Reversed and Remanded and Memorandum Opinion filed July 9, 2015.

In The

Fourteenth Court of Appeals

NO. 14-14-00213-CV

AMIR A. CHAMIE, Appellant

V.

MEMORIAL HERMANN HEALTH SYSTEM D/B/A UNIVERSITY PLACE 

RETIREMENT HOME, Appellee

On Appeal from the 234th District Court

Harris County, Texas

Trial Court Cause No. 2013-32676A

NO. 14-14-00226-CV

AMIR A. CHAMIE, Appellant

V.

CROTHALL HEALTHCARE, INC., Appellee

On Appeal from the 234th District Court

Harris County, Texas

Trial Court Cause No. 2013-32676
2

M E M O R A N D U M O P I N I O N

In these related appeals, Amir A. Chamie appeals from the trial court’s 

dismissal of personal injury claims for failure to timely file expert reports pursuant 

to section 74.351 of the Texas Medical Liability Act (TMLA). Tex. Civ. Prac. & 

Rem. Code § 74.351. As will be discussed below, Chamie alleged negligence 

against both Memorial Hermann Health System d/b/a University Place Retirement 

Home, Inc. and Crothall Healthcare, Inc. related to a slip-and-fall incident Chamie 

allegedly suffered while visiting his grandmother in a retirement home. Guided by

the Texas Supreme Court’s recent opinion in Ross v. St. Luke’s Episcopal Hospital, 

No. 13–0439, 2015 WL 2009744 (Tex. May 1, 2015), we reverse the judgments in 

these two cases and remand them to the trial court.

Background

Chamie initially filed suit against Memorial Hermann but subsequently 

amended his petition to include Crothall as a defendant. Chamie alleges that on or 

about September 13, 2011, he was visiting his grandmother at the University Place 

Retirement Home when he “was seriously injured as a result of a dangerous 

condition in that water was left upon the floor without indication of wet floor 

signs.” He further claims that his injuries were the “direct result of a fall that was 

proximately caused by th[is] dangerous condition . . . which Defendants knew or, 

in the exercise of ordinary care, should have known existed.” He additionally 

alleges that the defendants, their agents, or their employees were negligent in 

numerous possible ways, including permitting the floor to become slippery with 

liquid, allowing the condition to continue unabated, and failing to warn of the 

condition despite the fact that it had continued for such a length of time that in the 

exercise of ordinary care they should have noticed and corrected the condition. 

Chamie further claims negligence based on the alleged failures to inspect, maintain 

the floor in a reasonably safe condition, give adequate warnings, provide adequate 
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lighting, or discover and remove the liquid within a reasonable time.

Memorial Hermann acknowledges that it owns the retirement home where 

Chamie claims to have been injured, and Crothall acknowledges that at the time of 

the alleged incident, it “was under contract with Memorial Hermann to provide 

environmental services, e.g. janitorial and cleaning services” at the facility. Both 

appellees otherwise generally deny Chamie’s allegations.

Memorial Hermann filed a motion to dismiss Chamie’s claims, asserting that 

the claims are health care liability claims (HCLCs) and Chamie failed to timely file 

an expert report as required by section 74.351 of the TMLA. The parties offered 

no evidence in connection with this motion beyond an affidavit in support of 

attorney’s fees for Memorial Hermann. The trial court granted the motion, severed 

Chamie’s claims against Memorial Hermann from those against Crothall, and 

rendered a final judgment dismissing Chamies’s claims against Memorial 

Hermann. In the original action, Crothall then filed a substantially similar motion 

to dismiss. Crothall attached to its motion an affidavit from its Director of 

Environmental Services, which confirmed in general terms that Crothall provides 

housekeeping and cleanliness services at University Place. The trial court’s order 

granting that motion and dismissing Chamie’s claims against Crothall was 

effectively a final judgment as it disposed of all remaining claims and parties in 

that action. The current appeals followed.

