Court Opinion

ID: 4040561
Source: CourtListenerOpinion
Date Created: 2016-09-28 22:34:38.484328+00
Date Added: 2024-06-11T14:28:10.461595
License: Public Domain

ACCEPTED
                                                                           04-14-00803-CV
                                                                FOURTH COURT OF APPEALS
                                                                     SAN ANTONIO, TEXAS
                                                                      3/23/2015 2:17:23 PM
                                                                             KEITH HOTTLE
                                                                                    CLERK

              ORAL ARGUMENT REQUESTED                       FILED IN
                                                     4th COURT OF APPEALS
                                                      SAN ANTONIO, TEXAS
                     NO. 04-14-00803-CV
                                                     03/23/2015 2:17:23 PM
                                                         KEITH E. HOTTLE
                                                              Clerk
               IN THE COURT OF APPEALS
FOR THE FOURTH DISTRICT OF TEXAS AT SAN ANTONIO, TEXAS

    JUAN FRANCISCO MONTALVO, M.D., F.A.C.O.G., ET AL.,
                      Appellants
                             v.
                     GABRIELA LOPEZ,
                         Appellee.

            On Appeal from the 341st District Court
       Webb County, Texas, Cause No. 2013CVT 000841-D3
                     (Hon. Beckie Palomo)

              REPLY BRIEF OF APPELLANTS

                           Respectfully submitted,
                           DIANA L. FAUST
                           diana.faust@cooperscully.com
                           Texas Bar No. 00793717
                           R. BRENT COOPER
                           brent.cooper@cooperscully.com
                           Texas Bar No. 04783250
                           KYLE M. BURKE
                           kyle.burke@cooperscully.com
                           Texas Bar No. 24073089
                           COOPER & SCULLY, P.C.
                           900 Jackson Street, Suite 100
                           Dallas, Texas 75202
                           TEL: (214) 712-9500
                           FAX: (214) 712-9540

                           COUNSEL FOR APPELLANTS
                                      TABLE OF CONTENTS

                                                                                                       Page(s)

TABLE OF CONTENTS........................................................................................ i

TABLE OF AUTHORITIES ................................................................................. ii

ARGUMENT AND AUTHORITIES IN REPLY ...................................................1

I.      Section 74.251(a) Is a Constitutionally Permissible Exercise of the
        Legislature’s Police Power............................................................................1

II.     Even if Sections 16.001 and 16.003 Apply, Appellee’s Claims Are
        Barred by Limitations ...................................................................................6

CONCLUSION AND PRAYER.............................................................................9

CERTIFICATE OF COMPLIANCE ....................................................................12

CERTIFICATE OF SERVICE..............................................................................13

                                                        i
                                  TABLE OF AUTHORITIES

Case                                                                                               Page(s)

Adams v. Gottwald,
  179 S.W.3d 101 (Tex. App.—San Antonio 2005, pet. denied)........................... 5

Brown v. Shwarts,
  968 S.W.2d 331 (Tex. 1998) .............................................................................. 7

Gross v. Kahanek,
  3 S.W.3d 518 (Tex. 1999).................................................................................. 7

Lebohm v. City of Galveston,
  154 Tex. 192, 275 S.W.2d 951 (1955) ............................................................3, 5

Medina v. Lopez-Roman,
 49 S.W.3d 393 (Tex. App.—Austin 2000, pet. denied) ...................................... 8

Methodist Healthcare Sys. of San Antonio, Ltd., L.L.P. v. Rankin,
 307 S.W.3d 283 (Tex. 2010) .......................................................................2, 3, 5

Sax v. Votteler
  648 S.W.2d 661 (Tex. 1983) ...........................................................................1, 4

Shah v. Moss,
  67 S.W.3d 836 (Tex. 2001)................................................................................ 7

Tenet Hosps. Ltd. v. Rivera,
  445 S.W.3d 698 (Tex. 2014) .............................................................................. 5

