## In the Court of Appeals Second Appellate District of Texas at Fort Worth

-------------------------------------------- No. 02

- 18

- 00027

- CV

--------------------------------------------

On Appeal from the 141st District Court Tarrant County, Texas Trial Court No. 141

- 297189

- 18
Before Sudderth, C.J.; Gabriel and Pittman, JJ. Opinion by Chief Justice Sudderth 

### M ISTY 

### J ACKSON 

### , I NDIVIDUALLY AND ON 

### B EHALF OF THE 

### E STATE OF 

### R OGER 

### J. Y OUNG 

### , D ECEASED 

### ; AND 

### R OGER 

### J ACKSON 

### , Appellants

v.
K INDRED 

### H OSPITALS 

### L IMITED 

### P ARTNERSHIP D 

### / B 

### / A 

### K INDRED 

### H OSPITAL 

### F ORT 

### W ORTH 

### , Appellee2 OPINION
I. I ntroduction
This appeal arises out of an order sustaining Appellee Kindred Hospitals Limited Partnership d/b/a Kindred Hospital Fort Worth’s ( Kindred ) objection to Appellants Misty Jackson ’s , Individually and on Behalf of the Estate of Roger J. Young, Deceased, and Roger J ackson’s section 74.351 expert report. Tex. Civ. Prac. & Rem. Code Ann. § 74 .351(a) (West 2017)

. Because we conclude that the trial court abuse d its discretion by sustaining Kindred’s objection , we reverse and remand

. II. B ackground Roger J. Young , Roger Jackson’ s father and Misty Jackson’s father

- in

- law , was 79 years old when he was admitted to Kindred

— a long

- term care facility

— in January
2015. Young stayed at Kindred for a few months before being transferred to Plaza
Ho spital for critical care. Youn g died six days later on April 16, 2015. The Jacksons assert that while Young was at Kindred, he received insufficient monitoring from Kindred’s nursing and medical staff and that Kindred ’s staff failed to adequately treat and report changes in his medical condition , which caused his death

. Specifically, the Jacksons contend that during Young’s stay at Kindred, he developed
several pressure ulcers and abscess es on his scrotum and lower back 1 that t he Jacksons
contend c aused him to develop sepsis , septic shock , and metabolic encephalopathy.

1 Kindred concedes that “[d]espite the nursing staff’s treatment and care, Mr. Young developed pressure ulcers and sepsis d uring his admission period[.]”3 The Jacksons filed a hea lthcare liability claim (HCLC) against Kindred and
Dr. Muhammad Naveed Siddiqi

— Young’s treating physician

— and timely serve d both
with separate expert repor ts from Dr. Manuel Eskildsen. See id. § § 74. 001(a)(13), . 351 (a) (West 2017 ). Kindred and Dr. Siddiqi filed obje ctions to the expert reports. After granting Kindred’s objections and allowing the Jacksons to cur e the deficiencies, see i d. § 74.351(c), t he Jacksons served amended expert reports. Kindred a gain filed objections, and the trial court sustained Kindred’s objection s and dismissed Kindred
from the lawsuit ; but the trial court ordered that the Jacksons ’ lawsuit against Dr. Siddiqi could proceed

. Dr. Siddiqi then filed a motion for leave to designate Kindred as a responsible third party. The Jacksons filed a response and motion to reconsider the order
dism issing Kindred. After t he trial court denied the Jacksons ’ motion to reconsider and granted Dr. Siddiqi’s motion , the trial court granted the Jacksons’ motion to sever and rendered final judgment in favor of Kindred

. T his appeal followed. On appeal, the Jacksons raise two issues: First, that the tria l court abused its discretion by sustaining Kindred’s objection t o Dr. Eskildsen’s expert report, and

s econd, that the tria l court abused its discretion by denying their motion to reconsider.
III. Applicable Law
A
. Section 74.351 Expert Report s A plainti ff asserting a n HCL C must serve eac h defendant physician or health care provider with one or more expert reports and a curriculum vitae of each expert whose4 opinion is offered to subst antiate the merits of the HCLC

. See id. § 74.351(a) , (i) ; TTHR
Ltd. P’ ship v. Moreno , 401 S.W.3d 41, 42 (Tex. 2013)

. The statute requires that such a report must provide: (1 ) “a fair summary of the expert’ s opinions

