Deborah Rose Eezzuduemhoi, PLLC D/B/A Southeast Texas Opthalmology the Glaucoma Center and Deborah Rose Eezzuduemhoi v. Phillis Delli ( 2022 )


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  •                                        In The
    Court of Appeals
    Ninth District of Texas at Beaumont
    __________________
    NO. 09-22-00053-CV
    __________________
    DEBORAH ROSE EEZZUDUEMHOI, PLLC D/B/A/ SOUTHEAST
    TEXAS OPTHALMOLOGY THE GLAUCOMA CENTER AND
    DEBORAH ROSE EEZZUDUEMHOI, Appellants
    V.
    PHILLIS DELLI, Appellee
    ________________________________________________________________
    On Appeal from the 172nd District Court
    Jefferson County, Texas
    Trial Cause No. E-208,175
    __________________________________________________________________
    MEMORANDUM OPINION
    The Texas Medical Liability Act (“TMLA”) requires plaintiffs asserting a
    health care liability claim to serve each defendant with an “adequate” expert report
    or face dismissal of their claim. 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    . In this
    interlocutory   appeal,   Appellants    Deborah     Rose    Eezzuduemhoi      (“Dr.
    Eezzuduemhoi”) and Deborah Rose Eezzuduemhoi, PLLC d/b/a Southeast Texas
    Ophthalmology The Glaucoma Center (“The Glaucoma Center”) (collectively
    1
    “Defendants” or “Appellants”) argue that the trial court abused its discretion by
    denying their TMLA motion to dismiss. The Defendants contend the expert’s report
    is not adequate because it is speculative, fails to consider what condition Appellee
    Phillis Delli’s (“Appellee,” “Plaintiff,” or “Phillis”) eyes would be in without the
    surgery, contains conclusory statements and no more than ipse dixit, and only
    addresses the alleged injury to Phillis’s 1 left eye, rather than the “ultimate injury”
    which Plaintiff contends she received to both eyes. Because we cannot say the trial
    court abused its discretion in denying the motion to dismiss, we must affirm.
    The Original Petition
    Phillis Delli filed her Original Petition on August 19, 2021, naming Dr.
    Eezzuduemhoi and The Glaucoma Center as defendants. Delli alleged that she went
    to The Glaucoma Center on April 26, 2019 for a consultation for cataract surgery
    and complaints about vision difficulties and problems with glare from headlights
    when driving at night. The petition alleged that Dr. Eezzuduemhoi performed
    cataract extraction with intraocular lens implant of the left eye on August 26, 2019,
    and the surgery was complicated “by a posterior capsule rent with vitreous loss[,]”
    and a “+21.00 D anterior chamber intraocular lens (ACIOL) was placed.” In follow-
    1
    Phillis Delli died shortly after filing this suit, and her daughter Billie Delli
    continues to prosecute the lawsuit as executrix of Phillis’s estate. The claims against
    the Defendants are for negligence, they relate to complications from eye surgery,
    and the appellate record contains no allegation that Phillis’s death was related to the
    surgery or treatment provided by the Defendants.
    2
    up visits over the next two months, Delli received four prescriptions and was
    diagnosed with left eye corneal edema and left eye ocular hypertension, with a plan
    ultimately to replace the ACIOL with a different lens implant.
    On November 4, 2019, Phillis underwent ACIOL “explantation” at The
    Medical Center of Southeast Texas and a “3-piece Alcon Lens Model mn60ac” was
    inserted. At follow-up visits over the next month, she complained of foreign body
    sensation in her left eye, and she was told that an anterior vitrectomy of the left eye
    was necessary due to vitreous in the anterior chamber.
    Phillis underwent a third eye surgery performed by Dr. Eezzuduemhoi on
    December 9, 2019. The next day, Phillis presented with anterior vitrectomy of the
    left eye, and she was instructed to continue her medications. At follow-up visits the
    following month, she stated that her vision seemed to be getting worse, and on
    January 27, 2020, Dr. Eezzuduemhoi told Phillis there was nothing more the doctor
    could do for her, and the doctor continued two of Phillis’s prescriptions.
