### NUM BER 13-08- 0011 3-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 O R P U S C H R IS T I - 

## EDI NBURG

RGV H EA LT HC A RE A SSOC IATE S, IN C. A pp ellan ts, & L EG EN D R GV

MCA L L EN L P D /B /A LEGEND TRA NSITI ONA L CA RE - M CA LLEN,
v . OFELI A ESTEVI S, ODELIA

M A RROQUI N, ORE FE LIN DA

C A RD ENA S, D EL IA

F LOR ES, M IKE M A RROQUI N, BA LDEM A R M A RROQUI N, OFE LIA M . EST EVIS, A S R EPR ESEN TA TIVE OF TH E ES TA

TE OF SA NT O M A RR OQU IN, A pp ellees
.
On ap pe al f rom th e 3 32n d Dist rict C ou rt of H ida lgo C ou nt y , T exas .



## C ON C U R R I N G A N D D I S S E N T I N G OP I N I ON B ef o re C h ie f Ju st ic e Va ld ez a n d J u st ic es R o d rig u ez a n d V el a D is se n ti n g In P ar t an d C o n cu rri n g In P ar t Op in io n b y J u st ic e Ve la2

I concu r, in part, w ith the majo rity ’s opinion and dissent , in part. I believe that Dr. Rus hin g ’s r e por

t doe s n ot meet the sta tutor y r eq uir ements for a n ex per t r epor t und er
sec ti on 74.351 of Tex as Ci v il Pr act ic e and Remedi es Cod e. T EX
. C IV
. P R AC
. & R EM
. C ODE A NN . § 74.351 (V er non Supp. 2008)

. I w oul d r ev er se the o rd er of the t ri al cour

t den y ing RG V’ s mot ion to dis mis s. I. D I RECT L I A B I LI TY C LA I M S A GA I NST RG V I concu r in the majo rity ’s holding that Rushing’s r epo rt did not add ress how RGV’s direct con duct deviated f rom th e stan da rd o f ca re. But, I disa gr ee wi th th e ma jority ’s d e cis io n to excl u d e th e ne glige n t h irin g an d ne glige n t sup e rvisio n cla im s f ro m it s h o ld in g. Cl aims ag ain st an empl oy er for n eg li g ent h ir ing , s uper v is ing , t ra in ing , or

r etai nin g an employ ee ar e based on the theor y of di re ct li abi li ty

. LaBel la v. Cha rl

ie Thom as, Inc ., 942 S.W .2d 127 , 137 n. 9 (Te x . App .–A ma rill o 199 7, w rit den ied). I w ould hold th at Rush ing’s
re por t di d not se t fort h a s tandar d of car e or the br each of a st andar d w it h r eg ar d to any of the di re ct li abi li ty

cl aims pl eaded b y

the Ma rr oq uin s. The major it y

dec ides th a t th e neg li g ent h ir ing and super v is ion cl aims hav e been
w aiv ed bec ause RG V di d n o t arti cul ate a n obj ect ion thatR ushi ng ’s r epor t w as defici ent
w it h r eg ar d to thos e dir ect li abi li ty theor ies

. W hil e the maj or it y st ates that“ the c ontex t of Rushin g ’ s r ep or

t c l ea r l y i mp l i c at es R GV H ea l th c ar e’ s r ol e as P ab l o an d Gr ac i e’s supe rv isor,” the opin ion also recogniz es tha t Rushing’s report “implicat ed o nly the cond uct of Pablo and Gracie, RGV Health care’s em ployees.” Rushing’s report doe s n ot state t he stan dard o f care f or RGV w ith respe ct to direct liabil i ty or ho w R GV br ea c he d th e s ta nd ar d of c ar e i n th at r ol e. Bu t, ev en i f the report imp licated RGV in its r ole in the imple me nta tion o f policies, rules, an d proce dure s, I w ould3

conc lud e tha t R GV’ s o bje cti ons w ere s u f f icient w it h r espec t t o al l of the di re ct li abi li ty cl aims

. RG V obj ect ed in w ri ti ng that the repor t did not deli neate a standar d of care or how it w as br eache d. R GV a ls o obj ect ed th at “ Dr . R ushi ng ’s r epor t doe s n ot s tate how

R GV allegedly brea ched the stand ard of care.” At the he aring, RGV arg ued that Dr. Rushing’s repo rt fa iled to ad dress elem ent s nece ssaryf or a cause of actio n against RGV. The se obj ect ion s w er e suff ic ien t f or the Ma rr oq uin s to be on notic e that Dr . Rus hin g ’s repor t w as defici ent w it h r eg ar d to a ll o f their di re ct li abi li ty

cl aims ag ain st RG V. Cer tai nly , t he Marro qui n s kn ew

w hat d ir ect l iab il it y

cl aims they

had ass erted a g ain st RG V; i t w as they
w ho had ple aded di re ct li abi li ty ag ain st RG V. T here is no reason that RGV would be required to be more specif ic in its obje ctions. The M ar ro q uin s s oug ht di re ct li abi li ty aga in st RGV for

neg li g ent h ir ing , s uper v is ion and impl ementati on of

poli ci es and proc edur es. W hen objec ti ng to the suff ic ien cy of a r epor

t, the s tatut e does not set forth the spec ific it y req uir ed f or

object ion s. T EX
. C IV
. P R AC
. & R EM
. C OD E A NN . § 74.351( a) ( Ver non Su pp. 2 006) ; see als o M eyer s v. G o lden Pal

m s R et. & Hea lt h C tr ., Inc ., No. 13- 06- 289- CV , 200 7 W L 1500819, at *8 (Tex . App.–C or pus Chr is ti Ma y 24, 2007, pet. deni ed)

