Harlingen Medical Center, Limited Partnership v. Rosa Andrade, as Next Friend of M. H. A., a Minor Child
13-15-00119-CV
| Tex. App. | Sep 3, 2015Background
- Plaintiff Rosa Andrade (next friend of minor Mary Helen Andrade) sued Harlingen Medical Center (HMC) claiming negligent transfer efforts led to a ruptured ascending aortic dissection and death.
- Plaintiffs’ experts opined emergency surgical repair at another hospital would likely have prevented death but relied on the premise that another hospital and surgeon would have accepted Andrade for transfer.
- It was undisputed in the record that multiple qualified hospitals initially refused to accept Andrade—some because he was unfunded.
- HMC moved to dismiss under Texas Health Care Liability Act expert-report requirements, arguing plaintiffs’ reports failed to establish causation because they did not explain how a transfer acceptance would have occurred.
- Plaintiffs sought and used a thirty-day extension to amend reports; HMC argues plaintiffs already used the one statutory extension and cannot cure remaining deficiencies.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of expert reports on causation | Experts need only give a "good-faith" fair summary; they identified the surgical treatment that would have saved Andrade. | Reports are conclusory/speculative because they do not explain how another hospital/surgeon would have accepted the transfer (a necessary link). | Court found reports fail to establish cause in fact because they do not connect HMC’s conduct to a likely accepted transfer. |
| Whether unavailability of accepting facility is a "new and independent cause" | The lack of acceptance is a separate intervening cause that need not be addressed in expert reports. | The unavailability was foreseeable and integral to plaintiffs’ own theory—thus not a new independent cause but a missing causation link. | Court rejects treating nonacceptance as merely a defensive theory; it is part of proximate cause and must be addressed in reports. |
| Requirement to prove "cause in fact" at report stage | Plaintiffs contend foreseeability need not be shown in the report. | Defendant: expert reports must still show cause in fact/substantial factor (but need not establish foreseeability). | Court reiterated that while foreseeability may not be required in the report, cause-in-fact (but-for/substantial factor) must be shown; plaintiffs’ reports lack that showing. |
| Entitlement to additional extension to cure reports | Plaintiffs seek another extension to fix report deficiencies. | Defendant: plaintiffs already used the one 30-day statutory extension; further amendment is not permitted and dismissal is appropriate. | Court holds plaintiffs are not entitled to a second extension; dismissal is the statutory remedy if reports remain deficient. |
Key Cases Cited
- Columbia Rio Grande Healthcare v. Hawley, 284 S.W.3d 851 (Tex. 2009) (new-and-independent-cause and proximate-cause framework)
- Dew v. Crown Derrick Erectors, Inc., 208 S.W.3d 448 (Tex. 2006) (discussion of when an intervening act alters natural sequence of events)
- Dillard v. Texas Elec. Coop., 157 S.W.3d 429 (Tex. 2005) (intervening cause must be "by someone else later" to be new and independent)
- Bowie Mem’l Hosp. v. Wright, 79 S.W.3d 48 (Tex. 2002) (expert reports must explain basis of conclusions; courts cannot fill gaps)
- Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010) (conclusory expert opinions are insufficient under Chapter 74)
- Cornejo v. Hilgers, 446 S.W.3d 113 (Tex. App.—Houston [1st Dist.] 2014) (expert report must demonstrate substantial-factor causation)
- Hardy v. Marsh, 170 S.W.3d 865 (Tex. App.—Texarkana 2005) (expert report inadequate where it failed to explain what treatment would have been provided and how it would have prevented injury)