The State of Texas v. Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, Nonparty Patient No. 5, Nonparty Patient No. 6, Nonparty Patient No. 7, and Nonparty Patient No. 8, Nonparty Patient No. 9, Nonparty Patient No. 10, and Nonparty Patient No. 11

Opinion

ACCEPTED 15-25-00023-CV FIFTEENTH COURT OF APPEALS AUSTIN, TEXAS 3/17/2025 10:39 PM No. 15-25-00023-CV CHRISTOPHER A. PRINE CLERK

In the Court of Appeals 15th COURT FILED IN OF APPEALS

for the Fifteenth Judicial District3/17/2025 10:39:00 PM AUSTIN, TEXAS

Austin, Texas CHRISTOPHER A. PRINE Clerk

The State of Texas, Appellant, v. Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, Nonparty Patient No. 5, Nonparty Patient No. 6, Nonparty Patient No. 7, Nonparty Patient No. 8, Nonparty Patient No. 9, Nonparty Patient No. 10, Nonparty Patient No. 11, Appellees.

On Appeal from the 95th Judicial District of Dallas County, Texas Cause No. DC-25-01823, Hon. Monica McCoy Purdy

APPELLANT’S RESPONSE TO APPELLEE’S EMERGENCY MOTION TO STAY DISCOVERY PENDING INTERLOCUTORY APPEAL

Ken Paxton Abigail E. Smith Attorney General of Texas Assistant Attorney General State Bar No. 24141756 Brent Webster First Assistant Attorney General ROB FARQUHARSON Assistant Attorney General Johnathan Stone State Bar No. 24100550 Chief, Consumer Protection Division State Bar No. 24071779 Office of the Attorney General Consumer Protection Division 12221 Merit Drive, Ste. 650 Dallas, Texas 75251 Tel: (214) 290-88969-761530 Fax: (214) 969-7615 Counsel for Appellant Table of Contents Page

Index of Authorities ................................................ Error! Bookmark not defined. BACKGROUND .................................................................................................... 1 A. The State Sues Doctors for Violating SB 14, the Ban on Transgender Treatments for Minors, in Collin County. ...................... 1 B. The Non-party Patients Sue the State in Dallas County Court ............2 C. The Non-party Patients Mislead the Collin County Court at Multiple Hearings; the Collin County Court Orders Production. ......................................................................................... 3 D. Non-party Patients Continue to Seek Duplicative Relief in an Alternate Venue .................................................................................. 6 Argument................................................................................................................ 7 I. There is no Emergency. ............................................................................. 8 II. No Relief Is Necessary to Preserve the Status Quo. ................................... 9 III. Appellees’ request for injunctive relief is moot. ....................................... 11 IV. Appellees’ request for injunctive relief is not in the interest of justice. ..................................................................................................... 12 Prayer ................................................................................................................... 13 Certificate of Service............................................................................................. 14 Certificate of Compliance ..................................................................................... 14 Relator’s Appendix ............................................................................................... 23

i To the Honorable Justices of the Fifteenth Court of Appeals: The only issue before the Court is the appropriateness of the Dallas County

Court’s denial of the State’s Plea to the Jurisdiction and Plea in Abatement. Despite that, Appellees seek another bite at the apple via an emergency motion. But the only thing emergent about it is Appellees’ ongoing and desperate desire to venue shop for a favorable ruling. Appellees’ emergency motion, in fact, merely ex- acerbates an already complicated situation they created for themselves, by choosing to seek identical protective relief in multiple courts—relief they have already secured

in the Collin County Court. Appellees’ emergency motion should be denied for at least three reasons: (1) there is no emergency, (2) the status quo is that, by court order and party agree- ment, a tranche of documents is currently due to be produced on March 21, 2025, and (3) a stay issued by this Court will not protect Appellees or the hospitals from production of documents in Collin County, where discovery is underway and over

which this Court does not currently have jurisdiction.

BACKGROUND The procedural history of this case is lengthy and complicated, but necessary to contextualize and explain the unreasonable nature of Appellee’s request.

A. The State Sues Doctors for Violating SB 14, the Ban on Transgender Treatments for Minors, in Collin County. On October 17, 2024, after an investigation, the State sued Dr. May C. Lau for violations of SB 14, the statewide ban on providing cross-sex hormones, puberty

1 blockers, and so-called gender-affirming surgeries to minors. The State filed its Orig- inal Petition and Request for Injunctive Relief in the 493rd Judicial District Court of

Collin County. App’x Ex. A. On November 4, 2024, the State filed a similar lawsuit against a different doctor, Dr. M. Brett Cooper, also with the 493rd Judicial District Court of Collin County. App’x Ex. B. Discovery in that case is ongoing and the court

has entered a protective order to ensure privacy of the minor patients involved and their medical records. App’x Ex. C. On January 16, 2025, the State noticed its intent to serve non-party subpoenas on Children’s Health System of Texas (“Children’s”) and the University of Texas Southwestern Medical Center (“UTSW”) seeking patient medical, prescribing, and billing records for 21 patients relating to the claims and defenses in the ongoing suit.

App’x Exs. D, E. The State later withdrew the subpoenas for UTSW and then reis- sued substantially similar subpoenas for UTSW on February 4, 2025. App’x Ex. F. For each subpoena, the State mailed notices to each of the patients whose medical records were subpoenaed to notify them of the lawsuit, the subpoena, and their rights under HIPAA and the Texas Rules of Evidence and Civil Procedure. 1

B. The Non-party Patients Sue the State in Dallas County Court After these notices were issued, 11 of the 21 patients whose records were sought in the Lau case retained counsel (“Non-party Patients”). These eleven patients are

currently the appellees in this matter. On February 3, 2025, rather than challenge the

1 For patient confidentiality and out of an overabundance of caution, the State has not attached those notices to this response but can provide redacted copies to the Court upon request.

2 subpoenas before the 493rd Court in Collin County, the Non-party Patients filed a petition in Dallas County seeking protection from production from the subpoenas

issued to Children’s and UTSW, pursuant to Tex. R. Civ. P. 176.6(e). App’x Ex. G.

C. The Non-party Patients Mislead the Collin County Court at Mul- tiple Hearings; the Collin County Court Orders Production. On February 28, 2025, the Collin County Court held a hearing, at which counsel for the Non-party Patients was a present and active participant. During the hearing,

counsel for the Non-party Patients told the Court that appropriate redactions and in camera production of documents by the Collin County court would satisfy its privacy concerns, and that should those requests be met, they would not oppose production. App’x Ex. H at 51:15–53:10, 94:11-95:15. He also represented that the Dallas County court had already “taken jurisdiction” over the subpoenas served on Children’s and UTSW. Id. at 74:17-19. This was incorrect: The Dallas County Court did not deter-

mine jurisdiction until 10 days later. App’x Ex. I (order denying the State’s Plea to the Jurisdiction, filed March 6, 2025). At this hearing, counsel for the Non-party Patients engaged in further discus- sions and negotiated with the Parties to narrow the scope of requested medical, pre- scribing, and billing records. The Collin County Court subsequently determined that records should be released in limited sequential tranches based on the needs of the

case. It then directed the parties and interested nonparties to confer on an agreeable method of production. Despite the aforementioned representations and participation, the very next

day—February 27, 2025—the Non-party Patients filed a motion in the Collin

3 County Court to stay production of discovery by Children’s and UTSW pending a ruling in the Dallas County proceedings. App’x Ex. J (Non-party Pts.’ Ver. Exp.

Mtn. to Stay Prod. From Hosp. Sys.) at 5–6. This motion sought protection from party discovery in a manner substantively identical to the relief sought in the Non- party Patients’ Dallas County lawsuit: a protective order, appropriate redactions, and an opportunity to review and segregate any proposed production for in camera review. Id. at 11–12. Much of this relief had already been provided in Collin County, as the Parties had already entered into a protective order on January 13, 2025, ad-

dressing all of these concerns. App’x Ex. K. The same day, counsel for the Non- party Patients noticed a hearing for March 12, 2025 in Dallas County, seeking a final judgment in the 95th District Court of Dallas County. On February 28, 2025, the Collin County Court held a second hearing in the Lau and Cooper lawsuits. Counsel for the Non-party Patients was, again, present and participated in negotiating a document production schedule that adequately ensured

the rights and interests of all patients, including the represented Non-party Patients, were properly protected. Counsel for the Parties, hospitals, and the Non-party Pa- tients reached an agreement on the process for production of the first tranche of rec-

ords. The Court memorialized this agreement in its February 28, 2025 Order. App’x Ex. K (Order to Produce Documents by March 11, Produce a Privilege Log, and Set- ting an in Camera Hearing). That order and agreement limited the scope of the rec- ords to the medical, prescribing, and billing records relating to testosterone and pu- berty blockers prescribed by Drs. Lau and Cooper from January 1, 2022, through the

4 present. To ensure the patients’ privacy rights are protected, Children’s and UTSW would release records for the (represented) Non-party Patients to their counsel to

assert privileges and objections. For unrepresented patients, their records would be released to counsel for the physicians to assert the physician-patient privilege on the patients’ behalf. See Tex. R. Evid. 509, 510. Records would only be produced to the State after all patients—represented and unrepresented—had the opportunity to mark privileged information for redaction and to produce a privilege log. If re- quested, the Collin County Court would then conduct an in-camera inspection of the

privilege assertions and set a hearing within 14 days to consider any challenges to the privilege assertions. The parties would reconvene thereafter to discuss the scope of a second tranche of records, if necessary. The Collin County Court expressly entered this February 28 order with the goal of providing all the relief sought by Non-party Patients in both Collin County and Dallas County. Despite this and notwithstanding his active participation in the ne-

gotiations, counsel for the Non-party Patients refused to agree to these final terms of discovery. In light of all this, the Collin County Court ultimately entered its February 28

order the objections of the Non-party Patients. In effort to prevent the entrance of a conflicting ruling by another court, the State then orally moved for protection from the Dallas County suit filed by the Non-party Patients. That motion was originally set to be heard on March 4 but, due to inclement weather shutting the courthouse that day, is currently set to be heard on March 20, 2025.

5 D. Non-party Patients Continue to Seek Duplicative Relief in an Al- ternate Venue Three hours after the February 28 hearing, and in an attempt to secure a ruling from the Dallas County Court before the Collin County Court could rule on the

State’s motion for protection, the Non-party Patients filed an Amended Notice of Hearing in Dallas County, moving their hearing regarding final judgment from March 12, 2025, up to March 6. App’x Ex. L (Nonparty Patients' 1st Amd Ntc of

Hrg (Mar. 6)). The State’s Answer was not due in the Dallas County suit until March 17, 2025. On March 3, 2025—without having filed an Answer—the State filed an Emer-

gency Plea to the Jurisdiction and Plea in Abatement in the Dallas County suit. App’x Ex. M. That motion is the sole subject of this interlocutory appeal. In its motion, the State asserted its sovereign immunity from suit in Dallas County and argued that the dominant jurisdiction doctrine applies; thus, as the matter was first-filed in Collin County, the Collin County Court has dominant jurisdiction and the Dallas County matter should be abated pending its resolution.

On March 6, 2025, the Dallas County hearing occurred. The Court first heard the State’s Emergency Plea to the Jurisdiction and Plea in Abatement, which it promptly denied. App’x Ex. N. The State immediately filed a Notice of Interlocutory

Appeal and notified the Court that all further proceedings were stayed pursuant to Texas Civil Practice and Remedies Code §51.014(b). App’x Ex. O.

6 Despite this, the Dallas County Court proceeded to hear argument from the Non-party Patients concerning their Petition for Protection from Discovery Subpoe-

nas. Having been divested of the jurisdiction to do so and without any deference for the Collin County Court’s February 28th Order regarding production of discovery, the Dallas County Court nevertheless entered a void (or voidable) order that “any

and all production obligations” with respect to the subpoenas served on the hospitals are stayed and that the hospitals shall not produce “any” documents to the State during the pendency of the appeal, thereby staying production not only for the Eleven represented patients, but for the other Ten patients who are not represented and did not object to the production of their information. App’x Ex. P. Although the Dallas County Court and the Non-party Patients attempt to couch this ruling as a

preservation of status quo, the status quo prior to the appeal was that pursuant to the agreement of the parties and non-parties, and in accordance with the Collin County Court’s prior Order, a production of records—including those from Children’s and UTSW—is impending. At a hearing on March 7, 2025, the Collin County Court reaffirmed its previous rulings concerning production of discovery; the first tranche of documents is due to be produced on March 21, 2025. Finally, on March 11, 2025, the Non-party Patients filed an Emergency Motion to Stay Discovery Pending Interlocutory Appeal in the Fifteenth Court of Appeals. This brief addresses that motion.

Argument Appellees’ emergency motion should be denied for three reasons.

7 First, there is no emergency, because all the appropriate relief sought by Non- party Patients was already provided by the Collin County Court.

Second, granting the Non-party Patients’ stay request would disrupt the status quo. Contrary to Appellee’s contention, the status quo for several weeks has been that pursuant to the agreement of the parties and nonparties in the Collin County parent case—including the Non-party Patients—and in accordance with an order of the Collin County District Court, a tranche of documents is currently due to be pro- duced on March 21, 2025. That now the Non-party Patients have apparently decided

they do not want this to occur, and are subsequently venue shopping for a different result, does not require emergency relief. Third, a stay issued by this Court is futile and therefore moot. It will not protect Appellees or the hospitals from production of documents in Collin County, where discovery is underway and ongoing and over which this Court has not taken jurisdic- tion. Indeed, jurisdiction over that case is impossible because as of this filing, no

party (or non-party) has appealed any ruling of the Collin County Court. Any one of these reasons is sufficient to deny the Non-party Patients’ motion. Together, the grounds for denial are crystal clear.

I. There is no Emergency. There is no emergency in this case and, indeed, there is no possibility of harm warranting relief. In the parent case to this lawsuit—the posture of which Appellees quietly and almost entirely omit—the Collin County Court has already provided Ap- pellees the exact injunctive relief they asked the Collin County Court for: a protective

order ensuring the privacy rights of all implicated patients, production of documents

8 appropriately tailored to the needs of the case, the opportunity to review documents and propose redactions, and the opportunity to request in camera review prior to pro-

duction. App’x Ex. K (February 28, 2025 Order). Further, counsel for Appellees affirmatively represented to the Collin County Court that the relief they sought would be satisfied through appropriate redactions and in camera production of doc- uments relevant to the issues of the litigation, and that should those requests be met, they would not oppose production. App’x Ex. H at 51:15–53:10, 94:11-95:15. Non-party Patients now seek even broader relief from this Court than they ever

sought in Collin County. Specifically, they ask this Court to enjoin the production of any records for any patient, including patients they do not represent. That request clearly exceeds that which was pled and is therefore not properly before this Court. Furthermore, as the Collin County Court’s February 28, 2025 Order makes clear and as explained supra at Background Section C, the various protective and discovery orders currently in place in Collin County provide the same protections to the med-

ical records of unrepresented patients as to the represented Non-party Patients. In sum, there is no imminent risk that any patient’s medical records will be im- properly disclosed without first being reviewed and redacted by counsel for the hos-

pitals, the Non-party Patients, the doctors (in the case of unrepresented patients), and ultimately the Collin County Court itself. There is therefore no emergency.

II. No Relief Is Necessary to Preserve the Status Quo. Appellees’ sole argument is that a stay is necessary to preserve the status quo during the pendency of the State’s appeal. But that conveniently leaves out that the

9 actual status quo is for production to go forward in Collin County, pursuant to the discovery agreement and protections that the parties agreed to.

Appellee’s motion implies that, if this Court does not act to stay production of discovery, the result will be the unregulated and unprotected relief of large swathes of patient medical records. As this brief’s lengthy Background discussion attests, that could not be further from the truth. While the initial wording of the State’s sub- poenas to UTSW and Children’s may have been broad, the State, counsel for the doctors, counsel for the hospitals, and counsel for the Non-party Patients all agreed to

significantly narrow the requested documents to those discussing “the care and treatment” Dr. Lau “provided or ordered for the patients relating to testosterone or puberty blockers from January 1, 2022, through the present.” App’x Ex. XX (Feb- ruary 28, 2025 Order). The Collin County Court further ordered that any such rec- ords shall first be redacted by the hospital, produced to counsel for Non-party Pa- tients (or to counsel for the doctors, for unrepresented patients) to propose addi-

tional redactions, and then produced to the Court for an in camera review to sign off on the final redacted copies before any documents are produced to the State. Id. That is the status quo for documents in this case. The status quo is not a stay of

all production, for at least two reasons. First, the Dallas County Court had no au- thority to issue a stay of document production in the first place because of the ulti- mate merits of this appeal—the State has sovereign immunity in Dallas County (though not in Collin County, where it filed suit), and regardless, the Collin County Court has dominant jurisdiction. But second, even without getting into the merits, this case was automatically stayed when the State appealed the denial of its Plea to

10 the Jurisdiction. See Tex. Civ. Prac. & Rem. Code §§ 51.014(a)(8), (b). The Dallas County Court issued a stay of all discovery after the State’s appeal was noticed, so

that ruling was moot and void (or voidable). It did not and could not affect the status quo of the proceedings in the Collin County Court.

III. Appellees’ request for injunctive relief is moot. An appeal is moot when appellate relief would be futile. Rice v. Rice, 533 S.W.3d 58, 61 (Tex. App.—Houston [14th Dist.] 2017, no pet.); see also Marshall v. Hous.

Auth. of City of San Antonio, 198 S.W.3d 782, 787 (Tex. 2006). Appellees’ request for emergency injunctive relief is futile for two reasons: It has already been satisfied and a stay issued by this Court will have no impact on the discovery underway in the Collin County parent case. First, as repeatedly made clear throughout this brief, the Collin County Court has already provided the relief Appellees seek and the only relief that is appropriate.

When asked if a regime of redactions and in camera review, paired with a protective order and a narrowed scope of documents to be produced, would be sufficient to satisfy Non-party Patients’ privacy concerns, counsel for Non-Party Patients an-

swered the Collin County Court in the affirmative. App’x Ex. XX at 51:15-53. And indeed, the protections and production ordered by the Collin County Court are ap- propriate. The underlying parent case—a case alleging illegal medical care provided by Dr. Lau—is a case whose claims center on medical records. As the Collin County Court has repeatedly made clear to all counsel, including counsel for Non-party Pa- tients, there will be some medical records produced, in some fashion; the Texas Rules of Evidence expressly contemplate production in this circumstance. Tex. R. Evid.

11 509-510. Barring the production of any medical records would violate the Rules of Evidence and completely frustrate the State’s lawsuit, as authorized by the Legisla-

ture’s passage of SB 14. Second, a stay from this Court would be futile because it would only apply to the Dallas County Court this case is appealed from. Non-party Patients have not ap- pealed any rulings of the Collin County Court, at least as of this filing. This Court therefore does not currently have jurisdiction over any of its proceedings, including discovery. And the Collin County Court has ordered the hospitals to produce medi-

cal records consistent with its February 28 Order. Thus, any stay from this Court would not prevent the production of medical records as requested by the Non-party Patients.

IV. Appellees’ request for injunctive relief is not in the interest of justice. The foregoing demonstrates that granting injunctive relief to Appellees is not in the interest of justice. In addition to the foregoing reasons, granting Appellees’ re- quest is not in the interest of justice where Appellees are unlikley to succeed on the merits. Sovereign immunity is not abrogated by Appellant in suits, like the one filed in Collin County, where the only damages sought are civil penalties, see Nazari v. State, 561 S.W.3d 495, 507 (Tex. 2018) (holding that the State “never” abrogates sovereign immunity when bringing suits seeking civil penalties), and Appellees have

not and cannot show a clear and unambiguous waiver of sovereign immunity, Texas Off. of Comptroller of Pub. Accts. v. Saito, 372 S.W.3d 311, 313 (Tex. App. 2012); Tex.

12 Gov’t Code § 311.034. In the absence of abrogation or a waiver of sovereign immun- ity, the trial court lacks subject matter jurisdiction, and Appellees’ suit should be dis-

missed.

Prayer The Court should deny the motion for stay and grant Appellant any other relief to which it is justly entitled.

Respectfully Submitted, Johnathan Stone Division Chief, Consumer Protection Ken Paxton Division Attorney General of Texas /s/ Abigail E. Smith Brent Webster First Assistant Attorney General Abigail E. Smith Assistant Attorney General Austin Kinghorn State Bar No. 24141756 Deputy Assistant Attorney General abby.smith@oag.texas.gov P.O. Box 12548 Office of the Attorney General Consumer Protection Division 12221 Merit Drive, Ste. 650 Dallas, Texas 75251 Tel: (214) 290-8830 Fax: (214) 969-7615

Counsel for Appellant

13 Certificate of Service On October 3, 2024, this document was served to all counsel of record via e-File.

/s/ Abigail E. Smith Abigail E. Smith

Certificate of Compliance Microsoft Word reports that this brief contains 3,344words, excluding the por-

tions of the brief exempted by Rule 9.4(i)(1).

