Wysonga McGlothlin, appellant, appeals the trial court’s dismissal for want of prosecution of her medical negligence claim against Dr. James Cullington, appellee. We will affirm.
BACKGROUND
The resolution of this case depends largely upon the statutory requirements of the Texas Medical Liability and Insurance Improvement Act (the “Act”); 1 accordingly, a brief summary of the facts should prove sufficient. As a result of a malignant tumor, Ms. McGlothlin, in two surgical procedures per *450 formed by physicians not a party to this suit, had breast tissue removed from and a breast implant inserted into her right breast. After the surgery, Ms. McGlothlin experienced swelling around her right breast and under her arm, and it was necessary that the liquid causing the swelling be aspirated regularly. During this recovery period, Ms. McGloth-lin’s regular surgeon temporarily left town and referred Ms. McGlothlin to a colleague, Dr. Cullington. During the visit, Dr. Cull-ington, while attempting to aspirate Ms. McGlothlin’s swollen breast, allegеdly punctured her breast implant, causing the breast to flatten, which necessitated further reconstructive surgery. Ms. McGlothlin filed suit against Dr. Cullington on February 18, 1997.
The Act requires Ms. McGlothlin, as plaintiff in a medical malpractice lawsuit, to comply with a number of prerequisites in order to preserve her claim. The substance of this dispute concerns the specific requirements of section 13.01, 2 the relevant portions of which provide:
(a) In a health care liability claim, a claimant shall, not later than the 90th day after the date the claim is filed:
(1) file a separate cost bond in the amount of $5,000 for each physician or health care provider named by the claimant in the action;
(2) place cash in an escrow account in the amount of $5,000 for each physician or health care provider named in the action; or
(3) file an expert report for each physician or health care provider with respect to whom a cost bond has not been filed and cash in lieu of the bond has not been deposited under Subdivision (1) or (2) of this subsection.
Tex.Rev.Civ. Stat. Ann. art. 4590i, § 13.01(a) (West Supp.1999) (emphasis added). Should a plaintiff fail to comply with one of the listed requirements in section 13.01(a), the court shall enter an order that:
(1) requires the filing of a $7,500 cost bond with respect to the physician or health care provider not later than the 21st day after the date of the order; and
(2) provides that if the claimant fails to comply with the order, the action shall be dismissed for want of prosecution. ...
Id. (b)(1), (2) (emphasis added).
On April 1, 1997, forty-two days after Ms. McGlothlin filed her lawsuit, the Texas Commissioner of Insurance found Dr. Culling-ton’s insurance carrier, who was responsible for his defense, to be impaired, and the suit was automatically stayed for six months. 3 Ninety days after the automatic six-month stay lapsed, on January 30,1998, Dr. Culling-ton filed a motion to increase security pursuant to the Act asking the trial court to compel Ms. McGlothlin tо file a $7,500 cost bond, or to dismiss the case in the event the bond was not filed. Ms. McGlothlin, in a response to Dr. Cullington’s motion filed on February 26, 1998, claimed by affidavit that she lacked the financial ability to either pay the cost bond or, alternatively, to retain an expert to provide an expert report on causation. 4 On March 12, 1998, the court rendered an order compelling Ms. McGlothlin to file a $7,500 cost bond within twenty-one days. When no cost bond was filed, the court rendered an order on April 13, 1998 dismissing the cause for want of prosecution. Because Ms. McGlothlin failed to comply with the requirements of section 13.01(a) and (b), thе court had no discretion but to dismiss her claim pursuant to the statute. Ms. McGlothlin appeals, arguing that the requirements of section 13.01 of the Act (1) violate the Due Process clause of the United States Constitution, (2) violate the Open Courts Guarantee of the Texas Constitution, and (3) act as a “special law” in viоlation of Article II, Section *451 56, of the Texas Constitution. We do not address whether the trial court’s dismissal was error, but whether the statute, as applied to Ms. McGlothlin, is unconstitutional.
DISCUSSION
We begin by noting that a statute is presumed constitutional.
See Enron Corp. v. Spring Indep. Sch. Dist.,
Dm Process
Ms. McGlothlin initially contends that the cost bond and expert report requirements of article 4590i, section 13.01 violate the due process protections of the United States and Texas constitutions.
