Chad R. Dubois, Kenneth D. Simmons III, Monica Bentzen, and Lance T. Mendoza v. Anesthesia Associates
This text of Chad R. Dubois, Kenneth D. Simmons III, Monica Bentzen, and Lance T. Mendoza v. Anesthesia Associates (Chad R. Dubois, Kenneth D. Simmons III, Monica Bentzen, and Lance T. Mendoza v. Anesthesia Associates) is published on Counsel Stack Legal Research, covering Texas Court of Appeals, 9th District (Beaumont) primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
Opinion
In The
Court of Appeals
Ninth District of Texas at Beaumont
__________________
NO. 09-25-00345-CV __________________
CHAD R. DUBOIS, KENNETH D. SIMMONS III, MONICA BENTZEN, AND LANCE T. MENDOZA, Appellants
V.
ANESTHESIA ASSOCIATES, Appellee
__________________________________________________________________
On Appeal from the 136th District Court Jefferson County, Texas Trial Cause No. 25DCCV1411 __________________________________________________________________
MEMORANDUM OPINION
This is an accelerated appeal of a temporary injunction pertaining to an
employment agreement. Appellants Chad R. Dubois, Kenneth D. Simmons III,
Monica Bentzen, and Lance T. Mendoza appeal the trial court’s Order granting their
former employer Anesthesia Associates’ Application for Temporary Injunction. See
Tex. Civ. Prac. & Rem. Code Ann. § 51.014(a)(4). We overrule the Appellants’
issues and affirm the trial court’s order granting the temporary injunction.
1 Background
On August 1, 2025, Anesthesia Associates filed Plaintiff’s Original Petition,
Application for Temporary Restraining Order, and for Temporary Injunction (the
“Petition”) against Certified Registered Nurse Anesthetists Chad R. Dubois,
Kenneth D. Simmons III, Monica Bentzen, and Lance T. Mendoza (the “CRNA
Defendants” or “Defendants”). According to the Petition, Anesthesia Associates is
a professional association of physicians and healthcare providers providing services
to patients, and the CRNA Defendants were employed with Anesthesia Associates
until July 31, 2025. Anesthesia Associates alleges that each CRNA Defendant signed
an Employment Agreement (the Agreement) with Anesthesia Associates that
includes the following provisions:
11.4 Covenant Not to Compete In consideration of Employer’s disclosure to Employee of Confidential and Proprietary Information and the provision of specialized training and knowledge relating to the services to be provided by Employee under this Agreement, Employee hereby covenants and agrees that for a period of three (3) years immediately following the termination of this Agreement and Employee’s employment with Employer, Employee shall not, directly or indirectly, in any capacity whatever, practice nursing as a CRNA, or provide CRNA services, at any physician office, hospital, ambulatory surgical center, or other health care facility that is located within a twenty (20) mile radius of each physician office, hospital, ambulatory surgical center, and other health care facility at which Employee provided CRNA services as an employee of Employer at any time during the Employment Period.
11.5 Acknowledgement of Employee
2 Employee acknowledges and agrees that the limitations as to time, geographical area, and scope of activity in Paragraph 11.4 are reasonable limitations, do not impose any restraint on Employee greater than necessary to protect the good will or business interests of Employer, and do not prevent Employee from practicing nursing as a CRNA, or providing CRNA services, at any physician office, hospital, ambulatory surgical center, or any other location outside the twenty-mile area during the three year time period.
11.6 Reformation If a court determines that any provision of Paragraph 11 is unreasonably broad, limiting, or restrictive, Employee and Employer agree that such provision shall not be declared invalid or unenforceable, but instead shall be modified and reformed by the court to the minimum extent necessary to cause such provision to be valid and enforceable.
....
11.9 Remedies in the Event of Breach (a) Employee acknowledges and agrees that any material breach or violation of Employee’s promises, agreements, or covenants contained in Paragraph 11 will have an irreparable, material, and adverse effect upon Employer, and that such damages arising from any such breach or violation may be difficult to ascertain. Without limiting any other remedy at law or in equity available to Employer, in the event of any such breach, Employer shall have the right to an immediate temporary restraining order and temporary injunction enjoining Employee’s breach or violation, without the need to post any security or bond, as well as all other remedies available at law and in equity; (b) Employe[r] and Employee wish to fix in advance, as liquidated damages, the amount of compensation for which Employee shall be liable to Employer in the event of any material breach or violation of Employee’s promises, agreements, or covenants contained in Paragraph 11.3 (Non-Disclosure) or Paragraph 11.4 (Covenant Not to Compete). Employe[r] and Employee agree that Employer would suffer harm from any such material breach or violation, but that the amount of such damages is difficult or 3 incapable of estimation. Accordingly, Employer and Employee agree on the following liquated damages, which are their reasonable forecasts of just compensation: ... (ii) In the event of a material breach of violation of Employee’s promises, agreements, or covenants contained in Paragraph 11.4, Employee shall pay to Employer $30,000 immediately upon the occurrence of such breach or violation.
Anesthesia Associates alleges that each of the CRNA Defendants resigned from
employment with Anesthesia Associates effective July 31, 2025, and accepted
employment with a competitor. According to Anesthesia Associates, beginning on
or about August 1, 2025, each of the CRNA Defendants performed CRNA services
for a competitor of Anesthesia Associates at one or more locations, including
CHRISTUS St. Elizabeth Hospital in Beaumont. In the Petition, Anesthesia
Associates alleges that each CRNA Defendant violated Section 11.3 of the
Agreement and that, under Sections 11.4, 11.5, or 11.9 of the Agreement, Anesthesia
Associates is entitled to an immediate Temporary Restraining Order and a
subsequent Temporary Injunction, prohibiting each CRNA Defendant from
practicing nursing as CRNAs or providing CRNA services anywhere within a
twenty-mile radius of the location where the CRNAs worked for Anesthesia
Associates. Anesthesia Associates alleges that the CRNA Defendants breached the
terms of the Agreement by providing CRNA services in direct competition with
Anesthesia Associates within the restricted geographic area, in violation of the non-
competition provisions of the Agreement, and that Anesthesia Associates is entitled 4 to $30,000 from each of the CRNA Defendants for liquidated damages under the
terms of the Employment Agreement. Anesthesia Associates also requested a
temporary restraining order and temporary injunction enjoining the CRNA
Defendants from practicing nursing as CRNAs or providing CRNA services as set
forth in the Agreement executed by each Defendant.
On August 1, 2025, the trial court signed an Order granting Anesthesia
Associates’ Application for Temporary Restraining Order and setting a hearing on
Anesthesia Associates’ Application for Temporary Injunction for August 12, 2025.
On August 6, 2025, CHRISTUS Health Southeast Texas (“CHRISTUS”), the
entity that operates medical facilities in Beaumont, including St. Elizabeth Hospital,
filed an Original Petition in Intervention asking the trial court “to declare that the
restrictive covenants that A[nesthesia] A[ssociates] seeks to enforce should not
prohibit the Defendants from providing anesthesia services” to CHRISTUS’
facilities in and around Beaumont. CHRISTUS also filed an Emergency Motion to
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In The
Court of Appeals
Ninth District of Texas at Beaumont
__________________
NO. 09-25-00345-CV __________________
CHAD R. DUBOIS, KENNETH D. SIMMONS III, MONICA BENTZEN, AND LANCE T. MENDOZA, Appellants
V.
ANESTHESIA ASSOCIATES, Appellee
__________________________________________________________________
On Appeal from the 136th District Court Jefferson County, Texas Trial Cause No. 25DCCV1411 __________________________________________________________________
MEMORANDUM OPINION
This is an accelerated appeal of a temporary injunction pertaining to an
employment agreement. Appellants Chad R. Dubois, Kenneth D. Simmons III,
Monica Bentzen, and Lance T. Mendoza appeal the trial court’s Order granting their
former employer Anesthesia Associates’ Application for Temporary Injunction. See
Tex. Civ. Prac. & Rem. Code Ann. § 51.014(a)(4). We overrule the Appellants’
issues and affirm the trial court’s order granting the temporary injunction.
1 Background
On August 1, 2025, Anesthesia Associates filed Plaintiff’s Original Petition,
Application for Temporary Restraining Order, and for Temporary Injunction (the
“Petition”) against Certified Registered Nurse Anesthetists Chad R. Dubois,
Kenneth D. Simmons III, Monica Bentzen, and Lance T. Mendoza (the “CRNA
Defendants” or “Defendants”). According to the Petition, Anesthesia Associates is
a professional association of physicians and healthcare providers providing services
to patients, and the CRNA Defendants were employed with Anesthesia Associates
until July 31, 2025. Anesthesia Associates alleges that each CRNA Defendant signed
an Employment Agreement (the Agreement) with Anesthesia Associates that
includes the following provisions:
11.4 Covenant Not to Compete In consideration of Employer’s disclosure to Employee of Confidential and Proprietary Information and the provision of specialized training and knowledge relating to the services to be provided by Employee under this Agreement, Employee hereby covenants and agrees that for a period of three (3) years immediately following the termination of this Agreement and Employee’s employment with Employer, Employee shall not, directly or indirectly, in any capacity whatever, practice nursing as a CRNA, or provide CRNA services, at any physician office, hospital, ambulatory surgical center, or other health care facility that is located within a twenty (20) mile radius of each physician office, hospital, ambulatory surgical center, and other health care facility at which Employee provided CRNA services as an employee of Employer at any time during the Employment Period.
11.5 Acknowledgement of Employee
2 Employee acknowledges and agrees that the limitations as to time, geographical area, and scope of activity in Paragraph 11.4 are reasonable limitations, do not impose any restraint on Employee greater than necessary to protect the good will or business interests of Employer, and do not prevent Employee from practicing nursing as a CRNA, or providing CRNA services, at any physician office, hospital, ambulatory surgical center, or any other location outside the twenty-mile area during the three year time period.
