Texas San Marcos Treatment Center, L.P. D/B/A San Marcos Treatment Center v. Veronica Payton ( 2015 )


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  •                                                                              ACCEPTED
    03-14-00726-CV
    4336477
    THIRD COURT OF APPEALS
    AUSTIN, TEXAS
    3/2/2015 3:26:58 PM
    JEFFREY D. KYLE
    CLERK
    NO. 03-14-00726-CV
    FILED IN
    IN THE COURT OF APPEALS FOR THE 3rd AUSTIN,
    COURT OF APPEALS
    TEXAS
    THIRD DISTRICT OF TEXAS
    3/2/2015 3:26:58 PM
    JEFFREY D. KYLE
    Clerk
    TEXAS SAN MARCOS TREATMENT CENTER, L.P. d/b/a
    SAN MARCOS TREATMENT CENTER
    Appellant
    v.
    VERONICA PAYTON
    Appellee
    On Appeal from Hays County, Texas,
    428th Judicial District Court
    Trial Court Case Number: 13-2658
    APPELLANT’S REPLY BRIEF
    Ryan L. Clement
    Texas Bar No. 24036371
    SERPE JONES ANDREWS
    CALLENDER & BELL, PLLC
    2929 Allen Parkway, Suite 1600
    Houston, Texas 77019
    Telephone: (713) 452-4400
    Facsimile: (713) 452-4499
    Email: rclement@serpejones.com
    Attorneys for Appellant,
    Texas San Marcos Treatment Center,
    L.P. d/b/a San Marcos Treatment Center
    ORAL ARGUMENT RESPECTFULLY REQUESTED
    TABLE OF CONTENTS
    SUMMARY OF REPLY .........................................................................................1
    ARGUMENT IN REPLY .......................................................................................2
    1. Dr. Reid’s Report Provides No Relevant Facts ........................................... 2
    2. Dr. Reid Fails to Identify The Applicable Standards of Care or
    Alleged Related Breaches .............................................................................. 6
    3. Dr. Reid’s Causation Opinions are Conclusory and Founded on
    Speculation....................................................................................................11
    CONCLUSION AND PRAYER ...........................................................................14
    ii
    TABLE OF AUTHORITIES
    Cases
    American Transitional Care Ctrs. of Tex., Inc. v. Palacios,
    
    46 S.W.3d 873
    (Tex. 2001) ........................................................................... passim
    Austin Heart, P.A. v. Webb,
    
    228 S.W.3d 276
    (Tex. App.—Austin 2007, no pet.) ........................................9, 13
    Baylor All Saints Med. Ctr. v. Martin,
    
    340 S.W.3d 529
    (Tex. App.—Fort Worth 2011, no pet.) .....................................11
    Bowie Mem'l Hosp. v. Wright,
    
    79 S.W.3d 48
    (Tex. 2002) .......................................................................... 4, 5, 7, 9
    Earle v. Ratliff,
    
    998 S.W.2d 882
    (Tex. 1999) ...................................................................................4
    Gray v. CHCA Bayshore L.P.,
    
    189 S.W.3d 855
    (Tex. App.—Houston [1st Dist.] 2006, no pet.) ..........................9
    Hebert v. Hopkins,
    
    395 S.W.3d 884
    (Tex. App.—Austin 2013, no pet.) ................................. 9, 14, 15
    Jelinek v. Casas,
    
    328 S.W.3d 526
    (Tex. 2010) ......................................................... 5, 11, 12, 13, 14
    Kingwood Pines Hosp., LLC v. Gomez,
    
    362 S.W.3d 740
    (Tex. App.—Houston [14th Dist.] 2011, no pet.) ............... 11, 13
    Kocurek v. Colby,
    No. 03-13-00057-CV, 
    2014 WL 4179454
    –5
    (Tex. App.—Austin Aug. 22, 2014, no pet.) ........................................................12
    Kuykendall v. Dragun,
    No. 11-05-00230-CV, 
    2006 WL 728068
     (Tex. App.—Eastland Mar. 23, 2006, pet. denied) .................................................5
    McKenna Mem'l Hosp., Inc. v. Quinney,
    No. 03-06-00119-CV, 
    2006 WL 3246524
     (Tex. App.—Austin Nov. 10, 2006, pet. denied)....................................................7
    iii
    Regent Care Ctr. of San Antonio II, Ltd. P'ship v. Hargrave,
    
