## COURT OF APPEALS SECOND DISTRICTOFTEXAS FORT WORTH NO. 2 - 0 7 - 1 7 1 - CV W I SE REGI O NA LHEALTH SYSTE M S APPE L L AN TS F /K /A D E C A T U R C O M M U N IT YH O S P IT A L , K A T H I S IN G H , R .N ., S H IR L E Y B E V IS , R .N ., KE L L I W E ATHE RLY, L . V. N. , B E THANY IS B E L L , L .V .N ., B E T T YJ E A N S N O D G R A S S , R .N ., D E B B IE A T K IN S , R .N ., R O S E A N N S M IT H , R .N . AND T R AC I VA NS CH UY VE R , R . N. V . KATH I BRI TTAI N, I ND I VI DU ALL Y AN D APPE L L EE S A S N E X TF R IE N D O FB R E T TG E N T R Y , D E C E A S E D , A N D B R E T TM Y R O N G E N T R Y , I N D I V I D U A LLY

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FR O M THE 271STDI STRI CT CO URT O F W I SE CO UN TY

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### OP I NI ON

----- ----- -- I . I NT R ODU CT I ON Thi s i s an i nt er l ocu t ory app ea l f r om t he den i al of A ppe l l ant s’ pl ea t o t he j u ri sd i c ti o n . App e l l a n ts W i se R e g i o n a l H e a l th S y ste m s f/k/a D e c a tu r C o m m u n i ty H os pi t al , Kat hiSi ngh, R. N . , Shi r l ey Bevi s, R. N . , Kel l iW ea t her l y, L. R. N . , Bet han y1 ... Ap p e l l e e s K a t h i B r i t t a i n a n d B r e t t My r o n Ge n t ry h e r e i n a ft e r wi l l be

r ef er r ed t o a s Br i t t ai n. 2 I sb el l , L. R. N . , Bett y Je an Snodgr as s, R. N . , D ebb i e A t ki ns , R. N . , Rose ann Sm i t h, R . N. a n d T r a c i Va n s c h u y v e r , R . N. , a p p e a l t h e t r i a l c o u rt ’ s d e n i a l o f t h e i rpl ea t o t he j ur i sd i ct i on pr em i se d o n s o ver ei gn i m m uni t y. W e a f f i r m i n pa rtan d
rev e rse i n p a rt . I I . F AC T UALAN D P R OCE DUR ALB AC K GR OUN D S i x te e n -y e a r o l d B re tt G e n tryw a se v a l u a te d a t h e r p ri m a ryc a re d o c to r’s of f i ceon Dece m ber17, 2002 , co m pl ai ni ng ofhi gh t em per at ur e, co ugh,
con ges t i on, an d c hes tpa i n. Tw o da ysl at er , he rm ot hert ookhe rt o Decat ur C om m uni t y Hospi t alem er gen cy r oom w i t h com pl ai nt s ofco ughi ng, cr am pi ng, vom i t i ng, w ea kne ss, a n d d i z z i nes s. W hi l e i n t he hos pi t al , s he com pl ai ned of di f f i cul t y br eat hi ng and chestpai n and had l ow blood pr essur e and sever al
e p is o d e s o flo w o x y g e n s a t u r a t io n . T w o d a y sa ft e rb e in g a d m it t e d a n d w h ile bei ng t r ansport ed t o I C U , G ent ry suf f er ed a car di opu l m onar y ar r est , f r om w hi ch
s h e c o u l d n o t b e re s u s c i ta te d . K a th iB ri ttai n , a c ti n g i n d i v i d u a l l yan d a s n e x t fr i e n d o f G e n try , a n d B rett M yr on Gent ry, i ndi vi dua l l y, f i l ed a w r ongf ul de at h a nd s urvi valac t i on un dert he 1 T e x a s T o rt C l a i m sA c t (T T C A ) a g a i n s t A p p e l l a n ts , a l l e g i n g th a t A p p e l l a n ts w e re3

negl i g e n t and gr ossl y negl i gent i n di agno si ng and t r eat i ng G ent ry, w hi ch p ro x i m a te l yc a u s e d G e n try ’sd e a th . A ppel l an ts filed a pl ea t o t he j ur i sdi ct i on, assert i ng t hatt hey ar e a g o v e rnm e n tal u n i t ( a n d i ts e m p l o y e e s) a n d a re e n ti tl e d to so v e rei g n i m m u n i ty
a s to a l l o f B r i t t a i n ’sc l a i m s . S ee Tex. Ci v. Pr ac . & Rem . Code Ann. § 1 01 . 00 1( 3) ( B) ( V er non 20 05 ) . Speci f i cal l y, A ppel l an ts assert ed t hat B ri tta i n ’sa l l e g a ti o n sfa i l e d to w a i v e s o v e re i g n i m m u n i tyu n d e r th e T e x a sT o rt C l ai m s A ct bec aus e none of t he cl ai m s al l ege d t hat a con di t i on oru s e of t ang i bl e p er so nalpr ope rt y w asa pro x i m a t e c aus e o fG ent ry’ s dea t h. A ppe l l ant s att ac hed t o a n d i nco r por at ed i nt o t hei rpl ea t o t he j ur i sd i ct i on t he
r epo rt s oft hr eeex pertw i t nes se s r et ai ned by Br i t t ai n a s w el l as t he de pos i t i ons o ft h o s e t h r e ew it n e s s e s , a n d f u rt h e ra s s e rt e d t h a tt h e r e w a s n o e v id e n c e in B r it t a in ’s e x p e rt s ’ d e p o s it io n st h a ta n ys u c h c o n d it io n o ru s e p r o x im a t e ly
c a u s e d th e p a ti e n t’sd e a th . I n a s uppl em entt o Br i t t ai n’ s t hi r d a m end ed or i gi nalp e ti t i on, w hi ch t he tr i a l co u rtg ran ted l e a v e to fi l e o n the d a y o f th e h e a ri n g o n A p p e l l a n ts’ plea to th e j u ri s d i c ti o n , B ri tta i n p l e a d e d th e s e p o te n ti a l l yre l e v a n t a l l e g a ti o n s : [ T] hat[ A ppel l ant s] used and m i sused cert ai n ta n g ib l e per sonal p rop e rt yw h e n ca ri n g for/t rea ti n g B rett G e n try , a n d tha t B rett G ent ry’ s dam age s, i nj ur i es , an d dea t h w er e pr oxi m at el y c aus ed by t he cond i t i on or use of cert ai n t angi bl e per sonal pr opert y. Byw ay ofex am p l e o nl y, t he D ef end antN ur se s m i su se d t he f ol l ow i ng4

