Octavio Aguilera The Schumacher Group of Texas, Inc. VHS Harlingen Hospital Company, LLC D/B/A Valley Baptist Medical Center-Harlingen Adrian Alaniz Kristen White George Huddleston, IV, M.D. And William Taw, M.D. v. Eliazar Costilla, Individually and as the Representative of the Estate of Kristy Renee Costilla, and as Next Friend of A.J.C. and C.K.C., Minors Melinda Rodriguez Leal And Camilo Trevino ( 2023 )


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  •                   NUMBER 13-21-00135-CV
    COURT OF APPEALS
    THIRTEENTH DISTRICT OF TEXAS
    CORPUS CHRISTI – EDINBURG
    OCTAVIO AGUILERA; THE SCHUMACHER
    GROUP OF TEXAS, INC.; VHS HARLINGEN
    HOSPITAL COMPANY, LLC D/B/A VALLEY
    BAPTIST MEDICAL CENTER-HARLINGEN;
    ADRIAN ALANIZ; KRISTEN WHITE;
    GEORGE HUDDLESTON, IV, M.D.;
    AND WILLIAM TAW, M.D.,                               Appellants,
    v.
    ELIAZAR COSTILLA, INDIVIDUALLY AND
    AS THE REPRESENTATIVE OF THE ESTATE
    OF KRISTY RENEE COSTILLA, DECEASED,
    AND AS NEXT FRIEND OF A.J.C. AND C.K.C.,
    MINORS; MELINDA RODRIGUEZ LEAL;
    AND CAMILO TREVINO,                                   Appellees.
    On appeal from 197th District Court
    of Cameron County, Texas.
    CONCURRING AND DISSENTING MEMORANDUM OPINION
    Before Justices Benavides, Tijerina, and Peña
    Concurring and Dissenting Memorandum Opinion
    by Justice Benavides
    Because the majority sets too high a bar for a tool intended only to weed out
    frivolous claims, I respectfully dissent in part as to Dr. Taw, Nurses White and Alaniz, and
    VBM, and I would affirm as to these health care providers.1
    I.      PURPOSES OF THE EXPERT REPORT REQUIREMENT
    The trial court need only grant a motion challenging the adequacy of an expert
    report if the report does not represent an objective good faith effort to provide “a fair
    summary of the expert’s opinions . . . regarding applicable standards of care, the manner
    in which the care rendered by the physician or health care provider failed to meet the
    standards and the causal relationship between that failure and the injury, harm, or
    damages claimed.” TEX. CIV. PRAC. & REM. CODE ANN. § 74.351(l), (r)(6).
    “The TMLA dismissal provisions were not intended to create a ‘procedural
    minefield’; instead, they function ‘as a gatekeeper’ to flag frivolous cases for which no
    qualifying expert has been obtained while allowing nonfrivolous cases to move forward.”
    Shiloh Treatment Ctr., Inc. v. Ward, 
    608 S.W.3d 337
    , 341 (Tex. App.—Houston [1st Dist.]
    2020, pet. denied). “The requirement of producing a compliant expert report before
    discovery is allowed to go forward has been described as a ‘low bar’ and does not prohibit
    a defendant from later seeking summary judgment following discovery.” Morrison v.
    1I agree with the majority that the expert reports constitute “no report” as to Aguilera, SGT, and
    Dr. Huddleston.
    2
    Asamoa, 
    648 S.W.3d 628
    , 642 (Tex. App.—Eastland 2022, no pet.); see also Curnel v.
    Hous. Methodist Hosp.-Willowbrook, 
    562 S.W.3d 553
    , 562–63 (Tex. App.—Houston [1st
    Dist.] 2018, no pet.) (op. on reh’g) (“Thus, the requirements of the statute have been
    variously described as a ‘lenient standard,’ ‘low threshold,’ and ‘relatively low bar.’”
    (footnotes omitted)). “The question is not whether [plaintiffs] have adequately proved their
    claims but, rather, whether they have adequately stated their claims against
    [defendants].” Morrison, 648 S.W.3d at 643.