/s/ Abigail E. Smith Abigail E. Smith

14 No. 15-25-00023-CV

In the Court of Appeals for the Fifteenth Judicial District Austin, Texas The State of Texas, Appellant, v. Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, Nonparty Patient No. 5, Nonparty Patient No. 6, Nonparty Patient No. 7, Nonparty Patient No. 8, Nonparty Patient No. 9, Nonparty Patient No. 10, Nonparty Patient No. 11, Appellees.

On Appeal from the 95th Judicial District of Dallas County, Texas Cause No. DC-25-01823, Hon. Monica McCoy Purdy

APPELLANT’S APPENDIX

Tab 1. Plaintiff’s Verified Original Petition and Request for an Application or Temporary and Permanent Injunctions (State v. Lau, 493rd District Court, Collin County), filed October 17, 2024 ................................................ A

2. Plaintiff’s Verified Original Petition and Request for Temporary and Permanent Injunctions (State v. Cooper, 493rd District Court, Collin County), filed November 4, 2024 ................................................................... B

3. Protective Order (State v. Lau and State v. Cooper, Collin County), J signed January 13, 2025 ................................................................................ C

4. State’s Notice of Subpoena to Children’s Health System of Texas (State v. Lau, Collin County), dated January 16, 2025 ...................... D

15 5. State’s Notice of Subpoena to Children’s Health System of Texas (State v. Lau, Collin County), dated January 16, 2025 ...................... E

6. State’s Notice of Subpoena to Children’s Health System of Texas (State v. Lau, Collin County), dated February 4, 2025 ..................... F

7. Nonparty Patients’ Petition for Motion for Protection from Discovery Subpoenas (Nonparty Patients v. State of Texas, Dallas County), filed February 2, 2025..................................................................................... G

8. Hearing Transcript (State v. Lau & State v. Cooper, Collin County), dated February 26, 2025 ................................................................................ H

9. Order Denying the State’s Plea to the Jurisdiction and Plea in Abatement (Nonparty Patients v. State of Texas, Dallas County)....................... I

10. The Nonparty Patients’ Verified Expedited Motion to Stay Productions from the Hospital Systems (State v. Lau, Collin County), ............................... J

11. Order (State v. Lau and State v. Cooper, Collin County), dated February 28, 2025 ........................................................................ K

12. Nonparty Patients’ First Amended Notice of Hearing (Nonparty Patients v. State of Texas, Dallas County), dated February 28, 2025 ........ L

13. The State of Texas’s Verified Emergency Plea to the Jurisdiction and Plea in Abatement (Nonparty Patients v. State of Texas, Dallas County) .......................................................................................M

14. Order Denying the State’s Plea to the Jurisdiction and Plea in Abatement (Nonparty Patients v. State of Texas, Dallas County), Signed March 6, 2025 ............................................................................ N

15. The State of Texas’s Notice of Appeal (Nonparty Patients v. State of Texas, Dallas County), filed March 6, 2025 ............................................ O

16 16. Order (Nonparty Patients v. State of Texas, Dallas County), signed March 6, 2025 .............................................................................. P

17 Exhibit A AM KJS 10/17/2024 10:44Electronically Served Filed: 10/18/2024 10:54 AM Michael Gould District Clerk Collin County, Texas By Jessica Peltier Deputy 493-07676-2024 Envelop ID: 93309242 CAUSE NO

THE STATE OF TEXAS, § IN THE DISTRICT COURT OF Plaintiff, § § § V. § COLLIN COUNTY, TEXAS § § MAY C. LAU, M.D., § Defendant. § JUDICIAL DISTRICT PLAINTIFF'S VERIFIED ORIGINAL PETITION AND REQUEST FOR AN APPLICATION FOR TEMPORARY AND PERMANENT INJUNCTIONS

1. The debate in Texas on the legality of dangerous and experimental medical

procedures seeking to transition or affirm a child's belief that their gender identity is inconsistent

with their biological sex is over.

2. Texas law prohibits surgeries, puberty blockers, and cross-sex hormones for the

purposes of transitioning a child's biological sex or affirming a child's belief that their gender

identity is inconsistent with their biological sex. Tex. Health & Safety Code § 161.702.

3. The Supreme Court of Texas held that the law was constitutional. State v. Loe, 692

S.W.3d 215 (Tex. 2024).

4. Today, enforcement begins against those who have violated the law by providing,

prescribing, administering, or dispensing cross-sex hormones to minors for the purposes of

transitioning their biological sex or affirming the child's belief that their gender identity is

inconsistent with their biological sex.

5. Plaintiff, STATE OF TEXAS, by and through the Attorney General of Texas, KEN

PAXTON, complains of Defendant, MAY C. LAU, M.D. and will show Lau has engaged in

deceptive trade practices, including by misleading pharmacies, insurance providers, and/or

1 Electronically Served 10/18/2024 10:54 AM

patients by falsifying medical records, prescriptions, and billing records to represent that her

testosterone prescriptions are for something other than transitioning a child’s biological sex or

affirming a child’s belief that their gender identity is inconsistent with their biological sex.

6. Lau is a scofflaw who is putting the health and safety of minors at risk by prescribing

testosterone, a controlled substance, to biological female minors for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex in violation of Tex. Health & Safety Code § 161.702(3). See Tex. Occ. Code §

164.052(a)(24) (each violation separately violates the Texas Medical Practice Act); see also Tex.

Occ. Code § 164.0552 (each violation serves as an independent ground for revocation of Lau’s

medical license).

7. Lau is also violating Tex. Bus. & Com. Code §§ 17. 46(a), (b)(5), (24), by engaging

in false, misleading, and deceptive acts and practices to mislead pharmacies, insurance providers,

and/or patients by falsifying medical records, prescriptions, and billing records to represent that

her testosterone prescriptions are for something other than transitioning a child’s biological sex or

affirming a child’s belief that their gender identity is inconsistent with their biological sex.

8. Lau must be held accountable for her use, on at least 21 minor patients, of these

illegal, dangerous, and experimental medical procedures for the purposes of transitioning their

biological sex or affirming their belief that their gender identities are inconsistent with their

biological sex.

I. PARTIES

9. Defendant is MAY C. LAU, M.D. (NPI# 1750351375), an employee of the

University of Texas Southwestern Medical Center (“UT Southwestern”) in Dallas, Texas. She

2 Electronically Served 10/18/2024 10:54 AM

holds hospital privileges at Childrens Medical Center Dallas and Children’s Medical Center Plano.

Lau may be served with process at UT Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390.

II. DISCOVERY CONTROL PLAN

10. Discovery in this case should be conducted under Level 3 pursuant to Tex. R. Civ.

P. 190.4. This case is not subject to the restrictions of expedited discovery under Tex. R. Civ. P.

169 because Texas seeks nonmonetary injunctive relief.

11. Additionally, Texas claims entitlement to monetary relief in an amount greater than

$1,000,000, including civil penalties, reasonable attorney’s fees, litigation expenses, restitution,

and costs.

III. JURISDICTION AND VENUE

12. Texas Occ. Code § 161.706(b) provides that venue is proper in “the county where

the violation occurred or is about to occur.”

13. Venue of this suit lies in Collin County, Texas pursuant to Texas Bus. & Com. Code

§ 17.47(b), because transactions forming the basis of this suit occurred in Collin County, Texas and

Lau’s unlawful conduct occurred in Collin County, Texas.

IV. PUBLIC INTEREST

14. Lau violated Tex. Health & Safety Code § 161.702, Tex. Bus. & Com. Code §

17.46(a) and is engaged in unlawful practices, as set forth in this petition.

15. Texas has reason to believe that Lau is engaging in, has engaged in or is about to

engage in, the unlawful acts or practices set forth below. Texas has further reason to believe Lau

has caused injury, loss, and damage to Texas by endangering the health of its citizens. Therefore,

3 Electronically Served 10/18/2024 10:54 AM

the Consumer Protection Division of the Office of the Attorney General of the State of Texas is of

the opinion that these proceedings are in the public interest.

V. TRADE AND COMMERCE

16. At all times described below, Lau engaged in conduct, the purported practice of

medicine, which constitutes “trade” and “commerce” as defined in Tex. Bus. & Com. Code §

17.45(6).

VI. NO NOTICE BEFORE SUIT

17. The Consumer Protection Division has reason to believe that Lau “is engaging in,

has engaged in, or is about to engage in any act or practice declared to be unlawful … and that

proceedings would be in the public interest….” Tex. Bus. & Com. Code § 17.47(a).

18. The Consumer Protection Division did not contact Lau before filing suit to notify

her “in general of the alleged unlawful conduct” because it is the opinion of the Consumer

Protection Division that Lau likely “would destroy” or alter “relevant records if prior contact were

made.” Id.

VII. APPLICABLE LAW

19. Texas Bus. & Com. Code § 17.46(a) prohibits “false, misleading, or deceptive acts

or practices in the conduct of any trade or commerce.”

20. Texas Bus. & Com. Code § 17.47 authorizes the Consumer Protection Division to

bring an action for temporary and permanent injunction whenever it has reason to believe that

any person is engaged in, in has engaged in, or is about to engage in any act or practice declared

unlawful under Chapter 17 of the Business and Commerce Code.

4 Electronically Served 10/18/2024 10:54 AM

VIII. FACTUAL BACKGROUND

A. Texas Prohibits the Provision of Puberty Blockers and Cross-Sex Hormones to Minors for the Treatment of Gender Dysphoria.

21. On May 17, 2023, the Legislature added Subchapter X to the Health and Safety

Code, entitled “Gender Transitioning and Gender Reassignment Procedures and Treatments for

Certain Children (SB 14).” Act of May 17, 2023, 88th Leg., R.S., ch. 335; Loe, 692 S.W.3d at 223.

22. Senate Bill 14 prohibits physician and health care providers from performing certain

procedures or treatments when performed to (1) “transition[] a child’s biological sex as

determined by the sex organs, chromosomes, and endogenous profiles of the child”; or (2)

“affirm[] the child’s perception of the child’s sex if that perception is inconsistent with the child’s

biological sex.” Tex. Health & Safety Code § 161.702.

23. The effective date for SB14 was September 1, 2023.

24. Senate Bill 14 added Tex. Health & Safety Code § 161.702(3), which prohibits

physicians from knowingly prescribing the following to transition a child’s biological sex or affirm

a child’s perception of their sex if it is different from their biological sex: “(A) puberty suppression

or blocking prescription drugs to stop or delay normal puberty; (B) supraphysiologic doses of

testosterone to females; or (C) supraphysiologic doses of estrogen to males.”

25. Physicians were permitted to prescribe to patients already subject to a continuing

course of treatment that began prior to June 1, 2023, and who attended at least 12 mental health

counseling or psychotherapy sessions over a period of at least six months prior to starting

treatment, provided that the prescriptions were for the purpose of “wean[ing] off the prescription

drug over a period of time and in a manner that is safe and medically appropriate and that minimizes

the risk of complications.” Tex. Health & Safety Code § 161.703(b)-(c).

5 Electronically Served 10/18/2024 10:54 AM

26. Senate Bill 14 also added Tex. Occ. Code § 164.052(a)(24), which proscribed

physicians from “perform[ing] a gender transitioning or gender reassignment procedure or

treatment in violation of [Tex. Health & Safety Code § 161.702].”

27. Finally, SB14 added Tex. Occ. Code § 164.0552, which commands that the Texas

Medical Board “shall revoke the license or other authorization to practice medicine of a physician

who violates [Tex. Health & Safety Code § 161.702].” (emphasis added).

B. The Texas Supreme Court Held That SB 14 is Constitutional.

28. Before SB 14 took effect several minors, parents of minors, and physicians brought

suit in Travis County, TX, alleging a variety of constitutional challenges to the law. Loe, 692

S.W.3d at 222.

29. On August 25, 2023, a Travis County District Court entered a temporary injunction

enjoining enforcement of SB 14. Id.

30. Texas appealed directly to the Texas Supreme Court, thereby dissolving the

temporary injunction. Id.

31. On September 1, 2023, the Texas Supreme Court allowed SB 14 to take effect

during the pendency of the appeal. Id.

32. On June 28, 2024, the Supreme Court of Texas reversed and vacated the trial

court’s Temporary Injunction Order after rejecting each of the plaintiffs’ constitutional challenges

to SB 14. Id. at 239.

6 Electronically Served 10/18/2024 10:54 AM

C. Lau is a Radical Gender Activist.

33. Lau “specializes in adolescent female and male sexual and reproductive health,

including … gender dysphoria ….” Biography of May Lau, M.D., UT Southwestern (accessed

October 8, 2024), https://tinyurl.com/259556bc.

34. Lau serves as “Medical Director of the Adolescent and Young Adult clinic at

Children’s Medical Center Dallas.” Id.

35. Lau has published extensively advocating for the medical transition of children’s

biological sex, contributing to the following:

i. Tri Pham, et al., Transition from Pediatric to Adult Care for Transgender Youth: A Qualitative Study of Patient, Parent, and Provider Perspectives, LGBT Health (May-Jun 2021), https://tinyurl.com/5n8jbc6n.

ii. Bethany G. Hart, et al., Developing a Curriculum on Transgender Health Care for Physician Assistant Students, Journal of Physician Assistant Education (Mar. 2021), https://tinyurl.com/mvbhyp8e.

iii. Lauren R. Shaffer, et al., Gender-affirming hormone therapy in cystic fibrosis – A case of new Pseudomonas infection, Respiratory Medicine Case Reports (2021), https://tinyurl.com/mv4jp85.

iv. Laura E. Kuper, et al., Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy, Pediatrics (2020), https://tinyurl.com/5n8s75v8.

v. Laura E. Kuper, et al., Baseline Mental Health and Psychosocial Functioning of Transgender Adolescents Seeking Gender-Affirming Hormone Therapy, Journal of Developmental and Behavioral Pediatrics (Oct/Nov 2019), https://tinyurl.com/4wxxzes5.

36. Approximately 20% of the publications listed in Lau’s biography relate to gender

transitioning. Biography of May Lau, M.D., https://tinyurl.com/259556bc.

7 Electronically Served 10/18/2024 10:54 AM

37. On January 8, 2020, Lau and her physician’s assistant, Patti Pagels MPAS, PA-C,

gave a presentation entitled Transgender Care of Adolescents and Adults, Youtube (Jan. 8, 2020),

https://tinyurl.com/mkt4pzs3 wherein they asserted:

i. That Lau alters her patient’s medical records to reflect their preferred name, sex, and pronouns, which can change on a visit-to-visit basis, something that is apparently “fairly typical [and] kind of persists into adulthood” for her patients. 20:59-22:40.

ii. That “adolescents’ gender identity is fluid so from one day or one point in time they say no, I’m this, I’m female, but then realize later on that I’m male.” 28:08-28.

iii. That “we’re not sure about the safety and long-term effects of puberty suppression in youth with gender dysphoria we do know that this is safe to use in youth with precocious puberty, but we don’t know if we can translate those side effects and the long-term effects to those with gender dysphoria and who are using puberty suppression for those reasons.” 28:28-46.

iv. That “some of the consequences of hormonotherapy are permanent.” 29:57-30:09.

v. That biological females that take testosterone to transition their biological sex “will get some atrophy of the vagina … [and thereafter for the duration of their life] they’ll need some sort of water-based lubricant if they’re going to still use the vagina as part of sex ….” 32:41-52.

vi. That “it’s so important that these folks get identified in childhood because when they come to me and are 30 or 40 years old and they’ve been under the influence of their gender hormones all this time it’s very hard to reverse it. I can’t take somebody that’s, you know, five-foot ten and very muscular uh and make them a woman overnight even if they use the clothing and so forth “33:05-39.

vii. That “testosterone is a powerful hormone, so I tell them that the effect of estrogen is like a feather, you know, just it’s just a whiff and whereas testosterone you give a little bit [and] you get a lot of effect.” 33:39-59.

viii. That “I want you to look at the graphic to see that the number of surgeries has increased and continue to increase and many of our patients … are getting them done. There are more surgeries for the affirm females than the affirm males and we may not know how many people actually are getting gender affirming surgery because some of them are going to Thailand,

8 Electronically Served 10/18/2024 10:54 AM

they’re going to Europe, they’re going to other counties to get this done because its much cheaper.” 37:37-38:13.

ix. “There’s a recent study May 2018 that suggests the timing of top surgery or breast surgery for affirm males should be based on physical and mental health status of the youth not by a specific age and I will tell you that we have had youth in our clinic come in who have had top surgery before they have even started hormone treatment.” 39:39-40:05 (emphasis added).

38. Lau was previously associated with the now dissolved Gender Education and Care

Interdisciplinary Support (GENECIS) Program, which was dedicated to using medical

interventions to transition the biological sex of children or affirm a child’s beliefs that their gender

identity is inconsistent with their biological sex. May Lau, M.D., and Patti Pagels MPAS, PA-C,

Transgender Care of Adolescents and Adults, Mid-Atlantic Chapter of the Medical Library

Association (Jan. 8, 2020), https://tinyurl.com/mry8wtv9.

39. Ximena Lopez, M.D., the founder of the GENECIS, shuttered the program and

high-tailed it to California shortly after SB 14 was enacted. Paul Hunter, Texas ban on gender-

affirming care leaves trans teens without options, CBC News (July 5, 2023),

https://tinyurl.com/4r6c8kr5 (Lopez declaring that medically transitioning children is “one of the

most important things I’ve done in my life” and stating that she was leaving Texas because she

thinks the whole state is “crazy.”).

40. Lopez and Lau are co-authors on several publications advocating for the medical

transition of minors diagnosed with gender dysphoria. Biography of May Lau, M.D.,

https://tinyurl.com/259556bc.

41. Lau and the staff of GENECIS were thanked for assisting with a medical student’s

dissertation on transitioning minors from their biological sex. Antoinette Moore, Health Related

9 Electronically Served 10/18/2024 10:54 AM

Quality of Life of Transgender Adolescents Undergoing Hormonal Transition or Elective Pubertal Delay,

UT Southwestern (2018), https://tinyurl.com/3y6jwv7y.

42. Lau’s practices, publications, and presentations betrays an entrenched

commitment to a gender ideology that desires to medically transition the biological sex of children

or affirm the belief that a child’s gender identity is inconsistent with their biological sex.

IX. VIOLATIONS OF SB 14.

43. Lau has knowingly violated Tex. Health & Safety Code § 161.702(3).

A. Cross-Sex Hormones to Transition Biological Sex or Affirm a Child’s Belief that their Gender Identity is Inconsistent with their Biological Sex.

44. High dose cross-sex hormones are commonly used by gender activists to transition

the biological sex of children or affirm a child’s belief that their gender identity is inconsistent with

their biological sex.

45. High dose cross-sex hormones are prescribed to induce a supraphysiologic state

where the hormone levels are greater than would otherwise normally be present in the child’s body.

46. As a result of the hormones, the child will develop secondary sex characteristics.

47. Testosterone is a cross-sex hormone that is prescribed to transition biological

females to biological females with irreversible male secondary sex characteristics.

48. Testosterone is a Schedule III controlled substance.

49. Radical gender activists within the medical profession rely on the so-called

“Standards of Care” promulgated by the World Professional Association of Transgender Health

(WPATH) as guidelines for transitioning the biological sex of children or affirming a child’s belief

that their gender identity is inconsistent with their biological sex. See e.g. Selena Simmons-Duffin,

Rachel Levine calls state anti-LGBTQ bills disturbing and dangerous to trans youth, NPR (Apr. 29,

10 Electronically Served 10/18/2024 10:54 AM

2022) (claiming that the standard for treating gender dysphoria is set by the WPATH),

https://tinyurl.com/3jxymtum.

50. WPATH recommends that a doctor transitioning the biological sex of children or

affirming a child’s belief that their gender identity is inconsistent with their biological sex prescribe

enough testosterone to induce the same level that would be present in a biological male. Standards

of Care 8, WPATH pg. 110 (2023), https://tinyurl.com/32z3bnhr.

B. Lau’s Testosterone Prescribing

51. WPATH recommends transitioning the biological sex of children or affirming a

child’s belief that their gender identity is inconsistent with their biological sex by prescribing

injectable testosterone cypionate at 100-200 mg. so as to induce a state of male puberty in a

biological female such that she will develop irreversible male secondary sex characteristics,

Standards of Care 8, WPATH App’x C, https://tinyurl.com/32z3bnhr.