11.6 Reformation If a court determines that any provision of Paragraph 11 is unreasonably broad, limiting, or restrictive, Employee and Employer agree that such provision shall not be declared invalid or unenforceable, but instead shall be modified and reformed by the court to the minimum extent necessary to cause such provision to be valid and enforceable.
....
11.9 Remedies in the Event of Breach (a) Employee acknowledges and agrees that any material breach or violation of Employee’s promises, agreements, or covenants contained in Paragraph 11 will have an irreparable, material, and adverse effect upon Employer, and that such damages arising from any such breach or violation may be difficult to ascertain. Without limiting any other remedy at law or in equity available to Employer, in the event of any such breach, Employer shall have the right to an immediate temporary restraining order and temporary injunction enjoining Employee’s breach or violation, without the need to post any security or bond, as well as all other remedies available at law and in equity; (b) Employe[r] and Employee wish to fix in advance, as liquidated damages, the amount of compensation for which Employee shall be liable to Employer in the event of any material breach or violation of Employee’s promises, agreements, or covenants contained in Paragraph 11.3 (Non-Disclosure) or Paragraph 11.4 (Covenant Not to Compete). Employe[r] and Employee agree that Employer would suffer harm from any such material breach or violation, but that the amount of such damages is difficult or 3 incapable of estimation. Accordingly, Employer and Employee agree on the following liquated damages, which are their reasonable forecasts of just compensation: ... (ii) In the event of a material breach of violation of Employee’s promises, agreements, or covenants contained in Paragraph 11.4, Employee shall pay to Employer $30,000 immediately upon the occurrence of such breach or violation.
Anesthesia Associates alleges that each of the CRNA Defendants resigned from
employment with Anesthesia Associates effective July 31, 2025, and accepted
employment with a competitor. According to Anesthesia Associates, beginning on
or about August 1, 2025, each of the CRNA Defendants performed CRNA services
for a competitor of Anesthesia Associates at one or more locations, including
CHRISTUS St. Elizabeth Hospital in Beaumont. In the Petition, Anesthesia
Associates alleges that each CRNA Defendant violated Section 11.3 of the
Agreement and that, under Sections 11.4, 11.5, or 11.9 of the Agreement, Anesthesia
Associates is entitled to an immediate Temporary Restraining Order and a
subsequent Temporary Injunction, prohibiting each CRNA Defendant from
practicing nursing as CRNAs or providing CRNA services anywhere within a
twenty-mile radius of the location where the CRNAs worked for Anesthesia
Associates. Anesthesia Associates alleges that the CRNA Defendants breached the
terms of the Agreement by providing CRNA services in direct competition with
Anesthesia Associates within the restricted geographic area, in violation of the non-
competition provisions of the Agreement, and that Anesthesia Associates is entitled 4 to $30,000 from each of the CRNA Defendants for liquidated damages under the
terms of the Employment Agreement. Anesthesia Associates also requested a
temporary restraining order and temporary injunction enjoining the CRNA
Defendants from practicing nursing as CRNAs or providing CRNA services as set
forth in the Agreement executed by each Defendant.
On August 1, 2025, the trial court signed an Order granting Anesthesia
Associates’ Application for Temporary Restraining Order and setting a hearing on
Anesthesia Associates’ Application for Temporary Injunction for August 12, 2025.
On August 6, 2025, CHRISTUS Health Southeast Texas (“CHRISTUS”), the
entity that operates medical facilities in Beaumont, including St. Elizabeth Hospital,
filed an Original Petition in Intervention asking the trial court “to declare that the
restrictive covenants that A[nesthesia] A[ssociates] seeks to enforce should not
prohibit the Defendants from providing anesthesia services” to CHRISTUS’
facilities in and around Beaumont. CHRISTUS also filed an Emergency Motion to
Dissolve the TRO and for Emergency Hearing, and the CRNA Defendants joined
the Motion. On August 7, 2025, Anesthesia Associates filed a Motion to Strike
Intervenor-Plaintiff CHRISTUS’ Petition in Intervention.
Hearing on Motion to Dissolve TRO and Motion to Strike Intervention
On August 7, 2025, the trial court heard CHRISTUS’ Emergency Motion to
Dissolve the TRO, as well as Anesthesia Associates’ Motion to Strike CHRISTUS’ 5 Petition in Intervention, and the trial court received evidence and testimony at the
hearing.
Testimony of Tracy Young
Tracy Young, the chief operating officer for Essential Anesthesia
Management (“Essential”) (which he explained is “[a]lso known as
EmergencHealth[]”), 1 testified that the CRNA Defendants contracted with Essential
to provide services at St. Elizabeth Hospital in Beaumont. Young testified that at the
time of the hearing, Essential had “11 [CRNAs] minus the four [CRNA Defendants]
from the TRO[,]” so Essential is continuously trying to find people to fill the CRNA
Defendants’ shifts. Young oversees scheduling and the internal credentialing at
Essential and he testified that, even though Essential is able to pay above market to
get CRNAs to travel from other markets, it is difficult to hire CRNAs in a short
amount of time because Essential has to locate CRNAs that are not under contract
elsewhere and the potential hire must: be licensed in Texas, go through Essential’s
vetting process, go through the hospital’s vetting process, get hospital credentialing,
and go through an orientation at the hospital. Young recalled that Essential is
committed contractually to have sixteen CRNAs at St. Elizabeth during the
1 In pleadings and in the witnesses’ testimony, the names “Essential,” “Essential Anesthesia,” “Emergenc,” and “EmergencHealth” were used interchangeably to refer to the entity that contracted with the CRNA Defendants.
6 weekday. According to Young, there are approximately 350 CRNAs in Texas that
Essential has a relationship with and Essential has “gotten all the ones that we could
potentially get, sent them through the credentialing process; and those are the ones
that are on the schedule currently [and] no others . . . are available.” Young testified
that it is highly unlikely for Essential to find CRNAs to cover the CRNA Defendants’
shifts within the next several days and that Essential has tried to no avail to get
CRNAs from its other facilities to provide services at St. Elizabeth. According to
Young, the seven CRNAs, other than the CRNA Defendants, that Essential hired to
work at St. Elizabeth have all been asked to work extra shifts, but they are not always
able to do so, and Essential cannot force them to work on their days off. Young
testified that, including the four CRNA Defendants, Essential is scheduled next week
to have thirteen to fifteen CRNAs working, and without the CRNA Defendants,
Essential would be down to nine to eleven to work. Young testified that even if the
CRNA Defendants were able to work, Essential would not have sixteen CRNAs
working, but he agreed Essential would have enough CRNAs to meet the needs of
the community. Young estimated that if, hypothetically, the CRNA Defendants were
not available to work at St. Elizabeth going forward indefinitely, it would take
Essential two or three more weeks to provide necessary coverage to fully staff the
hospital. According to Young, the only other CHRISTUS facilities where Essential
provides CRNA services are in Corpus Christi and San Antonio, but he noted that
7 those facilities have their own credentialing. Young testified that in finding CRNAs
to come work at St. Elizabeth Beaumont, Essential avoided reaching out to CRNAs
working with Anesthesia Associates, but if those employees reached out to Essential
or responded to Essential’s job postings, then Essential’s recruiting team would
engage them.
Testimony of Michele Denman
Michele Denman testified that she is the administrative director for
perioperative services for CHRISTUS Southeast Texas and she provided an affidavit
in this case which is based on her personal knowledge. The affidavit, dated August
6, 2025, the day before the hearing, was admitted as evidence. Her affidavit
provided, in relevant part, that the hospital tries to have sixteen CRNAs available on
any given day, but from August 6th to August 12th, the CRNA’s on the schedule
ranged from three to fourteen, and each of the four CRNA Defendants were
scheduled on the weekdays. The affidavit stated that the short-term staffing problems
present an “imminent threat” to the hospital’s ability to operate a Level 3 Trauma
Center and provide 24/7 OB coverage. In the affidavit, Denman states, “CHRISTUS
Southeast Texas will have to perform roughly 50% fewer surgeries than what we
would typically expect on Thursday and Friday. We will then have to perform
roughly 50% fewer surgeries than [] we would typically expect on Saturday and
Sunday.”
8 Denman testified that in her affidavit she had estimated the number of CRNAs
available for the day of the hearing that included the CRNA Defendants, but that the
CRNA Defendants were not working that day and CHRISTUS Southeast Texas was
short-staffed on CRNAs that day. According to Denman, five surgeons were delayed
as to surgeries that day, meaning that “surgeons had a posted time . . . and due to not
all of the anesthesia that [was] scheduled for being available, those doctors had to
follow other doctors . . . . [and] every other surgery after that ha[d] to wait[.]”
Denman testified that a minimum number of five surgeries were delayed that day,
and she would not know the total number of delayed surgeries until the end of the
day. Denman explained that if the CRNA Defendants had been working that day,
the scheduled procedures would have started on time, and delays in procedures for
one day can roll over to the next day and result in cancellations. Denman testified
that she could not schedule CRNAs from another CHRISTUS location such as Jasper
or Corpus Christi because those CRNAs are only credentialed for those specific
facilities, and credentialing for the purpose of being able to perform work at a
particular hospital takes approximately a month unless it is fast-tracked. According
to Denman, the CRNA Defendants’ absence from work over the next five days
impacts CHRISTUS’ care to patients because CHRISTUS would not be able to do
elective surgeries and emergency surgeries and trauma surgeries would take
precedence. Denman testified that the types of elective surgeries for non-life-
9 threatening conditions that would have to be delayed included elective back
surgeries, ear tubes and tonsils for children, gallbladder surgeries, and elective hernia
surgeries. Depending on the number of births in a given day, the shortage of CRNAs
at CHRISTUS St. Elizabeth could also potentially impact care to the maternity ward.
Denman stated that on the day of the hearing a gastrointestinal case was delayed
because the scheduled CRNA had to first provide anesthesia services to an
emergency gastrointestinal bleed case.
