Stephen Courtney, M.D. and Plano Orthopedics Sports Medicine and Spine Center, P.A. v. Christel Pennington, Individually and as an Heir and Representative of the Estate of Steven Paul Pennington
05-16-01124-CV
| Tex. App. | Jul 21, 2017Background
- Plaintiff Christel Pennington sued Dr. Stephen Courtney and his practice after her husband Steven died during a second spinal surgery in July 2015; her complaint alleges negligence in a prior March 2012 surgery caused the need for the 2015 operation and ultimately his death.
- Pennington served an orthopedic expert report by Dr. George Wharton (addressing alleged breaches in the 2012 surgery and opining those breaches led to the 2015 surgery) and a cardiology report by Dr. Mark Entman (opining Steven would likely have lived had the 2015 surgery not occurred).
- Defendants objected that the reports failed to articulate standards and breaches for the 2015 surgery and, critically, failed to establish causation linking the 2012 surgery breaches to the cardiac arrest and death during the 2015 surgery.
- The trial court overruled the objections and denied defendants’ motion to dismiss for inadequate expert reports; defendants appealed interlocutorily under Tex. Civ. Prac. & Rem. Code § 51.014(a)(9).
- The appellate court framed the sole relevant question as whether the reports adequately explained causation—i.e., how negligence in the 2012 surgery was a proximate cause of death during the 2015 surgery.
- The court concluded the reports failed to explain the causal mechanism linking the alleged 2012 breaches to the cardiac arrest/death during the 2015 operation, but held the deficiencies were curable and remanded for the trial court to consider granting a 30‑day extension to cure.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Adequacy of expert reports under Chapter 74 (standards, breach, causation) | Wharton and Entman together show the 2012 negligence made the 2015 surgery necessary and that but for the 2015 surgery Steven would be alive | Reports fail to explain how an alleged 2012 breach caused cardiac arrest/death in 2015; no link to causation shown | Reports insufficient on causation; trial court abused discretion in overruling objections |
| Whether failure on causation warrants dismissal with prejudice | Plaintiff requested leave to cure any deficiencies and argues causation can be clarified | Defendant seeks dismissal with prejudice and fees/costs | Remand: deficiency is curable; trial court must consider 30‑day extension to cure rather than dismissal |
| Applicability of Chapter 74 procedural standards | Chapter 74 requires a written expert report showing standards, breach, and causal relationship; multiple reports may address different issues | Same; defendant argues the reports did not satisfy statutory definition | Court applies Chapter 74 and controlling proximate‑cause requirements; finds reports do not meet causation requirement |
| Standard of review on expert‑report adequacy | N/A (plaintiff asks deference to trial court’s ruling) | Abuse‑of‑discretion review; trial court must analyze law correctly | Abuse of discretion found because court failed to require adequate causation explanation |
Key Cases Cited
- Stockton v. Offenbach, 336 S.W.3d 610 (Tex. 2011) (Chapter 74 expert‑report requirement and timing)
- Methodist Hosps. of Dallas v. Winn, 496 S.W.3d 148 (Tex. App.—Dallas 2016) (abuse‑of‑discretion standard for expert‑report adequacy)
- Scoresby v. Santillan, 346 S.W.3d 546 (Tex. 2011) (requirement that a court grant one 30‑day extension to cure curable deficiencies in an expert report)
- Kelly v. Rendon, 255 S.W.3d 665 (Tex. App.—Houston [14th Dist.] 2008) (distinguishing proximate‑cause analysis in cases involving complications closely tied to an earlier procedure)