t ang i bl e p er so nalpr ope rt y, am ong ot her s, w hen ca r i ng f or /t r ea t i ng BrettG ent ry: an I V , m edi cat i o ns ( i ncl udi ng S t adol ) , a pul se oxym et er , a bl ood pr e s s u re m achi ne/ cuf f , an oxyg en suppl y, an oxyg en m ask, [ and] an am bu bag , and D ef endan tV anschyver m i sused t he f ol l ow i ng t angi bl e per sonal pr opert y ( am ong ot he rs) w hen car i ng f or /t r eat i ng Brett G ent ry: a pul se oxym et er , syr i nges, o x y g e n s u p p l y , a n o x y g e n m a s k , a n d a n a m b u b a g . T h e s e l i s ts a re n o t e x h a u s ti v e . A f t e ra h e a r in g , t h e t r ia l c o u rt d e n ie d A p p e lla n t s ’ p le a , a n d t h e y f ile d t h is i n te rl o c u to rya p p e a l . I I I . I S S UE A ppe l l ant s’ i ss ue i s t hatt he t r i al cou rter r ed i n de nyi ng t hei rpl ea t o t he j ur i s d i ct i on becau se Br i t t ai n’ s pl eadi ngs and t he depo si t i ons ofherexpert s, of f er ed by A ppel l ant s, f ai l ed t o est abl i sh a condi t i on oruse oft angi bl e per sonal pr opert y and f urt herf ai l ed t o est abl is h th a tany such cond i t i on oruse w as a p ro x i m a te c a u s e o f G e n try ’sd e a th . IV . A N A L Y S IS A . S over ei gn I m m uni ty and S t andar d ofRev i ew Ther e i s no di sp ut e t hatA ppe l l ant W i se Regi ona l

— and i t s em pl oye esw ho
ar e t he ot herA ppel l ant s and w er e act i ng w i t hi n t hei r scope of em pl oym entat al l t i m es r el evantt o t hi s case— const i t ut es a gover nm ent al ent i t y, and as such i se n ti tl e d to c l a i m s o v e re i g n i m m u n i ty . See Tex. D ep’t of Par ks & W i ldl if e v. Mi randa , 133 S. W . 3d 217, 224 ( Te x. 2004) . Sov e r e i gn i m m un i ty h a s tw o5

c o m p o n e n ts : i m m u n i tyfro m l i a b i l i tya n d i m m u n i tyfro m s u i t. Id. I m m u n i ty f r om l i abi l i t y i s an af f i r m at i ve def ense, w hi l e i m m uni t y f r om sui tdepr i ves a c o u rt o f s u bj e c t-m a tte r j u ri s d i c ti o n . Id. T h e T T C A c re a te s a u n i q u e s ta tu to ry sc h e m e i n w h i c h th e se tw o i m m u n i ti e s a re c o e x ten sive : “S o v e rei g n i m m u n i ty to s u i t i s w a i v e d a n d a b o l i s h e d to th e e x te n t o f l i a b i l i ty c re a te d b yth i sc h a p te r.” T e x . C i v . P ra c . & R e m . C o d e A n n . § 1 0 1 .0 2 5 (a ) (V e rn o n 2 0 0 5 ); se e Mi randa , 1 3 3 S . W . 3 d a t 2 2 4 . S o v e re i g n i m m u n i tyfro m s u i t d e fe a ts a tri a l c o u rt’s
su bj e c t - ma t t e r j u r i s d i c t i o n b e c a u s e , a b s e n t t h e S t a t e ’ s c o n s e n t t o sue a gove r nm ent alen t i t y, a t r i alco urtha s no ba si s f orj ur i sd i ct i on. Mi randa , 133 S. W . 3d at225. Sec t i on 101. 021 oft he ci v i l pr ac t i ce s and r em edi esco de
w a i v e s th e S ta te ’si m m u n i t y u n d e r c e rta i n c i rc u m s ta n c e s . T e x . C i v . P ra c . & Rem . Code Ann. § 1 01 . 02 1 ( V er non 20 05 ) . A t r i a l c ourt ’ s subj ect - m at t er j ur i sd i ct i on i s a q ues t i on ofl aw an d r evi ew ed de novo . State v. Hol l and, 221 S .W .3 d 6 3 9 , 6 4 2 (T e x . 2 0 0 7 ). W e fo c u s fi rst o n th e p l a i n ti ff’ s p l e a d i n g s to d e term i n e w h e th e r t h e fac ts p l e a d e d a ffir m a ti v e l y d e m o n s tra te th a t j u ri s d i c ti o n e x i s ts . Id. Th e pl eaderhas th e i n i ti a l b u rd e n o f a l l e g i n g fa c ts th a t a ffir m a ti v e l y d e m o n s tra te th e tri a l c o u rt’s j u ri s d i c ti o n to h e a r th e c a s e . Mi ran da, 133 S. W . 3d at226 ( ci t i ng T ex . A ss ’n of Bus . v. Tex. A i

r C o n tro l

Bd. , 8 5 2 S .W .2 d 4 4 0 , 4 4 6 (T e x . 1 9 9 3 )). We
c o n s tru e th e p l e a d i n g sl i b e ra l l yi n fa v o r o f a p l a i n ti ff, l o o k i n g to th e p l e a d e r’s6

i n te n t. Id. I ft he pl ea di ngsar e i ns uf f i ci entt o e st abl i sh j ur i sd i ct i on bu tdo n ot
a f f ir m a t iv e lyd e m o n s t r a t e a n in c u r a b le d e f e c tin ju r is d ic t io n , t h e p la in t if fs h o u ld b e a ffo rd e d th e o p p o rtu n i tyto a m e n d . Id . at226– 27. I ft he pl ea di ngs af f i r m at i vel y negate t he exi st ence ofj ur i sdi ct i on, t he pl ea t o t he j ur i sdi ct i on m ay b e g ra n te d w i th o u t a n o p p o rtu n i tyto a m e n d . Id . a t 2 2 7 . A co u rtd e c i d i n g a p l e a to th e j u ri sd i c ti o n i s n o t req u i red to l o o kso l e l yto th e p le a d i n g s b u t m a yco n side r ev i d e n c e an d m u st d o so w h e n n e c e ss a ry to
re s o l v e th e j u ri s d i c ti o n a l i s s u e s . Id. ( ci t i ng Bl and I ndep. Sch. Di

st. v. Blue , 34 S. W . 3d 547, 554 ( Tex. 200 0) ) . W hen a pl ea t o t he j ur i sd i ct i on c hal l eng est he exi st ence off act s al l eged t o est abl i sh t h e tr ia l court ’ s subj ectm at t er j ur i sd i ct i on, t he t r i alco urtm us tco ns i derr el eva ntev i den ceof f er ed by the p a rti e s . Id . W h e re, a s h e re, t h e j u ri sd i c ti o n a l ch a l l e n g e i m p l i c a tes the m e ri ts oft he pl eader ’ s c a u s e ofact i on and t he pl ea t o t he j ur i sdi ct i on i ncl udes evi dence, t he t r i al courtr eview s t he r el evantevi dence t o det er m i ne i fa f act i s s u e e x i s ts . Id. W h e n ev i d e n c e h a s b e e n su b m i tted th a t i m p l i c a tes th e m e ri ts o f th e su i t,
w e t a k e a stru e a l l e v i d e n c e fa v o ra b l e to th e n o n m o v a n t. Id . at2 2 8 . W e i ndul ge eve ry r ea so nab l e i nf er enc e a nd r es ol ve al l d o u b ts i n f avo roft he
n o n m o v a n t. Id. I f t he evi den cei s undi sp ut ed orf ai l s t o r ai sea f ac ti ss ue on7

