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Weatherford Texas Hospital Co., LLC v. Laudermilt

Court of Appeals of Texas, Second District, Fort Worth

November 2, 2017

WEATHERFORD TEXAS HOSPITAL COMPANY, LLC D/B/A WEATHERFORD REGIONAL MEDICAL CENTER, PEGGY GENTZEL, R.N., ALISHA BULLARD, R.N., AND BONNIE CALHOUN, R.N. APPELLANTS
v.
AMY LYNN LAUDERMILT AND STEVEN MELTON APPELLEES

         FROM THE 236TH DISTRICT COURT OF TARRANT COUNTY TRIAL COURT NO. 236-285372-16

          PANEL: SUDDERTH, C.J.; KERR and PITTMAN, JJ.

          MEMORANDUM OPINION [1]

          MARK T. PITTMAN, JUSTICE

         Appellants Peggy Gentzel, R.N., Alisha Bullard, R.N., and Bonnie Calhoun, R.N. (collectively, the Nurses) and their employer, Weatherford Texas Hospital Company, LLC d/b/a Weatherford Regional Medical Center (Hospital) appeal from the trial court's denial of their respective motions to dismiss the claims brought against them by Appellees Amy Lynn Laudermilt and Steven Melton, Laudermilt's husband, for failure to file a sufficient expert witness report as required by the Texas Medical Liability Act (the Act). See Tex. Civ. Prac. & Rem. Code Ann. § 74.351 (West 2017). The Nurses and Hospital argue that the trial court erred by not dismissing the lawsuit because the two expert reports relied on by Laudermilt and Melton were insufficient as to the applicable standard of care, each defendant's breach of that standard of care, and causation. Because we hold that the expert reports were sufficient, we affirm.

         I. Background

         Laudermilt and Melton sued the Nurses and Hospital after several feet of metal guidewire were left inside Laudermilt following a procedure at Hospital. They alleged that the Nurses were negligent in attempting to establish an external jugular or femoral catheterization for Laudermilt, resulting in their losing and permitting the guidewire to remain in Laudermilt, and by not properly accounting for and documenting the use and presence of all medical devices, including the guidewire. The guidewire remained in Laudermilt for nearly two years. After Laudermilt eventually went to a different hospital for ongoing pain in different parts of her body, an X-ray and CT scan revealed that the guidewire had degraded and fragmented, and those fragments had migrated to her head, neck, chest, abdomen, and pelvis. Laudermilt underwent surgery in which doctors removed most of the wire, but some parts could not be removed due to risk of "vein damage and catastrophic hemorrhage." Laudermilt and Melton then brought suit against the Nurses and Hospital based on the Nurses' alleged negligence. They also asserted negligent hiring, training, and supervision claims against Hospital.

         Laudermilt and Melton served the Nurses and Hospital with the expert reports of Theresa Posani, MS, RN and Ralph Terpolilli, MD. Each defendant objected that the reports were insufficient as to the standard of care, breach, and causation, and each filed a motion to dismiss. The trial court overruled the objections and denied the motions to dismiss. The Nurses and Hospital now appeal.

         II. Standard of Review

         A trial court may grant a motion to dismiss a plaintiff's claims for failure to file a sufficient expert report under the Act if the report does not represent a good-faith effort to comply with the statutory definition of an expert report. Fagadau v. Wenkstern, 311 S.W.3d 132, 137 (Tex. App.-Dallas 2010, no pet.). We review a trial court's denial of a motion to dismiss under section 74.351 of the Act for an abuse of discretion. Otero v. Richardson, 326 S.W.3d 363, 366 (Tex. App.-Fort Worth 2010, no pet.). To determine whether a trial court abused its discretion, we must decide whether the trial court acted without reference to any guiding rules or principles; in other words, we must decide whether the act was arbitrary or unreasonable. Id. Merely because a trial court may decide a matter within its discretion in a different manner than an appellate court would in a similar circumstance does not demonstrate that an abuse of discretion has occurred. Id.

         III. Analysis

         A. The Standard of Care and the Breach of that Standard

         Both the Nurses and Hospital argue that the expert reports provided by Laudermilt and Melton do not adequately set forth a standard of care. Regarding Nurse Posani's report, the Nurses argue that the report makes no attempt to define an identifiable nursing standard of care and makes no attempt to distinguish between the role of each Nurse in Laudermilt's care. As for Dr. Terpolilli's report, the Nurses argue that it improperly attempts to set forth a global emergency medical standard of care applicable to multiple categories of healthcare providers. Hospital makes the same arguments, asserting that Nurse Posani's report does not define an identifiable standard of care for either it or the Nurses. It further argues that Dr. Terpolilli improperly attempts to hold the nursing staff to the same standard of care as the emergency department doctor, that Dr. Terpolilli's statements about the emergency department nursing staff are vague and conclusory generalizations, and that Dr. Terpolilli's report attempts to impose an improper legal standard on Hospital by opining that the emergency department nursing staff had a duty to ensure that informed consent was obtained and appropriately documented.

          Regarding their alleged breaches of a standard of care, the Nurses argue that neither report identifies a specific breach of an applicable standard of care by each individual nurse. Likewise, Hospital argues that Nurse Posani's report does not specify a breach for any of the named defendants, that to the extent that it does, it is conclusory, and that Dr. Terpolilli's report does not link the alleged breaches to the harm alleged.

         An expert report must "provide a 'fair summary' of the expert's opinions regarding the applicable standards of care, the manner in which the care rendered failed to meet those standards, and the causal relationship between that failure and the injury, harm, or damages claimed." Fagadau, 311 S.W.3d at 137. "A 'fair summary' of the standard of care is 'something less than a full statement of the applicable standard of care and how it was breached.'" Id. at 138 (quoting Am. Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873, 880 (Tex. 2001)). "A fair summary need only inform the doctor what care was expected but not given." Id. "[I]n determining whether an expert report sets out the applicable standard of care with sufficient detail, we consider all provisions of the ...


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