On cross-examination, Denman agreed that the contract between St. Elizabeth
and Anesthesia Associates required that Anesthesia Associates have sixteen CRNAs
to provide services at the hospital, and shortly after the contract had started,
Beaumont Bone & Joint and Southeast Texas Gastroenterology disassociated from
the hospital. Denman stated that due to the hospital keeping the volume of surgeries
up, the demand for the sixteen CRNAs did not decrease. According to Denman,
during the week of the hearing, the hospital’s main operating room and the outpatient
pavilion in West Beaumont had fifty-two procedures serviced by Essential that
would have previously been serviced by Anesthesia Associates on that Monday; an
estimated fifty procedures on Tuesday, Wednesday, and Thursday; a few less on that
Friday; and approximately fifty procedures the following Monday and Tuesday.
Although she did not know if any surgeries were canceled for the Monday, Tuesday,
or Wednesday before the hearing or on Thursday, the day of the hearing, due to a
10 lack of CRNA coverage, she testified that two surgeries were delayed for that reason.
She agreed that for Thursday, the day of the hearing, she had estimated in her
affidavit that CHRISTUS would have to cancel twenty-five surgeries due to a lack
of anesthesia coverage that day, but that Essential had covered “to fill the holes that
were vacated by these four [CRNA Defendants]” and at that time it was possible that
zero surgeries would be cancelled for that day. As for Friday, the day following the
hearing, Denman testified that she had estimated in her affidavit that thirty-five out
of the fifty scheduled surgeries would have to be canceled if there were not enough
CRNAs, but that did not happen. According to Denman, six CRNAs were scheduled
for that Friday, none of the scheduled surgeries for that Friday were canceled as of
the time of the hearing, and there might be no cancellations if Essential could cover
the CRNA shifts. As for the weekend, the number of CRNAs CHRISTUS had
scheduled and on-call is the minimum necessary, and the normal demand for CRNAs
on the weekend is significantly less than during the week.
Denman testified that in a mass casualty situation over the weekend, there
would be some on-call CRNAs but, because the CRNA Defendants live in the
community and would not be able to work due to the TRO, CHRISTUS would have
to get coverage from CRNAs from out of town which might be difficult. Denman
agreed that the situation would be the same as if it had occurred prior to the TRO in
11 that in a mass casualty situation all the hospitals work together to provide necessary
resources.
Testimony of Dr. Gerald Callas
Dr. Gerald Callas, an anesthesiologist and the president of Anesthesia
Associates, testified that it was not Anesthesia Associates’ decision to terminate its
anesthesia relationship with CHRISTUS. According to Dr. Callas, CHRISTUS
negotiated a contract with Anesthesia Associates where Anesthesia Associates
needed to maintain a volume of CRNAs but the need for that “volume started
dwindling[,]” and Anesthesia Associates could not afford to continue to keep local
physicians and CRNAs at the hospital. Dr. Callas testified that CHRISTUS
representatives told him that they would work on renegotiating the contract, but that
when renegotiation was unsuccessful, Callas canceled the contract effective July 31,
2025, as allowed under the agreement. Dr. Callas agreed that this lawsuit was filed
the following day. At that time, Anesthesia Associates was not providing anesthesia
services at CHRISTUS, and it had signed a contract to cover anesthesia services at
Baptist Hospital. Dr. Callas acknowledged that for at least six months
EmergencHealth is now contractually obligated to provide anesthesia services at
CHRISTUS, and Anesthesia Associates is not going to provide services during those
six months or compete with EmergencHealth for the next six months. According to
Dr. Callas, Anesthesia Associates might be competing with EmergencHealth after
12 six months. When asked if Anesthesia Associates was no longer a competitor with
EmergencHealth because he had cancelled the contract, Dr. Callas answered, “I
canceled the contract, but we’re still always competitive.”
The Trial Court’s Order on the Motion to Dissolve the TRO and the Motion to Strike Petition for Intervention
On August 8, 2025, the trial court signed an Order Modifying Temporary
Restraining Order, modifying the August 1, 2025 TRO until the end of the
Temporary Injunction Hearing:
IT IS THEREFORE ORDERED the four individual Defendants may perform services at CHRISTUS Health Southeast Texas facilities if there is a mass trauma event, or if their services are otherwise necessary to a potentially “life or death” situation such that they need to be called in unscheduled. IT IS THEREFORE ORDERED that two of the four individual Defendants may perform services at CHRISTUS Health Southeast Texas facilities on Monday, August 11, and two may perform services on Tuesday, August 12, in order to avoid disruption or services being delayed. However, the individual Defendants shall be available to testify at the Temporary Injunction Hearing.
The trial court also struck the intervention of CHRISTUS. 2
2 This Court denied CHRISTUS’ Petition for Mandamus relief. See In re Christus Health Se. Tex., No. 09-26-00099-CV, 2026 Tex. App. LEXIS 2322, at *6 (Tex. App.—Beaumont Mar. 12, 2026, orig. proceeding).
13 The August 12th and 13th Hearing on Temporary Injunction
On August 12, 2025 and August 13, 2025, the trial court heard testimony and
evidence on Anesthesia Associates’ Application for Temporary Injunction.
Dr. Gerald Callas testified that Anesthesia Associates entered into a
negotiated contract with CHRISTUS Health Southeast Texas in 2024, to provide
anesthesia services to the hospital. The contract was admitted into evidence.
According to the CHRISTUS contract, Anesthesia Associates, in exchange for a
monthly stipend from CHRISTUS, agreed to provide anesthesia services at the
following CHRISTUS facilities: CHRISTUS Southeast Texas - St. Elizabeth,
CHRISTUS Southeast Texas - St. Elizabeth Outpatient Pavilion, and CHRISTUS
Southeast Texas – Orthopedic Specialty Center. Dr. Callas explained that the
agreement provides that either party could terminate the agreement at any time with
or without cause upon 120 days’ prior written notice. Dr. Callas testified that a month
or two after the agreement was entered into, there was a “nose dive” in the volume
of cases needing anesthesia services at CHRISTUS St. Elizabeth and the stipend was
no longer adequate to keep the Certified Registered Nurse Anesthetists employed at
Anesthesia Associates. Dr. Callas recalled that he provided written notice to the CEO
of CHRISTUS Southeast Texas in a letter dated March 31, 2025, wherein he stated
that Anesthesia Associates would terminate the contract effective August 1, 2025, 14 unless a renegotiated agreement was entered into because the current contract did
not adequately meet Anesthesia Associates’ financial needs. The letter was admitted
into evidence. According to Dr. Callas, CHRISTUS Southeast Texas decided it
would not renegotiate the contract and instead the hospital contracted with
EmergencHealth for CRNA service on July 3, 2025.
Dr. Callas testified that as of March 2025, Anesthesia Associates had fifteen
or sixteen “1099” registered nurse anesthetists that were not contracted employees
but that “worked under the umbrella of Anesthesia Associates.” According to Dr.
Callas, the CRNA Defendants then quit Anesthesia Associates and went to work for
EmergencHealth, and, because of the CRNA Defendants leaving, Anesthesia
Associates only had seven registered nurse anesthetists at the time of the hearing.
Dr. Callas recalled that each of the CRNA Defendants had signed an Employment
Agreement with Anesthesia Associates. A copy of the Employment Agreements
between Anesthesiologist Associates and each of the CRNA Defendants was
admitted into evidence. Dr. Callas testified that the CRNA Defendants joined
Anesthesia Associates immediately out of school and that Anesthesia Associates
worked hard to give them “a lot of our institutional memory and stuff that we thought
[was] very important to improve the delivery of anesthesia[]” and make sure they
were trained as to “everything from intubation or SLIC techniques, putting in arterial
line, [and] using ultrasound[.]” Dr. Callas agreed that each of the CRNA Defendants’
15 Employment Agreements includes: a nondisclosure provision prohibiting the
employee from disclosing confidential and proprietary information and
acknowledging that the employer’s business is competitive and that such a
disclosure would adversely affect the employer’s business; a covenant not to
compete for three years after termination of the Employment Agreement within a
twenty-mile radius of any office or facility at which the employee provided CRNA
services during the employment period in exchange for the employer’s disclosure to
the employee of confidential and proprietary information and the provision of
specialized training and knowledge; an acknowledgement that the employer has a
right to have an immediate temporary restraining order and temporary injunction
enjoining the employee’s breach or violation without the need to post any security
or bond and is entitled to other remedies at law and equity; the employee must pay
the employer $30,000 immediately upon breach or violation of the agreement; and
that the employer has the right to recover from the employee all reasonable
attorney’s fees, costs and expenses in any litigation necessary to enforce these
provisions. Anesthesia Associates’ office is located in the CHRISTUS St. Elizabeth
Hospital building in Beaumont.
Dr. Callas testified that the CRNA Defendants could leave Anesthesia
Associates at any time. Dr. Callas testified that he was not complaining about the
fact that the CRNA Defendants left or quit working for Anesthesia Associates, but
16 that his complaint was that their leaving put a strain on Anesthesia Associates’
business and the CRNA Defendants were competing with Anesthesia Associates in
Beaumont despite the non-compete clause in their Employment Agreements. Dr.
