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Hulsey v. Attalla

Court of Appeals of Texas, First District

August 1, 2019

RANDALL SCOTT HULSEY, Appellant
v.
MILAD ATTALLA, Appellee

          On Appeal from the 151st District Court Harris County, Texas Trial Court Case No. 2014-34758.

          Panel consists of Chief Justice Radack and Justices Higley and Hightower.

          MEMORANDUM OPINION

          Sherry Radack Chief Justice.

         Appellee, Milad Attalla, brought a negligence suit against appellant, Randall Scott Hulsey, for damages arising from an auto collision. Hulsey appeals the trial court's judgment against him, which was entered after a jury trial. In four issues, Hulsey contends that the evidence is factually insufficient to support causation, that the evidence is legally and factually insufficient to support the damages awarded, that the damages awarded are excessive, and that the trial court erred in admitting evidence of insurance. We affirm.

         Background

         The Collision

         On the morning of February 23, 2013, Attalla was driving on Farm-to-Market Road 529 ("FM 529") in Cypress. His son, J.A., was a passenger. At the intersection of FM 529 and Queenston Boulevard, Attalla stopped at a red signal light governing traffic in his eastbound direction. Traffic on the westbound side of FM 529 had a green signal light. Hulsey, who was traveling south on Queenston, approached the intersection and did not stop at the signal light, which was either stale yellow or red, governing traffic in his direction. Hulsey's Chevrolet Suburban was struck by a truck heading westbound on FM 529, then went over a median and collided with Attalla's passenger car, striking it on the driver's side and forcing it into another vehicle. Attalla suffered injuries and was taken by ambulance to a hospital. He was discharged later that day.

         Hulsey testified at trial that, as he was traveling southbound on Queenston, approaching FM 529, he saw that "the light had turned yellow before the intersection." He explained: "It was one of those situations where I had to make a split second decision whether to stop or go; and being the light traffic, I decided to move forward through the intersection." He remembered seeing a truck coming from the left and trying to slam on his brakes. He noted that he was "knocked unconscious" by the force of the impact and that emergency personnel "had to cut [him] out of the vehicle." He testified, "I believe that the light had just turned red when I was in the intersection," and "I know that because that's the last thing I saw before I got hit." He asserted that he "didn't enter [the intersection] on a red light." Hulsey's adult son, Brandon Hulsey, who was riding in the front passenger seat of the Suburban, testified that he told police officers at the scene, "My dad ran the red light."

         The trial court admitted into evidence photographs of the damage to each vehicle and the police officer's crash report from the scene.

         Suit for Damages

         Attalla, individually and on behalf of J.A., sued Hulsey for negligence, alleging that Hulsey had failed to keep a proper lookout, to apply his brakes, to control his speed, to stop at the traffic light, and to avoid the collision. Attalla sought damages for future medical expenses, past and future physical pain and mental anguish, and past and future physical impairment.[1]

         At trial, Attalla testified that, before the collision, he suffered from "normal" back pain from his work duties and from carrying around his children. In 2008, he went to his primary care physician, Lourice Abdelmelek, M.D., complaining of lower back pain and minor tingling in his legs. Dr. Abdelmelek ordered radiographs and an MRI. Based on her findings, she recommended that Attalla take Tylenol, which Attalla noted relieved his pain. Attalla testified that Abdelmelek's records from his 2012 visit accurately reflected that he did not have any neck or back pain at that point.

         After the collision in 2013, however, Attalla's quality of life "changed dramatically." He testified that he is "constantly" in pain, takes medication three to four times daily, requires help with "everything" he does, and cannot perform his usual duties at work. In addition, he can no longer play with his children as he did prior to the collision. Attalla has a master's degree in theology, and he used to perform the liturgies at his church and lead the congregation in hymns. Since the collision, however, he can no longer perform his duties at his church. Although Attalla underwent physical therapy, it did not help his pain. And, he underwent five or six epidural steroid injections, which he noted were very painful procedures. Attalla explained: "I'm trying my best to cope with medication and function as much as I can because I'm terrified of the surgery" that his orthopedic surgeon, Dr. Howard Cotler, had recommended. Dr. Cotler described the procedure to Attalla as being "like a C-section," involving an incision through his abdomen and another through his back, and involving the placement of a "cage" around his spine.

         During Attalla's testimony, as discussed in detail below, references were made to Hulsey's automobile liability insurance.

