Court Opinion

ID: 9811412
Source: CourtListenerOpinion
Date Created: 2023-08-31 22:19:25.235616+00
Date Added: 2024-06-11T15:13:26.925994
License: Public Domain

LEE ANN DAUPHINOT, Justice,
dissenting and concurring.
I concur with the result reached by the majority. But I write separately to emphasize that this opinion should be limited to the specific facts at issue and also to caution that we as judges must guard against the idea that it is better to toss out legitimate medical claims than to let a frivolous claim proceed.
An expert report under section 74.351 of the Texas Civil Practice and Remedies Code does not need to rise to the level of proof sufficient to win at trial; it need only assure the trial court that the plaintiffs claim is not frivolous.1 The report must, of course, demonstrate that the expert is qualified to render the opinions given in the report.2 As the majority points out, Dr. Haberer’s report did not demonstrate any personal expert knowledge, gained either from experience or training, about the effects of the overprescription of Reglan. His assertions about causation were based on the warnings of the drug manufacturer and the diagnoses of other doctors whose qualifications do not appear in his report.
A layperson can determine that if a drug manufacturer warns that overprescribing a drug could cause certain injuries — in this case tardive dyskinesia (“TDk”) — then it is a possibility that a doctor’s overprescription of the drug could indeed cause such injuries. But Texas law requires that, in medical malpractice actions, a medical expert give an opinion about whether a doctor’s act in fact did cause the alleged inju*469ries.3 To qualify as an expert, a person must demonstrate some knowledge beyond what a layperson would have.4 Thus, in this case, the expert must demonstrate some basis for knowledge about causation beyond stating that if Reglan’s manufacturer warned that overprescription of the drug could cause TDk, then ipso facto Dr. Collini’s overprescription of Reglan did cause Mrs. Pustejovsky’s TDk.5
I agree with the majority that Dr. Ha-berer’s report does not show that in this specific area, he had any knowledge beyond that of a layperson. He did not, for example, show that he had conducted research on TDk or on Reglan.6 Although Dr. Haberer had knowledge that failing to heed a drug manufacturer’s warning can cause injury, nothing in his report shows the basis for his assertion that the over-prescription of the drug at issue here actually caused the alleged injuries in this case.7
But I emphasize that the law is also clear that a medical expert is not uniformly required to be specialized in an area to be qualified to opine on it. And an expert need not necessarily have personal professional experience with a drug or procedure to be qualified to give an opinion that the drug or procedure caused a plaintiffs alleged injuries. The expert is qualified to give an opinion on causation so long as the expert demonstrates some “knowledge, skill, experience, training, or education” sufficient to support the opinion.8
The legislature did not intend to make it impossible or unjustly burdensome for legitimate medical malpractice claims to proceed to and succeed at trial. In this case, for example, a doctor failed to heed warnings by Reglan’s manufacturer that its overuse can cause TDk. Three different doctors examined Mrs. Pustejovsky and concluded that she developed TDk because of the use of Reglan. On the face of it, this case is an excellent example of a non-frivolous claim. Yet we are constrained to hold that evidence of these facts alone is not good enough to allow Mrs. Pustejovsky her day in court.
Statutes such as section 74.351 must be read in light of the open courts provision of our Texas constitution.9 The legislature did not abrogate that constitutional protection in passing section 74.351. We must *470not with our opinions indicate a zeal to scrutinize expert reports more closely than we are required to under the law, nor an apathy toward whether even legitimate claims are tossed out of court; we must always remember our obligation to preserve, protect, and defend the constitution of this state. I believe that in fulfilling that obligation, we must explicitly limit our holding to this case to prevent its broad misapplication in other cases.
Because the majority does not explicitly so limit the holding, I respectfully dissent.

. Jernigan v. Langley, 195 S.W.3d 91, 93 (Tex.2006) (stating that expert report "need not marshal every bit of the plaintiff's evidence” but must provide a "fair summary” of expert’s opinion on standard of care, breach of that standard of care, causation, and harm).

. See Tex. Civ. Prac. & Rem. Code Ann. § 74.351(5)(A) (Vernon Supp.2008), § 74.401(a)(4) (Vernon 2005) (defining “expert” to mean someone qualified on the basis of training or experience to offer an expert opinion).

. See id. § 74.351(a), (r)(6) (requiring plaintiff alleging medical malpractice claim to provide an expert report and defining "expert report” to mean a report by an expert that provides, among other things, the expert’s opinion regarding causation).

. See id. § 74.35l(r)(5)(C) ("'expert' means ... a physician who is otherwise qualified to render opinions on [causation] under the Texas Rules of Evidence”); Tex.R. Evid. 702 (stating that a witness may be qualified as an expert "by knowledge, skill, experience, training, or education”).

. See Leland v. Brandal, 217 S.W.3d 60, 62-63 (Tex.App.-San Antonio 2006) (holding that anesthesiologist’s report showed he was qualified to render opinion that cessation of medicines taken by plaintiff may cause stroke but did not show his qualification to give opinion that cessation of medication did cause plaintiff’s stroke), aff'd, 257 S.W.3d 204 (Tex.2008).

. See, e.g., Salvato v. Angelo, No. 14-07-00784-CV, 2008 WL 961772, at *6-7 (Tex.App.-Houston [14th Dist.] Apr. 08, 2008, no pet.) (mem. op.) (holding doctor qualified to opine on negligence of defendant in prescribing anabolic steroids and causation of plaintiff’s injuries even though expert doctor was not an endocrinologist when her report provided sufficient evidence of her knowledge in connection with clinical studies prescribing and monitoring hormones in patients).

. See Leland, 217 S.W.3d at 62-63.

. See Tex.R. Evid. 702.

. Tex. Const, art. I, § 13.