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Click here for the full text of this decision FACTS:Debi Rose filed a negligent-credentialing claim against Garland Community Hospital. The Dallas Court of Appeals initially ruled that such a cause of action did not fall within the purview of the Medical Liability and Insurance Improvement Act, but the Texas Supreme Court reversed and remanded. Consequently, the Dallas Court of Appeals is tasked with reviewing the expert witness’ report to see if it constituted a good-faith effort to comply with the MLIIA. Two reports from Dr. Robert A Ersek dealt with Rose’s treatment at Cosmetic Surgery Center of North Dallas by Dr. James H. Fowler from October 1998 to July 1999. A report dated April 10, 2001, dealt with Rose’s medical treatment, and the report of July 10, 2001, dealt with negligent credentialing. The trial court dismissed Rose’s complaint, and found that the report did not constitute a good-faith effort to comply with the MLIIA. HOLDING:Affirmed. The court examines both reports and finds that nowhere in either is there a fair summary of the expert’s opinions regarding causation between the center’s failure to meet the specialized standard of care for credentialing and the injury, harm or damages Rose claimed. The April 10 report, for example, makes the causal connection between the alleged negligent medical treatment and Rose’s injuries, but not between the alleged negligent credentialing by the center of the doctor and Rose’s injuries. The July 10 report does not deal with causation at all. “Neither affidavit states there were multiple previous complaints or allegations by patients of medical negligence against Dr. Fowler, which, if they had been investigated, would have been found to be meritorious and would have led to restriction of Dr. Fowler’s privileges. Perhaps the complaints and allegations would have been unsustained as lacking merit. We may not infer causation.” Because Rose’s expert’s report did not discuss a causal link, the trial court could have reasonably determined the report was conclusory. And because the statutory 180-day time period had passed when the trial court made its decision, the court finds that it is required to dismiss Rose’s claims against the hospital with prejudice. OPINION:Lagarde, J.; FitzGerald, Richter and Lagarde. JJ. DISSENT:FitzGerald, J. “I part company with the majority because of the approach used to analyze the issue. The majority searches the expert reports to determine if they state the hospital’s credentialing process caused Rose’s injuries. . . . The supreme court, on the other hand, dictates we recognize the inherently inseparable nature of the credentialing process and medical treatment. We, therefore, must review the expert reports to determine if they state that the hospital’s credentialing process, in conjunction with the medical treatment given Rose, caused Rose’s injuries.”

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