Callas explained that the local university, Lamar University, does not have a CRNA
program and that it is difficult to recruit CRNAs to Southeast Texas. He has had to
offer incentives to get CRNAs to come to Southeast Texas, including signing
bonuses as high as $100,000 to $150,000 or paying travel fees in addition to hourly
fees for contract employees living in areas such as Dallas, who would have to travel
back and forth to provide anesthesia services. According to Dr. Callas, he can find
CRNAs to cover Anesthesia Associates’ needs because of the CRNA Defendants
leaving, but finding replacements “comes at an exorbitant amount of cost.” With
respect to the irreparable harm to Anesthesia Associates resulting from the CRNA
Defendants leaving and as acknowledged by the Agreements, Dr. Callas described
the irreparable harm as:
Significant harm, irreplaceable damage and harm. First, the amount of morale in the community has totally changed because we are not only mom and pops, we’re not only brothers and sisters in this - - in this whole fight, but when you see the fragmentation and the deterioration of a practice that’s been here since 1952, it’s very concerning and it’s - - the community’s very upset and appalled. The other thing I’ll tell you, the morale just with Anesthesia Associates right now, it’s very concerning. And then the big thing is that it’s cost an arm and a leg for us to continue to try to recruit and try to bring people here. We have literally went from being very competitive in the market to where we had to go above and beyond in order to try to keep not only 17 our local CRNAs here but also try to recruit. Some of - - the package that we went from is that based on the guidelines of the CRNAs, that they recommended that we used to pay based on years of service; and there would be a number. We jumped all that up to 20 years of service. A starting CRNA in our practice right now is $367,550. That is way up more than we’ve ever done before. So - - and, also, too, not to talk about the emotional harm that it’s caused, the stress that we’re dealing with as a - - as a business that we’re being threatened because now I’m trying to find bodies in order to keep our business afloat, and we’ve been around forever. And so it’s a huge concern.
Dr. Callas testified that Anesthesia Associates sought a temporary injunction
preventing the CRNA Defendants from working within a twenty-mile radius and for
a period of three years as outlined in the Agreement. According to Dr. Callas, he has
seen surgeries get canceled, but not because of a lack of anesthesia staff, and he was
not aware of any canceled surgeries at St. Elizabeth Hospital due to a lack of
anesthesia staff in the days leading up to the hearing. Dr. Callas testified that if St.
Elizabeth Hospital called him today in a predicament with an emergency and not
enough nurse anesthetists, that Anesthesia Associates, as long as not prevented by
credentialing or licensing, “would hundred percent help out” just as it did years
before when there was a bus crash involving a local school district’s students and it
was “[a]ll hands . . . on deck.”
On cross-examination, Dr. Callas testified that he has no problem with the
CRNA Defendants going to work for a competitor outside of the twenty-mile radius.
Dr. Callas explained that he had attempted to renegotiate the contract with
18 CHRISTUS Southeast Texas because “the case volume went down to approximately
38 to 43 percent, that our stipend was based on that volume; and when that volume
left, we needed that in order to compensate and to maintain our economic viability
as a small business.” According to Dr. Callas, after Anesthesia Associates terminated
the contract with CHRISTUS Southeast Texas, Anesthesia Associates began
providing anesthesia services at Baptist Hospital, along with other facilities such as
Altus and Beaumont Surgical Affiliates. Dr. Callas also agreed that for at least six
months after CHRISTUS’ and Anesthesia Associates’ contract terminated,
Anesthesia Associates is not going to be competing for the opportunity to provide
anesthesiology services at CHRISTUS because Anesthesia Associates is providing
services at Baptist Hospital. Dr. Callas also testified that he had “disclosed a lot” to
Dubois and Mendoza and “confided in them a lot of the business strategies that
[Callas] utilize[s], especially payment, recruiting, [and] compensation.” Dr. Callas
acknowledged that he was not aware at the time of the hearing if the CRNA
Defendants have taken or used Anesthesia Associates’ business strategies. He
testified that during the prior year the CRNA Defendants, while employed with
Anesthesia Associates, had provided anesthesia services at multiple facilities
including CHRISTUS, and that the CRNA Defendants worked fifty-to-sixty percent
of the time at CHRISTUS Beaumont compared to the other facilities. Dr. Callas
explained that when the CRNA Defendants left Anesthesia Associates, it harmed the
19 community because it gives “a misconception that A[nesthesia] A[ssociates’] brand
is somehow falling apart; and, also, people like the idea of having these CRNAs - -
us working together as a team because we’ve been doing it forever.” According to
Callas, he did not want the CRNA Defendants to leave Anesthesia Associates, but
he would not want to force them to work there and, if they did leave, he wanted them
to be employed and provide for their family, but not within the twenty-mile radius
as provided for in the Employment Agreements. Dr. Callas testified that he agreed
that the closest facilities that the CRNA Defendants could provide services outside
the twenty-mile radius might be Lake Charles, Louisiana, or Baytown, Texas. Dr.
Callas acknowledged that whether the CRNA Defendants work for CHRISTUS
Southeast Texas or go out of state, Anesthesia Associates will have to pay more for
other CRNAs. Dr. Callas testified that he sent the CRNA Defendants a letter
approximately two weeks before August 1, 2025, reminding them of the non-
compete clause they agreed to and the consequences if they breached the Agreement.
Dr. Callas testified that he wants the CRNA Defendants to honor the contract they
signed.
Testimony of Monica Bentzen
Monica Bentzen testified that she currently works for Essential Anesthesia
Management which she agreed is “somehow tied in to” EmergencHealth. She agreed
she signed her Employment Agreement with Anesthesia Associates on April 6,
20 2022. She acknowledged that the agreement provided the amount Anesthesia
Associates would pay her, that she promised to not disclose confidential and
proprietary information material to Anesthesia Associates’ goodwill and effective
and successful conduct of its business, and that she agreed to a noncompete clause
that prohibited her for three years after her employment with Anesthesia Associates
from providing CRNA services within a twenty-mile radius of any facility she
provided CRNA services during her employment period with Anesthesia Associates.
Bentzen agreed that CHRISTUS St. Elizabeth was one of the facilities at which she
provided CRNA services while an employee of Anesthesia Associates. Bentzen
denied disclosing any of Anesthesia Associates’ trade secrets or confidential
information.
According to Bentzen, she first talked about going to work for Essential
Anesthesia when she spoke with Kyle Holmes, a CRNA that had previously worked
for Anesthesia Associates who had taken a position with Essential Anesthesia.
Holmes directed her to “Erasmo” who works for Essential Anesthesia, and she spoke
to Erasmo over the phone about the noncompete clause in her Employment
Agreement with Anesthesia Associates. At that time, she also submitted her
resignation to Anesthesia Associates, and she generally discussed her resignation
with other CRNAs who had also turned in their resignations to Anesthesia
Associates.
21 Bentzen recalled that because her Employment Agreement with Anesthesia
Associates had a provision that required her to pay $30,000 for breaching the
noncompete clause, she believed that there was a “buyout” and that “$30,000 would
be enough to settle the noncompete clause.” She agreed at the hearing that the
Employment Agreement does not include the word “buyout” and that the remedies
for breach of the noncompete clause include injunctive relief and a liquidated
damage clause that requires her to pay $30,000 immediately upon the occurrence of
the breach. According to Bentzen, she gave Essential Anesthesia a copy of the
Agreement she had signed with Anesthesia Associates, and she was told by Essential
Anesthesia that “they would handle” the $30,000, which she understood to mean
that Essential Anesthesia “would offer to pay the buyout on [her] behalf.” Bentzen
testified she also signed a contract with EmergencHealth to start working on August
1, 2025. Bentzen testified that she did not pay Anesthesia Associates the $30,000
when she went to work with Essential Anesthesia (also referred to as “Emergenc”),
but that later she believed EmergencHealth or Essential Anesthesia offered
Anesthesia Associates the $30,000 on her behalf. Bentzen recalled that while
working for Anesthesia Associates, she worked at CHRISTUS in Beaumont
“[p]robably more than half[]” the time and she has never been an employee of
CHRISTUS. According to Bentzen, when she gave Anesthesia Associates her
22 resignation, Anesthesia Associates did not know where she was going and no one at
Anesthesia Associates told her they would sue her.
Bentzen testified that before she had moved back to Texas, her father passed
away, and she moved home to take care of her grandmother and her mother who has
unique health issues because no one else in Bentzen’s family was able to care for her
grandmother and mother. At Essential, Betzen earns a base salary of $320,000 as a
“W-2 employee[]” and then has the option for “call pay[]” making $750 for a
weekday 24-hour call shift and $2,500 for a weekend. She testified she anticipates
her total compensation to be approximately $375,000 a year. According to Bentzen,
if the trial court were to enter an order that she is no longer able to perform her job
at Essential, she would have to leave and find employment elsewhere, most likely
back in Pittsburgh where she has contacts and the ability to have a guaranteed job,
but where her compensation would be significantly lower at about $165,000 per year
and she would have to hire someone to care for her mother and grandmother.
Bentzen agreed that there is a shortage of CRNAs and that she could also go to
Houston or Lake Charles for employment. She testified that she was not aware if
Essential had other facilities and she had not asked anyone at Essential if they had
other facilities outside of Beaumont where she could work if she was prohibited from
working in Beaumont. Bentzen testified that she has no interest in going back to
23 Anesthesia Associates under any circumstances even though she would make more
money there.
Bentzen testified that her noncompete agreement with Essential Anesthesia
restricts her from leaving them and working within a one-mile radius and that she
also has a separate written agreement with Essential wherein Essential has agreed to
cover her legal fees, damages, and expenses in this lawsuit with Anesthesia
Testimony of Chad Dubois
Chad Dubois testified that prior to July 31, 2025, he was employed by
Anesthesia Associates and spent “three-quarters of [his] time[]” working at St.
Elizabeth. He testified that in June 2025, he heard from physicians and CRNAs at
CHRISTUS St. Elizabeth while working there, that Essential would be taking over
the anesthesia services contract at the hospital effective August 1, 2025. Dubois
testified that in July of 2025, he had a meeting with Dr. Callas and Dr. Bergeron and
asked about the future of Anesthesia Associates. Upon learning at that meeting that
Anesthesia Associates did not have answers for how they were going to cover cases
and that the CRNAs’ workloads would increase, Dubois believed he would be
overworked and decided the next day to resign from Anesthesia Associates and go
work with Essential. The day after meeting with Dr. Callas, Dubois contacted
Erasmo, an Essential employee, and informed Erasmo that he would like a contract
24 with Essential. According to Dubois, Essential sent him a contract and the subject of
the noncompete clause in Dubois’ Employment Agreement with Anesthesia
Associates never came up with Erasmo even though Dubois was aware of the
noncompete clause. At the time of the hearing, Dubois stated he is an employee of
Essential Anesthesia and performs procedures at CHRISTUS St. Elizabeth Hospital.
