### NUM BER 13-07- 0049 7-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
GUA DA LU PE A DR IA NA M A RT INEZ , A pp ellan t,
v . JOR GE E . M IRA ND A , M .D., A pp ellee.

On ap pe al f rom th e 3 89t h Dist rict C ou rt of H ida lgo C ou nt y , T exas 

## ME MOR A N D U M OP I N I ON B efo re J u st ic es R o d rig u ez , G arza , a n d V el a M em o ra n d u m Op in io n b y J u st ic e Ve la App ellant , Gua dalu pe Ad riana Martine z , app eals f rom th e dism issal of a hea lth care li abi li ty cl aim she filed ag ain st appel lee , J or g e E. M ir anda, M. D. M arti nezco mplai ns that the trial court abu sed its discretio n in dism issing her com plaint and in aw arding atto rney’s2

fees. Dr . M ir anda ha s a ls o appea led the jud g men t, u rgin g that th e tr ial co urt abu sed it s di s c r et i on i n r ed uc i ng t he a mo un t of a tt or ne y ’ s fee s i t aw arde d to h i m. W e affi r m. I. B A CK GRO UND Ma rt ine zfil ed s uitag ain st Dr

. Mi ra nda for medic al malpr act ic e becau se a s ur g ic al spo n ge h a d b e en l eft in her abdomen after she had und er g one a Cae sar ian se cti on per formed by

D r. M ir anda. M arti nezfil ed her or ig ina l peti ti on on Janua ry 24, 2006. In an attemptto compl y

w it h secti on 74.351 of

the Tex as Ci v il Prac ti ce and Remedi es Code , s he
ser v ed D r. M ir anda w it h a re por t writt e n b y W ill iam Beaty , M .D

. See T EX
. C IV
. P R AC
. & R EM
. C OD E A NN . § 74.351 (V er non Su pp. 2 007)

. The or ig ina l re por t w as not a cc ompani ed by D r. Beat y ’s cu rr ic ulu m v it ae. Dr

. Mi ra nda filed his obj ect ion s to the r epor t and a mot ion to di smi ss
. The tr ial co urt den ied the moti on. Dr . M ir anda appeal ed th e or der deny ing the
mo ti o n t o d ism iss. In a me mo rand um opinio n, th is Court foun d the ex pert rep ort ina deq uate and r emanded t he case to the tri al cour t to dete rmi ne i f Mar

ti nezw as enti tl ed to an extens ion pursuantto sec ti on 74. 351( c)

. Mi ra nda v . M ar ti nez , No. 13- 06- 386- CV , 2007 W L 68700 1 ( Tex . Ap p.–C or pus Chr is ti , M ar . 8, 2007, pet. deni ed) ( mem. op.)

. After re mand to the tr ial cour t, Ma rt ine z filed both an amended r epor t pr epar ed by Dr . Beaty

and his curr ic ulu m v it ae. Dr . Mi ra nda f il ed objec ti ons to the repor t and a moti on to di smi ss bas ed o n t h e i n a deq uacy of the r epor

t. The tr ial co urt hel d a h ear ing on t he moti on and enter ed an or der di smi ss ing the cas e w it h pr eju dic e and aw ar din g D r. M ir anda attor ney ’s fees i n an amount l ess than he h ad r eq uest ed. I I

. T H E S TA TU TE Cha pter 74 o f the c iv il pr act ic e and re medies code re q uir es a c lai mant t o pr ov ide : a w r i tt en r ep or

t by a n ex pe rt th atp r ov i de s a fai r s um ma r y o f t he e x pert’s3

opi nio ns as of the dat e of the re por t r eg ar din g appli cabl e s tandards of car e, manner i n w hic h the ca re re nder ed by the phy si ci an or heal th c ar e prov ide r f ailed to m eet t he stan dard s, and t he causa l relat ionsh ip bet w een the f ailure and t he i nju ry , har m, or damag es cl aimed. Id . § 74. 351 (r) (6). T he sta tute f urthe r pro v ides tha t to be qualif ied to aut hor an expert re port, t he e x pert must be a phy si ci an or heal th car e pr ov ide r pr act ic ing medic ine at the t ime of the te sti mony or at the t ime the c lai m ar ose, hav e k n o wledge of the ac cept ed s tandard of car e for the diagnosis, ca re of

treatm ent of the injury , and be qualif ied ba sed o n training or ex perien ce to offer an ex per

t opi nio n r eg ar din g the acc epted sta ndar ds of m e d ical ca re
. T EX
. C IV
. P R AC
. & R EM
. C OD E A NN
. § 74. 401 ( Ver non 200 5)

