### NUM BER 13-09- 0066 6-CV 

## COURT OF A PP EA LS T H I R T E E N T H D I S T R I C T O F T E X AS C OR P U S C H R I S T I - E D I N B U R G
RA UL ERNESTO LOA IS IG A A ND RA UL ER NES TO LOA ISIGA , M .D., P .A ., A pp ellan t,
v. GUA DA LUPE CERDA , I NDIVI DUA LLY AN D AS N E X T F R I E N D O F M AR I S S A CER DA , A

M INOR , A ND C IND Y VE LE Z, A pp ellees
. On a p p ea l f ro m th e 44 4t h D is tr ic t C o u rt of C amero n Co un ty , T exas . 

## ME MOR A N D U M OP I N I ON B efo re C h ie f Ju st ic e Va ld ez a n d J u st ic es Y añ ez a n d G arza

M em o ra n d u m Op in io n b y J u st ic e Ga rza Appel lan ts, R aul Er nest o Loai si g a, M .D . ( “D r. Loai si g a” ) and R aul Er nest o Loai si g a, M.D., P.A. (the “P.A.”), challen ge the trial co urt’s ju dgme nt den y ing th eir m otion s t o dism iss
a l a w s u i t b ro u g h t b y a p p e l l e e s , G u a d a l u p e C e rd a , i n d i v i d u a l l y a n d a s n e xt fr i e n d of Ma ri ss a C erda, a min or , and C ind y Vel ez
. By

fiv e i ss ues, app e lla n ts a rg ue th at: ( 1) appel lee s’ cl aims are “ heal th c ar e l iab il ity cl aims ” under chapt er 74 of t he ci v il pract ic e and
re medies co de, see T EX
. C IV
. P R AC
. & R EM
. C OD E A NN
. § 74. 351 ( Ver non Su pp. 2 009) ; ( 2)
a p pellee s’ ex pert rep ort doe s not m eetthe requirem ent s of thatchap ter; (3) app ellees’
ex per t w it ness i s n ot q ual ified to re nder an opi nio n ag ain st appel lan ts; (4 ) appel lee s fai ledS u n s h in e is n o t a p a r ty t o th is a p p e a l. 1 2 to est ablish a ny “v iable ca use o f action ” against the P. A.; an d (5) th e purpo rted expert
r ep or t do es n otc on s ti tu te a n ex pe rt r ep or t un de r c ha pt er 7 4. W e affi r m. I. B A CKGRO UND Appel lee s fil ed th e underlying law sui t on June 17, 2 009 ag ain st Dr . Loa is ig a, t he P.A. , and Suns hin e Pedi atr ic s, LLP ( “S unshi ne” ). Ap pel lee s’ or ig ina l peti ti on al leg ed th e 1 f ollow i ng fac ts : O n or a bo utA pr i l 1 , 20 08 , Gu ad al up e to ok h er s ev en te en - y ear-old daug hter , M ar is sa, to Suns hin e for tr eatment of a sinus condit ion

. Dr . Loa is ig a ex amined Ma ri ss a, an d, “ under

the g uis e of li ste nin g to [M ar is sa’ s] hear t t hroug h the st ethos cope[ ,] . . . [he] c up pe d [M ar i s s a’ s ] brea s t w i th th e pa l m of hi s ha nd .” In a s ep arat e i nc i de nt in Janu ar y 2008, D r. Loai si g a ex amined Vel ez , w ho w as tw enty -four y ears o f age and
em ployed as a nu rse a t S u n s h in e, be cause she arriv ed a t w ork w ith f lu-like sy mp tom s. Acc ordin g to the p eti ti on, D r. Loai si g a “ ask ed [V ele z ] t o tak e off her top” at t he beg inn ing of the ex aminat ion

. W hen Ve lez compl ied , Dr

. Loai si g a all eg edl y “h ad [Vel ez ] s iton t he
ex amini ng tabl e and he undi d her br a from t he front