See
U.S. Const. amend. XIV; Tex. Const, art. I, § 13, art. III, § 56. Ms. McGlothlin argues that her due process rights were violated because she was not able to pursue her injury claim due to the onerous cost bond and expert report requirements of section 13.01; therefore, the statute uncоnstitutionally restricted the initiation of her medical malpractice claim.
5
When determining whether a statute denies a constitutional right to a litigant, we analyze the statute using the criteria established by
Sax v. Votteler,
Negligent infliction of injury by a medical practitioner is an undisputed cause of action under Texas common law.
See Humphreys v. Roberson,
Passed in 1977, the original Act sought to address what the legislature described as “a medical malpractice insurance crisis in the State of Texas.” See Medical Liability аnd Insurance Improvement Act, 65th Leg., R.S., ch. 817, § 1.02(a)(5), 1977 Tex. Gen. Laws 2040 (Tex.Rev.Civ. Stat. Ann. art. 4590i, since amended). The legislature added section 13.01 to the Act in 1993.
See
Act of May 25, 1993, 73d Leg., R.S., ch. 625, § 3, 1993 Tex. Gen. Laws 2347-49 (Tex.Rev.Civ. Stat. Ann. art. 4590i, § 13.01, since amended).
6
The cost bond and expert report provisions of section 13.01 were enacted “to address the perсeived problem that litigants were filing unmeritorious claims against medical practitioners which were not adequately investigated in a timely manner. This ... led doctors to settle such suits, regardless of the merits, and also to expend great amounts of money on defending against ultimately ‘frivolous claims.’ ”
Horsley-Layman v. Angeles,
Dr. Cullington relies upon two cases for the proposition that the
Sax
balancing test favors the constitutionality of the cost bond and expert report requirements of section 13.01.
See Horsley-Layman v. Angeles,
The
Horsley-Layman
court focused on the lack of evidence indicating why the requirements of a cost bond or expert report would result in an unreasonable financial burden above the costs of a medical malpractice claim in general.
See Horsley-Layman,
The Texas Open Courts Guarantee
Article I, section 13 of the Texas constitution provides:
Excessive bail shall not be required, nor excеssive fines imposed, nor cruel or unusual punishment inflicted. All courts shall be open, and every person for an injury done him, in his lands, goods, person or reputation, shall have remedy by due course of law.
Tex. Const. art. I, § 13 (emphasis added). This clause, commonly referred to as the “Open Courts Guarantee,” acts аs an additional due process guarantee granted in the Texas constitution, prohibiting legislative bodies from arbitrarily withdrawing all legal remedies from anyone having a well-defined cause of action under the common law.
See Sax,
In examining section 13.01 according to these standards, we first note that the statute offers litigants two means of preserving a malpractice claim: (1) a cost bond or cash deposit; or (2) an expert report.
9
The re
*453
quired amount of the cost bond significantly increased in 1995, more than doubling. Moreover, the 1995 statute now requires an actual expert report rather than a mere affidavit stating that a written expert opinion has been procured. However, we do not rеach an analysis of the constitutionality of the new section 13.01 because Ms. McGlothlin has failed to provide sufficient evidence that these requirements actually acted to keep her from pursuing her claim, as was her burden.
See Enron Corp.,
Ms. McGlothlin gives no reason in the record for not complying with the Act within the initial 90 days after filing suit. 10 We thus have no indication that Ms. McGlothlin ever attempted to comply with the statute. She claims by affidavit that, “based upon information from my attorney,” experts require a $2,000 retainer to furnish a report. This is, of course, hearsay, and no evidence that a $2,000 threshold actually exists. The statute cleаrly implies the expert report is but a minimal requirement, and includes numerous allowances for plaintiffs filing an expert report. 11 Finally, the affidavit makes no mention of any actual attempt to obtain an expert report, only some perceived financial barrier. Ms. McGlothlin’s failure to comply could be due as much to oversight or mistake as to actual financial inability. Accordingly, Ms. McGlothlin’s affidavit is wholly insufficient to establish proof that section 13.01 is unconstitutional as applied to her. We overrule her due process challenges.