. . . regarding applicable standards of care,” (2) a statement identifying “the manner in which the care rendered by the physician or [health care ] provider failed to meet the standards,” and (3) an explanation of “the causal relationship between that failure and the injury, harm, or damages claimed.” Tex. Civ. Prac. & Rem. Code Ann. § 74.351(r)(6) ; see TTHR Ltd.
P’ ship , 401 S.W.3d at 44

. The purpose of the report is to “ inform the defendant of the specific conduct the pla intiff has called into question,” and to “ provide a basis for the
trial court to conclude that the claims have merit .” Am. Transitional Care Ct rs . of Tex. , Inc. v. Palacios , 46 S.W.3d 873, 879 (Tex. 2001)

. Thus, t he expert report “ need not

mar shal every bit of the plaintiff’ s evidence,” Jernig an v. Langley , 195 S.W.3d 91, 93 (Tex. 2006) , but it must “explain, to a reasonable degree, how and why the breach caused the injury based on the facts presented.” Jelinek v. Casas , 328 S.W.3d 526, 539

– 40 (Tex. 2010)

. When a defendant timely files a motion to dismiss challenging the adequacy of an expert report, the trial cour t may take one of t hree actions. I f the court concludes that the report is adequate, i t may deny the motion

. See, e.g. , Hillery v. Kyle , 371 S.W.3d 482, 489, 492 (Tex. App.

— Houston [1st Dist.] 2012, no pet.). I f the trial court concludes that the report does not constitute an objective , good

- faith effort to comply with the statute, it must grant the motion

. See Tex. Civ. Prac. & Rem. Code Ann.5 § 74.351( l ); Bowie Mem’l Hosp . v. Wright , 79 S.W.3d 48, 51

– 52 (Tex. 2002); see also Jernigan , 195 S.W.3d at 94. Finally , if the court concludes that the report is an objective , good

faith effort to comply with the statute but is nevertheless deficient in some way, it may grant the plaintiff one 30

- day extension to cure the deficiency. See Tex. Civ. Prac. &
Rem. Code Ann. § 74.351(c); Scoresby v. Santillan , 346 S.W.3d 546, 557 (Tex. 2011). A report qualifies as an objective , good

- faith effort to comply if it (1) infor ms the defendant of the specific conduct the plaintiff questions, and (2) provides a basis
for the trial court to conclude that the plaintiff’ s claims have merit. Loaisiga v. Cerda , 379 S.W.3d 248, 260 (Tex. 2012)

. T he Supreme Court of Texas has held that a trial

court may look only to the “four corn ers” of the expert report to determine whether it constitutes an objective , good

- faith effort to comply. Wright , 79 S.W.3d at 52 ; Palacios , 46 S.W.3d at 878

. B
. Standard of Review We review a trial court’s ruling on a motion to dismiss pursuant to section 74.351
for an abuse of discretion. Palacios , 46 S.W.3d at 878 ; See Tenet Hosps., Ltd. v. Garcia , 462 S.W.3d 299, 304 (Tex. App.

— El Paso 2015, no pet.) (“ The trial court makes the decision whether the report is sufficient. Our role, whether the trial court has approved or rejected the report, is to determine if the trial court abused its discretion. ”) . A trial
court abuses its discretion if it acts in an arbitrary or unreasonable manner without reference to any guiding rules or principles. Walker v. Gutierrez , 111 S.W.3d 56, 62 (Tex. 2003). In reviewing the adequacy of an expert report, we bear in mind that “[t]he6 Legislature’s goal was to deter baseless claims, not to block earnest ones.” Gonzalez v.
Padilla , 485 S.W.3d 236, 242 (Tex. App.

— El Paso 2016, no pet.) (quoting Certified EMS,
Inc. v. Potts , 392 S.W.3d 625, 631 (Tex. 2013) ). IV. Analysis
A. In Assessing an Expert Report’s Sufficiency, Courts May Not Look Beyond the Expert Report’s “Four Corners”
We first address the Jacksons ’ contention that Kin dred violates the “four corners
rule ” by picking and choosing excerpts from Dr. Eskildsen’s reports and juxtapos ing
them in an effort to demonstrate the report addressing Kindred’s actions ( th e Kindred Report ) is inadequate. The gravame n of Kindred’s response is that t he predicate factual

statements in Dr. Eskildsen’s report addressing Dr. Sidd iqi ’s actions (the Siddiqi Report) as compared t o the factual statements in the Kindred Report “seemingly concede[] the [Kindred] nursing staff did, in fact, do what they were sup posed to do

. ” Kindred argues that while “ [ s ] tanding alone,” the factual statements in the Kindred Report “might be sufficien t ,” “ Dr. Eskildsen’s own report as to Dr. Siddiqi, as well as underlying facts, indicate otherwise.”
But i n an HCLC expert

- report challenge, a trial court’s job is to be a gatekeeper

— not to determine the truth or falsity of an expert’s opinion. See Mettau er v. Noble , 326 S.W.3d 685, 691 (Tex. App.

