Barbara Baty v. Olga L. Futrell, CRNA, and Complete Anesthesia Care, PC, 543 S.W.3d 269

Plaintiff Barbara Baty underwent left-eye cataract surgery on March 23, 2011; CRNA Olga Futrell administered retrobulbar anesthesia.
The initial retrobulbar block produced inadequate akinesia/anesthesia; Futrell performed a second needle-based retrobulbar injection.
Baty suffered permanent vision loss in the left eye; she alleges the second needle stick penetrated and irreparably damaged her optic nerve.
Baty served an amended seven-page, single-spaced expert report from ophthalmologist Dr. Steven Chalfin (board-certified; >3,500 retrobulbar blocks) addressing standard of care, breach, and causation.
Dr. Chalfin: (1) identifies the standard (avoid injuring orbital structures when administering retrobulbar blocks), (2) explains risk increase after an augmented second needle attempt and that many surgeons use a blunt cannula instead, (3) opines Futrell breached the standard by sticking the optic nerve with the needle, and (4) links that breach to Baty’s permanent visual loss and cites two treating physicians who attributed the injury to the block.
Trial court dismissed Baty’s health‑care‑liability claim under Tex. Civ. Prac. & Rem. Code § 74.351 for an allegedly inadequate expert report; the dissenting opinion (Justice Davis) would have reversed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Dr. Chalfin’s expert report satisfies § 74.351’s requirements (standard of care, breach, causation)	Chalfin’s report, read in entirety, fairly summarizes applicable standard (avoid injuring optic nerve), specific facts (second needle after inadequate block, alternative technique), breach (needle stick of optic nerve), and causation (medical records and treating doctors linking block to injury)	Report is conclusory: fails to explain what specific acts would satisfy the standard (how to administer the block properly), and does not sufficiently link conduct to injury	Dissent: the report is adequate as a good‑faith, fair summary addressing at least one pleaded theory; trial court erred in dismissal
Proper standard of appellate review for adequacy of expert report	De novo review appropriate because adequacy is a legal question (paper‑based evaluation)	Lower courts often apply abuse‑of‑discretion; trial court has leeway	Dissent endorses de novo review (criticizes deferring to trial court’s “zone of reasonable disagreement”); majority applied dismissal (affirmed trial court)

Palacios v. American Transitional Care Centers of Tex., 46 S.W.3d 873 (Tex. 2001) (expert report must set out what care was expected but not given; cannot be conclusory)
Certified EMS, Inc. v. Potts, 392 S.W.3d 625 (Tex. 2013) (a report adequate on at least one pleaded theory avoids dismissal)
Van Ness v. ETMC First Physicians, 461 S.W.3d 140 (Tex. 2015) (court must consider all factual statements and opinions in expert report)
Bowie Memorial Hosp. v. Wright, 79 S.W.3d 48 (Tex. 2002) (expert must explain basis for conclusions and link to facts)
Walker v. Packer, 827 S.W.2d 833 (Tex. 1992) (appellate courts review legal questions without deference)
Samlowski v. Wooten, 332 S.W.3d 404 (Tex. 2011) (overarching goal: weed out frivolous claims while preserving meritorious ones)
Benson v. Vernon, 303 S.W.3d 755 (Tex. App.—Waco 2009) (report identifying a specific injurious act can satisfy statutory requirements when it links standard, breach, and causation)