Opinion issued June 14, 2016.
In The
Court of Appeals For The
First District of Texas ———————————— NO. 01-16-00106-CV ——————————— PATRICK CHARLES, Appellant V. METHODIST HEALTH CENTERS D/B/A HOUSTON METHODIST SUGAR LAND HOSPITAL, Appellee
On Appeal from the 240th District Court Fort Bend County, Texas Trial Court Case No. 15-DCV-221990
MEMORANDUM OPINION
Appellant, Patrick Charles, is appealing the trial court’s dismissal of his suit
against appellee, Methodist Health Centers D/B/A Houston Methodist Sugar Land Hospital, pursuant to section 74.351 of the Texas Civil Practices and Remedies
Code. We affirm the trial court’s judgment.
Background
On March 17, 2015, appellant, proceeding pro se, filed suit against Methodist
alleging multiple claims, including negligence, neglect, elder abuse, and violations
of the Texas Human Resources Code. Specifically, appellant alleged that he was
admitted to Methodist on April 26, 2013 for prostate cancer surgery, and that while
he was recuperating after surgery, the hospital’s nursing staff ignored his repeated
pleas for assistance, denied him food and nourishment until appellant’s treating
physician intervened, and failed to render adequate care, in part, because they did
not promptly clean appellant.
Appellant further contends that he was admitted to Methodist on March 7,
2014 for treatment of complications from his 2013 prostate surgery. During that
hospital stay, appellant alleges that he soiled himself and was forced to remain in his
own waste and blood for an extended, and unacceptable, length of time because the
hospital’s nursing staff abandoned him with no bed pan or urinal and ignored his
repeated pleas for assistance. Appellant further contends that he developed a urinary
tract infection as a result of the nursing staff’s neglect and abuse, and that he is
suffering from depression as a result of the mistreatment he suffered at the hands of
the hospital’s staff.
2 On April 10, 2015, Methodist timely filed its original answer denying all of
appellant’s claims. After appellant failed to serve Methodist with an expert report
within 120 days of Methodist filing its answer in this case, Methodist moved to
dismiss appellant’s claims pursuant to Texas Civil Practice and Remedies Code
section 74.351. On September 9, 2015, the trial court held a hearing on Methodist’s
motion to dismiss and took the matter under advisement.
On January 21, 2015, the trial court held another hearing on Methodist’s
motion to dismiss for failure to file an expert report. Appellant acknowledges that
he attended the hearing and the record reflects that appellant subpoenaed two of
Methodist’s employees to testify at the hearing.1 No record was made of the hearing.
The following day, the trial court signed an order granting Methodist’s motion
to dismiss for failure to file an expert report and the trial court dismissed appellant’s
claims with prejudice on this basis. This appeal followed.
Dismissal for Failure to File Chapter 74 Expert Report
On appeal, appellant argues, among other things, that the trial court erred by
dismissing his suit without first addressing the merits of his claims and that the trial
court was biased against him, as reflected by the court’s refusal to allow two of
1 On January 19, 2015, Methodist filed a motion to quash the subpoenas, a motion for protection, and an objection to the subpoenas. The record does not reflect that the trial court ruled on Methodist’s motion.
3 appellant’s fact witnesses and a potential expert witness to testify at the January 21,
2015 hearing on Methodist’s motion to dismiss.2
A. Standard of Review
Generally, we review a trial court’s decision on a motion to dismiss a health
care liability claim for an abuse of discretion. See Am. Transitional Care Ctrs. of
Tex., Inc. v. Palacios, 46 S.W.3d 873, 875 (Tex. 2001). Whether a cause of action is
a health care liability claim, however, is a legal question that we review de novo.
Loaisiga v. Cerda, 379 S.W.3d 248, 254–55 (Tex. 2012). When determining whether
a claim is a health care liability claim, we focus on the facts underlying the claim
and not the language used in the plaintiff’s pleadings or the legal theories asserted.
Id. at 255.
B. Applicable Law
Pursuant to the Texas Medical Liability Act (TMLA), a claimant asserting a
health care liability claim must serve an expert report on the defendant within a
specified deadline and until that time, discovery is limited. TEX. CIV. PRAC. & REM.
CODE ANN. § 74.351(a),(c), & (s) (West Supp. 2015). If the claimant fails to serve
an expert report, the trial court must, on the defendant’s motion, dismiss the claims
2 Appellant also complains about alleged errors in the clerk’s record, including the district clerk’s classification of the disposition of his suit, and failure to give notice of Methodist’s motion to quash before the January 21, 2015 hearing. None of these alleged errors, however, impact the resolution of this appeal or the propriety of the trial court’s judgment.
4 with prejudice and award the defendant reasonable attorney’s fees and costs. Id.
§ 74.351(b) (West Supp. 2014). The TMLA defines a “health care liability claim”
as:
a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant, whether the claimant’s claim or cause of action sounds in tort or contract.
TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(13) (West Supp. 2015).
