Court of Appeals of Texas, Second District, Fort Worth
THE 352ND DISTRICT COURT OF TARRANT COUNTY TRIAL COURT NO.
WALKER, GABRIEL, and KERR, JJ. PANEL
MEMORANDUM OPINION 
ELIZABETH KERR JUSTICE.
asked to decide, under section 101.101(c) of the civil
practice and remedies code, whether certain entries in
medical records equate to actual notice to Appellant
University of North Texas Health Science Center, a
governmental unit, of an injury to its patient Pamela
Knight-an injury that is alleged to have triggered a cascade
of problems leading to her death. If the records sufficed to
put UNT Health on notice within the meaning of section
101.101(c), then the trial court properly denied UNT
Health's motion to dismiss for lack of subject-matter
that UNT Health did not have the requisite actual notice
within the meaning of the code and reverse the decision
latter part of 2012, Pamela Knight became a patient of UNT
Health and its employee Dr. Albert H. Olivencia-Yurvati, D.O.
Dr. Yurvati has been a UNT Health faculty member for over two
decades, and currently chairs UNT Health's Department of
Surgery. The record does not reveal when Dr. Yurvati became
department chair, nor does it show what sorts of
duties-investigative, reporting, risk-management-related, or
otherwise-accompany that position.
who was overweight, had undergone gastric lap-band surgery at
a weight-loss facility the previous year and, after
complications necessitated the band's removal, ultimately
developed a significant side effect known as "nutcracker
esophagus." This painful condition results in such
strong and involuntary esophageal contractions that food has
difficulty reaching the stomach.
evaluating Knight, Dr. Yurvati recommended surgery-a
"left thoracotomy with extensive esophageal
myotomy"-and performed that procedure on December
11, 2012. The next day, December 12, Dr. Yurvati ordered an
esophagram, which showed no problems. But in the days that
followed, Knight's condition "began to markedly
deteriorate"; she developed low levels of oxygen
concentration in her blood (hypoxemia) and needed support
ventilation in the form of bilevel positive airway pressure
so that she could breathe.
thoracostomy procedure on December 17 that placed a chest
tube in Knight's left lung-needed because of a loculated
pneumothorax-her condition continued to worsen. Eight days after
Knight's initial surgery, a second esophagram on December
19 revealed a leak in her esophagus that, according to
Appellees, had resulted from an esophageal perforation during
the December 11 surgery. Despite Dr. Yurvati's attempt to
repair the perforation on December 20 through a second
thoracotomy, Knight's condition worsened to the point of
developing a massive infection.
of additional medical problems and procedures culminated in
Knight's death in May 2013 at the age of 56. In November
2014, Appellees- Knight's brother (as estate
administrator) and Knight's mother and two adult
daughters-sued UNT Health and Plaza Medical for medical
both sides agree that UNT Health was not given written notice
of the incident forming the basis of the plaintiffs'
claims within six months of December 11, 2012, see
Tex. Civ. Prac. & Rem. Code Ann. § 101.101(a), we
focus only on whether Knight's medical records as
maintained by UNT Health provided "actual notice"
to that entity that she had "received some injury."
Id. § 101.101(c).
family points us to Dr. Yurvati's December 20, 2012
operative report, which contains entries that they contend
satisfy the statute:
1. Distal esophageal perforation.
2. Status post esophageal ...