Weiner v. Wasson,
 900 S.W.2d 316 (Tex. 1995) ....................................................................... 1-6, 9

Statutes                                                                                           Page(s)

TEX. CIV. PRAC. & REM. CODE § 74.051(a) ............................................................ 6

TEX. CIV. PRAC. & REM. CODE § 74.051(c) .........................................................6, 7

TEX. CIV. PRAC. & REM. CODE § 74.251(a) .........................................................1, 4

TEX. CIV. PRAC. & REM. CODE §16.001 ................................................................. 6
                                                      ii
TEX. CIV. PRAC. & REM. CODE §16.003 ................................................................. 6

Other Authorities                                                                                 Page(s)

Act of June 2, 2003, 78th Leg., R.S., ch. 204, § 10.01
  2003 Tex. Gen. Laws 847 ...............................................................................1, 2

Act of June 2, 2003, 78th Leg., R.S., ch. 204, § 10.11,
  2003 Tex. Gen. Laws 847 ............................................................................... 1-3

Michael S. Hull, et al., House Bill 4 and Proposition 12: An Analysis with
 Legislative History, 36 Tex. Tech. L. Rev. 1 (2005)........................................... 3

                                                     iii
                              NO. 04-14-00803-CV

                IN THE COURT OF APPEALS
 FOR THE FOURTH DISTRICT OF TEXAS AT SAN ANTONIO, TEXAS

       JUAN FRANCISCO MONTALVO, M.D., F.A.C.O.G., ET AL.,
                         Appellants

                                        v.

                              GABRIELA LOPEZ,
                                  Appellee.

                 On Appeal from the 341st District Court
            Webb County, Texas, Cause No. 2013CVT 000841-D3
                          (Hon. Beckie Palomo)

                      REPLY BRIEF OF APPELLANTS

TO THE HONORABLE JUSTICES OF THE FOURTH COURT OF
APPEALS:

      Appellants Francisco Montalvo, M.D., F.A.C.O.G. (“Dr. Montalvo”),

Winder N. Vasquez, M.D. (“Dr. Vasquez”), Miguel E. Najera, J.D. Executor of the

Estate of Miguel E. Najera, M.D., Deceased (“Dr. Najera”), and Laredo Regional

Medical Center, L.P. d/b/a Doctors Hospital of Laredo (“DHL”), (collectively

“Appellants”) submit this Reply Brief of Appellants in accordance with Rules 9.4

and 38 of the Texas Rules of Appellate Procedure and all local rules of this Court.

                                        iv
In Reply to the Amended Brief of Appellee,1 Appellants respectfully represent as

follows:2

1
       Appellants will cite to their opening brief as “Br.” and the Amended Brief of Appellee as
“Resp.”
2
        Appellants stand on the arguments and legal authority presented in their primary brief.
Thus, to the extent Appellants may not reply herein to a particular assertion or argument or
citation by Appellee, such conduct should not be construed as acquiescence by Appellants in any
of Appellee’s arguments or waiver by Appellants of any argument made in their Brief of
Appellants or in this Reply Brief.

                                               v
                ARGUMENT AND AUTHORITIES IN REPLY

I.    Section 74.251(a) Is a Constitutionally Permissible Exercise of the
      Legislature’s Police Power

      In its effort to curb the medical malpractice insurance and health care

availability crises that continued even after the passage of the Texas Medical

Liability Insurance Improvement Act (“TMLIIA” or “article 4590i”), the Texas

Legislature exercised its police power in 2003 by passing House Bill 4, sweeping

tort reform that is now codified in part in Chapter 74. See Act of June 2, 2003,

78th Leg., R.S., ch. 204, § 10.01-10.11, 2003 Tex. Gen. Laws 847. It is against

this backdrop, and the proper test for determining whether a statute violates the

open courts provision of the constitution, that one must examine the

constitutionality of the two-year limitations provision in section 74.251(a). See

TEX. CIV. PRAC. & REM. CODE § 74.251(a).         As Appellants have previously

explained, that provision has not been ruled unconstitutional by the Texas Supreme

Court. (See Br. at 12-19).