    300 S.W.3d 343
    (Tex. App.—San Antonio 2009, pet. denied) ............................14
    Russ v. Titus Hosp. Dist.,
    
    128 S.W.3d 332
    (Tex. App. – Texarkana 2004, pet. denied) .................................7
    Shenoy v. Jean,
    No. 01-10-01116-CV, 
    2011 WL 6938538
     (Tex. App.—Houston [1st Dist.] Dec. 29, 2011 .....................................................4
    Smith v. Wilson,
    
    368 S.W.3d 574
    (Tex. App.—Austin 2012, no pet.) ..................... 6, 11, 12, 14, 15
    Strom v. Mem'l Hermann Hosp. Sys.,
    
    110 S.W.3d 216
    (Tex. App.—Houston [1st Dist.] 2003, pet. denied) ...................7
    Taylor v. Fossett,
    
    320 S.W.3d 570
    (Tex. App.—Dallas 2010, no pet.)...............................................4
    Texarkana Nursing & Healthcare Center, LLC v. Lyle,
    
    388 S.W.3d 314
    (Tex. App. – Texarkana 2012, no pet.) ..................................7, 11
    W.B.M. Mgmt. Co. v. Flores,
    No. 07-14-00008-CV, 
    2014 WL 1691362
    –6
    (Tex. App.—Amarillo Apr. 25, 2014, no pet.) .......................................................4
    iv
    NO. 03-14-00726-CV
    IN THE COURT OF APPEALS FOR THE
    THIRD DISTRICT OF TEXAS
    TEXAS SAN MARCOS TREATMENT CENTER, L.P. d/b/a
    SAN MARCOS TREATMENT CENTER
    Appellant
    v.
    VERONICA PAYTON
    Appellee
    On Appeal from Hays County, Texas,
    428th Judicial District Court
    Trial Court Case Number: 13-2658
    APPELLANT’S REPLY BRIEF
    TO THE HONORABLE JUSTICES OF THE THIRD COURT OF APPEALS:
    Appellant Texas San Marcos Treatment Center, L.P. d/b/a San Marcos
    Treatment Center (“San Marcos Treatment Center” or “Appellant”) files this Reply
    Brief, and in support thereof, would respectfully show the Court the following:
    SUMMARY OF REPLY
    Dr. Reid’s report contains no relevant factual information. Instead, Dr.
    Reid’s report relies on vague statements, generalizations, inferences and also
    speculation to address the required statutory elements of an expert report under
    Chapter 74. Dr. Reid’s opinions are conclusory, as evidenced by his express
    acknowledgement that he lacks specific factual information central to his opinions
    and his reliance on vague statements, generalizations, inferences and speculation to
    support his conclusions.
    Consequently, Dr. Reid’s report does not satisfy the requirements under
    Chapter 74 or the standards established by Palacios and its progeny because the
    report fails to provide enough information to fulfill the two purposes of an expert
    report under the statute as it fails to inform San Marcos Treatment Center of the
    specific conduct called into question and also failed to provide the trial court with a
    basis to conclude that the claims have merit.
    ARGUMENT IN REPLY
    1. Dr. Reid’s Report Provides No Relevant Facts
    On page 5 of Dr. Reid’s report, a “brief narrative” is supplied.            This
    paragraph discusses the “facts” upon which Dr. Reid’s various opinions concerning
    the applicable standards of care and alleged breaches rest.         The only “facts”
    provided by Dr. Reid in his report concerning events preceding the assault are as
    follows:
    At the time of the assault, Veronica Payton (victim) was an aide on
    the boys’ unit (patients apparently about 11 years old and up) of San
    Marcos Treatment Center (SMTC). Leroy Simon (assailant) was a 17
    year-old, “stocky” male patient with a long history of assaultive
    behavior, sex offenses, fights, borderline intellectual function or mild
    mental retardation, and chronic symptoms of intermittent explosive
    2
    disorder, lack of impulse control, oppositional defiance disorder, and
    other mental and behavioral problems, most of all of which were
    known to SMTC prior to January 2, 2012. Mr. Simon was housed on
    the boys’ unit to which Ms. Payton was assigned.
    During the evening of January 2, 2012, Mr. Simon asked to be
    escorted off the unit to do his laundry. There were two staff, both
    female, assigned to the boys’ unit at the time, including Ms. Payton.
    Ms. Payton agreed to accompany him to the functioning laundry, and
    did so.
    (CR 36).
    Dr. Reid provides no additional facts concerning the events leading up to the
    assault in his report. Dr. Reid provides no facts concerning the facility’s staffing
    requirements or the patient-to-staff ratio. Dr. Reid provides no facts concerning
    the education, training, or instruction provided to the facility’s staff in general, or
    Ms. Payton specifically. Dr. Reid provides no facts concerning the information or
    notification provided to staff concerning the patient’s past mental health history.
    Dr. Reid provides no facts concerning the process of the patient’s admission to the
    facility and/or his placement on the unit. Dr. Reid provides no facts concerning the
    care and treatment ordered for this patient (i.e. the observation level and/or any
    limitations or restrictions) by his admitting physician. Dr. Reid provides no facts
    concerning the patient’s admission and care while at San Marcos Treatment Center
    and his interactions with patients and/or staff aside from the assault alone. In the
    absence of any relevant facts, Dr. Reid, nonetheless, offers opinions as to the
    3
    standards of care and alleged breaches with regard to all the aforementioned
    subject matters.
    An expert, however, must explain the basis for his statements to link his
    conclusions to the facts and not merely state conclusions. Bowie Mem’l Hosp. v.
    Wright, 
    79 S.W.3d 48
    , 52 (Tex. 2002) (quoting Earle v. Ratliff, 
    998 S.W.2d 882
    ,
    890 (Tex. 1999)).