    On February 5, 2020, Phillis saw Dr. Talbot for a second opinion, who
    observed “significant iris abnormalities including a hole inferiorly at 5 oclock,
    atrophy at 6 oclock, and iridocorneal adhesions.” Dr. Talbot concluded that Phillis
    would require another surgery, including a “corneal transplant, IOL reposition or
    exchange, and iris repair OS.” Dr. Talbot referred Phillis to Dr. Hamill at Baylor
    College of Medicine. On February 21, 2020, Phillis saw Dr. Hamill, who diagnosed
    3
    her with “corneal edema OS, pseudophakia OS, anterior synechiae OS, and age-
    related cataract of the right eye[,]” and the left eye showed a “tilted scleral PCIOL
    with severe diffuse corneal edema, a temporal vascularized corneal scar, and
    multiple iridocorneal adhesions[.]” A pre-operative exam on May 18, 2020, revealed
    “pseudophakic bullous keratopathy of the left eye with obscured view of the anterior
    segment and posterior segment with multiple iridocorneal adhesions of peripheral
    iris defects.” She underwent a fourth procedure on her left eye on July 8, 2020, for
    a “PKP, iris reconstruction, IOL exchange for a trans-sclerally sutured lens of the
    left eye.” One day after surgery, Phillis went for a follow-up visit, complaining of a
    slight headache. An examination revealed that the graft was in a good position, and
    there was some corneal edema with mild AC reaction. Phillis was to take two
    medications and return in a week, and after several more follow-up visits, she was
    “basically” doing well with “no complaints.”
    According to the petition, “[t]he pathology of the cornea revealed diffuse
    stromal edema, a retrocorneal fibrotic membrane, and near-total absence of
    endothelial cells[,]” and “[t]he damage to Plaintiff’s eye was caused by Defendants’
    negligence.” The petition asserted claims against Dr. Eezzuduemhoi for negligence
    and gross negligence for:
    1. Failing to timely correct the ACIOL haptic.
    2. Failing to refer Plaintiff to a cornea specialist to expedite the timely
    repair of the ACIOL haptic.
    3. Failing to correct the malpositioned sclerally-fixated PCIOL.
    4
    4. Such other and further acts of negligence as may be supplemented as
    a result of discovery performed in this suit.
    The petition also stated claims against The Glaucoma Clinic under a theory of
    respondeat superior for negligence and gross negligence. Plaintiff sought damages
    for medical bills, pain and suffering, mental anguish, loss of earning capacity,
    physical impairment, and loss of enjoyment of life as well as interest and attorney’s
    fees. Plaintiff also sought exemplary damages.
    Dr. Bradley’s Report
    Phillis served a report from Dr. Jay Cameron Bradley on October 4, 2021. 2 In
    his report, Dr. Bradley stated that he is a board-certified ophthalmologist and
    currently practicing as a “Cornea, External Disease, Cataract, & Refractive Surgery
    specialist” in Lubbock, Texas. Bradley stated that he had reviewed Phillis’s medical
    records from The Glaucoma Center, The Medical Center of Southeast Texas, and
    Baylor College of Medicine, and he included a summary description of Phillis’s
    history from April 26, 2019 through August 27, 2020.
    Bradley stated that for patients with a haptic of an ACIOL or a malpositioned
    or “tilted” sclerally-fixated posterior chamber intraocular lens, the standard of care
    2
    In the initial motion to dismiss under the TMLA, the Defendants argued that
    the matter should be abated until a representative of Phillis’s estate had been
    appointed. Plaintiff filed a Suggestion of Death of Plaintiff, Phillis Delli on
    December 4, 2021, and Letters Testamentary naming Billie Delli (“Billie”) as the
    executrix of Phillis’s estate. Defendants then refiled their Chapter 74 Motion to
    Dismiss RE Expert Report.