      Appellee asserts that Weiner v. Wasson3 and Sax v. Votteler4 compel that

section 74.251(a) is unconstitutional. (Resp. at 4-10). But when reviewing the

constitutionality of section 74.251(a), this Court must presume “that the

Legislature has not acted unreasonably or arbitrarily . . . a mere difference of
3
      900 S.W.2d 316 (Tex. 1995).
4
      648 S.W.2d 661 (Tex. 1983).

REPLY BRIEF OF APPELLANTS                                                  PAGE 1
opinion, where reasonable minds could differ, is not a sufficient basis for striking

down legislation as arbitrary or unreasonable.” Methodist Healthcare Sys. of San

Antonio, Ltd., L.L.P. v. Rankin, 307 S.W.3d 283, 285 (Tex. 2010). Appellee bears

the burden of showing the law is unconstitutional. Id.

       The Legislature had the Sax and Weiner decisions before it in 2003 when it

enacted section 74.251(a). See Act of June 2, 2003, 78th Leg., R.S., ch. 204, §

10.01, 2003 Tex. Gen. Laws 847. When the Legislature enacted the statute, it

articulated strong policy considerations underpinning that legislation. See id. §

10.11. This Court should not presume, because of the result in Weiner, that the

newer statute is unconstitutional. Rather, it should apply the principles established

in the proper test for the constitutionality of a statute when the Legislature has

exercised its police power, and examine the newer statute and the rationale

supporting its enactment, as applied to the facts of this case. Under the facts of this

case, section 74.251(a) is constitutional. See Weiner v. Wasson, 900 S.W.2d 316,

322 (Tex. 1995) (Owen, J., dissenting).

       In Weiner the court’s decision gave undue and overriding emphasis to the

nature and extent of the restriction of common-law causes of action. Weiner, 900
S.W.2d at 318-20.5 The court concluded that the minor’s cause of action had been

5
        See Rankin, 307 S.W.3d at 287 (noting that the court cannot focus solely on the
claimant’s lost right to sue: “Open Courts analysis is not quite this myopic; focusing solely on
Rankin’s lost right to sue ignores the broader societal concerns that spurred the Legislature to
act.”).

REPLY BRIEF OF APPELLANTS                                                               PAGE 2
totally abrogated and that no reasonable substitute had been provided, but the court

concluded without discussion that former section 10.01(a) was not a reasonable

exercise of the police power. Id.

       But the Texas Supreme Court has more recently returned to the proper focus

on whether the Legislature’s act is a reasonable exercise of its police power in the

interest of the general welfare. See Rankin, 307 S.W.3d at 286-292 (citing Lebohm

v. City of Galveston, 154 Tex. 192, 275 S.W.2d 951, 955 (1955) (on rehearing)).

The Legislature has the power to abrogate common-law causes of action altogether

in the proper exercise of its police power. Weiner, 900 S.W.2d at 330.

       The exercise of legislative power was constitutional here. The Legislature

articulated its findings and the basic purposes of Chapter 74. (See Br. at 16-18 &

n.7). In sum, the Legislature found that there is a medical malpractice crisis in this

state which has had a material adverse effect on the cost and availability of health

care; that there would be further reductions in the availability of health care in the

future. (Id.).6 Surely these findings meet the test of an “important” state interest

6
         It is important to note that the TMLIIA had not cured the problem. See Act of June 2,
2003, 78th Leg., R.S., ch. 204, § 10.11, 2003 Tex. Gen. Laws 847 (“the number of health care
liability claims (frequency) has increased since 1995 inordinately”); Michael S. Hull, et al.,
House Bill 4 and Proposition 12: An Analysis with Legislative History, 36 Tex. Tech. L. Rev. 1,
10-11 (2005) (“Medical malpractice premiums began to rise dramatically in 2000 and 2002,
exacerbating an already existing crisis of access to health care in Texas.”).

