Medical Malpractice Notice of Intent in California: The 90-Day Rule

What is a medical malpractice notice of intent in California?

It is a written notice to a health care provider that you intend to sue for professional negligence, sent before the lawsuit. Code of Civil Procedure section 364(a) says no such action may be commenced unless the defendant has been given at least 90 days' prior notice of the intention to commence it.

The rule reaches a wide group. Section 364 defines a health care provider as anyone licensed or certified under Division 2 of the Business and Professions Code (physicians, nurses, dentists, pharmacists and other licensed health professions), osteopathic and chiropractic practitioners, and licensed clinics, health dispensaries and health facilities.

Professional negligence means a negligent act or omission in rendering professional services that is the proximate cause of a personal injury or wrongful death, where the services were within the scope of the provider's license. A dispute about a bill is a different matter; our guide to disputing a medical bill covers that.

What must the notice include?

Section 364(b) says no particular form is required, but the notice must tell the provider three things:

• The legal basis of the claim, such as negligent diagnosis, treatment or failure to treat.
• The type of loss sustained, such as additional medical costs, lost earnings or pain and suffering.
• The nature of the injuries, described with specificity: what happened to your body or health, and when.

The notice may be served by the methods in the Code of Civil Procedure's general notice provisions, which begin at section 1010 (section 364(c)). The notice must reach each defendant, so a hospital or clinic and each individual clinician you may name would each need one. The 90-day requirement does not apply to a defendant whose name you do not know when you file and who is sued under a fictitious name (section 364(e)).

How do the 340.5 deadlines and the 90-day extension fit together?

Code of Civil Procedure section 340.5 gives you three years after the date of injury or one year after you discovered (or reasonably should have discovered) the injury, whichever comes first. The three-year limit is extended only for fraud, intentional concealment, or a foreign body with no therapeutic or diagnostic purpose left inside the patient.

Example (hypothetical): a patient's surgery takes place on February 1, 2025, and on June 15, 2026, a second doctor tells her a complication was caused by the first procedure. Her one-year discovery deadline would be June 15, 2027, which comes before the three-year date of February 1, 2028. If she serves her notice on May 1, 2027, that is within 90 days of the June 15 deadline, so section 364(d) extends her time to file. The statute's words are 90 days from the service of the notice, and courts have interpreted how that extension is counted against the one-year period, so the new deadline in a real case is a date a lawyer should calculate.

Why get your medical records before writing the notice?

Because the notice must describe your injuries with specificity, and the chart is where the specifics are. California's patient access law, Health and Safety Code section 123110, gives you two ways to see it.

1. Send each provider a written request identifying you, your dates of treatment and the records you want, including imaging reports, operative notes and nursing notes.
2. If you want to look first, ask to inspect the records. The provider must allow inspection during business hours within five working days after receiving the request, and you may bring one other person.
3. For copies, the provider must send them within 15 days after receiving your request, on payment of the reasonable copying costs the statute allows.
4. Ask for electronic copies if the records are kept electronically. The provider must give them in the form you request if it is readily producible, or in another readable form you agree on.
5. Keep a log of each request, the date sent and the date records arrived, and note anything missing.

A provider may ask for reasonable proof of identity, but section 123110(f) says that requirement may not be used to frustrate or delay compliance.

What are California's MICRA damage limits in 2026?

Civil Code section 3333.2, as rewritten by AB 35 (2022), limits noneconomic damages (pain, suffering, inconvenience, physical impairment, disfigurement) in professional negligence cases filed on or after January 1, 2023. It does not limit economic losses such as medical bills and lost earnings.

Each amount can apply up to three times in one case: once for health care providers collectively, once for health care institutions collectively, and once for unaffiliated providers or institutions whose separate negligence happened at, or during medical transport to, an unaffiliated facility. No single defendant is liable in more than one of those categories. The amount in effect at the time of judgment, arbitration award or settlement is the one that applies.

Drafting the notice: structure and sample language

The notice is a formal step, not a negotiation. Keep it factual, specific and calm, and leave out any settlement demand unless a lawyer advises including one.

If a public hospital or clinic run by a county, city or district was involved, a separate government claim process with its own short deadline may apply as well. Our guide to filing a government claim in California explains it.

When an attorney should prepare your notice of intent

A section 364 notice starts a 90-day countdown and can move your filing deadline, so the dates and the description of injuries need to be right. Talk to a malpractice lawyer about whether and when to serve a notice.

If you decide to serve one, you can have it prepared through Talk to My Lawyer: a licensed California attorney writes your notice from your medical records, treatment dates and account of what happened, and sends it on your behalf to each provider you identify.