Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Columbia North Hills Hospital Subsidiary, L.P. v. Gonzales

Court of Appeals of Texas, Second District, Fort Worth

June 1, 2017

COLUMBIA NORTH HILLS HOSPITAL SUBSIDIARY, L.P. D/B/A NORTH HILLS HOSPITAL APPELLANT
v.
MARCELO GONZALES, INDIVIDUALLY AND O/B/O THE ESTATE OF REBECCA GONZALES, DECEASED; JEREMIAH GONZALES; MARCELO GONZALES JR.; ROSE ANN GONZALES; MELISSA GONZALES; MICHELLE GONZALES; DAVE GONZALES; DAVID GONZALES; AND MARK GONZALES APPELLEES

         FROM THE 342ND DISTRICT COURT OF TARRANT COUNTY TRIAL COURT NO. 342-279557-15

          PANEL LIVINGSTON, C.J.; GABRIEL and KERR, JJ.

          MEMORANDUM OPINION [1]

          LEE GABRIEL JUSTICE

         In this appeal, we are asked to decide whether a medical expert's report was sufficient to establish causation such that it met the statutory requirements to avoid dismissal of the claims addressed in the report. Because we conclude that the trial court did not abuse its discretion by finding that the report was an objective, good-faith effort to explain the causal relationship between the breach and the injury, thereby establishing a chain of events leading to the patient's injuries, we affirm the trial court's order.

         I. BACKGROUND

         A. Facts Leading to Litigation

         On December 16, 2013, Rebecca Gonzales was admitted to appellant Columbia North Hills Hospital Subsidiary, L.P. d/b/a North Hills Hospital (Hospital) for acute respiratory failure and pneumonia. Rebecca was diabetic; therefore, her treating physician ordered that she be given fifty units of Detemir insulin at bedtime, thirty units of Glargine insulin once a day, and Lispro insulin on a sliding scale before meals. The amount of Lispro ordered was based on Rebecca's blood-glucose level (BGL):

150-199 4 UNITS
200-249 8 UNITS
250-299 12 UNITS
300-349 16 UNITS
>= 350 20 UNITS, REPEAT BS IN 2 HOURS
IF STILL > 350, NOTIFY PHYSICIAN
. . ..
LOWER SS [i.e., sliding scale] ONE LEVEL WHEN 2 BS IN 12 HOURS ARE < 100 OR IF . . . ANY INSTANCE OF BS < 70 . . . .

         On December 17, 2013, at 8:00 a.m., Rebecca's BGL was 115 and she was not given any insulin. At 9:00 a.m., she had a BGL of 116 and was given her once-daily dose of thirty units of Glargine. At 11:30 a.m., her BGL was 173 and she was administered four units of Lispro. At 4:30 p.m., Rebecca's BGL was forty-nine, and she was given no insulin at that time. At 9:00 p.m., her BGL was 356, and she was given twenty units of Lispro and her bedtime dose of fifty units of Detemir. The next day at 5:15 a.m., Rebecca was found unresponsive with a BGL of thirty-seven.[2]

         An emergency computerized-tomography scan of Rebecca's head ordered by a neurologist revealed "[n]o evidence of acute hemorrhage or acute infarction, " and an electroencephalogram (EEG) showed "[r]ecordings grossly abnormal with a very slow background along with a low amplitude" that was "consistent with a moderately severe diffuse cerebellar dysfunction." Rebecca was diagnosed with "[a]cute encephalopathy, most probably related to her hypoglycemic episode and this may have resulted in a significant global brain injury." After Rebecca remained unresponsive, she was discharged to Plaza Medical Center and later transferred to Pleasant Medical Center where she died on January 24, 2014.

         B. Petition, Expert Report, and Extension

         On July 2, 2015, Rebecca's estate, her husband, and her eight children (Appellants) filed suit against Hospital, alleging negligence under a vicarious-liability theory-"Hospital is vicariously liable for the acts of negligence of their servants, borrowed servants, employees[, ] and agents." Specifically, Appellants asserted that Hospital's nursing staff was negligent in two ways: (1) "failing to follow the physician's order and reduce the dosage from 20 units of [Lispro] insulin to 16 units of [Lispro] insulin at 21:03 on ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.