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Click here for the full text of this decision FACTS:Physicians in Artesia, N.M., diagnosed Lawrence Ashmore with a heart attack and transferred him to Covenant Hospital in Lubbock on Sept. 5, 2003. In Lubbock, Ashmore was treated by Dr. Guy A. Wells. That night, Lawrence developed seizures and irregular heart rhythms and died the next day. His surviving wife, Mary Ashmore, and daughter Frances McFarland, then sued Wells for medical malpractice, known under Texas law as a health care liability claim. The plaintiffs tendered an expert report to satisfy �74.351 of the Texas Civil Practice & Remedies Code. Dr. Howard I. Kurz provided plaintiffs’ expert report. In it, he stated the standards of care applicable to treating patients such as Lawrence Ashmore. Kurz specified the manner in which Wells allegedly breached those standards. To connect those alleged breaches to the death of Lawrence Ashmore, Kurz stated in part: “It is my opinion that Dr. Wells breached the applicable standard of care in his treatment of Mr. Ashmore . . . and these acts of or omissions proximately caused Mr. Ashmore’s death.” Wells argued that Kurz’s expert report failed to adequately explain, among other things, how the alleged deficiencies in Wells’ performance caused Lawrence’s death. Because of that perceived defect, Wells moved to dismiss the case with prejudice. The trial court denied the motion, and the appeal ensued. Wells contended that the trial court abused its discretion in denying his objections, because the report failed to set forth the element of causation in a non-conclusory manner. HOLDING:Reversed and remanded. Under the Texas Civil Practice & Remedies Code �74.351(a), a person suing for medical malpractice must serve on each party at least one expert report. This must occur at least 120 days the original petition is filed and include a curriculum vitae of each expert listed in the report for each physician or health care provider against whom a liability claim is asserted. If a plaintiff fails to serve an expert report, upon motion the trial court must enter an order awarding the moving party reasonable attorney’s fees and costs of court and dismiss the claim against physician or health care provider with prejudice. The court stated that expert reports are defined by statute to mean “a written report by an expert that provides a fair summary of the expert’s opinions as of the date of the report regarding applicable standards of care, the manner in which the care rendered . . . failed to meet the standards, and the causal relationship between that failure and the injury, harm or damages claimed.” To constitute a “fair summary” of the expert’s opinions, the document must contain more than conclusions. Instead, the expert must provide enough data to not only inform the defendant of the specific conduct called into question but also provide the trial court the means to preliminarily assess whether the claim has factual basis. The court found that Kurz’s report failed to satisfy Texas law governing health care liability claims, because it failed to establish proximate cause linking Lawrence Ashmore’s death to Wells’ breaches of duty. The court stated that had the report stated a cause of death, it may have been sufficient: “Similarly unmentioned by Kurz is the condition of which Lawrence ultimately died. This is of import because elsewhere in his report the expert uttered that 1) increased doses of levophed and dopamine were administered to Mr. Ashmore”which lead to peripheral vasoconstriction and hypoperfusion as manifested my [sic] mental confusion and kidney shutdown’ and 2) administering”large doses of pressors caus[ed] tissue hypoperfusion with kidney shutdown.’ Had the expert related that death resulted from vasoconstriction, hypoperfusion, mental confusion, or kidney shutdown, then it may be arguable that the report illustrated the requisite nexus between the purported conduct of Wells and the death of his patient. But, without specifying whether Ashmore died of heart failure, kidney failure, mental confusion, a combination of one or more of those conditions or of something else, Kurz provided us with no factual data tying the administration of those drugs to Lawrence’s death.” In sum, the court found that the Kurz’s allegations regarding the cause of Lawrence Ashmore’s death were conclusory because they did not explain how the purported defaults caused Lawrence’s death. Thus, “the report fell short of constituting a good faith effort to provide a fair summary between the alleged misconduct of Wells and its relationship to Mr. Ashmore’s death, and the trial court had no discretion but to sustain Wells’ objections.” OPINION:Quinn, C.J.; Quinn, C.J., and Campbell and Hancock, J.J.

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