    Appellate courts recognize that an expert’s failure to provide any facts in the
    report to support his or her conclusions on standard of care, breach, and causation
    prevents the trial court from concluding the plaintiff’s claims have merit. See
    Taylor v. Fossett, 
    320 S.W.3d 570
    , 578 (Tex. App.—Dallas 2010, no pet.) (finding
    trial court abused its discretion in denying physician’s motion to dismiss since
    expert report provided only conclusory opinions without supporting facts); W.B.M.
    Mgmt. Co. v. Flores, No. 07-14-00008-CV, 
    2014 WL 1691362
    , *5–6 (Tex. App.—
    Amarillo Apr. 25, 2014, no pet.) (holding that expert report was not a good faith
    effort to provide a fair summary of his opinions and warranted dismissal since
    expert failed to provide facts to support his conclusion); Shenoy v. Jean, No. 01-
    10-01116-CV, 
    2011 WL 6938538
    , *6 (Tex. App.—Houston [1st Dist.] Dec. 29,
    2011, pet. denied) (holding that “an expert report that merely asserts that a
    defendant physician’s breach caused the plaintiff’s injury without providing a
    4
    factual basis does not provide the trial court with the information necessary to
    evaluate the merits of the plaintiff’s claim.”).
    The failure to set forth facts supporting an expert’s opinions on the standard
    of care, breach, and causation is not an argument based on “semantics.”
    Kuykendall v. Dragun, No. 11-05-00230-CV, 
    2006 WL 728068
    , *3 (Tex. App.—
    Eastland Mar. 23, 2006, pet. denied). Rather, the facts are “vital” in determining
    whether the plaintiff’s claims have merit. 
    Id. As the
    Texas Supreme Court held in Jelinek v. Casas, 
    328 S.W.3d 526
    (Tex. 2010), when the report in question lacks any explanation linking the expert’s
    conclusion to the relevant facts, the trial court abuses its discretion in denying the
    defendant’s motion to dismiss. 
    Id. at 540
    (citing Bowie 
    Mem’l, 79 S.W.3d at 52
    ).
    Appellee’s attempts to draw comparisons between the sufficiency of Dr.
    Reid’s report and those provided in other cases fall short. See Appellee’s Brief at
    36-38. The primary distinction is that there were relevant facts provided in the
    other reports resulting in adequate specificity. However, the report of Dr. Reid
    fails to provide any relevant facts or the requisite specificity.
    Because Dr. Reid’s report fails to provide any relevant facts, the opinions
    are purely conclusory and the report does not represent a good faith effort. If an
    expert report contains only conclusions about the statutory elements in section
    74.351, the trial court has “no discretion but to conclude ... that the report does not
    5
    represent a good-faith effort” to satisfy the statute. Smith v. Wilson, 
    368 S.W.3d 574
    , 577 (Tex. App.—Austin 2012, no pet.) (citing American Transitional Care
    Ctrs. of Tex., Inc. v. Palacios, 
    46 S.W.3d 873
    , 877, 880 (Tex. 2001)).
    The trial court abused its discretion in holding that Dr. Reid’s report was
    adequate and in denying San Marcos Treatment Center’s motion to dismiss under
    Chapter 74 because Dr. Reid’s report fails to link relevant facts to his conclusions
    on any of the required elements of a Chapter 74 expert report.
    2. Dr. Reid Fails to Identify The Applicable Standards of Care or Alleged
    Related Breaches
    On page 1 of his report, under the heading “Duties, Standards and Breaches
    Thereof”, Dr. Reid offers the following conclusory opinions concerning the
    applicable standards of care:
    That employer (SMTC), by itself and through its various parts or
    assigns, had duties to its unit employee Ms. Payton, which included,
    but may not have been limited to, (a) adequate staffing and staff
    support in her work environment (sufficient to meet reasonable levels
    of staff safety, as well as patient safety and care), (b) adequate
    training with regard to recognizing and managing situations that
    might arise in which her safety could be compromised, (c) adequate
    notification of work situations or persons in her work environment
    that could reasonably present a danger to her or others, (d) adequate
    care in avoiding or declining admission of patients/clients who are
    inappropriate for the unit on which she worked, and (e) elimination or
    amelioration of reasonably known risks to her and other staff or
    patients created by patients/clients who are admitted to and housed on
    the unit on which she worked.
    (CR 32-33).
    6
    As this Court is aware, whether a defendant healthcare provider breached its
    duty cannot be determined absent specific information about what the defendant
    should have done differently. Russ v. Titus Hosp. Dist., 
    128 S.W.3d 332
    , 341-42
    (Tex. App. – Texarkana 2004, pet. denied) (quoting 
    Palacios, 46 S.W.3d at 880
    )).
    In other words, one must be able to determine from the report what was required
    by the standard of care, which requires “specific information about what the
    defendant should have done differently”.      Texarkana Nursing & Healthcare
    Center, LLC v. Lyle, 
    388 S.W.3d 314
    (Tex. App. – Texarkana 2012, no pet.)
    (quoting 
    Palacios, 46 S.W.3d at 880
    )). Identifying the standard of care is critical
    because whether a defendant breached its duty cannot be determined absent
    specific information about what the defendant should have done differently.
    McKenna Mem'l Hosp., Inc. v. Quinney, No. 03-06-00119-CV, 
    2006 WL 3246524
    ,
    *4 (Tex. App.—Austin Nov. 10, 2006, pet. denied) (mem. op.) (citing to Bowie
    Mem’l Hosp. v. Wright, 
    79 S.W.3d 48
    , 53 (Tex. 2002) (per curium); 
    Russ, 128 S.W.3d at 343
