The Court of Appeals Second Appellate District of Texas at Fort Worth (“Texas Appellate Court”) affirmed in its January 14, 2021 opinion that the defendant emergency room physician was entitled to summary judgment in a Texas medical malpractice wrongful death case involving a 7-year-old who was treated by the defendant in a hospital ER for an asthmatic attack earlier in the day and later that afternoon suffered from status asthmaticus. The young child died three days later from an anoxic brain injury after having suffered a cardiopulmonary arrest and acute respiratory failure.
Under Texas medical malpractice law, proximate causation is an essential element of a medical negligence claim and requires evidence, to a reasonable degree of medical probability, that (1) the act or omission was a cause in fact of the injury and (2) the injury was foreseeable. A cause in fact is established when the act or omission is shown to be a substantial factor in bringing about the harm and without which the harm would not have occurred. Foreseeability is shown through evidence that a person of ordinary intelligence should have anticipated the general danger created by a negligent act or omission. Both cause-in-fact and foreseeability must be established through expert evidence.
To raise a fact issue on causation, the plaintiff relied on her expert’s supplemented expert report, which she attached to her summary-judgment response, and specifically on her expert’s assertion that the defendant’s premature discharge of of her child with instructions “not to take any medication for an extended period of time unsupervised” caused her child’s cardiac event and eventual death.
The Texas Appellate Court, in affirming the lower court’s summary judgment granted to the defendant, stated, “We conclude that Camazine’s report, even assuming its form defects were not fatal, was conclusory as to causation and did not raise a genuine issue of material fact … Although Camazine attempted to tie Starr’s death to Purcell’s earlier decision to discharge Starr and to his discharge instructions, he failed to explain how these alleged breaches caused Starr’s subsequent exacerbation and cardiac event. He merely states that they did, which does not establish a causal link … Indeed, the summary-judgment evidence showed that Starr was stable when she was discharged and that she went home and slept without incident for approximately six hours before suffering a second, separate exacerbation and a cardiac event on the way to the pharmacy. Further, Camazine’s opinion is based on his supposition of the “likely” medical events that led to Starr’s death, which is mere guesswork that cannot raise a genuine issue of material fact … Camazine’s report was no evidence of a substantial cause-in-fact or of foreseeability; thus, the trial court did not err by granting Purcell judgment as a matter of law on this basis.”
The Texas Appellate Court concluded, “Although Eaglin has fairly presented her argument that genuine issues of material fact regarding causation prevented the trial court’s no-evidence summary judgment on her medical-negligence claim, the evidence she relies on is conclusory and, thus, is no evidence.”
Source Eaglin v. Purcell, No. 02-20-00199-CV.
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