    One of the purposes of the expert report requirement is to “inform the defendant
    of the specific conduct the plaintiff has called into question.” Am. Transitional Care Ctrs.
    of Tex., Inc. v. Palacios, 
    46 S.W.3d 873
    , 879 (Tex. 2001). Nurses White, Alaniz, VBM,
    and Dr. Taw all plainly acknowledge in their briefing the conduct appellees question. Dr.
    Taw writes that “Dr. Halbach claimed that Dr. Taw should have taken images of the left
    carotid artery” and describes the other claimed breach as “[t]he [a]lleged [i]mproper
    [d]escription of the [a]neurysm.” (Emphasis omitted). Nurses White and Alaniz clearly and
    succinctly lay out the conduct implicated as (1) “Nurse White failed to recommend to a
    physician or request an emergency CT scan after Mrs. Costilla exhibited signs of rebleed
    between 3:10 a.m. and 3:40 a.m.”; (2) “Nurse White failed to complete an ordinary CT
    scan at the time ordered by Dr. Tekle – 6:30 a.m.”; (3) “After the morning shift change,
    Nurse Alaniz failed to complete the ordinary CT scan order until 8:00 a.m.”; and (4) “Nurse
    Alaniz did not maintain [Kristy]’s fluid status between 7:00 a.m. and 7:00 p.m.” If these
    healthcare providers are clearly aware of the deficient behavior alleged by the appellees,
    then it is axiomatic that appellees have sufficiently apprised them of the specific conduct
    3
    called into question. See 
    id.
    The second purpose of the expert report requirement is to provide a basis for the
    trial court to conclude that the plaintiffs’ claims have merit. 
    Id.
     By not dismissing the claims
    before us, the trial court obviously concluded that the claims have merit, and we should
    exercise restraint in substituting our judgment for that of the trial court. See E.D. ex rel.
    B.O. v. Tex. Health Care, P.L.L.C., 
    644 S.W.3d 660
    , 664 (Tex. 2022).
    II.    ANALYSIS
    The majority remands the case for consideration of a thirty-day extension as to Dr.
    Taw, Nurses White and Alaniz, and VBM, because it concludes that the expert reports
    are deficient as to different required elements. For the sake of completeness, I will
    address the reports’ sufficiency as to all of the required elements; e.g., the standard of
    care, breach of that standard of care, and causation. See TEX. CIV. PRAC. & REM. CODE
    ANN. § 74.351(r)(6).
    A.     Dr. Taw
    The majority states that “[w]e are left to speculate whether Dr. Taw identified the
    aneurysm as being in the right region when there was no aneurysm in the right region,
    whether Dr. Taw was required to identify the aneurysm in both regions, or Dr. Taw should
    have determined that the aneurysm was only located in the left region.”
    I do not agree that the report requires any speculation on our part. The purpose of
    explaining the standard of care in an expert report is to inform the physician of what he
    should have done differently. See Palacios, 46 S.W.3d at 880 (“Identifying the standard
    of care is critical: Whether a defendant breached his or her duty to a patient cannot be
    4
    determined absent specific information about what the defendant should have done
    differently.” (emphasis added)); Baty v. Futrell, 
    543 S.W.3d 689
    , 695 (Tex. 2018)
    (disagreeing with the lower court “that more was required” to show the standard of care
    “than merely stating that Futrell should not have inserted the retrobulbar needle into the
    optic nerve”). There is no requirement that an expert report include the magic words: “The
    standard of care is x.” See Bowie Mem’l Hosp. v. Wright, 
    79 S.W.3d 48
    , 53 (Tex. 2002)
    (per curiam) (“[A] report’s adequacy does not depend on whether the expert uses any
    particular ‘magical words.’”).
