A service dog attacked a young child in a restaurant. Her parents sued, among other defendants, a medical doctor who had written letters for the dog’s owner saying that her service animals help with her anxiety disorder. The parents did not dispute the correctness of the doctor’s opinions that the owner—his patient—had a medical disorder that the dog helped treat. Instead, the parents contended the doctor was negligent because he failed to ascertain whether the dog (which was registered with an unrelated company) was in fact a service animal appropriately trained to behave in public. They also alleged this failure proximately caused their daughter’s injuries by enabling the owner to present the dog as a service animal that could enter the restaurant.
The question before the Texas Supreme Court was not whether the parents’ claims against the doctor have merit. Instead, it was whether the claims must be dismissed regardless of their merit because the parents failed to serve a
preliminary report from a medical expert addressing the doctor’s failure to evaluate the dog’s temperament with non-patients. The Texas Supreme Court concluded that because any such failure did not involve a “claimed departure from
accepted standards of medical care” that are “applicable” to the claim, this was not a health care liability claim for which an expert report was required. TEX. CIV. PRAC. & REM. CODE §§ 74.001(a)(13), 74.351(a), (r)(6).
Standing
The Supreme Court of Texas stated in its June 6, 2025 Opinion, “We narrowly conclude that, at this stage of the case, the Waldroups sufficiently alleged R.W.’s injuries were “fairly traceable” to Dr. Leibman’s letters … Although the Waldroups do not specifically allege that Kingston would not have been in the restaurant but for Dr. Leibman’s conduct, such an allegation is not required for standing. What is required are allegations that permit a reasonable inference that Dr. Leibman’s letters characterizing Kingston as a service animal contributed to Romano’s decision to take him into the restaurant where he injured R.W. … We interpret the allegations to assert that the letters emboldened Romano to take greater risks with Kingston, and that without the letters she would have been less likely to bring Kingston into public spaces like the restaurant. This assertion is sufficient for purposes of traceability at the pleadings stage.”
“We express no opinion as to whether the Waldroups can prove any causal connection and the other requirements for a court to render judgment in their favor. We conclude only that, at this point, the Waldroups’ pleadings are sufficient to establish their standing to pursue these claims.”
Health Care Liability Claim?
In determining whether the parents’ claims were health care liability claims, the Texas Supreme Court stated, “No party asserts that medical expert testimony would have any relevance to this causation theory. Indeed, the Waldroups do not allege that Romano showed Dr. Leibman’s letters to the restaurant staff to gain admittance for Kingston; rather, they allege the restaurant staff made no attempt to verify whether Kingston was a service animal. Nor is medical expert testimony needed to prove or refute an applicable standard of medical care or its breach … Because Dr. Leibman’s diagnosis and medical opinion are not “operative facts . . . relevant to the alleged injury,” Collin Creek, 671 S.W.3d at 885 (emphasis added), it cannot be the case that “expert medical . . . testimony is needed to establish the requisite standard of care and breach.””
Expert Report Not Required
“[T]he tortious conduct the Waldroups identify is that Dr. Leibman’s reference to Kingston as a service animal included an implied representation that the dog was appropriately trained to behave in public, and that Dr. Leibman made this representation without taking steps to ascertain the dog’s temperament … But even if there were an implication in the letter regarding Kingston’s general temperament, the dispositive question would be whether a medical expert report is needed to prove or refute an applicable standard of care and breach. The answer is no because opinion testimony regarding a dog’s general temperament is the province of veterinarians and dog trainers, not physicians … considering the totality of the circumstances, we see nothing else to indicate that an expert report from a physician would assist the trier of fact in deciding any disputed factual question. For these reasons, we hold that the Act does not require a report … Not every action that a doctor takes that bears any connection to his patient is done in the course of providing medical care, and concluding otherwise would expand the expert report requirement beyond any rational limits.”
“[W]e conclude no HCLC [health care liability claim] presumption applies on these facts. But even if there were such a presumption, the record rebuts it here. As mentioned above, the Waldroups have consistently denied that their claims arise from Dr. Leibman’s diagnosis of Romano’s anxiety disorder or his opinion that a service animal would help treat that anxiety. Instead, their claims focus solely on Dr. Leibman’s letters and his alleged failure to determine whether Romano’s dog really was a properly trained service animal with appropriate public behavior. Just as the connection between those letters and the plaintiffs’ injuries is so thin that the Waldroups barely make it over the standing threshold, see supra Part I, so too does that tenuous connection compel us to conclude that the claims are not HCLCs. The record contains no evidence that Romano showed the letters to anyone, and there is nothing to suggest that Dr. Leibman wrote the letters as part of treatment he furnished for anxiety. Dr. Leibman did not write the letters while Romano was in a treatment facility, nor were the letters intended to help her obtain any medications or examinations. Anyone—with or without medical training—could have described the dog’s behavior and temperament. Any presumption that the plaintiffs’ claims are HCLCs is therefore rebutted, and these facts confirm that the totality of the circumstances does not support treating the claims as HCLCs.”
Source Leibman, M.D. v. Waldroup, No. 23-0317.
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