Opinion issued August 26, 2025
In The
Court of Appeals For The
First District of Texas ———————————— NO. 01-24-00399-CV ——————————— PATRICIA ORAMAS, Appellant V. THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON, Appellee
On Appeal from the 405th District Court Galveston County, Texas Trial Court Case No. 23-CV-1415
MEMORANDUM OPINION
This appeal involves a claim of medical malpractice against a state hospital.
Appellant Patricia Oramas, proceeding pro se, brought the claim against appellee
The University of Texas Medical Branch at Galveston after the death of her husband
Henry Oramas, who had been a Covid-19 patient. UTMB moved to dismiss the lawsuit when Oramas did not serve an expert report before the deadline under the
Texas Medical Liability Act. See TEX. CIV. PRAC. & REM. CODE § 74.351(a), (b)(2).
The trial court granted the motion and dismissed Oramas’s action with prejudice.
Oramas challenges the trial court’s judgment in 27 issues on appeal. We hold that
the trial court was compelled to grant UTMB’s motion because Oramas did not serve
the expert report before the statutory deadline. We affirm.
Background
As alleged in her petition, Oramas’s husband died in September 2021 while
admitted to UTMB for Covid-19 treatment. Oramas filed suit against UTMB and
two individual defendants. The two individuals soon dropped out of the case, leaving
UTMB as the lone defendant and appellee. UTMB filed its original answer on
September 29, 2023, which started the 120-day clock for Oramas to serve UTMB
with an expert report and the expert’s curriculum vitae. See id. § 74.351(a).
Oramas explains that she made diligent efforts to find a lawyer and that she
contacted many of them, but no one was willing to take her case. Thus, she has had
to go it alone. She then encountered similar challenges in finding an expert witness
who would support her claim of medical malpractice. Although she eventually found
an expert who wrote a report for her, this did not take place until weeks after the
120-day deadline.
2 The deadline to serve the required expert report and CV fell on January 29,
2024.1 See id. Oramas was unable to meet this deadline. The parties do not
necessarily see eye to eye on why, but the undeniable reality is that the deadline was
not met. The month of February went by without a report. In early March 2024,
UTMB moved to dismiss the lawsuit. See id. § 74.351(b)(2).
After the motion to dismiss was filed, Oramas served UTMB with an expert
report by Dr. Elaine Goldhammer. Oramas filed the report with the trial court in late
March 2024. UTMB admits that Oramas eventually filed this report, although
UTMB denies that the report included Dr. Goldhammer’s CV.
The trial court held a hearing on the motion to dismiss. UTMB discussed its
reasons for seeking dismissal, and Oramas discussed her reasons for opposing it. The
court did not rule on the spot. But it subsequently granted the motion, dismissed the
claims, and signed UTMB’s proposed order with one modification: the court struck
through the part of the order that would have awarded attorney’s fees and costs. 2
This appeal followed.
1 Because 120 days after UTMB filed its answer fell on a Saturday, the Rules of Civil Procedure extended the deadline to the following Monday. See TEX. R. CIV. P. 4. 2 On appeal, UTMB does not challenge the trial court’s denial of its request for attorney’s fees and costs. 3 Expert Report
First, UTMB argues that Oramas’s appellate brief fails to comply with the
briefing rules. In UTMB’s view, Oramas “failed to brief any issues and the issues
are waived.” UTMB argues that we should strike the brief and dismiss the appeal
“because [Oramas] failed to comply with the briefing rules and, thus, waived all
arguments she attempts to raise in this appeal.” We disagree.
The Rules of Appellate Procedure “require adequate briefing,” and a party’s
failure to comply with these rules can result in waiver. Bertucci v. Watkins, 709
S.W.3d 534, 541 (Tex. 2025) (quotation omitted); see TEX. R. APP. P. 38.1(i) (“The
brief must contain a clear and concise argument for the contentions made, with
appropriate citations to authorities and to the record.”). Pro se litigants are held to
the same standards as attorneys and must comply with all applicable and mandatory
rules of pleading and procedure. Morris v. Am. Home Mortg. Servicing, Inc., 360
S.W.3d 32, 36 (Tex. App.—Houston [1st Dist.] 2011, no pet.) (“To apply a different
set of rules to pro se litigants would be to give them an unfair advantage over litigants
represented by counsel.”).
