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Salais v. Texas Department of Aging & Disability Services
323 S.W.3d 527
Tex. App.
2010
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*1 rights stating that enlarges tion Pena’s appeal

he not. right SALAIS, has to when he does Ana Maria Gonzalez Individu easily appeal distinguishable Pena’s ally Representative and as of the Es right from Few’s Few to appeal: had the Gonzalez, Deceased, tate of Ruben Ap appeal, procedural but a trivial mis- made pellants, take; right Pena to appeal had place. first Few, right Pena

Unlike has no TEXAS DEPARTMENT OF AGING appeal to this case because he confessed SERVICES, & DISABILITY Tex.R.App. exchange plea bargain. for a P. Appellee. 25.2(a)(2); 728; see Wayne, at Few, such, No. at 186. 10-09-00155-CV. S.W.3d As rule 25(a)(2) appeal. does authorize Pena’s Texas, of Appeals Court Morgan, See at S.W.3d 538. “We Waco. deficiency resolve the the trial court’s certification against finding jurisdic Aug. 2010. appeals, tion.” Id. at “A 538. court of having jurisdiction while to ascertain

whether an appellant plea bargained who permitted 25(a)(2), appeal by to rule prohibited

must dismiss a without appeal action, regardless

further for the basis State,

the appeal.” Chavez (en banc). (Tex.Crim.App.2006) judge certifying

While the trial erred in appeal,

Pena’s case for fact remains 25(a)(2)

that Rule grant juris does not us appeal.

diction to hear this Morgan, 185 Greenwell,

S.W.3d at See

at 649. if we Even were to the trial order certification,

court to amend its Pena

would appeal still be unable to convic Tex.R.App. 25.2(a)(2);

tion. See P. see also 538; Greenwell,

Morgan, 185 at 649. We conclude that we

do not need order the trial court

correct the certification because the record

affirmatively demonstrates that Pena does

not have right appeal.

III. Conclusion reasons,

For the foregoing we dismiss appeal jurisdiction.

Pena’s lack of for *3 go refused to to bed and was then

had by Sheri Thornton physically restrained Korn, employees. and Charles two TDADS Thomas, ar- employee, After Joel a third rived, they Ruben restraint placed on a Sanderson, nurse, a TDADS board. Sue called the scene and found Ruben pulse pressure. with no or blood pale was unable resuscitate Ru- Sanderson *4 An ben. automated external defibrillator (AED) but employed, was it was used arrived and to shock Ruben. Paramedics a flat line and no their monitor showed rhythm. to cardiac Ruben was taken pronounced hospital, where he dead. pleads: Salais also & Management In Prevention Synopsis Behavior Aggressive Course allegedly provided Defendant Mexia employees, employ- to its [State School] ees are warned that care “[e]xtreme during any must be exercised horizontal that abil- person’s restraint to insure Weber, R. Keith Woodfill & Pressler ity to is not breathe restricted.... LLP, Houston, Appellants. for restraints, [D]uring all horizontal Office, Giberson, Atty. John P. General’s side-lying posi- remain in a person must Division, Austin, Litigation Neal E. Tort continuously. Fail- tion and monitored Howell, LLP, Pirkle, Ñaman, Smith & Lee may injury ure to do risk serious and so Waco, for Appellee. positional asphyxia, death from [which] occurs when there insufficient intake GRAY, Before Justice Chief Justice oxygen body positioning a result of as REYNA, and Justice DAVIS. ability interferes with one’s orig- in [Ellipsis breathe.” and brackets OPINION inal]. DAVIS, REX D. Justice. that the “Mexia State pleads She further Maria appeals Ana Gonzalez Salais Synop- Retraining School Annual Course court’s her health- dismissing trial order sis,” partici- allegedly provided every De- against claim the Texas gives warning and also pant, the same Disability and Services partment Aging person “that the is restrain- provides who (TDADS). ing body important the lower has an role circulation, breathing, alleges monitoring that her son in and petition Salais’s live Me- individ- patient general Ruben was a at the condition restrained Gonzalez ual, maintaining School, facility, assisting be- and xia State a TDADS side-lying posi- in a developmental disability. restrained individual cause of his (after Ruben evening midnight), Late one tion.” liability cause of ac- straint board and the AED. The