. In de ter mini ng w hether the phy si ci an is q ual ified , t he tr ial co urt s houl d c onsi der w hether the physi ci an i s a cti v ely pr act ic ing medic ine i n r ender ing medi cal ca re se rv ic es re lev ant t o the cl aim. Id . § 74. 401 (c)( 2). If an ex pert r epo rt is not f iled in accord ance w ith the statu te, the tr ia l c o u rt shall enter an o rd er aw ar din g r eason abl e att or ney ’s f ees and cost s to the af fected ph y si ci an and dis mis s t he c lai m w it h prej udi ce. T EX
. C IV
. P R AC
. & R EM
. C OD E A NN . § 74. 351 (b)(1)-( b)(2). III

. S TAND ARD OF R EVI EW A. Ade quacy of

the Rep ort W e r ev iew

a t ri al cour

t’ s d eci si on r eg ar din g the adequ a cy o f the r epor

t und er an abuse of dis cr eti on s tandard. See Am . Tr ansiti onal Car e Ctr s. of Tex ., Inc . v

. Pa lacios , 46 S.W .3d 8 73, 8 77 ( Tex . 200 1)

. A tri al cour t abuses i ts dis cr eti on i f it act s i n an ar bit ra ry or unre ason able man ner w ithou t ref eren ce to an y g uiding rules or principles. B o w ie Me m’l Hos p. v
. W ri ght , 79 S.W .3d 4 8, 52 ( Tex . 200 2)

.4

B. Atto rn ey ’s F ees Pursuantto Sect ion 74.3 51( b) W e al so re v iew

the tr ial co u rt ’s aw ar d of atto rn ey ’s fees after di smi ss al under
sec ti on 74. 351 for an abus e of di sc re ti on. See Stromv. Mem’ l Herm ann Ho sp. Sys ., 110 S.W .3d 2 16, 2 20 ( Tex . Ap p.–H oust on [1 st Di st. ] 200 3, pe t. deni ed)

. IV. A N ALY SI S A. Sta nda rd of

Care In order for D r. Beaty ’s re por

t to be suffici ent, it must setforth the sta ndar d of car e. See T EX
. C IV
. P R AC
. & R EM
. C OD E A NN . § 74.351( a) , ( r) (6 ). An ex per t r epor t t hat
accom pan ies me dical ma lpractice pleadin gs mu st provide a f air summ aryof the expert's opi nio ns re g ar din g the appl ic abl e sta ndar d of car e. Id. W hil e a fai r summar y i s s omethi ng les s t han a full sta tement of the appl ic abl e s tandard of car e and how it w as bre ached , ev en a fair su mmary

mustse t out w hat c ar e w as ex pect ed, b ut no t g iv en. Pal aci os , 46 S.W .3d at 88 0. In a he alth ca re liability claim, th e stan dard of care i s def ined byw hat an ordin ary pr udent heal th c ar e prov ide r or phy si ci an w oul d hav e done u n d e r the s ame or si mil ar ci rc umstan ces
. Id. Pal aci os instructs tha t “[i]den tif y in g t h e s t a nda rd of

care is cr itical:
w hether a defendant br eache d his or her duty to a pati ent canno t be deter mined a bsent specif ic informa tion a bou t w hat the de f end ant shou ld have don e dif f eren tly .” Id. Dr