— Houston [1st Dist.] 2010, no pet.). Therefore, e ven if
Kindred were corr ect that the factual statements in the Kindred Report contradicted or7 conflicted with the factual statements in the Siddiqi Report , 2 resolving such conflicts
would require the trial court to go beyond the four corners of the Kindred Report and
compare it against the Siddiqi Report in order to determine the truth or falsity of the Jacksons ’ factual statements , which are not for the trial court to adjudicate in a section 74.351 expert

- report determination. See Gonzalez , 485 S.W.3d at 245 (“ There is nothing in the statute suggesting that we may consider an expert’ s credibility or the data he used at this stage of the litigation. ”); Christus Health Se. Tex. v. Br o ussard , 306 S.W.3d 934, 939 (Tex. App.

— Beaumont 2010, no pet.) (affirming trial court’s order denying medical providers’ motion to dismiss following plaintiff’s section 74.351 expert report even though the factual statements in report were possibly inconsistent with the statements in the plaintiff’s pleading because “the trial court could not look beyond the four corners of the report at this stage to determine whether the facts asserted in the pleadi ng and the report were fal se”); Collini v. Pustejovsky , 280 S.W.3d 456, 462 n.4 (Tex. App.

— Fort Worth 2009, no pet.) ( declining the invitation to go beyond four corners of expert’s

2 We disagree with this assessment in any event. A fair reading of the Kindred Report reveals allegations that Kindred’s staff provided some notes identifying some problems wi th Young’s skin infection that were sufficient to alert Dr. Siddiqi to follow up with his own examination , diagnosis, and treatment plan. Indeed, Dr. Eskildsen relied upon some of Kindred’s notes in compiling the Kindred Report

. B ut the Kindred Report also a lleges that Kindred’s staff was deficient by failing to document the extent
a nd increasing severity of Young’s skin infection, failing to properly examine Young, failing to try different treatments when one treatment plan did not lead to improvement, failing to properly monitor Young after noting his skin infection, failing to noti fy the attending physician of Young’s worsening condition and abnormal lab results, and failing to follow up with the attending physician af ter noting the onset of Young’s skin infection.8 report and instead “ constrain [ing] our review of the report’ s adequacy at this preliminary stage in the proceedings to the specific information and allegations
contained within it ”) ; Tenet Hosp s . , Ltd. v. Boada , 304 S.W.3d 528, 542 (Tex. App.

— El Paso 2009, pet. denied) (“Whether an expert’s opinions are correct is an issue for summary judgment, not a motion to dismiss under Chapter 74.”)

. B ecause the trial court could only look to the four corners of the Kindred Report , it was impermissible for the trial court to compare a separate expert report related to a
different health care provi der to negate the factual assertions in the Kindred Report

. 3 Wright , 79 S.W.3d at 52; Palacios , 46 S.W.3d at 878. Accordingly, w e hold that to the
extent the trial court sustained Kindred’s objection by looking beyond the four corners
of the Kindred Report and acting as a factfinder , the trial court abused its discretion

.

3 We recognize that when a plaintiff sues multiple defendants for a n HCLC, as in this case, the plaintiff may need to file multiple expert reports, in which case courts may read the reports together for certain purposes

. See Abilene Reg’l Med. Ctr. v. Allen , 387 S.W.3d 914, 918 (Tex. App.

— Eastland 2012, pet s . denied) (“[A ] plaintiff may serve multiple reports by separate experts regarding different defendants, different claims, and different issues, as long as the reports, read together, provide a fair summary of the standard of care, breach, and causation.”). We understa nd this to mean a trial court may “stack” a plaintiff’s expert reports in order to determine if the plaintiff has provided the defendants with fair notice of the allegations of duty, breach, and causation, but not that a trial court may ju xtapose factual s tatements in two separate exp ert reports in order to make factual determinations

. See Gonzalez , 485 S.W.3d at 245 (“ Appellants’ points on apparent conflicts between the medical records and the assumptions [the expert] makes are well

- taken. But ‘[w]hether an expert’s opinions are correct is an issue for summary judgment, not a motion to dismiss under Chapter 74.’ ” (quoting Tenet Hosps

