In The
Court of Appeals
Ninth District of Texas at Beaumont
___________________
NO. 09-12-00490-CV
___________________
CHRISTUS ST. ELIZABETH HOSPITAL, Appellant
V.
DOROTHY GUILLORY, Appellee
__________________________________________________________________
On Appeal from the County Court at Law No. 1
Jefferson County, Texas
Trial Cause Number 119806
__________________________________________________________________
OPINION
In this interlocutory appeal, we are asked to decide whether an expert report
is required under the provisions of the Texas Medical Liability Act where the
plaintiff, a hospital visitor and not a patient, files a suit seeking to recover for
injuries that allegedly occurred when the plaintiff slipped and fell on water that
was on the floor of a hallway. See Tex. Civ. Prac. & Rem. Code Ann. §
1
51.014(a)(9) (West Supp. 2012), § 74.351(a) (West 2011). 1 After the hospital
requested that the trial court dismiss the case based on the plaintiff’s failure to
timely file an expert report, the trial court denied the hospital’s motion. We
conclude that plaintiff’s claims against the hospital are not health care liability
claims under the Texas Medical Liability Act. See id. § 74.001(a)(13) (West Supp.
2012) (defining the term “health care liability claim”). We hold that the trial court
properly denied the hospital’s motion to dismiss, and we affirm the trial court’s
order.
Background
After visiting her husband in the intensive care unit, located on the second
floor of Christus Health Southeast Texas,2 Dorothy Guillory slipped in a liquid on
the floor of the hallway near the nurse’s station. Claiming that the hospital’s
employees “negligently permitted the floor to become slippery and wet,
1
Under the Texas Medical Liability Act, “‘[h]ealth care liability claim’
means a cause of action against a health care provider or physician for treatment,
lack of treatment, or other claimed departure from accepted standards of medical
care, or health care, or safety or professional or administrative services directly
related to health care, which proximately results in injury to or death of a claimant,
whether the claimant’s claim or cause of action sounds in tort or contract.” Tex.
Civ. Prac. & Rem. Code Ann. § 74.001(a)(13) (West Supp. 2012).
2
The hospital was initially named in Guillory’s original petition as Christus
St. Elizabeth Hospital. In Christus’s answer, Christus stated that its name is
Christus Health Southeast Texas, and that it did business as Christus Hospital—St.
Elizabeth. Guillory’s second amended complaint named Christus Health Southeast
Texas, d/b/a Christus Hospital—St. Elizabeth as the defendant.
2
negligently or willfully allowed such condition to continue[,] and negligently or
willfully failed to warn [Guillory] of the condition of the floor[,]” Guillory filed
suit and sought to recover for her injuries that resulted from the fall. Guillory later
filed her Second Amended Original Petition, her live pleading,3 and claimed that
the hospital had negligently failed to maintain the floor in a reasonably safe
condition, failed to adequately warn her of the floor’s unsafe condition, and failed
to adequately light the area where she fell.
Christus did not file a motion to dismiss until the Texas Supreme Court
decided Texas West Oaks Hospital, LP v. Williams, 371 S.W.3d 171 (Tex. 2012),
which construes the term “safety,” a component of the phrase “health care liability
claim.” See Tex. Civ. Prac. & Rem. Code Ann. § 74.001(a)(13). In its motion to
3
During the hearing on the hospital’s motion to dismiss, the trial court
allowed Guillory to amend her First Amended Original Petition. The trial court
stated that it would allow the amendment to clarify any ambiguity in Guillory’s
pleadings and to allow Guillory’s pleadings to reflect that Guillory was not
asserting a health care liability claim. During the hearing, the hospital did not
object to the trial court’s granting Guillory leave to amend her pleadings, even
though the amendment occurred after the hearing. Eight days after Guillory
amended her complaint, the trial court signed an order denying the hospital’s
motion to dismiss. The hospital has not complained on appeal that the trial court
allowed Guillory to amend her pleadings, and the hospital has not relied on the
allegations in Guillory’s prior petitions to argue that Guillory asserted a health care
liability claim against the hospital. Given the procedural history of this case and
the arguments of the parties, we resolve whether Guillory asserted a health care
liability claim against the hospital based on the allegations in Guillory’s Second
Amended Original Petition without deciding whether Christus could have claimed
that the allegations in Guillory’s original petition triggered her duty to file an
expert report under the Texas Medical Liability Act. See Tex. R. App. P. 33.1(a).
3
dismiss, Christus alleged that Guillory was required, but failed, to file an expert
report “critical of [the hospital’s] hallway maintenance and safety measures[.]” See
Tex. Civ. Prac. & Rem. Code Ann. § 74.351(a) (requiring an expert report to be
served in cases involving a “health care liability claim[]” on or before the 120th
day after the claim is filed). Guillory responded to the hospital’s motion, asserting
that she had not filed a health care liability claim against the hospital. Guillory’s
response explains that, on the day Guillory fell, she was a visitor and was not on
Christus’s premises to receive treatment.