Dubois explained that Essential was aware of the noncompete clause in his
Employment Agreement with Anesthesia Associates because Anesthesia Associates
had already had two CRNA employees, Simmons and Mendoza, resign from their
employment with Anesthesia Associates and accept a job with Essential. Dubois
testified that a statement was made by one of the Essential team members after
Dubois resigned from Anesthesia Associates that Essential “would cover [the]
buyout[,]” and the statement was made before Dubois’ start date with Essential.
Dubois denied divulging any trade secrets of Anesthesia Associates, and he denied
trying to recruit patients or doctors to move from Baptist Hospital to St. Elizabeth
Hospital and he denied trying to convince doctors that Dr. Callas may be recruiting
to stay at St. Elizabeth. According to Dubois, he did not knowingly breach the
noncompete clause because he knew that Essential was going to “take care of it[,]”
but he believed that Essential could do a “buyout” because it was his understanding
that a previous Anesthesia Associates’ employee, Eric LeBlanc, was able to continue
25 to work in Beaumont after such a “buyout.” Dubois had not talked to LeBlanc, and
the Essential employees did not ever bring up LeBlanc’s name.
Dubois testified that he is from Port Neches, Texas, and he lives in Orange,
Texas. He has an eleven-year-old daughter and nine-year-old son. According to
Dubois, if the noncompete clause is enforced for three years, his wife who owns a
local home health company and their children would have to stay in Southeast Texas
and he would have to be “on the road” to have employment. Dubois recalled that
Anesthesia Associates was his first job out of CRNA school. He testified that his
noncompete agreement with Essential/Emergenc restricts him from leaving and then
working as a CRNA within a one-mile radius. He also testified that he has a separate
written agreement with Essential/Emergenc wherein Essential/Emergenc agreed to
cover his legal fees, damages, and expenses in this lawsuit with Anesthesia
Testimony of Lance Mendoza
Lance Mendoza testified that he joined Anesthesia Associates in 2017 after
he graduated as a CRNA. According to Mendoza, his starting salary was $130,000
but the market has improved for CRNAs, and the salaries are two to three times as
much as when he started. He testified that immediately after school he had the
requisite knowledge of how to be a CRNA, and he testified he did not receive any
specialized training from Anesthesia Associates. Mendoza agreed that on at least
26 one occasion, a patient requested that Mendoza be the CRNA for the patient’s
scheduled surgery, and Dr. Callas made that accommodation for the patient.
Mendoza testified that in June 2025, he learned that Anesthesia Associates
was going to be leaving CHRISTUS St. Elizabeth Hospital, where he had been
working about eighty or ninety percent of the time, and he knew that July 31, 2025,
would be Anesthesia Associates’ last day with CHRISTUS. Mendoza explained that
when he signed his contract with Anesthesia Associates, he never considered that
Anesthesia Associates would cancel its contract with CHRISTUS, and if he had, he
would not have signed the contract. He testified that if Anesthesia Associates was
still providing services with CHRISTUS, he would not have left Anesthesia
Associates. He did not initially get feedback from St. Elizabeth about who was to
replace Anesthesia Associates, and Mendoza e-mailed the information for a job
posting with Essential Anesthesia at CHRISTUS in July. He informed the Essential
contact that he had a noncompete clause in his agreement with Anesthesia Associates
and sent pictures of those pages of the Agreement. According to Mendoza, a lady
responded to his e-mail and put him in contact with Erasmo who worked for
Essential. When Mendoza spoke to Erasmo for the first time, Erasmo told Mendoza
that Essential Anesthesia “would handle” the noncompete clause with Anesthesia
Associates. Mendoza recalled that he also entered into an agreement with
EmergencHealth, separate from his employment agreement that provided
27 EmergencHealth would pay for his legal fees and any damages assessed against him
if Anesthesia Associates sued him for breach of contract.
Mendoza testified that when he received Dr. Callas’ letter, he notified
someone at EmergencHealth, and EmergencHealth told Mendoza that, “We will
handle it.” After Mendoza was sued by Anesthesia Associates and an injunction was
entered against him, Mendoza contacted Erasmo, who told Mendoza that he “would
be in touch with legal.”
His current employment contract with EmergencHealth has a noncompete
clause prohibiting him from working within a one-mile radius of CHRISTUS, and it
states that if they lose the contract from an open bidding process, the noncompete
clause is null and void. He could not recall how many years the noncompete clause
was effective. With EmergencHealth, Mendoza spends one hundred percent of his
time working at CHRISTUS facilities.
Mendoza testified that he lives in Orange, Texas and if he is prohibited from
providing services in the Beaumont area for the next three years, he would have to
travel for work while his wife and children, ages six and eight, would stay in Orange.
According to Mendoza, if he had to work out of town like in Baytown or Lake
Charles, he would have to spend an hour-and-a-half on the road on top of his regular
shift hours of 7:00 a.m. to 4:00 p.m., he would have to leave before his children
awake in the morning and he would not get home until 6:00 p.m. or later, and he
28 might have to stay at the hospital if he takes a “call shift[.]” Mendoza explained that
he wanted the trial court to understand that requiring him to travel that far for work
would mean less time with his family, and he wanted the trial court to “[r]ealize that
this isn’t us against [Anesthesia Associates]. We’re doing what’s best for our
families, what’s best for us.”
Testimony of Kenneth Simmons
Kenneth Simmons testified that he began working with Anesthesia Associates
in 2020, upon his graduation from CRNA school. According to Simmons, as of June
2025, he did not want to quit Anesthesia Associates and did not plan to leave the
area because he and his wife have family in the area, and they have two young
children. Simmons testified that people generally do not choose where they are
getting surgery done based on a specific CRNA they want. Simmons denied that he
had received any specialized training from Anesthesia Associates, and he denied
having any business secrets or confidential information of Anesthesia Associates’
that he uses as an employee of EmergencHealth.
Simmons testified that on July 3, 2025, he was notified in a group message
from someone with Anesthesia Associates that the CRNA call requirements would
be changing, and he became concerned that with the new call system he was going
to have to work more hours. Simmons recalled that he had known of a CRNA job
29 posting from Essential for a while, and had no plans to inquire about that posting
until he learned that Essential “was coming in.”
According to Simmons, he contacted Erasmo, whose name and phone number
were on the Essential job posting, and Simmons informed Erasmo of the noncompete
clause in Simmons’ employment agreement with Anesthesia Associates. Simmons
testified that Essential informed him that they would take care of what was assumed
to be a buyout of the noncompete clause. When Simmons received the letter from
Anesthesia Associates reminding the CRNAs that they have a noncompete clause in
their Employment Agreements, he again brought the noncompete clause to Erasmo’s
attention and provided a copy of the noncompete clause to Erasmo. Simmons
testified that Erasmo responded, “We’re taking care of it[]” and “We’ll keep you
posted.” When Simmons found out Anesthesia Associates had filed the lawsuit and
a temporary restraining order had been issued, Simmons contacted Erasmo again,
and Erasmo stated, “We’ll be in touch with our legal team.” Simmons recalled that
in addition to his employment agreement with Essential, he has a separate written
agreement with Essential providing that Essential will cover Simmons’ legal fees
and damages awarded against Simmons in this lawsuit concerning the noncompete
clause with Anesthesia Associates.
Simmons recalled that in his contract with Essential, he negotiated a one-mile
radius noncompete clause with no time frame in his employment agreement with
30 Essential when Essential had proposed a five-mile radius noncompete clause, and
that it is his understanding of the agreement that it does not provide that he owes a
certain amount of money if he breaches the contract. Simmons testified that if
Essential presented him with a new contract he would not agree to a noncompete
clause with a five-mile radius because he learned from this experience with
Anesthesia Associates about signing noncompete agreements. Under his current
contract with Essential, Simmons works one hundred percent of his time at
EmergencHealth facilities. Simmons signed the contract with Essential on July 11,
2025, and sent a resignation letter to Anesthesia Associates’ office manager on July
14, 2025.
According to Simmons, if the noncompete clause with Anesthesia Associates
gets enforced and he is prohibited from working in the Beaumont area as a CRNA
for the next three years, he would potentially change careers and consider joining
his mother’s real estate company just to stay in Beaumont. He wants the trial court
to “[d]rop this injunction[] [and] allow [him] to work in [his] hometown with [his]
family because [he’s] not . . . leaving Beaumont.”
Michele Denman testified that no cancellations occurred in the days leading
up to the hearing, but some surgeries were not scheduled by doctors because of not
having enough CRNAs available for CHRISTUS Southeast Texas due to the CRNA
31 Defendants not being allowed to work as a result of the TRO. According to Denman,
without the CRNA Defendants, CHRISTUS Southeast Texas had anywhere from
eight to eleven CRNAs scheduled to work each day and that on the day of the
hearing, she estimated that two or three surgeries were not scheduled that day solely
because there was not going to be a CRNA. According to Denman, she speaks daily
with Erasmo Coutino, a CRNA that is on-site and a representative of Essential, about
scheduling. Denman testified that she believes that the variation from eight to eleven
of CRNAs available to work during this time that CHRISTUS is without the CRNA
Defendants due to the TRO is because CRNAs are being asked to work “when
they’re not supposed to work.” Denman testified that the current situation is not
sustainable because the CRNAs who are “doing favors and working extra are not
going to continue to do that because they have their own jobs [at] other places.”