In her health-care other Winston, M.D., tion, report, of that TDADS Donald address- alleges [Mexia Salais es the causation element. employees and TDADS State School] Korn, Thornton, negli- Thomas were objected TDADS reports in the care and treatment of Ruben gent moved to dismiss Salais’s health-care lia- followingways: each of bility claim under section 74.351. See id. The motion asserted that experts Salais’s recognize appreci- 1. Failure to and/or were not and that their reports potential ate the risk factors for the were inadequate. granted The trial court perform- of death when occurrence motion to TDADS’s dismiss without stat- restraint; ing physical ing issue, In any grounds. her first Salais of the restraints and re- Misuse argues that the trial court in grant- erred performing board when straint ing TDADS’s motion to dismiss. restraint; physical review the trial We court’s deci anticipate the risk of trau- 3. Failure *5 liability sion to dismiss a health-care claim a asphyxia performing matic when by the abuse-of-discretion standard. restraint; physical Tex., American Transitional Care Ctrs. of plan physical 4. Failure to the restraint (Tex. Palacios, 873, Inc. v. 877 according to the increased risk for 2001). Also, a trial court’s decision on Decedent; injury serious person whether a is to offer an Inappropriate management of the expert opinion liability a health-care performing physi- of complication claim is reviewed under the abuse-of-dis restraint; cal Gatica, cretion standard. Moore v. requisite the 6. Failure to have knowl- 134, 139 (Tex.App.-Fort Worth edge regarding appropriate respons- denied). 2008, “However, pet. a trial court restraint; physical es to a combative determining has no discretion in what the perform appropriate 7. Failure to the law is or the to the applying law facts. during physical interventions re- Packer, 833, Walker straint of Decedent once health com- (Tex.1992). by A clear the trial failure encountered; were plications analyze apply correctly court to or the law Id.” will constitute abuse of discretion. provide proper 8. Failure to education Heart, Webb, P.A. v. training to Austin employees and who were 2007, no (Tex.App.-Austin 279-80 in the upon called to assist restraint pet.); Hosp. Shep Methodist see also of Decedent. (Tex. herd-Sherman, Practices Section 74.351 Civil and App.-Houston pet.) [14th Dist.] provides that within 120 Remedies Code may judg not our (“Though we substitute suit, a claimant must serve a days filing of court, ment for that of the trial the trial (CV) curriculum vitae and one or more determining court has no discretion in expert reports regarding every defendant applying what the law is or law against whom a health care claim is assert- facts.”). ed. Tex. Civ. Prac. Ann. Rem.Code & (Vernon Salais Supp. pro- 74.351 Report Wohlers reports. One was vided two Qualifications Wohlers, paramedic, which James care and breach motion to dismiss and brief addresses the standard of TDADS’s the re- assert that and CV do relating elements to the use of Wohlers’s (b) qualifications testify not establish his In involving a suit a health care the standards of care about claim against pro- health care vider, the Mexia State School healthcare staff or person may qualify as an to the treatment for individuals with be- witness issue of whether havioral, mental, developmental and dis- health care provider departed from ac- abilities. Its brief also asserts that Woh- cepted only per- standards of care if the that lers’s does show son:

“management and care” of Ruben on the (1) practicing is health care in a field question “something occasion in univer- practice that type involves the same sally done.” of care or treatment as that delivered

Regarding qualifications, Wohlers’s provider, defendant health care if report states: provider defendant health care anis individual, my