After conducting a hearing on the hospital’s motion, the trial court signed an
order denying Christus’s motion to dismiss. Subsequently, Christus filed an
interlocutory appeal. In one issue, the hospital asserts that Guillory’s Second
Amended Petition asserts a “health care liability claim” under the Texas Medical
Liability Act because it alleges that Christus departed from accepted standards of
safety.
Discussion
The Texas Supreme Court has not yet addressed whether a garden-variety
premises case involving a visitor’s slip-and-fall is a “health care liability claim” as
defined by the Texas Medical Liability Act. See id., § 74.001(a)(13). In cases
involving similar facts, two of our sister courts have reached opposite conclusions
with respect to whether an expert report is required in a case brought by a visitor
4
who fell due to the condition of a common area of the hospital’s premises.
Compare Doctors Hosp. at Renaissance, Ltd. v. Mejia, No. 13-12-00602-CV, 2013
Tex. App. LEXIS 9633 (Tex. App.—Corpus Christi Aug. 1, 2013, pet. filed)
(mem. op.) (affirming the trial court’s order that denied a hospital’s motion to
dismiss a case brought by the plaintiff, a visitor who fell on the waxed floor of a
walkway, where the plaintiff failed to file an expert report), with Ross v. St. Luke’s
Episcopal Hosp., No. 14-12-00885-CV, 2013 Tex. App. LEXIS 2796 (Tex.
App.—Houston [14th Dist.] March 19, 2013, pet. filed) (affirming the trial court’s
order dismissing a case where the plaintiff, a visitor who fell in the hospital’s
lobby, failed to file an expert report).
The question of whether a particular claim falls under the expert report
requirements of the Texas Medical Liability Act is a question of law; as a result,
we review the trial court’s ruling under a de novo standard. West Oaks, 371
S.W.3d at 177; Marks v. St. Luke’s Episcopal Hosp., 319 S.W.3d 658, 663 (Tex.
2010). In West Oaks, the Texas Supreme Court stated that “our focus in
determining whether claims come under the TMLA is not the status of the
claimant, but the gravamen of the claim or claims against the health care provider.”
West Oaks, 371 S.W.3d at 178. The West Oaks Court further explained that the
term “claimant,” as defined under the Texas Medical Liability Act, “expands the
breadth of [health care liability claims] beyond the patient population.” Id.
5
In West Oaks, the plaintiff suffered an injury caused by a patient who, due to
the patient’s mental condition, required increased supervision by the hospital’s
staff. Id. at 181. Because the hospital’s relationship with the patient was material
and significant to the plaintiff’s allegations against the hospital, the West Oaks
Court concluded that the expert report requirements of the Texas Medical Liability
Act applied, holding that the claim in that case was “based on claimed departures
from accepted standards of health care.” Id. at 181. Although the Court in West
Oaks gave the phrase “health care liability claim” a broad meaning, the plaintiff’s
allegations in West Oaks included alleged departures from the applicable standards
that applied to a facility treating patients for mental conditions. Id.
In our opinion, no nexus exists between the claims Guillory asserts in her
Second Amended Original Petition and the hospital’s duties of providing
healthcare. Guillory did not allege that Christus had departed from any accepted
standards of health care. Instead, the gravamen of Guillory’s petition is that the
hospital breached standards of ordinary care to a visitor present in a common area
of the hospital, a duty that is no different than the duties imposed on other
businesses that permit visitors to be present on their premises.
More recently, in Psychiatric Solutions, Inc. v. Palit, 56 Tex. Sup. Ct. J. 946,
2013 Tex. LEXIS 598 (Tex. Aug. 23, 2013), the Texas Supreme Court held that a
claim that falls under the Texas Medical Liability Act requires a nexus between the
6
plaintiff’s injury and the alleged violation of an accepted standard of health care.
Id. at *7 (“[B]ecause Palit’s allegations implicate a standard of care that requires
expert testimony to prove or refute it, his claim is an HCLC.”). While the need to
have an expert report that articulates a medical standard is not a litmus test in
determining whether a claim is a health care liability claim, Guillory will not need
a physician or health care provider to create jury issues on her claim that the
hospital was negligent in failing to properly clean, inspect, or light its hallway. See
Murphy v. Russell, 167 S.W.3d 835, 838 (Tex. 2005) (“The fact that in the final
analysis, expert testimony may not be necessary to support a verdict does not mean
the claim is not a health care liability claim.”). Christus also failed to direct the trial
court or to direct us to any health care standards governing a hospital’s
maintenance or lighting of its halls or buildings.
We conclude that Guillory has not alleged that Christus departed from any
standard that is pertinent to accepted standards of health care; therefore, Guillory
has not asserted a health care liability claim against Christus under the Texas
Medical Liability Act. We hold the trial court did not err in denying the hospital’s
motion to dismiss, and we affirm the trial court’s order.
7
AFFIRMED.
___________________________
HOLLIS HORTON
Justice
Submitted on June 6, 2013
Opinion Delivered November 14, 2013
Before McKeithen, C.J., Kreger and Horton, JJ.
8