. [H e] pa lmed [Vel ez ’s ] breastdur ing his enti re ex aminat ion .” The pe ti ti on as ser ted c auses of act ion of ass aul t, medic al neg li g ence, ordin ar

y neg li g ence, g ro ss neg li g ence, and int enti onal i nflic ti on of emoti onal di s t r e s s a g a i n s tD r
. L o a i s i g a
. A p p e l l e e s a l s o a s s e rt e d c l a i ms o f m e d i c a l n eg li g ence,
ordin ar y neg li g ence, and g ro ss neg li g ence ag ain st Suns hin e. App ellees d id notex plicitly s t a t e i n their pet ition th at th eir claims are “hea lth care li abi li ty cl aims ” under

ch apter 74 o f the Tex as Ci v il Pract ic e and Remedi es Cod e. See i d. § 74. 001( a) (1 3) ( Ver non 200 5)

. Nev erthel ess , “ in an abun dance of cauti on .
. . g iv en th at [appel lee s’ ] c lai ms inv olv e a heal th care professi onal ,” appel lee s s er v ed an ex per

t medi cal
r e p o rt a n d c u r r i c u l u m v i t a e a s r e q u i r e d b y t hat c hapter

. See id. § 74.3 51. The ex pert
re por t w as authored by

M ic hael Ki lg or e, M. D. , a family pract it ion er

w ho has been li cens ed to pract ice since 19 85. Dr . Kilgore’s repo rt stated in relev antpart as follows: Dur ing a routi ne “ si ck ” v is itw it h at [si c] phy si cian , a stethos cope maybe utiliz ed to listen to th e he artbe at of a patie nt. Howev er , i n a ll applicab le3

me dical stan dard s of

care, it is unne cessary that a pa tien t r e m o ve their brazier [sic], no r is it nece ssaryto cup, palm or to uch th e brea st of a fem ale pati en te i t h e r

w i t h t h e h a n d h o l d i n g t h e s t e t h o s c o p e o r t h e o t h e r

h a n d not hol din g the ins tr ument t o li ste n to a hear t bea t. In fact, c ommon sen se and medic al professi onal is m di cta te t h a t the e x amini ng phy si ci an w oul d be cogniz antof the sensitivity of the chest area for a fem ale patien t and w ould take all precaut ions ne cessary to preve n t a n y touch ing of the pa tient ’s br east

. It is myopi nio n tha t i f the facts co ntai ned i n Pl ain ti ff ’s Pet it ion are tr ue, t hen the mann er in w hic h thes e pati ents w er e ex amined by D r. Loai si g a fell bel ow the s tandard of care i n the medi cal professi on and th a t giv en th e v iol ati on ag ain st thes e y oung w omen, t hen t hey hav e been har med. .

. .

. . . . In rev iew of the a cti on an[ d]/or

non- act ion s o f Sunshi ne Ped iat ri cs , i t i s c lea r this en tity fell below the stan dard [of] care that a prof ession al me dical of f ice shou ld provide. Sunsh ine Pe diatrics owed a d u t y t o its patie nts to ensu re the ir safe ty and to have policies in place to prevent the ty pe o f patie nt ab use t h a to c c u rr e d t o Ms

. Ce rd a a n d Ms

. V e le z. On Se pte mb er 3, 20 09, app ellees f urnishe d a sup ple m ent al report by Dr . Kilgore w hich
s t a t e d in it s e n t ir e t y: On Au gust 21, 2 0 0 9 I prov ided my prof ession al opin ion to [app ellees’ atto rney] regarding the ap plicable stan dard s of care and accep tab le pr act ic es in per

forming routi ne ex amin a ti o n s o n pat ien ts. Al l opi nio ns expressed an d con taine d in my prev ious repo rt are ado pte d in this suppl emental repor

t and are also appli cabl e to Rau l Er nest o Loai si g a, M .D ., P.A. I retai n the r ig ht t o furt her su ppl e m ent a nd c hang e any of myopi nio ns ex pr ess ed herein