    Here, the reports explain exactly what Dr. Taw should have done differently and
    why it should have been done differently. According to Dr. Halbach, Dr. Taw fell “below
    the standard of care” because he did not obtain images of the “left internal carotid artery
    which . . . would have shown the correct location of the aneurysm . . . , origin[,] and neck
    attachment,” all three of which are “important in deciding subsequent treatment.” Had
    these images been obtained, they would have shown “detailed pictures of the weakened
    blood vessel.” And the failure to obtain these images “prevented recognition of a possibly
    treatable aneurysm” and “precluded an easier treatment of her aneurysm from inside of
    [the] blood vessels.”
    Additionally, although the origin of the aneurysm was visible on the imaging that
    was obtained, Dr. Taw “incorrectly described the aneurysm as in the region of the anterior
    cerebral artery.” Dr. Cruz explains that the correct location was the “left A1 segment.”
    According to Dr. Cruz, that “particular anatomic location of the aneurysm is very
    accessible for surgical clipping and/or [the] interventional radiology procedure of coiling.”
    5
    Dr. Halbach’s report further explains that both surgical clipping and coiling “are [the]
    standard of care and would have prevented rebleeding.” Dr. Cruz states that “[i]ncredibly,
    n[either] of these life[-]saving procedures were pursued.” In other words, Dr. Taw should
    have obtained images of the left internal carotid artery and he should have identified the
    correct location of the aneurysm, so that surgical clipping and/or coiling could have been
    performed. See Palacios, 46 S.W.3d at 880; see also Baty, 543 S.W.3d at 695 (“If ‘sticking
    [the optic nerve] with the retrobulbar needle’ is a breach of the standard of care . . . then
    the ‘proper manner’ necessarily encompasses not sticking the optic nerve with the
    retrobulbar needle.”). However, he did not do any of these things.
    The majority concludes that because Dr. Cruz’s report does not mention Dr. Taw
    or specifically reference his conduct, it cannot “give insight as to how Dr. Taw’s actions
    caused Kristy’s injuries.” But “expert reports should be read together when determining
    whether they represent a good faith effort to satisfy the statute.” McKellar v. Cervantes,
    
    367 S.W.3d 478
    , 489 (Tex. App.—Texarkana 2012, no pet.). In reading Dr. Cruz and Dr.
    Halbach’s reports together, it is obvious that had Dr. Taw obtained images of the
    weakened blood vessels, either surgical clipping or coiling would have been performed,
    which would have prevented rebleeding and, according to the experts, saved Kristy’s life.
    The reports state that “[t]he failure to obtain these images (pictures) prevented
    recognition of a possibly treatable aneurysm,” the aneurysm “could have been treated at
    that time by either surgical clipping” or coiling, and these “life[-]saving” treatments “would
    have prevented rebleeding.” In their reports, Dr. Cruz and Dr. Halbach both explain that
    the rebleeding led to increased cranial pressure, which Dr. Cruz ties directly to the specific
    6
    brain herniation(s) that caused Kristy’s death.
    Specifically, Dr. Cruz states that “[i]t was obvious, in my opinion, that [Kristy’s]
    aneurysm most likely started to bleed and there was impending significant increase in
    intracranial pressure.” Dr. Halbach states that “[t]he buildup of fluid around the brain can
    increase the pressure inside of the skull and produce acute neurological change and
    death if untreated.” Finally, Dr. Cruz states that Kristy likely “died of uncal and/or
    subfalcine brain herniation” which are both the results of uncontrolled “increased
    intracranial pressure.” In other words, Dr. Taw’s failure to identify the aneurysm led to a
    cascading series of events that ultimately resulted in Kristy’s death.