         Attalla's wife, Maryana Attalla, testified that she and Attalla own a pharmacy. She is a pharmacist and Attalla manages their business. Before the collision, Attalla could perform the required work tasks, including regular heavy lifting and bending down. He was also the head deacon at their church, led liturgies lasting from three to four hours, and was head of the Sunday school services for high school students. He conducted training every Friday for an hour or two and went on retreats. During family vacations, he used to participate in activities such as walking for long distances, rafting, ziplining, and going on rides at amusement parks. At home, he played basketball with the children, went running with Maryana, and rode bicycles with the family.

         Since the collision, however, Attalla can no longer participate in these activities as he had or at all. Just riding in a car is an issue. Attalla cannot perform any of his duties at the church because he cannot stand for the required length of time. Maryana noted that church was his "passion," and he has had to resign. She noted that, during a recent family trip to Costa Rica, she and the children went ziplining, while Attalla had to stay behind.

         Maryana explained that, before the collision, Attalla experienced back pain, but it was not the disabling back pain he has suffered since. He is in constant pain. She and Attalla are "terrified" for him to undergo the recommended back surgery. However, the epidural steroid injections are no longer working and "someday he will have to."

         Gabriela De La Torre testified that she has worked for the Attallas at their pharmacy since 2011. She used to see Attalla every day, and he worked for a majority of each workday. She did not remember his ever having complained about back pain prior to the collision. Since the collision, however, Attalla has experienced back pain and headaches and cannot perform tasks as he had previously, including heavy lifting or bending down.

         Emad Mikhail Bishai, M.D., testifying as an expert for Attalla, stated that he was one of Attalla's treating physicians for pain management after the collision. Dr. Bishai noted that he is board certified in pain management and that about 95 percent of his practice involves treating patients with spine issues. Bishai testified regarding his review of Attalla's medical records, which the trial court admitted into evidence.

         In 2008, several years before the collision, Attalla went to Dr. Abdelmelek complaining of lower back pain. The March 4, 2008 MRI report states that Attalla's lumbar vertebrae were within normal limits, with the exception of the lumbosacral junction ("L5-S1"), which showed decreased "disc signal intensity," with "significant space narrowing" and "an approximately 6mm risk posterolateral disc protrusion impinging upon the right L5 nerve root and significant narrowing of the right neural foramen." Spondylosis[2] was also noted at L5, but with "no significant spondylolisthesis"[3] and "no spinal stenosis."[4] Thus, Bishai explained, the space between Attalla's L5-S1 vertebrae was too narrow, he had a bulging disc, and the opening through which the nerves passed and traveled down to his legs was impinged. Otherwise, Attalla's vertebrae and discs were "normally aligned."

         Dr. Abdelmelek referred Attalla to an orthopedic surgeon, Kenneth Lee, M.D., who reviewed Attalla's 2008 MRI films. In his April 3, 2008 report, Dr. K. Lee noted that Attalla had reported a three-month history of lower back pain and a two-year history of numbness and tingling in his legs. Dr. K. Lee concluded that the exam and diagnostic studies were consistent with "stable" L5-S1 spondylolisthesis. He also noted a "severe disk collapse at that level." He prescribed medication and ordered an EMG, or nerve conduction study, of Attalla's legs.

         The emergency room records of Methodist Hospital West, where Attalla was taken by ambulance after the collision, reflected that he presented complaining of neck and back pain. The record of the exam on February 23, 2013 showed that Attalla had "Grade 1 anterolisthesis at L5-S1 with likely bilateral spondylolysis."[5]Bishai explained that the term "anterolisthesis" is a misalignment or displacement of one vertebra as compared to another. Bishai noted that this condition was not present on Attalla's MRI taken in 2008, prior to the collision.

         Dr. Bishai also reviewed the records of Henry S. Lee, M.D., who treated Attalla three months after the collision. An MRI taken on May 23, 2013 showed a "Grade 1 anterolisthesis and advanced spondylosis and annular disc bulging."