Under the TMLA, there is “‘a rebuttable presumption that a patient’s claims
against a physician or health care provider based on facts implicating the defendant’s
conduct during the course of a patient’s care, treatment, or confinement’ are health
care liability claims.” Bioderm Skin Care, LLC v. Sok, 426 S.W.3d 753, 758 (Tex.
2014) (quoting Loaisiga, 379 S.W.3d at 252). Furthermore, when multiple claims
against the same defendant are based on the same underlying facts encompassed by
provisions of the TMLA, all claims brought against that defendant based on those
facts must be brought as health care liability claims. Yamada v. Friend, 335 S.W.3d
192, 193–94 (Tex. 2010).
C. Analysis
We begin by noting that, although we construe pro se pleadings and briefs
liberally, we hold pro se litigants, such as appellant, to the same standards as licensed
attorneys and require them to comply with all applicable laws and rules of procedure.
5 See Mansfield State Bank v. Cohn, 573 S.W.2d 181, 184–85 (Tex. 1978); Cooper v.
Circle Ten Council Boy Scouts of Am., 254 S.W.3d 689, 693 (Tex. App.—Dallas
2008, no pet.). An indigent, pro se claimant who asserts a health care liability claim
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Opinion issued June 14, 2016.
In The
Court of Appeals For The
First District of Texas ———————————— NO. 01-16-00106-CV ——————————— PATRICK CHARLES, Appellant V. METHODIST HEALTH CENTERS D/B/A HOUSTON METHODIST SUGAR LAND HOSPITAL, Appellee
On Appeal from the 240th District Court Fort Bend County, Texas Trial Court Case No. 15-DCV-221990
MEMORANDUM OPINION
Appellant, Patrick Charles, is appealing the trial court’s dismissal of his suit
against appellee, Methodist Health Centers D/B/A Houston Methodist Sugar Land Hospital, pursuant to section 74.351 of the Texas Civil Practices and Remedies
Code. We affirm the trial court’s judgment.
Background
On March 17, 2015, appellant, proceeding pro se, filed suit against Methodist
alleging multiple claims, including negligence, neglect, elder abuse, and violations
of the Texas Human Resources Code. Specifically, appellant alleged that he was
admitted to Methodist on April 26, 2013 for prostate cancer surgery, and that while
he was recuperating after surgery, the hospital’s nursing staff ignored his repeated
pleas for assistance, denied him food and nourishment until appellant’s treating
physician intervened, and failed to render adequate care, in part, because they did
not promptly clean appellant.
Appellant further contends that he was admitted to Methodist on March 7,
2014 for treatment of complications from his 2013 prostate surgery. During that
hospital stay, appellant alleges that he soiled himself and was forced to remain in his
own waste and blood for an extended, and unacceptable, length of time because the
hospital’s nursing staff abandoned him with no bed pan or urinal and ignored his
repeated pleas for assistance. Appellant further contends that he developed a urinary
tract infection as a result of the nursing staff’s neglect and abuse, and that he is
suffering from depression as a result of the mistreatment he suffered at the hands of
the hospital’s staff.
2 On April 10, 2015, Methodist timely filed its original answer denying all of
appellant’s claims. After appellant failed to serve Methodist with an expert report
within 120 days of Methodist filing its answer in this case, Methodist moved to
dismiss appellant’s claims pursuant to Texas Civil Practice and Remedies Code
section 74.351. On September 9, 2015, the trial court held a hearing on Methodist’s
motion to dismiss and took the matter under advisement.
On January 21, 2015, the trial court held another hearing on Methodist’s
motion to dismiss for failure to file an expert report. Appellant acknowledges that
he attended the hearing and the record reflects that appellant subpoenaed two of
Methodist’s employees to testify at the hearing.1 No record was made of the hearing.
The following day, the trial court signed an order granting Methodist’s motion
to dismiss for failure to file an expert report and the trial court dismissed appellant’s
claims with prejudice on this basis. This appeal followed.
Dismissal for Failure to File Chapter 74 Expert Report
On appeal, appellant argues, among other things, that the trial court erred by
dismissing his suit without first addressing the merits of his claims and that the trial
court was biased against him, as reflected by the court’s refusal to allow two of
1 On January 19, 2015, Methodist filed a motion to quash the subpoenas, a motion for protection, and an objection to the subpoenas. The record does not reflect that the trial court ruled on Methodist’s motion.
3 appellant’s fact witnesses and a potential expert witness to testify at the January 21,
2015 hearing on Methodist’s motion to dismiss.2
A. Standard of Review
Generally, we review a trial court’s decision on a motion to dismiss a health
care liability claim for an abuse of discretion. See Am. Transitional Care Ctrs. of
Tex., Inc. v. Palacios, 46 S.W.3d 873, 875 (Tex. 2001). Whether a cause of action is
a health care liability claim, however, is a legal question that we review de novo.
Loaisiga v. Cerda, 379 S.W.3d 248, 254–55 (Tex. 2012). When determining whether
a claim is a health care liability claim, we focus on the facts underlying the claim
and not the language used in the plaintiff’s pleadings or the legal theories asserted.