I at the time the paramedic testimony received education Creighton University given from in 1992. or practicing type of Omaha, I Initially paramedic arose; was a health care at the time the claim Nebraska from 1992 to then a (2) has knowledge accepted stan- paramedic City for the County dards of for providers health care from Denver 1996 until 2000. Since care, diagnosis, for the or treatment of 2000,1 have been with the Grand Island illness, injury, or condition involved Island, Department Fire in Grand Ne- claim; paramedic/firefighter. braska as a I *6 (3) qualified training on the basis of have also been involved in restraint as- experience or to offer an expert opinion phyxia education since I teach regarding accepted those standards of EMS, Law Enforcement persons and health care. involved in the restraining of combative (c) determining In whether a witness is persons. I qualified have been as an qualified on the basis of training or ex- expert in asphyxia. the field of restraint perience, the court shall consider wheth- history Wohlers’s CV restates the above er, at the time the claim arose or at the and notes his certification as an EMS in- testimony time the is given, the witness: structor specializes and that he in “re- (1) is by licensing certified agency straint-related issues” and instructs on of one or more states of the United Support Advanced Life and Basic Life States professional certify- or national Support topics. His further states: ing agency, or has other substantial I am familiar with the standard of training experience, or in the area of restraining care for person combative claim; health care relevant to the and steps and understand what should be (2) actively practicing health care in taken respiratory to monitor for dis- rendering health care services relevant education, Through my tress. back- to the claim. ground experience, I am knowledge- 74.402(b, § Civ. Prac. & Rem.Code Ann. able in the standard of care that Tex. c) (Vernon 2005). staff of Mexia State School should have provided night to Mr. Gonzales disagree We that Wohlers was re he died. quired to be general as an On the issue of qualifications, Wohlers’s about the applica standards of care statute, we turn applicable section ble to the Mexia State School healthcare 74.402, which provides pertinent part: staff for the care and treatment for indi- behavioral, mental, viduals with and devel cause it does not articulate the relevant Rather, under the opmental disabilities. standard of care the bases for the and/or 74.402(b)(1, literal of subsections language relevant standards of applicable care 2), only required practic Wohlers is to be TDADS and it does not specifically state in a ing practice health care field of that the manner in which TDADS breached the type involves the same care or treatment of standard of care. as that delivered health the defendant provider knowledge care and have considering When a motion to dis accepted of care for health care standards 74.351(b), miss under subsection the issue or providers for the care treatment is whether the report represents good- of condition involved in the claim. See id. faith effort comply statutory with the 74.402(b)(1,2); see, § e.g., Group Vicen definition an expert report. See Bowie ta, (Tex.App. 730-31 Hosp. Wright, Mem. denied). 2005, pet. Houston [14th Dist.] Palacios, (Tex.2002); 46 S.W.3d at 878. allegations Based on Salais’s the infor An “expert report” is “a written report by mation in report, type Wohlers’s provides that a fair summary of care or treatment and the condition in the expert’s opinions as of the date of the of physical volved is the use restraint and report regarding applicable standards of a restraint board on a person. combative care, the manner in which the care ren report and Wohlers’s CV show he is a physician dered or health pro practitioner certified and instructor standards, vider failed to meet the and the health care services relevant to the health causal relationship between that failure case; care liability claim in this he has harm, injury, and the or damages paramedic been a since 1992 and has been claimed.” Tex. Civ. Prac. &Rem.Code ANN. instructing asphyxia on restraint since 74.351(r)(6). 2006, including teaching persons involved restraining persons. combative In determining whether the re His states that he is familiar with *7 effort, port represents good-faith a the restraining the standard of care for a com inquiry is limited four corners of the person knowledgeable bative and is of the Palacios, report. at 878. The standard of care that the staff of Mexia report only represent need good-faith a State School provided should have to Ru effort to fair provide summary a night ben on the respect he died with to expert’s opinions. report Id. The does the use of physical restraint and a re plaintiffs not have to marshal all the straint board. proof plaintiff present and the need not Under the criteria in section in report actually evidence the as if it were 74.402(b), report Wohlers’s and CV demon- Rather, litigating the merits. Id. at 879. qualified strate that he is to offer an ex- effort, good-faith report to constitute a the pert opinion accepted standards of care, breach, must address standard of care for type this of care or treatment specificity and causation with sufficient to TDADS per- healthcare staff of combative inform the defendant of the conduct the sons. To the extent trial court con- plaintiff question provide calls into and to otherwise, cluded the trial court abused its a basis for the trial court to conclude that discretion. the claims have merit. Id. at 875. Adequacy motion The Wohlers notes that he

