## Facts

- A mother brought her nine-month-old daughter to a hospital emergency room with serious symptoms.
- Before any examination, hospital staff presented the mother with a Spanish-language medical-malpractice arbitration agreement in the form prescribed by California Code of Civil Procedure § 1295.
- The mother signed the form, later asserting she was told only to sign where marked, was not given an explanation, believed signing was required for treatment, and signed without reading due to anxiety over her child.
- The hospital contended staff asked her to read the agreement, did not say it was required for treatment, and did not misrepresent it, but did not ensure she understood its meaning.
- The child was discharged without proper diagnosis and later suffered severe harm from meningitis; a malpractice action was filed.
- The hospital petitioned to compel arbitration based on the signed agreement; the trial court ordered arbitration based on the agreement’s facial compliance with § 1295.
- The patient sought extraordinary writ relief to annul the order compelling arbitration.

## Issues

1. Whether a patient who signed a medical-malpractice arbitration agreement that facially complies with Code of Civil Procedure § 1295 may resist arbitration by showing the agreement was not entered into knowingly and voluntarily.
2. Whether a trial court may compel arbitration without first resolving factual disputes bearing on a claimed lack of knowing and voluntary waiver of the right to civil jury trial.

## Decision

- The Court of Appeal granted writ relief and annulled the order compelling arbitration.
- The court held that facial compliance with § 1295 does not preclude a patient from challenging the agreement as not knowingly and voluntarily made.
- The court directed the trial court to reconsider the petition to compel arbitration after resolving the factual dispute regarding voluntary and knowing consent.

## Legal Principles

- Arbitration is contractual and requires actual agreement; it cannot be imposed without valid consent.
- The civil jury-trial right may be waived by arbitration agreement only through a voluntary, knowing, and intelligent waiver.
- Code of Civil Procedure § 1295’s disclosure and formatting requirements facilitate informed consent but are not conclusive proof that consent and waiver occurred in fact.
- To avoid constitutional problems, § 1295 must be construed to permit challenges based on lack of knowing and voluntary consent, including claims grounded in coercive circumstances, language barriers, or related contract defenses.
- When a party contests enforceability on such grounds, the trial court must resolve material factual disputes before compelling arbitration.

## Conclusion

A medical-malpractice arbitration agreement’s compliance with Code of Civil Procedure § 1295 is not dispositive; courts must allow and decide challenges that the agreement was not knowingly and voluntarily accepted before ordering arbitration.


Ramirez v. Superior Court, 103 Cal. App. 3d 746, 163 Cal. Rptr. 223 (Ct. App. 1980)