t he j ur i sd i ct i ona l i ss ue, t hen t he t r i alco urtr ul eson t he pl ea t o t he j ur i sd i ct i on a s a m a tte r o f l a w . Id . T h e r e q u i r e me n t s t h a t a c a u s e o f a c t i o n mu s t me e t i n o r d e r t o c ome
w it h in t h e T T C A ’s w a iv e ro fg o v e r n m e n t a l im m u n it ya r e f o u n d in sect i on 1 01 . 02 1 o ft he A ct , w hi ch pr ovi des t hat , as appl i ed t o t hi s part i cul ar ca se , Br i t t ai n m us tes t abl i sh t hat G ent ry’ s dea t h w as pr oxi m at el y c aus ed by t he
n e g l i g e n c e o f a g o v e rnm e n tal e m p l o y e e a c ti n g w i th i n the sc o p e o f em p l o y m e n t, t hatG ent ry’ s dea t h w asca us ed by a con di t i on or us e o ft ang i bl e, pe r so nal , or r ea l pr ope rt y, an d t hatW i seRegi ona l w oul d, i fi tw er e a pr i vat e p er so n, be l i a b l e to G e n try a c c o rd i n g to T e x a sl a w . S ee Tex. C i v. Pr ac . & Rem . Code Ann. § 101 . 021 ( 2) . Spec i f i ca l l y , t he al l ege d ne gl i gen ceofA ppe l l ant s m us tha ve i nvol ved a con di t i on or us e oft ang i bl e p er so nalpr ope rt y, an d t he con di t i on or us e oft he t ang i bl e p er so nalpr ope rt y m us tbet he pr oxi m at e c aus e o ft he i nj ury. S e ei d.; se ea l

s o Tex . Te ch Univ. Hea lth S ci s . C tr. v. L u c ero , 234 S. W . 3d 158, 1 6 9 (T e x . A p p .— E l P a s o 2 0 0 7 , p e t. d e n i e d ). B. A l l egat i ons ofFai l ur e t o A ct M o st o f B ri ttai n ’s all e g a ti o n s in v o lv e the fai l u re o f A p p e l l a n ts to ac t,
r at hert han t he con di t i on orus e o ft ang i bl e p er so nalpr ope rt y— i ncl udi ng t he fai l u re to co m m u n i c a te w i th G e n t r y ’s p h y sici a n i n a ti m e l ym a n n e r, fai l u re to pr om pt l y docu m entvi t al si gns, and f ai l ur e t o t r ansf erG ent ry t o I C U once her8

cond i t i on deter i or at ed. W e agr ee w i t h A ppel l ant s t hatt he al l egat i ons oft hese “f ai l ur est o a ct ” ar e n ots uf f i ci ent t o w ai ve so ver ei gn i m m uni t y. Se eSo m ervell C ty. Hea lth c a reA u th . v. Sa n ders , 16 9 S . W . 3d 72 4, 72 7 ( Tex . A pp. — W aco 2 0 0 5 , n o p e t.) ; s e ea l s o Kerrvi

l leS ta teHo sp . v. Cl

a rk , 923 S. W . 2d 582, 584 ( Tex . 19 96 ) ( hol di ng t hatt he f ai l ur e t o adm i ni st eran i n je c ta b le dr ug i s a non- u s e o f tangi bl e p r ope rt y a nd do esnotf al l unde rt he w ai verpr ovi si onsof th e T T C A ); Sn ellingv. Mim s , 97 S . W . 3d 646, 654 ( Te x. App . — W a c o 20 02,
no pe t . ) ( h o l d i n g t h a tp l a i n t i f f ’ sp e t i t i o n a l l e g i n g t h a tt h e d e f e n d a n tn u r s i ng hom e f ai l ed t o di agno se, t r eatand r eporti nj ur i es and super vi se em pl oyees w as n o t s u fficie n t to w a i v e i m m u n i ty ). Ther e a r e n o a l l ega t i onsi n t he t hi r d am end ed or i gi nalpe t i t i on ofac t s or o m is s io n so t h e rt h a n f a ilu r e s t o a c t . T o t h is e x t e n t , w e s u s t a in A p p e lla n t s ’ s o le i ss ue and hol d t hatt hes e c l ai m s ar e not su f f i ci ent t o w ai ve so ver ei gn i m m uni t y. C . M edi cat i ons B r it t a in ’s s u p p le m e n tt o h e rt h ir d a m e n d e d o r ig in a l p e t it io n d o e sc o n t a in al l egat i ons al l udi ng t o t he use orm i suse oft angib le p e r sonal pr opert y t hat
r equi r e our anal ysi s of w het hert hese pl eadi ngs, and t he evi dence pr odu ced at t he hea r i ng, s upportt he t r i alco urt ’ s den i alofA ppe l l ant s’ pl ea t o t he j ur i sdi ct i on. The m ostpi vo tal f act s w e f i nd i n t he pl eadi ngs orevi dence t hat9

ar guab l y i nvol ve a condi t i on oruse ofpr opert y ar e t hose concer ni ng A ppel l ant s’
a d m i n i s tra ti o n o f c e rta i n m e d i c a ti o n sto G e n try .

1. U se orM i suse A ppe l l ant s con t end t hatBr i t t a i n di d notal l eget hatt he nur se s gav e m e d i c a ti o n i n an i m p rop e r m a n n e r, b u t rath e r, sh e a l l e g e d o n l ytha t A p p e l l a n ts f ai l ed t o quest i on G ent ry’ s physi ci a n abou thi s or derpr escr i bi ng t hese
m edi ca t i ons . Appel l ant s r ea so n t hatt he f ai l ur e t o que st i on t he doc t orab out adm i ni st r at i on of m edi cat i ons i s nota us e o r m is useoft angi bl e per sonal p rop e rt yan d d o e s n o t su p p o rta w a i v e r o f so v e rei g n i m m u n i ty. W e ag ree w i th A ppe l l ant s’ pr opos i t i on t hat a f ai l ur e t o que st i on a doc t orab outad m i ni st er i ng m edi ca t i onsi s nota us e o r m i s u seoft ang i bl e p er so nalpr ope rt y; w e d o not
a g ree w i th the i r i n terp reta ti o n o f B ri ttai n ’s all e g a ti o n s, w h i c h sp e c i fi c a l l ysta te t hat“D ef endan tN u rs e s m is u s e d . . . t angi bl e per sonal pr opert y . . . w hen
c a ri n g fo r/tre a ti n g B re tt G e n try : a n IV , m e d i c a ti o n s ( i n c l u d i n g S ta d o l ) . . . .” T h e se all e g a ti o n s fa i l to s e t f o rt h an yfac tu a l sp e c i fi c s a s to h o w A p p e l l a n ts al l ege dl y m i su se d m edi ca t i ons . Buti ti s unne ce ss ary t o de t er m i ne w het hert he concl usor y nat ur e oft he pl eadi ngs m akes t hem i nsuf f i ci entt o est abl i sh w ai ver ofs ove r ei gn i m m uni t y be ca us e t he evi den ce o ffe re d a tt he hea r i ng on A p p e l l a n ts ’ p l e a to th e j u ri s d i c ti o n a d d sth e n e c e s s a ryfa c tu a l s p e c i fi c s .10