    In Abshire v. Christus Health Southeast Texas, 
    563 S.W.3d 219
    , 225 (Tex. 2018),
    the supreme court discussed their holding in Miller v. JSC Lake Highlands Operations,
    
    536 S.W.3d 510
     (Tex. 2017), which further demonstrates the validity of a multi-step
    causal chain:
    In that case, a resident of an assisted-living facility swallowed her dental
    bridge and died shortly after it was extracted. Id. at 512. Although x-rays
    revealing the bridge’s presence in the patient’s trachea had been taken
    when she began showing signs of chest congestion, the reviewing physician
    failed to notice or identify the problem. Id. The expert reports concluded that
    the physician breached the standard of care by failing to detect the dental
    bridge in the x-rays and that the corresponding delay in discovering and
    removing the bridge caused a series of pulmonary issues that ultimately
    resulted in the patient’s death. Id. at 514. We held that this was a “more-
    than-adequate summary” of causation, as it explained how the physician’s
    breach—failing to identify the bridge and alert appropriate personnel—
    delayed timely removal which in turn caused the patient to aspirate. Id. at
    515.
    Abshire, 563 S.W.3d at 225 (discussing Miller, 536 S.W.3d at 512, 514–15). Here, Dr.
    Taw’s mistake was the failure to timely diagnose her ruptured aneurysm, which eventually
    7
    led to her death. See Windrum v. Kareh, 
    581 S.W.3d 761
    , 777 (Tex. 2019) (holding that
    the “failure to properly diagnose and treat can be a substantial factor in causing injury in
    a medical malpractice case”).
    As the majority rightly points out, all the report needs to do at this stage is (1) inform
    the defendant of the specific conduct the plaintiff has called into question (here, the failure
    to obtain images of the left internal carotid artery and the failure to correctly identify the
    location of the aneurysm, which Dr. Taw acknowledged in his own briefing); and
    (2) provide a basis for the trial court to conclude that the claims have merit (here, because
    images of the left internal carotid artery were not obtained and because the correct
    location of the aneurysm was not identified, surgical clipping and/or coiling was not
    performed, rebleeding was not prevented, and Kristy died). See Palacios, 46 S.W.3d at
    879. I do not believe we must conclude, as the majority does, that Dr. Halbach’s report is
    not criticizing Dr. Taw as being responsible for these failures when Dr. Halbach discusses
    them in a section of his report dedicated solely to Dr. Taw’s actions. Cf. Austin Heart, P.A.
    v. Webb, 
    228 S.W.3d 276
    , 281 (Tex. App.—Austin 2007, no pet.) (“Had Dr. Corove
    referenced only actions by Dr. Kessler in the background section of his report, the link
    between Dr. Corove’s opinions and the responsible physician might be more apparent.”).
    Because the reports, when read together, adequately address the standard of
    care, breach, and causation elements, I would affirm as to Dr. Taw.
    A.     Nurse White
    According to Nurse Griffith’s report, the “[a]pplicable standard of care would be for
    [Nurse White] to request an emergent head CT when these changes in the patient status
    8
    occurred.” But the experts all agree that no emergent CT scan was requested.
    The majority states that “the experts opined that a physician should have obtained
    an emergent CT scan, not White or Alaniz.” However, this directly contradicts Griffith’s
    statement that the appropriate standard of care required Nurse White “to request an
    emergent head CT.” See Van Ness v. ETMC First Physicians, 
    461 S.W.3d 140
    , 144 (Tex.
    2015) (“[T]he trial court had discretion—indeed it was incumbent on the trial court—to
    review the report, sort out its contents, resolve any inconsistencies in it, and decide
    whether the report demonstrated a good faith effort to show that the Van Nesses’ claims
    had merit.”); see also PIRF Operations, LLC v. Kerr, No. 05-20-00887-CV, 
    2021 WL 2801453
    , at *8 (Tex. App.—Dallas July 2, 2021, no pet.) (mem. op.) (“Based on Van Ness,
    to the extent Kerr’s expert reports are inconsistent or contradictory, the trial court was
    within its discretion in resolving these issues in Kerr’s favor.”).
    Additionally, there are several places in the physicians’ reports where the conduct
    of Nurse White—the failure to request a CT scan—is implicated. For instance, in Dr.
