Court of Appeals of Texas, Fifth District, Dallas
DEBBIE WHEELER, INDIVIDUALLY AND AS THE REPRESENTATIVE OF THE ESTATE OF LARRY WHEELER, KIM ADAMS, AND KRISTIE STEWART, Appellants
METHODIST RICHARDSON MEDICAL CENTER AND METHODIST HEALTH SYSTEM FOUNDATION, Appellees
Appeal from the 416th Judicial District Court Collin County,
Texas Trial Court Cause No. 416-01327-2016.
Justices Whitehill, Molberg, and Reichek.
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.
a wrongful death and survival action. We draw the following
facts from the allegations in appellants' live petition
and their expert reports.
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
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.
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.
February 19, Wheeler was diagnosed with hypoxic
encephalopathy. A few days later, his family removed
ventilator support and he soon died.
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."
later served two expert reports. One was by nurse Claudia
Estrada, and the other was by Dr. Jay S. Ellis, Jr., an
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.).
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.
timely appealed. See Tex. Civ. Prac. & Rem. Code
§ 51.014(a)(10). Dr. Gutierrez is not a party to this
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 ...