         Dr. Bishai testified that Attalla did not have his present injury before the collision. He explained that Attalla has "Grade 1 anterolisthesis," i.e., misalignment or displacement of one vertebra as compared to another, which is permanent, will not heal on its own, and likely to worsen over time. Bishai testified that, based on a "reasonable medical probability," the collision "more likely than not" aggravated Attalla's pre-existing condition, i.e., "caused his stable spondylolisthesis to become unstable." Although Attalla had back problems in 2008, his condition was "stable." As a result of the collision, however, Attalla's back became "unstable," in that there is "motion" in his vertebrae. Bishai explained that when a patient has offset vertebrae that are stable, the condition is usually medically managed. However, a patient with offset vertebrae that are unstable is at risk for cauda equina, a condition that can sever nerves and cause paralysis. Thus, "based on a reasonable medical probability," Attalla will need to have surgery to fix his issues "at some point in his life." Further, the pain management treatment that Bishai administered to Attalla will not manage his pain indefinitely and there is "no nonsurgical way to fix this." Rather, "surgery is crucial in an unstable spine." Dr. Bishai noted that the October 17, 2013 radiographs of Attalla's spine taken by his orthopedic surgeon, Dr. Howard Cotler, reflected that Attalla has "lytic spondylolisthesis" and three to seven millimeters of movement in his spine, which Bishai characterized as "huge[ly] unstable." And, Bishai noted that Cotler had recommended surgery.

         During cross-examination, Bishai clarified that he had not reviewed Attalla's 2008 MRI film. Rather, he reviewed the 2008 MRI report. He acknowledged that, although he had earlier testified, based on the report, that Attalla did not have spondylolisthesis prior to the collision, Dr. K. Lee had concluded that Attalla had spondylolisthesis in 2008, prior to the collision.

         Dr. Cotler, a board-certified orthopedic surgeon testifying as an expert for Attalla, stated that he examined Attalla on October 17, 2013 for neck and back pain that Attalla attributed to the collision. Cotler's examination revealed that Attalla had a "painful range of motion of his low[er] back or lumbar spine." Neurologically, he was "intact," but he had some tingling in both legs. Cotler diagnosed Attalla with "traumatic L5-S1 spondylolisthesis," meaning that there was a "fracture of the pars interarticularis area of the L5 vertebral body that allowed the L5 vertebral body, or the block of bone, to separate from the posterior elements." He testified that, "based on a reasonable medical probability," "something caused the break in the bone; and that's trauma." And, because of the separation, there was a "slippage of one block of bone on another," or "spondylolisthesis." Attalla had a disc herniation at L5-S1 and a "weight bearing intolerance" or "vertical instability," which made it painful for him to sit or put weight on his spine. Attalla quantified his neck pain as 10 out of 10, his leg pain as 8 out of 10, and his back pain as 7 out of 10.

         Dr. Cotler noted that Attalla's March 4, 2008 MRI showed that he had spondylolysis and a disc lesion. He opined that Attalla had a "chronic condition that potentially could have had an acute situation superimposed on it." Cotler advised Attalla that he could continue symptomatic care or undergo surgery. Cotler explained that surgery is appropriate when a patient has severe incapacitating pain that interferes with his quality of his life and nonoperative care has failed. Attalla had previously undergone two epidural steroid injections and physical therapy. Cotler noted that, Attalla had a "structural abnormality," i.e., a fracture and slippage of bone, and that "structural abnormalities require structural solutions."

         Dr. Cotler described the surgical procedure to be performed as a global fusion of a section of Attalla's spine. Cotler testified that the expenses for the surgery would total $225, 000 and that Attalla would require six to twelve weeks of physical therapy. Cotler noted that Attalla may later require additional surgeries and would "probably" have residual pain in the future. Cotler testified that his opinions were based on a "reasonable medical probability."

         At the close of trial, Attalla requested damages in the amount of $225, 000 for future medical expenses; $50, 000 for past physical pain and mental anguish; $200, 000 for future physical pain and mental anguish; $50, 000 for past physical impairment; and $200, 000 for future physical impairment. After the jury found that Hulsey's negligence proximately caused the occurrence in question, it awarded Attalla damages in the amount of $225, 000 for future medical expenses; $25, 000 for past physical pain and mental anguish; $175, 000 for future physical pain and mental anguish; $25, 000 for past physical impairment; and $200, 000 for future physical impairment.[6] The trial court rendered judgment in accordance with the verdict.

         Hulsey filed a motion for new trial, challenging the factual sufficiency of the evidence supporting the jury's findings as to causation and damages, and asserting that the trial court erred by admitting evidence of Hulsey's liability insurance. The trial court denied the motion for new trial.

         Sufficiency of the Evidence

         In his second issue, Hulsey argues that the evidence is factually insufficient to support the jury's finding that the collision proximately caused Attalla's injuries. In his first issue, Hulsey argues that the evidence is legally and factually insufficient to support the jury award of damages for future medical expenses, future physical pain and mental anguish, and future impairment. Alternatively, Hulsey argues that the amount of damages awarded is excessive.