. Subs eq uentl y , D r. Loai si g a and the P .A. each filed object ion s to D r. Ki lg or e’s repor ts and mot io n s to dis mis s a ppel lee s’ cl aims

. See i d. D r. Loai si g a and the P .A. both
com p lained spec ific all y thatthe cl aims ag ain st them s houl d be dis mis sed becau se the
e x p e rtre p o rt : ( 1 ) i s “ e n t i r e l y b a s e d u p o n s p e c u l a t i o n a n d a s s u mp t i o n s ” ; ( 2 ) fa i l s t o i d e n t i fy the s tandard of care appl ic abl e to them; (3 ) fails to ide nti fy the b re ach of the s tandard of care allegedly comm itted bythem ; and (4) fails to sta te w het her the ir alleg ed n eglig ence
w as the proxi ma te cause of app ellees’ injuries. Dr. Loaisiga also argued thatDr. Kilgore is not q ual ified to re nder an e xpe rt o p in io n i n thi s c ase becau se he i s n ot a pedi atr ic ian

. The P.A. addi ti onal ly

arg ued that the ex per

t repor t “ fails to impl ic ate [ the P .A.] ” becau se: (1 ) the s uppl emental repor t “ g iv es no bas is for w hy the opi nio ns in the A ug ust21, 20094

op i ni on ‘ are al s o ap pl i c ab l e to [ th e P. A. ]’ ” ; an d ( 2) ap pe l l ee s ma de n o “ di r ec t l i ab i l i ty c l ai ms (i .e
. [ , ] n e g l i g e n th i r i n g , re t e n t i o n , s u p e r v i s i o n ) a g a i n s t[ t h e P

. A

. ] ” a n d n o v a r i o u s l i a b il it y cl aims ag ain st the P .A. Af ter a he aring, the trial court de nied the m o t io n s
. T his accele rated interlocut ory appeal follo w ed. See T EX
. C IV
. P R AC
. & R EM
. C OD E A NN . § 51.014( a) (9 ) (V er non 200 8) (perm itting appe al of

interlocut oryorder den y ing all or part of a mo tion to dism iss for failure to ser v e an ex per

t repor t i n a h eal th c ar e l iab il ity cl aim) ; T EX
. R. A PP
. P. 2 8.1( a) ( sta ti ng that app eals f rom int erlocut oryorders are acce lerate d).

II. S TA NDA RD OF R E V I E W A ND A PPLI C A B LE L AW W e re v iew a tr ial cour

t’ s order deny ing a moti on to dis mis s for failu re to compl y w it h the e x per

t repor t req uirement un der

an a buse of d isc re ti on s tandard. NC EDMental Hea lt h, Inc. v. Kidd , 214 S .W .3d 2 8, 32 (Te x
. App .–E l Pa so 20 06, no pe t.) (applying abu se of dis creti on s tandard to tr ial co urt’ s d eni al of motion to di smi ss ); Ken drick v. Garcia , 171 S.W .3d 6 98, 7 02 ( Tex . Ap p.–Eas tl and 200 5, pe t. deni ed) ( same) ; see Am . T ran sition al Car e C tr s. of T e x. , Inc. v. Pal

aci os , 46 S.W .3d 8 73, 8 78 ( Tex . 200 1) ( appl y ing abus e of dis creti on s tandard to tr ial co urt’ s g ra nti ng of moti on to di smi ss ). A tr ial co urt a b uses i ts dis creti on i f it a ct s in an a rb it ra ry or unreason abl e manner or w it hout re ferenc e to any g uid ing r ule s o r pr inc ipl es. Dow ner v. Aqu a ma rine Ope rators, In c. , 701 S.W .2d 2 38, 241- 42 (Tex

. 1985)