    Halbach’s report, he states, “[t]he finding of fixed and dilated pupils should have prompted
    an emergency CT scan of the brain” and Kristy’s “clinical decline with a history of a
    recently ruptured cerebral aneurysm and CT evidence of early hydrocephalus mandated
    an emergency CT.” According to Nurse Griffith, Nurse White is the individual who
    monitored Kristy’s clinical decline and discovered Kristy’s pupils had become fixed and
    dilated. Dr. Cruz stated that when symptoms indicating her clinical condition was
    deteriorating became apparent, “[a]n immediate CT scan of the brain should have been
    done.” Again, Nurse Griffith’s report indicates that Nurse White was the first health care
    9
    provider to discover Kristy’s clinical condition was rapidly deteriorating. Although they do
    not explicitly name her, the physicians’ reports definitively implicated Nurse White’s
    conduct. See Beckwith v. White, 
    285 S.W.3d 56
    , 62 (Tex. App.—Houston [1st Dist.] 2009,
    no pet.) (“[A] defendant’s conduct is implicated when an expert report is ‘directed
    primarily’ to care provided by the defendant, . . . and the report informs the defendant of
    specific conduct called into question and provides a basis for the trial court to determine
    that the claim has merit.” (citation omitted)).
    In their briefing, appellants focus on White’s status as a nurse, and argue that
    requesting an emergent CT scan was outside the scope of her responsibilities as a nurse.
    There are several reasons this argument is unpersuasive: (1) White did not object to the
    expert report below on this basis, see TEX. R. APP. P. 33.1; see also TEX. CIV. PRAC. &
    REM. CODE ANN. § 74.351(a) (explaining that a defendant health care provider whose
    conduct is implicated in an expert report must file and serve any objections to the
    sufficiency of the report by a certain date “failing which all objections are waived”);
    Thompson v. Fong, 
    650 S.W.3d 164
    , 168 (Tex. App.—El Paso 2021, pet. denied) (“Given
    appellant failed to raise the issue the expert reports did not constitute ‘expert reports’ in
    the trial court, . . . [a]ppellant has failed to preserve her issue for our review.”); (2) any
    information concerning White’s inability to request emergent CT scans does not appear
    within the four corners of the experts’ reports, see Palacios, 46 S.W.3d at 878 (“Because
    the statute focuses on what the report discusses, the only information relevant to [our]
    inquiry is within the four corners of the document.”); and (3) even if White is unable to
    request emergent CT scans, the report is not subject to attack on this basis. See Vill.
    10
    Green Alzheimer’s Care Home, LLC v. Graves ex rel. Graves, 
    650 S.W.3d 608
    , 613 (Tex.
    App.—Houston [1st Dist.] 2021, pet. denied) (“Notably, an expert’s report is not subject
    to attack for stating the wrong standard of care.”); see also Miller, 536 S.W.3d at 516–17
    (“At this preliminary stage, whether those standards [of care] appear reasonable is not
    relevant to the analysis of whether the expert’s opinion constitutes a good-faith effort.”).
    In summary, Nurse Griffith adequately explained that (1) the standard of care for
    Nurse White required her to request an emergent CT scan at 3:10 a.m.; and (2) Nurse
    White breached this standard of care by failing to request an emergent CT scan.
    Dr. Halbach’s report explained the causation element. His report stated that, had
    a “STAT (urgent) head CT” been performed around 3 a.m., it “would have confirmed a
    rebleed,” but that instead ordering “a brain scan several hour[s]” after her severe
    neurological decline “prevented any chance of her making a useful recovery.” He also
    opined that “[h]ad [she] been evaluated by a neurosurgeon as requested, and the
    rebleeding detected at 3 AM and treated with a ventricular drain, more likely than not she
    would not have died.” (Emphasis added).
    While it is true that a plaintiff must show that the defendant’s breach was the
    proximate cause of her injuries, a plaintiff need not prove that the breach was the only
    cause. See Windrum, 581 S.W.3d at 777. An injury may have more than one proximate
    cause. Id. at 778. “[T]he cause-in-fact element of proximate cause is measured by
    whether the defendant’s conduct is too attenuated from the plaintiff’s injury to be a
    substantial factor in bringing about the injury.” Id. at 780. And the supreme court has held
    that the “failure to properly diagnose and treat can be a substantial factor in causing injury
    11
    in a medical malpractice case.” Id. at 777.
