Savannah Burns was admitted to St. David’s Medical Center on or about July 21, 2024, after complaints of pre-term contractions. She was treated in labor and delivery room 18 and was administered an epidural. While resting under epidural anesthesia in preparation for the delivery of her child, a ceiling tile above her hospital bed fell and allegedly struck her. It was alleged that an HVAC leak caused the ceiling tile to fall.
Burns filed suit on February 4, 2025, asserting a “premises liability” claim against St. David’s for physical injury and emotional distress. She alleged that St. David’s “failed to properly inspect and maintain the labor and delivery room, including the HVAC system and ceiling tiles[;]” “failed to properly monitor the room for safety risks and take appropriate corrective measures, which exposed [her] to the potential dangers of mold, toxins, and physical injury[;]” “failed to adequately document and respond to [her] complaints about the potential risks and her health concerns following the incident[;]” “failed to recognize the potential impact of the physical injury and weight loss on [her] health and the health of her unborn baby, neglecting to provide proper medical care and oversight during her stay[;]” and “failed to provide proper psychological care or support to [her] after the incident, neglecting to recognize the lasting emotional and psychological impact caused by the event, which has led to ongoing anxiety and distress.” Burns, however, did not file an expert report within 120 days of filing her petition. Based on this, St. David’s moved for dismissal under § 74.351 of the Texas Civil Practice and Remedies Code.
The Texas Medical Liability Act (TMLA) defines a health care liability claim (HCLC) 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 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.”
According to this definition, a HCLC consists of three elements: (1) the defendant must be either a health care provider or a physician; (2) the plaintiff’s claim must concern treatment, lack of treatment, or a departure from the accepted standards of care on one of four predicate grounds (the Four Breaches); and (3) the conduct complained of in element two proximately caused the plaintiff’s injury or death.
If a plaintiff asserting a HCLC fails to serve the defendant with an expert report on liability or causation within 120 days of the suit’s inception, the defendant is entitled to dismissal with prejudice and attorney’s fees and costs. Tex. Civ. Prac. & Rem. Code § 74.351(b), (j).
The parties did not dispute that St. David’s is a health care provider or that the alleged acts or omissions proximately caused Burns’s injuries. The only dispute is whether Burns’s claim “concern[s] treatment, lack of treatment, or a departure from the accepted standards of medical care, or health care, or safety”—the second element of a HCLC.
The Court of Appeals Eighth District of Texas stated in its Memorandum Opinion dated July 10, 2026: “Burns was admitted for pregnancy, was administered an epidural, and was resting in preparation to deliver her child in her assigned labor and delivery room at St. David’s. While she remained under St. David’s care as a patient, a ceiling tile fell on her as she slept. Burns argues that she “was resting in the room. She was not undergoing a medical procedure, receiving treatment, being examined, or interacting with medical staff when the ceiling tile fell.” In its dismissal motion, and on appeal, St. David’s argued that “she was sleeping, she was actively receiving treatment or in preparation for delivery and under the supervision of St. David’s health care providers.” We agree.”
“Burns not only alleged that St. David’s failed to provide a safe environment during her hospital stay, but she also alleged that St. David’s failed to adequately respond to her patient complaints and injuries, to document and address her physical symptoms, and to provide psychological care—all allegations that directly implicate her treatment as a patient.”
The Texas appellate court concluded: “Burns’s allegations that St. David’s failed to provide a safe environment during her hospital stay as a patient and failed to provide her with appropriate medical care following the incident assert that St. David’s did not comport with the required standard of patient care. We conclude that, although pleaded as a premises liability claim, Burns alleged “violations of safety standards directly related to the provision of health care,” including protecting patients from injury during their hospital stays … Because Burns alleged an HCLC, she was required to file an expert report within 120 days of filing suit and her failure to do so mandated dismissal under § 74.351. The trial court abused its discretion by denying St. David’s motion to dismiss.”
St. David’s Healthcare Partnership, L.P., LLP d/b/a St. David’s Medical Center v. Savannah Burns, No. 08-25-00257-CV.
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