TDADS’s to dismiss asserted inadequate that Wohlers’s be- an in has been as restraint forth his familiari investigative report Wohlers’s sets It cites an asphyxia. the course of ty that he reviewed and details with the standard of care and the basis employees of three therefor, is, events and the conduct care and what the standard of Thornton) (Thomas, Korn, in placing and it on how the TDADS staff breached and, according Ruben on a restraint board in The address question. occasion Thomas, strap across using restraint care breach with es the standard of and which Ruben “was diaphragm, his after inform TDADS of specificity sufficient hard, making gur- breathing gasps, in and question that Salais calls into conduct Korn, According to a re- gling sounds.” provides and a basis for the trial court to chest, Ruben’s strap straint was across the claims have merit. See conclude that in only “slight rise” and Korn observed Palacios, at 875. It informs chest; pulse. a weak Ruben had expected TDADS “what care was but on the restraint Thornton observed Ruben Wenkstern, given.” Fagadau asleep, but he thought board and he was (Tex.App.-Dallas “funny” breathing looked and was shallow. h.) Palacios, pet. (citing arrived, find- Nurse Sanderson and after To the extent the trial court concluded abnormally pale, color to be ing Ruben’s otherwise, the court abused its discre trial initi- pressure, pulse, no blood and no she tion. attempted ated and to use an AED. CPR arrived, then over Mexia took Fire/EMS

CPR, Report intubation Winston and did an endotracheal transferring before Ruben to Parkview 74.351(i) permits Section Regional Hospital, pro- where he was satisfy any requirement of claimant to sec nounced dead. states: Wohlers serving expert report by tion 74.351 for I am familiar with the standard of serving reports separate experts. Tex. restraining person for combative 74.351(i); see Ann. Civ. Prac. Rem.Code & be steps and understand what should Guerra, Packard v. respiratory taken to monitor for dis- (Tex.App.-Houston pet. [14th Dist.] education, Through my tress. back- denied). can Expert reports be consid ground experience, knowledge- I am together determining ered whether able the standard of care plaintiff a health-care action has staff of Mexia State School should have regard provided adequate opinion Mr. provided night Gonzalez on care, breach, cau ing the standard of he died. *8 Walgreen Hieger, sation. See Co. v. requires The standard of care that if 2 (Tex.App.-Houston 186 n. any of persons one the involved denied); pet. Martin v. [14th Dist.] restraining recog- of Mr. Gonzalez had Center, Med. No. 11-04- Regional Abilene distress, nized that he was in respiratory (Tex. 00303-CV, 241509, at *4-5 2006 WL placed he not have been on a should (mem. 2, 2006, pet.) App.-Eastland Feb. straps placed restraint board and had physician’s A on causation op.). report anyone across his chest. Had not read in isolation. See Mar should be the of prevented application restrainers tin, *4; at see also Tex. WL board, likely the restraint it is more than not Mr. that Gonzalez would Ann. Civ. Prac. & Rem.Code 74.351(r)(5)(C) a (providing only § that asphyxia. have suffered restraint No expert giving opinion can be an physician of application one intervened testimony relationship). causal restraint board. on Petition in Qualifications Cause 28901A which states employees that three of Mexia State and brief TDADS’s motion dismiss School physically restrained Mr. Gon- Dr. assert that Winston’s CV time, period zales. After a a nurse at qualifications testify do not establish hospital found Mr. Gonzales dead. Its brief first asserts about causation. failed, Resuscitation and after endotra- showing there is no that Dr. Winston that chial by [sic] intubation Mexia Fire De- means, physician. “Expert” is a licensed EMS, partment he was taken to Park- person opinion a respect giving “with Regional view Hospital where he was testimony relationship about the causal be pronounced dead. harm, damages or injury, tween the alleged departure claimed and the from My Autopsy focus is on the any standard of care in Case No. JP0Í87-07-0120ACG done claim, physician health care a who January 16th 2007. qualified opinions to render on is otherwise agree physical I findings with the of: relationship such causal under the Texas 1. Petechiae in the right and left Rules of Evidence.” Tex. Prac. & Civ. conjunctivae (Vernon 74.351(r)(5)(C) § Ann. Rem.Code 2. to the right Contusions arm and Prag 2009); Supp. see also Tex. Civ. & leg left 74.408(a) (Vernon 2005). Rem.Code Ann. hemorrhage Subcutaneous Dr. in a letter for- Winston’s upper back and lower back mat, typed signa- and his letterhead and him identify ture block as “Donald Win- 4. Two subgaleal hemorrhages ston, MD.” His letterhead also reveals his 5. Abrasions and contusions on face (www.urbansurgeon.com) and his website and arms email address at that website. Further- asphyxia 6. Mechanical more, his December 2008 CV reflects that disagree I with final opinion (No. physician he is licensed Texas pathologists nine to the extent F0832, ex- February licensed 1978 and there is evidence that Mr. Gonzales in May TDADS’s assertion piring death, any way contributed to his own showing that there is no that Dr. Winston I agree but that his death was homi- physician a licensed is incorrect. cide caused restraint and mechanical Winston’s is a letter to Sa- him three asphyxia imposed on attorney entirety: states in its lais’s employees. Mexia State School your request, At I have reviewed an questions, please If you any have other autopsy report and death certificate of feel free to contact me.1 Gonzales, Hispanic Ruben year old

