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Click here for the full text of this decision FACTS:On Feb. 11, 2005, Frances Mitchell, who suffered from dementia related to Alzheimer’s disease, was hospitalized after she fractured and displaced her left hip. On March 8, 2005, Dr. Anil Patel discharged her to the Sugar Land Health Care Center where he would be Mitchell’s treating physician. To treat Frances’ dementia, Patel prescribed Risperdal, a psychotropic drug with side effects including restlessness or a need to keep moving. Patel continued the Risperdal treatment after George Williams, a family member of Frances’, withheld consent to the use of the drug. While at the Sugar Land Health Care Center, Frances received nutrition through a gastrostomy tube. On March 27, 2005, nurses noted that Frances was very agitated and pulling on her gastrostomy tube, which she eventually dislodged. Sugar Land Health Care Center nurses improperly reinserted the tube. Frances suffered leakage of gastric contents into the peritoneum as a direct consequence of the improperly inserted gastrostomy tube. This leakage resulted in the formation of an abscess. Frances required multiple operations to address the abscess and infection stemming from the improperly inserted tube. She died on May 22, 2005. The death certificate identified the cause of death as small cut gangrene with the underlying cause of mesenteric artery thrombosis. Williams filed suit against Patel and Sugar Land Health Care Center asserting that their negligence and gross negligence resulted in Frances’ death. Pursuant to Texas Civil Practice & Remedies Code �74.351, Williams served Dr. Michael Zeitlin’s expert report on Patel and Sugar Land Health Care Center. Patel filed a motion to dismiss, contending Zeitlin’s report was not sufficient to fulfill the requirements of �74.351. The trial court denied the motion and an appeal followed. HOLDING:Affirmed. On appeal, Patel contended that Zeitlin’s report failed to state the applicable standard of care and was conclusory and speculative regarding the element of causation. Under �74.351, health-care liability claimants must provide an expert report to the defendant no later than 120 days after filing the original petition. An expert report, the court stated, is defined as a written report by an expert that provides a fair summary of the expert’s opinions regarding: 1. the applicable standard of care; 2. the manner in which the care provided failed to meet that standard; and 3. the causal relationship between that failure and the injury, harm or damages claimed. Thus, an expert report must incorporate enough information to fulfill two purposes: 1. the report must inform the defendant of the specific conduct the plaintiff has called into question; and 2. the report must provide a basis for the trial court to conclude the claims are meritorious. The court found that although Zeitlin’s report could have been more artfully written, it provided Patel with a fair summary of the standards of care applicable to him. Next, the court found that the trial court did not abuse its discretion in finding that Zeitlin sufficiently outlined the required causal relationship between Patel’s breach of the standard of care and the alleged injuries. Therefore, the court concluded that the trial court acted within its discretion in finding that Zeitlin’s report sufficiently addressed the element of causation. OPINION:Seymore, J.; Hedges, C.J., and Anderson and Seymore, JJ.

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