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Click here for the full text of this decision Because causation was an issue to be determined in appellants’ cause of action, subsection 13.01(j) of the Texas Medical Liability and Insurance Improvement Act did not relieve them of timely filing the required expert report. FACTS:Oswald Lookshin and his wife filed a medical-malpractice suit against Dr. Bernard Feldman following Lookshin’s prostate surgery. Lookshin alleged that Feldman was negligent in failing to properly inform him of the possible adverse consequences of the surgery, failing to properly perform the surgery and failing to treat Lookshin after the surgery. After filing a general denial, Dr. Feldman filed a motion to dismiss because Lookshin did not file an expert report by the 180th day after filing suit, as required by Medical Liability and Insurance Improvement Act, �13.01(d). Lookshin amended his complaint so that only the cause of action for failure to inform him of the surgery’s consequences remained. The trial court granted the motion to dismiss with prejudice. On appeal, Lookshin claims that a cause of action for alleged failure to disclose the risks and hazards of a surgical procedure does not require an expert report. HOLDING:Affirmed. The court notes that Lookshin relies on �13.01(j), which provides that the filing of an expert report is not required “regarding any issue other than an issue relating to liability or causation,” and dicta from Peterson v. Shields, 652 S.W.2d 929 (Tex. 1983), to conclude that standards predetermined by the Texas Medical Disclosure Panel govern actions based on failure to disclose. The court rejects Lookshin’s position that relying on an expert’s report instead of the standards as identified by the board would be to destroy the work of the panel. The court concludes that proximate cause is an element of a failure to disclose situation, and so Lookshin should still have had to comply with �13.01(d) by filing an expert’s report within 180 days. In granting Dr. Feldman’s motion for sanctions, the court finds Lookshin’s appeal frivolous. The court further chastises Lookshin for a “vitriolic political attack” against the Texas Medical Association and Texas Medical Liability Trust by accusing them of intimidating and harassing deserving parties. “[T]his Court will not allow the appeals process to be used by a litigant to make ad hominem attacks on an opposing party and subject that party to ‘needless burden and expense.’ “ OPINION:Jennings, J.; Radack, C.J., Taft and Jennings, JJ.

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