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Click here for the full text of this decision FACTS:The appellant, Alzada Hector, was injured when she fell from an operating table during surgery to remove cancer from her ear. Hector brought suit against the hospital and the surgeon. The trial court dismissed Hector’s case against each defendant for her failure to provide an expert report within 180 days as required by 13.01(d)(1) of former Texas Revised Civil Statutes Article 4590i, also known as the Texas Medical Liability and Insurance Improvement Act. Hector appealed, claiming that the trial court abused its discretion in dismissing her suit. HOLDING:Affirmed. Hector claims that 4590i does not apply to her case because her case is one of ordinary negligence (as opposed to medical malpractice); therefore, she argues, an expert report was not necessary. As a result, she asserts, the trial court abused its discretion in dismissing her claim for her failure to file a 4590i-required expert report. The court notes that a cause of action will generally be considered a health care liability claim if it is based on a breach of a standard of care applicable to health care providers. The complained-of act or omission must have been an inseparable part of the rendition of medical services. The court finds it abundantly clear that 4590i applies to Hector’s claims. Her claims against St. Joseph’s, a health care provider, and Harris, a physician, were based on their alleged departure from accepted standards of safety, of not letting a patient fall from an operating table. These alleged departures proximately resulted in Hector’s alleged injury. In so ruling, the court rejects Hector’s assertion that, since the operating table was under the control of hospital employees who were nonmedical providers, the alleged act of negligence concerns “administrative, ministerial, or routine care” and that 4590i should not apply to her claim. The court points out that any person in the operating room at the time of Hector’s accident would necessarily have been considered a health care provider. The court also rejects Hector’s claim that even if 4590i governs her case, the doctrine of res ipsa loquitur applies, thus obviating the need for an expert report under 4590i. The court finds that, while it is a given that a patient should not fall from an operating table during surgery, how an operating table works, the method of securing a patient to an operating table or the procedures for rotating a patient during surgery are not necessarily within the common knowledge of laymen. The court finds that Hector cannot therefore show that the character of the accident is such that it would not ordinarily occur in the absence of negligence. The court also holds that, even if Hector could make such a demonstration, her injury did not fall into any of the pre-1977 categories under which the doctrine of res ipsa loquitur applies. Finally, the court held that even if the doctrine were shown to apply, it still would not have excused Hector from filing an expert report as required by 4590i. OPINION:Hedges, C.J.; Hedges, Fowler and Frost, JJ.

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