. Beaty ’s re por

t sug g est s that he, per sonal ly , alw ay s ins pect s the a b d o m in al
cav it y to confir m that

bl eedi ng i s c ontr oll ed and all f o reig n bodi es hav e been re mov ed. How ev er , hi s s tatement co ncer nin g w hat h e does or d o es not d o does not est abl is h the
s t a n d a r d o f car e. See W arne r v. H urt , 834 S.W .2d 4 04, 4 07 ( Tex . Ap p.–H oust on [1 4th Di st. ] 1992, no w ri t)

. Dr . Be aty al so sta ted t hat e v en th oug h a s pong e c ount w as made by5

t h e s c r u b n u r s e , t h e su r g e o n h a s a n i n d e p e n d e n td u t y t o i n s u r e t h a tn o s p o n g e s a r e l e ft inside a patie nt. Howeve r, D r. B eat y doe s not sta te exactlyw hat Dr. Miranda’s respo nsibility w as und er these circumsta nces. He doe s n ot op ine con cerning w hat Dr. Mi ra nda s houl d hav e done differentl y . Re g ardle ss , an ex per t may not merel y

st ate
conc lus ion s a bout the req uir ed elements of a c ause of acti on. Bow ie Mem orial Hosp. v. W ri ght , 79 S.W .3d 48, 52 (Tex. 200 2). Dr. Bea ty’ s g ene ral statem ent is conclusory. His
re por t w hol ly fail s t o s et ou t t he s tandard of car e. A repor t t hat o mits any

of the s tatut or

y r eq uir ements i s n ot a g ood fait h eff ort t o compl y w it h sec ti on 74.351. See Pala ci os , 46 S.W .3d at 879. H er e, t he tr ial co urt di d not abuse its di sc re ti on in dis mis si ng Mar ti nez ’s clai m becau se the repor t w as ina deq uate, as itdi d notse t fort h the st andar d of car e. B. Cau sat ion A repo rt also cann ot m erely state the expert’s conclu sions a b o u t the statu torily
re q uir ed el ements

. Id . W it h r e gar d t o c a u sa ti o n , Dr. B e a ty st a te s th a t le a ving th e sp o n ge in Ma rt ine zca used infla mmation , pai n, i nfecti on, a nd fev er
. But, he d o e s n o t state that lea v ing the spong e i n M s. Ma rt ine zw as caus ed by any br each of the s tandard of care by Dr . M ir anda. The r epor t does not adeq uatel y

link Dr. Mir anda’ s acti ons to M arti nez ’s pai n, infect ion , and fev er
. See Castillo v. Augu st , 248 S

. W

. 3 d 8 7 4 , 8 82 (T ex. App.– El Paso 2008, no pet .)

. The tr ial co urt w as w it hin i ts dis cr eti on bec ause the rep ort w as ina deq uate
as itfail ed to i denti fy a c ausal l ink betw een any

br each and t he damag es or i nju ri es. Beca use Ma rt ine z ’s ex per t r epor t w as ina deq uate for the r eason s s et forth ab ov e, the t ri al cour

t w as w it hin i ts dis cr eti on to di smi ss the cl aim. W e ov er ru le appel lan t’ s s econd is sue.6 V

. A T T OR N EY ’ S F EES By cross -i ss ue, D r. M ir anda urg es that the t ri al cour t er re d in faili ng to aw ar d hi m the
am oun t of

atto rney’s f ees h e requeste d pu rsuan t to sectio n 74 .35 1(b) of the Civ il Practice and R emedie s C ode. See i d. § 74 .351( b)

