Julio A. Hernandez and Rocio Martinez v. Enes M. Kanlic, M.D. El Paso County Hospital District D/B/A University Medical Center And Texas Tech Health Sciences Center

CourtCourt of Appeals of Texas
DecidedAugust 14, 2019
Docket08-18-00011-CV
StatusPublished

This text of Julio A. Hernandez and Rocio Martinez v. Enes M. Kanlic, M.D. El Paso County Hospital District D/B/A University Medical Center And Texas Tech Health Sciences Center (Julio A. Hernandez and Rocio Martinez v. Enes M. Kanlic, M.D. El Paso County Hospital District D/B/A University Medical Center And Texas Tech Health Sciences Center) 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.

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Julio A. Hernandez and Rocio Martinez v. Enes M. Kanlic, M.D. El Paso County Hospital District D/B/A University Medical Center And Texas Tech Health Sciences Center, (Tex. Ct. App. 2019).

Opinion

COURT OF APPEALS EIGHTH DISTRICT OF TEXAS EL PASO, TEXAS

§ JULIO A. HERNANDEZ AND No. 08-18-00011-CV ROCIO MARTINEZ, § Appeal from Appellants, § 448th District Court v. § of El Paso County, Texas ENES M. KANLIC, M.D., EL PASO § COUNTY HOSPITAL DISTRICT D/B/A (TC # 2016DCV3128) UNIVERSITY MEDICAL CENTER, § AND TEXAS TECH HEALTH SCIENCES CENTER, §

Appellees. §

OPINION

This appeal explores the complexities of whether to sue either a governmental employee

or governmental entity under the Texas Tort Claims Act’s election-of-remedies provision and pre-

suit notice requirements. The situation is further complicated here with the overlap of the Texas

Medical Liability Act with its expert report requirement. And these issues all swirl around the

different governmental employees found in the surgical theater of a public hospital served by a

medical school.

Tragically, Julio Hernandez was rendered a paraplegic following pelvic surgery at

University Medical Center, which is a public hospital run by the El Paso County Hospital District (and hereinafter “UMC”). The surgeon, Enes M. Kanlic, MD, was employed at the time by Texas

Tech University Health Sciences Center (“TTUHSC”). As we explain below, UMC, Dr. Kanlic,

and TTUHSC were all dismissed on what could be termed procedural motions--that is, motions

based on the failure to file an expert report, or failure to serve a notice of claim, or failure to sue

the correct party. The net result is that Hernandez lost his opportunity to litigate the merits of his

medical malpractice claim. While that result adds a second possible tragedy to this story, we are

precluded from granting any of the relief sought, and we affirm the judgment below.

BACKGROUND

The Claim

Julio Hernandez was injured in a vehicular accident and admitted to UMC. While at UMC,

Dr. Kanlic performed a surgery to repair Hernandez’s pelvis on August 18, 2014. Following the

surgery, Hernandez lost all feeling below the waist. The claim here, supported by the expert report

of a physician, is that during the pelvic surgery Hernandez’s lower spine was negligently

mispositioned with the use some device, such as a sandbag, so as to hyperextend the spine. This

restricted blood flow to his spinal cord which rendered him a paraplegic. For the purposes of this

appeal, we assume all these facts to be true, noting that none of the allegations have been proven

before a fact finder.

Pre-suit Notices

UMC is a governmental entity and as such enjoys governmental immunity. 1 Dr. Kanlic

was an employee of TTUHSC at the time of the surgery. TTUHSC is as arm of the State of Texas

1 Salcedo v. El Paso Hosp. Dist., 659 S.W.2d 30, 31 (Tex. 1983).

2 and enjoys sovereign immunity.2 The status of these parties presented Hernandez with distinct

hurdles in vindicating his rights.

The Texas Tort Claims Act (TTCA) governs suits against state agencies and governmental

units. TEX.CIV.PRAC.&REM.CODE ANN. § 101.025 (waiver of immunity to the extent of TTCA’s

provisions). Under the TTCA, a governmental entity is entitled to receive notice of a claim against

it “not later than six months after the day that the incident giving rise to the claim” that describes

the incident, its time and place, and the damages or injury. Id. at § 101.101(a). As an exception,

formal notice is excused if the governmental unit has actual notice that the claimant has received

some injury. Id. at § 101.101(c).