D r. J o s e p h V a ron ’s d e p o sit i o n tes ti m o n yex p a n d s u p o n an d su p p o rt s B r it t a in ’s c la im t h a tt h e n u r s e sm is u s e d t h e m e d ic a t io n sb yn e g lig e n t ly
a d m i n i ste ri n g the m w h e n the ysh o u l d n o t ha v e d o n e so , i n ad d i ti o n to fa i l i n g to que st i on t he att end i ng ph ys i ci an’ s or der s t o gi ve t he m edi ca t i ons . Dr . V ar on t est i f i ed t hatt he nur ses w oul d have f ol l ow ed t he st andar d of car e i ft hey had
com m uni ca t ed w i t h t he doc t or t hat t he pat i entw ashyp ot ens i ve and ha d a l ow o x y g e n sa tu rati o n an d told h i m tha t t h e y“ d [ id n ’ t ] t h i n ktha t i t [ w a s] sa fe to gi ve [ S] t ado l . ” H ow eve r , hew asal so ad am ant th a t “ th ey gav e m edi ca t i ons t hatt hey shou l d not have gi ven on t he basi s oft he c li n ic al condi t i on of [ t he] pat i ent . . . . Th ey f ai l ed by adm i ni st er i ng m edi cat i on t hat shoul d not have been adm i ni st er ed t o a l ady un dert hese condi t i ons. ” D r . V ar on’ s deposi t i on al so con t ai ned t he r el eva ntco l l oquy :

Q . A n d w h a t y o u a re s a y i n g [i s ] th e re i s a p h y s i c i a n o rd e rs [ si c] f orSta d ol , buti t ’ s youropi ni on t hatt he nur se s sh oul d not hav e f ol l ow ed t he phys i ci an or deran d gi ven t hat m edi ca t i on t o t he p a ti e n t? A . C or r ec t , ba se d on j us t com m on se ns e and , aga i n a ct i ng as t he pat i entadvocate and kno w i ng t hatt he r i sk ofg iv in g [ t he] p a t ie n tt h e a g e n tf a ro u t w e ig h st h e b e n e f itt h a tt h e p a t ie n tw o u ld g e t. N otevery pl eadi ng ori t em ofevi dence i n suppo rtoft hatpl eadi ng— t hat
m e d ic a t io n c o n t r ib u t e d t o a n i n j u ry — c o n s t it u t e sa u s e o rm is u s e o ft a n g ib le p e rs o n a l p ro p e rty . S ee D al l as County v. A le

jo , 243 S . W . 3d 21, 27 ( Tex.11

A pp. — D al l as 20 07 , no pet . ) . Forexam pl e, t he non use of m edi ca t i on doe s not
w a i v e i m m u n i ty . Kassen v. Hatley , 887 S. W . 2d 4, 14 ( Tex. 1994 ) . I n Kassen , a w o m a n s u ffe ri n g f r o m m e n ta l p ro b l e m sw a sta k e n to a p u b l i c h o s p i ta l . Id. H erpr es cr i pt i o n m e di ca t i on w asco nf i sc at ed by h os pi t alpe r so nne l . W i t hout
re tu rn i n g h e r m e d i c a t i o n to h e r, th e h o s p i ta l re l e a s e d h e r. Id. S h o rt ly th e re a fte r, sh e c o m m i tte d s u i c i d e . Id. T h e c o u rt h e l d th a t th e fa i l u re to re tu rn t h e p a t ie n t ’s m e d ic a t io n t o h e r u p o n d is c h a r g e w a sa n o n u s e o ft a n g ib le p ro p e rtyth a t d i d n o t tri g g e r w a i v e r o f s o v e re i g n i m m u n i ty . Id. I n another S u p r e m e C o u rto fT e x a sc a s e , a h o s p it a l re le a s e d a p a t ie n tw h o s u b s e q u e n t ly
m u rd e re d h i se s tra n g e d w i fe . Cl a rk , 923 S. W . 2d at583. The i ss ue bef or e t he
courtw as w het hert he hospi t al ’ s adm i ni st ra tio n o f an or al f or m ofan ant i

- ps ych ot i c d r ug r at hert han an i nj ec t abl e d r ug c ons t i t ut ed us e o rm i su seof ta n g i b l e p e rs o n a l p ro p e rty . Id. T h e c o u rth e ld t h a t t h e s u b s t a n c e o ft h e c la im
w as , r at her , t he f ai l ur e t o a dm i ni st eran i nj ec t abl e d r ug, w hi ch con st i t ut ed a non use oft angi bl e per sonal pr opert y a n d , th us, di d not f al l undert he w ai ver p ro v i s i o n so f th e T T C A . Id. T h e c o u rt s ta te d : T h e r e c a n n o tb e w a iv e r o f s o v e r e ig n im m u n it yin e v e ryc a s e in w h i c h m e d i c a l tre a tm e n t i sp ro v i d e d b ya p u b l i c fa c i l i ty . D o c to rs i n st at e m edi cal f aci l i t i es use s om e f or m oft angi bl e per sonal p r o p e rt y n e a r ly e v e ry t im e t h e y t r e a t a p a t ie n t . B e c a u s e o ft h is fac t, a p a ti e n t su i n g for n e g l i g e n c e co u l d alw a y s c o m p l a i n tha t a di f f ere n t for m oft r ea t m entt han t he oneem pl oye d w oul d ha ve b e e n m o re e ffe c ti v e a n d s ti l l c l a i m w a i v e r u n d e r th e A c t. Id. a t585– 86.12