    ). Moreover, the standard of care is defined by what an ordinarily
    prudent health-care provider would have done under the same or similar
    circumstances. See 
    id. (citing to
    Palacios, 46 S.W.3d at 880
    ; Strom v. Mem'l
    Hermann Hosp. Sys., 
    110 S.W.3d 216
    , 222 (Tex. App.—Houston [1st Dist.] 2003,
    pet. denied)).
    7
    Dr. Reid’s opinions concerning the standards of care provide nothing more
    than vague, generalized statements that are wholly reliant on inferences because
    they are devoid of any factual information and lack the specificity required under
    the statute. In summary, Dr. Reid’s opinions provide no information as to what the
    standard of care applicable to San Marcos Treatment Center is in this context and
    under the facts.
    Using the first standard of care expressed by Dr. Reid as an example (though
    the others are equally as deficient), Dr. Reid opines that San Marcos Treatment
    Center had a duty to provide “adequate staffing and staff support” and “failed to
    provide adequate staffing to meet the foreseeable needs for patient care and staff
    and patient safety.” (CR 32-33). However, Dr. Reid also openly acknowledges in
    his report that, “Specific staffing data from SMTC is not yet available to me.” (CR
    33). Thus, his statement as to the standard of care for adequate staffing is without
    any factual support and, therefore, because his conclusions are not linked to any
    relevant facts his opinion as to this standard of care is purely conclusory. All of
    Dr. Reid’s opinions concerning the standards of care and breach suffer from the
    same failure to link any relevant factual information to the opinions expressed or
    provide sufficient specificity as to the specific conduct called into question.
    Because there is no link to any relevant factual information, all of the Dr. Reid’s
    opinions concerning the standards of care are expressed in vague, general terms
    8
    and lack the specificity required by the statute. None of the standards of care
    and/or alleged breaches offered by Dr. Reid are sufficiently tied to any facts or
    provide any information beyond vague, general statements and, therefore, Appellee
    has failed to provide an adequate expert report supportive of any of her legal
    theories.
    In so far as Dr. Reid makes any attempt to link any “facts” to his
    conclusions, Dr. Reid merely refers to materials listed under “Sources Reviewed
    and/or Relied Upon.” (CR 37-38). However, those materials are neither described
    within his report nor are they attached and incorporated. Thus, Dr. Reid’s opinions
    rely repeatedly on inferences as to the contents of those materials cited and
    whether or not support they support his conclusions.          The only information
    relevant to determining whether a report complies with the statute is “within the
    four corners of the document.” 
    Palacios, 46 S.W.3d at 878
    . This requirement
    precludes a court from filling gaps in a report by drawing inferences or guessing as
    to what the expert likely meant or intended. Austin Heart, P.A. v. Webb, 
    228 S.W.3d 276
    , 279 (Tex. App.—Austin 2007, no pet.) (citing Bowie 
    Mem’l, 79 S.W.3d at 53
    ; Gray v. CHCA Bayshore L.P., 
    189 S.W.3d 855
    , 859 (Tex. App.—
    Houston [1st Dist.] 2006, no pet.)). This Court declared, “neither the trial court nor
    this Court may infer additional opinions or underlying facts to fill in gaps that the
    report itself leaves open.” Hebert v. Hopkins, 
    395 S.W.3d 884
    , 890 (Tex. App.—
    9
    Austin 2013, no pet.). Because Dr. Reid provides no relevant facts, his report is
    fatally reliant on inferences for any support and naturally requires that gaps be
    filled in to complete and support his conclusions. However, Dr. Reid’s report’s
    reliance on inference is impermissible under the statute and the interpretive legal
    precedent.
    Appellee misunderstands that purpose for which Appellant referred to
    materials outside the four corners of the report. See Appellee’s Brief at 25. The
    materials referenced were not provided for this Court’s consideration of their
    substance or contents, but rather, to provide a description of available materials in
    Ms. Payton’s personnel file as an illustration of Dr. Reid’s reliance on inference
    because he fails to describe or detail what particular contents he reviewed in her
    personnel file, what materials he anticipated finding in her personnel file, and how
    the absence of specifically described items support his opinions. Dr. Reid offers
    no such description but, instead, merely offers:
    Review of Ms. Payton’s SMTC personnel file and relevant portions of
    the SMTC Employee Handbook reveals no indication that Ms. Payton
    received any SMTC training regarding her safety in the workplace,
    and particularly none related to recognizing potentially dangerous
    patients, recognizing potentially assaultive patients, or protection
    herself from patient assault.
    (CR 33).
    Dr. Reid’s vague statement, which lacks any factual reference to specific
    materials (present or absent), naturally required the trial court to infer as to the
    10
    materials that should be present but were not found and to then fill in the gap by
    making assumptions.
    Dr. Reid’s vague, generalized statements concerning the standards of care
    (without any reference to relevant facts) are similar to those found in other reports
    served in assault cases where similar reports were likewise found to be deficient.
    E.g. Lyle, 
    388 S.W.3d 314
    ; Baylor All Saints Med. Ctr. v. Martin, 
    340 S.W.3d 529
    (Tex. App.—Fort Worth 2011, no pet.); Kingwood Pines Hospital, LLC, v. Gomez,
    