Governing Law

In two issues in each of these appeals, Chamie contends that the trial court 

erred in dismissing his claims against Memorial Hermann and Crothall because his 

claims are not HCLCs and, thus, no expert report was required to be filed under 

section 74.351. The TMLA defines a “health care liability claim” as:
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a cause of action against a health care provider or physician for 

treatment, lack of treatment, or other claimed departure from accepted 

standards of medical care, or health care, or safety or professional or 

administrative services directly related to health care, which 

proximately results in injury to or death of a claimant, whether the 

claimant’s claim or cause of action sounds in tort or contract.

Tex. Civ. Prac. & Rem. Code § 74.001(a)(13). Pursuant to section 74.351, a 

claimant bringing an HCLC must, “not later than the 120th day after the date each 

defendant’s original answer is filed, serve on that party or the party’s attorney one 

or more expert reports.” Id. § 74.351(a)). If an expert report has not been served 

within the 120–day deadline and the defendant physician or health care provider 

files a motion to dismiss, the trial court must “dismiss[ ] the claim with respect to 

the physician or health care provider, with prejudice to the refiling of the claim,” 

and award the physician or health care provider reasonable attorney’s fees and 

costs of court. Tex. Civ. Prac. & Rem. Code § 74.351(b).1

Appellate courts generally review a trial court’s ruling on a motion to 

dismiss under section 74.351 for an abuse of discretion. Rosemond v. Al–Lahiq, 

331 S.W.3d 764, 766 (Tex. 2011). However, to the extent that our review involves 

a matter of statutory construction, the issue is a legal question we review de novo. 

See Tex. W. Oaks Hosp., LP v. Williams, 371 S.W.3d 171, 177 (Tex. 2012). 

Accordingly, in determining whether Chamie’s allegations constitute HCLCs

governed by the TMLA, we apply a de novo standard of review. Id.

While this appeal was pending, the Texas Supreme Court resolved a split 

among the courts of appeals concerning whether and to what extent claimed 

departures from accepted standards of safety by a health care provider must be 

related to the provision of health care to constitute an HCLC governed by the 

 

1

For purposes of this opinion, we assume without deciding that Memorial Hermann and 

Crothall both qualify as health care providers under the TMLA.
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TMLA. See Ross, 2015 WL 2009744, at *2. Accordingly, our analysis is guided 

by the Ross court’s interpretation of the scope of the TMLA and its instructions for 

determining whether a plaintiff’s claim constitutes a health acre liability claim.

The facts addressed in Ross are similar but not identical to those presented 

here. In Ross, a visitor to a hospital sued the hospital on a premises-liability theory 

after she slipped and fell on allegedly wet flooring near the lobby exit doors. Id. at 

*1. The hospital moved to dismiss Ross’s claim, asserting that the claim was an

HCLC and Ross had not filed an expert report. Id. The trial court granted the 

hospital’s motion, and this court affirmed, following the binding precedent of 

Williams, supra, and concluding that a claimed departure from a safety standard 

need not be directly related to health care in order to come within the TMLA. See 

id.; Ross v. St. Luke’s Episcopal Hosp., No. 14-12-00885-CV, 2013 WL 1136613, 

at *1-2 (Tex. App.—Houston [14th Dist.] Mar. 19, 2013), rev’d, 2015 WL 

2009744.

The supreme court then reversed our judgment, holding that for a safetybased claim against a health care provider to be an HCLC “there must be a 

substantive nexus between the safety standards allegedly violated and the provision 

of health care.” Ross, 2015 WL 2009744, at *6. The court further explained that 

“[t]he pivotal issue in a safety standards-based claim is whether the standards on 

which the claim is based implicate the defendant’s duties as a health care provider, 

including its duties to provide for patient safety.” Id.

Acknowledging that “the line between a safety standards-based claim that is 

not an HCLC and one that is an HCLC may not always be clear,” the court 

articulated seven non-exclusive factors to aid in analyzing whether a safety 

standards-based claim is substantively related to the defendant’s providing of 

medical or health care and is therefore an HCLC:
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1. Did the alleged negligence of the defendant occur in the course 

of the defendant’s performing tasks with the purpose of 

protecting patients from harm;

2. Did the injuries occur in a place where patients might be during 

the time they were receiving care, so that the obligation of the 

provider to protect persons who require special, medical care 

was implicated;

3. At the time of the injury was the claimant in the process of 

seeking or receiving health care;

4. At the time of the injury was the claimant providing or assisting 

in providing health care;

5. Is the alleged negligence based on safety standards arising from 

professional duties owed by the health care provider;

6. If an instrumentality was involved in the defendant’s alleged 

negligence, was it a type used in providing health care; or

7. Did the alleged negligence occur in the course of the 

defendant’s taking action or failing to take action necessary to 

comply with safety-related requirements set for health care 

providers by governmental or accrediting agencies?

