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Click here for the full text of this decision FACTS:On Oct. 17, 2002, 86-year-old Arturo Labao was a passenger in a car being driven by his son-in-law Pacifico Ferrer, when a car being driven by Noemi Guevara turned in front of them. The cars collided. Pacifico and Arturo were injured and taken to a hospital emergency room by ambulance. After Arturo died in May 2003, Pacifico and Corazon Labao Ferrer, Arturo’s daughter and Pacifico’s wife, sued Guevara as a result of the injuries Pacifico and Arturo suffered in the accident. The only testimony at trial regarding damages came from Pacifico and Corazon. Their testimony was to the effect that Arturo had a seatbelt on at the time of the accident and that after the accident Arturo was screaming, complaining about a stomachache and moaning. Corazon testified without objection that he underwent abdominal surgery on the night of the accident, then had another surgery because the first was not healing properly. The plaintiffs did not introduce medical records or medical testimony. Medical bills admitted into evidence show that Arturo was in the hospital’s intensive care unit from Oct. 18, 2002, until Jan. 2, 2003, then remained in the hospital for another month. Following his discharge from the hospital in February 2003, Arturo spent approximately two more weeks in a continuing care facility. The only medical record introduced for the two-week admission was a note by a consulting physician which listed Arturo’s chief complaint upon admission as shortness of breath. The doctor’s “History of Present Illness” noted, among other matters, the automobile wreck in which Arturo “sustained multiple orthopedic injuries and has developed bacteremia and respiratory distress” and that he had a tracheostomy on Nov. 13, 2002. The note also reflected that Arturo had a significant past medical history of “atrial fibrillation and hypertension as well as acute and chronic renal failure” and significant past surgical history for “ileal resection as well as cataract surgery.” The note did not indicate dates as to the conditions noted in the history. On March 6, 2003, Arturo was admitted to another medical center for two weeks. The only medical records introduced for the March admission were the attending physician’s “History and Physical” notes and a consultant’s report. Those two records reflected that Arturo came to the emergency room because of “[c]ough and shortness of breath.” He was having chills and low-grade fever, and his condition was worsening. His past medical history was noted as “complicated” and included a “long history of hypertension and atrial fibrillation,” “known history of hypertension, atherosclerotic heart disease, history of congestive heart failure,” peripheral vascular disease, chronic venous insufficiency, degenerative joint disease, and the auto accident in October 2002 and subsequent medical treatment including an “exploratory laparotomy for internal bleed.” The attending physician noted that, upon admission, Arturo was not having “any significant complaints except for pain in his left knee which he developed about two days ago. He has not been able to walk due to the pain.” The medical bills in evidence included bills for the hospital and both care facility confinements and associated expenses for items such as drugs, laboratory procedures, respiratory services, physical therapy, renal dialysis, multiple anesthesia administrations, echo cardiograms and “ancillary charges” of various kinds. The total expenses exceeded $1 million. Corazon testified that before the accident Arturo had atrial fibrillation and high blood pressure for several years but did not have medical treatment except for checkups and blood pressure medications. At the close of evidence, Guevara moved for a directed verdict. Although she did not contend that the treatments Arturo received were unnecessary for treatment of his conditions or that the charges were unreasonable in amount, she argued that there was no evidence the conditions treated were caused by the accident. Corazon argued that evidence of the sequence of treatments following the accident combined with lay testimony about the accident and Arturo’s having no abdominal problems or requiring a ventilator prior to the accident was sufficient to establish a causal relationship. The trial court denied the motion for directed verdict. The jury found damages in the amount of more than $1.1 million for Arturo’s medical expenses and $125,000 for his pain and mental anguish. Guevara then moved for judgment notwithstanding the verdict based in part on the same causation arguments made in her motion for directed verdict. Corazon responded in the same vein as to the motion for directed verdict. The trial court granted Guevara’s motion and entered a take-nothing judgment as to Arturo. Corazon appealed. The 8th Court of Appeals held that there was legally sufficient evidence of causation. It noted Corazon’s testimony that Arturo “did not suffer from any of his post-accident injuries prior to the accident,” that he was not in bad health prior to the accident, and that “[n]o great length of time passed between the accident and [Arturo's] death during which he was not in the hospital or receiving care at home.” The 8th Court reversed and remanded for entry of judgment based on the jury’s verdict. On appeal to the Texas Supreme Court, Guevara asserted that the 8th Court alleged “post hoc, ergo propter hoc reasoning” (which means, “after this, therefore because of this,” according to Black’s Law Dictionary) was erroneous. She urged the court to overrule its precedent to the extent it was inconsistent with the rule that expert testimony of causation is required in cases involving complex medical conditions. HOLDING:Reversed and remanded. The general rule, the court stated, has long been that expert testimony is necessary to establish causation as to medical conditions outside the common knowledge and experience of jurors. In personal injury cases, the court stated, trial evidence generally includes evidence of the pre-occurrence condition of the injured person, circumstances surrounding the occurrence, and the course of the injured person’s physical condition and progress after the occurrence. The record contained lay testimony about Arturo’s pre-accident physical condition, his activities and other events leading up to the accident, the accident, an investigating police officer’s report and post-accident events including medical treatments. The causal connection between some events and conditions of a basic nature and treatment for such conditions are within a layperson’s general experience and common sense, the court stated. This conclusion accords with human experience, previous cases and the law in other states where courts have held that causation as to certain types of pain, bone fractures and similar basic conditions following an automobile collision can be within the common experience of lay jurors. Thus, the court stated that non-expert evidence alone is sufficient to support a finding of causation in limited circumstances where both the occurrence and conditions complained of are such that the general experience and common sense of laypersons are sufficient to evaluate the conditions and whether they were probably caused by the occurrence. Nonexpert evidence of circumstances surrounding the accident and Arturo’s complaints, the court stated, was sufficient to allow a layperson of common knowledge and experience to determine that Arturo’s immediate post-accident condition which resulted in his being transported to an emergency room and examined in the emergency room were causally related to the accident. Thus, legally sufficient evidence supported a finding that some of Arturo’s medical expenses were causally related to the accident. On the other hand, legally insufficient supported a finding that the accident caused all of the conditions and the expenses for their treatment. On remand, the court stated that if the 8th Court concludes that a proper remittitur cannot be determined, then the case should be remanded to the trial court for a new trial. OPINION:Johnson, J., delivered the opinion of the court.

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