52. WPATH recommends “induction of male puberty” in a biological female minor by

prescribing testosterone esters at “25mg/m2/2 weeks (or alternatively half this dose weekly).

Increase by 25 25mg/m2/2 weeks every 6 months until adult dose and target testosterone levels

achieved.” Id.

53. WPATH alternatively recommends the following testosterone regime for biological

females to induce male secondary sex characteristics, “testosterone enanthate/cypionate 50-100

IM/SQ weekly or 100-200 IM every 2 weeks.” Id.

54. A “testosterone cypionate injection is use[d] to treat males whose bodies do not

make enough natural testosterone, a condition called hypogonadism. Testosterone is a male

hormone responsible for the growth and development of the male sex organs and maintenance of

11 Electronically Served 10/18/2024 10:54 AM

secondary sex characteristics. This medicine is not for use in female patients.”

TESTOSTERONE CYPIONATE, Mayo Clinic (accessed October 15, 2024) (emphasis added),

https://tinyurl.com/558b8fcv.

55. The Federal and Drug Administration warns that testosterone cypionate “is

contraindicated in pregnant women and not indicated for use in females.” TESTOSTERONE

CYPIONATE INJECTION, FDA (June 2022) (emphasis added), https://tinyurl.com/4psvbdeb.

56. Lau has violated the law by providing, prescribing, administering, or dispensing

testosterone to minor patients for the purposes of transitioning their biological sex or affirming

their belief that their gender identity is inconsistent with their biological sex:

Patient One 1

57. Patient One resides in Collin County, TX.

58. Patient One was 17 years old during the relevant time.

59. Lau identifies Patient One as a biological female.

60. On October 2, 2023, after SB 14 went into effect, Lau wrote Patient One a

prescription for a 14-day supply of 200 mg/ml of testosterone cypionate.

61. The prescriptions purpose is for transitioning her biological sex or affirming her

belief that her gender identity is inconsistent with her biological sex.

62. On October 12, 2023, Patient One filled the prescription at a pharmacy located in

Collin County, TX.

63. Later, Patient One turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone.

1 Pseudonyms are used throughout to protect the identity of the victim minor patients.

12 Electronically Served 10/18/2024 10:54 AM

64. The prescriptions purpose is for transitioning her biological sex or affirming her

belief that their gender identity is inconsistent with her biological sex.

Patient Two

65. Patient Two resides in Collin County, TX.

66. Patient Two was 17 years old during the relevant time.

67. Lau identifies Patient Two as a biological female.

68. On October 9, 2023, after SB 14 went into effect, Lau wrote Patient Two a

prescription for a 90-day supply of 200 mg/ml of testosterone cypionate.

69. The prescriptions purpose is for transitioning her biological sex or affirming her

belief that her gender identity is inconsistent with her biological sex.

70. The same day, Patient Two filled the prescription at a pharmacy located in Collin

County, TX.

Patient Three

71. Patient Three resides in Denton County, TX.

72. Patient Three was 17 years old during the relevant time.

73. Lau identifies Patient Three as a biological male, but upon information and belief,

Patient Three may be a biological female.

74. On August 25, 2023, Lau wrote Patient Three a prescription for a 21-day supply of

200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

75. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

13 Electronically Served 10/18/2024 10:54 AM

76. On January 7, 2024, 135-days after the prescription was written and after SB 14 went

into effect, Patient Three filled the prescription at a pharmacy located in Denton County, TX.

77. On February 23, 2024, Lau wrote Patient Three a prescription for a 30-day supply

of 200 mg/ml of testosterone cypionate.

78. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

79. On February 25, 2024, Patient Three filled the prescription at a pharmacy located

in Denton County, TX.

80. Later, Patient Three turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone to them.

81. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

Patient Four

82. Patient Four resides in Dallas County, TX.

83. Patient Four was 16 during the relevant time.

84. Lau identifies Patient Four as a biological female.

85. On August 31, 2023, Lau wrote Patient Four two prescriptions for a 28-day supplies

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

86. The prescriptions purposes is for transitioning her biological sex or affirming her

belief that her gender identity is inconsistent with her biological sex.

87. On September 1, 2023, after SB 14 went into effect, Patient Four filled the

prescription at a pharmacy located in Travis County, TX.

14 Electronically Served 10/18/2024 10:54 AM

88. On October 28, 2023, Patient Four refilled the prescription at a pharmacy located

in Travis County, TX.

89. On March 26, 2024, Lau wrote Patient Four two prescriptions for a 28-day supply

of 200 mg/ml of testosterone cypionate.

90. On March 28, 2024, Patient Four filled the prescription at a pharmacy located in

Travis County, TX.

91. On July 26, 2024, Patient Four refilled the prescription at a pharmacy located in

Travis County, TX.

Patient Five

92. Patient Five resides in Collin County, TX.

93. Patient Five was 16 years old at the relevant time.

94. Lau identifies Patient Five as a biological male, but upon information and belief,

Patient Five may be a biological female.

95. On August 17, 2023, Lau wrote Patient Five a prescription for a 28-day supply of

200 mg/ml of testosterone cypionate with orders to fill the prescription both before and after SB

14 took effect.

96. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

97. On October 7, 2023, after SB 14 went into effect, Patient Five filled the prescription

at a pharmacy located in Collin County, TX.

98. On November 14, 2023, Lau wrote Patient Five a prescription with five refills for

28-day supplies of 200 mg/ml of testosterone cypionate.

15 Electronically Served 10/18/2024 10:54 AM

99. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

100. The same day, Patient Five filled the prescription at a pharmacy located in Collin

County, TX.

101. On December 11, 2023, Patient Five refilled the prescription at a pharmacy located

in Collin County, TX.

102. On January 17, 2024, Patient Five refilled the prescription at a pharmacy located in

Collin County, TX.

103. On March 11, 2024, Patient Five refilled the prescription at a pharmacy located in

Collin County, TX.

104. On April 12, 2024, Patient Five refilled the prescription at a pharmacy located in

Collin County, TX.

105. On June 21, 2024, Lau wrote Patient Five multiple prescriptions for 22-day supplies

of 200 mg/ml of testosterone cypionate.

106. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

107. On June 24, 2024, Patient Five filled the prescription a pharmacy located in Collin

County, TX.

108. On July 13, 2024, Patient Five refilled the prescription a pharmacy located in Collin

County, TX.

109. On August 18, 2024, Patient Five refilled the prescription a pharmacy located in

Collin County, TX.

16 Electronically Served 10/18/2024 10:54 AM

Patient Six

110. Patient Six resides in Collin County, TX.

111. Patient Six was 17 years old at the relevant time.

112. Lau identifies Patient Six as a biological male, but upon information and belief,

Patient Six may be a biological female.

113. On August 30, 2023, Lau wrote Patient Six one prescription with one refill for 84-

day supplies of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14

took effect.

114. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

115. On October 24, 2023, 55-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Six filled the prescription at a pharmacy located in Collin County, TX.

116. On January 22, 2024, Patient Six refilled the prescription at a pharmacy located in

Collin County, TX.

117. Later, Patient Six turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone to them.

118. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

Patient Seven

119. Patient Seven resided in Wise County, TX.

120. Patient Seven was 17 at the relevant time.

121. Lau identifies Patient Seven as a biological female.

17 Electronically Served 10/18/2024 10:54 AM

122. On August 31, 2023, Lau wrote Patient Seven a prescription for an 84-day supply

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

123. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

124. On September 1, 2023, after SB 14 went into effect, Patient Seven filled the

prescription at a pharmacy located in Wise County, TX.

125. Later, Patient Seven turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone to them.

126. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

Patient Eight

127. Patient Eight resides in Dallas County, TX.

128. Patient Eight was 16 years old at the relevant time.

129. Lau identifies Patient Eight as a biological male, but upon information and belief,

Patient Eight may be a biological female.

130. On August 28, 2023, Lau wrote Patient Eight a prescription for a 28-day supply of

200 mg/ml of Depo-testosterone with orders to fill the prescription after SB 14 took effect.

131. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

132. On October 16, 2023, 61-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Eight filled the prescription at a pharmacy located in Dallas County, TX.

18 Electronically Served 10/18/2024 10:54 AM

Patient Nine

133. Patient Nine resides in Dallas County, TX.

134. Patient Nine was 14 years old at the relevant time.

135. Lau identifies Patient Nine as a male, but upon information and belief, Patient Nine

may be a biological female.

136. On July 5, 2023, Lau wrote Patient Nine a prescription for a 21-day supply of 200

mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

137. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

138. On October 27, 2023, 114-days after Lau wrote the prescription and after SB 14

went into effect, Patient Nine filled the prescription at a pharmacy located in Dallas County, TX.

Patient Ten

139. Patient Ten resides in Tarrant County, TX.

140. Patient Ten was 14 years old at the relevant time.

141. Lau identifies Patient Ten as a biological female.

142. On August 29, 2023, Lau wrote Patient Ten two prescriptions for either a 7-day or

28-day supply of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB

14 took effect.

143. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

144. On October 2, 2023, after SB 14 went into effect, Patient Ten filled the prescription

at a pharmacy located in Tarrant County, TX.

19 Electronically Served 10/18/2024 10:54 AM

145. On November 1, 2023, Patient Ten refilled the prescription at a pharmacy located

in Tarrant County, TX.

146. On December 4, 2023, Patient Ten refilled the prescription at a pharmacy located

in Tarrant County, TX.

147. On January 5, 2024, Patient Ten filled the second prescription at a pharmacy

located in Tarrant County, TX.

148. On February 12, 2024, Patient Ten refilled the prescription at a pharmacy located

in Tarrant County, TX.

Patient Eleven

149. Patient Eleven resides in Kaufman County, TX.

150. Patient Eleven was 14 years old at the relevant time.

151. Lau identifies Patient Eleven as a biological female.

152. On August 29, 2023, Lau wrote Patient Eleven four prescriptions for 28-day

supplies of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took

effect.

153. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

154. On September 5, 2023, after SB 14 went into effect, Patient Eleven filled the

prescription at a pharmacy located in Kaufman County, TX.

155. On October 15, 2023, Patient Eleven refilled the prescription at a pharmacy located

in Kaufman County, TX.

20 Electronically Served 10/18/2024 10:54 AM

156. On November 17, 2023, Patient Eleven refilled the prescription at a pharmacy

located in Kaufman County, TX.

157. On January 7, 2024, Patient Eleven refilled the prescription at a pharmacy located

in Kaufman County, TX.

Patient Twelve

158. Patient Twelve resides in Rockwall County, TX.

159. Patient Twelve was 14 years old at the relevant time.

160. Lau identifies Patient Twelve as a biological female.

161. On August 31, 2023, Lau wrote Patient Twelve a prescription for a 90-day supply

of testosterone 1.62% Gel Pump with orders to fill the prescription after SB 14 took effect.

162. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

163. On January 19, 2024, 141-days after Lau wrote the prescription and after SB 14 took

effect, Patient Twelve filled the prescription at a pharmacy located in Rockwall County, TX.

Patient Thirteen

164. Patient Thirteen resides in Dallas County, TX.

165. Patient Thirteen was 15 years old at the relevant date.

166. Lau identifies Patient Thirteen as a biological female.

167. On July 11, 2023, Lau wrote Patient Thirteen several prescriptions for a 90-day

supply of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took

effect.

21 Electronically Served 10/18/2024 10:54 AM

168. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

169. On October 13, 2023, 94-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Thirteen refilled the prescription at a pharmacy located in Dallas County, TX.

Patient Fourteen

170. Patient Fourteen resides in Denton County, TX.

171. Patient Fourteen was 15 years old at the relevant time.

172. Lau identifies Patient Fourteen as a biological female.

173. On August 21, 2023, Lau wrote Patient Fourteen a prescription for a 34-day supply

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

174. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

175. On October 27, 2023, 67-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Fourteen filled the prescription at a pharmacy located in Denton County, TX.

Patient Fifteen

176. Patient Fifteen resides in Dallas County, TX.

177. Patient Fifteen was 15 years old at the relevant time.

178. Lau identifies Patient Fifteen as a biological female.

179. On June 23, 2023, Lau wrote Patient Fifteen a prescription for a 21-day supply of

200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

180. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

22 Electronically Served 10/18/2024 10:54 AM

181. On September 11, 2023, 80-days after Lau wrote the prescription and after SB 14

went into effect, Patient Fifteen filled the prescription at a pharmacy located in Dallas County, TX.

Patient Sixteen

182. Patient Sixteen resides in Tarrant County, TX.

183. Patient Sixteen was 15 years old at the relevant time.

184. Lau identifies Patient Sixteen as a biological female.

185. On August 23, 2023, Lau wrote Patient Sixteen a prescription for an 84-day supply

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

186. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

187. On January 7, 2024, 137-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Sixteen filled the prescription at a pharmacy located in Tarrant County, TX.

Patient Seventeen

188. Patient Seventeen resides in Potter County, TX.

189. Patient Seventeen was sixteen years old at the relevant time.

190. Lau identifies Patient Seventeen as a biological female.

191. On August 31, 2023, Lau wrote Patient Seventeen a prescription for a 42-day supply

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

192. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

193. On September 1, 2023, after SB 14 went into effect, Patient Seventeen filled the

prescription at a pharmacy located in Potter County, TX.

23 Electronically Served 10/18/2024 10:54 AM

Patient Eighteen

194. Patient Eighteen resides in Collin County, TX.

195. Patient Eighteen was 16 years old at the relevant time.

196. Lau identifies Patient Eighteen as a biological male, but upon information and belief,

Patient Eighteen may be a biological female.

197. On August 24, 2023, Lau wrote Patient Eighteen a prescription for an 80-day

supplies of 200 mg/ml of testosterone 12.5 mg/1.25 g with orders to fill the prescription after SB

14 took effect.

198. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

199. On October 27, 2023, 64-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Eighteen filled the prescription at a pharmacy located in Saint Louis County,

MO.

Patient Nineteen

200. Patient Nineteen resides in Collin County, TX.

201. Patient Nineteen was 16 years old at the relevant time.

202. Lau identifies Patient Nineteen as a biological male, but upon information and

belief, Patient Nineteen may be a biological female.

203. On August 31, 2023, Lau wrote Patient Nineteen a prescription for a 14-day supply

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

204. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

24 Electronically Served 10/18/2024 10:54 AM

205. On October 24, 2023, 54- days after Lau wrote the prescription and after SB 14 went

into effect, Patient Nineteen filled the prescription at a pharmacy located in Collin County, TX.

Patient Twenty

206. Patient Twenty resides in Dallas County, TX.

207. Patient Twenty was 17 years old at the relevant time.

208. Lau identifies Patient Twenty as a biological female.

209. On August 31, 2023, Lau wrote Patient Twenty a prescription for a 21-day supply

of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

210. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

211. On November 22, 2023, 83-days after Lau wrote the prescription and after SB 14

went into effect, Patient Twenty filled the prescription at a pharmacy located in Dallas County,

TX.

Patient Twenty-One

212. Patient Twenty-one resides in Dallas County, TX.

213. Patient Twenty-one was 17 years old at the relevant time.

214. Lau identifies Patient Twenty-one as a biological female.

215. On August 15, 2023, Lau wrote Patient Twenty-one a prescription for a 14-day

supply of 200 mg/ml of testosterone cypionate with orders to fill the prescription after SB 14 took

effect.

216. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

25 Electronically Served 10/18/2024 10:54 AM

217. On September 10, 2023, after SB 14 went into effect, Patient Twenty-one filled the

prescription at a pharmacy located in Dallas County, TX.

218. Later, Lau identifies the now 18-year-old Patient Twenty-one, as a biological male.

***

219. Paragraphs 58-219 describe 21 minor patients who Lau has unlawfully treated with

testosterone for the purposes of transitioning their biological sex or affirming their belief that their

gender identity is inconsistent with their biological sex in violation of SB 14.

220. Some of Lau’s medical records for the patients identified in the preceding

paragraphs indicate that the patients are male, but upon information and belief, all of these

patients are biological females and Lau is prescribing to them for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex. See also supra ¶ 37(i) (Lau admitting that she commonly changes the biological sex

of her patients in her medical records).

221. Lau cannot circumvent SB 14 by writing prescriptions to her patients prior to the

SB 14 taking effect with orders to fill or refill the prescriptions after it takes effect, see 22 Tex.

Admin. Code § 315.3(b)(2) (Schedule III Controlled Substances can be refilled up to five times

within six months of the date of issuance), because a “prescription” order is not a singular discrete

act, but a continuing act of treatment that begins with the prescription being written and continues

through the pharmacist filling the prescription and the drug being used as directed by the patient,

or until the written prescription expires or is cancelled, and alternatively, because by issuing

prescriptions with orders to fill them after the effective date of SB 14 Lau is “providing” the

26 Electronically Served 10/18/2024 10:54 AM

prescribed medication to the patient at the time they fill and use the prescription as directed, which

they could not do otherwise without the prescription.

222. Each and every prescription written by Lau after September 1, 2023, or filled or

taken as directed by a patient after September 1, 2023, for the purpose of transitioning the minor’s

biological sex or affirming their belief that their gender identity is inconsistent with their biological

sex violates Tex. Health & Safety Code § 161.702(3).

X. FALSE, MISLEADING, OR DECEPTIVE ACTS

223. Texas incorporates and adopts by reference the allegations contained in each and

every preceding paragraph of this Petition.

224. Lau, as alleged herein, has in the course of trade and commerce engaged in false,

misleading, and deceptive acts and practices declared unlawful in violation of Tex. Bus. & Com.

Code §§ 17. 46(a), (b)(5), (24).

225. Texas Bus. & Com. Code § 17.46(a) prohibits “false, misleading, or deceptive acts

or practices in the conduct of any trade or commerce.”

226. As illustrated in the representative example below, Lau deceptively misleads

pharmacies, insurance providers, and/or the patients by falsifying patient medical records,

prescriptions, and billing records to indicate that the use of puberty blockers for minor patients are

for something other than transitioning their biological sex or affirming their belief that their gender

identity is inconsistent with their biological sex.

227. Lau also likely deceptively misled pharmacies, insurance providers and/or the

patients by falsifying patient medical records, prescriptions and billing records to indicate the use

of Testosterone for minor Patients One through Twenty-one for something other than

27 Electronically Served 10/18/2024 10:54 AM

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

228. Texas Bus. & Com. Code § 17.46(b)(5) prohibits “representing that goods or

services have sponsorship, approval, characteristics, ingredients, uses, benefits, or quantities

which they do not have or that a person has a sponsorship, approval, status, affiliation, or

connection which the person does not.”

229. As illustrated in the representative example below, Lau deceptively represents that

goods or services have approval, characteristics, uses, or benefits which they do not or that a person

has a sponsorship, approval, status, affiliation, or connection which the person does not have by

falsifying patient medical records, prescriptions, and billing records for something other than

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

230. Texas Bus. & Com. Code § 17.46(b)(24) prohibits “failing to disclose information

concerning goods or services which was known at the time of the transaction if such failure to

disclose such information was intended to induce the consumer into a transaction if such failure to

disclose such information was intended to induce the consumer into a transaction into which the

consumer would not have entered had the information been disclosed.”

231. As illustrated in the representative example below, Lau deceptively induces

pharmacies, insurance providers, and/or the patients into entering into transactions by falsifying

patient medical records, prescriptions, and billing records to indicate that treatments are for

something other than transitioning a child’s biological sex or affirming their belief that their gender

identity is inconsistent with their biological sex.

28 Electronically Served 10/18/2024 10:54 AM

A. Lau uses false diagnoses and billing codes on transgender patients.

Patient Twenty-Two

232. Patient Twenty-Two, a 15-year-old minor, was first seen by Lau in January 2023.

233. Lau represented that Twenty-two was identified in the medical records as a male at

the time.

234. Lau falsely billed Patient Twenty-Two’s insurance using the diagnostic code for an

endocrine disorder, unspecified (E349).

235. In fact, Lau diagnosed Twenty-two with gender dysphoria and began “treatment”

for that condition by prescribing and inserting a puberty blocker device in the patient for the

purposes of transitioning their biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

236. On August 3, 2023, Lau changed Twenty-two’s sex to female in the medical and

billing records—further proof that Lau was transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

237. Less than a week later, Twenty-two met with Lowell, the founder of Queer Med

and who exclusively treats transgender patients, see What We Do, QueerMed (accessed October 8,

2024), https://tinyurl.com/2rr2ff7e, for a fertility preservation counseling visit.