Special Law
Ms. McGlothlin additionally claims that section 13.01 violates article III, sеction 56 of the Texas constitution, which states “in all other cases where a general law can be made applicable, no local or special law shall be enacted.” Tex. Const. art. III, § 56. She contends that section 13.01 creates a separate class of physicians proteсted from suit by section 13.01. A statute is not special or local if it operates on a subject in which people at large are interested.
See Langdeau v. Bouknight,
CONCLUSION
Because the record fails to reflect any evidence of Ms. McGIothlin’s actual financial inability to comply with the requirements of section 13.01, she has not carried her burden of demonstrating that the statute fails to meet constitutional requirements. Moreover, because section 13.01 addresses the important state interest of containing medical mаlpractice insurance costs, it is not a special law under the Texas constitution. We overrule appellant’s points of error and affirm the order of the trial court.
Notes
. See Tex.Rev.Civ. Stat. Ann. art. 45901 (West Supp.1999).
. See Tex.Rev.Civ. Stat. Ann. art. 4590Í, § 13.01 (West Supp.1999).
. SeeTex. Ins.Code Ann. art. 21.28-C, § 17 (West Supp.1999).
. Ms. McGlothlin states in her affidavit:
It is my understanding such an expert report would have to be a physician because Dr. Cullington, the defendant in this case, is a physician. It is my further understanding, based upon information from my attorney, that an expert physician would likely require that I pay him a retainer of at least $2,000.00 in order to engage the expert and obtain a liability report from him. I do not have the financial ability to рay such a large sum of money and therefore could not obtain an expert's report.
. We will discuss Ms. McGlothlin’s due process challenges under the Texas and United States constitutions together, as our analysis is disposi-tive of both points.
. In its original form, entitled Affidavit or Cost Bond, section 13.01 required the affidavit of the plaintiff or plaintiff's counsel attesting to an obtained written opinion of an expert to be filed within ninety days of the commencement of the action, or, in the alternative, a $2,000 cost bond. Tex.Rev.Civ. Stat. Ann. art. 4590i, § 13.01(a), (b) (West Supp.1999). Should the plaintiff fail to comply with either of these alternatives, the cost bond, upоn motion, would be increased to $4,000; should another thirty days pass without the filing of an expert report or the $4,000 cost bond, the action must be dismissed by the court without prejudice. Id.% 13.01(c).
. Texas law has traditionally required expert testimony to establish causation in medical malpractice actions.
See Hart
v.
Van Zandt,
. See note 6, infra.
.Section 13.01 defines "expert report” as a
written report by an expert that provides a fair summary of the expert’s opinions as of the date of the report regarding applicable standards of care, the manner in which the care rendered by the physician or health care provider failed to meet the standards, and the causal relation *453 ship between that failure and the injury, harm, or damages claimed.
Tex.Rev.Civ. Stat. Ann. art. 4590i, § 13.01(r)(6) (West Supp.1999).
. Ms. McGIothlin's affidavit claiming financial inability was filed on February 26, 1998, in response to Dr. Cullington's motion to increase security, more than one year after she originally brought suit. Thus, she was given substantially more than the statutory 90-day period in which to procure a report or file a cost bond.
. Section 13.01 contains several subsections defining the nature and use of an "expert report," including:
Section 13.01(j): "[Njothing in this section shаll be construed to require the filing of an expert report regarding any issue other than an issue relating to liability or causation.”
Section 13.01 (k): “[Njotwithstanding any other law, an expert report filed under this section: (1) is not admissible in evidence by a defendant; (2) shall not be used in a deposition, trial, or other proceeding; and (3) shall not be referred to by a defendant during the course of the action for any purpose.”
Section 13.01(Z): “[A] court shall grant a motion challenging the adequacy of an expert report only if it appears to the court, after Hearing, that the report does not represent a good faith effort to comply with the definition of an expert report in Subsection (r)(6) of this section.”
Tex.Rev.Civ. Stat. Ann. art. 4590i, § 13.01 (j), (k), (Z) (West Supp.1999) (emphasis added).
