Court of Appeals of Texas, Sixth District, Texarkana
KEVIN D. FIELDS, Appellant
GOOD SHEPHERD HOSPITAL, INC., D/B/A GOOD SHEPHERD MEDICAL CENTER, Appellee
Submitted: April 18, 2017
Appeal from the County Court at Law No. 2 Gregg County, Texas
Trial Court No. 2015-1911-CCL2
Morriss, C.J., Moseley and Burgess, JJ.
R. Morriss III Chief Justice.
second attempt at providing a qualifying expert report to
support his health care liability claim against Good Shepherd
Hospital, Inc., d/b/a Good Shepherd Medical Center, Kevin D.
Fields filed a report that Good Shepherd attacked as being
deficient. The trial court, agreeing that Fields'
second report also failed to comply with the statutory
requirements, dismissed Fields' claims with
appeals the dismissal. We affirm the trial court's ruling
because (1) the expert report stated no standard of care for
Good Shepherd or its employees, (2) the report failed to
state how a standard of care was breached, and (3) the report
stated a conclusory opinion on causation.
claimant who files a health care liability claim must serve
on each defendant one or more expert reports, along with each
expert's curriculum vitae (CV), not later than the 120th
day after each defendant files an answer. Tex. Civ. Prac.
& Rem. Code Ann. § 74.351(a). A trial court may
grant a motion to dismiss under Section 74.351 if it
determines that the expert report does not constitute a good
faith effort to comply with subsection (r)(6) "with
sufficient specificity to inform the defendant of the conduct
the plaintiff has called into question and to provide a basis
for the trial court to conclude that the claims have
merit." Am. Transitional Care Ctrs. of Tex., Inc. v.
Palacios, 46 S.W.3d 873, 875 (Tex. 2001); Highland
Pines Nursing & Rehab. v. Wiley, 496 S.W.3d 804, 809
(Tex. App -Texarkana 2016, no pet.); see Tex. Civ.
Prac. & Rem. Code Ann. § 74.351(r)(6). Merely stating
the expert's conclusions about the standard of care,
breach, and causation does not constitute a good-faith effort
to comply with the statute. Palacios, 46 S.W.3d at
879. Rather, to be a good-faith effort, the report must
discuss the expert's opinions regarding the standard of
care, breach, and causation with sufficient specificity to
both inform the defendant of the questionable conduct and to
give the trial court a basis to determine the claims have
merit. Id; Wiley, 496 S.W.3d at 809. Further,
"the expert must explain the basis of his statements to
link his conclusions to the facts." Bowie Mem'l
Hosp. v. Wright, 79 S.W.3d 48, 52 (Tex. 2002) (per
curiam) (quoting Earle v. Ratliff, 998 S.W.2d 882, 890
(Tex. 1999)). If the report omits any of the elements
required by subsection (r)(6), it does not constitute a
good-faith effort. Palacios, 46 S.W.3d at 879.
review for an abuse of discretion a trial court's
decision on a motion to dismiss pursuant to Section 74.351.
Marente v. Asah, 486 S.W.3d 680, 684 (Tex.
App-Texarkana 2016, no pet.) (citing Palacios, 46 S.W.3d
at 875). We will reverse the trial court's decision
only if we find it acted in an unreasonable or arbitrary
manner without reference to any guiding rules or principles.
Wiley, 496 S.W.3d at 809 (citing Wright, 79
S.W.3d at 52). In our review, we may not substitute our
opinion for that of the trial court. Id. (citing
Wright, 79 S.W.3d at 52).
The Expert Report Stated No Standard of Care for Good
Shepherd or Its Employees
section of the report titled "Standard of Care, "
Edwards set out the purpose of an IV lock placement, but
otherwise simply recited the facts regarding Fields'
emergency room visit and discharge and Edwards'
understanding of subsequent events. Nowhere in the section
was a standard of care stated for either Good Shepherd or its
nurses. Further, the "Breach of Standard of Care"
section merely recited Edwards' understanding of the
legal definition of negligence and proximate cause.
Recognizing these deficiencies, Fields argues that Edwards
made an "open ended statement" on the standard of
care when he stated that he was familiar with the standard of
care for IV placement and removal in an emergency room visit.
He also argues that the "Proximate Cause" section
of the report stated the standard of care, and the breaches
thereof, "in the Negative." The "Proximate
Cause" section stated:
(1) Amanda Olivera-Hall, no title given, discharged the
patient with the IV still in place at 14:45.
(2) The discharge instructions do not mention the examination
of Mr. Fields['] skin where the IV was placed and the
condition it was in when he was discharged by the nurse or
doctor. Therefore, the patient was not made aware what to
possibly look for in his discharge summary of what signs,
symptoms, fever, uncontrollable pain, nausea, vomiting, or
signs of infection at the site of the IV.
(3) No documentation of Mr. Fields' return to the ED as
to the time of his signed in or did not sign in as a patient
or the time of the return.
(4) No documentation that Mr. Fields['] chart was
re-opened or an addendum of the time he returned, his
condition upon his ...