Diagnostic Healthcare Services D/B/A Onsite Balance Solutions, LLC v. Dianne Jackson, 13-15-00170-CV

Background

Dianne Jackson underwent balance testing for vertigo at Dr. P. Palivela Raju’s office on March 28, 2012; testing was performed by Onsite Balance Solutions, LLC (OBS), a third‑party vendor.
After a caloric stimulation test, Jackson fell from a rotating/balance chair operated by OBS and allegedly injured her knee and shoulder; no Dr. Raju staff were present during the test.
Jackson sued Dr. Raju and OBS alleging health‑care liability claims (HCLCs) under Chapter 74 (safety/maintenance and supervision failures) and attached an expert report and CV from orthopedic surgeon Arnold Ravdel, M.D.
Dr. Ravdel’s report criticized Dr. Raju for failing to maintain equipment and supervise testing and stated OBS administered/operated the malfunctioning chair; the report did not include a dedicated “standard of care” paragraph expressly labeled for OBS.
OBS moved to dismiss for “no report” as to it; Dr. Raju moved to dismiss asserting the report was not a good‑faith expert report and Dr. Ravdel lacked qualification on vertigo testing. Trial court denied both motions; appellants appealed.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Jackson’s claims are HCLCs subject to Chapter 74	Jackson argued claims were ordinary negligence/premises liability	Defendants argued Chapter 74’s expert report requirement applied	Court held claims are HCLCs (safety component tied to medical testing) and TMLA applies
Whether Dr. Ravdel’s report is a “report” as to OBS (Scoresby third prong: implicate defendant)	Jackson: report mentions OBS administered/operated the chair and thus implicates OBS	OBS: report only references OBS in passing and lacks standard‑of‑care/causation specific to OBS (so “no report”)	Court held report implicated OBS (more than passing mention); trial court did not abuse discretion; OBS waived sufficiency objections by not timely objecting
Whether Dr. Ravdel is qualified to opine against Dr. Raju under §74.401	Jackson: orthopedist can address standards on maintenance/supervision of equipment and safety obligations of a private practitioner	Dr. Raju: orthopedist lacks training/experience in vertigo testing and balance‑chair maintenance; unqualified to opine	Court held Dr. Ravdel qualified to opine on general practitioner duties to maintain equipment and supervise testing in this safety claim context
Whether Dr. Ravdel’s report was a good faith expert report re: standard, breach, causation	Jackson: report states standard, breach (poorly maintained chair; lack of supervision), and causal link (chair rolled and caused fall) — an objective good faith effort	Dr. Raju: report is conclusory, speculative, and fails to fairly summarize standard/breach/causation	Court held report met §74.351(r)(6) requirements as an objective good faith effort; trial court did not abuse discretion

Key Cases Cited

Scoresby v. Santillan, 346 S.W.3d 546 (Tex. 2011) (three‑part test for an expert report: served timely, expert shows claim has merit, and report implicates each defendant)
Ogletree v. Matthews, 262 S.W.3d 316 (Tex. 2007) (timely expert report requirement and waiver rule for objections)
Tex. W. Oaks Hosp., LP v. Williams, 371 S.W.3d 171 (Tex. 2012) (tests to determine whether a claim is a health‑care liability claim under Chapter 74)
Ross v. St. Luke's Episcopal Hosp., 462 S.W.3d 492 (Tex. 2015) (safety component of HCLCs can encompass claims indirectly related to healthcare; substantive nexus required)
Samlowski v. Wooten, 332 S.W.3d 404 (Tex. 2011) (good faith effort standard for expert reports; a report must not contain a material deficiency)
Am. Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873 (Tex. 2001) (expert report must explain standard, breach, and causation; conclusory reports insufficient)
Gammill v. Jack Williams Chevrolet, Inc., 972 S.W.2d 713 (Tex. 1998) (expert’s qualifications must fit the specific subject matter of the opinion)