Burleson v. Lawson, 487 S.W.3d 312

Patricia Burleson presented to Hendrick Medical Center ER with severe left-sided chest pain; nurses obtained EKG, labs, and chest X‑ray before physician evaluation.
Dr. Robert Lawson examined Burleson ~40 minutes after arrival, ordered repeat EKG and cardiac enzymes 90 minutes after initial tests, reviewed results (EKGs read as not abnormal; troponin/CK within lab normals), diagnosed "atypical chest pain," deemed her "stable," and discharged her with medication.
Burleson died about 14 hours later of a probable acute myocardial infarction; survivors sued Lawson for medical malpractice alleging failure to recognize/treat an acute MI (should have observed longer, performed cath, or obtained cardiology consult).
Parties filed competing summary‑judgment motions: plaintiffs sought declaration that Tex. Civ. Prac. & Rem. Code § 74.153 (heightened willful-and-wanton standard for ER care) did not apply; Lawson moved (traditional and no‑evidence) that § 74.153 applied and plaintiffs had no evidence of willful-and-wanton (gross) negligence.
Trial court granted Lawson’s summary judgment and denied plaintiffs’ partial summary judgment; plaintiffs appealed arguing (1) § 74.153 does not apply because Lawson perceived the patient as "stable," and (2) alternatively plaintiffs produced more than a scintilla proving gross negligence.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether § 74.153’s willful-and-wanton (gross negligence) standard applies to malpractice arising from care in an ER when physician perceived patient as "stable"	§ 74.153 shouldn’t apply because Lawson perceived Burleson as stable and thus did not render emergency medical care requiring the statute’s heightened standard	§ 74.153 applies because diagnosis/treatment in the ER—viewed prospectively/objectively—constituted "emergency medical care" under § 74.001(7) even if physician later deemed patient stable	Court held § 74.153 applies; ER diagnosis/treatment (including assessment that patient was "stable") falls within statutory definition viewed objectively/prospectively (affirming Turner/Crocker analyses)
Whether plaintiffs produced more than a scintilla of evidence on willful-and-wanton (gross) negligence to defeat Lawson’s no‑evidence summary judgment	Plaintiffs relied principally on expert Dr. Davidson’s testimony that Lawson was "grossly" or "willfully and wantonly" negligent and on facts showing possible misdiagnosis/discharge	Lawson argued plaintiffs offered only conclusory expert statements and no evidence of the subjective component of gross negligence (actual awareness and conscious indifference)	Court held plaintiffs’ evidence was conclusory and failed to raise a fact issue on the subjective element of gross negligence; no‑evidence summary judgment proper

Turner v. Franklin, 325 S.W.3d 771 (Tex. App.—Dallas 2010) (holds ER diagnosis/treatment should be viewed prospectively/objectively and § 74.153 can apply even if physician later deems patient "stable")
Crocker v. Babcock, 448 S.W.3d 159 (Tex. App.—Texarkana 2014) (analyzes ER context to determine § 74.153 applicability; finds willful-and-wanton standard applies where patient presented with emergency and received emergency services)
Elizondo v. Krist, 415 S.W.3d 259 (Tex. 2013) (conclusory expert opinion insufficient to create fact issue to defeat summary judgment)
IHS Cedars Treatment Ctr. v. Mason, 143 S.W.3d 794 (Tex. 2004) (conclusory expert testimony cannot defeat summary judgment)
Transp. Ins. Co. v. Moriel, 879 S.W.2d 10 (Tex. 1994) (defines gross negligence elements: extreme departure from ordinary care and likelihood of serious injury)
Columbia Med. Ctr. of Las Colinas, Inc. v. Hogue, 271 S.W.3d 238 (Tex. 2008) (gross negligence requires subjective awareness and conscious indifference)