    362 S.W.3d 740
    (Tex. App.––Houston [14th Dist.] 2011, no pet.).
    Dr. Reid’s report fails to identify the applicable standards of care in
    connection with any factual information or discuss any related alleged breaches
    but, instead, relies on vague, general statements and inferences to reach purely
    conclusory opinions as to these required elements.
    3. Dr. Reid’s Causation Opinions Are Conclusory and Founded on
    Speculation
    As this Court recently noted in Smith v. Wilson, an expert must explain, with
    supporting facts, how the defendant’s alleged breach in the standard of care caused
    the injury in question. 
    Smith, 368 S.W.3d at 577
    –78. A conclusory statement on
    causation is wholly insufficient. 
    Id. Further, as
    the Supreme Court has recognized, “[a]n expert cannot simply
    opine that the breach caused the injury. … Instead, the expert must go further and
    explain, to a reasonable degree, how and why the breach caused the injury based
    11
    on the facts presented.” 
    Jelinek, 328 S.W.3d at 539
    –40. (emphasis added).
    Without this explanation, the trial court cannot conclude the claims have merit. Id.;
    see also 
    Smith, 368 S.W.3d at 578
    (Austin Court reversing trial court’s denial of
    motion to dismiss after finding report failed to provide facts explaining the causal
    link between alleged breach and the occurrence or injury); Kocurek v. Colby, No.
    03-13-00057-CV, 
    2014 WL 4179454
    , *4–5 (Tex. App.—Austin Aug. 22, 2014, no
    pet.).
    This Court has also stated that an expert report must explain how taking the
    suggested measures would have prevented the particular injuries complained of.
    