Denman explained that CHRISTUS Southeast Texas cannot get CRNAs from other
towns to fill the gaps because their credentials do not allow them to go from one
hospital to the next, other hospitals do not have surpluses of CRNAs, and the
credentialing process usually takes sixty to ninety days. Denman recalled that she
had earlier predicted that the Wednesday before the hearing that there would be
twenty-five cancellations for the next day on Thursday due to a shortage of CRNAs
and there would be thirty-five cancellations on that Friday before the hearing, but
she testified that no cancellations happened on either day. Denman agreed
32 CHRISTUS Southeast Texas was “underscheduling” surgeries to adjust for the
situation and that is why the surgeries that were not scheduled due to the CRNA
shortage would not show up as “official cancellations[.]” According to Denman, she
fields complaints from doctors and others at CHRISTUS about the lack of CRNAs,
and she and others are concerned about the ability of the hospital to continue
functioning in the best way to serve patients of Southeast Texas without the hospital
being able to utilize the four CRNA Defendants. Denman disagreed with Dr. Callas’
testimony that there is no evidence of disruption to patient care at CHRISTUS in the
days leading up to the hearing due to the CRNA Defendants being unable to work at
CHRISTUS, and Denman testified that, “I’m there working every day. [Dr. Callas
and his counsel] haven’t been in the facility working. So as far as . . . the impacts to
patients, they wouldn’t be aware of that.” Denman acknowledged that she had not
communicated “up the Christus chain” to have other CRNAs from Essential
Anesthesia fill the spots or to have CHRISTUS CRNAs fill in in Southeast Texas.
According to Denman, she would like to have more CRNAs available but she just
schedules based on how many CRNAs Erasmo tells her are available.
The First Temporary Injunction Order
On August 20, 2025, the trial court signed a Temporary Injunction restraining
the CRNA Defendants from practicing nursing as CRNAs or providing CRNA
services anywhere within a twenty-mile radius of where they provided services
33 while employed with Anesthesia Associates, pursuant to the terms of the non-
competition agreement the CRNAs executed as part of their Employment
Agreements. The CRNA Defendants appealed, but because the trial court issued a
temporary injunction without setting a trial date for a trial on the merits as required
by Rule 683 of the Texas Rules of Civil Procedure, this Court reversed the trial
court’s order as void and remanded the case to the trial court. See Dubois v.
Anesthesia Assocs., No. 09-25-00302-CV, 2025 Tex. App. LEXIS 7108 (Tex.
App.—Beaumont Sept. 4, 2025, no pet.) (mem. op.). 3
First Amended Petition and Application for Temporary Injunction
Anesthesia Associates filed a First Amended Petition and Application for
Temporary Injunction, stating that “Plaintiff Anesthesia Associates Group, PLLC
d/b/a Anesthesia Associates is a PLLC doing business in Jefferson County, Texas[,]”
and Anesthesia Associates added an allegation that it “has demonstrated the
existence of a cause of action or other claim for permanent relief against
Defendants[.]” Anesthesia Associates also filed a Motion for Entry of Order with an
attached proposed order tracking the language of the prior Order granting a
3 This Court also noted that the order set a hearing on Anesthesia Associates’ application for permanent injunction, but the Petition did not seek a permanent injunction as relief. See Dubois v. Anesthesia Assocs., No. 09-25-00302-CV, 2025 Tex. App. LEXIS 7108, at *3 (Tex. App.—Beaumont Sept. 4, 2025, no pet.) (mem. op.). 34 Temporary Injunction, but that also included a trial setting for the entire case on the
merits for June 8, 2026.
Second Temporary Injunction Order
On September 12, 2025, the trial court signed a second Temporary Injunction
Order (the Second Temporary Injunction Order) granting Anesthesia Associates’
application for a temporary injunction “[b]ased on the arguments and evidence
received during the hearings on August 7, 12 and 13, 2025[.]” The Second
Temporary Injunction Order included a trial setting on the merits for the entire case
setting it for June 8, 2026, and it included the findings set forth in the trial court’s
letter ruling attached as an exhibit. In the Second Temporary Injunction Order, the
trial court included the following findings 4 from the letter ruling:
The Court finds that the covenants to compete signed by Defendants are valid and enforceable, in that each was ancillary to an otherwise enforceable agreement at the time it was made; and that each covenant contains reasonable limitations as to time, geographical area, and scope of activity to be restrained that do not impose a greater restraint than is necessary to protect the goodwill or other business interests of the promisee—in this case, Plaintiff. The Court finds that the terms are reasonable with respect to time (3 years), geographical area (20-mile radius of an AA office), and scope (practicing as a CRNA), and do not impose a greater restraint than necessary to protect the goodwill and business interests of AA.
4 If the trial court decides to grant an injunction, Rule 683 of the Texas Rules of Civil Procedure states that the order “shall set forth the reasons for its issuance; shall be specific in terms; shall describe in reasonable detail and not by reference to the complaint or other document, the act or acts sought to be restrained[.]” Tex. R. Civ. P. 683. 35 The Court further finds that the agreements were properly supported by consideration in light of the goodwill received by Defendants by virtue of their employment at AA. In order to work as a CRNA at the Beaumont Christus facilities, Defendants were required to be supervised and work underneath the anesthesiologist physicians at AA. The employment with AA provided Defendants with the credentialing needed to practice at St. Elizabeth Hospital, and access to other surgeons, hospital staff, and hospital administrators as they helped fulfill the anesthesiology needs of that medical facility. Moreover, it was the existing credentialing that made Defendants such ideal targets for hire by non-party EmergencHealth because it provided a fast-track means for EmergencHealth to fulfill its own contractual obligations to Christus St. Elizabeth. The Court further finds that Plaintiff has demonstrated the existence of a cause of action or other claim for permanent relief against Defendants; a probable right to the permanent relief, i.e., a determination that the covenant was enforceable and that a breach occurred; and that there is a probable, imminent and irreparable injury before trial with no adequate remedy at law. The Court finds that the legal remedy of damages does not offer complete relief because damages cannot protect Plaintiff against future competition by Defendants. In addition, the Court finds that damages caused by loss of business, use of trade secrets, and the like cannot readily be determined with sufficient certainty for damages to be an adequate remedy. In the present case, Plaintiff has alleged a cause of action for breach of contract in its pleadings, which satisfies the first requirement outlined above. Second, the Court has previously determined that the covenants not to compete are enforceable, and that each Defendant conceded in their own testimony that their employment with non-party EmergencHealth at St. Elizabeth Hospital in Beaumont was a violation of the terms of their non-compete agreement. The Court notes that irreparable injury to a promisee sufficient to support the necessity of equitable relief is frequently presumed from the fact of breach, and evidence of a breach by a highly trained employee, such as the Defendants herein, constitutes prima facie proof of irreparable injury to the former employer. In the present case, the undisputed testimony has established that the CRNAs are highly trained, highly skilled, in high demand, and are extremely hard to replace when a vacancy arises. Furthermore, if the non-compete clauses were not enforced, Plaintiff would face the possibility of losing 36 additional CRNAs to competitors, which could render Plaintiff unable to fulfill its own ongoing contractual anesthesia requirements to other medical facilities, or could even result in the practice having to close or relocate altogether. The Court finds that the scarcity of CRNA medical professionals and the consequence of losing those professionals could result in permanent and irreparable damage to Plaintiff and the viability of its business. The Court finds that the acts of the CRNA Defendants in violation of their covenants not to compete have been carried out, and will be carried out, before the Court can render judgment in this case if a Temporary Injunction is not entered, and the Court further finds that the continuing of these acts will tend to make ineffectual a future Judgment or Permanent Injunction in favor of Plaintiff.
The CRNA Defendants filed this appeal. 5
Issue on Appeal
On appeal, the CRNA Defendants argue that the trial court should reverse the
Second Temporary Injunction Order because Anesthesia Associates did not meet the
requirements for a temporary injunction for three independent reasons: it has no
legitimate business interest in restraining the CRNA Defendants from working at
CHRISTUS St. Elizabeth Hospital, there is no irreparable harm and damages are an
5 After the CRNA Defendants filed this appeal, the CRNA Defendants also filed a Motion for Temporary Order Staying Second Temporary Injunction Pending Appeal Based on New Evidence. On January 13, 2026, this Court issued an Order denying the CRNA Defendants’ motion for temporary relief. See Tex. R. App. P. 29.3 (“the appellate court must not suspend the trial court’s order if the appellant’s rights would be adequately protected by supersedeas or another order made under Rule 24”). To the extent that the parties discuss in their appellate briefs what they call “new evidence,” we note that our review on appeal is limited to the validity of the second temporary injunction order, wherein the trial court’s order was “[b]ased on the arguments and evidence received during the hearings on August 7, 12 and 13, 2025[.]” 37 adequate remedy, and the balance of equities weighs strongly in the CRNA
Defendants’ favor.6 According to the CRNA Defendants, Anesthesia Associates has
no legitimate interest in restraining them from working at the St. Elizabeth Hospital
because Anesthesia Associates terminated its anesthesia contract with St. Elizabeth
Hospital and admitted it will not compete for St. Elizabeth’s business for at least six
months. The CRNA Defendants argue that because Anesthesia Associates admitted
it can hire other CRNAs at an additional cost, there is no irreparable harm, and
damages are an adequate remedy. As for balancing the equities of the parties, the
CRNA Defendants assert that Anesthesia Associates will suffer little, if any, harm
because it voluntarily terminated its anesthesia contract with St. Elizabeth Hospital
and admitted it will not compete for St. Elizabeth’s business for at least six months.
6 In the “Statement Regarding Oral Argument” section of the CRNA Defendants’ appellate brief, they assert the following: This case presents an important issue in non-compete law: Can a company that voluntarily terminated its contract with a customer—and swore it would not compete for that customer’s business for at least six months—prohibit its former employee from continuing to work at that customer’s business for a new employer?
