Court of Appeals of Texas, Second District, Fort Worth
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
AMY LYNN LAUDERMILT AND STEVEN MELTON APPELLEES
THE 236TH DISTRICT COURT OF TARRANT COUNTY TRIAL COURT NO.
SUDDERTH, C.J.; KERR and PITTMAN, JJ.
MEMORANDUM OPINION 
T. PITTMAN, JUSTICE
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.
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.
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.
Standard of Review
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.
The Standard of Care and the Breach of that Standard
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.
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