REPLY BRIEF OF APPELLANTS                                                              PAGE 3
justifying the exercise of the Legislature’s power. Weiner, 900 S.W.2d at 331

(Owen, J., dissenting).7

       The remedy, limiting the time over which physicians and health care

providers face liability, is directly related to the crisis identified by the Legislature

and bears a real relationship to the articulated legislative goal of making health

care more affordable, and above all available, for all Texans.                     (Id.).     The

Legislature reasonably concluded that reducing the potential of long-term liability

would help to ease the strain on health care services. (Id.). Without section

74.251(a), a physician could be forced to defend a claim arising out of injuries

incurred during childbirth long after the occurrence. (Id.); See TEX. CIV. PRAC. &

REM. CODE § 74.251(a). Taken in tandem with the Legislature’s adoption of a

higher threshold age at which limitations begins to run, the legislative findings

support the constitutionality of this statute. Weiner, 900 S.W.2d at 331.

       There is a demonstrable nexus between limiting the time in which suit for

malpractice must be brought and the goals articulated by the Legislature, which

include availability and affordability of adequate professional liability insurance

and hence, the availability and affordability of health care services. Id. It is within

the authority of the Legislature to make reasoned adjustments in the legal system.

Id.

7
      And significantly, the statute at issue in Sax contained no such detailed findings. Weiner,
900 S.W.2d at 331 (Owen, J., dissenting); see generally, Sax, 648 S.W.2d 661.

REPLY BRIEF OF APPELLANTS                                                                   PAGE 4
       This Court should apply the proper test found in Rankin,8 Rivera,9 Lebohm,10

and Justice Owen’s dissent in Weiner.11              To do otherwise is to restrict the

Legislature unduly in carrying out its obligations under our Constitution: to

exercise its police power where necessary to “ameliorat[e] a rationally perceived

social evil.” Weiner, 900 S.W.2d 316, 326 (Owen, J., dissenting). The statute of

limitations in section 74.251(a) is not arbitrary or unreasonable and thus, is a

reasonable exercise of the police power in the interest of the general welfare must

be sustained. See Rankin, 307 S.W.3d at 286.12 Appellee has not met her burden

to show that the statute is unconstitutional.13

       Here, Appellee’s treatment occurred no later than December 17, 2005, and

she was not “under the age of 12 years” at that time. Under section 74.251(a),

8
       See Rankin, 307 S.W.3d at 286-92.
9
       See Tenet Hosps. Ltd. v. Rivera, 445 S.W.3d 698, 706 (Tex. 2014).
10
       See Lebohm, 275 S.W.2d at 955.
11
       See Weiner, 900 S.W.2d at 325-26.
12
       For similar reasons, Adams v. Gottwald, 179 S.W.3d 101 (Tex. App.—San Antonio 2005,
pet. denied) is not compelling. Adams relied on the misguided reasoning in Sax and Weiner.
This Court should reevaluate Adams. And again, the Texas Supreme Court has not specifically
addressed section 74.251(a) as applied to minors.
13
       While Appellee contends that Appellants have not previously asserted that Appellee must
demonstrate that section 74.251(a) is an unreasonable exercise of the Legislature’s police power,
Appellants previously asserted that Appellee had not proven that section 74.251(a) is
unconstitutional under the open courts provision. (CR 421-22, 558-59, 580-81). Part of
Appellee’s burden in showing an open courts violation is showing that the statute is an
unreasonable exercise of the police power in the interest of the general welfare. See Tenet
Hosps. Ltd. v. Rivera, 445 S.W.3d 698 (Tex. 2014).

REPLY BRIEF OF APPELLANTS                                                                PAGE 5
Appellee should have filed suit by December 17, 2007. But Appellee did not file

suit until May 17, 2013, more than seven years after treatment. Appellee’s suit is

therefore barred by the two-year statute of limitations in section 74.251(a). This

Court should reverse the trial court’s order and render judgment that Appellee’s

claims are barred by the statute of limitations and that she take nothing on all

claims against Appellants.

