Justia Texas Supreme Court Opinion Summaries

Plaintiffs, as next friends of their daughter (Daughter) sued Hospital for injuries sustained by Daughter following her premature birth. One hundred and sixteen days after filing their original petition, Plaintiffs nonsuited their claim. Plaintiffs later filed a new lawsuit against Hospital and other health care providers and served an expert report on Hospital. Hospital objected to the report as untimely and moved to dismiss the claim against it. The trial court overruled the objection and denied the motion to dismiss. The court of appeals affirmed, concluding that Plaintiffs timely served their expert report. At issue on appeal was the Texas Medical Liability Act's (TMLA) expert-report requirement, which requires a claimant to serve an expert report on health care providers against whom the claim is asserted 120 days after the original petition is filed. The Supreme Court affirmed, holding that a claimant's nonsuit of a health care liability claim before the expiration of the 120-day period tolls the expert-report period until suit is refiled. View "CHCA Woman's Hosp., LP v. Lidji" on Justia Law

In an earlier suit, fourteen Texas hospitals filed a declaratory relief action against the Texas Health and Human Services Commission and its Executive Commissioner (collectively HHSC), challenging a cutoff date used by HHSC to cap the collection of data used to calculate Medicaid reimbursement rates for inpatient services. The Supreme Court declared the cutoff-date rule invalid and enjoined its enforcement. The Court further remanded the cause to the district court, where the hospitals argued that the Court's judgment should apply retroactively to provide them a basis to reopen their earlier administrative appeals and to seek reimbursement for the underpayment of past Medicaid claims calculated under the invalid cutoff-date rule. The district court found in favor of the hospitals. The court of appeals reversed, determining that the injunction should only operate prospectively. The Supreme Court affirmed, holding that the court of appeals correctly concluded that the Court's earlier opinion and judgment did not purport to reopen past rate determinations or closed administrative proceedings. View "El Paso County Hosp. Dist. v. Tex. Health & Human Servs." on Justia Law

Plaintiff sued the hospital (Hospital) where she gave birth to a newborn and the two doctors who assisted in delivery, alleging that Hospital was liable for injuries to the newborn because of its own direct negligence as well as its vicarious liability for the negligence of the two doctors. Plaintiff served Hospital with three expert reports, all of which Hospital objected to. The trial court determined that when the three reports were read in concert, Plaintiff had met the requirements of the Texas Medical Liability Act (TMLA). The court of appeals concluded Plaintiff's reports were adequate as to the vicarious liability claim but remanded to the trial court to consider granting an extension to cure other deficiencies. The Supreme Court (1) affirmed the court of appeals' judgment as to the adequacy of the reports regarding the claim that Hospital was vicariously liable for the doctors' actions; and (2) did not address whether the court of appeals erred by remanding the case for the trial court to consider granting an extension of time for Plaintiff to cure deficiencies, as the expert reports satisfied the TMLA requirements as to one theory of liability alleged against Hospital. View "TTHR Ltd P'ship v. Moreno" on Justia Law

Several hospitals (Hospitals) sued Aetna, Inc. and Aetna Health, Inc. (collectively Aetna) for allegedly violating the Prompt Pay Statute. Aetna provided a Medicare plan (Plan) through an HMO called NYLCare. It delegated the administration of its Plan to North American Medical Management of Texas (NAMM), a third-party administrator. IPA Management Services (Management Services) provided medical services to Plan enrollees. Management Services entered into contracts with the Hospitals to secure hospital services for the Plan employees. Aetna was not a party to these contracts. The Hospitals submitted hospital bills to NAMM for payment. After NAMM and Management Services became insolvent, Aetna de-delegated NAMM and assumed responsibility for processing and paying claims. However, Aetna instructed the Hospitals to continue submitting their bills to NAMM. The Hospitals argued that Aetna was liable for NAMM's failure to timely pay claims and was responsible for $13 million in outstanding bills. The trial court granted summary judgment for Aetna. The court of appeals affirmed, concluding that because the Hospitals entered into contracts with Management Services and not with Aetna directly, the Hospitals had no viable prompt-pay claim. The Supreme Court affirmed, holding that the lack of privity between the Hospitals and Aetna precluded the Hospitals' suit. View "Christus Health Gulf Coast v. Aetna, Inc." on Justia Law