But the Texas Supreme Court has repeatedly instructed that appellate courts
“should hesitate to resolve cases based on procedural defects and instead endeavor
to resolve cases on the merits.” Bertucci, 709 S.W.3d at 541–42 (quoting Lion
Copolymer Holdings, LLC v. Lion Polymers, LLC, 614 S.W.3d 729, 732 (Tex. 2020)
4 (per curiam)); see also Horton v. Stovall, 591 S.W.3d 567, 569 (Tex. 2019) (per
curiam) (“[B]riefs are to be liberally, but reasonably, construed so that the right to
appeal is not lost by waiver.”); Perry v. Cohen, 272 S.W.3d 585, 587 (Tex. 2008)
(per curiam) (“Simply stated, appellate courts should reach the merits of an appeal
whenever reasonably possible.”). “Whenever possible, we reject form-over-
substance requirements that favor procedural machinations over reaching the merits
of a case.” Bertucci, 709 S.W.3d at 542 (quotation omitted). “[S]ubstantial
compliance” with the briefing rules “is sufficient.” Horton, 591 S.W.3d at 569
(quoting TEX. R. APP. P. 38.9).
Oramas’s briefing cites numerous cases supporting her arguments, and she
explains her position well enough such that we can easily understand it. Had it been
written by a lawyer, the brief presumably would have had the customary features
and formatting; but it came from a pro se litigant, so we will not insist on the same
level of technical compliance with the briefing rules that we would require of an
attorney. See id. Oramas has laid out her position clearly, and she has done so in a
way that allows us to reach the legal arguments with no serious difficulty.3 Many
3 To the extent UTMB contends that Oramas’s brief did not provide record citations, we note that resolution of this appeal requires us to review only the file-stamped dates on which UTMB filed its answer and Oramas filed the expert report, and perhaps the pleadings for context. See TEX. CIV. PRAC. & REM. CODE § 74.351(a) (imposing 120-day deadline to file expert report after defendant files answer). We disagree with UTMB that doing so requires the Court to “abandon its role as a neutral adjudicator and become, in essence, an advocate for [Oramas].” 5 pro se briefs fall short of that standard, so we are unwilling to strike her briefing or
dismiss her appeal. We conclude that Oramas substantially complied with the
briefing rules. See TEX. R. APP. P. 38.9; Horton, 591 S.W.3d at 569.
Second, UTMB argues that the trial court ruled correctly in dismissing the
case pursuant to section 74.351 because of the failure to serve an expert report and
a CV before expiration of the 120 days. UTMB explains: “The Texas Supreme Court
and courts of appeals have repeatedly held that this statutory provision is mandatory
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Opinion issued August 26, 2025
In The
Court of Appeals For The
First District of Texas ———————————— NO. 01-24-00399-CV ——————————— PATRICIA ORAMAS, Appellant V. THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON, Appellee
On Appeal from the 405th District Court Galveston County, Texas Trial Court Case No. 23-CV-1415
MEMORANDUM OPINION
This appeal involves a claim of medical malpractice against a state hospital.
Appellant Patricia Oramas, proceeding pro se, brought the claim against appellee
The University of Texas Medical Branch at Galveston after the death of her husband
Henry Oramas, who had been a Covid-19 patient. UTMB moved to dismiss the lawsuit when Oramas did not serve an expert report before the deadline under the
Texas Medical Liability Act. See TEX. CIV. PRAC. & REM. CODE § 74.351(a), (b)(2).
The trial court granted the motion and dismissed Oramas’s action with prejudice.
Oramas challenges the trial court’s judgment in 27 issues on appeal. We hold that
the trial court was compelled to grant UTMB’s motion because Oramas did not serve
the expert report before the statutory deadline. We affirm.
Background
As alleged in her petition, Oramas’s husband died in September 2021 while
admitted to UTMB for Covid-19 treatment. Oramas filed suit against UTMB and
two individual defendants. The two individuals soon dropped out of the case, leaving
UTMB as the lone defendant and appellee. UTMB filed its original answer on
September 29, 2023, which started the 120-day clock for Oramas to serve UTMB
with an expert report and the expert’s curriculum vitae. See id. § 74.351(a).
Oramas explains that she made diligent efforts to find a lawyer and that she
contacted many of them, but no one was willing to take her case. Thus, she has had
to go it alone. She then encountered similar challenges in finding an expert witness
who would support her claim of medical malpractice. Although she eventually found
an expert who wrote a report for her, this did not take place until weeks after the
120-day deadline.
2 The deadline to serve the required expert report and CV fell on January 29,
2024.1 See id. Oramas was unable to meet this deadline. The parties do not
necessarily see eye to eye on why, but the undeniable reality is that the deadline was
not met. The month of February went by without a report. In early March 2024,
UTMB moved to dismiss the lawsuit. See id. § 74.351(b)(2).
After the motion to dismiss was filed, Oramas served UTMB with an expert
report by Dr. Elaine Goldhammer. Oramas filed the report with the trial court in late
March 2024. UTMB admits that Oramas eventually filed this report, although
UTMB denies that the report included Dr. Goldhammer’s CV.
The trial court held a hearing on the motion to dismiss. UTMB discussed its
reasons for seeking dismissal, and Oramas discussed her reasons for opposing it. The
court did not rule on the spot. But it subsequently granted the motion, dismissed the
claims, and signed UTMB’s proposed order with one modification: the court struck
through the part of the order that would have awarded attorney’s fees and costs. 2
This appeal followed.
