IN THE SUPREME COURT OF TEXAS
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NO. 10-0524
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ST. DAVID’S HEALTHCARE PARTNERSHIP, L.P., LLP D/B/A ST. DAVID’S
HOSPITAL AND ST. DAVID’S COMMUNITY HEALTH FOUNDATION, PETITIONERS,
v.
GENARO ESPARZA, JR.,RESPONDENT
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ON PETITION FOR REVIEW FROM THE
COURT OF APPEALS FOR THE THIRD DISTRICT OF TEXAS
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PER CURIAM
In this case, we decide whether a patient’s claim against a hospital for injuries suffered when
he slipped and fell on a lubricating gel that fell to the floor of his hospital room during or
immediately after a bladder scan is a health care liability claim. We hold that it is. Accordingly,
we reverse the court of appeals’ judgment and remand the case to the trial court with instructions
to dismiss Esparza’s claims and for further proceedings consistent with this opinion.
Genaro Esparza was admitted to St. David’s Hospital for acute kidney failure and his doctor
ordered bladder scans (ultrasounds of the bladder). On the day of the incident, the attending nurse
allegedly used “copious amounts of lubricating gel” for the scan. After the nurse left, Esparza got
up to use the bathroom in his hospital room and slipped on the gel that fell on the floor during or
after the scan. He sued the hospital asserting negligence and premises liability. Esparza did not file
an expert report, and the hospital filed a motion to dismiss under section 74.351 of the Code. See
TEX. CIV. PRAC. & REM. CODE § 74.351(a), (b) (requiring expert report within 120 days of filing suit
and mandating dismissal if no report is served). The trial court denied the hospital’s motion and the
court of appeals affirmed. ___ S.W.3d ___, ___. The court of appeals relied on our now-withdrawn
opinion in Marks v. St. Luke’s Episcopal Hospital in holding that Esparza’s claims were not health
care liability claims. No. 07-0783, 2009 WL 2667801 (Tex. Aug. 28, 2009), withdrawn, 319 S.W.3d
658 (Tex. 2010). The court also cited Harris Methodist Fort Worth v. Ollie for the same
proposition. 270 S.W.3d 720, 726–27 (Tex. App.—Fort Worth 2008), vacated, ___ S.W.3d ___
(Tex. 2011) (per curiam).
In this Court, the hospital argues that the court of appeals erred by holding litigation over a
dangerous condition caused by a health care provider—a nurse1—during the provision of health
care—performance a bladder scan2—was not a health care liability claim. Esparza responds that the
court of appeals correctly determined that his claims were based on premises liability because they
were not directly related to or inseparable from the hospital’s rendition of care. We disagree.
The Texas Medical Liability Act (TMLA) defines a health care liability claim as:
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
1
See TEX. CIV. PRAC. & REM. CODE § 74.001(a)(12)(A)(i) (defining a health care provider as a person or entity
“duly licensed, certified, registered, or chartered by the State of Texas to provide health care, including [] a registered
nurse”).
2
See TEX. CIV. PRAC. & REM. CODE § 74.001(a)(10 (defining health care as “any act or treatment performed
or furnished, or that should have been performed or furnished . . . to or on behalf of a patient” during the patient’s
medical care, treatment, or confinement).
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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 § 74.001(a)(13); Diversicare Gen. Partner, Inc. v. Rubio, 185 S.W.3d
842, 847 (Tex. 2005).
Whether a claim falls within the scope of section 74.001(a)(13) is not determined from the
form of the plaintiff’s pleadings. See Yamada v. Friend, 335 S.W.3d 192, 196 (Tex. 2010). Rather,
the underlying nature of the claim determines whether it is subject to the statutory requirements of
the TMLA. Id.; see also Ollie, ___ S.W.3d at ___. Esparza’s claim stemmed from the nurse’s
performance of the doctor-ordered scan and her failure to properly dispose of the gel used in the
procedure. Moreover, both the prescribed procedure and its performance were directly related to
Esparza’s treatment, and thus an integral and inseparable part of his health care. See TEX. CIV.
PRAC. & REM. CODE § 74.001(a)(10),(13); Diversicare, 185 S.W.3d at 854–55.
In its evaluation of the merits in this case, the trier of fact would need to be informed of
hospital procedures on safely disposing of gloves covered with a slippery substance after a medical
procedure. Accordingly, the underlying nature of Esparza’s suit was a health care liability claim
against the hospital for which an expert report would be required.
We hold that the alleged negligence in permitting the gel to fall and remain on the floor of
Esparza’s room, causing his fall, is inseparable from the procedures for the disposition of gloves in
a hospital. Esparza’s claims are properly classified as health care liability claims because they arose
from a departure from accepted standards “that should have been performed or furnished” by St.
David’s during Esparza’s “medical care, treatment, or confinement.” TEX. CIV. PRAC. & REM. CODE
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§ 74.001(a)(10),(13). The trial court should have dismissed Esparza’s claim for failure to comply
with the expert report requirements of the TMLA, and the court of appeals erred in holding
otherwise. We grant the petition for review and, without hearing oral argument, reverse the court
of appeals’ judgment and remand the case to the trial court with instructions to dismiss Esparza’s
claims and for further proceedings consistent with this opinion. See TEX. R. APP. P. 59.1, 60.2(d).
OPINION DELIVERED: August 26, 2011
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