. How ev er , a tr ial cour t has no dis creti on in deter mini ng w hat t he l aw is or i n appl y ing the law

to the fact s. W

alk er v. Packer

, 827 S.W .2d 833 , 840 (Tex. 1992 ); Bayl or Uni v. Me d. Ct

r. v. Big gs , 237 S.W .3d 9 09, 9 16 ( Tex . Ap p.–D all as 2007, pet. den ied). Th erefore, when the issues are pu rely question s of law , w e ef

fectively cond uct a de nov o rev iew

. See Pallares v. Magic Valley Ele c. Coop ., Inc. , 267 S.W .3d 6 7, 69 -7 0 (Te x . App .–Corp us Christi 2008 , pet . ref ’d). Und er ch apter 74, a pl ain ti ff

as ser ti ng a “ heal th c a re l iabil ity cl aim” mustse rv e a medic al ex per

t repor t upo n eac h par

ty ’s attor ney no lat er than the 120th day after the d ate the ori g ina l peti ti on w as filed

. T EX
. C IV
. P R AC
. & R EM
. C OD E A NN . § 74. 351 (a). The report
mu st “prov ide[] a fair summ aryof the expert’s opin ions as o f the da te of

the rep ort5

re g ardin g appl ic abl e s tandards of care, t he manner i n w hic h the ca re rendered by the physician or hea lth care provider f ailed to me et the st and ards, and t he causa l relationsh ip bet w een thatfailure an d the injury , harm , or dam ages claime d.” Id. § 7 4

. 3 5 1 (r )(6). If it appears to the cour

t, after a hear ing , t hat t he repor t doe s n ot repr esentan “ obj ect iv e g ood faith e ffort t o c omply

w it h the def ini ti on of

an ex per

t repor t in Subsec ti on ( r) (6 ), ” then the tr ial co urt mus t di smi ss the cl aim. Id. § 74 .351( l). To cons ti tute a “ g ood fait h effort,” the repo rt mustprovi de e nou gh informa tion to (1) i nform th e de fend antof the specif ic condu ct the p lai nti ff

has call ed into q uest ion , and (2) prov ide a basi s for the tr ial co urt t o c oncl ude that the cl aims hav e meri t. Bowie Me m ’ l Hos p. v . Wri ght , 79 S. W .3d 48, 52 (Tex. 2002 );
see Pal aci os , 46 S.W .3d a t 879

. To d e te r mi n e w h e t h e r

a c a u s e o f a c t i o n fa l l s u n d e r t h e s t a t u t e ’ s d e fi n i t i o n o f a heal th c ar e l iab il it y

clai m, w e must ex amine the cl aim’ s under ly ing nature. Valley Ba ptist Me d. Ctr . v. S tr adley , 210 S.W .3d 770 , 775 (Tex. App. –Corpu s Christi 200 6, pe t. de nied ). T he sta tute def ines “hea lth care liability claim” as:
a c ause of acti on ag ain st a heal th c ar e prov ide r or phy si ci an for treatment, lac k of t re atment, or

othe r cl aimed depar

ture from ac cept ed s tandards of m e d ic a l c a re , o r h e a lt h ca re , o r s a fe t y o r p ro fe s s io n a l o r a d m in is t ra t ive ser v ic es direct ly

rela ted t o heal th care, w hic h prox imat ely re sul ts in inj ur y to or deat h of

a cl aimant , w hether

the cl aimant ’s cl aim or ca use of acti on sound s i n tor

t or co ntract

. Id. § 74. 001( a) (1 3) ( Ver non 200 5)