1 Because 120 days after UTMB filed its answer fell on a Saturday, the Rules of Civil Procedure extended the deadline to the following Monday. See TEX. R. CIV. P. 4. 2 On appeal, UTMB does not challenge the trial court’s denial of its request for attorney’s fees and costs. 3 Expert Report
First, UTMB argues that Oramas’s appellate brief fails to comply with the
briefing rules. In UTMB’s view, Oramas “failed to brief any issues and the issues
are waived.” UTMB argues that we should strike the brief and dismiss the appeal
“because [Oramas] failed to comply with the briefing rules and, thus, waived all
arguments she attempts to raise in this appeal.” We disagree.
The Rules of Appellate Procedure “require adequate briefing,” and a party’s
failure to comply with these rules can result in waiver. Bertucci v. Watkins, 709
S.W.3d 534, 541 (Tex. 2025) (quotation omitted); see TEX. R. APP. P. 38.1(i) (“The
brief must contain a clear and concise argument for the contentions made, with
appropriate citations to authorities and to the record.”). Pro se litigants are held to
the same standards as attorneys and must comply with all applicable and mandatory
rules of pleading and procedure. Morris v. Am. Home Mortg. Servicing, Inc., 360
S.W.3d 32, 36 (Tex. App.—Houston [1st Dist.] 2011, no pet.) (“To apply a different
set of rules to pro se litigants would be to give them an unfair advantage over litigants
represented by counsel.”).
But the Texas Supreme Court has repeatedly instructed that appellate courts
“should hesitate to resolve cases based on procedural defects and instead endeavor
to resolve cases on the merits.” Bertucci, 709 S.W.3d at 541–42 (quoting Lion
Copolymer Holdings, LLC v. Lion Polymers, LLC, 614 S.W.3d 729, 732 (Tex. 2020)
4 (per curiam)); see also Horton v. Stovall, 591 S.W.3d 567, 569 (Tex. 2019) (per
curiam) (“[B]riefs are to be liberally, but reasonably, construed so that the right to
appeal is not lost by waiver.”); Perry v. Cohen, 272 S.W.3d 585, 587 (Tex. 2008)
(per curiam) (“Simply stated, appellate courts should reach the merits of an appeal
whenever reasonably possible.”). “Whenever possible, we reject form-over-
substance requirements that favor procedural machinations over reaching the merits
of a case.” Bertucci, 709 S.W.3d at 542 (quotation omitted). “[S]ubstantial
compliance” with the briefing rules “is sufficient.” Horton, 591 S.W.3d at 569
(quoting TEX. R. APP. P. 38.9).
Oramas’s briefing cites numerous cases supporting her arguments, and she
explains her position well enough such that we can easily understand it. Had it been
written by a lawyer, the brief presumably would have had the customary features
and formatting; but it came from a pro se litigant, so we will not insist on the same
level of technical compliance with the briefing rules that we would require of an
attorney. See id. Oramas has laid out her position clearly, and she has done so in a
way that allows us to reach the legal arguments with no serious difficulty.3 Many
3 To the extent UTMB contends that Oramas’s brief did not provide record citations, we note that resolution of this appeal requires us to review only the file-stamped dates on which UTMB filed its answer and Oramas filed the expert report, and perhaps the pleadings for context. See TEX. CIV. PRAC. & REM. CODE § 74.351(a) (imposing 120-day deadline to file expert report after defendant files answer). We disagree with UTMB that doing so requires the Court to “abandon its role as a neutral adjudicator and become, in essence, an advocate for [Oramas].” 5 pro se briefs fall short of that standard, so we are unwilling to strike her briefing or
dismiss her appeal. We conclude that Oramas substantially complied with the
briefing rules. See TEX. R. APP. P. 38.9; Horton, 591 S.W.3d at 569.
Second, UTMB argues that the trial court ruled correctly in dismissing the
case pursuant to section 74.351 because of the failure to serve an expert report and
a CV before expiration of the 120 days. UTMB explains: “The Texas Supreme Court
and courts of appeals have repeatedly held that this statutory provision is mandatory
in all health care liability claims and causes of action and requires strict compliance.
In addition, none of [Oramas’s] explanations for her failure to adhere to the statute
absolved her of having to comply with this expert report and CV service
requirement.” In UTMB’s view, “the trial court was required” to dismiss the case.
On this point, we agree with UTMB.
Because the 120-day requirement is statutory and thus presents an issue of
statutory interpretation, we review this issue de novo. See Randol Mill Pharmacy v.