. , Ltd. , 304 S.W.3d at 542) )

. That is to say, multiple s ection 74.351 expert reports can be combined to satisfy all of the report requirements as to one health care provider

. But nothing in the statute or case law authorizes the trial court to pit one report as to one health care provider against another report as to a d ifferent health care provider.9 B. T he Expert Report Satisfies the Statutory Requirements Having held that the trial court could not act as a factfinder by comparing the

two reports , we still must examine the four corners of the Kindred Report to determine
if it “ include [d] opinions on the three statutory elements

— standard of care, breach, and
causation. ” Walgreen Co. v. Hieger , 243 S.W.3d 183, 1 88 (Tex. App.

— Houston [14th Dist.] 2007, pet. denied)

. 1. Standard s of Care and Breach es The Kindred Report is not required to provide Kindred with “litigation

- ready evidence,” Certified EMS , 392 S.W.3d at 631, or to “meet the same requirements as the
eviden ce offered in a summary

- judgment proceeding,” Palacios , 46 S.W.3d at 879. T o satisfy the notice requirements for Kindred’s standards of ca re and alleged breaches thereof, the report must only fairly “ set out what care was expected, but not given.” Id.
at 880. Dr. Eskildsen opines in the Kindred Report that Kindred’s general standard of

care “requires that the medical facility provide that level of care and treatment that a reasonable, prudent, similar facility would provide under the same or similar
ci rcumstances based on the known medical needs of the resident at issue.” See Birchfield v. Texarkana Mem’l Hosp. , 747 S.W.2d 361, 366 (Tex. 1987) (holding the standard of care for a hospital is what an ordinarily prudent hospital would do under the same or similar circumstances). Dr. Eskildsen then provided nine more specific standards of care regarding Young’s skin infection :10 • that Kindred assess his skin and any related rashes or breakdown properly. Proper ly documented skin assessment would allow the staff to assay any improvement in his affected areas of skin;

• th at Kindred assess Young’s condition and continue to change his treatment on ongoing bases un til signs of healing occurred;

• th at Kindred clearly document its monitoring, assessing, and treating of Young’s i nfe ction in the medical record;

• th at Kindred e valuate and closely monitor Young’s skin for any signs and symptoms of infection and implement interventions to add re ss risks of further infection;

• that Kindred develop plans of care documenting the implemented interventions designed to mi nimize any infection ;

• that the facility properly treat any infections that Young had upon admission or developed during his residency at the facility by following all physician orders and evaluating the outcome of those orders;

• th at the facility treat any infection with the appropriate antibiotics as ordered by the physician, mo nitor the infection to determine if the treatment plan was successfully treating the infection, obtain laboratory testing of the infection to determine the effectiveness of the treatmen ts, and continually monitor Young until all laboratory testing confirme d that the infection was fully treated;

• that the staff monitor Young’s vital signs during each shift until all of his infection symptoms had resolved and the antibiot ic treatment plan was completed; and

• that the facility pe r form continuing assessments of Young, including an evaluation by a physician to establish a baseline, clearly document in the medical record a specific diagnosis of the infection, develop and document a treatment and care plan to address the infection, document a list of medications pr escribed to treat the infection, develop a plan to reassess the condition with a specific time table, and document any additional treatment notes or requirements needed to address the specific condition.11 The Kindred Report identified two ways that Kindre d breached the standard of

care and then provided numerous specific examples under each heading. Dr. Eskildsen also broadly stated the two identified breaches: Kindred failed to ensure Mr. Young received the necessary medical care and treatment to maintain his skin integrity and failed to ensure that the signs and symptoms of infection and abscess exhibited by Mr. Young were assessed by his physician [ ; and]

. . . .

. . . Kindred failed to timely and properly treat Mr. Young’s infection prior to the infec tion progressing to him going into septic shock and developing endoc arditis. Under the first alleged breach, Dr. Eskildsen further elaborated that

• Kindred did not write new orders after Young developed an abr asion and drainage on his penis;

• Young had a scrotal excoriation and abscess, which Kindred left uncovered and untreated; and