S om e Tex as court s have f oun d the di sp ensi ngofm edi ca t i onsby a h o s p i ta l a “ u s e ” fa l l i n g s q u a re l y w i th i n th e w a i v e r s ta tu te . S ee Q ui nnv. Mem ’l Me d. C tr. , 7 6 4S .W .2 d 9 1 5 , 9 1 7 (T e x . A p p .— C o rp u s C h ri s ti 1 9 8 9 , n o w ri t);
se e al soEdi nbur g Hosp. A uth. v. Trevi no , 90 4 S. W . 2d 831, 838 ( Tex. A p p .— C o rp u sC h ri s ti1 9 9 5 ), rev’ d on other

grounds , 941 S. W .2 d 7 6 (Tex . 1997) ;A dam s v. Ri

os , N o. 14- 95- 002 39- C V , 199 6 W L 337 108 , at*4 ( Tex. A pp. — H ous t on [ 14t h Di st . ] Jun e 20, 1996 , no w r i t ) ( notde si gna te d f or publ i c a ti o n ) . I n Q ui nn , a physi ci an r esi dent- i n- t r ai ni ng ata count y hospi t al
o b t a in e d a p r e s c r ip t io n f r o m t h e h o s p it a l p h a r m a c y f o r a n a b o rt io n p ill. W h ile of fdut y, t he doc t orad m i ni st er ed th e pi l l t o hi s pr egn antgi r l f r i end . The gi r l f r i end s uf f er ed com pl i ca t i onsaft ert ak i ng t he pi l l an d w asa d m i tte d t o t he h o s p i ta l fo r s u rg e ry . Q ui nn , 764 S . W . 2d at916. The c o u rt h e l d t hatt he di spensi ng of t he dr ug by t he hospi t al phar m acy w as a use of t angi bl e per sonal pr ope rt y. Id. at 917 . Si m i l ar l y, i n A da ms , th e co u rtfou n d the d i sp e n sing o f a d r u g b y t h e h o s p it a l’s p h a r m a c y a “ u s e o f t a n g ib le p r o p e rt y [t h a t ] f a llsw it h in t he w ai verofsover e ign i m m uni t y und ert he [ TT C A ] . ” A da ms , 1 9 9 6 WL 3 3 7 1 0 8 , a t * 4 . I n c o n t ra s t, th e W a c o c o u rt h a sh e l d th a t a n u rs i n g h o m e ’s di st r i buti on of m edi cat i on accor di ng t o a pr escr i bi ng do ct or ’ s di r ect i on w as i nsuf f i ci entt o f al l w i t hi n t he w ai verbecause t he essence oft he cl ai m w as t hat13

th e n u rse s w e re a w a re o f se d a ti n g side e ffec ts o f th e m e d i c a ti o n a n d fai l e d to
m oni t ort he pat i ent , w ho s l i ppe d a nd f el l , and su ch f ai l ur e t o m oni t orw asnot
a m i su seoft he m edi ca t i on. Se eSo m ervell, 169 S. W . 3d a t728. V i e w i n g th e p l e a d i n g s a n d ev i d e n c e i n the l i g h t m o st fav o rab l e to B r it t a in

— s p e c if ic a llyt h e p le a d in g t h a ta lle g e sG en t ry’s “de a t h [w a s ] p r o x im a t e ly
ca us ed by t he con di t i on or us e o f[ ce rt ai n m edi ca t i ons ] ” and t he t es t i m ony f r om D r . V ar on t hatt he nur ses adm i ni st er ed th e m edi cat i ons t o G ent ry w hen t hey shoul d have r ef used t o do so— w e hol d t hatt he pl eadi ngs and evi dence suf f i ce to es tab l i sh a “ u s e ” o f m e d i c a ti o n s i n this ca se su ffi c i e n t t o w a i v e i m m u n i ty
u n d e r th e T T C A . 2. Pr oxi m at e C ause I n addi t i on t o t he r equi r em ent of “use, ” t he T TC A speci f i cal l y st at es t hat t he i nj ury m us tbe“ so caused by a cond i t i on or use oft angi bl e per sonal orr eal p rop e rt yi f t h e g o v e rnm e n tal u n i t w o u l d , w e re i t a p ri v a te p e rso n , b e l i a b l e to t he cl ai m antac co r di ng t o Tex asl aw . ” Tex. Ci v. Pr ac . & Rem . Code Ann. § 101 . 021( 2) ( em pha si s add ed) . A cc or di ngl y, t he pl ai nt i f fm us tal l eget hatt he pr ope rt y’ s con di t i on orus e p ro x i m at el y c aus ed t he per so nali nj ury orde at h. D al l as Coun ty Mental

Health and Mental

Retardati

on v. Bo ssl

ey , 968 S. W . 2d 3 3 9 , 3 4 2

– 4 3 (T e x .), cert. denied, 5 2 5 U .S . 1 0 1 7 (1 9 9 8 ).14

P ro x i m a te c a u s e c o n s i s ts o f c a u s e -i n -fa c t a n d fo re s e e a b i l i ty . W. I n vs ., I nc. v. Urena , 16 2 S . W . 3d 54 7, 55 1 ( Tex . 20 05 ) . The t estf orcause- i n- f act i s w het hert he ac torom i ss i on w asa su bs t ant i alf ac t ori n c a u s i n g t he i nj ury,
w i th o u t w h i c h th e h a rm w o u l d n o t h a v e o c c u rre d . F o rd Mo to r Co . v. L e desma , 2 4 2 S .W .3 d 3 2 , 4 5

– 4 6 (T e x . 2 0 0 7 ); D oe v. Bo ys Clubs of Greater D al l as, I nc. , 9 0 7 S .W .2 d 4 7 2 , 4 7 7 (T e x . 1 9 9 5 ). T o e s ta b l i s h c a u s e -i n - fa c t, o r “ b u t fo r” causat i on, a part y m ustshow t hat t he def endan t ’ s negl i gence w as a s ubst ant i al f ac t or i n br i ngi ng abo uthi s i nj ur y w i t hou tw h ic h n o har m w oul d have been i n c u rre d . L e desma , 2 4 2 S .W .3 d a t 4 5

– 4 6 ; Excel Cor p. v. A podaca , 81 S . W . 3d 8 1 7 , 8 2 0 (T e x . 2 0 0 2 ); se e a l so Sa l a s v. W i l so nMem ’l

Ho sp . D i

st. , 139 S. W . 3d 3 9 8 , 4 0 3 (T e x . A p p .— S a n A n to n i o 2 0 0 4 , n o p e t.). A p p e l l a n ts fo c u s o n a l i n e o f ca se s th a t us e s th e p h ras e “i n stru m e n tal i ty
o f ha rm ” to d e sc ri b e p rox i m a te c a u se . A n d w e ag ree tha t so m e T e x a s c o u rt s u s e th i s p h ra s e to d e s c ri b e p ro x i m a te c a u s e u n d e r th e T T C A . See McCl ai n v. Univ. o f T

ex . Hea lthC tr. , 1 1 9 S .W .3 d 4 , 7 ( T e x . A p p .— T y l e r 2 0 0 2 , p e t. d e n i e d ) (us i n g the l a n g u a g e “i n stru m e n tal i ty o f t h e h a rm ” to d e sc ri b e p rox i m a te
ca us e u nde rt he TTC A ) . How eve r , A ppe l l ant s co n s tru e t he phr as e “ t he i n stru m e n tal i ty o f ha rm ” a s th o u g h i t req u i res so l e c a u sa ti o n . W e d i sa g ree w i th t hi s po rt r a ya l of c a us a t i on . Th e c a us a t i on r e qu i r e m e nt i n s e c t i on 101. 021( 2) i s one ofpr oxi m at e cause— not a hei ght e n e d st andar d such as sol e cause.15