From our record, an attorney representing Hernandez and his wife, Rocio Martinez, sent a

notice letter to UMC on February 13, 2015, which would be within the six-month window. Our

record lacks any formal notice letter sent to TTUHSC or Dr. Kanlic, or proof of their actual

knowledge of the injury.3

The Lawsuit

Hernandez and his wife (who we collectively refer to as “Hernandez”) filed their suit on

August 16, 2016. They named Dr. Kanlic and UMC as defendants, but the pleading itself made

no substantive allegations against UMC. Instead, the pleading in its factual and liability sections,

uses to the singular term “Defendant” which refers only to Dr. Kanlic. UMC answered and

complained that the body of the petition made no substantive mention of UMC. Hernandez

responded by filing an amended petition, that added this single sentence allegation against UMC:

2 See Lowe v. Texas Tech University, 540 S.W.2d 297, 298 (Tex. 1976)(State universities are state agencies and share the State’s immunity); Texas Tech University Health Sciences Ctr.-El Paso v. Bustillos, 556 S.W.3d 394, 400 n.6 (Tex.App.--El Paso 2018, no pet.).

3 A separate body of law has developed around the requirements of that notice. See e.g. Cathey v. Booth, 900 S.W.2d 339, 340 (Tex. 1995).

3 Additionally, and in the alternative, EL PASO COUNTY HOSPITAL DISTRICT D/B/A UNIVERSITY MEDICAL CENTER is vicariously liable and directly liable for the negligence of its employees who dropped the plaintiff or otherwise mishandled the plaintiff resulting in injury to his spinal column resulting in paralysis. [bolding original]

UMC is Dismissed

Hernandez’s claim also implicates the Texas Medical Liability Act (TMLA), as UMC and

Dr. Kanlic are health care providers, the injury occurred during a medical procedure, and would

undoubtedly constitute a health care liability claim. TEX.CIV.PRAC.&REM.CODE ANN. §

74.351(a). The TMLA requires that within 120 days of when each defendant health care provider

files an answer that an “expert report” as to that provider must be served by the plaintiff.

TEX.CIV.PRAC.&REM.CODE ANN. § 74.001(a)(11)(12)(13)(definitions of health care institution,

health care provider, and health care liability claim). An “expert report” is statutorily defined as

one that “provides a fair summary of the expert’s opinions” regarding (1) the standard of care, (2)

how the health care provider failed to meet that standard, and (3) the causal relationship between

that failure and the injury, harm, or damages claimed. Id. at § 74.351(r)(6). The report must

distinctly address each health care defendant’s breach of the standard of care and how that breach

caused injury. Clapp v. Perez, 394 S.W.3d 254, 259 (Tex.App.--El Paso 2012, no pet.).

Hernandez filed a report directed at the conduct of Dr. Kanlic. It generally alleged that the

use of sandbags or other devices used to position Hernandez’s body were misused so as to cause

ischemia (loss of blood flow) in the nerves innervating the legs. The loss of blood flow caused

permanent injury to those nerves, rendering Hernandez a paraplegic. The report directs its

criticism exclusively at Dr. Kanlic, who is referred to a doctor employed by Texas Tech University.

After the deadline for filing reports passed, UMC filed a motion to dismiss the claim against it

based on the lack a report directed to the conduct of its employees. The record does not show that

4 Hernandez and his wife filed any responsive pleading to the motion to dismiss. The court granted

UMC’s motion. Our record does not contain the transcript of a hearing on that motion, but at a

later hearing Hernandez’s counsel stated that he agreed to the dismissal order.

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Julio A. Hernandez and Rocio Martinez v. Enes M. Kanlic, M.D. El Paso County Hospital District D/B/A University Medical Center And Texas Tech Health Sciences Center, Counsel Stack Legal Research, https://law.counselstack.com/opinion/julio-a-hernandez-and-rocio-martinez-v-enes-m-kanlic-md-el-paso-texapp-2019.