238. Lowell used the same false diagnostic billing code for endocrine disorder,

unspecified (E349), when she was actually providing treatment to Patient Twenty-Two for the

purposes of transitioning their biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

29 Electronically Served 10/18/2024 10:54 AM

239. Two weeks later, on August 18, 2023, Twenty-two visited Lau who falsely billed for

the removal and reinsertion of a puberty blocker for the treatment of an endocrine disorder,

unspecified (E349)—when in fact Lau was using puberty blockers for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex.

240. The same day, Twenty-two was seen by a different provider at Children’s Medical

Center of Dallas who correctly used billing codes for gender identity disorder, unspecified (F649).

241. Patient Twenty-Two had follow up visits with Lowell of QueerMed in January and

March 2024, where her diagnosis was again falsely billed as an endocrine disorder, unspecified

(E349).

242. Thus, even prior to September 1, 2023, and despite other providers correctly

diagnosing Twenty-two with gender identity disorder, unspecified (F649), Drs. Lau and Lowell

demonstrated a pattern of false, misleading, and deceptive acts by choosing to falsify Patient

Twenty-Two’s biological sex, medical records, diagnoses, treatment plan, prescriptions, and

billing records to conceal that they were transitioning Patient Twenty-Two’s biological sex or

affirming their belief that their gender identity is inconsistent with their biological sex.

B. Gender dysphoria is not an endocrine disorder.

243. “Insurance Coding Alternatives for Trans Healthcare,” Campaign for Southern

Equality (accessed October 8, 2024), https://tinyurl.com/5ce62v2d, purports to assist healthcare

providers with instructions on how to use false billing codes to provide medical treatments for the

purposes of transitioning a minor’s biological sex or affirming their belief that their gender identity

is inconsistent with their biological sex.

30 Electronically Served 10/18/2024 10:54 AM

244. The fact sheet claims that it is intended to “assist trans people in advocating for

themselves with their healthcare providers and insurance companies” and discusses “insurance

codes for trans healthcare that are commonly accepted and rejected.” Id.

245. The fact sheet notes certain billing codes that are commonly rejected by insurance

providers include the F64 set of codes for gender dysphoria or gender identity disorder. Id.

246. The fact sheet recommends billing for hormone replacement therapy to transition

a minor’s biological sex as an endocrine disorder, unspecified (E34.9).

247. Upon information and belief, Lau is using this diagnostic billing code to falsely

represent that she’s treating patients for an unspecified endocrine disorder, when in fact she is

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex—something that is not an endocrine disorder.

248. An endocrine disorder results from the improper function of the endocrine system.

249. Children normally enter puberty reflecting their biological sex. There is no disorder

at all. Rather, the disorder results when a physician intervenes in a child’s natural puberty to induce

through puberty blockers and cross-sex hormones a state of puberty naturally occurring in the

opposite sex. Such physician causes a disorder rather than treats one, by introducing

supraphysiological dose of a cross-sex hormone to force a child’s body (a biological reality) to fit

that child’s gender identity (a mental construct).

250. Here, Lau is engaging in false, misleading, or deceptive practices, by falsely

diagnosing and billing patients using the endocrine disorder, unspecified, code instead of the F64

gender related diagnosis codes to conceal that she is transitioning their biological sex or affirming

31 Electronically Served 10/18/2024 10:54 AM

their belief that their gender identity is inconsistent with their biological sex in violation of Tex.

Bus. & Com. Code §§ 17. 46(a), (b)(5), (24).

XI. APPLICATION FOR TEMPORARY AND PERMANENT INJUNCTIONS

251. Texas incorporates and adopts by reference the allegations contained in each and

every preceding paragraph of this Petition.

252. Texas has reason to believe that Lau is engaging in, has engaged in, or is about to

engage in acts and practices declared to be unlawful under Tex. Health & Safety Code § 161.702(3)

and Tex. Bus. & Com. Code §§ 17. 46(a), (b)(5), (24), and believes these proceedings to be in the

public interest.

253. Texas is entitled to, and seeks, temporary and permanent injunctions pursuant to

Tex. Health and Safety Code § 161.702 as well as Tex. Bus. & Com. Code § 17.47.

254. Cessation of unlawful conduct by Lau shall not render such court action moot under

any circumstances. Id.

255. Immediate injunctive relief is necessary to prevent continuing harm prior to trial.

256. In addition to the above-requested relief, pursuant to Tex. Civ. Prac. Rem. Code §

65.011 et seq. and Tex. R. Civ. P. 680 et seq., to preserve the status quo pending a full trial on the

merits, see Butnaru v. Ford Motor Co., 84 S.W.3d 198, 204 (Tex. 2002), the Texas Attorney

General’s Office request a temporary injunction against Lau that enjoins her from the following

until final resolution of this matter:

i. Prescribing supraphysiologic doses of testosterone and estrogen to minors for the purpose of transitioning their biological sex; and

ii. Deceptively misleading pharmacies, insurance providers, and/or the patients as to the correct medical diagnosis by writing prescriptions and billing for treatments to transition a child’s biological sex under false

32 Electronically Served 10/18/2024 10:54 AM

diagnoses, such as endocrine disorder, unspecified, rather than gender dysphoria (or other similarly related diagnosis).

XII. PRAYER FOR RELIEF

257. NOW THEREFORE Texas prays that Lau be cited to appear and that after due

notice and hearing, a temporary injunction be issued, and that upon final hearing a permanent

injunction be issued, restraining and enjoining Lau and all persons in active concert or participation

with her, who receive actual notice of the injunction by personal service or otherwise from engaging

in false, misleading or deceptive acts and practices declared to be unlawful by Tex. Health and

Safety Code § 161.702 and Tex. Bus. & Com. Code § 17. 46(a), (b)(5), (24), including but not

limited to:

i. Prescribing supraphysiologic doses of testosterone and estrogen to minors for the purpose of transitioning their biological sex;

ii. Deceptively misleading pharmacies, insurance providers, and/or the patients as to the correct medical diagnosis by writing prescriptions and billing for treatments to transition a child’s biological sex under false diagnoses, such as endocrine disorder, unspecified, rather than gender dysphoria (or other similarly related diagnosis).

258. TEXAS FURTHER PRAYS that upon final hearing, this Court order:

i. Adjudge against Lau civil penalties in favor of the State in the amount of not more than $10,000 per violation of Tex. Bus. & Com. Code § 17. 46(a), (b)(5), (24);

ii. Order Lau to pay Texas’s attorneys’ fees and costs of court pursuant to Tex. Gov’t Code § 402.006(c);

iii. Order Lau to pay both pre-judgment ad post-judgment interest on all money awards as provided by law; and

iv. Grant all other and further relief Texas may show itself entitled to.

33 Electronically Served 10/18/2024 10:54 AM

Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

JAMES LLOYD Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY State Bar No. 24092619 Deputy Chief, Consumer Protection Division

Consumer Protection Division Office of the Attorney General P.O. Box 12548 Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Matt.Kennedy@oag.texas.gov Telephone: 512-463-2185 Facsimile: 512-473-8301 ATTORNEYS FOR TEXAS

34 Electronically Served 10/18/2024 10:54 AM

DECLARATION

Pursuant to Tex. Civ. Rem. & Prac. Code § 132.001(f), JOHNATHAN STONE submit

this unsworn declaration in lieu of a written sworn declaration, verification, certification, oath, or

affidavit required by Texas Rule of Civil Procedure 682. I am an employee of the following

governmental agency: Texas Office of the Attorney General. I am executing this declaration as part

of my assigned duties and responsibilities. I declare under penalty of perjury that the factual

statements in the foregoing are true and correct.

Executed in Travis County, State of Texas, on the 17th day of October, 2024.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

35 Electronically Served 10/18/2024 10:54 AM

Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Emily Samuels on behalf of David Shatto Bar No. 24104114 emily.samuels@oag.texas.gov Envelope ID: 93309242 Filing Code Description: Plaintiff's Original Petition (OCA) Filing Description: Plaintiff's Verified Original Petition and Request for an Application for Temporary and Permanent Injunctions Status as of 10/18/2024 10:26 AM CST

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

Johnathan Stone johnathan.stone@oag.texas.gov 10/18/2024 9:47:53 AM SENT

Matthew T.Kennedy matt.kennedy@oag.texas.gov 10/18/2024 9:47:53 AM SENT

David G. Shatto david.shatto@oag.texas.gov 10/18/2024 9:47:53 AM SENT

Zoann Willis zoann.willis@oag.texas.gov 10/18/2024 9:47:53 AM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 10/18/2024 9:47:53 AM SENT

Emily Samuels emily.samuels@oag.texas.gov 10/18/2024 9:47:53 AM SENT

Melinda Pate melinda.pate@oag.texas.gov 10/18/2024 9:47:53 AM SENT

Clayton Watkins 24103982 clayton.watkins@oag.texas.gov 10/18/2024 9:47:53 AM SENT Exhibit B Filed: 11/4/2024 10:03 AM Michael Gould District Clerk Collin County, Texas 493-08026-2024 By Jessica Peltier Deputy Envelope ID: 93879102 CAUSE NO. _____________

THE STATE OF TEXAS, § IN THE DISTRICT COURT OF Plaintiff, § § § v. § COLLIN COUNTY, TEXAS § § M. BRETT COOPER, M.D., § Defendant. § ______ JUDICIAL DISTRICT

PLAINTIFF’S VERIFIED ORIGINAL PETITION AND REQUEST FOR TEMPORARY AND PERMANENT INJUNCTIONS 1

Defendant, M. BRETT COOPER, M.D. , is a scofflaw who is harming the health and safety

of Texas children by providing cross-sex hormones to children for the purpose of transitioning

their biological sex or affirming their belief that their gender identity or sex is inconsistent with

their biological sex in violation of Tex. Health & Safety Code § 161.702(3), and falsifying medical

records, prescriptions, and billing records to intentionally conceal the unlawful conduct in violation

of Tex. Bus. & Com. Code §§ 17.46(a), (b)(5). 2

Cross-sex hormones, when used for the purpose of transitioning a child’s biological sex or

affirming their belief that their gender identity or sex is inconsistent with their biological sex,

interfere with a child’s normal physical development and result in long-term harm to the child,

including inter alia, sterilization, loss of bone density, and the development of irreversible

secondary opposite sex characteristics. Children, by definition, lack the cognitive maturity to

1 Pursuant to Local Rule 2.3, the State hereby notifies the district clerk that this litigation involves claims and parties related to the pending litigation, State of Texas v. Lau, Case No. 493-07676-2024 (493rd Dist. Ct., Collin County); therefore, the State requests that this matter be assigned and/or transferred to that court for future proceedings.

2 Each prescription for cross-sex hormones for the purpose of transitioning a child’s biological sex or affirming their belief that their gender identity or sex is inconsistent with their biological sex also serves as an independent ground for the Texas Medical Board to revoke Cooper’s medical license under Tex. Occ. Code §§ 164.052(a)(24), .0552.

1 provide informed consent/assent to these harmful and irreversible, life-altering decisions.

Therefore, the Texas legislature chose to prohibit physicians and health care providers from

providing, prescribing, administering, or dispensing puberty blockers and cross-sex hormones to

children for the purpose of transitioning their biological sex or affirming their belief that their

gender identity or sex is inconsistent with their biological sex. By banning these dangerous and

experimental treatments for minors, Texas is ensuring that children receive the opportunity to

resolve temporary feelings of discomfort and confusion about their biological sex with time and

therapeutic support—without being pressured by radical gender activists to undergo irreversible

medical procedures before they are capable of comprehending the significant life-long

consequences. The prohibition took effect on September 1, 2023.

Despite the enactment of the law, Cooper continues to prescribe and distribute cross-sex

hormones to his minor patients for the purposes of transitioning their biological sex or affirming

their belief that their gender identity or sex is inconsistent with their biological sex—writing

unlawful prescriptions for the drugs as recently as September 25, 2024, with patients filling those

unlawful prescriptions as recently as October 8, 2024.

Cooper, additionally, engaged in false, misleading, and deceptive acts and practices to

mislead pharmacies, insurance providers, and/or patients by falsifying medical records,

prescriptions, and billing records to conceal that his treatments and prescriptions were for the

purposes of transitioning a child’s biological sex or affirming a child’s belief that their gender

identity is inconsistent with their biological sex in violation of Tex. Bus. & Com. Code §§ 17. 46(a),

(b)(5).

2 Plaintiff, STATE OF TEXAS, by and through the Attorney General of Texas, KEN

PAXTON, has a vested interest in ensuring that medical treatments provided to minors are safe,

evidence-based, and in the best interest of the child’s physical and emotional development. Texas

is prioritizing the safety and well-being of children by holding Cooper accountable for violating

state laws prohibiting deceptive trade practices and providing cross-sex hormones to minors for

the purpose of transitioning their biological sex or affirming their belief that their gender identity

or sex is inconsistent with their biological sex.

I. PARTIES

1. Defendant is M. BRETT COOPER, M.D. (NPI# 1477819241; TX Lic.# Q4928),

an employee of the University of Texas Southwestern Medical Center (“UT Southwestern”) in

Dallas, Texas. He has hospital privileges at Children’s Medical Center Dallas and is an Associate

Professor at UT Southwestern Medical Center. Cooper may be served with process at Children’s

Health Specialty Center, 7609 Preston Road, 3rd Floor, Plano, Texas 75024, or wherever he may

be found.

II. DISCOVERY CONTROL PLAN

2. Discovery in this case should be conducted under Level 3 pursuant to Tex. R. Civ.

P. 190.4. This case is not subject to the restrictions of expedited discovery under Tex. R. Civ. P.

169 because Texas seeks nonmonetary injunctive relief.

3. Additionally, Texas claims entitlement to monetary relief in an amount greater than

$1,000,000, including civil penalties, reasonable attorney’s fees, litigation expenses, restitution,

and costs.

3 III. JURISDICTION AND VENUE

4. Texas Occ. Code § 161.706(b) provides that venue is proper in “the county where

the violation occurred or is about to occur.”

5. Venue of this suit lies in Collin County, Texas pursuant to Texas Bus. & Com. Code

§ 17.47(b), because transactions forming the basis of this suit occurred in Collin County, Texas.

Also, Cooper practices at UT Southwestern Pediatric Group at Plano in Collin County and

Cooper’s unlawful conduct occurred in Collin County, Texas.

IV. PUBLIC INTEREST

6. Cooper violated Tex. Health & Safety Code § 161.702, Tex. Bus. & Com. Code §

17.46(a) and is engaged in unlawful practices, as set forth in this petition.

7. Texas has reason to believe that Cooper is engaging in, has engaged in or is about to

engage in, the unlawful acts or practices set forth below. Texas has further reason to believe Cooper

has caused injury, loss, and damage to Texas by endangering the health of its citizens. Therefore,

the Consumer Protection Division of the Office of the Attorney General of the State of Texas is of

the opinion that these proceedings are in the public interest.

V. TRADE AND COMMERCE

8. At all times described below, Cooper engaged in conduct, the purported practice of

medicine, which constitutes “trade” and “commerce” as defined in Tex. Bus. & Com. Code §

17.45(6).

4 VI. NO NOTICE BEFORE SUIT

9. The Consumer Protection Division has reason to believe that Cooper “is engaging

in, has engaged in, or is about to engage in any act or practice declared to be unlawful … and that

proceedings would be in the public interest….” Tex. Bus. & Com. Code § 17.47(a).

10. The Consumer Protection Division did not contact Cooper before filing suit to

notify him “in general of the alleged unlawful conduct” because it is the opinion of the Consumer

Protection Division that Cooper likely “would destroy” or alter “relevant records if prior contact

were made.” Id.

VII. APPLICABLE LAW

11. Texas Bus. & Com. Code § 17.46(a) prohibits “false, misleading, or deceptive acts

or practices in the conduct of any trade or commerce.”

12. Texas Bus. & Com. Code § 17.47 authorizes the Consumer Protection Division to

bring an action for temporary and permanent injunction whenever it has reason to believe that any

person is engaged in, has engaged in, or is about to engage in any act or practice declared unlawful

under Chapter 17 of the Business and Commerce Code.

VIII. FACTUAL BACKGROUND

A. Texas Prohibits the Provision of Puberty Blockers and Cross-Sex Hormones to Minors for the Treatment of Gender Dysphoria.

13. On May 17, 2023, the Legislature added Subchapter X to the Health and Safety

Code, entitled “Gender Transitioning and Gender Reassignment Procedures and Treatments for

Certain Children (SB 14).” Act of May 17, 2023, 88th Leg., R.S., ch. 335; State v. Loe, 692 S.W.3d

223 (Tex. 2024).

5 14. Senate Bill 14 prohibits physicians and health care providers from performing

certain procedures or treatments when performed to (1) “transition[] a child’s biological sex as

determined by the sex organs, chromosomes, and endogenous profiles of the child”; or (2)

“affirm[] the child’s perception of the child’s sex if that perception is inconsistent with the child’s

biological sex.” Tex. Health & Safety Code § 161.702.

15. The effective date for SB 14 was September 1, 2023.

16. Senate Bill 14 added Tex. Health & Safety Code § 161.702(3), which prohibits

physicians from knowingly prescribing the following to transition a child’s biological sex or affirm

a child’s perception of their sex if it is different from their biological sex: “(A) puberty suppression

or blocking prescription drugs to stop or delay normal puberty; (B) supraphysiologic doses of

testosterone to females; or (C) supraphysiologic doses of estrogen to males.”

17. Physicians were permitted to prescribe to patients already subject to a continuing

course of treatment that began prior to June 1, 2023, and who attended at least 12 mental health

counseling or psychotherapy sessions over a period of at least six months prior to starting

treatment, provided that the prescriptions were for the purpose of “wean[ing] off the prescription

drug over a period of time and in a manner that is safe and medically appropriate and that minimizes

the risk of complications.” Tex. Health & Safety Code § 161.703(b)-(c).

18. Senate Bill 14 also added Tex. Occ. Code § 164.052(a)(24), which proscribed

physicians from “perform[ing] a gender transitioning or gender reassignment procedure or

treatment in violation of [Tex. Health & Safety Code § 161.702].”

6 19. Finally, SB 14 added Tex. Occ. Code § 164.0552, which commands that the Texas

Medical Board “shall revoke the license or other authorization to practice medicine of a physician

who violates [Tex. Health & Safety Code § 161.702].” (emphasis added).

B. The Texas Supreme Court Held That SB 14 is Constitutional.

20. Before SB 14 took effect several minors, parents of minors, and physicians brought

suit in Travis County, TX, alleging a variety of constitutional challenges to the law. Loe, 692

S.W.3d at 222.

21. On August 25, 2023, a Travis County District Court entered a temporary injunction

enjoining enforcement of SB 14. Id.

22. Texas appealed directly to the Texas Supreme Court, thereby dissolving the

temporary injunction. Id.

23. On September 1, 2023, the Texas Supreme Court allowed SB 14 to take effect

during the pendency of the appeal. Id.

24. On June 28, 2024, the Supreme Court of Texas reversed and vacated the trial

court’s Temporary Injunction Order after rejecting each of the plaintiffs’ constitutional challenges

to SB 14. Id. at 239.

C. Cooper is a Radical Gender Activist.

25. In his own words, Cooper makes clear that he is an advocate for transitioning the

biological sex or affirming their belief that children’s gender identities are inconsistent with their

biological sex.

26. Cooper said, in a Physicians for Reproductive Health Meet Our Advocates article: “I

try to actively encourage all of our [physician] trainees to find some way to incorporate advocacy

7 into their professional careers.” Cooper added that the most important policy issue for him is

“[l]egislators trying to criminalize the provision of gender affirming medical care for patients under

18.” https://tinyurl.com/4bj646e6, last updated December 22, 2020.

