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Wheeler v. Methodist Richardson Medical Center

Court of Appeals of Texas, Fifth District, Dallas

June 21, 2019

DEBBIE WHEELER, INDIVIDUALLY AND AS THE REPRESENTATIVE OF THE ESTATE OF LARRY WHEELER, KIM ADAMS, AND KRISTIE STEWART, Appellants
v.
METHODIST RICHARDSON MEDICAL CENTER AND METHODIST HEALTH SYSTEM FOUNDATION, Appellees

          On Appeal from the 416th Judicial District Court Collin County, Texas Trial Court Cause No. 416-01327-2016.

          Before Justices Whitehill, Molberg, and Reichek.

          MEMORANDUM OPINION

          BILL WHITEHILL JUSTICE.

         The trial court dismissed appellants' health care liability claims because it concluded that their expert report was deficient as to causation. The pivotal question is whether the expert's report sufficiently explained the how and why of his causation opinion. The report stated that the deceased's life probably would have been saved had his nurses timely alerted a treating physician to his declining blood oxygen levels because the physician probably would have properly performed a successful, non-emergent intubation under favorable conditions. Because we conclude that the report contained sufficient specificity for Chapter 74 purposes, we hold that the trial court abused its discretion and accordingly reverse and remand.

         I. Background

         A. Factual Allegations

         This is a wrongful death and survival action. We draw the following facts from the allegations in appellants' live petition and their expert reports.

         Larry Wheeler was admitted to Methodist Hospital on February 8, 2015, with pulmonary edema thought to be secondary to congestive heart failure, and he required immediate intubation and mechanical ventilation. He underwent a left carotid endarterectomy on February 11 and a coronary artery bypass, mitral valve repair, and aortic valve replacement on February 13.

         Wheeler remained intubated after his surgery until he was extubated the morning of February 18. His oxygen saturation levels declined to around 92-93% that afternoon. That night, shortly after midnight, his oxygen saturation was 57%, and a code blue was started.

         Dr. Jose Gutierrez intubated Wheeler at 0052 hours. The intubation was difficult, and later Wheeler's "pulse was lost." A chest x-ray indicated that the tube had been placed in Wheeler's esophagus instead of his trachea. Wheeler was extubated, and a second intubation was performed at 0101 hours.

         On February 19, Wheeler was diagnosed with hypoxic encephalopathy. A few days later, his family removed ventilator support and he soon died.

         B. Procedural History

         Appellants sued appellees and Gutierrez asserting wrongful death and survival claims. They alleged that Gutierrez placed the tube in Wheeler's esophagus rather than in his trachea and that he negligently failed to verify that he had placed the tube correctly. They also alleged that appellees' nurses negligently "failed to institute a number of interventions" that would have helped correct Wheeler's "critically low oxygen saturations."

         Appellants later served two expert reports. One was by nurse Claudia Estrada, and the other was by Dr. Jay S. Ellis, Jr., an anesthesiologist.

         Appellees challenged the reports' sufficiency. Appellants responded and requested a thirty-day extension to amend or supplement their reports. They also filed a brief supporting their extension request, and they attached an amended Ellis report. The trial court dismissed the case without expressly ruling on appellants' request for a time extension. Appellants appealed, and we reversed, holding that the trial court abused its discretion by failing to give appellants an opportunity to cure the deficiencies in their reports. Wheeler v. Methodist Richardson Med. Ctr., No. 05-17-00332-CV, 2017 WL 6048153, at *4 (Tex. App.-Dallas Dec. 7, 2017, pet. denied) (mem. op.).

         After remand, appellants again served their original reports and the amended Ellis report. Appellees objected again, this time based solely on the premise that the amended Ellis report did not adequately establish causation. Appellants responded. The trial court again sustained appellees' objections and dismissed the claims against them.

         Appellants timely appealed. See Tex. Civ. Prac. & Rem. Code § 51.014(a)(10). Dr. Gutierrez is not a party to this appeal.

         II. Analysis

         Appellants' sole issue urges that the trial court erred by dismissing their claims because the amended Ellis report adequately addresses causation, the only element that appellees challenged in the ...


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