Court of Appeals of Texas, Fifth District, Dallas
JOEL HENDRICKS, M.D. AND TEXAS HEALTH PHYSICIANS GROUP A/K/A SURGICAL ASSOCIATES OF KAUFMAN, Appellants
JOHN PERALES, Appellee
Appeal from the County Court At Law No. 1 Kaufman County,
Texas Trial Court Cause No. 94963-CC
Justices Fillmore, Whitehill, and Schenck
M. FILLMORE JUSTICE
interlocutory appeal, appellants Joel Hendricks, M.D. and
Texas Health Physicians Group a/k/a Surgical Associates of
Kaufman (THP) challenge the trial court's order
overruling their joint objections to appellee John
Perales's expert's report and denying their joint
motion to dismiss Perales's health care liability claims
against them. In two issues, Dr. Hendricks and THP contend
the trial court abused its discretion by overruling their
joint objections and denying their joint motion to dismiss
because Perales's expert's report under chapter 74 of
the civil practice and remedies code failed to sufficiently
address Dr. Hendricks's standard of care, the manner in
which Dr. Hendricks purportedly breached the standard of
care, and the purported causal relationship between the
alleged breach of the standard of care by Dr. Hendricks and
Perales's injuries and damages. Because we conclude the
expert's report is deficient with regard to the statutory
element of causation, we reverse the trial court's order
overruling Dr. Hendricks and THP's joint objections to
the expert's report and remand the case to the trial
court to consider whether a thirty-day extension of time for
Perales to attempt to cure the deficiency is appropriate.
sued Dr. Hendricks for negligence in the rendering of medical
treatment to him. Perales sued THP under the doctrine of
respondeat superior for Dr. Hendricks's
negligence.Given the procedural posture
of this case, we draw the facts from the allegations against
Dr. Hendricks in Perales's live petition in the trial
March 8, 2014, Dr. Hendricks diagnosed Perales with right and
left inguinal hernias and recommended a bilateral
laparoscopic surgical procedure to repair the hernias. Dr.
Hendricks performed this surgical procedure on March 27,
2014. During the procedure, surgical mesh was placed over the
hernia; however, extra mesh was left inside the abdominal
cavity after the cavity was deflated and the incision closed.
Perales alleges the surgical mesh was negligently placed or
inserted in a way that made it highly susceptible to
infection and complications.
followed the post-operative instructions provided by Dr.
Hendricks. However, at a follow-up visit on April 2, 2014,
Perales reported bloody bowel movements, positional fever,
and a high level of pain when lying on his left side. Dr.
Hendricks noted there was swelling and bruising in
Perales's scrotum, but told Perales that despite his
severe pain, he was "doing well." Dr. Hendricks
recommended another follow-up visit in May 2014.
continued to have extreme abdominal pain and contacted Dr.
Hendricks on April 8, 2014. Dr. Hendricks instructed Perales
to go to the emergency room of Texas Health
Presbyterian Hospital-Kaufman, where Perales was diagnosed
with abdominal abscesses and advanced-stage sepsis. Perales
was then transferred to Texas Health Presbyterian Hospital-
Dallas for further treatment. During his hospitalization from
April 8 to May 19, 2014, fluid was drained from Perales's
pelvic area on multiple occasions in order to address the
infection. Perales alleges he was "in-and-out" of
hospitals for many months thereafter and he continues to
experience abdominal pain and limitation of his ability to
function in connection with the activities of daily life.
alleges the following acts or omissions by Dr. Hendricks
proximately caused his injuries and damages:
i. Improperly assessing the degree of necessity for surgery;
ii. Failing to properly prepare the area for surgery;
ii. [sic] Failing to properly suture the surgical wounds;
iii. Using improper mesh and/or applying the mesh improperly
to the hernia;
iv. Leaving the mesh exposed, thereby increasing the chance
v. Providing [Perales] with improper after-care instruction;
vi. Failing to adequately monitor [Perales]'s health
during and after surgery; and
vii. Using improper technique while performing
[Perales]'s hernia repair surgery.