Matthew McKerley, D.O. v. Danisha Jackson and Devin Jackson, Individually and as Representatives of the Estate of Merlenia Jackson, 05-21-00050-CV

On Aug. 1, 2017, Merlenia Jackson presented to Medical City Dallas ER with dyspnea, hypertension, and leg swelling; Dr. Matthew McKerley examined and discharged her; she died the next day from a pulmonary embolism (PE).
Plaintiffs (Merlenia's children) sued McKerley and the hospital for gross negligence and served an expert report from Elizabeth Jones, M.D., an emergency-medicine–trained, board-certified physician.
Dr. Jones’s report explained the standard of care for unexplained dyspnea (complete history/physical, differential, consider PE, use PERC/Well’s/D-dimer/CT as appropriate), stated those steps were not performed, and opined that the failure to evaluate/diagnose PE caused Merlenia’s death.
The hospital was later voluntarily dismissed; McKerley moved to dismiss under Tex. Civ. Prac. & Rem. Code ch. 74 for an inadequate expert report. The trial court denied the motion but ordered an addendum to address causation and treatment efficacy.
Plaintiffs filed a one-page unsigned addendum summarizing PE mortality and treatment (citing UpToDate) and stating failure to diagnose deprived the decedent of mortality reduction from anticoagulation.
The trial court considered the addendum, denied McKerley’s renewed motion to dismiss; McKerley appealed and the Court of Appeals affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the trial court could consider the unsigned addendum to the expert report	Addendum supplements Dr. Jones’s signed report; authorship and purpose are clear; signature not required	Addendum is unsigned, not identified to an expert, so it cannot supplement the report	Court: addendum may be considered with the signed report; statute does not require a signature and no authenticity dispute was raised before the hearing
Whether Dr. Jones’s report (with addendum) met Chapter 74’s adequacy requirements on breach and causation	Report identifies standard of care, specific omissions (no D-dimer/CT, incomplete eval), links breach to death via comparative PE mortality and treatment benefit	Report is conclusory on causation and insufficient to show breach caused death; addendum does not cure defects	Court: report satisfied the low threshold to inform defendant and show non-frivolous claim; denial of dismissal affirmed

Abshire v. Christus Health Se. Tex., 563 S.W.3d 219 (Tex. 2018) (explains purpose and adequacy standard for Chapter 74 expert reports)
Bowie Mem’l Hosp. v. Wright, 79 S.W.3d 48 (Tex. 2002) (expert must explain basis of conclusions to link opinion to facts)
Loaisiga v. Cerda, 379 S.W.3d 248 (Tex. 2012) (characterizes expert-report requirement as a low threshold to avoid frivolous claims)
Schorp v. Baptist Mem’l Health Sys., 5 S.W.3d 727 (Tex. App.—San Antonio 1999) (discusses requirement to identify and establish qualifications of an opining physician)