. “A caus e of act ion al leg es a depar ture from ac cept ed sta ndards of

m e d ical ca re or

heal th c ar e i f the ac t or omi ss ion co mplai ned of i s a n insep arab le part of

the ren dition of

med ical serv ices.” Diversicare Gen. Pa rtn e r, I nc. v. Rubio , 185 S.W .3d 842 , 848 (Tex. 2005 ). The tr ial co urt s houl d l ook no furt her than t h e repor

t i tse lf, bec ause all the infor mati on rele v ant t o the i nq uir y i s c ontai ned w it hin the document ’s four cor ners. Bow ie Me m ’ l Hos p. , 7 9 S. W .3 d at52 (cit in g Pal aci os , 46 S.W .3d a t 878 ). T h e r epor t nee d not
mars hal all the plai nti ff ’s proof, but itm ustincl ude the ex per t’ s o pin ion on e ach of the th re e ele ments that the c iv il pract ic e and re medies code identi fies: standard of care, breach, and
caus ati on. Id. Moreover, an ex pert canno t me rely state conclu sions abou t the se elem ent s;6

the e x per

t mus t ex pla in the basi s o f his or her st atements to li nk the c oncl usi ons w it h the facts. Id. (cit in g Pal

aci os , 46 S.W .3d at 878; Ear le v. Rat li ff , 9 9 8 S

. W

. 2 d 8 8 2 , 8 9 0 (T e x. 199 9)). III
. A N AL Y S IS A
. Claims Against Dr. Loaisi ga W e begi n ou r

a na l y s i s b y

a s s es s i ng t he n at ure of t he c l ai ms ma de a g ai ns t Dr. Loai si g a personal ly

. The al leg ati ons under pin nin g thes e cla ims are s traig htforw ard: appel lee s c ontend that Dr . Loa is ig a s ex ual ly as saul ted the tw o pati ents w hil e per forming
ro uti ne ex aminat ion s. As note d , a p p e lle es filed D r. Ki lg or e’s ex per t repor ts out o f an abu nda nce o f

cautio n, w ithou t conce ding t hatt heir claims w ere “hea lth care liability claims” as define d i n c h a p t e r

7 4

. W e c o n c l u d e t h a tt h e s e c l a i ms a r e n o t“ h e a l t h c a r e l i abi li ty cl aims ” and t her efore, no ex per t medi cal repor

t w as re q uired. This ca se is anal og ous to Hol gui n v . Lar edo R egi onal Medical C enter , 256 S.W .3d 349 (Tex . App.–San Anton io 2008, no pet .)

. In Holguin , the pla int iff c lai med thathe w as
s e x u a l l y a s s a u l t e d w h i l e h e w a s a p a t i e n t a t t h e d e fe n d ant h ospi tal

. Id. at 351. The pla int iff sued bo th t he hos pit al and t he nurse w ho all eg edl y carr ied out the ass aul t. Id. The t ri a l c o u rtd is m is s e d t h e cl a im s a ga in s tb o t h d e fe n d a n t s b e c a u s e t h e p la in t if f fa il e d t o se rve
an ex per t medica l re por

t pursuantto chapt er

74. Id. T he San Anton io Court of Appe als
re v ersed the t ri al cour

t’ s j udg ment w it h respec t t o the cl aims made ag ain st the n urse,
conc lud ing thatthos e c lai ms w er e not“ heal th c ar e l iab il ity cl aims ” as defined in the s tatut e. Id. at 353 -54. T he court not ed that “ [i]t w ould def y logi c to suggest that a se x ual assa ult ‘i s an i n s e p a r a b l e p a rto f t h e re n d i t i o n o f m e d i c a l c a r e ’ o r a d e p a rt u r e fro m a cc epted stan dard s of

hea lth care.” Id. at35 3 (quo ti n g Diversicare , 185 S

. W

. 3 d a t 8 4 8); se e Chr is tus Spohn Health Sys . C or p. v . Sa nchez , 299 S.W .3d 8 68, 8 74 ( Tex . Ap p.–C or pus Chr is ti 2009, pet. deni ed) ( hol din g thatpl ain ti ff ’s cl aim ag ain st tw o nurses t h a t sh e w as sexually assau lted d uring an examina tion was not a “he a lt h ca re liability claim” in part becau se the n urses ’ all eg ed c onduc t “ w as [not] rel ated to t he heal th c ar e bei ng prov ide d” and did not “s omehow inv olv e[] the professi onal jud g ment o f [t h e nurse s]” ); Jone s v.7

