## Facts

- Gita Landeros, an infant, allegedly suffered repeated severe beatings by her mother and the mother’s partner, Reyes, during her first year of life.
- At 11 months old, her mother brought her to San Jose Hospital for examination, diagnosis, and treatment; Dr. A. J. Flood treated her and was alleged to be the hospital’s agent.
- The child presented with a spiral fracture of the right tibia and fibula consistent with twisting, extensive bruising on her back, abrasions, and a healing linear skull fracture; she appeared fearful when approached.
- The mother provided no explanation for the leg fracture.
- The complaint alleged these signs indicated “battered child syndrome,” a condition that reasonably competent physicians at the time should have recognized.
- The complaint alleged Dr. Flood failed to diagnose battered child syndrome and failed to report suspected child abuse to authorities as required by California’s mandatory reporting statute.
- After discharge, the child was returned to the same home and allegedly continued to be abused until a later hospital visit resulted in proper diagnosis and government intervention.
- The trial court sustained general demurrers to the amended complaint and entered a judgment of dismissal after plaintiff elected to stand on the pleading.

## Issues

1. Whether the amended complaint adequately stated a medical negligence claim based on failure to recognize and respond to battered child syndrome.
2. Whether violation of California’s mandatory child-abuse reporting statute could supply a negligence per se theory under Evidence Code section 669.
3. Whether subsequent intentional criminal abuse by the mother and Reyes was a superseding cause barring liability as a matter of law at the pleading stage.
4. Whether allegations of agency were sufficient to plead hospital liability for the physician’s conduct.
5. Whether punitive damages allegations could be rejected on demurrer.

## Decision

- The California Supreme Court reversed the judgment of dismissal and held the amended complaint stated a cause of action.
- The court held the pleadings sufficiently alleged negligence based on failure to diagnose battered child syndrome and failure to take protective steps, including reporting.
- The court held the mandatory reporting statute could support negligence per se if the statutory elements were met and causation was proved.
- The court held intervening criminal acts did not necessarily break causation as a matter of law; foreseeability and superseding cause were factual questions inappropriate for resolution on demurrer.
- The case was remanded for further proceedings.

## Legal Principles

- A physician must use the skill, prudence, and diligence commonly exercised by members of the profession in similar circumstances; failure to diagnose a recognized condition may constitute malpractice.
- When presented with injuries reasonably indicating battered child syndrome, a physician’s duty of reasonable care may include steps aimed at protecting the child from further harm.
- A mandatory child-abuse reporting statute may establish a standard of care under Evidence Code section 669; violation can be negligence per se when the statute protects the plaintiff’s class, targets the type of harm suffered, and the violation proximately causes injury.
- An intervening intentional or criminal act does not automatically sever proximate cause; if the risk of such conduct is foreseeable and within the scope of the duty, superseding cause is typically a fact question.
- A hospital may be liable for a physician’s negligence when an agency relationship is adequately alleged.

## Conclusion

The court held that a child’s malpractice complaint may proceed where it plausibly alleges that a physician and hospital failed to recognize battered child syndrome and failed to report suspected abuse, and that continued abuse in the same environment was a foreseeable result not barred by superseding cause at the demurrer stage.


Landeros v. Flood, 551 P.2d 389 (Cal. 1976)