    Dr. Halbach’s report provides a sufficient causal chain between Nurse White’s
    inaction and Kristy’s death. As discussed above, he explained that because Kristy did not
    receive an emergent CT scan, a timely diagnosis of the rebleeding was not made, which
    led to Kristy’s death. Thus, I believe that appellees adequately showed that Nurse White’s
    failure to request an emergent CT scan was a “substantial factor” in her death. See id.;
    see also Abshire, 563 S.W.3d at 226 (“[W]ith respect to causation, the court’s role is to
    determine whether the expert has explained how the negligent conduct caused the injury.
    Whether this explanation is believable should be litigated at a later stage of the
    proceedings.”).
    In my opinion, the expert reports here constitute a good-faith effort to address
    standard of care, breach, and causation. I would affirm as to Nurse White.
    B.     Nurse Alaniz
    Nurse Griffith’s report only states that Nurse Alaniz fell below the standard of care
    by failing “to complete the head CT . . . at the specified time ordered by Dr. Tekle” and by
    failing “to maintain a euvolemic fluid status . . . to avoid secondary neurological injury to
    [the] patient.” The reports are more than sufficient as to this second failure.
    Nurse Griffith’s report explains that the “[a]pplicable standard of care would be to
    maintain a euvolemic fluid status in order to prevent ischemic complications.” This
    “standard of nursing care for strict intake and output monitoring is important because it
    helps the medical team evaluate if the fluid volume in the blood is enough to get the
    required blood flow and oxygen to the brain to maintain adequate oxygenation and
    12
    prevent ischemic complications.” However, according to Nurse Griffith, Nurse Alaniz
    breached this standard of care because he “fail[ed] to maintain a euvolemic fluid status.”
    The majority opines that no “expert asserted the alleged failure to maintain Kristy’s
    fluid status had any causal relation to Kristy’s death.” I disagree. True, no expert stated
    the fluid imbalance was the immediate cause of Kristy’s death, but the supreme court has
    never “adopted an ‘immediate cause’ standard.” Windrum, 581 S.W.3d at 778.
    Dr. Cruz discussed in-depth the importance of maintaining a certain balance of
    fluids when dealing with an injury such as Kristy’s:
    Another obvious complication that [Kristy] developed was severe increased
    intracranial pressure (ICP) which should have been monitored and treated
    aggressively in a timely fashion. . . . The delicate, steady, increased [ICP]
    requires balancing the in-and-out flow of the fluid component and the
    balance between the inflow of arterial blood and outflow of venous blood
    from the head. The early diagnosis and characterization of increased [ICP]
    is of prime importance in the management of Ms. Costilla. However, again,
    there was deviation from the standard of care by not providing ICP
    monitoring. . . . The reason I am insisting on controlling [ICP] is because, if
    not, the result is brain herniation and secondary death. . . . Anatomically
    speaking, there are several types of brain herniations, such as transtentorial
    herniation, uncal herniation, subfalcine herniation, tonsillary herniation.
    Most likely, [Kristy] died of uncal and/or subfalcine brain herniation. . . . No
    neurological or neurosurgical notes indicate that this complication was
    being entertained or that the proper procedures would be taken care of in
    order to monitor and manage the [ICP]. . . .
    ....
    In summary, the result of these intracranial hemodynamic events led
    to [ICP] with subsequent progressive brain damage and finally death. In
    these particular cases, the sooner a diagnosis and treatment is provided to
    reduce the [ICP] in the brain, the better the outcome.
    (Emphasis added). Dr. Halbach also explained that “[t]he buildup of fluid around the brain
    can increase the pressure inside of the skull and produce acute neurological change and
    13
    death if untreated,” and that here, “there was no blood flow to the brain as the pressure
    inside the brain caused by the rebleeding was so high that the brain had no oxygen or
    blood flow.”