    Smith, 368 S.W.3d at 577
    -578.
    Appellee’s reliance on UHS of Timberlawn, Inc. is misapplied.           See
    Appellee’s Brief at 34-36. While assault may not be a medical condition, this does
    not eliminate the required element of causation and how that element must be
    sufficiently addressed within an expert report served pursuant to Chapter 74. As
    discussed later in Appellee’s Brief, causation remains a required element in an
    expert report in assault cases. See 
    id. at 35-36.
    However, Dr. Reid’s report fails to
    adequately address causation.
    Concerning causation, Dr. Reid opines, “But for one or more of the breaches
    by SMTC, summarized in items 2-6, it is more likely than not that the January 2,
    2012, assault would not have occurred, and thus the above damages to Ms. Payton,
    12
    would not have occurred.” (CR 035). However, Dr. Reid’s causation opinion is
    purely conclusory because it fails to explain how and why the alleged failures by
    San Marcos Treatment Center resulted in the assault. Kingwood Pines Hosp., 
    LLC, 362 S.W.3d at 750
    . In short, Dr. Reid’s conclusions as to causation amount to
    nothing more than an ipse dixit, which the Supreme Court has consistently
    criticized. 
    Jelinek, 328 S.W.3d at 539
    .
    Dr. Reid’s report offers no explanation, with supporting facts, how San
    Marcos Treatment Center’s alleged breach (of an unidentified standard of care)
    caused Ms. Payton’s injuries, or for that matter, caused her to decide to go to the
    laundry room with the patient alone.            Dr. Reid offers nothing more than
    speculation and conjecture in his report to support his conclusions as to causation.
    In short, Dr. Reid opines that Ms. Payton would not have escorted the patient alone
    on that occasion. (CR 35). In support of this speculative opinion, Dr. Reid refers
    to a statement by Ms. Payton. However, the statement is never described within
    his report and is also not attached is support of his opinion.           This again
    demonstrates Dr. Reid’s reliance on inference, which this Court has correctly noted
    is specifically precluded. Austin Heart, 
    P.A., 228 S.W.3d at 279
    . Additionally, it
    is also pure speculation and conjecture for Dr. Reid to opine as to the state of mind
    of Ms. Payton on January 2, 2012 and what she would or would not have done in
    relation to this patient under varying scenarios.
    13
    Conclusory (and speculative) statements on causation, like those offered in
    Dr. Reid’s report, will not satisfy Chapter 74’s expert report requirements. See
    
