Opinion ID: 3008296
Heading Depth: 2
Heading Rank: 2

Heading: Adequacy of the Expert Report

Text: In his petition, Dr. Jelinek raises a single issue: whether the trial court abused its discretion by denying his motion for sanctions and dismissal because the Casases ’ expert report was deficient under former article 4590i § 13.01, the statute in effect at the time. See Tex. Rev. Civ. Stat. art. 4590i § 13.01. Article 4590i required the report to provide “a fair summary of the expert’s opinions as of the date of the report regarding applicable standards of care, the manner in which the care rendered by the physician or health care provider failed to meet the standards, and the causal relationship between that failure and the injury, harm, or damages claimed.” Id. § 13.01(r )( 6). “If a plaintiff timely files an expert report and the defendant moves to dismiss because of the report’s inadequacy, the trial court must grant the motion ‘ only if it appears to the court, after hearing, that the report does not represent a good faith effort to comply with the definition of an expert report in Subsection (r )( 6) of this section.’” Bowie Mem’l Hosp. v. Wright , 79 S.W.3d 48, 51–52 (Tex. 2002) (per curiam ) (quoting § 13.01(l)). Dismissal for failure to serve an adequate expert report also carried mandatory sanctions, requiring an award to the defendant of his costs and attorney’s fees against the plaintiff or the plaintiff’s attorney. See Am. Transitional Care Ctrs . of Tex., Inc. v. Palacios , 46 S.W.3d 873, 877 (Tex. 2001) (citing § 13.01(e)). We have defined a “good-faith effort” as one that provides information sufficient to (1) “inform the defendant of the specific conduct the plaintiff has called into question,” and (2) “provide a basis for the trial court to conclude that the claims have merit.” Wright , 79 S.W.3d at 52 (citing Palacios , 46 S.W.3d at 879). All information needed for this inquiry is found within the four corners of the expert report, which need not “marshal all the plaintiff’s proof” but must include the expert’s opinion on each of the three main elements: standard of care, breach, and causation. Id. Importantly for this case, the “report cannot merely state the expert’s conclusions about these elements,” but “‘the expert must explain the basis of his statements to link his conclusions to the facts.’” Id. ( quoting Earle v. Ratliff , 998 S.W.2d 882, 890 (Tex. 1999)). “A report that merely states the expert’s conclusions about the standard of care, breach, and causation” does not fulfill the two purposes of a good-faith effort. Palacios , 46 S.W.3d at 879 . We review the trial court’s grant or denial of a motion for sanctions and dismissal under the abuse-of-discretion standard. Palacios , 46 S.W.3d at 877–78 . A district court “abuses its discretion if it acts in an arbitrary or unreasonable manner without reference to any guiding rules or principles.” Wright , 79 S.W.3d at 52 (citing Downer v. Aquamarine Operators, Inc. , 701 S.W.2d 238, 241–42 (Tex. 1985)). Dr. Jelinek argues that the Casases ’ report is deficient in two ways, failing (1) to state the applicable standard of care, and (2) to provide more than conclusory statements of causation. We focus on the latter. Dr. Daller’s report concluded that Dr. Jelinek’s breach of the appropriate standard of care in “reasonable medical probability, resulted in a prolonged hospital course and increased pain and suffering being experienced by Ms. Casas .” Aside from repeating essentially the same phrase twice more, the report says nothing more regarding causation. The Casases argue this statement is sufficient to meet the good-faith requirement. We disagree. An expert cannot simply opine that the breach caused the injury. Stated so briefly, the report fails the second Palacios element—it does not give the trial court any reasonable basis for concluding that the lawsuit has merit. See 46 S.W.3d at 879. An expert’s conclusion that “in medical probability” one event caused another differs little, without an explanation tying the conclusion to the facts, from an ipse dixit , which we have consistently criticized. See Pollock , 284 S.W.3d at 818 (citing Burrow , 997 S.W.2d at 235); Earle , 998 S.W.2d at 890 (“An expert’s simple ipse dixit is insufficient to establish a matter; rather, the expert must explain the basis of his statements to link his conclusions to the facts.”). Instead, the expert must go further and explain, to a reasonable degree, how and why the breach caused the injury based on the facts presented. While we have said that no “magical words” need be used to meet the good-faith requirement, mere invocation of the phrase “medical probability” is likewise no guarantee that the report will be found adequate. See Wright , 79 S.W.3d at 53 . Under these standards, the Casases ’ report is conclusory on causation. It offers no more than a bare assertion that Dr. Jelinek’s breach resulted in increased pain and suffering and a prolonged hospital stay. Beyond that statement, the report offers no explanation of how the breach caused the injury. Again, the plaintiff need not marshal all of his proof in the report, but he must include sufficient detail to allow the trial court to determine if the claim has merit. Because the Casases ’ report lacks any explanation linking the expert’s conclusion to the relevant facts, we hold that the trial court abused its discretion by denying Dr. Jelinek’s motion and the court of appeals erred by affirming that ruling. 9 See id. at 52. Accordingly, we remand the case to the trial court for an award of attorney’s fees and costs 1 0 under former article 4590i § 13.01(e) against the Casases and their counsel. 1 1