NOT FOR PUBLICATION FILED

UNITED STATES COURT OF APPEALS AUG 14 2025

MOLLY C. DWYER, CLERK

U.S. COURT OF APPEALS

FOR THE NINTH CIRCUIT

ESTATE OF KAREN THIEL; LAMAR No. 24-5512 THIEL, D.C. No. 2:21-cv-00279-SAB Plaintiffs - Appellants,

v. MEMORANDUM*

ADAMS COUNTY PUBLIC HOSPITAL

DISTRICT #2, a Washington Public Hospital District; MATTHEW MECHAM,

Defendants - Appellees.

Appeal from the United States District Court for the Eastern District of Washington Stanley Allen Bastian, District Judge, Presiding

Submitted August 12, 2025** Seattle, Washington

Before: HAWKINS, McKEOWN, and WARDLAW, Circuit Judges.

Karen Thiel’s estate and her surviving spouse, Lamar Thiel (collectively

“Plaintiffs”), appeal the district court’s dismissal of their Washington Law Against

* This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3. ** The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2). Discrimination (“WLAD”) claim1 against East Adams Rural Hospital (“EARH”)

and Nurse Matthew Mecham (collectively “Defendants”). We have jurisdiction

under 28 U.S.C. § 1291, and we affirm.

The complaint alleges that Karen Thiel suffered from Lewy body dementia.

Due to her dementia, Thiel had “limited communication abilities” and required

“special attention and assessment.” On January 9, 2019, Thiel was admitted into

the swing bed facility at EARH. On January 29, 2019, Thiel attempted to stand up

from her chair and fell, breaking her hip. Immediately after the fall, defendant

Matthew Mecham, a registered nurse at EARH, heard Thiel call for help and

complain about hip pain, but did nothing. EARH staff placed Thiel back in her

chair and did not examine her for injuries. No one immediately charted the fall,

nor did anyone inform other staff about the fall. Other EARH staff, unaware of the

fall, later attempted to make Thiel walk on multiple occasions, which was

excruciatingly painful. Thiel’s broken hip was detected the day after the fall by

physical therapy staff when they also attempted to make her walk. Mecham then

attempted to create a backdated record of the fall on Thiel’s chart, thirty-six hours

after the fall.

1 Plaintiffs brought five additional claims: ordinary negligence, medical negligence, and three claims under 42 U.S.C. § 1983. On summary judgment, the district court disposed of Plaintiffs’ federal claims and remanded the medical negligence claim to Washington Superior Court. Plaintiffs do not appeal the judgments on these claims.

2 24-5512 Plaintiffs sued Defendants, alleging state and federal law violations. The

district court granted Defendants’ motion to dismiss in part, dismissing Plaintiffs’

ordinary negligence and WLAD claims as preempted by Washington’s medical

malpractice statute—RCW 7.70. On appeal Plaintiffs challenge only the dismissal

of the WLAD claim.2

The district court correctly concluded that Plaintiffs’ WLAD claim was

preempted by RCW 7.70. Under Washington law, a plaintiff seeking damages for

“injury occurring as a result of health care” must seek relief under RCW 7.70

exclusively. Wash. Rev. Code Ann. § 7.70.010. Section 7.70 preempts “all civil

actions and causes of action, whether based on tort, contract, or otherwise.” Id.

“Health care” under RCW 7.70.010 is “the process in which [a health care provider

is] utilizing the skills which he had been taught in examining, diagnosing, treating,

or caring for the plaintiff as his patient.” Branom v. State, 94 Wash. App. 964,

969–70 (1999) (citation omitted). This “utilizing the skills” test encompasses both

acts and omissions of health care. Id. Washington courts have interpreted this

2 Plaintiffs initially presented a second issue for review—whether the court should correct a scrivener’s error contained in the district court’s judgment. However, on July 2, 2025, Plaintiffs submitted a notice that the scrivener’s error was corrected, mooting the issue. Pursuant to the amended order, only Plaintiffs’ medical malpractice claim has been remanded.

3 24-5512 statute to “sweep[] broadly” and to “govern[] exclusively” all civil actions for

damages for injury occurring as a result of health care. Id. at 969.

Here, Ms. Thiel’s injuries arose from her health care providers’ failure to

supervise her, physically examine her, and chart her injuries—all of which are

skills that nurses and doctors are taught to utilize in examining, diagnosing,

treating, or caring for patients. See Reagan v. Newton, 7 Wash. App. 2d 781, 792–

93 (2019) (finding that a doctor performing an examination constituted “health

care”); Est. of Essex by & through Essex v. Grant Cnty. Pub. Hosp. Dist. No. 1, 3

Wash. 3d 1, 16–17 (2024) (holding medical malpractice claim should survive

summary judgment when nurses failed to timely document or report patient’s

symptoms, causing a delay in patient’s diagnosis.).

Plaintiffs argue these actions should not be considered “health care” because

they were not motivated by medical judgment and instead were motivated by

discriminatory intent, citing Reed v. ANM Health Care, 148 Wash. App. 264, 271

(2008). However, recent authority suggests that the Washington Supreme Court

has not adopted Reed’s distinction between motivations for health care decisions.

In M.N. v. MultiCare Health Sys., Inc., 2 Wash. 3d 655, 672 (2024), the

Washington Supreme Court held all patients who received injections while a

particular nurse was on duty, even those not assigned to this specific nurse, had

valid RCW 7.70 claims based on their potential exposure to hepatitis C. The court

4 24-5512 reasoned that a nurse’s diversion of narcotics for herself and injection of her

patients with contaminated needles fell within RCW 7.70’s definition of “health

care” because (1) the plaintiffs were the nurse’s patients; (2) injections are a skill

the nurse was taught; and (3) the plaintiffs’ injuries were the result of the nurse’s

failure to follow the accepted standard of care. Id. at 663. The reasons for the

nurse’s failure to follow that standard were treated as immaterial. Thus, even if

Thiel’s medical providers were motivated by discriminatory intent, their alleged

conduct remains “health care” within the meaning of the statute as interpreted by

the state’s highest court. Plaintiffs’ WLAD claim is preempted.

AFFIRMED.

5 24-5512