We note that the CRNA Defendants did not argue in the trial court that the temporary injunction is improper because the employees would be working for the “same customer” but for a “new employer.” Accordingly, the CRNA Defendants failed to preserve this complaint. See Tex. R. App. P. 33.1(a)(1) (a party’s argument on appeal must comport with its argument in the trial court to preserve error). 38 Anesthesia Associates argues that it has a legitimate business interest in
restraining the CRNA Defendants from working at CHRISTUS St. Elizabeth
Hospital because Anesthesia Associates’ contract with Baptist Hospital does not
prevent Anesthesia Associates from providing services elsewhere and that Dr. Callas
testified that he would, if called upon by St. Elizabeth Hospital, provide services
there. According to Anesthesia Associates, Dr. Callas’ testimony does not support
the idea that Anesthesia Associates is “boycotting” St. Elizabeth Hospital, and that
Dr. Callas only made a logical assumption that it would be unlikely for Anesthesia
Associates to get St. Elizabeth’s business for six months because the hospital had a
six-month contract with EmergencHealth. Anesthesia Associates also emphasizes
that the covenant not to compete lasts for three years – which leaves more than two
and a half years for the covenant not to compete to apply even after the six-month
contract period between St. Elizabeth and EmergencHealth expired on February 1,
2026. Anesthesia Associates cites to several Texas cases 7 in arguing that goodwill,
specialized training, and a company’s interest in not having its employees poached
are legitimate business interests worthy of protection by a covenant not to compete.
7 Marsh USA, Inc. v. Cook, 354 S.W.3d 764, 769 (Tex. 2011); Smith v. Nerium Int’l, LLC, No. 05-18-00617-CV, 2019 Tex. App. LEXIS 6741, at **15-16 (Tex. App.—Dallas Aug. 5, 2019, no pet.) (mem. op); Orbison v. Ma-Tex Rope Co., 553 S.W.3d 17, 43 (Tex. App.—Texarkana 2018, pet. denied); Neurodiagnostic Tex, L.L.C. v. Pierce, 506 S.W.3d 153, 164 (Tex. App.—Tyler 2016, no pet.). 39 As for irreparable harm, Anesthesia Associates argues that its live Petition
includes the language of the Employment Agreements wherein the CRNA
Defendants agreed that a material breach of the noncompete clause would result in
“irreparable, material, and adverse effect” on Anesthesia Associates. Anesthesia
Associates also asserts it has proven irreparable harm because a breach of a covenant
not to compete is the “epitome” of irreparable harm, and Dr. Callas’ testimony
provides sufficient evidence of irreparable harm supporting the trial court’s exercise
of its discretion in granting the temporary injunction.
Standard of Review
“A temporary injunction is an extraordinary remedy and does not issue as a
matter of right.” Abbott v. Anti-Defamation League Austin, Sw., & Texoma Regions,
610 S.W.3d 911, 916 (Tex. 2020) (quoting Walling v. Metcalfe, 863 S.W.2d 56, 57
(Tex. 1993)). Such an injunction functions “to preserve the status quo of the
litigation’s subject matter pending a trial on the merits.” Butnaru v. Ford Motor Co.,
84 S.W.3d 198, 204 (Tex. 2002) (op. on reh’g) (citing Walling, 863 S.W.2d at 57).
“To obtain a temporary injunction, the applicant must plead and prove three specific
elements: (1) a cause of action against the defendant; (2) a probable right to the relief
sought; and (3) a probable, imminent, and irreparable injury in the interim.” Id.
Because the temporary injunction only preserves the status quo pending final trial,
the trial court’s determination regarding whether to issue the temporary injunction
40 does not resolve the ultimate merits of the suit. Brooks v. Expo Chem. Co., 576
S.W.2d 369, 370 (Tex. 1979) (explaining that appellate review does not include “the
merits of the underlying case” but is “strictly limited to a determination of whether
there has been a clear abuse of discretion by the trial court in determining whether
the applicant is entitled to a preservation of the status quo pending trial on the
merits[]”). The assumption is that the evidence may well change between the
preliminary temporary-injunction stage of the proceeding and a final trial on the
merits. Davis v. Huey, 571 S.W.2d 859, 862 (Tex. 1978). Thus, the probability-of-
success requirement does not require an applicant to show that it will prevail at final
trial. Walling, 863 S.W.2d at 58. For purposes of a temporary injunction, “[a]n injury
is irreparable if the injured party cannot be adequately compensated in damages or
if the damages cannot be measured by any certain pecuniary standard.” Butnaru, 84
S.W.3d at 204. “An application for injunction is a request that a court exercise its
equitable jurisdiction, and in exercising that power the court balances competing
equities.” NMTC Corp. v. Conarroe, 99 S.W.3d 865, 868 (Tex. App.—Beaumont
2003, no pet.) (citing In re Gamble, 71 S.W.3d 313, 317 (Tex. 2002)).
In deciding whether to grant or deny an application for a temporary injunction,
trial courts are given discretion. Butnaru, 84 S.W.3d at 204 (citing Walling, 863
S.W.2d at 58). “A reviewing court should reverse an order granting injunctive relief
only if the trial court abused that discretion.” Id. The reviewing court may not
41 substitute its judgment for that of the trial court unless the trial court’s action was so
arbitrary that it exceeded the bounds of reasonable discretion. Id. Our abuse-of-
discretion review requires that we view the evidence in the light most favorable to
the trial court’s order and that we indulge every reasonable inference in its favor.
See Thomas v. Beaumont Heritage Soc’y, 296 S.W.3d 350, 352 (Tex. App.—
Beaumont 2009, no pet.). Our review is confined to the validity of the order. Id.
Also, “[w]hen the trial court embeds findings of fact and conclusions of law in its
order denying a temporary injunction, the findings and conclusions may be helpful
in determining whether the trial court exercised its discretion in a principled
fashion[;] however, they are not binding on this court.” Communicon, Ltd. v. Guy
Brown Fire & Safety, Inc., No. 02-17-00330-CV, 2018 Tex. App. LEXIS 2055, at
*17 (Tex. App.—Fort Worth Mar. 22, 2018, no pet.) (mem. op.) (citing Tom James
of Dallas, Inc. v. Cobb, 109 S.W.3d 877, 884 (Tex. App.—Dallas 2003, no pet.)).
“An abuse of discretion does not exist where the trial court bases its decisions on
conflicting evidence.” Davis, 571 S.W.2d at 862. If the trial court must resolve a
conflict in the evidence, its resolution of a fact issue is one to which we must defer.
Wright v. Sport Supply Grp., Inc., 137 S.W.3d 289, 292 (Tex. App.—Beaumont
2004, no pet.).
We first address the CRNA Defendants’ argument that Anesthesia Associates
is not entitled to a temporary injunction because it has failed to show it has a
42 legitimate business interest in restraining the CRNA Defendants from working at
CHRISTUS St. Elizabeth because Anesthesia Associates voluntarily terminated its
anesthesia contract with that hospital and admitted it would not compete for the
CHRISTUS St. Elizabeth’s business for at least six months. The trial court heard Dr.
Callas’ testimony that he had hoped to renegotiate Anesthesia Associates’ contract
with CHRISTUS but that CHRISTUS decided not to renegotiate, and that
Anesthesia Associates would still assist at CHRISTUS St. Elizabeth in an emergency
scenario. The trial court heard Dr. Callas testify that for at least six months
Anesthesia Associates is not going to be competing for the opportunity to provide
anesthesiology services at CHRISTUS because Anesthesia Associates is providing
services at Baptist Hospital. The trial court also heard testimony that CHRISTUS
had a six-month contract with Essential or EmergencHealth, a competitor of
Anesthesia Associates. Dr. Callas testified that Anesthesia Associates might be
competing with EmergencHealth after six months, and when asked if Anesthesia
Associates was no longer a competitor with EmergencHealth because he had
cancelled the contract, Dr. Callas answered, “I canceled the contract, but we’re still
always competitive.” Further, the evidence submitted at the hearing showed that the
Agreements signed by the CRNA Defendants stated that the noncompete clause
prevented them from working within 20 miles of where they had worked for
Anesthesia Associates for a period of three years. The trial court heard Dr. Callas
43 testify that he provided the CRNA Defendants with valuable training and experience
when they joined Anesthesia Associates directly out of school and that Anesthesia
Associates “gave them a lot of our institutional memory . . . important to improve
the delivery of anesthesia[,]” and that he “disclosed a lot” to Dubois and Mendoza
and “confided in them a lot of the business strategies that [Callas] utilize[s],
especially payment, recruiting, [and] compensation.” See Smith v. Nerium Int’l, LLC,
No. 05-18-00617-CV, 2019 Tex. App. LEXIS 6741, at *12 (Tex. App.—Dallas Aug.
5, 2019, no pet.) (mem. op) (“‘Business goodwill, confidential or proprietary
information, trade secrets, customer information, and specialized training are
examples of interests that can be, in appropriate circumstances, worthy of protection
by a covenant not to compete.’”) (quoting Neurodiagnostic Tex, L.L.C. v. Pierce,
506 S.W.3d 153, 164 (Tex. App.—Tyler 2016, no pet.)). Viewing all the evidence
in the light most favorable to the trial court’s order, the trial court could have
reasonably determined that Anesthesia Associates demonstrated that it had a
legitimate business interest in restraining the CRNA Defendants from working at
CHRISTUS St. Elizabeth in Beaumont.
Next, we address the CRNA Defendants’ argument that Anesthesia
Associates is not entitled to a temporary injunction because it has failed to show
there is irreparable harm, and damages are an adequate remedy. “‘An injury is
irreparable if the injured party cannot be adequately compensated in damages or if
44 the damages cannot be measured by any certain pecuniary standard.’” Poole v. U.S.
Money Reserve, Inc., No. 09-08-137 CV, 2008 Tex. App. LEXIS 8257, at *30 (Tex.
App.—Beaumont Oct. 30, 2008, no pet.) (mem. op.) (quoting Butnaru, 84 S.W.3d
at 204). “Damages are inadequate, so as to support a temporary injunction, if they
are difficult to calculate.” Id. at **30-31 (citing Rollins v. Universal Coin & Bullion
Ltd., No. 09-06-150 CV, 2006 Tex. App. LEXIS 8764, at *13 (Tex. App.—
Beaumont Oct. 12, 2006, no pet.) (mem. op.).
