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Click here for the full text of this decision FACTS:Alonzo Hutchinson, who had a long medical history of diabetes and vascular disease, sought treatment from Dr. David Montemayor, Dr. Praful Mehta and Dr. Peter Fisher for an ulcer on his heel. Despite medical treatment, his heel ulcer worsened and ultimately Hutchinson underwent a below-the-knee amputation of his left leg. He then filed a medical malpractice lawsuit against all three physicians, Christus Care Medical Group, and San Antonio Plastic Surgery Center, P.A. In order to comply with the Texas Medical Liability and Insurance Improvement Act, Hutchinson timely filed an expert report prepared by Dr. Elena Villavicencio. All defendants moved to dismiss the lawsuit with prejudice, claiming the report did not comply with the statutory requirements of Texas Revised Civil Statutes Annotate Art. 4590i, 13.01 (e), (l), (r)(6). The trial court granted the defendants’ motions to dismiss, and the plaintiff appealed. HOLDING:The judgment of the trial court is affirmed. The defendants challenge only the causation element of the report. They contend it does not meet the statutory requirements, because it is conclusory and based upon mere conjecture and possibility. Hutchinson responds that the following statement within the report is a positive statement of fact: “If an arteriogram had been done, there would have been a possibility that Mr. Hutchinson may have had bypassable lesions and that the amputation may have been avoided. Within reasonable medical probability these doctor’s [sic] breaches caused injury to Mr. Hutchinson.” To constitute a good faith effort to establish the causal relationship element under the act, the appellate court points out, the expert report need not marshal all of the plaintiff’s proof or present evidence as if the plaintiff was actually litigating the merits. “The report, however, must provide enough information within the document to both inform the defendant of the specific conduct at issue and to allow the trial court to conclude that the suit has merit. . . . A report that merely sets forth the expert’s conclusions is insufficient to satisfy these two purposes.” “Neither of the two sentences quoted above upon which Hutchinson relies to meet the Act’s causation element provides any information linking the defendants’ alleged inaction (failure to do an arteriogram) to Hutchinson’s injury (the amputation).” The court also found that Dr. Villavicencio’s conclusory reference to causation and use of the phrase “reasonable medical probability” does not satisfy the causation requirement of the Act. Nowhere in her report does Dr. Villavicencio set forth facts or explain the medical basis for her opinion that the “doctor’s [sic] breaches caused injury to Mr. Hutchinson.” Simply adding what have often been described as the “magic words of”reasonable medical probability’” to an expert’s opinion is not evidence of causation. OPINION:Speedlin, J.; Stone, Duncan and Speedlin, JJ.

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