         Standard of Review

         When an appellant challenges the legal sufficiency of the evidence supporting an adverse finding on an issue on which he did not have the burden of proof, he must demonstrate that no evidence supports the finding. Graham Cent. Station, Inc. v. Pena, 442 S.W.3d 261, 263 (Tex. 2014). We will sustain a legal sufficiency or "no-evidence" challenge if the record shows any one of the following: (1) a complete absence of evidence of a vital fact, (2) rules of law or evidence bar the court from giving weight to the only evidence offered to prove a vital fact, (3) the evidence offered to prove a vital fact is no more than a scintilla, or (4) the evidence establishes conclusively the opposite of the vital fact. City of Keller v. Wilson, 168 S.W.3d 802, 810 (Tex. 2005). In conducting a legal-sufficiency review, we consider the evidence in the light most favorable to the verdict and indulge every reasonable inference that supports it. Id. at 822.

         If there is more than a scintilla of evidence to support the challenged finding, we must uphold it. Formosa Plastics Corp. USA v. Presidio Eng'rs & Contractors, Inc., 960 S.W.2d 41, 48 (Tex. 1998). "[W]hen the evidence offered to prove a vital fact is so weak as to do no more than create a mere surmise or suspicion of its existence, the evidence is no more than a scintilla and, in legal effect, is no evidence." Ford Motor Co. v. Ridgway, 135 S.W.3d 598, 601 (Tex. 2004) (internal quotations omitted). However, if the evidence at trial would enable reasonable and fair-minded people to differ in their conclusions, then jurors must be allowed to do so. City of Keller, 168 S.W.3d at 822. "A reviewing court cannot substitute its judgment for that of the trier-of-fact, so long as the evidence falls within th[e] zone of reasonable disagreement." Id.

         When an appellant challenges the factual sufficiency of the evidence supporting an adverse finding on an issue on which he did not have the burden of proof, he must demonstrate that the adverse finding is so contrary to the overwhelming weight of the evidence as to be clearly wrong and manifestly unjust. Cain v. Bain, 709 S.W.2d 175, 176 (Tex. 1986); Levine v. Steve Scharn Custom Homes, Inc., 448 S.W.3d 637, 653 (Tex. App.-Houston [1st Dist.] 2014, pet. denied). In conducting a factual-sufficiency review, we examine, consider, and weigh all of the evidence that supports or contradicts the fact finder's determination. See Dow Chem. Co. v. Francis, 46 S.W.3d 237, 242 (Tex. 2001); Plas-Tex, Inc. v. U.S. Steel Corp., 772 S.W.2d 442, 445 (Tex. 1989). We note that the jury is the sole judge of the witnesses' credibility, and a reviewing court may not impose its own opinion to the contrary. See Golden Eagle Archery, Inc. v. Jackson, 116 S.W.3d 757, 761 (Tex. 2003). When presented with conflicting testimony, the fact finder may believe one witness and disbelieve others, and it may resolve inconsistencies in the testimony of any witness. McGalliard v. Kuhlmann, 722 S.W.2d 694, 697 (Tex. 1986). We set aside the verdict only if the evidence is so weak or the finding is so against the great weight and preponderance of the evidence that it is clearly wrong or manifestly unjust. See Dow Chem. Co., 46 S.W.3d at 242; Pool v. Ford Motor Co., 715 S.W.2d 629, 635 (Tex. 1986).

         A. Causation [7]

         In his second issue, Hulsey argues that the evidence is factually insufficient to support the jury's finding as to causation because the evidence does not link the alleged negligence to the alleged injuries. He asserts that Dr. Cotler testified that Attalla had spondylolisthesis prior to the collision. And, Dr. Bishai's testimony that the collision caused Attalla's injuries, although couched in terms of "reasonable medical probability," was conjectural because the condition seen on the 2013 MRI could have developed before the collision.

         A negligence cause of action has three elements: (1) a legal duty owed by one person to another, (2) a breach of that duty, and (3) damages proximately caused by the breach. D. Houston, Inc. v. Love, 92 S.W.3d 450, 454 (Tex. 2002). "Proximate cause requires both cause in fact and foreseeability." Id. Foreseeability exists if the actor, as a person of ordinary intelligence, should have anticipated the dangers his negligent act creates for others. Id. "Foreseeability does not require that a person anticipate the precise manner in which injury will occur once he has created a dangerous situation through his negligence." Travis v. City of Mesquite, 830 S.W.2d 94, 98 (Tex. 1992). "Cause in fact means that the defendant's act or omission was a substantial factor in bringing about the injury which would not otherwise have occurred." Union Pump Co. v. Allbritton, 898 S.W.2d 773, 775 (Tex. 1995).