male apparently who student correct that Dr. TDADS is the Mexia State School. he is report fails to show how Winston’s on expert opinion to render an way knowing exactly I have no what *9 15, 2007, the in case. Rule 702 of place January took on or about causation this an requires I of Evidence that but have reviewed a Third Amended Texas Rules part properly of the 1. To the extent that Salais has asserted a court dismissed liability alleged claim health-care based on Ver- claim. See Benson v. health-care (it report, 755, the AED in the Wohlers non, misuse of is (Tex.App.-Waco 303 S.W.3d 760-61 Salais), pleaded by but it is not there is "no 2009, pet.). no causation, report" at all and the trial as 536 skill,

expert qualified by “knowledge, drawing be inferences or guessing as to what experience, training, likely or education.” meant or intended.” Heart, qualifications Tex.R. Evid. 702. The of an Austin 228 S.W.3d at 279. But here, in there is appear report gap, must itself and no and there is no Dr. Hall, guessing, that opinion cannot be inferred. v. Winston’s See Benson 10-09-00284-CV, 376957, cause of Ruben’s 2010 death —“restraint and No. WL mechanical 3, 2010, asphyxia imposed on him *1 (Tex.App.-Waco pet. Feb. no the three Mexia h.); 19, employ- State School Estorque Schafer, v. 302 S.W.3d 26 ees”—is the same conduct 2009, referred to pet.); (Tex.App.-Fort Worth no Phi report being Wohlers as 682, the three v. lipp McCreedy, 298 S.W.3d 686 Mexia State employees’ School breach of 2009, (Tex.App.-San pet.); Antonio no the standard of care in restraining per- Pokluda, Baylor College Medicine v. respiratory son in distress. 110, (Tex.App.-Houston 283 S.W.3d 117 2009, pet.); no [14th Dist.] Hansen v. reports When the together, are read as Starr, 13, (Tex.App.-Dallas case, they they must be this satisfy the denied). 2003, pet. Dr. report Winston’s causal-relationship requirement because qualifications does not forth set at all. they a good-faith constitute pro effort to currently His CV reflects that he is prac a fair summary vide of the causal relation ticing in emergency the field of medicine in ship between the employees’ conduct and positions Houston has held several as Ruben’s death asphyxia. restraint See Martin, an emergency physician 241509, medicine 2006 WL at *5. Read general surgeon. together, they provide and trauma Aside from “enough informa itself, linking tion being report their not defendant’s breach these of the standard of care to position descriptions plaintiffs inadequate injury.” alone are Gomez, 1, (Tex. Baker v. 276 S.W.3d to show how Dr. Winston qualified denied). 2008, App.-El pet. Paso And be opine on the relationship causal of Ruben’s Dr. cause Winston’s link does Merely being death. a physician is insuffi death, employees’ conduct with Gonzalez’s qualify cient to expert. as medical See Bogar TDADS’s reliance on Esparza v. Heise, 148, Broders v. Healthcare, and Shaw v. BMW Inc. (Tex.1996); Tisdale, Hagedorn misplaced, as distinguish those cases are 341, 2002, 350 (Tex.App.-Amarillo able on that basis. Bogar Esparza, pet.). no Cf. 364 (Tex.App.-Austin Because there is no in Dr. showing Win- (“In essence, pet.) Adame’s give ston’s that he is autopsy is a second report, opining about causation, expert opinion on to the extent the cause of Ms. Guerrero’s death without granted the trial court the motion to dis- (em how.”) explaining who caused it or basis, miss on this it did not abuse its added); phasis Healthcare, Shaw v. BMW discretion. We overrule Salais’s first is- Inc., 12-13 (Tex.App.-Tyler sue. denied) (“An pet. (op. reh’g) opin on Adequacy solely ion addressing the cause of death Because disposition of our does not satisfy statutory require issue, ments.”). second we must address TDADS’s challenge adequacy of Dr. Winston’s Extension its motion to dismiss. On the

