the conduct in question was part of the provider’s medical skill or judgment toward a patient. If not, a motion to dismiss on MICRA grounds may fail, and it’s better to prepare for litigation under ordinary negligence principles.
• For insurers and plaintiffs: understand the correct limitations period. Medical malpractice insurers and plaintiffs’ attorneys alike should note that a claim by a non-patient third party against a provider will often fall outside MICRA. Plaintiffs injured incidentally by medical personnel (for example, in traffic collisions or slip-and-fall scenarios at a clinic) have the benefit of the full two-year window to file their lawsuit. Conversely, insurers cannot assume the shorter one-year cutoff applies unless the claim truly arises from patient care. The Gutierrez ruling provides a clearer framework to determine the applicable statute of limitations based on the duty involved, reducing the uncertainty about which deadline governs borderline cases.
• Reevaluate protocols in mixed-duty situations. Many healthcare operations involve hybrid situations—for instance, transporting patients on public roads, or doctors rushing between facilities. This case underscores the importance of training and protocols in those scenarios, because negligence occurring there will be judged under common law standards. Ensure that employees are aware that when they step into roles governed by ordinary safety rules (like driving), they must exercise caution just as any reasonable person should. An accident or injury in those contexts will not be viewed as “part of the job” in a way that limits liability; instead, it opens the organization to standard negligence exposure. By proactively addressing these risks (through training, insurance, and compliance with traffic and safety regulations), healthcare providers can mitigate the chances of facing lawsuits outside the protective scope of MICRA.

Gutierrez v. Tostado serves as a valuable clarification of California law: it firmly confines MICRA’s one-year statute of limitations to its intended lane – situations where the cause of injury is a lapse in professional medical care to a patient. When a negligence claim involves a breach of the general duty of care that “each person owes to all other members of the public”, it will be treated as an ordinary personal injury case, even if a health care provider is the defendant.[xxv] Clients should take this ruling as guidance to adjust their expectations and practices. By recognizing which duties are considered “professional” and which are not, healthcare providers and insurers can better navigate potential liabilities.

The key takeaway is that the courts will keep MICRA in its proper scope—allowing deserving malpractice defendants the benefit of special rules in true medical-negligence cases but not extending those benefits to unrelated accidents that just happen to involve medical personnel. This calibrated approach ultimately promotes fairness: injured parties like Mr. Gutierrez get their day in court under the normal rules, and medical professionals are accountable under ordinary standards when acting outside their patient-care role. The California Supreme Court’s message is unmistakable: when it comes to statutes of limitations, a healthcare provider must stay in the proper lane.

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Sources

[i] Gutierrez v. Tostado (2025) 18 Cal.5th 222, 525.

[ii] Code Civ. Proc., § 340.5.

[iii] Code Civ. Proc., § 335.1.

[iv] Gutierrez, supra, 18 Cal.5th at 525.

[v] Gutierrez, supra, 18 Cal.5th at 525.

[vi] Ibid.

[vii] Id.

[viii] Code Civ. Proc., § 340.5.

[ix] Code Civ. Proc., § 335.1.

[x] Gutierrez, supra, 18 Cal.5th at 529.

[xi] Gutierrez v. Tostado (2023) 97 Cal.App.5th 786, 794.

[xii] Id. at 795–796 (Bromberg, J., dis. opn.)

[xiii] Hensler v. City of Glendale (1994) 8 Cal.4th 1, 22–23.

[xiv] Code Civ. Proc., § 340.5, subd. (1).

[xv] § 340.5, subd. (2).

[xvi] Flores v. Presbyterian Intercommunity Hospital (2016) 63 Cal.4th 75.

[xvii] Id. at 89.

[xviii] Id. at 88–89.

[xix] Gutierrez, supra, 18 Cal.5th at 1022–1023.

[xx] Ibid.

[xxi] Gutierrez, supra, 18 Cal.5th at 532.

[xxii] Id. at 7–8.

[xxiii] Gutierrez, supra, 18 Cal.5th at 536.

[xxiv] Gutierrez, supra , 18 Cal.5th at 536.

[xxv] Flowers v. Torrance Memorial Hospital Medical Center (1994) 8 Cal.4th 992, 998–999.