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.

Keepers v. Blessett

Court of Appeals of Texas, First District

April 9, 2019

JERRY M. KEEPERS, M.D., Appellant
v.
CONNIE BLESSETT, Appellee

          On Appeal from the 113th District Court Harris County, Texas Trial Court Case No. 2018-22971

          Panel consists of Justices Keyes, Higley, and Landau.

          MEMORANDUM OPINION

          Sarah Beth Landau, Justice.

         Connie Blessett filed a health care liability claim against Dr. Jerry Keepers, alleging that he negligently performed an epidural steroid injection that was meant to minimize Blessett's on-going pain following a car accident five months earlier. Blessett's petition alleged that Keepers injured her spinal cord during the injection procedure, which caused severe and permanent paralysis on the right side of her body. As required by Chapter 74 of the Civil Practice and Remedies Code, Blessett provided an expert report to support her claim.[1] Keepers moved to dismiss Blessett's claim, challenging the adequacy of the report.[2] The trial court denied his motion, and this interlocutory appeal followed.[3]

         In three issues, Keepers contends the trial court abused its discretion in denying his motion because Blessett's expert was not qualified to offer an expert opinion on the standard of care or breach and because the expert's opinions on the elements of the standard of care, breach, and causation were conclusory.

         We affirm.

         Background

         Blessett provided three expert reports in support of her health care liability claims. All three reports were authored by Dr. Michael Dogali, a neurosurgeon who, according to his curriculum vitae, has held past positions as a professor of neurological surgery at the University of Southern California's medical school, a professor at the University of California, Irvine and chair of its neurological surgery department, a director of New York University Medical Center's neurosurgery department, and a clinical instructor at Yale University Medical Center.

         Dogali's expert reports provide the background facts in this case, and we accept the factual statements in the reports for the limited purpose of this appeal. See Bowie Mem'l Hosp. v. Wright, 79 S.W.3d 48, 52 (Tex. 2002) (review of Chapter 74 report is limited to four corners of report). Blessett's medical records are not before us.

         Blessett was involved in a car accident in February 2016. When her neck, shoulder, and back pain did not subside after several weeks, Blessett obtained an MRI, which revealed disc herniations in her lower cervical spine. Blessett sought pain management treatment from Keepers.

         On June 21, 2016, Keepers performed an epidural steroid injection in Blessett's lower cervical spine, and Blessett later reported a reduction in pain. On July 19, Keepers performed a second epidural steroid injection at the same spinal location (C7-T1). Around noon the next day, Blessett went to St. Luke's Medical Center Emergency Department with complaints of extreme pain and paralysis on her right side. An MRI revealed a lesion in the cervicothoracis spinal cord which St. Luke's noted as a possible "spinal cord injury secondary to needle mispositioning." Blessett continues to have severe and permanent paralysis on the right side of her body more than one year later.

         Blessett sued Keepers and provided an expert report from Dr. Michael Dogali, who opined that Keepers was negligent in mispositioning the needle during the July 19 epidural steroid injection, causing Blessett's severe and permanent injuries. Keepers moved to dismiss Blessett's claim for failing to provide an adequate expert report. See Tex. Civ. Prac. & Rem. Code § 74.351(b) (providing mechanism for dismissal of health care liability claims for failure to provide adequate expert report). Blessett supplemented her report, Keepers again sought dismissal, and the trial court denied his motion. Keepers appeals.

         Motion to Dismiss

         Keepers contends the trial court abused its discretion by denying his motion to dismiss Blessett's health care liability claims because (1) Dogali was not qualified to opine on the standard of care or breach and (2) Dogali's opinions on the standard of care, breach, and causation were conclusory.

         A. Standard of review

         We review a trial court's ruling on a motion to dismiss a health care liability claim for an abuse of discretion. Van Ness v. ETMC First Physicians, 461 S.W.3d 140, 142 (Tex. 2015) (per curiam). We "defer to the trial court's factual determinations if they are supported by evidence," but we review its legal determinations de novo. Id. "A trial court abuses its discretion if it rules without reference to guiding rules or principles." Id.

         B. Expert report requirements

         Under the Medical Liability Act, a plaintiff asserting health care liability claims must timely serve each defendant physician and health care provider with one or more expert reports and a curriculum vitae of each expert whose opinion is offered to substantiate the merits of the claims. Tex. Civ. Prac. & Rem. Code § 74.351(a), (i); see Mangin v. Wendt, 480 S.W.3d 701, 705 (Tex. App.-Houston [1st Dist.] 2015, no pet.). The expert report must provide a "fair summary" of the expert's opinions regarding the (1) applicable standards of care, (2) manner in which the care rendered by the physician or health care provider failed to meet the standards, and (3) causal relationship between that failure and the injury, harm, or damages claimed. Tex. Civ. Prac. & Rem. Code § 74.351(r)(6). "No particular words or formality are required, but bare conclusions will not suffice." Scoresby v. Santillan, 346 S.W.3d 546, 556 (Tex. 2011). Instead, the report must explain the basis of the expert's statements and link the expert's conclusions to the facts of the case. Jelinek v. Casas, 328 S.W.3d 526, 539 (Tex. 2010).

         For standard of care and breach, the expert report must explain what the physician or health care provider should have done under the circumstances and what the physician or health care provider did instead. Am. Transitional ...


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.