27. Here, Cooper’s following contributions align with his call for activism:

i. M. Brett Cooper, Resources for LGBTQ youth during challenging times, (Feb. 14, 2023), https://tinyurl.com/yck9f2y7;

ii. M. Brett Cooper, Incorporating LGBT Health in an Undergraduate Medical Education Curriculum Through the Construct of Social Determinants of Health, 14 MedEdPORTAL (Dec. 7, 2018) (power point presentation slides include statements that “our internal gender identity is essentially formed and stays consistent by the age of 7,”and falsely claiming that Texas physicians “are required to notify CPS for all minors who have sex with someone of the same gender.”), https://tinyurl.com/3a7c8nrs;

iii. Laura E. Kuper, Supporting and Advocating for Transgender and Gender Diverse Youth and their Families Within the Sociopolitical Context of Widespread Discriminatory Legislation and Politics, Clinical Practice in Pediatric Psychology 3, 336 (2022), https://tinyurl.com/bdabj3ra;

iv. Lauren T. Roth, Developing an Entrustable Professional Activity to Improve the Care of LGBTQ+ Youth 23 Academic Pediatrics. 4, 697 (May 1, 2023), https://tinyurl.com/56bk9hdz;

v. M. Brett Cooper, Welcoming LGBTQ Patients, Pediatric News (Apr. 17, 2024), https://tinyurl.com/3vyxr9ae;

vi. M. Brett Cooper, LGBTQ+ Youth Consult Questions remain over use of sex hormone therapy, Pediatric News (Apr. 13, 2023), https://tinyurl.com/54y ecjdd;

vii. M. Brett Cooper, The WPATH guidelines for treatment of adolescents with gender dysphoria have changed, Pediatric News (Oct. 17, 2022), https://tiny url.com/53txa22h;

viii. M. Brett Cooper, How gender-affirming care is provided to adolescents in the United States, Pediatric News (Apr. 22, 2022), https://tinyurl.com/3yv3 n6nj;

8 ix. M. Brett Cooper, Call them by their names in your office, Pediatric News (Oct. 14, 2021), https://tinyurl.com/2swpe6vf;

x. M. Brett Cooper, Advocate for legislation to improve, protect LGBTQ lives, Pediatric News (Dec. 11, 2020), https://tinyurl.com/zruxkhmf;

xi. M. Brett Cooper, Back to school: How pediatricians can help LGBTQ youth, Pediatric News (Aug. 11, 2020), https://tinyurl.com/36wf2xyy;

xii. Cooper submitted a sworn affidavit on behalf of the Plaintiffs in the Loe suit wherein he stated that “SB 14 thus not only endangers the health and wellbeing of my patients, but also places me in the unsustainable position of having to choose between providing my patients with the medical care that they need and deserve and having to comply with a discriminatory law like SB 14. I have an ethical duty to provide my patients with the best medical care for their conditions, if it is medically indicated for them. I consider the provision of gender-affirming medical care to treat a transgender adolescent’s gender dysphoria to be the best medical care for my patients when medically indicated”; and,

xiii. Cooper is also prolific on X under the handle “TeenDocMBC.” His presence on X reveals that he infuses his medical practice with radical gender activism and exercises poor judgment, as exemplified by the following set of representative tweets:

9 10 28. Cooper’s practices, publications, and social media presence reveal an entrenched

commitment to a gender ideology advocacy that desires to medically transition the biological sex

of children or affirm the belief that a child’s gender identity is inconsistent with their biological

sex.

IX. VIOLATIONS OF SB 14.

29. Cooper has knowingly violated Tex. Health & Safety Code § 161.702(3).

A. Cross-Sex Hormones to Transition Biological Sex or Affirm a Child’s Belief that their Gender Identity is Inconsistent with their Biological Sex.

30. High dose cross-sex hormones are commonly used by certain gender activists to

transition the biological sex of children or affirm a child’s belief that their gender identity is

inconsistent with their biological sex.

31. Cross-sex hormones induce a supraphysiologic state where the hormone levels are

greater than would otherwise normally be present in the child’s body.

32. As a result of the cross-sex hormones, the child will develop secondary sex

characteristics.

33. Testosterone is a cross-sex hormone that is used to induce irreversible male

secondary sex characteristics in biological females.

34. Testosterone is a Schedule III controlled substance.

35. Radical gender activists within the medical profession rely on the so-called

“Standards of Care” promulgated by the WPATH as guidelines for transitioning the biological sex

of children or affirming a child’s belief that their gender identity is inconsistent with their biological

sex. See e.g. Selena Simmons-Duffin, Rachel Levine calls state anti-LGBTQ bills disturbing and

11 dangerous to trans youth, NPR (Apr. 29, 2022) (claiming that the standard for treating gender

dysphoria is set by the WPATH), https://tinyurl.com/3jxymtum.

36. WPATH recommends transitioning the biological sex of a child or affirming a

child’s belief that their gender identity is inconsistent with their biological sex by prescribing

injectable testosterone cypionate to induce a state of male puberty in a biological female such that

she will develop irreversible male secondary sex characteristics, WPATH SOC at App’x C.

37. WPATH and the Endocrine Society Guidelines recommends “induction of male

puberty” in a biological female minor by prescribing “25mg/m2/2 weeks (or alternatively half this

dose weekly) [of testosterone]. Increase by 25mg/m2/2 weeks every 6 months until adult dose and

target testosterone levels achieved.” Id.; Endocrine Society Guidelines at 3884, Tbl. 8 (same).

38. WPATH and the Endocrine Society Guidelines alternatively recommend the

following testosterone regime for biological females to induce male secondary sex characteristics,

“testosterone enanthate/cypionate 50-100 IM/SQ weekly or 100-200 IM every 2 weeks.”

WPATH SOC at App’x C; Endocrine Society Guidelines at 3887, Tbl. 11 (same).

B. Testosterone is not FDA approved for biological females.

39. The FDA has not approved testosterone for the treatment of any medical conditions

in biological females.

40. Indeed, the FDA warns that testosterone cypionate “is contraindicated in

pregnant women and not indicated for use in females.” TESTOSTERONE CYPIONATE

INJECTION, FDA (June 2022) (emphasis added), https://tinyurl.com/4psvbdeb.

41. Under appropriate medical practices, testosterone is, instead, “use[d] to treat

males whose bodies do not make enough natural testosterone, a condition called hypogonadism.

12 Testosterone is a male hormone responsible for the growth and development of the male sex organs

and maintenance of secondary sex characteristics. This medicine is not for use in female

patients.” TESTOSTERONE CYPIONATE, Mayo Clinic (accessed October 15, 2024)

(emphasis added), https://tinyurl.com/558b8fcv.

42. There is no valid medical reason within the standard of care to prescribe

testosterone to a minor biological female. See e.g., Gary Donovitz, et.al., Testosterone Insufficiency

and Treatment in Women: International Expert Consensus, Medicina y Salud Pública (Sept. 4, 2019)

(noting that some physicians use low-dose testosterone off-label to treat certain conditions in adult

females associated with menopause), https://tinyurl.com/2ay9wsav.

43. The only reasons to prescribe testosterone to a minor biological female is for

the purposes of transitioning their biological sex or affirming their belief that their gender

identity is inconsistent with their biological sex.

C. Cooper’s Testosterone Prescribing

44. Radical gender activists in the medical profession, like Cooper, habitually alter the

biological sex of their transgender patients in their medical records. See e.g., May C. Lau, M.D.,

Transgender Care of Adolescents and Adults, Youtube 20:59-22:40 (Jan. 8, 2020),

https://tinyurl.com/mkt4pzs3 (Cooper’s hospital colleague doctor May C. Lau admitting that she

alters patient’s medical records to reflect their preferred name, sex, and pronouns, which can

change on a visit-to-visit basis, something that is apparently “fairly typical [and] kind of persists

into adulthood” for her minor transgender patients).

13 45. Cooper has violated the law by providing, prescribing, administering, or dispensing

testosterone to minor patients for the purposes of transitioning their biological sex or affirming

their belief that their gender identity is inconsistent with their biological sex:

Patient One 3

46. Patient One resides in Collin County, TX.

47. Patient One was 17 years old during the relevant time.

48. Cooper’s records identify Patient One as a biological female.

49. On September 25, 2024, over a year after SB 14 went into effect, Cooper wrote

Patient One a prescription for a 28-day supply of 200 mg/ml of testosterone cypionate for the

purposes of transitioning their biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

50. The same day, Patient One filled the prescription at a pharmacy located in Collin

County, TX.

Patient Two

55. Patient Two resides in Dallas County, TX.

56. Patient Two was approximately 16 years old at the relevant time.

57. Cooper’s records identify Patient Two as a biological female.

58. On October 11, 2023, after SB 14 went into effect, Cooper wrote Patient Two a

prescription for a 7-day supply of 200 mg/ml of testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

3 Pseudonyms are used throughout to protect the identity of the victim minor patients.

14 59. On the same day, Patient Two filled the prescription at a pharmacy located in Dallas

County, TX.

60. On December 16, 2023, Cooper wrote Patient Two a prescription for a 30-day

supply of 200 mg/ml of testosterone cypionate for the purposes of transitioning their biological sex

or affirming their belief that their gender identity is inconsistent with their biological sex.

61. On December 16, 2023, Patient Two filled the prescription at a pharmacy located

in Dallas County, TX.

62. On February 20, 2024, Patient Two refilled the prescription at a pharmacy located

in Dallas County, TX.

63. On March 26, 2024, Patient Two refilled the prescription at a pharmacy located in

Dallas County, TX.

64. On June 1, 2024, Patient Two refilled the prescription at a pharmacy located in

Dallas County, TX.

Patient Three

65. Patient Three resides in Tarrant County, TX.

66. Patient Three was 16 years old at the relevant time.

67. Cooper’s records identify Patient Three as a biological female.

68. On August 6, 2024, after SB 14 went into effect, Cooper wrote Patient Three a

prescription for a 42-day supply of 200 mg/ml of testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

15 69. On August 8, 2024, Patient Three filled the prescription at a pharmacy located in

Tarrant County, TX.

70. On September 18, 2024, Patient Three refilled the prescription at a pharmacy

located in Tarrant County, TX.

Patient Four

71. Patient Four resides in Dallas County, TX.

72. Patient Four was 16 years old at the relevant time.

73. Cooper’s records identify Patient Four as a biological female.

74. On February 12, 2024, after SB 14 went into effect, Cooper wrote Patient Four a

prescription for a 28-day supply of 200 mg/ml of testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

75. On the same day, Patient Four filled the prescription at a pharmacy located in Dallas

County, TX.

76. On August 7, 2024, Cooper wrote Patient Four a prescription for an 84-day supply

of 200 mg/ml of testosterone cypionate for the purposes of transitioning their biological sex or

affirming their belief that their gender identity is inconsistent with their biological sex.

77. On August 7, 2024, Patient Four filled the prescription at a pharmacy located in

Dallas County, TX.

Patient Five

78. Patient Five resides in Denton County, TX.

79. Patient Five was approximately 15 years old at the relevant time.

16 80. Cooper’s records identify Patient Five as a biological female.

81. On November 20, 2023, Cooper wrote Patient Five a prescription for a 24-day

supply of 200 mg/ml of testosterone cypionate for the purposes of transitioning their biological sex

or affirming their belief that their gender identity is inconsistent with their biological sex.

82. On December 13, 2023, Patient Five filled the prescription at a pharmacy located in

Denton County, TX.

83. On January 25, 2024, Patient Five refilled the prescription at a pharmacy located in

Denton County, TX.

84. On February 29, 2024, Patient Five refilled the prescription at a pharmacy located

in Denton County, TX.

85. On May 5, 2024, Patient Five refilled the prescription at a pharmacy located in

Denton County, TX.

86. On May 20, 2024, Cooper wrote Patient Five a 90-day supply of 1,000 mg/5 ml

testosterone enanthate for the purposes of transitioning their biological sex or affirming their belief

that their gender identity is inconsistent with their biological sex.

87. On May 22, 2024, Patient Five filled the prescription at a pharmacy in Denton

County, TX.

Patient Six

88. Patient Six resides in Nueces County, TX.

89. Patient Six was 14 years old at the relevant time.

90. Cooper’s records identify Patient Six as a biological female.

17 91. On September 25, 2023, after SB 14 went into effect, Cooper wrote Patient Six a

prescription for an 84-day supply of 200 mg/ml testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

92. On the same day, Patient Six filled the prescription at a pharmacy located in

Johnson County, TX.

93. On January 12, 2024, Patient Six refilled the prescription at a pharmacy located in

Johnson County, TX.

Patient Seven

94. Patient Seven resides in Collin County, TX.

95. Patient Seven was 17 during the relevant time.

96. Some of Cooper’s records identify Patient Seven’s gender as “unknown.”

97. Some of Cooper’s records identify Patient Seven as a biological female.

98. On September 25, 2023, after SB 14 went into effect, Cooper wrote Patient Seven

a prescription for a 21-day supply of 200 mg/ml of testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

99. On September 26, 2023, Patient Seven filled the prescription at a pharmacy located

in Illinois.

100. On January 29, 2024, Cooper wrote Patient Seven a prescription for an 87-day

supply of 200 mg/ml testosterone cypionate for the purposes of transitioning their biological sex

or affirming their belief that their gender identity is inconsistent with their biological sex.

18 101. On the same day, Patient Seven filled the prescription at a pharmacy located in

Collin County, TX.

Patient Eight

102. Patient Eight resides in Dallas County, TX.

103. Patient Eight was approximately 17 years old during the relevant time.

104. Some of Cooper’s record’s identify Patient Eight as a biological female.

105. Later, Cooper’s records change Patient Eight’s sex to biological male, but upon

information and belief, Patient Eight is a biological female.

106. On January 10, 2024, after SB 14 went into effect, Cooper wrote Patient Eight two

prescriptions, each for a 14-day supply of 200 mg/ml of testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

107. On January 10, 2024, Patient Eight filled the first prescription at a pharmacy located

in Dallas County, TX.

108. On March 6, 2024, after SB 14 went into effect, Patient Eight filled the second

prescription at a pharmacy located in Dallas County, TX.

109. On August 31, 2024, Cooper wrote Patient Eight a prescription for a 42-day supply

of 200 mg/ml testosterone cypionate for the purposes of transitioning their biological sex or

affirming their belief that their gender identity is inconsistent with their biological sex.

110. On the same day, Patient Eight filled the prescription at a pharmacy located in

Dallas County, TX.

19 Patient Nine

111. Patient Nine resides in Collin County, TX.

112. Patient Nine was approximately 16 years old at the relevant time.

113. Some of Cooper’s record’s identify Patient Nine as a biological female.

114. Later, Cooper’s records change Patient Nine’s sex to biological male, but upon

information and belief, Patient Eight is a biological female.

115. On December 22, 2023, after SB 14 went into effect, Cooper wrote Patient Nine

two prescriptions, each for an 84-day supply of 200 mg/ml testosterone cypionate for the purposes

of transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

116. On the same day, Patient Nine filled the first prescription at a pharmacy located in

Collin County, TX.

117. On May 7, 2024, Patient Nine filled the second prescription at a pharmacy located

in Collin County, TX.

118. On July 3, 2024, Cooper wrote Patient Nine two prescriptions, each for an 84 and

63-day supply of 200 mg/ml testosterone cypionate, respectively, for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex.

119. On August 3, 2024, Patient Nine filled the first prescription at a pharmacy in Collin

County, TX.

120. On August 5, 2024, Patient Nine filled the second prescription at a pharmacy in

Collin County, TX.

20 Patient Ten

120. Patient Ten resides in Collin County, TX.

121. Patient Ten was 16 years old at the relevant time.

122. Cooper’s records identify Patient Ten as a biological male, but upon information

and belief, Patient Ten is a biological female.

123. On September 6, 2023, after SB 14 went into effect, Cooper wrote Patient Ten a

prescription for a 30-day supply of 1,000 mg/5ml of testosterone enanthate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

124. On September 7, 2023 Patient Ten filled the prescription at a pharmacy located in

Collin County, TX.

125. On December 15, 2023, after SB 14 went into effect, Cooper wrote Patient Ten a

prescription for a 90-day supply of 200 mg/ml testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

126. On the same day, Patient Ten filled the prescription at a pharmacy in Collin County,

TX.

127. On June 7, 2024, Cooper wrote Patient Ten a prescription for a supply of 200

mg/ml testosterone cypionate for the purposes of transitioning their biological sex or affirming

their belief that their gender identity is inconsistent with their biological sex.

128. On the same day, Patient Ten filled an 84-day supply of the prescription at a

pharmacy in Collin County, TX.

21 129. On October 8, 2024, Patient Ten refilled a 28-day supply of the prescription at a

pharmacy in Collin County, TX.

Patient Eleven

130. Patient Eleven resides in Tarrant County, TX.

131. Patient Eleven was 17 years old during the relevant time.

132. Cooper’s records identify Patient Eleven as a biological male, but upon information

and belief, Patient Eleven is a biological female.

133. On December 18, 2023, after SB 14 went into effect, Cooper wrote Patient Eleven

a prescription for a 28-day supply of XYOSTED 50 mg/0.5 ml Auto-Injection of testosterone

enanthate, an alternative to testosterone cypionate, for the purposes of transitioning their

biological sex or affirming their belief that their gender identity is inconsistent with their biological

sex.

134. On December 20, 2023, Patient Eleven filled the prescription at a pharmacy located

in Tarrant County, TX.

135. On January 19, 2024, Patient Eleven refilled the prescription at a pharmacy located

in Tarrant County, TX.

136. On February 20, 2024, Patient Eleven refilled the prescription at a pharmacy

located in Tarrant County, TX.

137. On March 20, 2024, Patient Eleven refilled the prescription at a pharmacy located

in Tarrant County, TX.

138. On April 22, 2024, Patient Eleven refilled the prescription at a pharmacy located in

Tarrant County, TX.

22 139. On May 24, 2024, Patient Eleven refilled the prescription at a pharmacy located in

Tarrant County, TX.

Patient Twelve

140. Patient Twelve resides in Tarrant County, TX.

141. Patient Twelve was 16 years old at the relevant time.

142. Cooper’s records identify Patient Twelve as a biological male, but upon information

and belief, Patient Twelve is a biological female.

143. On February 26, 2024, after SB 14 went into effect, Cooper wrote Patient Twelve

a prescription for a 28-day supply of 200 mg/ml testosterone for the purposes of transitioning their

biological sex or affirming their belief that their gender identity is inconsistent with their biological

sex.

144. On February 26, 2024, Patient Twelve filled the prescription at a pharmacy in

Tarrant County, TX.

145. On April 17, 2024, Patient Twelve refilled the prescription at a pharmacy in Tarrant

County, TX.

146. On May 29, 2024, Patient Twelve refilled the prescription at a pharmacy in Tarrant

County, TX.

147. On July 15, 2024, Patient Twelve refilled the prescription at a pharmacy in Tarrant

County, TX.

148. On August 7, 2024, Cooper wrote Patient Twelve a prescription for a 28-day supply

of 200 mg/ml of testosterone cypionate for the purposes of transitioning their biological sex or

affirming their belief that their gender identity is inconsistent with their biological sex.

23 149. On the same day, Patient Twelve filled the prescription at a pharmacy located in

Tarrant County, TX.

Patient Thirteen

150. Patient Thirteen resides in Denton County, TX.

151. Patient Thirteen was 17 years old at the relevant time.

152. Cooper’s records identify Patient Thirteen as a biological male, but upon

information and belief, Patient Thirteen is a biological female.

153. On March 19, 2024, after SB 14 went into effect, Cooper wrote Patient Thirteen a

prescription for a 28-day supply of 200 mg/ml of testosterone cypionate for the purposes of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

154. On the same day, Patient Thirteen filled the prescription at a pharmacy located in

Denton County, TX.

155. On April 19, 2024, Patient Thirteen refilled the prescription at a pharmacy located

in Denton County, TX.

156. On May 14, 2024, Patient Thirteen refilled the prescription at a pharmacy located

in Denton County, TX.

157. On July 10, 2024, Patient Thirteen refilled the prescription at a pharmacy located

in Denton County, TX.

158. On August 11, 2024, Patient Thirteen refilled the prescription at a pharmacy

located in Denton County, TX.

24 Patient Fourteen

159. Patient Fourteen resides in Collin County, TX.

160. Patient Fourteen was approximately 15 years old at the relevant time.

161. Cooper’s records identify Patient Fourteen as a biological male, but upon

information and belief, Patient Fourteen is a biological female.

162. On October 11, 2023, after SB 14 went into effect, Cooper wrote Patient Fourteen

two prescriptions, each for a 30-day supply of 200 mg/ml of testosterone cypionate for the

purposes of transitioning their biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

163. On the same day, Patient Fourteen filled the first prescription at a pharmacy located

in Collin County, TX.

164. On November 17, 2023, Patient Fourteen refilled the first prescription at a

pharmacy located in Collin County, TX.

165. On December 28, 2023, Patient Fourteen filled the second prescription at a

pharmacy located in Collin County, TX.

166. On January 28, 2024, Patient Fourteen refilled the second prescription at a

pharmacy located in Collin County, TX.

167. On February 28, 2024, Patient Fourteen refilled the second prescription at a

pharmacy located in Collin County, TX.

