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NUMBER 13-04-258-CV
COURT OF APPEALS
THIRTEENTH DISTRICT OF TEXAS
CORPUS CHRISTI - EDINBURG
JOYCE O=NEAL, INDIVIDUALLY
AND AS REPRESENTATIVE OF THE
ESTATE OF TIMOTHY O=NEAL, DECEASED;
AND ON BEHALF OF RAYMOND O=NEAL
AND ALLISON O=NEAL, MINOR CHILDREN;
T.J. O=NEAL AND ERIN SELF, Appellant,
v.
PETER COLDWELL, M.D., Appellee.
On appeal from the 24th District Court of Refugio County, Texas.
MEMORANDUM OPINION
Before Justices Yañez, Castillo, and Garza
Memorandum Opinion by Justice Garza
Appellants sued appellee for medical negligence following the death of Timothy O=Neal. After appellants filed an expert report pursuant to the Texas Medical Liability and Insurance Improvement Act,[1] appellee filed a motion to dismiss appellants= claims with prejudice, contending that the expert report did not comply with the Act because (1) appellants= expert, Brian S. Frist, M.D., was unqualified to testify as an expert; (2) Dr. Frist=s report failed to state the standard of care applicable to appellee=s treatment of O=Neal; and (3) Dr. Frist=s report failed to state the causal relationship between appellee=s deviation from the standard of care and the injury, harm, and damages claimed by appellants. The trial court granted appellee=s motion and dismissed appellants= claims with prejudice. We reverse the trial court=s order and remand the case for further proceedings consistent with this opinion.
An expert report must represent only a good‑faith effort to provide a fair summary of the expert=s opinions. Am. Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873, 878 (Tex. 2000). A report need not marshal all the plaintiff=s proof, but it must include the expert=s opinion on each of the elements identified in the statute: standard of care, breach, and causal relationship. Id. We conclude that Dr. Frist=s report represents a good faith effort to provide a fair summary of his expert opinion on each of these elements. According to the report, the standard of care required appellee to hospitalize and monitor O=Neal and to perform a thorough diagnostic cardiac evaluation, including isoenymes and catherization. Instead, appellee discharged O=Neal from the emergency room without performing the required diagnostic evaluations or diagnosing or treating his underlying cardiac disease. The report further states that a full cardiac evaluation would have revealed that O=Neal had a focal lesion within his left anterior descending artery. The report states that the lesion could have been addressed successfully with a stint placement, by-pass surgery, or other cardiac modalities. Instead, the lesion went untreated and O=Neal died from myocardial infarction due to atherosclerotic involvement of the left anterior descending artery. Dr. Frist=s report thus provides adequate information to fulfill the two purposes of expert reports: (1) it informs the defendant of the specific conduct the plaintiffs have called into question and (2) it provides a basis for the trial court to conclude that the claims have merit. See id. at 879.
In the motion to dismiss, appellee also contended that the report did not comply with the Act because Dr. Frist has no knowledge of the accepted standards of medical care applicable to emergency medicine, the treatment of emergency room patients, or the treatment of patients with chest pain or cardiovascular disease. In short, appellee argued that Dr. Frist was not a qualified expert. To qualify as an expert, an individual must (1) be practicing medicine at the time the opinion is rendered or at the time the claim arose; (2) have knowledge of accepted standards of medical care for the diagnosis, care, or treatment of the illness, injury, or condition involved in the claim; and (3) be qualified on the basis of training or experience to offer an expert opinion regarding those accepted standards of medical care.[2] Dr. Frist=s curriculum vitae and report establish that he currently practices medicine and has done so for over thirty years. He is certified by the National Board of Medical Examiners and the American Board of Pathology in anatomic and clinical pathology.[3] Dr. Frist=s medical training and experience are substantial. The record provides no basis upon which this Court or the trial court could reasonably conclude that Dr. Frist=s extensive medical training and experience were insufficient to establish his knowledge and qualification to offer expert opinions regarding the accepted standards for the diagnosis, care, and treatment of cardiac complications, such as the one involved in this case.
Having concluded that appellee=s objections to the report are entirely without merit, we further conclude that the trial court abused its discretion by dismissing appellants= claims with prejudice. See Palacios, 46 S.W.3d at 877 (stating that trial court=s ruling on a motion to dismiss for inadequate expert report is reviewed for abuse of discretion). The trial court=s order is reversed and the case is remanded for further proceedings consistent with this opinion.
_______________________
DORI CONTRERAS GARZA,
Justice
Dissenting Memorandum Opinion
by Justice Errlinda Castillo.
Memorandum Opinion delivered and
filed this the 21st day of July, 2005.
1 See Act of May 30, 1977, 65th Leg., R.S., ch. 817, 1977 Tex. Gen. Laws 2039 (as amended) (former Tex. Rev. Civ. Stat. art. 4590i ' 13.01), repealed by Act of June 2, 2003, 78th Leg., R.S., ch. 204, ' 10.09, 2003 Tex. Gen. Laws 847, 884 (current version at Tex. Civ. Prac. & Rem. Code '' 74.001 et seq.).
2 See note 1 supra.
2 According to Stedman=s Medical Dictionary, Apathology@ is Athe medical science, and specialty practice, concerned with all aspects of disease, but with special reference to the essential nature, causes, and development of abnormal conditions, as well as the structural and functional changes that result from the disease processes.@ Stedman=s Medical Dictionary (Lippincott, Williams & Wilkins, 25th ed. 1990). AClinical pathology,@ in turn, is defined as
(1) any part of the medical practice of pathology as it pertains to the care of patients; (2) the subspeciality in pathology concerned with the theoretical and technical aspects (i.e., the methods and procedures) of chemistry, microbiology, parisitology, immunobiology, hematology, and other fields as they pertain to the diagnosis of disease and the care of patients, as well as to the prevention of disease.
Id. (emphasis added).