Negligence as Basis for License Discipline

The longstanding purpose of license discipline laws is to protect the public from incompetent practitioners. Although the standards differ somewhat from agency to agency, almost every licensing agency has laws that allow it to take disciplinary action against a licensee when their conduct falls below what is expected of the profession.
There are three “types” of negligence that can generally result in license discipline in the state of California:

  1. Gross Negligence.  Defined in case law as “(1) a lack of even scant care or (2) an extreme departure from the ordinary standard of conduct.” (Kearl v. Board of Med. Quality Assur. (1986) 189 Cal.App.3d 1040, 1052.) The agency need only prove one of the two grounds. (Id. at 1053.)  Willfulness or recklessness is not required. (Gore v. Board of Med. Quality Assur. (1980) 110 Cal.App.3d 184, 197.) Deliberate acts can constitute gross negligence. (Cooper v. Board of Med. Exam’rs (1975) 49 Cal.App.3d 931, 941, fn 8.) Several agencies (Board of Registered Nursing; Board of Vocational Nursing and Psychiatric Technicians) adopted regulatory definitions of the standard.
  2. Negligence.  Unlike “gross negligence” there is no generally accepted definition of ordinary negligence derived from case law. Thus, the definition is either provided by tort law (i.e. failure to use reasonable care, through action or omission; failure to use the standard of care for the profession), regulation (i.e. Board for Professional Engineers, Land Surveyors, and Geologists), or is derived from applying a less serious version of the gross negligence standard. The difficulty with these definitions is that it could penalize a licensee whose conduct differs from the norm because it is new or untried.
  3. Repeated Acts of Negligence. Defined by statute (i.e. Business & Professions Code section 2234(c) [to be repeated there must be two or more negligent acts or omissions]), case law (see, e.g. Gillis v. Dental Bd. (2012) 206 Cal.App.4th 311, 320 [two acts of negligence can be disciplined], or regulation (i.e. Title 16, California Code of Regulations section 4260(s) defines repeated negligent acts for naturopathic medicine). An initial negligent act or omission followed by a separate and distinct departure from the applicable standard of care constitutes repeated negligent acts.

Not all agencies discipline for all three types. Rather, most highly technical and health care-related licensing agencies use “gross negligence” and “repeated acts of negligence” standards. “Ordinary negligence”, for these agencies, will not give rise to discipline-able conduct. (Gromis v. Medical Bd. (1992) 8 Cal.App.4th 589, 599, fn 9. [If the agency’s regulations or laws provide that only gross negligence or repeated acts of negligence give rise to discipline, a single act of ordinary negligence will not give rise to discipline].)
Still other agencies discipline for a standard similar to negligence, but not exactly the same. For example, the Contractors’ State License Board makes “willful departure in any material respect from accepted trade standards for good and workmanlike construction” grounds for discipline of a contractor’s license. The “willful” used in the statute has been defined as “simply a purpose or willingness to commit the act, or make the omission referred to. It does not require any intent to violate the law, or to injure another, or to acquire any advantage.” (Mickelson Concrete Co. v. Contractors’ State License Bd. (1979) 95 Cal.App.3d 631, 635.)  This definition renders the standard to be more in line with negligence than with an intentional act. This “blurring” of the lines has also been applied to statutes and regulations using the word “knowingly”. (See, e.g., Brown v. State Dep’t of Health (1978) 86 Cal.App.3d 548, 554 [“knowledge” did not require an intent to deceive, just knowledge of the falsity of facts.].)