MSHC the Waterton at Cowhorn Creek, LLC v. Donna Miller, Individually and as Representative of the Estate of Nellie Mae Jackson, 391 S.W.3d 551

The Waterton at Cowhorn Creek, a Texas nursing facility, admitted Nellie Mae Jackson, who died shortly after a hospital readmission following dehydration and sepsis.
Donna Miller, as Jackson’s daughter, sued The Waterton for vicarious liability and direct liability under the Texas Health Care Liability Act.
The trial court overruled The Waterton’s motion to dismiss an expert report by Dr. Milton Shaw; Miller appealed the denial.
The court held Shaw’s report sufficiently addressed standard, breach, and causation for vicarious liability, but not for direct liability claims.
Applying an abuse-of-discretion standard, the court affirmed dismissal of direct-liability claims for failure to address them in the expert report, while affirming the vicarious-liability portion.
The court declined to adopt the Potts interpretation of Chapter 74 requirements and reaffirmed that a report must separately address both vicarious and direct liabilities.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Does Shaw's report satisfy vicarious liability standards?	Miller contends the report meets standard, breach, and causation for vicarious liability.	The Waterton argues the report lacks adequate standard of care, breach, and causal analysis for vicarious claims.	Yes; report sufficient for vicarious liability.
Does Shaw's report cover direct liability claims?	Miller argues the report also supports direct liability theories.	The Waterton asserts the report does not address direct liability claims.	No; report does not support direct liability claims.
Should Potts interpretation govern whether a single report can support multiple theories?	Miller relies on Potts to allow one adequate theory to sustain a whole cause of action.	Waterton argues Potts should control the allocation of theories within a single report.	Court declines to adopt Potts approach.
Are separate concerns for vicarious and direct liability required under the report rule?	Miller contends a single report suffices if it covers at least one theory.	Waterton asserts separate addressing is required for each liability theory.	Yes; expert report must address both vicarious and direct liability separately.

Jernigan v. Langley, 195 S.W.3d 91 (Tex. 2006) (expert reports must include standard, breach, and causation with specificity)
In re Jorden, 249 S.W.3d 416 (Tex. 2008) (definition of 'cause of action' for purposes of needing an expert report)
Am. Transitional Care Ctrs. of Tex. v. Palacios, 46 S.W.3d 873 (Tex. 2001) (good-faith basis for a report must discuss standard, breach, and causation)
Wright v. Bowie Mem’l Hosp., 79 S.W.3d 48 (Tex. 2002) (abuse-of-discretion standard for expert report rulings under §74.351)
Certified EMS, Inc. v. Potts, 355 S.W.3d 683 (Tex. App.—Houston [1st Dist.] 2011) (Potts permits addressing at least one liability theory for a claim within a single report)
Loaisiga v. Cerda, 379 S.W.3d 248 (Tex. 2012) (interprets 'health care liability claim' and trigger of report requirements)
Barzingus v. Wilheim, 306 F.3d 17 (10th Cir. 2010) (moved here as a general note on related procedure)
Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010) (circumstantial evidence cannot substitute for direct causation in medical negligence)