Miller, 465 S.W.3d 612, 615 (Tex. 2015). Section 74.351 contains the requirement:
(a) In a health care liability claim, a claimant shall, not later than the 120th day after the date each defendant’s original answer is filed or a later date required under Section 74.353, serve on that party or the party’s attorney one or more expert reports, with a curriculum vitae of each expert listed in the report for each physician or health care provider against whom a liability claim is asserted. The date for serving the report may be extended by written agreement of the affected parties. . . .
6 (b) If, as to a defendant physician or health care provider, an expert report has not been served within the period specified by Subsection (a), the court, on the motion of the affected physician or health care provider, shall, subject to Subsection (c), enter an order that: **** (2) dismisses the claim with respect to the physician or health care provider, with prejudice to the refiling of the claim.
TEX. CIV. PRAC. & REM. CODE § 74.351(a), (b)(2).4
Under section 74.351, the trial court was absolutely required to dismiss the
case because Oramas did not serve UTMB with an expert report by January 29, 2024.
See id. This conclusion is not open to debate. If the trial court had had a choice, it
may have allowed Oramas to have her day in court before a jury of her peers. But
Texas law takes a very strict approach to this question. If a claimant in a health care
liability case wants a day in court, the claimant must serve an expert report with a
CV, or else the judge must dismiss the case. “Dismissal with prejudice is required if
an expert report is not timely served.” Baylor Scott & White, Hillcrest Med. Ctr. v.
Weems, 575 S.W.3d 357, 362 (Tex. 2019); see also Rusk State Hosp. v. Black, 392
S.W.3d 88, 93 (Tex. 2012) (“[A] court must dismiss a health care liability claim if
the plaintiff does not timely serve an expert report and the defendant physician or
health care provider properly objects.”).
4 The parties do not dispute that the 120-day deadline was not extended either by agreement or under Section 74.353. See id. 7 Oramas asks whether the statute is constitutional when it “slams the door
closed on justice for wrongful death cases against a state hospital by not allowing
the injured party to acquire a contingency attorney[.]” The Texas Supreme Court has
heard this argument before and found it wanting. The court has upheld the statute as
constitutional. See Stockton v. Offenbach, 336 S.W.3d 610, 618 (Tex. 2011). “When
a statute is unambiguous, our role is to apply it as written despite its imperfections.”
Id. at 619; see also Walker v. Gutierrez, 111 S.W.3d 56, 66 (Tex. 2003). This Court
has done likewise. Strom v. Memorial Hermann Hosp. Sys., 110 S.W.3d 216, 227
(Tex. App.—Houston [1st Dist.] 2003, pet. denied); Gill v. Russo, 39 S.W.3d 717,
718–19 (Tex. App.—Houston [1st Dist.] 2001, pet. denied); see also Wilson-Everett
v. Christus St. Joseph, 242 S.W.3d 799, 802–04 (Tex. App.—Houston [14th Dist.]
2007, pet. denied).
Oramas points out that this law can make life very difficult for pro se litigants
or for anyone who, for whatever reason, has trouble finding an expert within the 120
days. She beseeches the Court to recognize that her case has merit, that it is not
frivolous, and that the law was designed to filter out bad claims rather than good
ones like hers. In her view, the trial court was not required to dismiss the case.
This Court cannot rewrite a valid law passed by the people’s representatives.
See Badaracco v. Comm’r of Internal Revenue, 464 U.S. 386, 398 (1984) (“Courts
are not authorized to rewrite a statute because they might deem its effects susceptible
8 of improvement.”); Miles v. Tex. Cent. R.R. & Infrastructure, Inc., 647 S.W.3d 613,
624 (Tex. 2022) (“Of course, we may not rewrite statutes to broaden their
applicability beyond what the plain language encompasses.”). The law at issue here
leaves no room for judges to create exceptions to make the law more flexible or less
harsh. If the claimant fails to serve an expert report with a CV on a timely basis and
the health care provider moves for dismissal—which is what happened here—the
case cannot proceed to a trial. See TEX. CIV. PRAC. & REM. CODE § 74.351(b)(2).
This outcome remains the same regardless of whether the underlying claim has
genuine merit.
An airline passenger who tries to board a commercial flight without a boarding
pass will be kept off the plane, even if she bought a ticket. The gate agent will stop
the passenger from getting on board. Texas medical malpractice law works in a
similar way. It treats the expert report like the airlines treat a boarding pass. Without
timely serving an expert report, the litigant has not presented a boarding pass for
going to trial. When that happens, the judge has no choice but to dismiss the case,
even if the case has genuine merit. See id. For these reasons, although we reject any
suggestion that Oramas’s case is in fact frivolous, we conclude that the trial court
had no choice but to grant the motion to dismiss.
9 Conclusion
We decline to strike Oramas’s brief or dismiss her appeal. After fully
reviewing the entire record and both parties’ legal arguments, we affirm the trial
court’s judgment.
David Gunn Justice
Panel consists of Justices Guerra, Gunn, and Dokupil.