. There appear s to be li ttl e cas e law outl ini ng w hat i s r eq uir ed for an obj ect ion t o be suff ic ien t und er the sta tute. None the less, RGV’s obje ctions were suffici ent t o put the Ma rr oq uin s o n not ic e tha t t he ex per t re por t w as ins uff ic ien t r eg ar din g all of the direct liability

claims it plead ed a gainst RGV. I t w as clear tha t Rushing’s report did not addr ess the dir ect l iab il it y cl aims at all

.4 II. C LA I M S A GA I NST T H E N U R SE A ND CNA The Ma rr oq uin s als o asser ted v ic ar iou s l iab il it y

cl aims ag ain st RG V th at c omplai ned of the cond uct of

a nurse an d an assistan t and asserted negligence claims against the nu rse and the C NA , i ndi v idu all y
. I w oul d hol d tha t R ushi ng ’s r epor t w as ina deq uate in arti cul ati ng the app licable sta nda rd of care and breach conce rning each of the de f end ant s. Th e expert
re por t i s r eq uir ed to sp eci fical ly i mpli cat e the co nducto f each def end ant (emp hasis ad ded ). Am . T ra nsi ti onal C ar e C tr s. of T ex. v
. Pal

aci os , 46 S.W .3d 8 73, 8 78 ( Tex . 200 1)

. R ushi ng ’s r epor

t doe s n ot s peci fy a s ta n d a rd of car e for a nur se or a c erti fied
nur si ng as si sta nt. W it h resp ect to the stand ar d of car e, R ushi ng ’s r epor t i ndi cat es that a body ch eck sh oul d hav e been per

formed. How ev er , Rus hin g does not sta te that suc h a chec k h ad not been done. Ev en th e maj or it y ac know led g es that the r epor t doe s n ot menti on w hether

dai ly body chec ks w er e done dur ing the tw o- and- a- hal f dayper iod that Mrs. Santo s resided a t RGV. Ru shing a lso f ails t o articulat e w hose d uty it w as to pe rf orm the bod y check. W as it the duty of the nurse , the CNA, or bot h? Dr. Rushing’s repo rt is ina deq uate w it h re g ar d to the sta ndar ds of c ar e for an enti ty suc h as RG V, a nur se and a CNA. It is also inad equate with resp ect to how th e stan dard s of care w ere brea ched in this
cas e. III
. T A Y LO R V . C H R I STU S S P OHN I al so bel iev e the maj or it y opi nio n c onfli cts w it h T a y l o r v
. C h r i s t u s S p o h n H eal th Sys tem , w her e thi s C our t s a id “ an ex per

t r epor t may not ass ert t hat mul ti ple defendants
ar e al l neg li g ent for faili ng to meet the sta ndar d of car e w it hout pr ov idi ng an e x pla nati on
o f h o w each def endant spec ific all y breac hed the standar d and how thatbr each caus ed or5

cont ribute d to the ca use of in jury .” Tay

lor , 169 S.W .3d 241, 244 (Tex

. App.–C or pus Chr is ti 2004, no pet .). ( e m phasi s a dded)

. Rus hin g ’s r epor t nev er sp eci fied w hic h par

ty w as
re spons ibl e for under

tak ing w hic h pr ocedu re s. See i d. at 24 6. The major it y att empts to dis ti ng uis h Tay

lor bec ause it di d not deal w it h heal th c ar e l iab il it y cl aims a ss e rt ed unde r
a t h e o r y o f v i c a r i o u s l i a b i l i t y
. N e v e rt h e l e s s , I b e l i e v e t h e r u l e o f l a w s e t fo rt h i n Ta ylor appl ies

. Ev en unde r v ic ar iou s li abi li ty , it is nec ess ar y for a defendant w ho has been sued, and w ill be u ltima tely respo nsible if liability is i mp osed , to know w hat the sta nda rd of care enta i l s fo r i t s e mp l o y e e s w h o h a v e b e e n s u e d , w h i c h o f i t s e mp l o y e e s b r e a c h e d the stan dard of

care, and h ow the stand ard w as brea ched bythose specif ic emp loyees. W hile the r epor t nee d not name the hospi tal in sit uati ons w her e only vi car iou s l iab il it y

i s s oug ht, the re por t mus t non ethel ess , i denti fy the s tandar d of car e appl ic abl e to the e mploy ee, h ow the stand ard w as brea ched , and how the breach cause d injury . Univ. of Sw . Med. Ctr. v. Dale , 188 S.W .3d 877 , 879 (Tex. App. –Dallas 20 06, no pe t.). W e ar e al so confine d to the four cor ner s o f the r epor t i n our r ev iew

. Pal

aci os , 46 S.W .3d a t 878

. The Ma rr oq uin s’ ow n repor t state d that the doctor

w as ask ed to dete rmi ne
w hether or not the c ar e and tr eatment pr ov ide d by The Leg end Tr ansi ti onal Hea lth Car e C enter

and it s s taff

[R GV], Pabl o, R N las t name unkno w n, Gracey [sic], last n am e unkn own, CNA, me t the app licable sta nda rds of care and i f th e c a re d id fall bel ow su ch sta ndar ds, w hether the inj ur ies r esul ted from the br each of the s tandar ds.6

I believe the rep ort doe s not m eet the sta tuto ry s tan dard and is i nad equate . I w ould
re v er se the o rd er

of the t ri al cour

t.

RO SE VELA

J u s t i c e
Di ss enti ng In Par

t and C oncur ri ng In Par t O pin ion del iv er ed and filed thi s 2 nd day of Jul y , 200 9.