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Click here for the full text of this decision FACTS:The parents of 3-year-old Justin Maurice Evans found an open bottle of Prozac medication with only one pill remaining. His parents took Justin to the hospital, where Dr. Meria Aulds examined him. Though the local poison control center alerted Aulds that Justin was on his way in and that he should be treated with activated charcoal and kept under observation for six hours, Aulds did not administer activated charcoal and released Justin after 35 minutes. Justin’s parents brought Justin back to the emergency room two-and-a-half hours later. He was vomiting, sweating, unable to focus his eyes and his arms and legs were rigid. Aulds found Justin had overdosed on Prozac and admitted him to the hospital. Drs. Milton Brownlow and Layne Collums took over Justin’s care, ordering that he be transferred to another hospital the following morning. Becky Vanden Bosch, as Justin’s next friend, sued the three doctors involved in Justin’s case for medical malpractice. As required by statute, Bosch filed an expert report applicable to all three doctors (Collums died while the suit was pending), though the report was described as a “preliminary report.” The doctors objected to the report, saying it omitted the standard of care and failed to identify a breach of that standard by Aulds; that a causal link, standard of ordinary care and emergency room standard of care were omitted as to Brownlow; and that the causal link as to Collums was omitted. The trial court signed an order sustaining the doctors’ objections to the expert report, granted their motions to dismiss, and denied Bosch’s request for a 30-day extension. HOLDING:Affirmed in part; reversed and remanded in part. The court addresses Bosch’s claim that the trial court erred in sustaining Aulds’ objection to the expert report based on the med-mal statute’s emergency care provisions. Aulds claims that the report was insufficient under Texas Civil Practice & Remedies Code �74.351(r)(6) because it did not contend that Aulds’ actions or inactions amount to willful and wanton negligence or that she acted with conscious indifference to Justin’s rights, safety or welfare. The court explains that in the context of medical malpractice actions, the phrases “standard of care” and “standard of proof” are not synonymous. But, by ��74.153 and 74.154, when the health care liability claim against a physician or health care provider is implicated and emergency medical care is involved, the Legislature has heightened the standard of proof. The court thus concludes that �74.153 does not constitute a standard of care contemplated by �74.351(r)(6). Instead, the section provides the evidentiary standard of proof in emergency room medical care cases. The report was thus sufficient as to Aulds. Turning to the adequacy of the report as to Brownlow and Collums, the court finds that the report does not identify any improper treatment. By implication, it suggests that Justin’s condition resulted from the failure to administer the activated charcoal. Moreover, the report does not indicate that Justin’s condition at the time he was returned to the hospital would have been improved had the charcoal been administered upon his second visit at the hospital. Accordingly, the trial court did not abuse its discretion in sustaining the objection of Collums and Brownlow, and in granting their motions to dismiss the suit. Finally, the court rules the trial court did not err in denying Bosch a 30-day extension, noting that Bosch did not timely file her request for an extension. OPINION:Reavis, J; Reavis, Campbell and Hancock, JJ.

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