Id.

Analysis

As in Ross, Chamie’s negligence claims are based on alleged violations of 

safety standards; Chamie makes no allegations specifically regarding the provision 

of health care by appellees and does not state where he slipped and fell at the 

retirement home.2 Appellees likewise have not asserted any connection between 

Chamie’s safety-related claims and the provision of health care, other than to assert 

that they (the appellees) are health care providers.3 As the Ross court made clear, 

 

2

 In its appellate briefing, Memorial Hermann suggests that the alleged incident occurred 

in a patient’s room; however, Memorial Hermann offers no record citation in support of this 

suggestion, and the record contains no evidence supporting it. The suggestion therefore plays no 

role in our analysis.

3 As Memorial Hermann states in its brief: “Keeping the floors safe and free of hazards 

is a safety claim that meets the fundamental needs of both its patients and visitors . . . .” Both 
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“[a] safety standards-based claim does not come within the TMLA’s provisions 

just because the underlying occurrence took place in a health care facility, the 

claim is against a heath care provider, or both.” Id. at *5 (citing Loaisiga v. Cerda, 

379 S.W.3d 248, 257 (Tex. 2012)).

Applying the non-exclusive considerations set forth in Ross, we conclude 

that no substantive nexus exists between the safety standards appellees allegedly 

violated and the provision of health care. The records before us do not show that 

the alleged negligence—leaving water on the floor—occurred in the course of 

performing tasks with the purpose of protecting patients from harm. Cf. Ross, 

2015 WL 2009744, at *6 (holding that cleaning a floor near exit doors was not 

shown to be for the purpose of protecting patients). Similarly, there is no 

indication in the records that the alleged negligence occurred in a place where 

patients might be while receiving care. See Lout v. The Methodist Hosp., No. 14-

14-00302-CV, 2015 WL 3878135, at *3 (Tex. App.—Houston [14th Dist.] June 

23, 2015, no pet. h.) (noting that even though incident allegedly occurred in 

hospital’s “heart failure unit,” there was no evidence in the record to substantiate 

that the plaintiff slipped in an area where patients might be while receiving 

treatment).

Chamie’s allegation that he was visiting his grandmother at the time of the 

incident indicates that he was not seeking, receiving or providing health care at the 

time. See id. (holding hospital visitor was not seeking or receiving health care at 

the time she fell). Furthermore, the records include no indication that the alleged 

negligence concerning water on the floor implicated safety standards arising from 

professional duties appellees owed as health care providers, that any 

instrumentality involved in the negligence was of a type used in providing health 

 

appellees took the position that there needed to be no nexus between a safety claim against a 

health care provider and the provision of health care for the claim to be an HCLC.
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care, or that the alleged negligence occurred in the course of taking action or 

failing to take action necessary to comply with a requirement set for health care 

providers by governmental or accrediting agencies. See Ross, 2015 WL 2009744, 

at *6; see also Lance Thai Tran, DDS, PA v. Chavez, No. 14-14-00318-CV, 2015 

WL 2342564, at *3-4 (Tex. App.—Houston [14th Dist.] May 14, 2015, no pet. h.) 

(mem. op.) (coming to similar conclusions in case involving wet flooring in a 

dentist’s office).

Conclusion

Concluding that the records in these two cases do not demonstrate a 

substantive nexus between the safety standards Chamie alleged appellees breached

and the provision of health care, we sustain Chamie’s issues, reverse the trial 

court’s two judgments, and remand both cases for further proceedings in 

accordance with this opinion.

/s/ Martha Hill Jamison

Justice

Panel consists of Justices Jamison, Busby, and Brown.