168. On April 8, 2024, Cooper wrote Patient Fourteen three prescriptions, the first was

for a 30-day supply and the second and third were for a 7-day supply of 200 mg/ml of testosterone

25 cypionate for the purposes of transitioning their biological sex or affirming their belief that their

gender identity is inconsistent with their biological sex.

169. On the same day, Patient Fourteen filled the first prescription at a pharmacy located

in Collin County, TX.

170. On May 24, 2024, Patient Fourteen refilled the first prescription at a pharmacy

located in Collin County, TX.

171. On June 29, 2024, Patient Fourteen filled the second prescription at a pharmacy

located in Collin County, TX.

172. On August 2, 2024, Patient Fourteen refilled the second prescription at a pharmacy

located in Collin County, TX.

173. On September 1, 2024, Patient Fourteen filled the third prescription at a pharmacy

located in Collin County, TX.

174. On October 2, 2024, Patient Fourteen refilled the third prescription at a pharmacy

located in Collin County, TX.

Patient Fifteen

175. Patient Fifteen resides in Collin County, TX.

176. Patient Fifteen was approximately 16 years old at the relevant time.

177. Cooper’s records identify Patient Fifteen as a biological male, but upon information

and belief, Patient Fifteen is a biological female.

178. On October 22, 2023, after SB 14 went into effect, Cooper wrote Patient Fifteen a

prescription for an 84-day supply of 200 mg/ml testosterone cypionate for the purposes of

26 transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

179. On October 23, 2023, Patient Fifteen filled the prescription at a pharmacy in Collin

County, TX.

180. On January 14, 2024, Patient Fifteen refilled the prescription at a pharmacy in

Collin County, TX.

181. On April 9, 2024, Cooper wrote Patient Fifteen a 30-day supply of 200 mg/ml of

testosterone cypionate for the purposes of transitioning their biological sex or affirming their belief

that their gender identity is inconsistent with their biological sex.

182. On the same day, Patient Fifteen filled the prescription at a pharmacy in Collin

County, TX.

***

183. Paragraphs 46-182 describe 15 minor patients who Cooper has unlawfully treated

with testosterone for the purposes of transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex in violation of SB 14.

184. Some of Cooper’s medical records for the patients identified in the preceding

paragraphs indicate that the patients are male, but upon information and belief, all of these patients

are biological females and some of Cooper’s medical records indicate that the patient’s sex has

been recorded first as female and then as male. The result is a clear indication that Cooper is

prescribing testosterone to them for the purposes of transitioning their biological sex or affirming

their belief that their gender identity is inconsistent with their biological sex.

27 185. Each of Cooper’s prescriptions above were written and filled after SB 14 went into

effect. Even so, for any prescriptions that were written prior to SB 14, Cooper cannot circumvent

the law by writing prescriptions to his patients prior to the SB 14 taking effect with orders to fill or

refill the prescriptions after it takes effect, see 22 Tex. Admin. Code § 315.3(b)(2) (Schedule III

Controlled Substances can be refilled up to five times within six months of the date of issuance),

because a “prescription” order is not a singular discrete act, but a continuing act of treatment that

begins with the prescription being written and continues through the pharmacist filling the

prescription and the drug being used as directed by the patient, or until the written prescription

expires or is cancelled, and alternatively, because by issuing prescriptions with orders to fill them

after the effective date of SB 14 Cooper is “providing” the prescribed medication to the patient at

the time they fill and use the prescription as directed, which they could not do otherwise without

the prescription.

186. Each and every prescription written by Cooper after September 1, 2023, or filled or

taken as directed by a patient after September 1, 2023, for the purpose of transitioning the minor’s

biological sex or affirming their belief that their gender identity is inconsistent with their biological

sex violates Tex. Health & Safety Code § 161.702(3).

X. FALSE, MISLEADING, OR DECEPTIVE ACTS

187. Texas incorporates and adopts by reference the allegations contained in each and

every preceding paragraph of this Petition.

188. According to gender dysphoria providers, many insurance companies will not

accept transgender related billing codes when coupled with prescriptions for testosterone because

testosterone is not Federal and Drug Administration (“FDA”) approved for use in the treatment

28 of gender dysphoria for minors. See e.g., Stephen Rosenthal, Insurance Coverage and Coding

Considerations in Gender Affirming Hormonal Care for Adolescents & Young Adults, WPATH ppt 12

(Jul. 28, 2021), https://tinyurl.com/4vycb29r.

189. Upon information and belief, Cooper regarded Patients One through Fifteen as

transgender patients and he evaluated, diagnosed, and treated them for gender dysphoria, while

falsely, misleadingly, and deceptively, diagnosing, billing, and prescribing testosterone for

something other than the purpose of transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

190. Cooper is engaging in false, misleading, or deceptive practices, by falsely diagnosing

and billing patients using precocious puberty or endocrine disorder, undefined codes, or similarly

false codes, instead of gender dysphoria, or other gender related diagnosis codes, 4 to conceal that

he is prescribing testosterone and treating the patient for the purposes of transitioning their

biological sex or affirming their belief that their gender identity is inconsistent with their biological

sex in violation of Tex. Bus. & Com. Code §§ 17.46(a), (b)(5).

191. Cooper, as alleged herein, has in the course of trade and commerce engaged in false,

misleading, and deceptive acts and practices declared unlawful in violation of Tex. Bus. & Com.

Code §§ 17.46(a), (b)(5).

192. Texas Bus. & Com. Code § 17.46(a) prohibits “false, misleading, or deceptive acts

or practices in the conduct of any trade or commerce.”

4 The International Classification of Diseases, 10th Revision’s medical classification for gender identity disorders includes the following diagnosis codes: F64.0 Transsexualism, including other gender identity disorder and gender dysphoria in adolescents and adults; F64.1 Dual role transvestism; F64.2 Gender identity disorder of childhood; F64.8 Other gender identity disorders; and F64.9 Gender identity disorder, unspecified.

29 193. Cooper deceptively misleads pharmacies, insurance providers, and/or the patients

by falsifying patient medical records, prescriptions, and billing records to indicate that office visits

and prescriptions written to minor patients are for something other than the purpose of

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

194. Texas Bus. & Com. Code § 17.46(b)(5) prohibits “representing that goods or

services have sponsorship, approval, characteristics, ingredients, uses, benefits, or quantities

which they do not have or that a person has a sponsorship, approval, status, affiliation, or

connection which the person does not.”

195. Cooper deceptively misleads pharmacies, insurance providers and/or the patients

by falsifying patient medical records, prescriptions, and billing records to indicate the use of

testosterone are for the treatment of medical conditions the patient does not have when, in fact,

the drugs are for the purposes of transitioning the minor patient’s biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

196. Cooper deceptively induces pharmacies, insurance providers, and/or the patients

into entering into transactions by falsifying patient medical records, prescriptions, and billing

records to conceal that the treatments and prescriptions are for the unlawful purposes of

transitioning a child’s biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

197. Upon information in belief, Roberts is falsely diagnosing children with precocious

puberty and/or other medical conditions to prescribe them puberty blockers and cross-sex

30 hormones for the purpose of transitioning their biological sex or affirming their belief that their

gender identity is inconsistent with their biological sex.

XI. APPLICATION FOR TEMPORARY AND PERMANENT INJUNCTIONS

197. Texas incorporates and adopts by reference the allegations contained in each and

every preceding paragraph of this Petition.

198. Texas has reason to believe that Cooper is engaging in, has engaged in, or is about

to engage in acts and practices declared to be unlawful under Tex. Health & Safety Code §

161.702(3) and Tex. Bus. & Com. Code §§ 17.46(a), (b)(5), and believes these proceedings to be in

the public interest.

199. Texas is entitled to, and seeks, temporary and permanent injunctions pursuant to

Tex. Health and Safety Code § 161.702 as well as Tex. Bus. & Com. Code § 17.47.

200. Cessation of unlawful conduct by Cooper shall not render such court action moot

under any circumstances. Id.

201. Immediate injunctive relief is necessary to prevent continuing harm prior to trial.

202. In addition to the above-requested relief, pursuant to Tex. Civ. Prac. Rem. Code §

65.011 et seq. and Tex. R. Civ. P. 680 et seq., to preserve the status quo pending a full trial on the

merits, see Butnaru v. Ford Motor Co., 84 S.W.3d 198, 204 (Tex. 2002), the Texas Attorney

General’s Office request a temporary injunction against Cooper that enjoins him from the

following until final resolution of this matter:

i. Prescribing puberty blockers and testosterone or estrogen to minors for the purposes of transitioning the minor’s biological sex or affirming their belief that their gender identity or sex is inconsistent with their biological sex; and

ii. Deceptively misleading pharmacies, insurance providers, and/or the patients as to the correct medical diagnosis by writing prescriptions and billing for the purposes of transitioning the minor’s biological sex or

31 affirming their belief that their gender identity or sex is inconsistent with their biological sex under false diagnoses, such as precocious puberty or endocrine disorder, undefined, rather than gender dysphoria (or other similarly related diagnosis).

XII. PRAYER FOR RELIEF

203. THEREFORE Texas prays that Cooper be cited to appear and that after due notice

and hearing, a temporary injunction be issued, and that upon final hearing a permanent injunction

be issued, restraining and enjoining Cooper and all persons in active concert or participation with

him, who receive actual notice of the injunction by personal service or otherwise from engaging in

false, misleading or deceptive acts and practices declared to be unlawful by Tex. Health and Safety

Code § 161.702 and Tex. Bus. & Com. Code § 17. 46(a), (b)(5), including but not limited to:

i. Prescribing puberty blockers and testosterone or estrogen to minors for the purpose of transitioning the minor’s biological sex or affirming their belief that their gender identity or sex is inconsistent with their biological sex; and

ii. Deceptively misleading pharmacies, insurance providers, and/or the patients as to the correct medical diagnosis by writing prescriptions and billing for the purposes of transitioning the minor’s biological sex or affirming their belief that their gender identity or sex is inconsistent with their biological sex under false diagnoses, such as precocious puberty or endocrine disorder, undefined, rather than gender dysphoria (or other similarly related diagnosis).

204. TEXAS FURTHER PRAYS that upon final hearing, this Court order:

i. Adjudge against Cooper civil penalties in favor of the State in the amount of not more than $10,000 per violation of Tex. Bus. & Com. Code § 17.46(a), (b)(5);

ii. Order Cooper to pay Texas’s attorneys’ fees and costs of court pursuant to Tex. Gov’t Code § 402.006(c);

iii. Order Cooper to pay both pre-judgment and post-judgment interest on all money awards as provided by law; and

iv. Grant all other and further relief Texas may show itself entitled to.

32 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

JAMES LLOYD Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY State Bar No. 24092619 Deputy Chief, Consumer Protection Division

Consumer Protection Division Office of the Attorney General P.O. Box 12548 Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Matt.Kennedy@oag.texas.gov Telephone: 512-463-2185 Facsimile: 512-473-8301

ATTORNEYS FOR TEXAS

33 DECLARATION

Pursuant to Tex. Civ. Rem. & Prac. Code § 132.001(f), JOHNATHAN STONE submit

this unsworn declaration in lieu of a written sworn declaration, verification, certification, oath, or

affidavit required by Tex. R. Civ. P. 682. I am an employee of the following governmental agency:

Texas Office of the Attorney General. I am executing this declaration as part of my assigned duties

and responsibilities. I declare under penalty of perjury that the factual statements in the foregoing

are true and correct.

Executed in Travis County, State of Texas, on the 4th day of November 2024.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

34 Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Melinda Pate on behalf of Johnathan Stone Bar No. 24071779 melinda.pate@oag.texas.gov Envelope ID: 93879102 Filing Code Description: Plaintiff's Original Petition (OCA) Filing Description: Plaintiff's Verified Original Petition and Request for an Application for Temporary and Permanent Injunctions Status as of 11/4/2024 1:39 PM CST

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

Johnathan Stone johnathan.stone@oag.texas.gov 11/4/2024 10:03:47 AM SENT

Matthew T.Kennedy matt.kennedy@oag.texas.gov 11/4/2024 10:03:47 AM SENT

David G. Shatto david.shatto@oag.texas.gov 11/4/2024 10:03:47 AM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 11/4/2024 10:03:47 AM SENT

Zoann Willis zoann.willis@oag.texas.gov 11/4/2024 10:03:47 AM SENT

Emily Samuels emily.samuels@oag.texas.gov 11/4/2024 10:03:47 AM SENT

Melinda Pate melinda.pate@oag.texas.gov 11/4/2024 10:03:47 AM SENT Exhibit C Filed: 1/13/2025 10:18 AM Michael Gould District Clerk Collin County, Texas By Elizabeth Anderson Deputy Envelope ID: 96128789 Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Envelope ID: 96128789 Filing Code Description: Order Filing Description: Protective Order Status as of 1/14/2025 9:29 AM CST

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

Clayton Watkins 24103982 clayton.watkins@oag.texas.gov 1/13/2025 10:18:45 AM SENT

David G. Shatto david.shatto@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Matthew T.Kennedy matt.kennedy@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Associated Case Party: MayCLau

Name BarNumber Email TimestampSubmitted Status

Craig Smyser csmyser@steptoe.com 1/13/2025 10:18:45 AM SENT

Alexander Wolf awolf@steptoe.com 1/13/2025 10:18:45 AM SENT

Nicole LeBoeuf 791091 nicole@leboeuflaw.com 1/13/2025 10:18:45 AM SENT

Drew Padley dpadley@steptoe.com 1/13/2025 10:18:45 AM SENT

Amy S.Ooi amy@leboeuflaw.com 1/13/2025 10:18:45 AM SENT

Case Contacts

Name BarNumber Email TimestampSubmitted Status

Pauline Sisson pauline.sisson@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Admin Leboeuflaw admin@leboeuflaw.com 1/13/2025 10:18:45 AM SENT

Tina White tiwhite@steptoe.com 1/13/2025 10:18:45 AM SENT

Emily Samuels emily.samuels@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Melinda Pate melinda.pate@oag.texas.gov 1/13/2025 10:18:45 AM SENT Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Envelope ID: 96128789 Filing Code Description: Order Filing Description: Protective Order Status as of 1/14/2025 9:29 AM CST

Case Contacts

Melinda Pate melinda.pate@oag.texas.gov 1/13/2025 10:18:45 AM SENT

Steptoe Docketing docketing@steptoe.com 1/13/2025 10:18:45 AM SENT Exhibit D Filed: 2/5/2025 1:25 PM Michael Gould District Clerk Collin County, Texas CAUSE NO. 493-07676-2024 By Elizabeth Anderson Deputy Envelope ID: 97014287

THE STATE OF TEXAS. § IN THE DISTRICT COURT OF § Plaintiff, § VS. § COLLIN COUNTY, TEXAS § MAY C. LAU, M.D. § Defendant. § 493RD JUDICIAL DISTRICT

AFFIDAVIT OF SERVICE

On this day personally appeared Mauricio Segovia who, being by me duly sworn, deposed and said:

"The following came to hand on Jan 16, 2025, 11:25 am,

STATE’S NOTICE OF SUBPOENA DUCES TECUM, SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205, PROTECTIVE ORDER,

and was executed at 1999 BRYAN ST SUITE 900, DALLAS, TX 75201 within the county of DALLAS at 12:35 PM on Thu, Jan 16 2025, by delivering a true copy to the within named

CHILDREN'S HEALTH SYSTEM OF TEXAS C/O CT CORPORATION SYSTEM accepted by Intake Specialist William Miller Witness Fee $1.00

in person, having first endorsed the date of delivery on same.

I am a person over eighteen (18) years of age and I am competent to make this affidavit. I am a resident of the State of Texas. I am familiar with the Texas Rules of Civil Procedure as they apply to service of Process. I am not a party to this suit nor related or affiliated with any herein, and have no interest in the outcome of the suit. I have never been convicted of a felony or of a misdemeanor involving moral turpitude. I have personal knowledge of the facts stated herein and they are true and correct."

Mauricio Segovia Certification Number: PSC-1689 Certification Expiration: 8/31/2026

BEFORE ME, a Notary Public, on this day personally appeared Mauricio Segovia, known to me to be the person whose name is subscribed to the foregoing document and, being by me first duly sworn, declared that the statements therein contained are within his or her personal knowledge and are true and correct.

SUBSCRIBED AND SWORN TO ME ON ‌ 1/16/2025

Notary Public, State of Texas Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Emily Samuels on behalf of Rob Farquharson Bar No. 24100550 emily.samuels@oag.texas.gov Envelope ID: 97014287 Filing Code Description: Subpoena Return - Not DC Issued Filing Description: Affidavit of Service- Children's Health System of Texas Status as of 2/6/2025 9:04 AM CST

Associated Case Party: MayCLau

Name BarNumber Email TimestampSubmitted Status

Craig Smyser csmyser@steptoe.com 2/5/2025 1:25:17 PM SENT

Alexander Wolf awolf@steptoe.com 2/5/2025 1:25:17 PM SENT

Nicole LeBoeuf 791091 nicole@leboeuflaw.com 2/5/2025 1:25:17 PM SENT

W. Henry Legg wlegg@steptoe.com 2/5/2025 1:25:17 PM SENT

Drew Padley dpadley@steptoe.com 2/5/2025 1:25:17 PM SENT

Evelyn M.Hudson ehudson@steptoe.com 2/5/2025 1:25:17 PM SENT

Amy S.Ooi amy@leboeuflaw.com 2/5/2025 1:25:17 PM SENT

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

Clayton Watkins 24103982 clayton.watkins@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 2/5/2025 1:25:17 PM SENT

David G. Shatto david.shatto@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Ian Bergstrom Ian.Bergstrom@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Christopher Molak christopher.molak@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Case Contacts

Name BarNumber Email TimestampSubmitted Status

Deb Hardy dhardy@steptoe.com 2/5/2025 1:25:17 PM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 2/5/2025 1:25:17 PM SENT Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Emily Samuels on behalf of Rob Farquharson Bar No. 24100550 emily.samuels@oag.texas.gov Envelope ID: 97014287 Filing Code Description: Subpoena Return - Not DC Issued Filing Description: Affidavit of Service- Children's Health System of Texas Status as of 2/6/2025 9:04 AM CST

Case Contacts

Pauline Sisson pauline.sisson@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Admin Leboeuflaw admin@leboeuflaw.com 2/5/2025 1:25:17 PM SENT

Tina White tiwhite@steptoe.com 2/5/2025 1:25:17 PM SENT

Steptoe Docketing docketing@steptoe.com 2/5/2025 1:25:17 PM SENT

Emily Samuels emily.samuels@oag.texas.gov 2/5/2025 1:25:17 PM SENT

Melinda Pate melinda.pate@oag.texas.gov 2/5/2025 1:25:17 PM SENT Cause No. 493-07676-2024

THE STATE OF TEXAS., § IN THE DISTRICT COURT OF Plaintiff, § § v. § COLLIN COUNTY, TEXAS § MAY C. LAU, M.D., § Defendant. § 493rd JUDICIAL DISTRICT

STATE’S NOTICE OF SUBPOENA DUCES TECUM

To: Children’s Health System of Texas c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201

Please take notice that pursuant to Tex. R. Civ. P. 205 gives you 10 days’ notice of its intent

to serve the attached subpoena duces tecum. The State of Texas has complied with all the

requirements in Tex. R. Civ. P. 205.

Please take notice that the Court has entered the attached Protective Order in this matter

expressly finding that attestations are not required. See Prot. Ord. at 10.

January 16, 2025 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

JAMES LLOYD Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Rob.Farquharson@oag.texas.gov David.shatto@oag.texas.gov Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

CERTIFICATE OF SERVICE

I hereby certify that on January 16, 2025, a copy of the foregoing document was served to

all counsel of record in accordance with the Texas Rules of Civil Procedure.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779 THE STATE OF TEXAS

SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205

CAUSE NO. 493-07676-2024 IN THE 493rd JUDICIAL DISTRICT COURT OF COLLIN COUNTY, TEXAS

State of Texas vs. Defendant May C. Lau, M.D.

TO ANY SHERIFF OR CONSTABLE OF THE STATE OF TEXAS OR OTHER PERSON AUTHORIZED TO SERVE AND EXECUTE SUBPOENAS AS PROVIDED IN RULE 176 T.R.C.P.

YOU ARE HEREBY COMMANDED TO SUMMON Children’s Health System of Texas c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201, to provide documents to the

Office of the Attorney General 300 West 15th Street Austin, Texas 78701

SAID ABOVE NAMED IS FURTHER COMMANDED to produce the documents listed in the attachment WITHIN SEVEN DAYS OF RECEIPT OF THIS SUBPOENA with an accompanying business records affidavit for inspection and copying during normal business hours at the Office of the Attorney General or send the documents electronically or by certified mail to the Office of the Attorney General, 300 W. 15th Street, 9th Floor, Austin, TX 78701. If providing documents electronically, please provide them to Rozanne Lopez at Rozanne.Lopez@oag.texas.gov.