adequacy 74.351(c) of Dr. report, Winston’s we are provides: Subsection “If an ex- *10 precluded filling “from gaps report by pert report a has not been served within the (a) because health claim specified against Subsection care the Tex- period deficient, Department Aging Disability are found as elements and extension may grant 30-day one Services. Because the trial court court did not the defi- to the claimant order to cure in granting abuse its discretion TDADS’s ciency.” Tex. Civ. Prac. & Rem.Code motion to dismiss or in denying Salais’s Ann. 74.351(c). issue, § In Salais her second 30-day extension, a request for should we that the its dis- asserts trial court abused judgment. affirm the trial court’s Because mo- granting in not her alternative not, cretion I respectfully Court does dissent. cure thirty-day tion for a extension to her

expert report’s deficiency. BACKGROUND re The docket sheet to appears son, Gonzalez, pa- Salais’s Ruben awas motion, trial flect the court’s denial of that tient at facility, a TDADS State Mexia “of-rec but docket-sheet entries are not an School. After altercation with rulings. Any judgment, order or to ord” staff, State School Gonzalez on placed effective, must of record. be be entered a restraint board. He then Salais died. 516, Kocman, Kocman sued both TDADS and the State Mexia writ); (Tex.Civ.App.-Waco no see granted School. trial court The TDADS’s Corp., also Willis Nucor 282 S.W.3d motion to dismiss. pet.). (Tex.App.-Waco appeal, argues In two on issues Salais technically Winston’s the trial court in granting erred “no re opposed being deficient —as to TDADS’s motion to dismiss pursuant qualifi port” report lacks —because section of the Texas 74.351 Civil Practice give an on causa opinion cations denying and Remedies Code and erred in appropriate is thus this tion. It to remand for a request 30-day Salais’s extension to the trial court so it can exercise its case 74.351(c) pursuant to section of the Texas thirty-day grant discretion whether to a and Civil Practice Remedies Code. attempt so that can extension Salais Heart, deficiency. cure this See Austin Dismissal 284-85; re see In Bust also Section 74.351 of the Civil Practices and (Tex.2008) (“A er, provides Remedies that within Code by will some unqualified expert days filing, a claimant must serve good- (though always) reflect times curriculum vitae and one or more 30-day justify faith effort sufficient to reports every against regarding defendant extension.”). whom a health claim is asserted. Accordingly, we sustain the second issue 74.351(a) & Tex. Civ. Prac. Rem.Code Ann. court and remand this cause to the trial (Vernon has “Section 74.351 Supp. instruction to and rule with the consider subparts, including: numerous exten- thirty-day on Salais’s motion for a (cid:127) (b) deficiency in attempt sion to to cure the requiring trial courts to subpart report. Dr. Winston’s award prejudice dismiss a claim with been expert report fees if “an has not dissenting. Justice GRAY Chief deadline; statutory served” GRAY, Justice, dissenting. TOM Chief (cid:127) (c) exten- allowing 30-day subpart found deadline if a appeals Ana Maria Gonzalez Salais sion of the judgment dismissing inadequate; her trial court’s *11 538 Palacios,