Anesthesia Associates notes in its Petition that each CRNA Defendant agreed
in their Employment Agreements that a breach of the noncompete clause would
cause Anesthesia Associates “an irreparable, material, and adverse effect . . . and
that such damages arising from any such breach or violation may be difficult to
ascertain.” The CRNA Defendants contend that Anesthesia Associates cannot rely
on this Court’s opinion in Dickerson v. Acadian Cypress & Hardwoods, Inc., No.
09-13-00299-CV, 2014 Tex. App. LEXIS 3889, at **16-17 (Tex. App.—Beaumont
Apr. 10, 2014, no pet.) (mem. op.), in claiming that Anesthesia Associates does not
have to prove irreparable injury. The CRNA Defendants argue that a parties’
contractual stipulation of irreparable injury is not binding on courts. The CRNA
Defendants maintain that two of our sister courts have rejected the argument that a
contractual stipulation of irreparable injury is binding on courts and, by itself, the
45 contractual stipulation is insufficient to support injunctive relief. 8 Anesthesia
Associates argues that a trial court can properly consider as evidence an employee’s
agreement that the employer lacks an adequate remedy and irreparable harm, which
is entirely consistent with our opinion in Dickerson. See 2014 Tex. App. LEXIS
3889, at **16-17.
This Court has previously explained in other cases that the language of a
parties’ agreement is one factor that the trial court can consider, along with the entire
record, in determining the reasonableness of a covenant in an employment
agreement, and this reasoning is consistent with other courts who have determined
that the agreement is some evidence to consider when analyzing covenants
containing similar acknowledgements. See id. at **16-17; Poole, 2008 Tex. App.
LEXIS 8257, at **23-24 & n.5.
8 Citing W.R. Grace & Co.–Conn v. Taylor, No. 14-06-01056-CV, 2007 Tex. App. LEXIS 3779, at *7 n.7 (Tex. App.—Houston [14th Dist.] May 17, 2007, no pet.) (mem. op.); Sec. Telecom Corp. v. Meziere, No. 05-95-01360-CV, 1996 Tex. App. LEXIS 806, at *6 (Tex. App.—Dallas Feb. 28, 1996, no writ) (not designated for publication). We note that the CRNA Defendants also cite to some out-of-state authorities in support of their argument that federal courts have also rejected the same argument. We find these cases distinguishable on their facts. That said, even assuming without deciding that the cases are factually analogous, we are not bound to follow them. See Penrod Drilling Corp. v. Williams, 868 S.W.2d 294, 296 (Tex. 1993) (explaining that while other federal or state court opinions might be persuasive authority, we “are obligated to follow only higher Texas courts and the United States Supreme Court[]”). 46 Also, there is a rebuttable presumption that an employer is suffering
irreparable injury when the employer produces some evidence that a highly-trained
employee is engaging in conduct of a continual breach of his or her covenant not to
compete. Cardinal Health Staffing Network, Inc. v. Bowen, 106 S.W.3d 230, 236
(Tex. App.—Houston [1st Dist.] 2003, no pet.) (citing Unitel Corp. v. Decker, 731
S.W.2d 636, 641 (Tex. App.—Houston [14th Dist.] 1987, no writ); Martin v. Linen
Sys. For Hosps., Inc., 671 S.W.2d 706, 709 (Tex. App.—Houston [1st Dist.] 1984,
no writ); Hartwell’s Office World, Inc. v. Systex Corp., 598 S.W.2d 636, 639 (Tex.
App.—Houston [14th Dist.] 1980, writ ref’d n.r.e.)). The trial court could have
reasonably concluded from the testimony at the hearings that the CRNAs each knew
they were breaching the noncompetition clause of their respective Employment
Agreements with Anesthesia Associates when they resigned and began working with
EmergencHealth. The CRNA Defendants testified they knew they had a
noncompetition agreement with a twenty-mile radius for three years, but each CRNA
Defendant had been told by their new employer that the new employer would take
care of paying all damages caused from their breach of the Agreement. Accordingly,
the trial court reasonably could have applied a presumption of irreparable injury. Id.
Dr. Callas also explained that the local university, Lamar University, does not have
a CRNA program and that it is difficult to recruit CRNAs to Southeast Texas. He
testified he has had to offer incentives to get CRNAs to come to Southeast Texas,
47 including signing bonuses as high as $100,000 to $150,000 or paying travel fees in
addition to hourly fees for contract employees living in areas such as Dallas, who
would have to travel back and forth to provide anesthesia services. According to Dr.
Callas, this has affected Anesthesia Associates’ “good will[,]” and finding
replacements “comes at an exorbitant amount of cost.” “Damages attributable to a
former employee’s competition and appropriation of goodwill can be difficult to
calculate.” Equine Sports Med. & Surgery Weatherford Div., PLLC v. Tipton, No.
02-19-00346-CV, 2020 Tex. App. LEXIS 8343, at *14 (Tex. App.—Fort Worth Oct.
22, 2020, no pet.) (mem. op.) (citing Tranter, Inc. v. Liss, No. 02-13-00167-CV,
2014 Tex. App. LEXIS 3398, at **27-28 (Tex. App.—Fort Worth Mar. 27, 2014,
no pet.) (mem. op.) (noting that “[i]n Texas, injury resulting from the breach of non-
compete covenants is the epitome of irreparable injury”) (quoting Daily Instruments
Corp. v. Heidt, 998 F.Supp. 2d 553, 569 (S.D. Tex. 2014))). Assigning a dollar
amount to intangibles such as loss of goodwill and office stability is challenging.
Frequent Flyer Depot, Inc. v. Am. Airlines, Inc., 281 S.W.3d 215, 228 (Tex. App.—
Fort Worth 2009, pet. denied). In testifying to the irreparable harm incurred by
Anesthesia Associates resulting from the CRNA Defendants leaving and working in
Beaumont for a competitor, Dr. Callas described the irreparable harm as:
Significant harm, irreplaceable damage and harm. First, the amount of morale in the community has totally changed because we are not only mom and pops, we’re not only brothers and sisters in this - - in this whole fight, but when you see the fragmentation and the 48 deterioration of a practice that’s been here since 1952, it’s very concerning and it’s - - the community’s very upset and appalled. The other thing I’ll tell you, the morale just with Anesthesia Associates right now, it’s very concerning. And then the big thing is that it’s cost an arm and a leg for us to continue to try to recruit and try to bring people here. We have literally went from being very competitive in the market to where we had to go above and beyond in order to try to keep not only our local CRNAs here but also try to recruit. Some of - - the package that we went from is that based on the guidelines of the CRNAs, that they recommended that we used to pay based on years of service; and there would be a number. We jumped all that up to 20 years of service. A starting CRNA in our practice right now is $367,550. That is way up more than we’ve ever done before. So - - and, also, too, not to talk about the emotional harm that it’s caused, the stress that we’re dealing with as a - - as a business that we’re being threatened because now I’m trying to find bodies in order to keep our business afloat, and we’ve been around forever. And so it’s a huge concern.
Dr. Callas also explained that when the CRNA Defendants left Anesthesia
Associates it harmed the community because it gives “a misconception that
A[nesthesia] A[ssociates’] brand is somehow falling apart; and, also, people like the
idea of having these CRNAs - - us working together as a team because we’ve been
doing it forever.”
On this record, considering the language of the Employment Agreements, the
CRNA Defendants’ acknowledgment of their breach of the noncompete provisions,
the rebuttable presumption of irreparable harm, along with Dr. Callas’ testimony as
to the irreparable harm to Anesthesia Associates caused by the CRNA Defendants
leaving Anesthesia Associates to work for EmergencHealth, we cannot say that the
49 trial court’s action was so arbitrary that it exceeded the bounds of reasonable
discretion in finding that Anesthesia Associates, prior to trial, had no adequate
remedy at law and would suffer an irreparable injury in the interim. See Butnaru, 84
S.W.3d at 204.
Last, we address the CRNA Defendants’ contention that in balancing the
equities of the parties, Anesthesia Associates will suffer little, if any, harm because
it voluntarily terminated its anesthesia contract with CHRISTUS St. Elizabeth
Hospital in Beaumont and admitted it will not compete for that business for at least
six months. “In balancing equities, a trial court may consider whether the degree of
injury to the applicant would be slight or significant if the temporary injunction were
erroneously denied, and whether the injury to the opposing party would be slight or
significant if the temporary injunction were erroneously granted.” NMTC Corp., 99
S.W.3d at 869 (citing Universal Health Servs., Inc. v. Thompson, 24 S.W.3d 570,
578 (Tex. App.—Austin 2000, no pet.)). Based on the evidence before the trial court,
we cannot say the trial court abused its discretion in balancing the equities and
finding that the equities weighed in Anesthesia Associates’ favor.
Viewing the evidence in the light most favorable to the trial court’s order and
indulging every reasonable inference in its favor, as we must, we cannot conclude
that the trial court abused its discretion in granting Anesthesia Associates’
application for temporary injunction against the CRNA Defendants. See Thomas,
50 296 S.W.3d at 352. We overrule the CRNA Defendants’ issue on appeal, and we
affirm the trial court’s order granting Anesthesia Associates a temporary injunction
against the CRNA Defendants.
AFFIRMED.
LEANNE JOHNSON Justice
Submitted on February 19, 2026 Opinion Delivered April 16, 2026
Before Golemon, C.J., Johnson and Wright, JJ.
Related
Cite This Page — Counsel Stack
Chad R. Dubois, Kenneth D. Simmons III, Monica Bentzen, and Lance T. Mendoza v. Anesthesia Associates, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chad-r-dubois-kenneth-d-simmons-iii-monica-bentzen-and-lance-t-txctapp9-2026.