    5
    requires that the lens needs to be repositioned or exchanged as soon as possible to
    avoid progressive and irreversible damage to the cornea. According to Bradley, “[i]n
    both instances in this case, there were prolonged delays before the issue was
    corrected.” Dr. Bradley stated that Dr. Eezzuduemhoi should have “corrected the
    ACIOL haptic in the wound and the malpositioned sclerally-fixated PCIOL without
    delay to prevent progressive and irreversible damage to the cornea [or] referred the
    patient to a cornea specialist if she was unable to correct these issues.” In Dr.
    Bradley’s opinion, Dr. Eezzuduemhoi breached the applicable standard of care by
    failing to correct the ACIOL haptic in the wound for over seven weeks after the
    initial surgery and failing to correct the malpositioned sclerally-fixated PCIOL.
    Dr. Bradley states:
    Dr. Eezzuduemhoi delayed correction of both issues for a prolonged
    period of time directly resulting in progressive and irreversible corneal
    damage. When intraocular lens implants are not in correct position
    (such as in this case), the lens implant moves inside the eye and rubs
    against the cornea. This causes the endothelial cells (which line the
    inner surface of the cornea and keep the cornea clear) to progressively
    die, resulting in corneal swelling and cloudiness. If the malpositioned
    intraocular lens implant is not corrected, the number of endothelial cells
    progressively decrease over time until the cornea is irreversibly
    damaged and a corneal transplant is required to clear the cornea. The
    delays in care of this case resulted in a need for additiona1 surgery and
    poor outcome. With earlier intervention of the ACIOL haptic in the
    wound and the malpositioned sclerally-fixated PCIOL, further surgery
    would most likely have been avoided and a better outcome would most
    likely been attained.
    6
    According to Dr. Bradley, Phillis had complicated cataract surgery, and because
    ACIOL haptic in the surgery wound and malpositioned sclerally-fixated PCIOL
    were not managed “urgently[,]” Phillis developed progressive and irreversible
    corneal damage. Dr. Bradley wrote that most patients who suffer these issues are
    able to achieve “complete restoration of vision[,]” and Phillis was unable to achieve
    such recovery due to the lack of prompt diagnosis and treatment.
    Defendants’ Motion to Dismiss
    In Defendants’ motion to dismiss, the Defendants argued that Dr. Bradley’s
    report did not meet the requirements of the TMLA because “causation of the
    ‘ultimate injury’ is lacking.” Specifically, the motion states:
    Dr. Bradley was not provided the affidavit of Ms. Billie Delli,
    and therefore could not have addressed the “ultimate injury,” i.e., the
    full scope of damages claimed in this case.
    Dr. Bradley does not address the status of Ms. Delli’s right eye.
    Additionally, according to the Defendants, Dr. Bradley’s statements that Phillis had
    a “poor outcome[]” and that most patients in Phillis’s position “often enjoy complete
    restoration of vision[]” are impermissibly conclusory. The Defendants also argued
    that an expert report must address other plausible causes of the harm for which
    recovery is sought, and Dr. Bradley should have addressed the problems Phillis had
    with her right eye because it “would point to causes and conditions bearing on the
    7
    left eye[.]” 3 According to the Defendants, Dr. Bradley’s report was deficient under
    the TMLA standards, and the case should be dismissed.
    Attached to the Defendants’ motion to dismiss was a copy of Dr. Bradley’s
    report and Billie Delli’s affidavit. Billie’s affidavit was signed and sworn on
    September 23, 2021. In her affidavit, Billie described her mother Phillis before the
    surgery as outgoing and very involved with her family. According to Billie, after her
    surgery, Phillis was unable to work, financially dependent, withdrawn, and “sorrow-
    filled[.]”
    At the hearing on the motion to dismiss, Defendants argued that, even though
    Plaintiff’s burden at this stage of the litigation does not require it to marshal all its
    proof, Plaintiff is still required to “provide a reasonably detailed explanation based
    upon the facts of how they would prove proximate causation at trial.”
