Gonzalez v. Padilla

485 S.W.3d 236, 2016 Tex. App. LEXIS 2203, 2016 WL 815449
CourtCourt of Appeals of Texas
DecidedMarch 2, 2016
DocketNo. 08-14-00286-CV
StatusPublished
Cited by36 cases

This text of 485 S.W.3d 236 (Gonzalez v. Padilla) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gonzalez v. Padilla, 485 S.W.3d 236, 2016 Tex. App. LEXIS 2203, 2016 WL 815449 (Tex. Ct. App. 2016).

Opinion

OPINION

YVONNE T. RODRIGUEZ, Justice

Appellee Oscar Padilla was struck by a [240]*240car while riding his motorcycle in El Paso.1 The accident left Padilla with a broken leg and a “de-gloved” heel totally devoid of any skin. After being stabilized at the University Medical Center (UMC) trauma ward, Padilla was discharged into the care of Highlands Clinic general practitioner Dr. Kevin Sandberg, who in turn referred Padilla to Dr. Omar Gonzalez, a rehabilitative specialist at SCCI Hospital, doing business as Kindred Hospital. Padilla was scheduled to receive three to four weeks of hyperbaric oxygen treatments to promote healing of the open wound, but Dr. Gonzalez discharged him after five days when Padilla failed to tolerate the treatments well. Neither doctor nor medical facility prescribed or administered antibiotics other than topical creams during the course of treatment, and the evidence is disputed as to what extent either doctor followed up after Padilla began receiving home health care. The open wound on Padilla’s de-gloved heel eventually became infected and gangrenous.' A month after his motorcycle accident, Padilla returned to UMC, where doctors amputated Padilla’s leg below the knee after making attempts to save it. Padilla and his wife Cecilia sued.

The question in this case is whether an expert report certifying merit, in which the Padillas’ medical expert alleged that Drs. Sandberg, Gonzalez, and their respective employers breached the standard of care, was- sufficient to allow the Padillas to survive a motion to dismiss. We agree with the trial court that the Padillas’ expert report was made in good faith and sufficiently demonstrated that the pleaded health care liability claims were- not wholly frivolous. As such, we affirm the trial court’s denial of the Appellants’ motions to strike and dismiss.

BACKGROUND

As required by the Texas Medical Liability Act, the Padillas-timely filed an expert report from Dr. Rathel Linwood “Skip” Nolan, a Mississippi-licensed, board certified infectious disease specialist and professor of medicine at the University of Mississippi Medical Center. In his report, Dr. Nolan stated that he had reviewed Padilla’s medical records and understood the course of Padilla’s treatment to be as follows.

On September 8, 2011, Padilla was struck on his motorcycle and taken to UMC with a broken leg and a de-gloved heel. At UMC:

[H]e underwent open reduction external fixation surgery of the compound, com-minuted fracture he suffered to his lower right leg. The procedure was a success and a ‘halo type’ fixation device [was] placed around the leg to hold the bones in place as the fracture healed.
Among other medications, UMC placed Mr. Padilla on IV antibiotics. These antibiotics included Gentamicin and Ce-fazolin (Ancef).[sic], Mr. Padilla received multiple doses of IV Gentamicin on September 8 and 9, 2011 and multiple doses of IV Cefazoline on September 9,12 and 13, 2011. At the time of his transfer from UMC on September 16, 2011, Mr. Padilla was prescribed IV Oefazolin for a 10 day period from September 12, 2011 through September 22, ■

UMC discharged Padilla into the care of Highlands for follow-up rehabilitative care on September 16, 2011. At that time, he had been .treated with daily wound care treatments and twice daily doses of Ancef. Padilla was in “fair” condition, and UMC [241]*241medical reports indicated that his injured leg showed “obvious evidence of continued blood flow, and there was no obvious necrosis beneath the heel tissue itself.”

Highlands’ medical records show that Padilla received topical antibiotics, but not oral antibiotics or the IV antibiotics prescribed by UMC. He also received wound care treatment with a “wound vac.” On September 28, 2011, twelve days after being admitted to Highlands, Padilla was transferred to Kindred’s Triumph facility2 for additional wound care treatments, including hyperbaric oxygen (HBO) • treatments. According to. their records, Triumph never administered oral or IV antibiotics. Although originally scheduled for a three, to four week course of treatment, Padilla did not tolerate the HBO treatments well. , Padilla requested additional treatment, but five days after admission, on October 3, 2011, Triumph discharged Padilla, still with an open wound and still wearing- the stabilization ■device on his leg. Dr. Nolan further stated in his report:

There is no indication in the Triumph medical records that Triumph timely put in place or implemented a comprehensive. treatment plan for Mr. Padilla. The first, attempt to do so took place very shortly before Mr. Padilla’s release from Triumph. However, due to Mr. Padilla’s release, Triumph made no attempt to implement the treatment plan. No effort was made to have him seen by a wound care specialist physicians or plastic surgeon prior to his return to UMC although his wound was high risk for development of an infection.

Padilla received home health care after leaving Triumph. Nine days after his discharge, on October 12, 2011, Padilla’s home health care service recommended he seek emergency room treatment for his leg. The emergency room physician at East El- Paso Physician’s Medical Center diagnosed a “serious infection in the leg and instructed Mr. Padilla to return to UMC for treatment.” Padilla returned to UMC, “where efforts were made to save his leg. However, due to the presence of gangrene Mr. Padilla’s leg could not be saved and on October 21, 2011, Mr. Padilla’s right leg was amputated below the knee.” '

Dr. Nolan’s expert report then contains five sections containing his findings, entitled “Standard of Care,” “Breach of the Standard of Care,” “Proximate Cause,” “Damages Proximately Caused by Breaches of the Applicable Standard of Care in the Treatment of Mr.-Padilla,” and “Summary.” In brief, Dr. Nolan accused Appellants of-failing to create a comprehensive treatment plan and failing to follow up. All Appellants objected to the report on various grounds, and requested' that the report be struck and the case dismissed with prejudice as a sanotion for the Padil-las’ failure to file a complaint expert report in good faith. After a hearing, the trial court denied Appellants’ request for relief. This appeal followed. We have interlocutory jurisdiction. Tbx.Civ.PRAc. & Rem. Code Ann. § 51.014(a)(8)(West Supp.2015).

DISCUSSION

The four Appellants in this case have collectively brought multiple issues before this Court, many with subparts. Appellants also, to a certain extent, incorporate each'óther’s briefs by reference. Their complaints can be broadly grouped into attacks on Dr. Nolan’s qualifications and assertions that his report was brought in bad faith and is too vague to give them or the trial e'ourt adequate notice- of what conduct Padilla specifically cdntends was [242]*242negligent. We agree with Padilla that Appellants have failed to provide any valid grounds for reversing the trial court’s decision.

A.

Standard of Review and Applicable Law

We review a trial court’s decision to dismiss a case on inadequate expert report grounds for abuse of discretion. Tenet Hosps., Ltd. v. Barajas, 451 S.W.3d 535, 539 (Tex.App.-El Paso 2014, no pet.).

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Cite This Page — Counsel Stack

Bluebook (online)
485 S.W.3d 236, 2016 Tex. App. LEXIS 2203, 2016 WL 815449, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gonzalez-v-padilla-texapp-2016.