         To establish causation in a personal injury suit, a plaintiff must prove that the defendant's conduct caused an event and that the event caused the plaintiff to suffer compensable injuries. Burroughs Wellcome Co. v. Crye, 907 S.W.2d 497, 499 (Tex. 1995); Benson v. Chalk, 536 S.W.3d 886, 902 (Tex. App.-Houston [1st Dist.] 2017, pet. denied). A jury may decide the required causal nexus between the event sued upon and the plaintiff's injuries when (1) general experience and common sense will enable a layperson fairly to determine the causal nexus; (2) expert testimony establishes a traceable chain of causation from injuries back to the event; or (3) expert testimony shows a probable causal nexus. LMC Complete Auto., Inc. v. Burke, 229 S.W.3d 469, 478 (Tex. App.-Houston [1st Dist.] 2007, pet. denied). Causation cannot be established by mere conjecture, guess, or speculation. McClure v. Allied Stores of Tex., Inc., 608 S.W.2d 901, 903 (Tex. 1980). However, proximate cause may be established by direct or circumstantial evidence and the reasonable inferences that may be drawn from that evidence. Id. at 903-04.

         When a plaintiff claims damages for a medical condition, the cause of which is not within the common knowledge and experience of jurors, expert testimony is necessary to show that the defendant's conduct caused that condition. JLG Trucking, LLC v. Garza, 466 S.W.3d 157, 162 (Tex. 2015). A plaintiff is not required to show that the defendant's negligent act or omission was "the sole cause of [his] injury," only that it was a "substantial factor in bringing about the injury." Bustamante v. Ponte, 529 S.W.3d 447, 457 (Tex. 2017). Further, "a medical causation expert need not disprov[e] or discredit[] every possible cause other than the one espoused by him." Transcon. Ins. Co. v. Crump, 330 S.W.3d 211, 218 (Tex. 2010) (internal quotations omitted). "Trial evidence generally includes evidence of the pre-occurrence condition of the injured person, circumstances surrounding the occurrence, and the course of the injured person's physical condition and progress after the occurrence." Guevara v. Ferrer, 247 S.W.3d 662, 666-67 (Tex. 2007). "Evidence of an event followed closely by manifestation of or treatment for conditions which did not appear before the event raises suspicion that the event at issue caused the conditions." Id. at 668. The expert must base his opinion on facts or data perceived or reviewed during or before trial, and his opinion must rest on "reasonable medical probability." LMC Complete Auto., 229 S.W.3d at 478. Reasonable probability is determined by the substance and context of the opinion and does not turn on semantics or on the use of a particular term or phrase. Id.

         Here, Attalla sought to prove through the expert testimony of Dr. Bisai and Dr. Cotler that the collision, which occurred on February 23, 2013, caused him to suffer injuries to his back.

         Dr. Bishai testified that he is board certified in pain management and that about 95 percent of his practice involves treating patients with spine issues. Bishai testified regarding his review of Attalla's medical records and from his own examination and treatment of Attalla after the collision.

         Dr. Bishai testified that Attalla's March 4, 2008 MRI report states that his lumbar vertebrae were within normal limits, with the exception of L5-S1, which showed decreased "disc signal intensity," with "significant space narrowing" and "an approximately 6mm risk posterolateral disc protrusion impinging upon the right L5 nerve root and significant narrowing of the right neural foramen." Spondylosis was also noted at L5, but with "no significant spondylolisthesis" and "no spinal stenosis."[8] Thus, Bishai explained, the space between Attalla's L5-S1 vertebrae was too narrow, he had a bulging disc, and the opening through which the nerves passed and traveled down to his legs was impinged and causing pain. Otherwise, Attalla's vertebrae and discs were "normally aligned." Further, Dr. K. Lee, in his April 3, 2008 report, opined that the exam and diagnostic studies of Attalla were consistent with "stable" L5-S1 spondylolisthesis, although he noted a "severe disk collapse at that level."

         The emergency room records of Methodist Hospital West, where Attalla was taken by ambulance after the collision, reflect that he presented complaining of neck and back pain. The record of the exam on February 23, 2013 showed that Attalla had "Grade 1 anterolisthesis at L5-S1 with likely bilateral spondylolysis."[9] Thus, after the collision, Attalla's vertebrae were misaligned or displaced. Bishai noted that this condition was not present on Attalla's 2008 MRI, prior to the collision. And, the records of Dr. S. Lee, who treated Attalla three months after the collision, reflected that an MRI taken on May 23, 2013 showed a "Grade 1 anterolisthesis and advanced spondylosis and annular disc bulging."

