## IN THE SUPREME COURT O F TEX AS

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. 10-0928

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O N P E T I T I O N F O R R E V I E W F R O M T H E C O U R T O F A P P E A L S F O R T H E T H I R T E E N T H D I S T R I C T O F T E X A S

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J U S T I C E L E H R M A N N , concur ring and dissenting

.
Whether a claim ag ainst a health car e provider is a health car e liability claim is a knotty issue this Court has repe atedly strug g led with. See, e.g. , Tex. W

. Oaks Hosp., LP v. W

illiams , ___ S.W .3d

___, 2012 WL 2476807 (Tex. 2012); St. David’s Healthcare P’ship v. Esparza , 348 S.W .3d 904 (Tex. 2011); Omaha Healthcare C tr., LLC v. Joh n s o n , 344 S.W .3d 392 (Tex. 2011); Diversicare
Gen. Partner, Inc. v. Rubio , 185 S.W .3d 842 (Tex. 2005). Claims alleg ing that a phy sician’s actions in examini ng a patient amounted to a n assault can be par

ticularly confounding , for the r easons the
Court discusses: the phy sical examination of a patient nece ssarily involves touching , which may be uncomforta

ble, unexpected, and misunderstood. I concur in the Court’s judgme nt remanding this

ca se to allow the plaintiffs an opportunity to establish that their assault claims are not health car e liability claims. I write separ ately , howeve r, beca use I believe the Court place s too onerous a burdenon claimants by requiring them to conclusively establish that their claims are not health car e liability

claims. I wo u l d require a claimant to satisfy a standard compar able to a “cle ar and convincing ” standard of proof. Under that s t andar d, a trial court should require a claimant asser ting claims
ag ai n s t a h ea l t h car e provider arising in the context of the delivery of medical service s to file an expert repor

t unless the rec ord justifies a firm conviction or belief that the claims prese nted are not health ca re liability

claims. Unquestionably , the L eg islature intended to alleviate what it deeme d a “hea lth car e liability crisis” when it enac ted the Texas Medica l L iability Act, T E X
. C I V
. P R A C
. & R E M
. C O D E §§ 74.001–.507. Acc ording ly , I ag ree that claims arising in the context of the delivery of health car e service s are presumptively health car e liability claims. But, as the Court rec og nizes, nothing in the
Act signa ls an intent to shield phy sicians from liabili t y fo r s ex u al assaults or simil ar intentional misconduct. I fea

r that the require ment the Court imposes, that a claimant conclusively establish that a cla im is not a hea lth care liability claim in or der to r ebut the Act’s presumptive application, may forc e assa ult victims to submit expert repor ts or see the ir ca ses dismissed.
I n descr ibing the expert repor t require ment imposed by the Act’s prede cessor , we have noted

on more than one occa sion that claimants are not require d to marshal their proof to comply with the
statute. Bowie Mem ’l Hosp. v. W right , 79 S.W .3d 48, 52 (Tex. 2002); Am. Transit ional Care Ctrs. of Tex., Inc. v. Palacios , 46 S.W .3d 873, 878 (Tex. 2001). The policy underly ing the expert repor

t require ment in the curr ent Act rema ins unchang ed; not to shield health car e provider s fr o m leg itimate claims, but to wee d out frivolous claims at an ear ly stag e, befor e the parties and the courts have expended extensive resour ces. Scoresby v. S a n tillan , 346 S.W .3d 546, 554 (Tex. 2011). I t

2makes sense not to place a heavy burden on claimants ear ly in the proce ss, in part, beca use the Act
g rea tly restric ts the di scover y that is available befor e an expert repor t is filed. T E X
. C I V
. P R A C
. &
R E M
. C O D E § 74.351(s). I n my view, the Court’s imposit ion of a require ment that claiman t s conclusively establish that their alleg ations d o n o t amount to health car e liability claims is inconsistent with those considera tions.
I n light of the Act’s purposes and its broad ap p l i ca t i on, I ag ree that claimants must to do more than establish that their claims are plausibly , or even likely , not health care liability claims.
But I would not g o so far as the Court. I nstead, I would hold that plaintiffs whose claims arise in the medical context are n o t require d to provide expert repor ts if the rec ord justifies a firm belief or conviction that the claims are not health car e liability claims. This is essentiall y the same as the burden of proof required to terminate parenta l rig hts. See Santosky v. Kramer , 455 U.S. 745, 769 (1982); In re G.M. , 596 S.W .2d 846, 847 (Tex. 1980). Surely a burden sufficie nt to protec t pare nts’ constitutional rig hts in raising the ir children should be sufficie ntly stringe nt to protec t a ny interest medical providers might enjoy in ha ving a cause of action alleg ing assault proce ed as a health car e l i ab i l i t y claim. Acc ording ly , I respe ctfully concur in the Court’s judgme nt but disag ree with th e standard the Court imposes.

_________________________________ Debr a H. L ehrma

nn J ustice

OP INION DELIVERED: Aug ust 31, 2012

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