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Click here for the full text of this decision FACTS:On May 2, 2004, a patient of a Texarkana hospital died and his family donated his organs. Dr. Srinath Chinnakotla, a transplant surgeon at Baylor, flew to Texarkana to harvest the donor’s kidneys for transplantation at Baylor University Medical Center. On May 4, one of the donor’s kidneys was transplanted into Cheri Biggs. After the surgery, Biggs’s follow-up tests were normal until May 20, when Biggs began to experience complications. After her discharge on May 27, Biggs experienced additional complications, ultimately resulting in her hospitalization on June 1. Biggs’s condition continued to deteriorate, and she was pronounced dead on June 9. The parties agree that the medical records show Biggs died from the transplantation of a rabies-infected kidney. The family sued Baylor, Dr. Edmund Sanchez and Chinnakotla for medical malpractice. Contemporaneously with the filing of their lawsuit and pursuant to Chapter 74 of the Texas Civil Practice & Remedies Code, the family filed two medical expert reports. Appellants objected to the reports, contending the reports did not comply with �74.351(r)(6), because they did not state the applicable standard of care, the alleged breach or how the alleged breach proximately caused Biggs’s death. In response to these objections, the family provided supplemental expert reports. The appellants objected to the supplemental expert reports on the same grounds; Sanchez and Chinnakotla also challenged the qualifications of one of the experts. The appellants each moved to dismiss the suit, contending the expert reports were insufficient under �74.351(r)(6) as a matter of law. The trial court denied appellants’ motions, and appellants filed this interlocutory appeal. HOLDING:Reversed and remanded. The family alleges Biggs would have declined the kidney if appellants had informed her about the donor’s high-risk social and medical history, including specifically the information about his condition when he presented at the emergency room and after he was admitted to the hospital. They also allege they were not told that the transplant center offered the donor’s kidneys to several hospitals and that those hospitals declined the organs because of the donor’s high-risk social history, recent incarceration and overall poor donor quality. The family further contends Baylor was negligent by failing to develop, implement, and enforce effective policies and procedures and/or standard guidelines for physicians regarding informed consent as it applied to high-risk donors. Sanchez and Chinnakotla contend that William M. Bennett, M.D., one of the family’s experts, is not qualified to render an opinion in this case. The doctors argue that Bennett is a practicing nephrologist, not a transplant surgeon, and that his curriculum vitae and report do not indicate he is familiar with surgical standards of care or that he obtains surgical consent for kidney transplants. Although Bennett’s curriculum vitae and report state he is a transplant physician, they do not specifically state he has training and experience as a transplant surgeon or that he has training and experience in obtaining informed consent from patients awaiting transplant surgery. Whether the trial court should have sustained appellants’ objections to Bennett’s qualifications and excluded his report is a close call. Close calls go to the trial court. Because the reports omit the required elements of an expert report with regard to Baylor, they do not comply with �74.351(r)(6).To support their claim that Biggs would have declined the donor’s kidney if appellants had informed her about the donor’s high-risk social and medical history, the family submitted initial and supplemental reports from experts Bennett and Youmin Wu, M.D., a transplant surgeon at the University of Arkansas for Medical Sciences. Bennett and Wu do not refer to Baylor by name in their reports other than to say they reviewed Baylor’s records. The expert reports do not contain a statement of the standard of care, breach or causation applicable to Baylor on any of the theories raised by the pleadings. The trial court should determine whether appellees should be granted an extension in which to cure the deficiencies. The family’s expert reports do not satisfy the requirements of �74.351(r)(6) with regard to the standard of care. Bennett states the “receiving surgeon has a medical and ethical obligation when calling in potential recipients to explain any particular risks that an individual donor poses for a potential recipient.” But Bennett does not refer to either Sanchez or Chinnakotla as the receiving surgeon. Additionally, Wu does not refer to either doctor by name. When an expert opines about the care provided by more than one physician, the report must refer to each physician by name and state the standard of care with regard to that physician. Additionally, Bennett does not state whether the particular risks to which he referred are the same as the inherent risks that must be disclosed. The family’s expert reports do not comply with the statute’s requirements concerning breach of the standard of care. Neither expert states that he actually reviewed the informed consent forms. These experts state they do not know whether Biggs was informed about the donor’s history. They do not state whether either doctor breached a duty to inform Biggs of this information. The family’s expert reports do not comply with the statute’s requirements concerning causation. There are two separate parts to the causation analysis in informed consent cases: 1. whether a reasonable person could have been influenced to decide to give or withhold consent by being informed of the risks or hazards that were not disclosed; 2. whether the injury complained of was caused in fact by the undisclosed risk. Wu’s report does not address causation at all and does not comply with the statute’s requirements concerning causation. Only Bennett’s supplemental report addresses causation, but not with the specificity required. Bennett states Biggs was denied “an opportunity to turn down these organs,” because she was not informed about the donor’s history. But the standard is whether a reasonable person, not Biggs, could have been influenced by information about the donor’s condition. Bennett does not state the significance of information regarding the donor’s condition, why it should have been disclosed to Biggs, whether it could have influenced a reasonable person in deciding whether to give or withhold consent, or how it relates to Biggs’s death. Bennett does not connect any of the donor’s symptoms or possible conditions to Biggs’s death. OPINION:Lang-Miers, J.; Wright, Lang-Miers and Mazzant, JJ.

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