Plaintiff alleged that while she was a patient at a hospital, a hospital nurse, who was temporarily placed with the hospital by a staffing service, assaulted her. Plaintiff sued under the Texas Medical Liability Act, asserting that the staffing service was directly and vicariously liable for the nurse's conduct. The staffing service filed a motion to dismiss because the patient's expert reports did not specify how the service was directly negligent. The trial court denied the motion. The court of appeals affirmed, holding that because the reports supported a theory of vicarious liability against the staffing service, the lack of a description supporting direct liability was not fatal to Plaintiff's maintaining her cause of action. The Supreme Court affirmed but on different grounds, holding (1) an expert report that adequately addresses at least one pleaded liability theory satisfies the statutory requirements, and the trial court must not dismiss in such a case; and (2) Plaintiff demonstrated that at least one of her alleged theories, vicarious liability, had expert support, and therefore, the trial court correctly denied the motion to dismiss. View "Certified EMS, Inc. v. Potts" on Justia Law

Doctor examined Patient to determine whether she met the criteria for involuntary hospitalization for psychiatric care. Doctor decided she did not and released her. Three days later Patient committed suicide. Patient's sons (Plaintiffs) sued Doctor for negligence in failing to involuntarily hospitalize Plaintiff. The jury found against Doctor and awarded damages of $200,000. The trial court rendered judgment on the verdict, and the court of appeals affirmed. The Supreme Court reversed and rendered judgment in favor of Doctor, holding that because there was no evidence that Patient's involuntary hospitalization by Doctor probably would have prevented her death, the evidence was legally insufficient to support the finding that his negligence proximately caused her death. View "Rodriguez-Escobar v. Goss" on Justia Law

Two female patients sued a medical doctor, the professional association bearing his name, and a clinic, alleging the doctor assaulted the patients by groping their breasts while examining them for sinus and flu symptoms. Although they maintained the claims were not health care liability claims (HCLCs), the patients served the doctor and professional association with reports from a physician who, based only on the assumption that allegations in the plaintiffs' pleadings were true opined that the defendant doctor's alleged actions did not fall within any appropriate standard of care. The trial court denied Defendants' motions for dismissal on the suit on the basis that the claims were HCLCs and that the reports were deficient. The court of appeals affirmed without considering the reports' adequacy. The Supreme Court reversed, holding (1) the Texas Medical Liability Act (TMLA) creates a rebuttable presumption that a patient's claims against a physician or health care provider based on facts implicating the defendant's conduct during the patient's care, treatment, or confinement are HCLCs; and (2) the record did not rebut the presumption as it related to the TMLA's expert report requirements, nor were the expert reports served by the plaintiffs adequate under the TMLA. Remanded. View "Loaisiga v. Cerda" on Justia Law

At issue in this interlocutory appeal was whether the claims of an employee against his employer, both of whom were health care providers, alleging injuries arising out of inadequate training, supervision, risk-mitigation, and safety in a mental health facility, constituted health care liability claims (HCLCs) under the Texas Medical Liability Act (Act). Employer filed a motion to dismiss on the grounds that Employee's claims constituted HCLCs under the Act and that Employee had not served an expert report on Employer as required under the Act. The trial court denied Employer's motion. The trial court affirmed. The Supreme Court reversed, holding (1) Employee here was properly characterized as a "claimant" under the Act and his allegations against his nonsubscribing Employer were health care and safety claims under the Act's definition of HCLCs, requiring an expert report to maintain his lawsuit; and (2) the Act does not conflict with the Texas Workers' Compensation Act. Remanded. View "Tex. W. Oaks Hosp., LP v. Williams " on Justia Law

This suit was filed by a daughter against an organ donation charity when she discovered that the charity - contrary to an earlier representation to her - would allegedly profit from harvesting her deceased mother's tissues. The charity requested a defense from its insurer, and the insurer denied a defense. The insurer's subsequent suit against the charity resulted in two certified questions from the Fifth Circuit Court of Appeals. The Supreme Court held (1) the insurance policy provision for coverage of "personal injury" does not include coverage for mental anguish, unrelated to physical damage to or disease of the daughter's body; and (2) the insurance policy provision for coverage of "property damages," does not include coverage for the underlying plaintiff's loss of use of her deceased mother's tissues, organs, bones, and body parts. View "Evanston Ins. Co. v. Legacy of Life, Inc." on Justia Law

Plaintiff brought this suit against defendant alleging negligence in the treatment of Ronnie Young. At issue was whether the presumed harm analysis applied to a broad-form submission in a single-theory-of-liability case when the negligence charge included both an improper defensive theory of contributory negligence and an improper inferential rebuttal instruction. The court held that it did not and that meaningful appellate review was provided through a traditional harm analysis. Inasmuch as the court of appeals ruled otherwise, the court reversed the judgment and remanded for further consideration. View "Venkateswarlu Thota, M.D., et al. v. Young" on Justia Law