Khor sandi , 148 S.W .3d 2 01, 2 06 ( Tex . Ap p.–Eas tla n d 2 0 0 4, pe t. deni ed) ( hol din g that pla in t i ff’ s c l a i m t h a t h e w a s s e x u a l l y a s s a u l t e d b y a d o c t o r w h i l e u n d e r t h e i n fluence of medic ati on w a s not a “h eal th c ar e l iab il ity cl aim” bec ause “t he nat ur e of the all eg ati ons ag ain st [the doct or] do not i nv olv e a b re ach of the appl ic abl e s tandard of care for heal th
care prov ide rs ”) ; see als o Wasser m an v . G ugel , N o. 14 -0 9- 00450-CV, 2 0 1 0 Tex . Ap p. LEX IS 3 749, at *7- 8 (Tex . App.–H oust on [14th Di st. ] May 20, 2010, pet. filed ) (h old ing that pla int iff’s c lai m thatdoc tor se x ual lya ss aul ted h er dur ing a s urg ic al cons ultw as not a “hea lt h c a re l ia b ility

claim” in part be cause the claim “has not hing to do wi th a lap se in professi onal j udg ment or a failu re to protec t a pati ent due to an abs ence of super v is ion or
mo nitoring”). Dr . Loais ig a reli es on Van derwerff v. Bea tha rd , 239 S.W .3d 4 06 ( Tex . Ap p.–D all as 2007, no pet .) , i n arg uin g thatthe cl aims made ag ain st hi m w er e in fact“ heal th c ar e l iab il it y cl aims .” I n Vander

werf f , the pla int iff al leg ed that the defendant c hiropract or “ ru bbed he r g eni tal s” w hil e per

forming a c hiropract icex aminat ion

. Id. at 407. The D all as Cou rtof Appeal s c oncl uded t hat t he c lai m w as a “ heal th c ar e l ia b il ity cl aim” i n par

t bec ause the question o f

wh e t h er the d ef end ant ’s actions were “ w ithin th e scop e of a chiropractic
ex aminat ion

. . . ca nnot be answ er ed w it hout re ferenc e to the sta ndard of care req uired of a chiropra ctic provi der.” Id. at 409. W e bel iev e Vander werf f i s readi ly

di sti ng uis habl e from the i nst ant c ase. I n Vander werf f , t he c lai mant adv ised t he c hiropract or thatsh e w as
ex per ien ci ng pai n from he r knee to he r upper thi g h. Id. at 407. The defendant as ser ted that hi s a c t i o n s w e r e “ w i t h i n t h e s c o p e o f a c h i ro p r a c t i c e x a mi n a t i o n ” a n d t h a t“ he w as using subject iv e me ans to man ipulat e [pla intif f ’s ] m u s c uloske letal system.” Id. at 409. Here, on the other

hand, D r. Loai si g a i s a cc used of tw ic e fondli ng a pa ti ent’ s b re astw it h
one han d w hile listenin g to th e pa tient ’s heart w ith a steth oscop e w ith the o the r hand . Th is is not a case w here the doct or’s cond uct could be fe asibly explained as a ne cessary part of tre atment. See Wasser m an , 201 0 T ex. App. LEXIS 374 9, at *10 (“Under no reaso nab le
v iew of the allegatio ns w e are presente d w ith here could it be argued tha t a surgical consult for bac k s urg er

y w oul d req uire [t he doc tor ], an or thopedi c s urg eon, to i nser t hi s fin g er

