The Supreme Court of Texas (“Texas Supreme Court”) held in its opinion delivered on November 16, 2018 that the Texas medical malpractice plaintiff’s expert’s report sufficiently identified the applicable standard of care and the link between the defendant hospital’s nurses’ alleged breaches of the stadard of care and the plaintiff’s injuries.
The plaintiff had visited the defendant hospital’s emergency room five times in late 2012. During the initial visit, no spinal evaluation was conducted and the plaintiff’s medical history failed to note that she suffered from osteogenesis imperfecta (“OI”), which is commonly known as brittle bone disease. After her fifth visit to the defendant hospital’s emergency room, the plaintiff’s rehab physician intervened and had her transferred to another hospital, where an MRI revealed that she suffered from a compression fracture of her T-5 vertebrae that ultimately rendered her a paraplegic and incontinent.
The plaintiff filed her Texas medical malpractice case against the defendant hospital and others. The plaintiff alleged that the defendant hospital was vicarioulsy liable for its nurses’ negligence by “fail[ing] to recognize the signs and symptoms of a spinal compression fracture resulting in a delay in treatment which caused [her] paraplegia” and “miss[ing] the history of [OI] that predisposes one to fractures.”
The Texas Medical Liability Act (“Act”) requires a health care claimant to furnish a written expert report early in the proceedings summarizing the applicable standards of care and explaining how the provider’s alleged negligence caused the claimant’s injury. The defendant hospital attacked the sufficiency of the plaintiff’s medical expert’s report. The Texas lower appellate court held that the claimant’s expert report was insufficient as to causation with respect to one of her providers and dismissed her claims against that provider. The plaintiff then appealed to the Texas Supreme Court.
The Texas Supreme Court stated that the purpose of the expert report requirement is to weed out frivolous malpractice claims in the early stages of litigation, not to dispose of potentially meritorious claims. An expert report is sufficient under the Act if it “provides a fair summary of the expert’s opinions . . . regarding applicable standards of care, the manner in which the care rendered . . . failed to meet the standards, and the causal relationship between the failure and the injury.” § 74.351(r)(6). The Texas Supreme Court stated that the trial court need only find that the report constitutes a “good faith effort” to comply with the statutory requirements. § 74.351(l).
Good Faith Effort
The Texas Supreme Court stated that an expert report demonstrates a “good faith effort” when it (1) informs the defendant of the specific conduct called into question and (2) provides a basis for the trial court to conclude the claims have merit. A report need not marshal all the claimant’s proof, but a report that merely states the expert’s conclusions about the standard of care, breach, and causation is insufficient.
The Texas Supreme Court held in the present case that the plaintiff’s expert’s explanation provides a straightforward link between the nurses’ alleged breach of the standard of care and the plaintiff’s spinal injury: that is, the report draws a line directly from the nurses’ failure to properly document the plaintiff’s OI and back pain, to a delay in diagnosis and proper treatment (imaging of her back and spinal fusion), to the ultimate injury (paraplegia).
The Texas Supreme Court further held “it appears the court of appeals simply did not agree with [the plaintiff’s expert’s] conclusions in light of [the plaintiff’s] overall course of treatment. However, the court’s job at this stage is not to weigh the report’s credibility; that is, the court’s disagreement with the expert’s opinion does not render the expert report conclusory.”
Source Abshire v. Christus Health Southeast Texas D/B/A Christus Hospital-St. Elizabeth, No. 17-0386.
If you or a loved one may be the victim of medical malpractice in Texas or in another U.S. state, you should promptly consult with a Texas medical malpractice lawyer or a medical malpractice lawyer in your state who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
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