II.   Even if Sections 16.001 and 16.003 Apply, Appellee’s Claims Are
      Barred by Limitations

      Even if section 74.251(a) is unconstitutional as applied to Appellee, her suit

was untimely because she is not entitled to tack on an additional 75-day tolling

period by invoking the pre-suit notice provisions of Chapter 74.14

      If Appellee’s open courts challenge is successful, the statute of limitations

and tolling provisions in sections 16.001 and 16.00315 would likely apply and give

Appellee until her twentieth birthday to file suit. See Weiner, 900 S.W.2d at 321.

But even if Appellee had until her twentieth birthday to file suit, Appellee did not

file suit until 67 days after her twentieth birthday. (See CR 26-27, 228). And if

Appellee has chosen to rely on the limitations and tolling provisions of Chapter 16,

she cannot supplement that law with additional tolling provisions of Chapter 74.

14
      See TEX. CIV. PRAC. & REM. CODE §§ 74.051(a), (c).
15
      TEX. CIV. PRAC. & REM. CODE §§ 16.001, 16.003.

REPLY BRIEF OF APPELLANTS                                                    PAGE 6
       Appellee contends that the tolling provision of section 74.051 is not limited

to only claims falling within Chapter 74’s limitation provision in section 74.251(a).

(Resp. at 12-13).         But Appellee cannot provide any legal support for that

contention; no appellate court has directly addressed the issue.16                      And it is

inconsistent for Appellee to argue that the 75-day tolling period granted by Chapter

74 applies in this case because that statute applies to the applicable statute of

limitations as defined by Chapter 74, the same statute of limitations that Appellee

argues is unconstitutional. (See 1 RR 41). And, the notice provision in section

74.051(c) states that “[n]otice given as provided in this chapter shall toll the

applicable statute of limitations . . . .” TEX. CIV. PRAC. & REM. CODE § 74.051(c).

The “chapter” referred to is Chapter 74, undermining Appellee’s argument that the

notice provision extends to Chapter 16.17

       Appellee suggests that the purpose of the pre-suit notice provision

(encouraging negotiations and settlement prior to suit) supports that she is entitled

16
       If Appellee asserted a health care liability claim arising out of the death of a minor, the
minor’s survival claim may be subject to the 75-day tolling period. See, e.g., Gross v. Kahanek,
3 S.W.3d 518, 520 (Tex. 1999) (interpreting former art. 4590i); Brown v. Shwarts, 968 S.W.2d
331, 334 (Tex. 1998) (same).
17
        Any suggestion that the legislative history of the tolling provision provides support for
Appellee is unfounded. An exhaustive review of the legislative history of section 74.051 and its
predecessor revealed no evidence that the Legislature used the phrase “applicable statute of
limitations” to refer to statutes of limitations outside of the medical malpractice statute. Again,
the phrase “applicable statute of limitations” likely refers to the fact that limitations is measured
from one of three dates: (1) the occurrence of the breach or tort, (2) the last date of the relevant
course of treatment, or (3) the last date of the relevant hospitalization. TEX. CIV. PRAC. & REM.
CODE § 74.251(a); see Shah v. Moss, 67 S.W.3d 836, 841 (Tex. 2001).

REPLY BRIEF OF APPELLANTS                                                                    PAGE 7
to additional tolling of the statute of limitations. (Resp. at 13-15). But again,

Appellee already had the benefit of a negotiation period of two years after her

eighteenth birthday. She could have approached the Appellants with her claims

well before her twentieth birthday and prompted negotiations. Yet, she chose to

wait until just three days before her twentieth birthday to send letters. (CR 184-90,

287-94).18

       None of the cases cited by Appellee held (or even addressed) that a minor

who has benefitted from an open courts challenge may also invoke the pre-suit

tolling provisions of Chapter 74 (or article 4590i) to toll the statute of limitations

for an additional 75 days. (See Resp. at 15-16). But as Appellants have urged, the

Austin Court of Appeals decision in Medina v. Lopez-Roman, 49 S.W.3d 393 (Tex.