FAILURE BY ANY PERSON without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

DO NOT FAIL to return this writ to said Court, with return thereon, showing the manner of execution.

ISSUED on January 16, 2025, at the request the request of the State of Texas. /s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY Deputy Chief, Consumer Protection Division State Bar No. 15092619

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Matt.Kennedy@oag.texas.gov Rob.Farquharson@oag.texas.gov David.shatto@oag.texas.gov Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS 12. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

13. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

14. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 15. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

16. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

17. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

18. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

19. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

20. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

21. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. WITNESS SUBPOENA RETURN

Came to hand the ____ day of _________, 2025, at ___ o’clock, __ .M. and executed

the ____ day of _________, 2025, at ___ o’clock, __ .M. by delivering to the within named

______________ in person at ______________________________ in ______

County, TX, a true copy of this Subpoena, and tendering said witness the sum of $____.

By Deputy: _______________, ________ County, TX.

Sheriff/Constable: _______________, ________ County, TX.

OR

By: Person who is not a party to the suit and is not less than 18 years of age.

ACCEPTANCE OF SERVICE OF SUBPOENA BY WITNESS PER RULE 176 T.R.C.P.

I, the undersigned witness named in the Subpoena acknowledge receipt of a copy thereof, and hereby accept service of the attached subpoena, and will appear in said court on said date and time directed in this subpoena.

Rule 176.8(a) Contempt. Failure by any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

______________________ ________________ SIGNATURE DATE Exhibit E CAUSE NO. 493-07676-2024

THE STATE OF TEXAS § IN THE DISTRICT COURT OF § Plaintiff, § VS. § COLLIN COUNTY, TEXAS § MAY C. LAU, M.D. § Defendant. § 493RD JUDICIAL DISTRICT

AFFIDAVIT OF SERVICE

On this day personally appeared Mauricio Segovia who, being by me duly sworn, deposed and said:

"The following came to hand on Jan 23, 2025, 3:07 pm,

SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205,

and was executed at 1999 Bryan Street Suite 900, Dallas, TX 75201 within the county of Dallas at 08:38 AM on Mon, Jan 27 2025, by delivering a true copy to the within named

UT SOUTHWESTERN MEDICAL CENTER C/O CT CORPORATION SYSTEM accepted by Intake Specialist: Zachary Rouse $1 Witness Fee Attached

in person, having first endorsed the date of delivery on same.

I am a person over eighteen (18) years of age and I am competent to make this affidavit. I am a resident of the State of Texas. I am familiar with the Texas Rules of Civil Procedure as they apply to service of Process. I am not a party to this suit nor related or affiliated with any herein, and have no interest in the outcome of the suit. I have never been convicted of a felony or of a misdemeanor involving moral turpitude. I have personal knowledge of the facts stated herein and they are true and correct."

Mauricio Segovia Certification Number: PSC-1689 Certification Expiration: 8/31/2026

BEFORE ME, a Notary Public, on this day personally appeared Mauricio Segovia, known to me to be the person whose name is subscribed to the foregoing document and, being by me first duly sworn, declared that the statements therein contained are within his or her personal knowledge and are true and correct.

SUBSCRIBED AND SWORN TO ME ON ‌ 1/27/2025

Notary Public, State of Texas Cause No. 493-07676-2024

THE STATE OF TEXAS., § IN THE DISTRICT COURT OF Plaintiff, § § v. § COLLIN COUNTY, TEXAS § MAY C. LAU, M.D., § Defendant. § 493rd JUDICIAL DISTRICT

STATE’S NOTICE OF SUBPOENA DUCES TECUM

To: UT Southwestern Medical Center c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201

Please take notice that pursuant to Tex. R. Civ. P. 205 gives you 10 days’ notice of its intent

to serve the attached subpoena duces tecum. The State of Texas has complied with all the

requirements in Tex. R. Civ. P. 205.

Please take notice that the Court has entered the attached Protective Order in this matter

expressly finding that attestations are not required. See Prot. Ord. at 10.

January 16, 2025 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

JAMES LLOYD Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Rob.Farquharson@oag.texas.gov David.shatto@oag.texas.gov Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

CERTIFICATE OF SERVICE

I hereby certify that on January 16, 2025, a copy of the foregoing document was served to

all counsel of record in accordance with the Texas Rules of Civil Procedure.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779 THE STATE OF TEXAS

SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205

CAUSE NO. 493-07676-2024 IN THE 493rd JUDICIAL DISTRICT COURT OF COLLIN COUNTY, TEXAS

State of Texas vs. Defendant May C. Lau, M.D.

TO ANY SHERIFF OR CONSTABLE OF THE STATE OF TEXAS OR OTHER PERSON AUTHORIZED TO SERVE AND EXECUTE SUBPOENAS AS PROVIDED IN RULE 176 T.R.C.P.

YOU ARE HEREBY COMMANDED TO SUMMON Children’s Health System of Texas c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201, to provide documents to the

Office of the Attorney General 300 West 15th Street Austin, Texas 78701

SAID ABOVE NAMED IS FURTHER COMMANDED to produce the documents listed in the attachment WITHIN SEVEN DAYS OF RECEIPT OF THIS SUBPOENA with an accompanying business records affidavit for inspection and copying during normal business hours at the Office of the Attorney General or send the documents electronically or by certified mail to the Office of the Attorney General, 300 W. 15th Street, 9th Floor, Austin, TX 78701. If providing documents electronically, please provide them to Rozanne Lopez at Rozanne.Lopez@oag.texas.gov.

FAILURE BY ANY PERSON without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

DO NOT FAIL to return this writ to said Court, with return thereon, showing the manner of execution.

ISSUED on January 16, 2025, at the request the request of the State of Texas. /s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY Deputy Chief, Consumer Protection Division State Bar No. 15092619

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Matt.Kennedy@oag.texas.gov Rob.Farquharson@oag.texas.gov David.shatto@oag.texas.gov Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS SUBPOENA DUCES TECUM—DOCUMENTS REQUESTED

1. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

2. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

3. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

4. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

5. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

6. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

7. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

8. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

9. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

10. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

11. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 12. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

13. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

14. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 15. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

16. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

17. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

18. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

19. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

20. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

21. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. WITNESS SUBPOENA RETURN

Came to hand the ____ day of _________, 2025, at ___ o’clock, __ .M. and executed

the ____ day of _________, 2025, at ___ o’clock, __ .M. by delivering to the within named

______________ in person at ______________________________ in ______

County, TX, a true copy of this Subpoena, and tendering said witness the sum of $____.

By Deputy: _______________, ________ County, TX.

Sheriff/Constable: _______________, ________ County, TX.

OR

By: Person who is not a party to the suit and is not less than 18 years of age.

ACCEPTANCE OF SERVICE OF SUBPOENA BY WITNESS PER RULE 176 T.R.C.P.

I, the undersigned witness named in the Subpoena acknowledge receipt of a copy thereof, and hereby accept service of the attached subpoena, and will appear in said court on said date and time directed in this subpoena.

Rule 176.8(a) Contempt. Failure by any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

______________________ ________________ SIGNATURE DATE Exhibit F Filed: 2/18/2025 12:49 PM Michael Gould District Clerk Collin County, Texas CAUSE NO. 493-07676-2024 By Mya Love Deputy Envelope ID: 97494063

THE STATE OF TEXAS § IN THE DISTRICT COURT § Plaintiff, § VS. § COLLIN COUNTY, TEXAS § MAY C. LAU, M.D. § Defendant. § 493RD JUDICIAL DISTRICT

AFFIDAVIT OF SERVICE

On this day personally appeared Mauricio Segovia who, being by me duly sworn, deposed and said:

"The following came to hand on Feb 14, 2025, 8:38 am,

SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205, SUBPOENA DUCES TECUM—DOCUMENTS REQUESTED, PROTECTIVE ORDER,

and was executed at 5323 Harry Hines Boulevard, Dallas, TX 75390 within the county of Dallas at 02:05 PM on Fri, Feb 14 2025, by delivering a true copy to the within named

UT SOUTHWESTERN MEDICAL CENTER BY AND THROUGH ITS VICE PRESIDENT AND GENERAL COUNSEL, ERIN M. SINE $1.00 Witness Fee Attached

in person, having first endorsed the date of delivery on same.

I am a person over eighteen (18) years of age and I am competent to make this affidavit. I am a resident of the State of Texas. I am familiar with the Texas Rules of Civil Procedure as they apply to service of Process. I am not a party to this suit nor related or affiliated with any herein, and have no interest in the outcome of the suit. I have never been convicted of a felony or of a misdemeanor involving moral turpitude. I have personal knowledge of the facts stated herein and they are true and correct."

Mauricio Segovia Certification Number: PSC-1689 Certification Expiration: 8/31/2026

BEFORE ME, a Notary Public, on this day personally appeared Mauricio Segovia, known to me to be the person whose name is subscribed to the foregoing document and, being by me first duly sworn, declared that the statements therein contained are within his or her personal knowledge and are true and correct.

SUBSCRIBED AND SWORN TO ME ON ‌ 2/15/2025

Notary Public, State of Texas THE STATE OF TEXAS

SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205

CAUSE NO. 493-07676-2024 IN THE 493rd JUDICIAL DISTRICT COURT OF COLLIN COUNTY, TEXAS

State of Texas vs. Defendant May C. Lau, M.D.

TO ANY SHERIFF OR CONSTABLE OF THE STATE OF TEXAS OR OTHER PERSON AUTHORIZED TO SERVE AND EXECUTE SUBPOENAS AS PROVIDED IN RULE 176 T.R.C.P.

YOU ARE HEREBY COMMANDED TO SUMMON UT Southwestern Medical Center by and through its Vice President and General Counsel, Erin M. Sine, at Office of Legal Affairs, UT Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas, Texas 75390-9008, to provide documents to the: Office of the Attorney General 300 West 15th Street Austin, Texas 78701

SAID ABOVE NAMED IS FURTHER COMMANDED to produce the documents listed in the attachment WITHIN TWENTY DAYS OF RECEIPT OF THIS SUBPOENA with an accompanying business records affidavit for inspection and copying during normal business hours at the Office of the Attorney General or send the documents electronically or by certified mail to the Office of the Attorney General, 300 W. 15th Street, 9th Floor, Austin, TX 78701. If providing documents electronically, please provide them to Rozanne Lopez at Rozanne.Lopez@oag.texas.gov.

FAILURE BY ANY PERSON without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

DO NOT FAIL to return this writ to said Court, with return thereon, showing the manner of execution.

ISSUED on February 4, 2025, at the request the request of the State of Texas. JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

/s/ David Shatto DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Rob.Farquharson@oag.texas.gov David.shatto@oag.texas.gov Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS SUBPOENA DUCES TECUM—DOCUMENTS REQUESTED

1. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

2. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

3. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

4. Produce documents relating to the care and treatment of (DOB: , ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

5. Produce documents relating to the care and treatment of (DOB: , ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

6. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

7. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

8. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

9. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

10. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

11. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 12. Produce documents relating to the care and treatment of (DOB: , ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

13. Produce documents relating to the care and treatment of (DOB: , ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

14. Produce documents relating to the care and treatment of (DOB: , ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

15. Produce documents relating to the care and treatment of (DOB: including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

16. Produce documents relating to the care and treatment of (DOB: , ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

17. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

18. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

19. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

20. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

21. Produce documents relating to the care and treatment of (DOB: ), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. WITNESS SUBPOENA RETURN

Came to hand the day of , 2025, at o’clock, .M. and executed

the day of , 2025, at o’clock, .M. by delivering to the within named

in person at in

County, TX, a true copy of this Subpoena, and tendering said witness the sum of $ .

By Deputy: , County, TX.

Sheriff/Constable: , County, TX.

OR

By: Person who is not a party to the suit and is not less than 18 years of age.

ACCEPTANCE OF SERVICE OF SUBPOENA BY WITNESS PER RULE 176 T.R.C.P.

I, the undersigned witness named in the Subpoena acknowledge receipt of a copy thereof, and hereby accept service of the attached subpoena, and will appear in said court on said date and time directed in this subpoena.

Rule 176.8(a) Contempt. Failure by any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

SIGNATURE DATE Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Pauline Sisson on behalf of David Shatto Bar No. 24104114 pauline.sisson@oag.texas.gov Envelope ID: 97494063 Filing Code Description: Subpoena Return - Not DC Issued Filing Description: Affidavit of Service- UT Southwestern Medical Center Status as of 2/18/2025 1:07 PM CST

Associated Case Party: MayCLau

Name BarNumber Email TimestampSubmitted Status

Craig Smyser csmyser@steptoe.com 2/18/2025 12:49:17 PM SENT

Alexander Wolf awolf@steptoe.com 2/18/2025 12:49:17 PM SENT

Nicole LeBoeuf 791091 nicole@leboeuflaw.com 2/18/2025 12:49:17 PM SENT

W. Henry Legg wlegg@steptoe.com 2/18/2025 12:49:17 PM SENT

Drew Padley dpadley@steptoe.com 2/18/2025 12:49:17 PM SENT

Evelyn M.Hudson ehudson@steptoe.com 2/18/2025 12:49:17 PM SENT

Amy S.Ooi amy@leboeuflaw.com 2/18/2025 12:49:17 PM SENT

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

Clayton Watkins 24103982 clayton.watkins@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 2/18/2025 12:49:17 PM SENT

David G. Shatto david.shatto@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Ian Bergstrom Ian.Bergstrom@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Christopher Molak christopher.molak@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Case Contacts

Name BarNumber Email TimestampSubmitted Status

Deb Hardy dhardy@steptoe.com 2/18/2025 12:49:17 PM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 2/18/2025 12:49:17 PM SENT Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Pauline Sisson on behalf of David Shatto Bar No. 24104114 pauline.sisson@oag.texas.gov Envelope ID: 97494063 Filing Code Description: Subpoena Return - Not DC Issued Filing Description: Affidavit of Service- UT Southwestern Medical Center Status as of 2/18/2025 1:07 PM CST

Case Contacts

Pauline Sisson pauline.sisson@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Admin Leboeuflaw admin@leboeuflaw.com 2/18/2025 12:49:17 PM SENT

Tina White tiwhite@steptoe.com 2/18/2025 12:49:17 PM SENT

Steptoe Docketing docketing@steptoe.com 2/18/2025 12:49:17 PM SENT

Cory Sutker Cory.Sutker@cooperscully.com 2/18/2025 12:49:17 PM SENT

Jackie Cooper Jackie.Cooper@cooperscully.com 2/18/2025 12:49:17 PM SENT

Emily Samuels emily.samuels@oag.texas.gov 2/18/2025 12:49:17 PM SENT

Melinda Pate melinda.pate@oag.texas.gov 2/18/2025 12:49:17 PM SENT Exhibit G FILED FILED PER ATTY 2/3/202512:00 AM FELICIA PITRE DISTRICT CLERK DALLAS 00., TEXAS Belinda Hernandez DEPUTY

Cause No. DC-25-01823

Nonparty Patient No .l, Nonparty Patient No .2, Nonparty Patient No .3, Nonparty Patient No .4, IN THE DISTRICT COURT OF Nonparty Patient No .5, Nonparty Patient No .6, DALLAS COUNTY, TEXAS Nonpalty Patient No .7, and 95th Nonparty Patient No .8, JUDICIAL DISTRICT

Plaintiffs,

VS.

The State of Texas,

Defendant.

THE NONPARTY PATIENTS’ PETITION FOR MOTION FOR PROTECTION FROM DISCOVERY SUBPOENAS To the Honorable Judge of this Court:

Pursuant to Texas Rule of Civil Procedure 176.6(e), Plaintiffs (“Nonparty Patients”)1 move

for protection from discovery subpoenas (Exhibits A and B) (“Subpoenas”) that the State of Texas

served on Children’s Health System of Texas and UT Southwestern Medical Center (“Hospital

Systems”). Ex. C 1H] 3—4. Nonparty Patients would respectfully show the Court as follows:

I. INTRODUCTION 1. The State has brought a lawsuit in the 493rd Judicial District in Collin County,

Texas (the “Lau Litigation”), alleging in its Petition (attached as Exhibit D) that Dr. May C. Lau

violated provisions in Senate Bill l4 (“SB14”) and engaged in false, misleading, or deceptive acts

1 Pursuant to the Collin County District Court’s Protective Order § III(F) (attached as Exhibit E), the Nonparty Patients have filed this Motion using a generic reference to avoid disclosing their identities as patients related to that litigation. Ex. C 1] 5. Consistent with the Protective Order, the Nonparty Patients may be identified in camera or as otherwise ordered by the Court. Id. l by providing gender affirming care to teenage patients. Ex. D 1H] 23, 43. On Monday, January 27,

the State served sweeping Subpoenas in Dallas County on the Hospital Systems, demanding

private medical records of 21 individuals, including the Nonparty Patients. Ex. A at 7; Ex. B at 7.

The State’s requests broadly seek all “documents relating to the care and treatment [of the

nonparty],” irrespective of any relevance to the underlying litigation. Ex. A at 7; Ex. B at 7. The

non-limiting examples in the State’s requests underscore that the Subpoenas are invasive and target

sensitive medical records, including psychotherapy notes. Ex. A at 7; Ex. B at 7.

2. The Texas Rules of Evidence codify a longstanding physician-patient privilege that

precludes such discovery. Tex. R. Evid. 509; Tex. R. Evid. 510. This privilege acknowledges that

meaningful healthcare requires allowing patients to talk freely with their doctors on sensitive topics

without fear of disclosure, or repercussions from the State. See, e. g., R.K. v. Ramirez, 887 S.W.2d

836, 843 (Tex. 1994) (“The basis for the privileges is twofold: (l) to encourage the full communication necessary for effective treatment, and (2) to prevent unnecessary disclosure of

highly personal information”). The State’s requests in the Subpoenas—which are untethered to

any issue of consequence in the Lau litigation—cannot plausibly satisfy the narrow exceptions to

that privilege, and the requests are impermissibly broad, unduly burdensome, and unnecessarily

target irrelevant information. The Nonparty Patients have thus filed this Petition in Dallas County,

where the Subpoenas were served, seeking protection from the discovery sought.

II. JURISDICTION 3. The Court has jurisdiction over this matter under Texas Rules of Civil Procedure

176.6 and 192.6(a). A “[p]erson affected by the subpoena, may move for a protective order under

Rule 192.6(b) in a district court in the county where the subpoena was served.” Tex. R. Civ. P.

176.6(e). The Nonparty Patients are not parties to the Lau Litigation but are each a nonparty patient

about whom the State has sought medical records and other information from the Hospital Systems

2 in the Subpoenas. Ex. C 11 2. The Nonparty Patients thus have standing to seek “an order protecting

[Movant] from the discovery sought” because each is “a person affected by the subpoena.” Tex.

Tex. R. CiV. P. 176.6(e); R. CiV. P. 192.6(a). The Hospital Systems were both served the

Subpoenas in Dallas County, where this Court is situated, Via their common registered agent, CT

Corporation System, at 1999 Bryan St, Suite 900, Dallas, TX 75201. Ex. A at 2; Ex. B at 2.

III. BACKGROUND 4. In the Lau Litigation, the State’s allegations largely center on Dr. Lau purportedly

prescribing medicines to teenage patients, including testosterone. Ex. D 1] 56. The State alleges

that such care became unlawful under SB14 on September 1, 2023. Id. 1H 23, 222. The State also

alleges that Dr. Lau engaged in false, misleading, or deceptive practices after or around the

enactment of SB14, purportedly to mislead pharmacies, insurance providers, or patients into

believing that the patients’ testosterone treatments were for purposes other than gender-affirming

care to circumvent the restrictions in SB14. Id. fl 226-27. 5. On January 27, 2024, the State served the Subpoenas on the Hospital Systems.

Ex. A; Ex. B. The Subpoenas are substantially identical. Ex. A; Ex. B. Each includes the same

requests for production for 21 nonparty patients:

Produce documents relating to the care and treatment of [a patient] ..., including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Ex. A at 7; Ex. B at 7. There are no accompanying instructions or definitions that would limit the

requested production in a meaningful way, such as only to materials that would be of legal

consequence in the Lau Litigation. The only limitation in time is ambiguous. It is unclear whether the

requests are limited to “documents from January 1, 2021, through present,” or whether that

timeframe applies only to “correspondence from January l, 2021, through present.” In either event,

there is no apparent, meaningful relationship between the nonparty patients’ medical records

3 (including highly sensitive materials, like psychotherapy notes) from 2021 or earlier and the State’s

allegations about Dr. Lau’s actions in or around the enactment of SBl4 in September 2023.