. Ma rt ine z co unters b y arg uin g thatthe tes ti mony
re g ar din g att or ney ’s fees w as not c lea r and di re ct, thatthe atto rn ey di d notpr ov e tha t t he fee s w er e ne c es s ar

y a nd t ha t D r . M i r an da ’ s att or ne y di d no t br i ng c on te mp or an eo us t i me re cords. W hen a heal th car e li abi li ty sui t is dis mis sed for failu re to pr ov ide a n ad e q uate repo rt, the trial court “ shall en ter an o rder tha t aw ards the af f ecte d ph y sician of

hea lth care provider reasona bl e a t torne y ’s fe es.” Id. § 74 .35 1(b)(1). In det ermin ing i f the trial court abuse d i ts dis cr eti on, t he appropr iat e tes t i s w hether the ev ide nce in suppo rtof the fees cont aine d the atto rney’s qualif ication s, his opinio n r eg ardi ng rea s on ab l en es s , an d th e basis for hi s o r her

opi nio n
. See B asi

n C re dit C onsultants , Inc. v. Obr egon , 2 S.W .3d 3 72, 3 73 (Tex . Ap p.–San Ant oni o 1999, pet. deni ed)

. T he trial cou rt heard testim ony from Ronald Hole, D r. Miranda’s attorne y . Mr . Hole tes ti fied to hi s q ual ific ati ons, opi nin g thatr eason abl e att or ney ’s f e e s f ro m the poi nt of inc epti on unt il the hear ing w er e $35, 000, in addi ti on to appel lat e att or ney ’s fees t otal ing $15,500 and $6,000 if petit ion f or rev iew is g ra nted. He outl ine d the w or k h e per formed and th e n u mb e r

o f h o u r s h e h a d e x p e n d e d i n t h e c a s e
. T h e t r i a l c o u rta l s o q u e s t i o ned
coun sel abo ut his f ees. She asked Hole to seg regate the f ees in the case currently bef ore itfrom t he fees i ncur re d i n the pr ior appeal

. The cour

t ask ed w hat Hol e’s fees w oul d be
w it hout the a ppel lat e c ost s. H e es ti mated t he fees t o be in the rang e of $20,00 0. The tr ial
cour t’ s a w ar d w as $16,600 and condi ti onal ly aw ar din g appel lat e fees.7

Al thoug h aw ar din g fees und er the statu te is mand ator y , c our ts ar e aff or ded dis cr eti on in deter mini ng the amount of t he aw ar d. Gr eat Glo bal

Assur ance Co. v. Keltex Props. , 904 S.W .2d 771, 776 (Tex . App.–C or pus Chr is ti 1995, no w ri t) ; see als o Ar ango
v. Br um m ett , No. 13 -0 2 -3 26-CV, 2 003 W L 22 025 897 , at *1 (T ex. App.– Corpus Christi, Aug . 29, 2003, pet. deni ed)

. Dr . M ir anda’ s ar g ument, in ess ence, i s t he s ame arg ument
couns el made i n Ar

ango ; t hat the tr ial cour

t had no d is cr eti on to aw ar d l ess att or ney ’s fees than the amount he soug ht t o es tabl is h bec ause the t est imony w as uncon tr adi cte d. Se e Ar ango, 2003 W L 22025 897 , at * 2. Her e, couns el for Ma rt ine z cross -e x amined couns el on the re asona ble ness and
nece ssity

of certain f ees. Similarly , the tria l c o urt said th at it w as no t going to award attor ney ’s fees for the first appeal of t his cas e. W hen c ounse l for D r. M ir anda t est ified that he es ti mated t he amount in the rang e of $20,000, he presu mably ex cl uded the amount of hou rs spent in th e f irst appe al. Th e trial court ha d the disc re t io n t o a w ard tho se f ees it det ermin ed were reasona ble an d ne cessary. Dr. Mirand a ha s not sho w n tha t the aw ard
w as a r b i t r a r

y o r u n r e a s o n a b l e
. I f w e w e r e t o g r a n t D r
. M i r a n d a t h e e n t i r e amount of atto rney’s f ees, w e w ould be substitu ting our discr etion for that of the trial court. W e are
w it hout suc h aut hor it y . See id. , 2 003 W L 220 258 97, a t *2. W e overrule appe llant’s f irst is sue and c ro ss -a ppel lan t’ s s ole i ss ue.8 VI. C ONCL US I ON The ju dg ment of the tr ial co urt i s a ff ir med.

RO SE V ELA J u s t i c e Me moran dum Opi nio n del iv er ed and filed thi s 3 rd day

of Jul y , 200 8.