Univ. of

N. Tex. v. Harvey , 1 2 4S . W . 3 d 2 1 6 , 2 2 0 ( T e x . A p p .— F o rtW o rt h 2 0 0 3 , p e t. d e n i e d ); Mi cha el v. Travi

s County Hous. A uth. , 995 S. W . 2d 909, 9 1 2

– 1 5 (T e x . A p p .— A u s ti n 1 9 9 9 , n o p e t.); see Bo ssl ey , 968 S . W . 2d a t342 ( “Se ct i on 101. 021 ( 2) s t at est hat f ori m m uni t y t o bew ai ved , pe r so nali nj ury or d e a th m u s t be pr oxi m at el y ca us ed by t he con di t i on or us e of t ang i bl e . . . p r o p e rt y .” ). P r o x im a t e c a u s e d o e sn o tre q u ir e a p la in t if ft o le a p t h e h ig h h u r d le th a t A p p e l l a n ts s u g g e s t. Li ber al l y c ons t r ui ng t he pl ea di ngsi n f avo rofBr i t t ai n, s he al l ege d onl y a sing l e co n c l u so ry sta tem e n t th a t th e l a u n d ry l i st o f tan g i b l e p e rso n a l p rop e rt y i t em s, i ncl udi ng m edi ca t i ons , pr oxi m at el y c aus ed t he i nj ur i esan d d e a th of G e n try . T h e se p l e a d i n g s a re n o t su ffi c i e n tl ysp e c if ic , s t a n d i n g alon e , to
es t abl i sh a w ai verofs ove r ei gn i m m uni t y. S ee Tex . D ept. of Cr i m i nal Justi ce
v. Mi l ler, 51 S. W . 3d 583, 592 ( Tex. 2001 ) ( H ec ht, J. , co ncu r r i ng) ( not i ng a l l e g a ti o n tha t pro p e rt yw a s d i rec tl yi n v o l v e d i n ac ti o n a b l e i n j u ry o r de a th g e n e ra l l y s u fficie n t to s u rv i v e a p l e a to th e j u ri s d i c ti o n ); compare City of D al l as
v. Hea rd

, 2 5 2 S .W .3 d 9 8 , 1 0 6 (T e x . A p p .— D a l l a s2 0 0 8 , n o p e t. h .) ( con cl udi ng f ac t ualal l ega t i ons w er e su f f i ci ent t hatpl ai nt i f fw ast r app ed i n z oo enc l os ur e w hen door s m al f unc t i one d s o a s t o a l l ow gor i l l a t o pi ckhe rup a nd th ro w h e r a g a i n s t w a l l ), with A ger v. W ichita Gen. Hosp. , 977 S. W . 2d 658, 66 0 ( Tex . A pp. — FortW ort h 1 99 8, no pet . ) ( hol di ng con cl usor y al l egat i on t hat16

f ai l ur e t o r ecogn i ze s ym pt om s r esul t ed f r om m i suse orcondi t i o n o f m edi cal devi ces i ncl udi ng st et hoscop es and t her m om et er s a n d t hatsuch w as a pr oxi m at e c aus e o fpl ai nt i f f ’ s i nj ur i esf ai l ed t o s uf f i ci entl y a l l e ge t hatan y ta n g i b l e i te m o f p ro p e rtyo r i ts u s e w a sa c o n tri b u t i n g fa c to r o f p l a i n ti ff’s i n j u ri e s to c o n s ti tu te w a i v e r o f s o v e re i g n i m m u n i ty ). Br i t t ai n’ s pl ea di ngs , how eve r , do nots t and al one . W e m us tco ns i dert he
ev i d e n c e o f f er ed att he hea r i ng, w hi ch con si st ed oft he t hr eede pos i t i onsof B ri ttai n ’s ex p e rtw i tn e s s e s o ffered b yA p p e l l a n ts. A p p e l l a n ts a rgu e tha t,
r egar dl ess oft he l evel ofpr oxi m at e cause r equi r ed by Tex as l aw , Br i t t ai n has f ai l ed t o r ai sea f ac ti ss ue as t o t he ca us at i on of any har m t o G ent ry byus e o f t he m edi cat i ons i n quest i on and t hatt he evi dence A ppel l ant s of f er ed
e sta b l i sh e s l a c ko f ca u sa ti o n as a m a tter of l a w . W e d i sa g ree w i th A p p e l l a n ts th a t a n yb u rd e n w a so n B ri tta i n i n th e fi rs t i n s ta n c e to ra i s e a fa c t i s s u e . T h i s i s n o t a rev i e w o f a “n o ev i d e n c e ” s u m m a ry j u d g m e n t. A p p e l l a n ts
ar e hel d t o t he sam e bur den as a m ovant f ora tra d itio n a l su m m a ry j u d g m e n t,
a n d m u s t n e g a te j u ri s d i c ti o n a sa m a tte r o fl a w . Mi ran da, 13 3 S . W . 3d at 227 –28 ( st at i ng go ver nm ent alen t i t y he l d t o s a m e s t and ar d on pl ea of j u ri s d i c ti o n a sm o v a n t fo r s u m m a ryj u d g m e n t u n d e r ru l e 1 6 6 a (c )); Hendeev. D ewhust, 22 8 S . W . 3d 35 4, 36 6 ( Tex . A pp. — A ust i n 20 07 , pet . deni ed) ( sam e) ;17

D al l as Coun ty v. W

adley , 168 S. W . 3d 373, 376–7 7 ( Te x. App.