App.—Austin 2000, pet. denied) suggests that no such additional tolling is proper.

(See Br. at 21-22).

       Appellee attempts to undermine Medina by incorrectly claiming that the

notice question was irrelevant to the court’s opinion. (Resp. at 17-18).                   But

Appellee overlooks that the court would not have had to consider whether the

limitations deadline fell on the plaintiff’s twentieth birthday if the notice provision

had given him an extra 75 days to file suit. Medina, 49 S.W.3d at 398-99. And if,

18
         Contrary to Appellee’s assertions, Appellants do not concede that the pre-suit notice
letters and authorization forms meet statutory requirements, but have assumed so for purposes of
the argument. (See Resp. at 17; Br. at 22).

REPLY BRIEF OF APPELLANTS                                                               PAGE 8
as Appellee states, “the limitations period provided by the general tolling and

limitations provisions of Texas Civil Practice and Remedies Code sections 16.001

and 16.003 apply to [her] claim,” Appellee must be held to the tolling provisions in

those sections, and not be allowed to mix-and-match beneficial limitations and

tolling provisions from Chapters 16 and 74. (See Resp. at 16) (citing Weiner, 900
S.W.2d at 321). And Appellants’ interpretation creates no “trap for the unwary” as

Appellee urges, because if Weiner is so well-established as Appellee claims, then

she knew that she had until her twentieth birthday to file suit and that no Texas

court had made an extra 75-day allowance based on pre-suit notice.

      Appellee already received seven years and three months after the treatment

in question in which to engage in pre-suit negotiations and file suit. Appellee

should not get the benefit of an additional 75 days tolling based on Chapter 74

when she has distanced herself from Chapter 74’s limitation provisions and instead

relied on Chapter 16. Consequently, if her open courts challenge is successful, she

should have filed suit by her twentieth birthday. She did not, and her claims are

barred by limitations.

                         CONCLUSION AND PRAYER

      This Court should reverse the trial court’s order denying Appellants’

motions for summary judgment. Appellee filed suit more than seven years after

the medical treatment at issue in her claims. The two-year statute of limitations in

section 74.251(a) bars Appellee’s claims.
REPLY BRIEF OF APPELLANTS                                                    PAGE 9
      Appellee has not met her burden to show that the statute violates the open

courts provision of the Texas Constitution. Rather, the statute was a reasonable

exercise of the Legislature’s police power to address the health care and medical

malpractice insurance crises which had not been remedied by the TMLIIA.

      But even if section 74.251(a) violates the open courts provision, giving

Appellee until her twentieth birthday to file suit, she did not do so. Appellee filed

suit more than two months after her twentieth birthday, rendering her suit untimely

and barred by the limitations period in section 16.003 of the Texas Civil Practice

and Remedies Code.

      Appellee cannot tack on the pre-suit notice tolling provisions meant to toll

the Chapter 74 limitations period to limitations periods governed by Chapter 16.

At least one Texas appellate court opinion suggests that a minor making a

successful open courts challenge does not get an additional 75-day tolling period.

Appellee had two years after reaching majority in which to prepare her suit and

engage in pre-suit negotiations, and has offered no reason why she could not have

filed suit by her twentieth birthday.

      Appellee’s suit is barred by the statute of limitations. Thus, the trial court

erred in denying Appellants’ motions for summary judgment. This Court should

reverse the trial court’s order and render judgment that Appellee take nothing in all

her claims against Appellants.