i ntoT hese com pl ai nt s ar e ba sed o n t he f act t hat D r
. Ki l gor e st at ed i n hi s i ni t i al r epor t t hat hi s opi ni ons 2 are ap pl i c ab l e o nl y “i f t he fac t s co ntai ne d i n P l ai nti ff’ s P eti t i on are tru e
. . . .” A pp el l an t s argu e t ha t D r. K i l go re’ s op i ni on s are t he refore pu re s pe c ul ati on an d c on j ec t ure , w hi c h m ay no t form t he ba s i s of an ex pe rt m e d i c a l o p i n i o n
. H ut chinson v. Mont em ayor , 1 4 4 S .W .3 d 6 1 4 , 6 1 8 ( T e x . A p p .– S a n A n to n i o 2 0 0 4 , n o p e t.) ( ci t i ng Lenge r

v. Physi cian’

s G en. H osp. , I nc. , 4 5 5 S .W .2 d 7 0 3 , 7 0 6 (T e x . 1 9 7 0 ); Bow l es v. Bourdon , 148 T ex. 1, 21 9 S

. W

. 2d 77 9, 78 5 (19 49 ))

. H ow eve r, an ex pe rt m ed i c al repo rt ne ed no t m ars ha l al l t he pl ai nti ff’ s proo f. Bow i e M em ’

l H osp. v. W r

i ght , 79 S. W

. 3d 48, 52 ( T ex. 2002)

. I t m er el y m ust i ncl ude t he e xper t ’ s opi ni on o n s ta n d a rd o f c a re , b re a c h , a n d c a u s a ti o n
. I d. I n an y case, we ne ed n ot add r ess t hi s par t i cul ar cont ent i on be c au s e, as ex pl ai ne d h ere i n, t he pl ai nti ffs as s ert ed no “hea l t h c are l i ab i l i t y cl ai m ” ag ai ns t t he P

. A

. an d w ere th e re fo re u n d e r n o o b l i g a ti o n to s e rv e a n e x p e rt m e d i c a l re p o rt w i th re s p e c t t o th e P .A

. See T EX

. R. A PP

. P. 47. 1. 8 [plain tif f ’s] v agina an d ask if

she ha d feelings in thatlocation .”). W e c oncl ude t hat a ppel lee s’ cl aims ag ain st Dr

. Loai si g a ar e not “ heal th c ar e l iab il it y claims” an d are th erefore no t s ubje ct to the ex pert rep ort requireme nts for such claim s. Accordin gly , the trial cou rt d id not err in den y ing D r. Loaisiga’s mot ion to dismiss. A p p e ll a n t s ’ f ir s tis s u e is o ve rr u le d a s itre la t e s t o t h e c la im s a ga in s t Dr

. L o a is ig a p e rs o n a ll y. B
. C l a i m s Ag a i n s tT h e P
. A. W e now tur n to the c lai ms made by appel lee s ag ain st the P.A. The P.A. arg ues on app eal th at th ese claim s are “health care liability claims” and thatDr. Kilgore’s ex pert repo rts are insuf

f icient be cause he is not qualif ied to ren der an ex pert op inion wi th respe ct to t he P. A., and bec a u se his re por ts do notsa ti sfythe re q uirements of chapt er 74. Spec ific all y , t he P. A. c ontends thatD r. Ki lg or e’s re por ts: (1 ) ar e “c omplet ely

bas ed upon
ass umpti ons, sp ecul ati on and conj ect ur e” ; ( 2) req uire the t ria l cour t “ to as sume fact s
ou ts i de of th e fou r c or ne rs of th e ex pe rt r ep or t” ; ( 3) fai l to i de nt i fy th e s ta nd ard of care 2 appl ic abl e to the P .A.; (4 ) fail to ide nti fy how the P.A. br eache d it s sta ndard of care; an d (5) fa il to state whethe r the P.A .’s alleged acts proximat ely cause d ap pellee s’ injuries. W e hav e al re ady