Id. at 255.
B. Applicable Law
Pursuant to the Texas Medical Liability Act (TMLA), a claimant asserting a
health care liability claim must serve an expert report on the defendant within a
specified deadline and until that time, discovery is limited. TEX. CIV. PRAC. & REM.
CODE ANN. § 74.351(a),(c), & (s) (West Supp. 2015). If the claimant fails to serve
an expert report, the trial court must, on the defendant’s motion, dismiss the claims
2 Appellant also complains about alleged errors in the clerk’s record, including the district clerk’s classification of the disposition of his suit, and failure to give notice of Methodist’s motion to quash before the January 21, 2015 hearing. None of these alleged errors, however, impact the resolution of this appeal or the propriety of the trial court’s judgment.
4 with prejudice and award the defendant reasonable attorney’s fees and costs. Id.
§ 74.351(b) (West Supp. 2014). The TMLA defines a “health care liability claim”
as:
a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant, whether the claimant’s claim or cause of action sounds in tort or contract.
TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(13) (West Supp. 2015).
Under the TMLA, there is “‘a rebuttable presumption that a patient’s claims
against a physician or health care provider based on facts implicating the defendant’s
conduct during the course of a patient’s care, treatment, or confinement’ are health
care liability claims.” Bioderm Skin Care, LLC v. Sok, 426 S.W.3d 753, 758 (Tex.
2014) (quoting Loaisiga, 379 S.W.3d at 252). Furthermore, when multiple claims
against the same defendant are based on the same underlying facts encompassed by
provisions of the TMLA, all claims brought against that defendant based on those
facts must be brought as health care liability claims. Yamada v. Friend, 335 S.W.3d
192, 193–94 (Tex. 2010).
C. Analysis
We begin by noting that, although we construe pro se pleadings and briefs
liberally, we hold pro se litigants, such as appellant, to the same standards as licensed
attorneys and require them to comply with all applicable laws and rules of procedure.
5 See Mansfield State Bank v. Cohn, 573 S.W.2d 181, 184–85 (Tex. 1978); Cooper v.
Circle Ten Council Boy Scouts of Am., 254 S.W.3d 689, 693 (Tex. App.—Dallas
2008, no pet.). An indigent, pro se claimant who asserts a health care liability claim
is required to comply with the TMLA’s expert report requirement. See generally
Bankhead v. Spence, 314 S.W.3d 464, 467–69 (Tex. App.—Waco 2010, pet. denied)
(affirming dismissal of indigent pro se plaintiff’s health care liability claim for
failure to file expert report).
Appellant alleged that Methodist’s nursing staff abused, abandoned, and
neglected him, and violated his rights when he was Methodist’s patient by failing to
adequately provide for his basic health and safety needs, such as food and proper
hygiene. These allegations that Methodist departed from accepted standards of
health care and patient safety implicate Methodist’s conduct during the course of
appellant’s care and treatment when he was a patient, and, therefore, meet the
statutory definition of a health care liability claim. See TEX. CIV. PRAC. & REM. CODE
ANN. § 74.001(a)(13); see also Bioderm Skin Care, LLC, 426 S.W.3d at 758;
Loaisiga, 379 S.W.3d at 252.
Because all of appellant’s claims, including his elder abuse and statutory
violation claims, stem from the same set of facts relating to the post-surgical care
and treatment he received at Methodist while he was a patient, all the claims must
be brought as health care liability claims. See Yamada, 335 S.W.3d at 193–94; see
6 generally Shaw v. BMW Healthcare, Inc., 100 S.W.3d 8, 15 (Tex. App.—Tyler
2002, pet. denied) (holding patient could not bring claim for elder abuse separate
from his health care liability claim because claims arose from same set of facts).
Therefore, the TMLA required appellant to serve Methodist with a written expert
report within 120 days of Methodist filing its answer. See TEX. CIV. PRAC. & REM.
CODE ANN. § 74.351(a),(c),(r). It is undisputed that appellant never served Methodist
with an expert report. Because Methodist moved for dismissal based on appellant’s
failure to serve a timely expert report, the trial court was required to dismiss
appellant’s claims with prejudice. See id. § 74.351(b).
The trial court did not err or abuse its discretion by refusing to address the
merits of appellant’s complaints against Methodist or by refusing to allow
appellant’s witnesses to testify at the hearings on the motion because dismissal with
prejudice was required in this case. See Obstetrical & Gynecological Assocs., P.A.
v. McCoy, 283 S.W.3d 96, 101 (Tex. App.—Houston [14th Dist.] 2009, pet. denied)
(stating when plaintiff fails to comply with expert report requirement and defendant
moves to dismiss on that basis, “the trial court has no discretion to do anything other
than dismiss the case with prejudice”).
7 Conclusion
We affirm the trial court’s judgment.
Russell Lloyd Justice
Panel consists of Chief Justice Radack and Justices Jennings and Lloyd.