    Palacios, 46 S.W.3d at 875
    ; Regent Care Ctr. of San Antonio II, Ltd. P'ship v.
    Hargrave, 
    300 S.W.3d 343
    , 346 (Tex. App.—San Antonio 2009, pet. denied).
    Since Dr. Reid only offered conclusory opinions concerning the statutory elements
    required of an expert report, the trial court had “no discretion but to conclude ...
    that the report does not represent a good-faith effort” to satisfy the statute. 
    Smith, 368 S.W.3d at 577
    . The trial court’s ruling amounted to an abuse of discretion. 
    Id. CONCLUSION &
    PRAYER
    To constitute a good faith effort, the report must, at a minimum: (1) inform
    the defendant of the specific conduct called into question; and (2) provide a basis
    for the trial court to conclude the claims have merit. 
    Palacios, 46 S.W.3d at 879
    .
    “A report that merely states the expert’s conclusions about the standard or care,
    breach, and causation does not fulfill the two purposes of a good-faith effort.”
    
    Hebert, 395 S.W.3d at 890
    (quoting 
    Jelinek, 328 S.W.3d at 539
    ).
    Because Dr. Reid provides absolutely no facts to support his conclusions on
    the applicable standard of care, breach, and causation he also fails to inform San
    Marcos Treatment Center of the specific conduct called into question. Similarly,
    because Dr. Reid fails to link his conclusions on the applicable standard of care,
    breach, and causation to any relevant facts, but instead relies on vague, general
    14
    statements, inferences and speculation, his report also fails to provide a basis for
    the trial court to conclude the claims have merit. As such, the trial court abused its
    discretion in finding the report was sufficient. See 
    Smith, 368 S.W.3d at 577
    .1 As a
    result, San Marcos Treatment Center requests that the Court reverse the trial
    court’s order.
    WHEREFORE, PREMISES CONSIDERED, San Marcos Treatment Center
    respectfully requests that this Court reverse the trial court’s order denying
    Appellant’s Chapter 74 Motion to Dismiss and remand to the trial court with an
    order that all claims and causes of action asserted by Appellee against San Marcos
    Treatment Center be dismissed with prejudice and that San Marcos Treatment
    Center be awarded its reasonably attorneys’ fees and costs as allowed by Chapter
    74 of the Texas Civil Practices and Remedies Code. San Marcos Treatment Center
    further prays for such other relief that it may be justly entitled.
    1
    Also, without the relevant facts, the trial court either misapplied the law regarding the
    sufficiency of expert report or inferred additional underlying facts to fill in gaps that the report
    itself left open. This amounts to an abuse of discretion. See 
    Hebert, 395 S.W.3d at 890
    .
    15
    Respectfully submitted,
    SERPE, JONES, ANDREWS,
    CALLENDER & BELL, PLLC
    By:   /s/ Ryan L. Clement
    Ryan L. Clement
    Texas Bar No. 24036371
    rclement@serpejones.com
    America Tower
    2929 Allen Parkway, Suite 1600
    Houston, Texas 77019
    Telephone: (713) 452-4400
    Facsimile: (713) 452-4499
    Attorneys for Appellant,
    Texas San Marcos Treatment Center,
    L.P. d/b/a San Marcos Treatment Center
    CERTIFICATE OF COMPLIANCE
    I hereby certify that the foregoing Reply Brief for Appellant is computer
    generated, has been prepared in a conventional typeface no smaller than 14-point
    for text and 12-point for footnotes, contains 3,405 words according to word count
    function of the computer program used to prepare this Reply Brief, excluding any
    parts exempted by TEX. R. APP. P. 9.4(i)(1), and otherwise complies with Texas
    Rule of Appellate Procedure 9.4.
    /s/ Ryan L. Clement
    Ryan L. Clement
    16
    CERTIFICATE OF SERVICE
    I hereby certify that a true and correct copy of the above and foregoing
    instrument has been forwarded to all known counsel of record in accordance with
    the Texas Rules of Appellate Procedure on this the 2nd day of March, 2015.
    Adam S. Ward
    Aaron Allison
    Keely Allison Ward
    Allison & Ward
    2001 N. Lamar Blvd.
    Austin, Texas 78705-4907
    /s/ Ryan L. Clement
    Ryan L. Clement
    17