REPLY BRIEF OF APPELLANTS                                                    PAGE 10
      THEREFORE, Appellants Juan Francisco Montalvo, M.D., F.A.C.O.G.,

Winder N. Vasquez, M.D., Miguel E. Najera, J.D. Executor of the Estate of Miguel

E. Najera, M.D., Deceased, and Laredo Regional Medical Center, L.P. d/b/a

Doctors Hospital of Laredo respectfully pray this Court grant Appellants’ issues on

appeal, reverse that portion of the trial court’s November 3, 2014 Amended Order

denying Appellants’ motions for summary judgment, and render judgment that

Appellee take nothing in all claims against Appellants. Appellants also pray for all

such other and further relief, whether general or special, at law and in equity, as

this Court deems just.

REPLY BRIEF OF APPELLANTS                                                   PAGE 11
                                     Respectfully submitted,

                                     COOPER & SCULLY, P.C.

                                     By: /s/Diana L. Faust
                                         DIANA L. FAUST
                                         diana.faust@cooperscully.com
                                         State Bar No. 00793717
                                         R. BRENT COOPER
                                         brent.cooper@cooperscully.com
                                         State Bar No. 04783250
                                         KYLE M. BURKE
                                         kyle.burke@cooperscully.com
                                         State Bar No. 24073089

                                     900 Jackson Street, Suite 100
                                     Dallas, Texas 75202
                                     TEL: (214) 712-9500
                                     FAX: (214) 712-9540

                                     ATTORNEYS FOR APPELLANTS

                     CERTIFICATE OF COMPLIANCE

      I hereby certify that this Brief of Appellants was prepared using Microsoft

Word 2003, which indicated that the total word count (exclusive of those items

listed in rule 9.4(i)(1) of the Texas Rules of Appellate Procedure, as amended) is

2,708 words.

                                     /s/ Diana L. Faust
                                     DIANA L. FAUST

REPLY BRIEF OF APPELLANTS                                                 PAGE 12
                        CERTIFICATE OF SERVICE

     I hereby certify that I served a true and correct copy of this Reply Brief of
Appellants upon all counsel of record as indicated below, on this the 23rd day of
March, 2015, at the following address:

Mr. Darrell L. Keith                                                 VIA EFILE
dkeith@keithlaw.com
Keith Law Firm, P.C.
301 Commerce Street, Suite 2850
Fort Worth, Texas 76102
Counsel for Appellee

Mr. James Kevin Oncken                                               VIA EFILE
kevin@unolaw.com
Mr. Roger A. Berger
rberger@uzickoncken.com
Uzick & Oncken, P.C.
238 Westcott Street
Houston, Texas 77007
Trial Counsel for Appellant
Juan Francisco Montalvo, M.D.

Mr. Bruce E. Anderson                                                VIA EFILE
banderson@brinandbrin.com
Mr. James W. Veale, Jr.
jveale@brinandbrin.com
Mr. Loren L. Whyte
lwhyte@brinandbrin.com
Brin & Brin, P.C
6223 IH 10 West
San Antonio, Texas 78201
Trial Counsel for Appellant
Winder N. Vasquez, M.D.

REPLY BRIEF OF APPELLANTS                                                 PAGE 13
Mr. W. Richard Wagner                                   VIA EFILE
rwagner@wagnercario.com
Mr. Peter Cario
pcario@wagnercario.com
Wagner Cario, L.L.P.
7718 Broadway, Suite 100
San Antonio, Texas 78209
Trial Counsel for Appellant
Miguel E. Najera, J.D., Executor of
Estate of Miguel E. Najera, M.D., Deceased

Mr. Steven M. Gonzalez                                  VIA EFILE
Mr. Edward J. Castillo
ecastillo@valleyfirm.com
Gonzalez Castillo, L.L.P.
1317 E. Quebec Avenue
McAllen, Texas 78503
Trial Counsel for Appellant
Laredo Regional Medical Center, L.P.
d/b/a Doctors Hospital of Laredo

                                    /s/Diana L. Faust
                                   DIANA L. FAUST
D/922983v3

REPLY BRIEF OF APPELLANTS                                  PAGE 14