         Dr. Bishai testified that, based on a "reasonable medical probability," the collision "more likely than not" aggravated Attalla's pre-existing condition, i.e., "caused his stable spondylolisthesis to become unstable." Although Attalla had back problems in 2008, his condition was "stable." As a result of the collision, however, Attalla's back became "unstable," in that there is "motion" in his vertebrae. Bishai noted that the October 17, 2013 radiographs of Attalla's spine taken by Dr. Cotler reflect that Attalla has "lytic spondylolisthesis" and movement in his spine from 7 mm to 3 mm, which Bishai characterized as "huge[ly] unstable." Bishai explained that Attalla has "Grade 1 anterolisthesis," which is permanent. He noted that a patient with offset vertebrae that are unstable is at risk for cauda equina, a condition that can sever nerves and cause paralysis.

         Dr. Cotler, a board-certified orthopedic surgeon, testified that he examined Attalla on October 17, 2013 for neck and back pain that Attalla attributed to the collision. Cotler diagnosed Attalla with "traumatic L5-S1 spondylolisthesis," which he explained meant that there was a "fracture of the pars interarticularis area of the L5 vertebral body that allowed the L5 vertebral body, or the block of bone, to separate from the posterior elements." He testified that, "based on a reasonable medical probability," "something caused the break in the bone; and that's trauma." And, because of the separation, there was a "slippage of one block of bone on another," or "spondylolisthesis." Cotler also diagnosed Attalla with a disc herniation at L5-S1. Cotler noted that Attalla's March 4, 2008 MRI showed that he had spondylolysis and a disc lesion. He opined that Attalla had a "chronic condition that potentially could have had an acute situation superimposed on it."

         Thus, Drs. Bishai and Cotler each testified based on Attalla's medical records, on the results of Attalla's pre- and post-collision MRIs and radiographs, and on their examinations of Attalla. Bishai testified that, before the collision, Attalla's vertebrae and discs were "normally aligned." And, after the collision, his vertebrae were misaligned. Bishai testified that, based on a "reasonable medical probability," the collision "more likely than not" aggravated Attalla's pre-existing condition, i.e., "caused his stable spondylolisthesis to become unstable." Cotler opined that the post-collision condition of Attalla's L5-S1 vertebrae was suggestive of "trauma."

         During cross-examination, Dr. Bishai acknowledged that, although he had earlier testified, based on the 2008 MRI report, that Attalla did not have spondylolisthesis before the collision, Dr. K. Lee, an orthopedic surgeon who reviewed the 2008 MRI film, had concluded that Attalla had spondylolisthesis in 2008, prior to the collision. When presented with conflicting testimony, the jury may believe one witness and disbelieve others, and it may resolve inconsistencies in the testimony of any witness. See McGalliard, 722 S.W.2d at 697.

         Based on the evidence of the temporal proximity of the onset of Attalla's symptoms, i.e., the debilitating pain in his back that began after the collision, together with the testimony of Drs. Cotler and Bishai about the pre- and post-collision MRI results, their examinations of Attalla, and their experience as a board-certified orthopedic surgeon and board-certified pain-management specialist, respectively, the jury could have reasonably inferred that Attalla's injuries were proximately caused by the collision and not simply by degeneration, the only other possible cause for his injuries suggested by the record. See Guevara, 247 S.W.3d at 666-67; Williams v. Crawford, No. 03-16-00696-CV, 2018 WL 1124306, at *6 (Tex. App.-Austin Mar. 2, 2018, no pet.) (mem. op.) (holding temporal proximity of onset of patient's symptoms, together with physician's testimony that results from patient's MRI "showed that the herniation at L5-S1 was 'acute,' meaning recent, and suggestive of trauma," and his experience as an orthopedic surgeon, constituted sufficiently reliable basis from which doctor could opine that herniations were, "in reasonable medical probability, caused by the accident" and not by degeneration, as suggested); see also Transcon. Ins. Co., 330 S.W.3d at 218 (concluding that causation expert reasonably ruled out possibility that patient died solely from other conditions based on objective evidence of patient's good health before injury, his contraction of infection at site shortly afterward, and effect of infection on patient's health).

         We conclude that the evidence supporting the jury's finding as to causation is not so weak as to render it clearly wrong and manifestly unjust. See Cain, 709 S.W.2d at 176. We hold that ...


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