co ncl uded t hat t he clai ms aga ins t Dr . Loais ig a personal ly are not “h e a lt h c a re l ia b il it y c la im s , ” a n d t h a ta p p e ll e e s we re t h e re fo re u n d e r n o o b li ga t io n t o se rve
an e x pert m edica l report und er chap ter 74. W e also find tha t chap ter 74 d oes n ot ap ply to the claims mad e against th e P.A ., bu t for a dif feren t reason . Appe llees’ pet ition ref ers to t he P.A. only

once—i n its introduct or y secti on rec it ing the names and address es of the de f e n d a n t s
. T he a ppe llees ma ke no claim tha t the P.A. is v icariously liable for Dr. Loai si g a’s neg li g ence or i ntent ion al act s; and th e a ppel lee s mak e no cl aim that the P .A.Appel l an t s d o as ser t by t hei r f our t h i ssue o n ap peal t hat t he P. A. shou l d be di sm i ssed a s a 3 d e f e n d a n t b e c a u s e “ p la in tif f s f a ile d to e s ta b lis h a n y v ia b le c a u s e o fa c tio n a g a in s t [ th e P .A .] .” H o w e v e r , t h is cont ent i on was not m ade i n t he P. A. ’ s m ot i on t o di sm i ss. T he onl y ar gum ent s m ade i n i t s m ot i on t o di sm i ss wer e r el at ed t o t he a l l eged l ack ofan adequ at e exp er t r epor t as t o t he P. A. under chapt er 74. W e con cl ude, t her ef or e, t hat t he i ssue of whet her appel l ees hav e “ f ai l ed t o est abl i sh a v i abl e cau se of act i on a gai nst [ t he P .A .] ” h a s n o t b e e n p re s e rv e d fo r o u r re v i e w
. See T EX

. R. A PP

. P. 33

. 1(a )( 1)(A ) (“ A s a prere qu i s i t e to pr esent i ng a com pl ai nt f or app el l at e r ev i ew, t he r ecor d m ust show t hat

. . . t he co m pl ai nt was m ade t o t he t r i al cour t by a t i m el y r equest , obj ect i on, or m ot i on t hat

. . . st at ed t he gr ounds f or t he r ul i ng t hat t he co m pl ai ni ng pa rt y so ug ht from t he t ri al co urt w i t h s uffi c i en t sp ec i fi c i t y to m ak e t he tr i al c ou rt a w are o f t he c om pl ai nt .

. . . ”)

. 9 is directly

liab le for n eglig enth iring , negligent supe rv ision, or an y othe r fo rm of

neglig ence
or i ntent ion al tor

t. In fact, t he petit io n d o e s not c ontai n a s ing le all eg ati on or ca use of
a ct io n as se rt e d aga in stth e P. A

. ; rat h e r, al le gat io n s a re m a d e on ly aga in stDr. Lo a isi ga personal ly

and ag ain st Suns hin e. Beca use n o allegation s of m edica l n eglig ence or othe rw ise w ere asse rted against the P .A. in appel lee s’ or ig ina l peti ti on, w e cannot say that the req uirements of chapt er 74
w er e ap p lic abl e as to the P .A. See T EX
. C IV
. P R AC
. & R EM
. C OD E A NN
. § 74. 351( a) (req u ir in g an ex pert m edica l report “for each physici an o r health care provider aga inst
w h o m a li abi lity cl aim i s a ss er ted

. . . ” ( em ph as i s a dd ed ) )

. W e ov er r ul e ap pe l l an ts ’ f irst is sue as itrela tes to the P .A. 3 IV. C ONCL US I ON W e need not a ddr ess appel lan ts’ remaini ng i ss ues as they hav e no bear ing on th e final di spos it ion of the a ppeal

. See T EX
. R. A PP
. P. 47. 1. T he judgmen t of the trial court is aff ir med.

_________ _________

________ DORI CONTRERAS GARZA J u s t i c e Del iv er ed and filed the 5th d ay of Aug ust , 201 0.