    In layman’s terms, the increased pressure in the brain required balancing both the
    flow of fluids and blood in and out of the body. Because that balance was not maintained,
    fluid built up around Kristy’s brain, the pressure inside the skull increased, and it led to a
    “brain herniation.” According to Dr. Cruz, Kristy most likely died from an “uncal and/or
    subfalcine brain herniation.” Nurse Griffith opined that it was Nurse Alaniz’s duty to
    monitor and maintain a certain euvolemic fluid status in Kristy. But this was not done.
    Thus, per Dr. Cruz, Kristy died from a herniation that resulted from improper management
    of increased pressure in the brain, pressure that resulted from an imbalance in fluids that
    Nurse Alaniz was responsible for balancing. See Windsor v. Maxwell, 
    121 S.W.3d 42
    , 48
    (Tex. App.—Fort Worth 2003, pet. denied) (“It is sufficient that the report contains
    information summarizing and explaining the causal relationship between the [health care
    provider]’s failure to meet the applicable standards of care and the plaintiff’s injury.” (citing
    Wright, 79 S.W.3d at 53). Based on the adequacy of the expert reports, I would affirm as
    to Nurse Alaniz.
    C.     VBM
    Because I would affirm as to Nurses White and Alaniz, I would necessarily affirm
    as to VBM, whom plaintiffs assert was vicariously liable for the nurses’ negligence. See
    Certified EMS, Inc. v. Potts, 
    392 S.W.3d 625
    , 632 (Tex. 2013) (“[A]n expert report that
    adequately addresses at least one pleaded liability theory satisfies the statutory
    14
    requirements, and the trial court must not dismiss in such a case.”).
    III.    CONCLUSION
    In response to the majority’s criticisms of this dissent, I reiterate that this is not the
    appropriate stage of the proceedings to litigate the merits of the underlying health care
    liability claim. See Miller, 536 S.W.3d at 517 (“Whether each defendant is liable for
    Hathcock’s death is not the question at this stage; that will be answered further in the
    litigation process.”). The only question is whether the expert reports here constituted a
    “good faith effort” to comply with the statutory definition of an expert report. TEX. CIV.
    PRAC. & REM. CODE ANN. § 74.351(l). The majority would decide this issue differently than
    the trial court, that is painfully obvious. But because we review this issue for an abuse of
    discretion, we may reverse only if the lower court’s decision was arbitrary and
    unreasonable. See Walker v. Packer, 
    827 S.W.2d 833
    , 840 (Tex. 1992) (“Even if the
    reviewing court would have decided the issue differently, it cannot disturb the trial court’s
    decision unless it is shown to be arbitrary and unreasonable.”).
    “The purpose of the expert report requirement is to deter frivolous claims, not to
    dispose of claims regardless of their merits.” Scoresby v. Santillan, 
    346 S.W.3d 546
    , 554
    (Tex. 2011). Because the majority does not affirm as to Dr. Taw, Nurses White and Alaniz,
    and VBM, they are implying, necessarily, that if the experts do not amend their reports,
    the plaintiffs’ claims are frivolous and must be dismissed. See 
    id.
     Based on the three
    detailed expert reports presented, I believe that it was neither arbitrary nor unreasonable
    for the trial court to decide that the plaintiffs’ claims were not frivolous. See Walker, 827
    S.W.2d at 840. And to the extent that decision might be considered a close call, “[c]lose
    15
    calls must go to the trial court.” Larson v. Downing, 
    197 S.W.3d 303
    , 304 (Tex. 2006) (per
    curiam). For the reasons stated herein, I would affirm as to Dr. Taw, Nurses White and
    Alaniz, and VBM. Thus, I respectfully dissent in part.
    GINA M. BENAVIDES
    Justice
    Delivered and filed on the
    30th day of March, 2023.
    16
    

Document Info

Docket Number: 13-21-00135-CV

Filed Date: 3/30/2023

Precedential Status: Precedential

Modified Date: 4/1/2023