Ramarao Denduluri, M.D. and Houston Urology Parters v. Maria Nancy Bravo, Individually and as Representaive of the Estate of Jose Antonio Quintero A/K/A Hector Rodriguez, 01-22-00230-CV

May 2019: Quintero had imaging showing a right hydrocele, abnormal right testicle/spermatic cord, and bilateral pulmonary nodules.
June 2019: Dr. Denduluri performed hydrocele surgery; postoperative hematoma and repeated follow-ups without documented review/assessment of prior abnormal imaging.
Sept–Oct 2019: Scrotal ultrasound showed testicular masses; October orchiectomy pathology revealed an aggressive mixed germ cell tumor with lymphovascular invasion.
Late 2019–2020: Quintero received chemotherapy and additional surgery; he died in August 2020 from metastatic testicular cancer.
Procedural posture: Appellee sued for health-care liability under Chapter 74 and served expert reports from urologist Dr. Douglas Dow; defendants moved to dismiss for deficient expert report; trial court denied dismissal after a 30-day supplementation; appellate court affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Sufficiency of expert report on causation	Dow’s reports link specific omissions (failure to review/act on imaging, failure to order further testing/referrals) to progression to Stage III and worse prognosis	Reports are conclusory, speculative, lack factual basis tying an earlier diagnosis to a changed outcome	Reports were a good-faith effort, provided timeline/factual links and adequate explanation of how breach increased risk; sufficient — dismissal denied
Expert qualifications to opine on causation/prognosis	Dow is a board-certified urologist, completed residency with a year at Moffitt Cancer Center, treated testicular cancer patients and performed extensive scrotal surgery	Dow lacks oncology board certification and specific recent experience staging/treating testicular cancer to opine on prognosis/timing	Dow’s urology training/experience qualified him to opine on the standards for scrotal evaluation and the causal link to delayed cancer diagnosis; qualified
Abuse of discretion standard for denial of motion to dismiss	Trial court reasonably found a good-faith expert report under Section 74.351	Trial court misapplied law and should have dismissed for insufficient report/qualifications	No abuse of discretion; appellate court affirms trial court order

Palacios v. Raymond, 46 S.W.3d 873 (Tex. 2001) (expert-report statutory requirements and standard for good-faith effort)
Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010) (requirement that expert explain how and why breach caused injury)
Abshire v. Christus Health Se. Tex., 563 S.W.3d 219 (Tex. 2018) (expert must link conclusions to specific facts; report adequacy)
Gunn v. McCoy, 554 S.W.3d 645 (Tex. 2018) (causation includes cause-in-fact and foreseeability)
Broders v. Heise, 924 S.W.2d 148 (Tex. 1996) (expert qualifications: limits on testifying about effects of delayed diagnosis/treatment)
Baty v. Futrell, 543 S.W.3d 689 (Tex. 2018) (what constitutes informing defendant and providing basis for trial court to conclude claims have merit)
Miller v. JSC Lake Highlands Operations, 536 S.W.3d 510 (Tex. 2017) (expert report sufficiency where expert tied delay in identifying foreign body on x-ray to death)