— Dal l a s2005 , p e t. d e n i e d ) (sa m e ). A pl ai nt i f f s i s notr equ i r ed t o s how a di sp ut ed m at er i alf ac ti ss ue re gar di ng j ur i sdi ct i on w her e f act s under l yi ng t he m er i t s and subj ectm at t er ju r is d ic t io n a r e in t e rt w in e d u n t il after th e d e fen d a n t as se rt s a n d su p p o rt s w i th evi de n c e th att he t r i alco urtl ac ksj ur i sd i ct i on . Mi randa , 133 S. W . 3d a t228 (ho l d i n g p l a i n ti ffs r e q u i red to s h o w a d is p u ted m a teri a l fac t i ss u e ex i sts
r egar di ng t he j ur i sdi ct i onal i ssue w her e f act s und er l yi ng t he m er i t s and subj ect
m att erj ur i sd i ct i on a r e i nt ert w i ned a fter S tate as se rt s a n d su p p o rt s w i th
e v i d e n c e th a t tri a l c o u rt l a c k ss u bj e c t m a tte r j u ri s d i c ti o n ); W adley , 168 S. W . 3d at37 6– 77 ( r ej ect i ng coun t y’ s ar gum ent t hat pl ai nt i f f s pr esent ed “no evi dence” t hatcounty had act ual know l edge of dang er ous cond i t i on of el evat orbecause p l a i n t i f f s h a d n o b u rd e n to p re s e n t e v i d e n c e o f c o u n ty ’sk n o w l e d g e w h e re c o u n tyfa i l e d to m e e t i ts b u rd e n to fi rs t e s ta b l i s h i ts l a c ko f k n o w l e d g e ). I ft he evi dence m er el y cr eat es a f actquest i on r egar di ng t he j ur i sdi ct i onal i ssue, t hen t he t r i al court canno t gr ant t he pl ea t o t he j ur i sdi ct i on, and t he f act i s s u e w i l l b e re s o l v e d b y th e fa c t fi n d e r. Mi ran da, 1 3 3 S .W .3 d a t 2 2 8 ; Tar rant C o un ty v. Morales , 207 S . W . 3d 870, 875 ( Tex. A pp. — FortW ort h 2006, no pet . ) . H ol di ng t he gov er nm ent al ent i t y t o t he bur den of m eet i ng t he t r adi t i onal
su m m ary j udgm ent st and ar d ofpr oofunde rr ul e 166a( c) pr ot ec t s pl ai nt i f f s f r om18

havi ng t o “puton t hei rcase s i m pl y t o e s t abl i sh j ur i sdi ct i on. ” Mi randa , 133 S. W . 3d at228 ( quot i ng Bl and, 3 4S .W .3 d a t 5 5 4 ). O urr evi ew oft he evi den ces ubm i t t ed by Appel l ant s l ea dsust o c onc l ude t hati ts upport s, r at her t han neg at es , t he al l ega t i onst hatt he us e o fm edi ca t i ons b yA p p e l l a n ts w a sa c o n tri b u ti n g fa c to r i n c a u s i n g G e n try ’sd e a th . See i d. D r. V ar on, a boar d cert i f i ed phy si ci an i n cr i t i cal car e and pul m onar y and i nt er nal
m e d ic in e , a n d a p r o f e s s o ra tt h e U n iv e r s it yo fT e x a sS c h o o l o f N u r s in g in H o u s t o n , t e s t if ie d in a 2 0 0 5 d e p o s it io n t a k e n b yA p p e lla n t st h a t , b a s e d o n h is
r evi ew oft he m edi ca l r ec or ds , G ent ry’ s con di t i on s i gni f i ca nt l y w or se ned f r om t he t i m e s he ent er ed t he hos pi t alon t he ni ghtofD ec em ber19 unt i l t he t i m e o f herdeat h. O n th e eveni ng of D ecem ber20 , heroxygen sat ur at i on l evel decr eased t o 8 1 p er centf i f t een m i nutes af t erherf ourt h dose ofStadol , even t hough s he w asal r ea dy o n ox yge n byna sa l ca nnul a. She w ast hen pl ac ed on a nonr ebr ea t her oxyg en m as k, an ot herm odeofpr ovi di ng s uppl em ent aloxy gen ; att em pt s w er e m ade t o w ak e her up and m ak e herco ugh; an d c al l s w er e m ade t o t he t r eat i ng ph ysi ci an and t he nur se supervi sor . A t12 : 10 p. m . on D ecem ber 21 , she had t o be i nt ubated a n d g iv e n C PR , butatt em pt s t o r esusci t at e her f ai l ed. The i nt uba t i on he rw asap pr opr i at e bas ed on at l ea st t hr eecr i t er i a: f or m or e t han 24 hour s pr i or t o her f i nal “e ven t ” her oxyg en r equ i r em ent s w er e t oo hi gh, she w a s in im p e ndi ng r espi r at or y f ai l ur e, and she had been gi ven19

m edi cat i ons know n t o al t erone’ s m ent a l s ta te , “so herabi l i t y t o pr ot ecther ai r w ay w as i m pai r ed. ” A p p e l l a n ts a l s o o ffe re d th e d e p o s i ti o n o f D r. M a rkE n tm a n , a b o a rd
ce rt i f i ed ca r di ol ogi stan d C hi ef of C ar di ova sc ul ar Sci enc es at Bayl or C ol l egeof M edi ci ne, an e x p ertr et ai ned byBr i t t ai n r egar di ng causat i on. D r . Ent m an tes ti fi e d th a t, i n h i s o p i n i o n , G e n tryd i e d a “ c a rdiac d e a th se c o n d a ry to ac u te
m yocar di t i s ofpr obab l e vi r al or i gi n. ” I n hi s opi ni on, t he m yocar di t i s i t sel fw as a secondar y cause by “i ndu ci ng an ar r hyt hm i a. ” Th er e coul d have been a vi r al
or , l ess l i kel y, a bact er i al i nf ect i ng agent. W i t h m yocar di t i s, how everi toccur s, t her e i s a si gni f i ca nt r i sk of an ar r hyt hm i a, a dep art ur e f r om t he nor m albe atof t he hea rt , w hi ch i n hi s opi ni on occ ur r ed i n t hi s ca se . I n D r . Ent m an’ s opi ni on, G e n try s u ffe re d a s u d d e n c a rd i a c d e a th fro m a n u n e x p e c te d a rrh y th m i a . D r . Entm an di d not bel i eve t hatt he pat i ent ’ s oxygen sat ur at i on l evel had anyt hi ng t o do w i t h her dea t h. I n c ont r as t , an ot herca us at i on e xpe rthi r ed by Br i t t ai n, w hos e d epo si t i on w asal so of f er ed by Appel l ant s, be l i eve d t h att he
o x y g e n s a tu ra ti o n l e v e l w a sv e ryi m p o rta n t, “ a b i g th i n g .”D r. G u i l e y a rd o , a boar d cert i f i ed cl i ni cal , anat om i c, and f or ensi c pat hol ogi sti n D al l as, not ed t hat G ent ry’ s oxyg en sa t ur at i on l eve l de cr ea se d s i gni f i ca nt l y on s eve r aloc ca si ons as sh e pr ogr es se d t o c ar di opul m ona ry a r r es t . He w asoft he opi ni on t hats he d i e d o f“ i d i o p a t h i c my o c a r d i t i s ” mo s t l i k e l ya s s o c i a t e d wi t h b a c t e r i a l s e p s i s . He20

