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Requirement of Expert Report in Texas Medical Negligence Cases

In Methodist Health Centers v. Crawford, a Texas woman’s son and daughter sued a health center for medical malpractice in connection with its care of their mother. The mother was admitted to a nursing facility with a history of diabetes and dementia. She had a pressure ulcer on her back and needed a feeding tube. A month later, she was transferred to the defendant’s hospital for treatment of her urinary tract infection and vomiting. She also had another pressure sore on her hip. A few days later, the pressure ulcers had gotten worse. She was discharged back to the nursing facility. A few months later she again had vomiting, a fever, and shortness of breath and was transferred back to the hospital.

Her condition deteriorated in spite of antibiotics and other treatment. She died of pneumonia, infection, and respiratory failure a few days later. Her son and daughter sued the medical and nursing facilities, both individually and as the woman’s heirs. They attached a doctor’s expert report and CV to the petition, as required by Texas law. They settled with the nursing facility, but the hospital moved to dismiss for failure to serve an adequate expert report. The trial court denied the motion to dismiss.

Under Texas law, a plaintiff must serve a defendant with an expert report, along with a CV of the experts listed in the report. An expert is only qualified to offer an opinion on whether the health care provider deviated from the standard of care if the person practices health care in the same field as the defendant, knows the accepted standard of care for the provider, and is qualified due to training or experience to offer an expert opinion about the standard of care. If a doctor doesn’t state in the expert report that he or she has knowledge of the standard of care, the court will find he or she is not qualified to offer an opinion.

The appellate court explained that the claim against the health care center involved standards of nursing care. Doctors familiar with the appropriate standard of care for nurses in this situation could offer an opinion about whether the nurses departed from the standard of care. The doctor in this case discussed his training and education in wound care, he was board certified as a wound specialist, and he served both as director and active physician at a center for wound care. He had also practiced geriatric medicine in multiple settings. In his report, he referred to the standard of care for nurses and showed his familiarity.

The health care center argued that his report didn’t demonstrate familiarity with the standard of care for nurses. It also argued that it didn’t specifically consider critically ill patients in a hospital setting, as opposed to a nursing setting. The court explained that the doctor did describe not only the standard of care, but also what would happen if nurses did not meet the standard of care. His CV noted that he was an active member of the staff at two hospitals, and therefore his training and experience went beyond a nursing setting. The court affirmed the lower court’s denial of the motion to dismiss.

If you or a loved one is hurt due to a doctor’s or nurse’s negligence, it’s important to retain attorneys with experience in these challenging cases. The experienced San Antonio medical malpractice attorneys at Carabin Shaw may be able to help. Call our office for more information at 1-800-862-1260.

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