    Plaintiff’s Response to Motion to Dismiss
    In their response to the Defendants’ motion to dismiss, Plaintiff argued that
    Dr. Bradley’s report provides “very specific and consistent opinions” about the
    probable cause of Phillis’s injuries. According to Plaintiff, Billie’s affidavit was not
    executed until forty-one days after Dr. Bradley’s report was issued, and the affidavit
    has no bearing on whether the report meets the TMLA requirements. Plaintiff also
    3
    The Defendants’ motion to dismiss does not challenge Dr. Bradley’s
    qualifications nor his opinions on standard of care and breach.
    8
    argues that Dr. Bradley’s failure to address Phillis’s right eye is not relevant because
    “only the left eye is at issue in this case.” Plaintiff argues that Dr. Bradley’s opinion
    on causation is not conclusory because it provides a fair summary of the causal
    relationship between the breach and the injury, it is sufficient to inform Defendants
    of the specific conduct Plaintiff challenges, and it provides a sufficient basis for the
    trial court to conclude that Plaintiff’s claims have merit.
    At the hearing on the motion to dismiss, Plaintiff argued the “gist of this entire
    case [] only has to do with [Phillis’s] left eye[]” and the allegations about Phillis’s
    “life enjoyments” and how problems with her right eye may have affected the left
    eye only go to the scope of damages.
    After the hearing on the motion to dismiss, the trial court signed an order
    denying Defendants’ motion to dismiss. Defendants timely filed a notice of
    interlocutory appeal.
    Standard of Review and Applicable Statutory Requirements
    The TMLA governs health care liability claims and requires that the plaintiff,
    to avoid dismissal, serve an expert report addressing liability and causation as to
    each defendant within 120 days after the defendant files an original answer. Rogers
    v. Bagley, 
    623 S.W.3d 343
    , 348 (Tex. 2021) (citing 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    (a)). The purpose of the expert report requirement is to weed out
    frivolous malpractice claims in the early stages of litigation, not to dispose of
    9
    potentially meritorious claims. Abshire v. Christus Health Se. Tex., 
    563 S.W.3d 219
    ,
    223 (Tex. 2018) (per curiam) (citing Am. Transitional Care Ctrs. of Tex., Inc. v.
    Palacios, 
    46 S.W.3d 873
    , 877 (Tex. 2001)); see also Loaisiga v. Cerda, 
    379 S.W.3d 248
    , 258 (Tex. 2012) (“[Expert report] requirements are meant to identify frivolous
    claims and reduce the expense and time to dispose of any that are filed.”). In
    accordance with that purpose, the Act provides a mechanism for dismissal of the
    claimant’s suit in the event of an untimely or deficient report. 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    (b).
    In a case under the TMLA, we review a trial court’s ruling on a motion to
    dismiss challenging the adequacy of an expert report for an abuse of discretion. See
    Abshire, 563 S.W.3d at 223; Van Ness v. ETMC First Physicians, 
    461 S.W.3d 140
    ,
    142 (Tex. 2015) (per curiam); Palacios, 46 S.W.3d at 877-78. “A trial court abuses
    its discretion if it acts in an arbitrary or unreasonable manner without reference to
    any guiding rules or principles.” Bowie Mem’l Hosp. v. Wright, 
    79 S.W.3d 48
    , 52
    (Tex. 2002) (per curiam). A trial court’s ruling does not constitute an abuse of
    discretion simply because the appellate court would have ruled differently under the
    circumstances. See 
    id.
     A trial court also abuses its discretion if it fails to analyze or
    apply the law correctly. See In re Prudential Ins. Co. of Am., 
    148 S.W.3d 124
    , 135
    (Tex. 2004) (citing Walker v. Packer, 
    827 S.W.2d 833
    , 840 (Tex. 1992)).
