P. Palivela Raju, M.D. v. Dianne Jackson, 13-15-00171-CV

Background

Dianne Jackson was seated in a balance-testing chair at Dr. P. Palivela Raju’s ENT office while a third‑party tech (Onsite Balance Solutions) prepared testing; the chair tilted and fell, injuring Jackson. No physician or Raju staff member was in the room when the chair failed.
Jackson sued Raju and Onsite Balance Solutions asserting professional negligence and, alternatively, general negligence/premises‑liability; she timely attached an expert report from orthopedic surgeon Arnold Ravdel, M.D. under Chapter 74 (filed in an abundance of caution).
Raju objected to the expert report under Tex. Civ. Prac. & Rem. Code §74.351(a); the trial court overruled objections, Raju later moved to dismiss under §74.351(b) after the 120‑day window and the trial court denied the motion.
Procedural posture: interlocutory appeal of the trial court’s denial of the §74.351(b) motion (appellate deadlines and filing technicalities noted).
Central factual/legal focus: whether Jackson’s claims are health‑care‑liability claims (HCLCs) subject to the Texas Medical Liability Act (TMLA/Ch. 74), and if so whether Ravdel’s report satisfies the Chapter 74 expert‑report sufficiency requirements (qualification, fair summary of standard of care, causation).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held (trial court / appellee position)
1. Is Jackson’s cause of action a Healthcare Liability Claim (HCLC) under Chapter 74?	Jackson: No — injury was caused by faulty equipment/safety issue, not by medical treatment; mere location in a medical office is insufficient.	Raju: Claim should be treated as HCLC because injury occurred on medical premises and relates to provision of health care.	Trial court did not expressly rule on status; appellee argues claim is not an HCLC and, if it is, Ch. 74 still satisfied.
2. If HCLC, is Ravdel qualified to opine on the standard of care?	Jackson: Yes — Ravdel (a physician who runs a practice) can opine on premises/equipment maintenance obligations of a medical practice owner; specialty match to ENT is unnecessary.	Raju: No — expert must be qualified in the relevant medical specialty (ENT/balance testing); Ravdel lacks that specialty.	Trial court overruled objections; appellee contends Ravdel is sufficiently qualified for the premises/equipment issues.
3. If HCLC, does Ravdel’s report provide a "fair summary" of standard of care (statutory good‑faith effort)?	Jackson: Yes — given limited discovery and simple facts (chair collapsed when occupied), the report fairly summarizes breaches (failure to maintain equipment, supervise testing).	Raju: No — report is vague/general and lacks specific acts or maintenance standards to show breach.	Trial court denied dismissal; appellee argues the "good faith effort" standard is met under the case facts.
4. If HCLC, does the report adequately support causation (not based on unsupported assumptions)?	Jackson: Yes — report relies on medical records and commonsense inference (chair failed to hold patient’s weight); res ipsa loquitur logic applies.	Raju: No — report rests on unsupported assumptions and fails to explain how different acts would have prevented the fall.	Trial court denied dismissal; appellee maintains causation is sufficiently explained given the straightforward facts.

Key Cases Cited

Am. Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873 (Tex. 2001) (standard for expert‑report sufficiency and abuse‑of‑discretion review in TMLA context)
Diversicare General Partner, Inc. v. Rubio, 185 S.W.3d 842 (Tex. 2005) (look to the underlying nature of the claim to determine whether it is a health‑care liability claim)
Texas West Oaks Hosp., LP v. Williams, 371 S.W.3d 171 (Tex. 2012) (if medical/health‑care expert testimony is necessary to prove or refute the claim, it is an HCLC)
Stockton v. Offenbach, 336 S.W.3d 610 (Tex. 2011) (standards for de novo review on statutory‑construction questions and abuse‑of‑discretion for expert‑report rulings)
Loaisiga v. Cerda, 379 S.W.3d 248 (Tex. 2012) (courts must examine entire record and gravamen of the claim when determining TMLA applicability)
Good Shepherd Med. Ctr.–Linden, Inc. v. Twilley, 422 S.W.3d 782 (Tex. App. — Texarkana 2013) (safety claims must have at least an indirect nexus to health care to be HCLCs)
Marks v. St. Luke’s Episcopal Hosp., 319 S.W.3d 658 (Tex. 2010) (guidance on determining whether acts are within TMLA’s scope)
Benish v. Grottie, 281 S.W.3d 184 (Tex. App. — Fort Worth 2009) (expert may draw reasonable inferences from medical records; report can be adequate despite limited factual detail)