(cid:127) (l) 52; at that a motion 79 at 46 S.W.3d subpart providing S.W.3d “Rather, adequacy should be the challenging report’s expert explain 879. the must repre- only report if the does granted to link his conclu- basis his statements the comply effort to with good-faith sent a Ratliff, to the facts.” Earle v. 998 sions Funderburk, v. 253 statute.” Lewis (Tex.1999). 882, 890 S.W.2d (footnotes (Tex.2008) omit- 207 S.W.3d We review a trial court’s order dismiss ted); Prac. & Ann. Tex. Civ. Rem.Code the ing comply a claim for failure to with (i) (Vernon 2009). 74.351(b), (c), Supp. § requirements an report under considering a motion to dismiss When Bowie, 79 abuse-of-discretion standard. 74.351, the for the trial under section issue Palacios, 52; at 46 at 878. S.W.3d S.W.3d report represents the court whether Expert reports that omit at least one of the statu- good-faith comply effort with specifically require the three enumerated tory expert report. definition of an See expert report of an cannot consti ments Hosp. Wright, Bowie Mem’l good tute a faith effort to meet the statu (Tex.2002); American Transitional tory requirements. Jernigan See Tex., Palacios, Inc. v. Care Ctrs. of (Tex.2006); Langley, 195 S.W.3d (Tex.2001). “expert An S.W.3d Palacios, 46 at 879. report” means: report by pro- A written provided reports Salais two to serve as summary expert’s a fair of the vides expert report. report pre- her One was of the date of the opinions as Wohlers, pared by paramedic James regarding standards of Nebraska, alleged from which Salais ad- care, ren- the manner which expert report dressed the elements of the by physician dered or health care standard of care and the breach of that provider failed to meet standards The other report prepared standard. was relationship and the causal between that Winston, by physician Donald from harm, injury, damages failure and the or alleged Houston. Salais re- Winston’s claimed. port addressed the causation element. Tex. Prac. & Ann. Civ. Rem.Code complains, agree, TDADS and I that Dr. (Vernon 74.351(r)(6) Supp. To report wholly Winston’s fails to address effort,” “good-faith constitute a the causation element. care, breach, must discuss standard Assuming deciding without that Dr. specificity and causation with sufficient (1) Winston is otherwise to render an purposes: fulfill two to inform the de- causation, opinion on he does not. Dr. specific plaintiff conduct the fendant (2) question; provide has called into Winston states that he re- a basis for the trial court to conclude that autopsy report viewed the of Ruben Gon- Bowie, merit. Then, the claims have 79 S.W.3d zalez and the death certificate. he Palacios, 52; at at 879. that, although he simply disagrees states the nine on Gon- pathologists with whether expert’s The must include the for his own part responsible zalez was opinion on each of the three elements that death, with them in their conclu- agrees he care, the statute identifies: standard sion that it homicide caused re- Bowie, breach, relationship. and causal “im- 52; Palacios, asphyxiation straint and mechanical at posed on him the three Mexia State merely expert’s A report cannot state Borne, employees.” these School conclusions about elements.