    10
    When reviewing the sufficiency of a report, “we consider only the information
    contained within the four corners of the report.” Abshire, 563 S.W.3d at 223 (citing
    Palacios, 46 S.W.3d at 878). And we view the entirety of the report rather than
    isolating specific portions or sections. See E.D. v. Tex. Health Care, P.L.L.C., 
    644 S.W.3d 660
    , 667 (Tex. 2022) (appellate review of an expert’s report must consider
    “the report as a whole[]”) (citing Van Ness, 461 S.W.3d at 144); see also Baty v.
    Futrell, 
    543 S.W.3d 689
    , 694 (Tex. 2018).
    While the report “need not marshal all the plaintiff’s proof,” it must provide
    a fair summary of the expert’s opinions as to the applicable standards of care, how
    the care rendered by the health care provider failed to meet the standards, and the
    causal relationship between that failure and the injury claimed. Jelinek v. Casas, 
    328 S.W.3d 526
    , 539 (Tex. 2010); see also 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    (r)(6) (An expert report is sufficient under the TMLA if it “provides a fair
    summary of the expert’s opinions . . . regarding applicable standards of care, the
    manner in which the care rendered . . . failed to meet the standards, and the causal
    relationship between that failure and the injury[.]”); Jernigan v. Langley, 
    195 S.W.3d 91
    , 93 (Tex. 2006); Palacios, 46 S.W.3d at 875, 878. In determining the
    adequacy of an expert report, a court reviews the pleadings to determine the claims
    alleged and whether the report addresses those claims. See Christus Health Se. Tex.
    v. Broussard, 
    306 S.W.3d 934
    , 938 (Tex. App.—Beaumont 2010, no pet.) (citing
    11
    Windsor v. Maxwell, 
    121 S.W.3d 42
    , 51 (Tex. App.—Fort Worth 2003, pet. denied)).
    The report must “explain, to a reasonable degree, how and why the breach caused
    the injury based on the facts presented.” Jelinek, 328 S.W.3d at 539-40. The trial
    court need only find that the report constitutes a “good faith effort” to comply with
    the statutory requirements. 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    (l); see also
    Abshire, 563 S.W.3d at 223; Palacios, 46 S.W.3d at 878. The Texas Supreme Court
    has held that an expert report demonstrates a “good faith effort” when it
    “(1) inform[s] the defendant of the specific conduct called into question and
    (2) provid[es] a basis for the trial court to conclude the claims have merit.” Baty, 543
    S.W.3d at 693-94.
    The expert report “‘must set forth specific information about what the
    defendant should have done differently’”; that is, “‘what care was expected, but not
    given.’” E.D., 644 S.W.3d at 664 (quoting Abshire, 563 S.W.3d at 226). A report
    adequately addresses causation when the expert explains “how and why” the breach
    of the standard caused the injury in question by “explain[ing] the basis of his
    statements and link[ing] conclusions to specific facts.” Abshire, 563 S.W.3d at 224.
    The report need only make “‘a good-faith effort to explain, factually, how proximate
    cause is going to be proven.’” Id. (quoting Columbia Valley Healthcare Sys., L.P. v.
    Zamarripa, 
    526 S.W.3d 453
    , 460 (Tex. 2017)). The report presents a sufficient
    12
    causation analysis when it “draws a line directly” from the alleged breach of the
    standard of care to the ultimate injury. See 
    id. at 225
    .
    As to causation, “[n]o particular words or formality are required[]” to explain
    how the healthcare provider’s negligence caused the patient’s injury, but the report
    must contain more than a conclusory statement explaining the expert’s theory of
    causation to comply with the good-faith-report requirements of the TMLA. Scoresby
    v. Santillan, 
    346 S.W.3d 546
    , 556 (Tex. 2011) (footnotes omitted); Jelinek, 328
    S.W.3d at 539-40. At this stage, an expert’s report does not have to meet the
    evidentiary requirements needed to make an expert’s opinion relevant and
    admissible in a summary judgment proceeding or a trial. Miller v. JSC Lake
    Highlands Operations, LP, 
    536 S.W.3d 510
    , 517 (Tex. 2017) (per curiam).
