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Torts No. 07-03-0027-CV, 5/12/2003. Click here for the full text of this decision FACTS: In this original proceeding, the relators, Craig W. Barker M.D., High Plains Radiological Associates and Muleshoe Area Hospital District d/b/a Muleshoe Area Medical Center seek a writ of mandamus requiring the respondent to withdraw his order denying the relators’ motion to dismiss the cause underlying this action, dismiss the cause and award them the sanctions they sought. In the underlying suit, Calvin A. Meissner and Gereta Meissner, the real parties, seek the recovery of damages for alleged medical negligence relating to care given to Calvin. HOLDING: Denied. The real parties filed a report by Dr. William Fleming within the 180-day period. The trial court deemed that first offering insufficient but granted a 30-day extension within which to file additional reports. Within that 30-day grace period, the real parties filed supplemental reports from Fleming and Dr. Michael G. Keller. Neither party disputes that in this type of matter, this court would have jurisdiction to issue a writ of mandamus if it were justified. Moreover, the relators do not challenge the authority of the trial court to grant the 30-day extension of time within which to file an expert report meeting statutory requirements. Rather, the relators contend that the expert reports the real parties have filed fail to “adequately state how the allegedly negligent medical care caused injury or damage to Calvin,” thereby failing to meet that portion of the Texas Revised Civil Statutes article 4590i �13.01(r)(6) requirements. Thus, the question is whether the reports filed by the real parties were sufficient to meet the causation requirement. In contending Dr. Fleming’s report is insufficient in regard to causation, relators cite and rely upon Bowie Memorial Hospital v. Wright, 79 S.W.3d 48 (Tex. 2002), in which the court found an expert report was not sufficient with regard to causation. In that case, the plaintiff went to Bowie Memorial Hospital after being involved in an automobile accident. X-rays were taken of her knee and foot, and a fractured patella (knee cap) was diagnosed and surgically repaired. About a month later, it was discovered that she also had sustained a foot fracture which required two additional surgeries to repair. The plaintiffs filed suit alleging negligence in the failure to recognize the foot fracture on the x-rays taken at the hospital. With regard to the issue of causation, the expert report merely stated, “I do believe that it is reasonable to believe that if the x-rays would have been correctly read and the appropriate medical personnel acted upon those findings then Wright [the plaintiff] would have had the possibility of a better outcome.” The trial court held the report was insufficient and dismissed the cause. The court of appeals disagreed and reversed the trial court. In determining the court of appeals erred in its reversal, the high court reasoned that the trial court could reasonably have concluded the report was not sufficient “because the report simply opines that Barbara [the injured party] might have had ‘the possibility of a better outcome’ without explaining how Bowie’s conduct caused injury to Barbara.” The court went on to explain that it could not infer from the report that “Bowie’s alleged breach precluded Barbara from obtaining a quicker diagnosis and treatment for her foot,” and reversed the court of appeals and dismissed the suit. In contrast to the report in the Bowiecase, Fleming explains in considerable detail the treatment which was needed if the bleeding had been timely diagnosed, and that medical science “recognizes the relationship between the amount of intracerebral blood, delayed diagnosis, and the presence of vasospasm and the subsequent severity of global neurological injury and deficit.” He goes on to conclude that without the negligent failure to recognize the cranial bleeding, and the resulting delay in treatment, Calvin’s injuries would not be as severe as they were. The trial court could reasonably have inferred that Fleming’s reports were sufficient to meet the statutory requirements and did not abuse its discretion in doing so. OPINION: Boyd, J.; Quinn, Reavis and Boyd, JJ.

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