539 Dr. alleged What Winston fails do is draw the breach injury. and the According- explain connection or the causal link be ly, I would hold that Dr. Winston’s report negligent specific tween the actions of a does not meet the requirement of an ex- (the health care elements of provider stan pert report because there nothing in the by dard of care and breach as described report that addresses the causal connec- Wohlers, the other purported expert) and tion by between the breach the Mexia (Gonzalez’s death). damages/injury In State School employees of the standard of words, other report on causation must allegedly care as contained in Wohlers’s make the by connection that the death report the injury, the death of Gonza- asphyxiation mechanical was caused lez, claimed. The causation element has Wohlers, conduct described assuming been omitted from the report. that was in adequately presented the other Because Salais’s expert reports omit at Bowie, expert report. See 79 at S.W.3d least one of the specifically three enumer- 53. Because Dr. Winston did not indicate (r)(6), ated requirements of subsection he had purported reviewed other ex they cannot good constitute a faith effort pert’s report, required this connection is to meet those requirements. I need not Further, simply missing. it impermissi objections decide TDADS’s to Wohlers’s ble to infer that the conduct referenced in report. Accordingly, because the trial report one is the for the basis conclusions court did not abuse its discretion in grant- Heart, report. in the other See Austin ing TDADS’s motion to dismiss Salais’s Webb, 276, (Tex. P.A. v. 279 TDADS, against suit Salais’s first issue 2007, App.-Austin pet.). no should be overruled. Winston’s is similar to an expert report discussed Shaw v. B.M.W. Continuance

Healthcare, Inc., (Tex.App.- 100 S.W.3d 8 denied). 2002, Tyler Shaw, pet. In Salais argues further that should we de Shaws expert reports filed two to address deficient, termine the reports were we elements, the three one a physician from should remand the matter back to the trial registered and one from a nurse. The 30-day court for a extension. See Tex. Civ. agreed Shaws that the physician’s report 74.351(c)(Vernon Prac. & Rem.Code Ann. applicable did not set out the standards of 2009). Supp. parties agree The and the care or address how the defendants trial court’s docket that a sheet indicates any breached They argued, standards. request 30-day for extension was denied. however, that those omissions were irrele- 74.351(c) provides part Section that the physician only vant because the rendered trial may grant 30-day court one extension an opinion Citing on the cause of death. deficiency to the claimant to cure a in an Palacios, Tyler of Appeals Court expert report. “may” Id. The term as held that because there was no discussion (c) used in subsection vests the trial court as standard with grant 30-day discretion to exten standard, any of care and breaches of that Wilbarger Hosp., sion. Bosch v. Gen. an opinion solely addressing the cause of (Tex.App.-Amarillo satisfy statutory death did not require- denied); Marsh, pet. Hardy Shaw, ments of an report. (Tex.App.-Texarkana 870-71 Palacios, (citing 46 S.W.3d at pet.). Shaw, Like the Dr. Win- report only deciding ston’s I assume without that once the addressed Gonzalez’s cause of death without a link between the trial court determines that the fur- good faith ef- not constitute nished did FLEMING, Appellant, Mark requirements

fort to meet *13 can, nevertheless, court report, the trial cure the defi- extension to grant 30-day Texas, The STATE of State. extension, the such an ciency. grant To No. 2-09-215-CR. the to- have to consider trial court would surrounding the circumstances tality of the Texas, of Appeals Court of such as the diffi- preparation report, Fort Worth. plaintiff culty, any, if encountered Aug. 2010. necessary experts or obtaining necessary for the medical records getting Discretionary Review Granted review, diligence Dec. spe-

plaintiff securing claim,

cific of healthcare type 30-day would have

whether a extension defect, plaintiff to cure the

allowed deficiency prof-

the extent of the report. This list of considerations is

fered

by no means exhaustive. case, pro

But in this we have not been any from which we could

vided record

review the trial court’s determination. Be review, Salais

cause we have no record to support complaint

is unable to that the in failing

trial court abused its discretion 30-day See In the grant extension. (Tex. D.W.,

Interest (because 2008, no App.-Fort pet.) Worth on to extend hearing

no record motion deadline, presumes

dismissal court evi supported ruling

dence trial court’s and no shown).

abuse of discretion

Salais’s second issue should be over-

ruled.

Conclusion issue,

Having overruled each I would interlocutory

affirm the order of dismissal

of the trial court. Because the Court does

not, I respectfully dissent.

Case Details

Case Name: Salais v. Texas Department of Aging & Disability Services
Court Name: Court of Appeals of Texas
Date Published: Aug 4, 2010
Citation: 323 S.W.3d 527
Docket Number: 10-09-00155-CV
Court Abbreviation: Tex. App.
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