    Analysis
    Here, the Appellants’ primary challenge to the report pertains to its alleged
    insufficiency on causation. Appellants argue that Dr. Bradley’s report is inadequate
    as to causation because (1) it does not address how bad Delli’s vision was in both
    eyes before she saw Dr. Eezzuduemhoi, (2) it does not address Delli’s vision at key
    points in the timeline, (3) it does not address whether Delli’s vision improved after
    the cornea transplant, (4) it does not address how the condition in Delli’s right eye
    “informs what could or could not have been accomplished with the left eye,” and
    (5) it does not address how “vague terms such as ‘poor outcome’” actually affect the
    13
    life activities Delli’s daughter’s affidavit describes. Appellants also argue that Dr.
    Bradley’s opinion that there was a “poor outcome” with Delli’s left eye is vague and
    conclusory. In addition, Appellants argue that Dr. Bradley did not compare what
    Delli’s vision would have been without Dr. Eezzuduemhoi’s treatment, and
    Bradley’s opinion “about ‘complete restoration of vision’ is speculative and
    conclusory ipse dixit.” According to Appellants, Dr. Bradley speculates that a
    different course of action by Dr. Eezzuduemhoi would have improved Delli’s
    chances for a “complete restoration of vision” and this is nothing more than a “last
    chance” theory that the Texas Supreme Court rejected in Kramer v. Lewisville
    Memorial Hospital, 
    858 S.W.2d 397
    , 400 (Tex. 1993). Finally, Appellants argue that
    even if the complaints against Dr. Eezzuduemhoi are accepted as true, Dr. Bradley’s
    report only addresses Delli’s left eye, and because the report does not address Delli’s
    right eye, it is inadequate for failing to address the “ultimate injury.”
    At this stage of the proceeding we may not require a claimant to “present
    evidence in the report as if it were actually litigating the merits[,]” and we cannot
    say that the trial court abused its discretion in reaching the conclusion that Dr.
    Bradley’s amended report constitutes a good faith effort to comply with the TMLA’s
    requirement to provide a fair summary of his opinion with respect to the causal
    relationship between Defendants’ alleged breach and Phillis’s claimed injury. We
    also cannot say that the amended report failed to inform the Defendants of the
    14
    specific conduct called into question or that it fails to provide a basis for the trial
    court to conclude the claims have merit. See Abshire, 563 S.W.3d at 226 (citing 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    (l), (r)(6); Palacios, 46 S.W.3d at 879); Baty,
    543 S.W.3d at 693-94.
    We disagree with Appellant’s argument that the report contains nothing more
    than the mere ipse dixit of the expert. “[T]he mere ipse dixit of [an] expert—that is,
    asking the jury to take the expert’s word for it—will not suffice.” Windrum v. Kareh,
    
    581 S.W.3d 761
    , 769 (Tex. 2019) (citing City of San Antonio v. Pollock, 
    284 S.W.3d 809
    , 816 (Tex. 2009); see also Cooper Tire & Rubber Co. v. Mendez, 
    204 S.W.3d 797
    , 806 (Tex. 2006) (explaining that testimony is fundamentally unsupported when
    “the only basis for the link between the [expert’s] observations and his conclusions
    was his own say-so[]” (citing Volkswagen of Am., Inc. v. Ramirez, 
    159 S.W.3d 897
    ,
    912-13 (Tex. 2004) (Hecht, J., concurring))). Here, the report contains Dr. Bradley’s
    opinion that: Dr. Eezzuduemhoi delayed correction of the ACIOL haptic in the
    surgery wound and the malpositioned sclerally-fixated PCIOL; that when intraocular
    lens implants are not in the correct position, the implant rubs against the cornea; and
    that this causes the endothelial cells to die, which results in corneal swelling and
    cloudiness. Dr. Bradley also explained the basis of his opinions when he wrote that
    delayed correction of both issues for a prolonged period of time directly resulted in
    progressive and irreversible corneal damage, and that with earlier intervention of the
    15
    ACIOL haptic in the wound and the malpositioned sclerally-fixated PCIOL, further
    surgery would most likely have been avoided and a better outcome would most
    likely have been attained. Dr. Bradley’s report “draws a line directly from” the
    Defendants’ breach of the standard of care, to the delay in diagnosis and treatment,
    and to the eye injury. See Abshire, 563 S.W.3d at 225. Dr. Bradley explains “to a
    reasonable degree, how and why the breach caused the injury based on the facts
    presented.” See Jelinek, 328 S.W.3d at 539-40.