• Kindred did not order antibiotics to treat Yo ung’s urinary tract infection. Regarding the second alleged breach, Dr. Eskildsen asserted more specifically
that
th ere continued to be no attempt by Kindred’s nurses and clinical staff to address [ Young’s] scrotal abscess. Kindred’s nurses did not make any documentation or any attempts to notify the attending physician that Mr. Young needed skin and scrotal assessment and at the very least, further orders and diagnostic testing to rule out his abscess as the causative factor causing his change of condition and infection.12 In its appellate brief , Kindred acknowledges that “[s]ta nding alone”
Dr. Eskildsen ’s identified br eaches of the standards of care “might be sufficient,” but that “Dr. Eskildsen’s own report [as] to Dr. Siddiqi, as well as underlying facts, indicate
otherwise. ” If indeed the Kindred Report is sufficient “ [ s ] tanding alone,” then it is sufficient pursuan t to section 74.351. 4 A s explained above, it is an abuse of discretion
for a trial court or a reviewing court to act as a factfinder and look beyond the four corners of the expert report. See Gonzalez , 485 S.W.3d at 244 (rejecting defendant’s
invitation to look “beyond the four corners of the report and consider extrinsic evidence, or at the very least the actual records [the expert] relied on, to determine if his op inion is worthy of credence”).
Kindred also asserts that the Kindred Report does not provi de s tandards of care
related to Young’s specific injuries because Dr. Eskildsen does not provide a standard of care for wound care “despite his criticisms [that] the staff failed to properly cover the scrotal wound, which Dr. Eskildsen opines led to infection.” The Jacksons argue that s uch a level of specificity is no t required by section 74.351. We agree with Kindred’s observation that the standard for wound care recited by Dr. Eskildsen is not extremely detailed

. For example, Dr. Eskildsen generally states that Kindred was required to “properly treat” any infections that Young had upon

4 The very premise of Kindred’s argument requires that we look beyond the four corners of the Kindred Report itself ; thus, on its face Kindred’s argument invites us to misapply the applicable standard

.13 admission or that may have developed during his stay at Kindred. Likewise,
Dr. Eskildsen alleges that Kindred was required to administer “ appropriate ” antibiotics as ordered by the physician, “ monitor the infection , ” and “ determine if the treatment plan was successfully treating the infection.” However, “ [a] ‘fair summary’ of the
standard of care is ‘ something less than a full statement of the applicable standard of
care and how it was breached. ’ ” Faga dau v. Wenkstern , 311 S.W.3d 132, 138 (Tex. App.

— Dallas 2010, no pet.) (quoting Palacios , 46 S.W.3d at 880 ) ; see also Certified EMS , 392
S.W.3d at 630 (“ A report need not cover every alleged liability theory to make the
defendant aware of the conduct that is at issue. ”)

. Though lacking in painstaking details , the Kindred Report has sufficiently notified Kindred of the applicable standard of care
and the conduct at issue

— Kindred failed to assess Young’s condition, administer appropriate antibio tics, monitor the infection, determine if its treatment plan was succeeding and alter it if necessary, and properly document and notify the attending physician of changes in Young’s condition that would require additional diagnostic testing and orders

. As to identifyi ng the standard of care and the conduct at issue, the Kindred Report need not do more.
Therefore , we hold that the Kindred Report satisfied the requirement that it identify the applicable standards of care and conduct for which they seek to hold
Kindred li able. See Gonzalez , 485 S.W.3d at 25 0 (affirming denial of motion to dismiss HCLC because “this case involves the treatment of infection and wounds, which are subjects common to all areas of medicine, and it involves an alleged complete failure to14 coordinate a treatment plan between doctors,” “the level of technical detail needed

to
. . . determine if a case is frivolous is less than that needed to determine if a suit involving a highly complex procedure like a surgery is frivolous”). Regarding brea ch, the Kindred Report avers that Kindred failed to write new orders, failed to order antibiotics, failed to attempt to notify the attending physician that Young needed a skin and scrotal assessment, and failed to make further orders and diagnostic testing when Young’s condition had worsened. We hold that this provided Kindred with a fair summary of how Kindred breached the standards of care. See Gonzale z , 485 S.W.3d at 252 (affirming denial of HCLC motion to dismiss for duty and
breach elements of wound

- care case whe n expert alleged that defendant doctor failed to create and enforce an adequate follow

- up plan); Trisun Healthcare, LLC v. Lopez , No. 13

- 13

- 00238

- CV, 2014 WL 3050350, at *3 (Tex. App.

— Corpus Christi July 3, 2014, no pet.) (mem. op.) ( affirming trial court’s denial of HCLC motion to dismiss when expert report stated that medical facility “ fail[ed] to i mmediately notify the
deceased’s physician of the deterioration of the wound on his hand and fail [ed] to recognize and treat the dete riorating wound on the deceased’ s hand [which] caused the infection to progress and worsen ”)

. 2
. Causation “To satisfy the required element of causation under chapter 74, an expert report must include a fair summary of the expert’s opinion regarding the causal relat ionship between the breach of the standard of care and the injury, harm, or damages claimed.”15 Whisenant v. Arnett , 339 S.W.3d 920, 923 (Tex. App.

