the University of Texas Medical Branch at Galveston v. Kai Hui Qi
370 S.W.3d 406
| Tex. App. | 2012Background
- Qi sued UTMBG for alleged negligent care by its staff leading to stillbirth; expert Dr. Caughey was disclosed under Tex. Civ. Prac. & Rem. Code § 74.351; UTMBG challenged the adequacy of the report; the trial court denied dismissal and UTMBG appealed; the court held the report failed to specify which standard of care applied to which defendant and identified several gaps; the case was remanded for cure extension.
- Dr. Caughey’s report discussed three key care interactions (Jan. 12 clinic visit, Jan. 18 triage, and Jan. 19 admission) and opined violations of the standard of care but did not clearly attribute standards to specific defendants or address all asserted theories.
- The court emphasized that a good-faith expert report must identify the standard of care, breach, and causation, and that vicarious liability theories can be viable without naming UTMBG if the claim is purely vicarious.
- UTMBG argued the report failed to address communication of preeclampsia risks, diagnosis/admission for hypertension, and other specific acts; the court found deficiencies but ultimately remanded for cure.
- The decision focused on whether the report could be cured within a 30-day extension under §74.351(c).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Standard of care for each defendant | Qi asserts a uniform standard applies to all clinicians. | UTMBG argues the report must specify distinct standards for each defendant. | Sustained; insufficient to delineate applicable standards for each defendant. |
| Failure to address communication of preeclampsia risks | Qi’s experts identified communication failures about risks/symptoms. | Caughey failed to address this theory. | Sustained; standard-of-care for communication not adequately described. |
| Failure to address diagnosis/admission for elevated BP | Qi claimed failure to diagnose preeclampsia and admit for hypertension. | Caughey did not identify standards breached for diagnosis/admission. | Sustained; such standards not sufficiently identified. |
| Failure to address specific acts of negligence (cuffs, testing, referrals) | Qi’s petition alleged negligent use of cuffs, strips, and failure to refer to specialists. | Report did not address these acts. | Overruled; court found the broader cause-of-action approach allows cure but still remands for extension. |
Key Cases Cited
- Univ. of Tex. Sw. Med. Ctr. v. Dale, 188 S.W.3d 877 (Tex. App.—Dallas 2006) (purely vicarious claims may rely on agent conduct without naming the hospital)
- American Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873 (Tex. 2001) (good-faith compliance with §74.351 must be shown)
- Scoresby v. Santillan, 346 S.W.3d 546 (Tex. 2011) (three elements: standard of care, breach, causation; not mere conclusions)
- Walgreen Co. v. Hieger, 243 S.W.3d 183 (Tex. App.—Houston [14th Dist.] 2007) (good-faith effort requirement; four-corners rule)
- Lopez v. Brown, 356 S.W.3d 599 (Tex. App.—Houston [14th Dist.] 2011) (addressing cause-of-action grouping for liability theories)
- Potts, 355 S.W.3d 683 (Tex. App.—Houston [1st Dist.] 2011) (expert need not address every act so long as at least one theory within each cause is addressed)
- Hayes v. Carroll, 314 S.W.3d 494 (Tex. App.—Austin 2010) (uniform standard of care vs individual standardsBalancing)
- Polone v. Shearer, 287 S.W.3d 229 (Tex. App.—Fort Worth 2009) (distinguishing same standard of care across providers)