Clapp v. Perez, 394 S.W.3d 254

Perez underwent gastric bypass in Dec 2007, developed intestinal obstruction requiring emergency surgery, and aspirated during anesthesia, leading to death two weeks later.
Two years later Perez’s personal representative sued Drs. Clapp (surgeon) and Gagot-Pizzaro (anesthesiologist) for wrongful death alleging failure to insert a nasal-gastric tube and to halt surgery.
Plaintiffs served a single expert report by Dr. Hector J. Herrera; defendants moved to dismiss for inadequacy.
Trial court denied the motions to dismiss; the appeals challenge that Herrera’s report fails to provide the necessary individualized standards, breaches, and causation for two physicians with different specialties.
The court applies Texas expert-report standards requiring a good-faith, fact-linked explanation of standard of care, breach, and causation for each defendant and clarifies that grouping physicians with differing standards without individualized analysis is inadequate.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Did Herrera’s report differentiate each physician’s standard of care?	Clapp and Gagot cannot be treated under a single standard.	Herrera’s report indicates a shared standard for both physicians.	No; report inadequate for lacking individualized standards.
Did Herrera adequately identify each physician’s breach of the standard of care?	Breaches are not tied to specific actions by Clapp or Gagot.	The report asserts a general breach without attributing acts to each doctor.	No; insufficient specificity to attribute breach to either physician.
Did Herrera show a causal link between each breach and Perez’s death?	The report links failure to insert a tube to death broadly.	Causation is asserted in general terms without physician-specific chain of causation.	No; lacks showing that breach by either physician was a substantial factor.

Am. Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873 (Tex. 2001) (standard for reviewing expert reports in health care liability claims)
Bowie Mem'l. Hosp. v. Wright, 79 S.W.3d 48 (Tex.2002) (limits on courts’ discretion; requires meaningful, fact-based reports)
Hollingsworth v. Springs, 353 S.W.3d 506 (Tex.App.-Dallas 2011) (careful naming of defendants and per-defendant standards matters in groups)
Taylor v. Christus Spohn Health Sys. Corp., 169 S.W.3d 241 (Tex.App.-Corpus Christi 2004) (single standard for mixed-defendant groups inadequate without explanation)
Jernigan v. Langley, 195 S.W.3d 91 (Tex.2006) (predecessor to require specific actions constituting breach)