— Dallas 2011, no pet.). To provide fair notice of causation, “[a]n expert is required to link his or her conc lusions to the facts, but no ‘magical words’ are required.” SCC Partners, Inc v. Ince , 496 S.W.3d 111, 118 (Tex. App.

— Fort Worth 2016, pet. dism’d). The Kindred Report assert ed that [a]s a direct result of Kindred’s breaches of the above standards of care, Mr. Young developed an infe ction prior to his myocardial infa r ction on April 10, 2015. Specifically, the nurses’ failure to properly treat his abscessed wound, which did not heal, thus allowing a mode of transmission for the bacteria to proliferate and spread the infection in Mr. Young’s body. His endocarditis was caused by sep sis. The onset of sepsis occurs only after an infection. Between January 29, 2015 and April 10, 2015, Mr. Young developed a serious infection that showed symptoms of infecti on by delivering pus from his scrotum which had created an abscess. This is further confirmed by blood cultures that confirmed Mr. Young had Enterococcus faecalis bacteria, which are found in wound infections and is a cause of endocarditis.
Had Kindred properly monitored and assessed Mr. Young during this period of time, clinical findings would have indicated signs and symptoms of an ongoing infection process. Specifically, had the nurses informed Mr. Young’s attending physician of the changes to his co ndition, and his abnormal lab results in a timely manner, this would have provided a window of opportunity in which assessment and treatment could have, and based on reasonable medical probability would have, been implemented before sepsis developed. Thus , had Kindred properly evaluated, assessed, and monitored Mr. Young from January 29, 2015 through April 10, 2015, Mr. Young would have received treatment for his infection. Unfortunately, these opportunities were missed due to Kindred’s failure to ensure he was timely assessed and treated. As a direct result of not identifying and receiving timely treatment for his infection, Mr. Young developed bacterial endocarditis as a result of infection in his blood (sepsis), had an acute myocardial infarction and c ardiogenic shock resulting in his untimely death on April 16, 2015.16 Similar to Kindred’s assertions regarding the standard of care and breach, its assertions concerning causation center on Kindred’s belief that Dr. Eskildsen’s

statements are “contradicted by the facts and Dr. Eskildsen’s own report ” as to
Dr. Siddiqi. And just as we explained in those instances, it is not proper for the trial

court or a reviewing court to act as a factfinder by going outside of the four corners of the expert report.
The allegations within the four corners of the Kindred Report provide d fair
notice to Kindred of the Jacksons ’ allegations that Kindred’s staff’s failure to assess, monitor, and treat Young’s infection and failure to notify the attending physician of Young’s changed condition and abnormal lab results, caused sepsis, lea d ing to endocarditis, an acute myocardial infarction and cardiogenic shock , and Young’s death

. Accordingly, we hold that the Kindred Report satisfied section 74.351’s requirement of providing K ind red with fair notice of its specific breaches of the applicable standards
of care and how those breaches were linked to Young’s injuries and death. Allen , 387
S.W.3d at 923 ( rejecting appellants’ contention that the expert’s “ opinion on causation
is insufficient because it conflicts with matters contained in other expert re ports and the facts in the case” because “[t] he inquiry at the report stage focuses on whether the information within the four corners of the report meets the good f aith requirement of
the statute” and “ [i] f the facts do not s upport a plaintiff’ s claim, summary judgm ent procedures provide a remedy”)

.17 Thus, i n limiting our review to the allegations in the four corners o f the Kindred Report , we hold that the report satisfied the fair

- notice requirements of section 74.351
and that the trial co urt abused its discretion by sustaining Kindred’s objection. We
sustain the Jacksons ’ first issue. 5
V. Conclusion
Havin g held that the trial court abused its discretion by sustaining Kindred’s objection s to the Jacksons ’ expert report and dismissing their claims , we reverse the trial court’s judgment and remand for further consistent proceedings

. See Tex. R. App

. P. 43.2(d), 43.3. /s/ Bonnie Sudderth
Bonnie Sudderth Chief Justice
Delivered: November 1, 2018

5 Because we sustain the Jacksons ’ first issue, we need n ot address their second issue concerning their motion to reconsider. See Tex. R. App. P. 47.1

.