d e fi n e d m y o c a rd i ti sa si n fl a m m a ti o n o f th e h e a rt m u s c l e n o t d u e to c o ro n a ry d i s e a s e , l a c ko f b l o o d fl o w , o r i s c h e m i a . D r . G u ile y a r d o e x p la in e d t h a tm y o c a r d it is k ills b yc a u s in g t h e h e a rtt o f a il
orby causi ng a ventr i cul arar r hyt hm i a. H e f urt hert est i f i ed t hatanyt hi ng t hat
ca us esda m age , ev en ofa sm al l ar ea , oft he hea rtm us cl e c an bec om e t he f ocus f oran ar r hyt hm i a. H e observed t h a t th e n u r ses’ not es i ndi cat ed t hat G e n tryex h i b i ted “h y p o x i a ,” m e a n i n g th a t G e n try ’s o x y g e n sa tu rati o n w a s q u i te lo w s e v e r a l t im e s . T h is w a sv e ryim p o rt a n t , h e s a id , b e c a u s e h y p o x ia “i nt ens i f i est he d a m agef r om m yoc ar di t i s. ” I n t hi s ca se , i n hi s opi ni on, t he h y p o x i a w o rk i n g to g e th e r w i th th e m y o c a rd i t i sc a u s e d d a m a g e to th e h e a rt
m u s c l e , w h i c h c a u s e d th e h e a rt to g o i n to th e a rrh y th m i a . V ie w in g t h e e v id e n c e in t h e lig h t m o s tf a v o r a b le t o B r it t a in , a re a s o n a b le i nf er enc e m ay be dr aw n f r om t he m edi ca l t es t i m ony t hatt he m edi ca t i o ns a d m i n i ste red to G e n tryca u se d o r c o n tr i b u ted to h y p o x i a , w h i c h c o n c u rr e d w i th t h e m y o c a r d it is in c a u s in g d a m a g e t o t h e h e a rtm u s c le , w h i c h re s u lt e d in G ent ry’s a rrhyt hm i a a nd de at h. M or eov er , w e h aveco m bed t he vol um i nous rec o rd o f t e sti m o n yo ffered b yA p p e l l a n ts a n d fi n d n o ev i d e n c e tha t nosuch causal connecti on exi st ed. A ppel l ant s t ook t he expert s’ depo si t i ons but never i nqu i r ed as t o any c a u s a l e ff ectoft he m edi cat i ons. W e concl ude t hat A ppe l l ant s f ai l ed t o c ar ry t hei rbur den t o c onc l us i vel y e st abl i sh l ac k o fca us at i on21

so as t o r equi r e Br i t t ai n t o c o m e fo r w ar d w i t h af f i r m at i ve evi dence t o r ai se a f acti ssue on hercl ai m . C oncer ni ng t he m i suse oft hese m edi cat i ons as a pr oxi m at e c aus e o f her dea t h, w e hol d t hat t he t r i alco urtdi d noter ri n de nyi ng A p p e lla n t s ’ p le a t o t h e ju r is d ic t io n . W e o v e r r u le t h is p o rt io n o f A p p e lla n t s ’ s o le i s s u e . D . U seo f O th e r T a n g i b l eP e rso n a lP rop e rty I n addi t i on t o al l egi ng t he use ofm edi cat i ons, Br i t t ai n’ s suppl em entt o her t hi r d am ended or i gi nal pet i t i on con t ai ns a l i t any of ot her ta n g ibl e per sonal pr ope rt y t hat Br i t t ai n cl ai m s A ppe l l ant s us ed or m i su se d w hen t r ea t i ng Gent ry, t o w i t : an I V , a pul se oxym et er , a bl ood pr essur e m achi ne and cuf f , an oxyg en s u p p l y , a n o x y g e n m a s k , a n a m b u b a g , a n d s y ri n g e s . W hi l e w e agr ee t hatBr i t t ai n has pl eaded t hatA ppel l ant s used orm i sused t hese i t em s of t angi bl e pr opert y, w e do not agr ee t hat Bri t t ai n h a s p le a ded
s u ff i ci entf act ual al l egat i ons t hatt he use orm i suse oft hese addi t i onal i t em s ca us ed orev en con t r i but ed t o Gent ry’ s dea t h, an d no evi den ceof f er ed att he hea r i ng on t he pl ea t o t he j ur i sd i ct i on t end ed t o e st abl i sh an y c aus alco nne ct i on b e tw e e n u s e o f th o s e i te m s a n d a n y h a rm to G e n try . S ee A ger, 977 S. W . 2d
a t 6 6 2 ( “W i th o u t pro o f t h a t a s p e c i fi c ac t or i te m o f p r o p e rt yco n tr i b u ted to i nj ury, t her e c an be no pr oxi m a te ca us e. ”) . H ow eve r , t hes e p l ea di ngsdo n ot
a ffir m a ti v e l yn e g a te j u ri s d i c ti o n . S e eHo l l a nd, 2 21 S. W . 3d at64 3. I n such22

c a s e s , th e p l a i n ti ff s h o u l d o rd i n a ri l yb e a ffo rd e d th e o p p o rtu n i ty to re -p l e a d . Id.; see al so Mi randa , 1 3 3 S .W .3 d a t2 2 6

– 2 7 . B u t , a sa p r a c t ic a l m a t t e r , B r it t a in h a s a l re a d yh a d th e o p p o rtu n i tyto re -p l e a d . B ri tta i n ’s s u p p l e m e n t to h e r th i rd
am ended pet i t i on cl ear l y w as an att e m p tt o r e- pl ead t o cur e t he j ur i sdi ct i onal def ec t s r ai se d byt he pl ea t o t he j ur i sd i ct i on. Ther ef or e, sh e doe s notne ed, nor i s she ent i t l ed t o, another opp ort uni t y t o r e- pl ead . See Mi randa, 221 S. W . 3d
a t 2 3 1 . V . C onc l us i on H a v i n g o v e rru l e d i n p a rt a n d s u s ta i n e d i n p a rt A p p e l l a n ts ’ so l e i s s u e , w e a ffi rm the tr i a l co u rt ’s o rde r de n y i n g A p p e l l a n ts’ plea to t h e ju r i sd i c ti o n as to Br i t t ai n’ s cl ai m s t hatar e b as ed on t he us e oft he af or em ent i one d m edi ca t i ons and r em and t hose cl ai m s t o t he t r i al courtf or f urt her pr oceedi ngs. W e r ever se t h e t r ia l c o u rt ’s o r d e r d e n y in g t h e ir p le a t o t h e ju r is d ic t io n a s t o B r it t a in ’s c la im s t hatar e based on f ai l ur es t o actand di sm i ss t hose cl ai m s f orw antofsubj ect
m a tte r j u ri s d i c ti o n . F i n a l l y , w e re v e rs e th e tri a l c o u rt’so rd e r a sto B ri tta i n ’s
r em ai ni ng cl ai m s al l egi ng use oft angi bl e per sonal pr opert y and di sm i ss t hose
c l a i m s fo r w a n t o f s u bj e c t m a tte r j u ri s d i c ti o n .

A N N E GA RD N ER J U S T I C E PA N EL: C A YC E, C. J. ; D A U PH I N O T and G A RD N ER, JJ.23

DEL I VERE D: Se pt e m be r25, 2008