    The trial court could have also rejected Appellants’ argument that the report
    was deficient because it only addressed the left eye and failed to address Phillis’s
    right eye. The report explained sufficient detail at this preliminary stage to provide
    a basis for the trial court to conclude that Plaintiff’s claims may have merit. The
    report contained an explanation with respect to the alleged causal relationship
    between Defendants’ alleged breach and Phillis’s left eye injury. We need not
    determine whether the report is deficient for failing to address an injury to Phillis’s
    right eye because the Supreme Court has explained that an expert report is sufficient
    so long as it adequately addresses at least one liability theory against a defendant
    health care provider. See Certified EMS, Inc. v. Potts, 
    392 S.W.3d 625
    , 630 (Tex.
    2013); see also Abshire, 563 S.W.3d at 224 (explaining that the expert report need
    not account for every known fact).
    16
    We also cannot say the trial court abused its discretion in rejecting Appellants’
    suggestion that the claims alleged are nothing more than the “last chance” or “lost
    chance of survival” claims rejected in Kramer. See 858 S.W.2d at 400; see also
    Columbia Rio Grande Healthcare, L.P. v. Hawley, 
    284 S.W.3d 851
    , 859-62 (Tex.
    2009) (addressing Kramer and explaining that the Texas Supreme Court has rejected
    the notion that the lost chance of survival or improved health is a distinct,
    compensable injury). At this stage of the litigation, the plaintiff is not required to
    marshal all evidence, and “the expert need not prove the entire case or account for
    every known fact[]” as long as it is a good-faith effort to explain factually how the
    plaintiff will prove proximate cause. Abshire, 563 S.W.3d at 224 (citing Zamarripa,
    526 S.W.3d at 460).
    Nor can we say that the trial court erred in rejecting Appellants’ argument that
    Dr. Bradley’s opinion on causation was deficient because it did not address “all the
    activities set forth in the affidavit of Ms. Billie Delli, i.e., the ‘ultimate injury’ for
    which recovery in dollar damages is sought.” In evaluating the sufficiency of the
    expert report, the trial court “could not look beyond the four corners of the report at
    this stage to determine whether the facts asserted in the pleading and the report were
    false.” See Broussard, 
    306 S.W.3d at
    939 (citing Wright, 79 S.W.3d at 52; Palacios,
    46 S.W.3d at 878). Billie’s affidavit was first filed with the Defendants’ motion to
    dismiss, and it was not available to Dr. Bradley when he wrote his report. Any
    17
    alleged deficiency in failing to address certain activities described in Billie’s
    affidavit may be the subject of further development in discovery or the subject of
    other pretrial motions, but it is not instructive at this stage of the litigation because
    the failure to address Billie’s affidavit does not render Dr. Bradley’s expert report
    deficient under section 74.351. See 
    Tex. Civ. Prac. & Rem. Code Ann. § 74.351
    ;
    Broussard, 
    306 S.W.3d at 939
    .
    We overrule Appellants’ issue, and we affirm the trial court’s order.
    AFFIRMED.
    _________________________
    LEANNE JOHNSON
    Justice
    Submitted on August 3, 2022
    Opinion Delivered November 17, 2022
    Before Kreger, Horton and Johnson, JJ.
    18
    

Document Info

Docket Number: 09-22-00053-CV

Filed Date: 11/17/2022

Precedential Status: Precedential

Modified Date: 11/18/2022