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Click here for the full text of this decision FACTS:Archie Moreno went to the emergency room at Columbia Medical Center in April 1995 with stomach pain. Dr. Ascencion Mena, the attending physician, felt that Moreno’s symptoms were consistent with kidney stones, which Moreno had a history of. Mena ordered tests. The results prompted Mena to refer Moreno him to a urologist, Dr. Murray Vann. Vann’s examination did not rule out the possibility of kidney stones, and he did not see anything that indicated Moreno had appendicitis. Several hours later, however, Moreno’s symptoms changed significantly. Vann called in a general surgeon, Dr. Antonio Davalos, who diagnosed Moreno with acute abdomen, but not appendicitis. He found that an infection was spreading, and he ordered surgery. Moreno was eventually diagnosed with a ruptured appendix. Following surgery, Moreno developed complications, including sepsis and wound infection, requiring his hospitalization for more than a week. Moreno sued Mena, Vann and the hospital for medical malpractice, and the case went to trial. Dr. Terry Simpson provided expert testimony for Moreno. In his opinion, Mena should have consulted with a general surgeon when Moreno came into the ER with the symptoms that he had and when Mena could not rule out appendicitis. Otherwise, Simpson generally found the actions of Mena and Vann reasonable; he even called Vann’s assessment of Moreno’s condition as “elegant” and thorough. At the close of Moreno’s evidence, the trial court granted the separate summary judgment motions filed by the hospital and the doctors. Moreno appeals only the directed verdict against the doctor. The appellate record presented by Moreno contains only the testimony of Simpson and an abbreviated court reporter’s transcript. HOLDING:Affirmed. From the scarce appellate record, the court notes that in addition to the concessions in support of the doctors’ treatment that Simpson made during his testimony, Simpson also confirmed that neither doctor actually caused Moreno’s appendicitis. The rest of Simpson’s testimony does not otherwise establish that the diagnostic process followed by the doctors was deficient in any way or failed to meet the appropriate standard of care. The court notes that the only evidence presented on the causation element of Moreno’s claim is that the type of complications Moreno suffered may occur after removal of a non-ruptured appendix, and that with an earlier consultation and surgery they may not have occurred. The court finds that this testimony amounted to, “at most, speculation,” and testimony in medical malpractice cases requires more. OPINION:Barajas, C.J.; Barajas, C.J., McClure and Chew, JJ.

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