6. Despite the obvious gravity of the privacy rights threatened by the Subpoenas for

21 nonparty patients, the State has inexplicably demanded compliance from the Hospital Systems

within seven days from when the Subpoenas were served on January 27, 2024 (Ex. A at 5; Ex. B

at 5), effectively denying many of the 21 nonparty patients a reasonable opportunity to obtain

counsel and seek advice on their legal rights before compliance is due.

IV. ARGUMENT AND AUTHORITIES 7. The Court should enter an order preventing the Hospital Systems from producing

the materials sought in the Subpoenas because the State’s requests are overly broad, seek irrelevant

materials, and demand materials that are protected from disclosure under the Physician-Patient

Privilege (Tex. R. Evid. 509) and the Mental Health Information Privilege (Tex. R. Evid. 510).

Courts may enter orders protecting individuals from discovery by subpoena to prevent an invasion

of personal rights, including privacy and privileges. Tex. R. Civ. P. 192.6(b); Tex. R. Civ. P.

176.6(e), 176.7. Courts also have the authority to limit the scope of discovery based on the needs

and circumstances of the case. Tex. R. Civ. P. 192 cmt. 7.

8. Under the Physician-Patient Privilege, “a patient has a privilege to refuse to disclose

and to prevent any other person from disclosing: (1) a confidential communication between a

physician and the patient that relates to or was made in connection with any professional services

the physician rendered the patient; and (2) a record of the patient’s identity, diagnosis, evaluation,

or treatment created or maintained by a physician.” Tex. R. Evid. 509(0). Similarly, under the

Mental Health Information Privilege, “a patient has a privilege to refuse to disclose and to prevent

any other person from disclosing: (A) a confidential communication between the patient and a professional; and (B) a record of the patient’s identity, diagnosis, evaluation, or treatment that is

created or maintained by a professional.” Tex. R. Evid. 510(b)(l).

9. It is self-evident from the State’s Subpoenas that the documents sought are subject

to the Physician-Patient Privilege and the Mental Health Information Privilege. Each request asks

for “document relating to the care and treatment” of the nonparties, such as “medical records,”

“psychotherapy notes,” and “correspondence” with the nonparty patients, including Movant. Ex. A

at 7; EX. B at 7; Ex. C 1} 2. Documents relating to the care and treatment of the nonparties, medical

records, psychotherapy notes, and correspondence between the Hospital Systems, the nonparty

patients, and healthcare providers will necessarily include confidential communications between

the nonparty patients and their physicians and/or professionals, along with records of the nonparty

patients’ identities, diagnoses, evaluations, and treatments that were created or maintained by

physicians and/or mental health professionals. See generally In re Irvin, No. 05-98-01771-CV,

1998 WL 908955, at *4 (Tex. App—Dallas Dec. 31, 1998, no pet.) (finding abuse of discretion

and granting mandamus when district court ordered production of mental health records).

10. There is no exception to the Physician-Patient Privilege or the Mental Health

Information Privilege that would plausibly apply to the broad requests in the Subpoenas. If the

State is suggesting that it is entitled to the nonparty patients’ medical records because some

information therein may be relevant to a party’s claim or defense in the Lau Litigation it is wrong.

The State’s expansive requests cannot fit under such an exception. The exception to the Physician-

Patient Privilege and Mental Health Information Privilege that applies when a party relies on a

patient’s medical condition (often referred to as the “patient-litigant exception”) is narrow,

particularly for nonparty patients. See R.K. v. Ramirez, 887 S.W.2d 836, 843 (Tex. 1994). As the

Texas Supreme Court has explained, it is not enough that there are allegations in the lawsuit for which a condition of the nonparty patient may be relevant—rather, “[t]he scope of the exception

should be tied in a meaningful way to the legal consequences of the claim or defense.” Id. at 842.

ll. In other words, for the patient-litigant exception to apply, discovery must be

directed to information about a patient’s condition that is “a ‘part’ of a claim or defense,” and

“must itself be a fact to which the substantive law assigns significance.” Id. Generally, this means

the discovery must be directed to a condition about which “the jury must make a factual

determination.” Id. at 843. Even then, the exception applies “only to the extent necessary to satisfy

the discovery needs of the requesting party” when balanced against the privacy interests of the

patients and requires in camera review of each document so that “any information not meeting this

standard remains privileged and must be redacted or otherwise protected.” Id.

12. The State’s Subpoenas cannot remotely meet this standard. The Subpoenas’

requests are not directed to any specific condition whatsoever. They are broad requests to entire

Hospital Systems for all medical records and psychiatry notes about any condition or treatment,

without any bounds or guidance based on the underlying lawsuit. Nor are the requests reasonably

limited in time. At best, they seek all the Nonparty Patients’ medical records, including psychiatry

notes, for the past four years. Potentially, they seek all the Nonparty Patients’ medical records,

including psychiatry notes, since birth. Either way, they are untethered in time and scope from the

Lau Litigation, which involves acts around or after SB14 was enacted in September 2023. These

requests are thus too broad in scope and time to satisfy the patient-litigant exception. See R.K., 887

S.W.2d at 843 (requiring “the request for records and the records disclosed are closely related in

time and scope to the claims made to avoid any unnecessary incursion into private affairs”).

l3. The Court should therefore enter an order protecting the Nonparty Patients from

disclosure under the Subpoenas, including because the requests are not restrictively tailored to maintain the privilege for records and communications that would not be subject to the patient-

litigant exception, if it applied at all. See id.; cf Groves v. Gabriel, 874 S.W.2d 660, 661 (Tex. 1994) (“However, a trial court’s order compelling release of medical records should be

restrictively drawn so as to maintain the privilege with respect to records or communications not

relevant to the underlying suit”).

14. Alternatively, if the Court does not enter an order protecting the Nonparty Patients

from the Subpoenas in whole, Movant respectfully requests an opportunity to review any proposed

productions from the Hospital Systems to evaluate the documents produced for privilege before

they are provided to the State. For claims of privilege, “the documents themselves may constitute

the only evidence substantiating the claim of privilege.” Weisel Enterprises, Inc. v. Curry, 718

S.W.2d 56, 58 (Tex. 1986). The Nonparty Patients thus require a reasonable opportunity to review

any documents that the Hospital Systems would produce to the State so that they may “segregate

and produce the documents to the court” for in camera review to ensure that only relevant materials

subject to the applicable privilege exception are produced, with appropriate redactions. See id.

(providing for in camera review); R.K., 887 S.W.2d at 843 (“Even when a document includes some

information meeting this standard, any information not meeting this standard remains privileged

and must be redacted or otherwise protected”) (“[W]hen requested, the trial court must perform

an in camera inspection of the documents produced to assure that the proper balancing of interests,

which we have described, occurs before production is ordered”).

15. For example, the State has no apparent interest in receiving documents that contain

personally identifiable information about the Nonparty Patients, and that information should be

redacted in any production. Nor does the State have any apparent interest in the Nonparty Patients’

medical records from before SB14 was enacted in September 2023. After all, the State’s allegations in the Lau Litigation turn on the actions after SB14 became law, and neither the

identities of Dr. Lau’s patients, nor their medical records and communications before

September 2023, are facts of consequence that must be adjudicated.

16. Apart from the Nonparty Patients’ privilege assertions, the requests in the

Subpoenas are overbroad, directed to irrelevant information, and not proportional to the needs of

the case. For instance, there are no limitations to exclude from production materials unrelated to

the allegations against Dr. Lau. The State’s expansive requests instead presumably encompass all

care the Nonparty Patients have received from any provider affiliated with the Hospital Systems,

potentially without any meaningful limitation in time, no matter how attenuated or divorced that

care is from the Lau Litigation. The State’s requests would potentially encompass, for instance, all

unrelated physical and mental healthcare (including communications with providers other than

Dr. Lau, emergency room visits, vaccinations, and pharmacy records) at the Hospital Systems,

without any apparent limitation whatsoever to restrict the requests to the subject matter of the Lau

Litigation or a relevant timeframe.

17. Given the extraordinary breadth of the requests and the attendant high likelihood

that irrelevant materials would be produced, if the Court does not enter an order protecting the

Nonparty Patients from production under the Subpoenas in whole, the Nonparty Patients request

the opportunity to review any proposed production for relevance and, if appropriate, request that

the Court conduct an in camera inspection of materials proposed for production that the Nonparty

Patients identify as irrelevant to the Lau Litigation. See, e.g., Weisel Enterprises, 718 S.W.2d at

58 (holding in camera review appropriate in situations when the documents’ contents are the only

evidence of discoverability). V. CONCLUSION 18. The State has overstepped the bounds of permissible nonparty discovery. Its

Subpoenas to the Hospital Systems plainly seek materials about the Nonparty Patients that are

protected from disclosure under the Physician-Patient Privilege and the Mental Health Information

Privilege. The requests are also overbroad, seek irrelevant information, and are not proportional to

the needs of the case, as they are not meaningfully restricted in time or subject matter to the

allegations underpinning the Lau Litigation. The Court should therefore enter a protective order

preventing the Hospital Systems from producing discovery in response to the Subpoenas or,

alternatively, provide the Nonparty Patients an opportunity to review any proposed production and

segregate documents for in camera review for relevance and privilege before they are produced.

VI. PRAYER FOR RELIEF 19. For the foregoing reasons, the Nonparty Patients respectfully request that the Court

set this Motion for hearing and, after the hearing, issue an order granting the relief requested herein.

DATED: February 2, 2025 Respectfully submitted,

/S/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500

William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 651-2600

ATTORNEYS FOR NONPARTY PATIENTS 9 CERTIFICATE OF CONFERENCE Counsel for movants has personally attempted to contact counsel for respondent as follows:

by email on February 2, 2025, at 6:03 PM. Counsel has not yet received a response. An emergency

exists of such a nature that filrther delay would cause irreparable harm to movants, as follows:

Counsel has only just been retained, and given the State’s expedited request for compliance with

the subpoenas by tomorrow (Monday, February 3), there is no opportunity to wait for a response

from the State before seeking relief as production of movants’ privileged records may be imminent.

Counsel for movants will continue attempting to confer with respondent in good faith.

Certified to the Day of February 2, 2025, by:

/s/ William M. Logan William M. Logan Texas Bar No. 24106214

CERTIFICATE OF SERVICE

Ihereby certify that on February 2, 2025 , an electronic copy of this Petition was served to

counsel of record for the State of Texas that are listed on the relevant subpoenas, as follows:

Jonathan Stone — Jonathan.Stone@oag.texas.gov Matthew Kennedy — Matt.Kennedy@oag.texas. gov Rob Farquaharson — Rob.Farquharson@oag.texas.gov David Shatto — David.Shatto@oag.texas.gov

I further certify that a copy of this Petition and citation are being served via registered or

certified mail, return receipt requested, to the above-listed counsel at the following address listed

for compliance on the relevant subpoenas:

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711

/s/Jerv0nne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869

10 EXHIBIT A CAUSE NO. 493-07676-2024

THE STATE 0F TEXAS. § IN THE DISTRICT COURT OF § Plaintiff, § VS. § COLLIN COUNTY, TEXAS § MAY C. LAU. M.D. § Defendant. § 493RD JUDICIAL DISTRICT

AFFIDAVIT OF SERVICE

0n this day personally appeared Mauricio Segovia who, being by me duly sworn, deposed and said:

"The following came to hand onJan 16, 2025, 11:25 am,

STATE’S NOTICE 0F SUBPOENA DUCES TECUM, SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVII. PROCEDURE 176 AND 205, PROTECTIVE ORDER.

and was executed at 1999 BRYAN ST SUITE 900, DALLAS, TX 75201 within the county of DALLAS at 12:35 PM on Thu,jan 16 2025, by delivering a true copy to the within named

CHILDREN'S HEALTH SYSTEM OF TEXAS C/O CT CORPORATION SYSTEM accepted by Intake Specialist William Miller Witness Fee $1.00

in person, having first endorsed the date of delivery on same.

Iam a person over eighteen (18) years of age and I am competent to make this affidavit. I am a resident of the State of Texas. I am familiar with the Texas Rules of Civil Procedure as they apply to service of Process. am not a party to this I

suit nor related or affiliated with any herein, and have no Interest in the outcome of the suit. I have never been convicted of a felony or of a misdemeanor involving moral turpitude. I have personal knowledge ofthe facts stated herein and they are true and correct."

_ x.

Mauricio Segovia Certification Number: PSC-1689 Certification Expiration: 8/31/2026

BEFORE ME, a Notary Public, on this day personally appeared Mauricio Segovia, known to me to be the person whose name is subscribed to the foregoing document and, being by me first duly sworn, declared that the statements therein contained are within his or her personal knowledge and are true and correct.

SUBSCRIBED AND SWORN TO ME ON 1/15/2925 I

$34 WMSEGOVIA otary F} , State of Tex Cause No. 493-07676-2024

THE STATE 0F TEXAS, IN THE DISTRICT COURT OF

§§§§§§§ Plaintifij

v. COLLIN COUNTY, TEXAS

MAY C. LAU, M.D., Defendant. 493‘“ JUDICLAL DISTRICT

STATE’S NOTICE OF SUBPOENA DUCES TECUM To: Children’s Health System of Texas c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201

Please take notice that pursuant to Tex. R. Civ. P. 205 gives you 10 days ’ notice of its intent

to serve the attached subpoena duces tecum. The State of Texas has complied with all the

requirements in Tex. R. Civ. P. 205.

Please take notice that the Court has entered the attached Protective Order in this matter

expressly finding that attestations are not required. See Prot. Ord. at 10.

January 16, 2025 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

JAMES LLOYD Deputy Attorney General for Civil Litigation

/5/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division PO. Box 12548 (MC-010) Austin, Texas 78711 IQ?1§1§.1%13111§1<»1«311911111321311:915 thfiamuluteoa 1: ‘1::- ~ >81 U .

Qatié1§311§91§¥1v11cc1311.}: Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

CERTIFICATE OF SERVICE I hereby certify that on January 16, 2025, a copy of the foregoing document was served to

all counsel of record in accordance with the Texas Rules of Civil Procedure.

/3/ Johnathan Stone JOHN ATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779 THE STATE OF TEXAS SUBPOENA DUCES TECUM PURSUANT T0 TEXAS RULES 0F CIVIL PROCEDURE 176 AND 205

CAUSE NO. 493-07676-2024 IN THE 493'“ JUDICIAL DISTRICT COURT OF COLLIN COUNTY, TEXAS

State of Texas v5. Defendant May C. Lau, M.D.

TO ANY SHERIFF OR CONSTABLE OF THE STATE OF TEXAS OR OTHER PERSON AUTHORIZED TO SERVE AND EXECUTE SUBPOENAS AS PROVIDED IN RULE 176 T.R.C.P.

YOU ARE HEREBY COMMANDED TO SUMMON Children’s Health System of Texas c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201, to provide documents to the

Oflice of the Attorney General 300 West 15th Street Austin, Texas 78701

SAID ABOVE NAMED IS FURTHER COMMANDED to produce the documents listed in the attachment WITHIN SEVEN DAYS OF RECEIPT OF THIS SUBPOENA with an accompanying business records affidavit for inspection and copying during normal business hours at the Office of the Attorney General or send the documents electronically or by certified mail to the Office of the Attorney General, 300 W. 15th Street, 9th Floor, Austin, TX 78701. If providing documents electronically, please provide them to Rozanne Lopez at Rozanne.Lopez@oag.texas.gov.

FAILURE BY ANY PERSON Without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

D0 NOT FAIL to return this writ to said Court, with return thereon, showing the manner of execution.

ISSUED onJanuary 16, 2025, at the request the request of the State of Texas. /s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY Deputy Chief, Consumer Protection Division State Bar No. 15092619

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar N 0. 24104114

Consumer Protection Division 13.0. Box 12548 (MC-010) Austin, Texas 78711 1121232113313fiéxiutsxéél'w 'éztzmré-a<2v Manliqw confluent. “595; M33193; a 1“ <20. 9:8 {landmines ..ztzx 2.320;: Telephone: (512) 963-2613 Facsimile: (512) 473—8301

ATTORNEYS FOR TEXAS SUBPOENA DUCES TECUM—DOCUMENTS REQUESTED

Produce documents relating to the care and treatment of _ (DOB: - -), including medical and billing records, psychotherapy notes, January 1, 2021, through the present. and correspondence from

Produce documents relating to the care and treatment of_ (DOB: —), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment of medical and — notes, and (DOB:_), correspondence from January including billing records, psychotherapy 1, 2021, through the present.

Produce documents relating to the care and treatment of medical and — and (DOB: -, correspondence from including billing records, psychotherapy notes, January 1, 2021, through the present.

Produce documents relating to the care and treatment of — (DOB: - - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment including medical and of_ billing records, psychotherapy notes, and (DOB: _), correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatmentof_ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to thc care and treatment of_ (DOB:—), including medical and billing records, psychotherapy notes, and correspondence fromJanuary 1, 2021, through the present.

Produce documents relating to the care and treatment of including medical and billing records, psychotherapy — notes, and (DOB:_), correspondence from January 1, 2021, through the present.

10. Produce documents relating to the care and treatment of_ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence fromJanuary 1, 2021, through the present.

11. Produce documents relating to the care and treatment of _ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 12. Produce documents relating to the care and treatment of — (DOB- - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

13. Produce documents relating to the care and treatment of _ (DOB: - - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

l4. Produce documents relating to the care and treatment - 0F_(DOB: - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 15. Produce documents relating to the care and treatment of _ (DOB:- - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

16. Produce documents relating to the care and treatment of — (DOB: - - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

l7. Produce documents relating to the care and treatment of_ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

18. Produce documents relating to the care and treaUnent of_ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence fromJanuary 1, 2021, through the present.

19. Produce documents relating to the care and treatment of - (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

20. Produce documents relating to the care and treatmentof_ (DOB:— including medical and billing records, psychotherapy notes, and correspondence fromJanuary 1, 2021, through the present.

21. Produce documents relating to the care and treatment of — (DOB: - - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. WITNESS SUBPOENA RETURN

Came to hand the day of , 2025, at _ o’clock, __, .M. and executed

the day of , 2025, at o’clock, __ .M. by delivering to the within named

in person at in

County, TX, a true copy'of this Subpoena, and tendering said witness the sum of $ .

By Deputy: , County, TX.

Sheriff/ Constable: , County, TX.

OR

By: Person who is not a party to the suit and is not less than 18 years of age.

ACCEPTANCE OF SERVICE OF SUBPOENA BY WITNESS PER RULE 176 T.R.C.P.

I, the undersigned witness named in the Subpoena acknowledge receipt of a copy thereof, and hereby accept service of the attached subpoena, and will appear in said court on said date and time directed in this subpoena.

Rule 176.8(a) Contempt. Failure by any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt ofthe courtfrom which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished byfine or confinement, or both.

SIGNATURE DATE EXHIBIT B CAUSE NO. 4934376764024

YHE STAYS OF TEXAS 5 N THE DlSl'RlCT COURYGF 5 Plaintiff, § vs. § COLLIN COUNT”, Tm § MAYCLAU.M.D. § .

Defendant. 5 493RDJUDIC1AL 918182?!

AFFIDAVIT OF SERVICE

On this-day personally appeared Mauricio Segovia who, being by me duly sworn, deposed and said:

”The following came to hand on 33a 16, 2025. 11:25 am,

SYATE'S NOTlCE OF SUBPOENA DUCKS TECUM, SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES OF CIVIL PROCEDURE 176 AND 205. 9ROTEC‘HVE ORDER.

and was executed at 1999 BRYAN Si” SUITE 900. DALLAS. TX 75201 within the county of UALLAS at 1 2:35 PM on 16 2025, by delivering a true copy to the within named “Hum

UT SOUTHWESTERN MEDlCAL CENTER C10 Cl" CORPORATION SYSTEM accepted by intake Specialist William Miller Witness Fee $1.00

In person having first endorsed the dataof delivery on same.

i am a person over eighteen (18) years of age and i am competent to make this affidavit. i am a resident of the State of Texas. I am familiar with the Texas Rules of CMI Procedure as they apply to service of Process. i am not a party tothls suit nor related or affiliated with any herein, and have no interest in the outcome of the sum I have never been corwlcted of a felony or of a misdemeanor involving moral turpizude. i have personal knowledge of the facts stared herein and they are true and correct.“ /,¢5

(1 Segovia Certification Number: 9561-689 Codification Expiration: 8131Q026

BEFORE NE. a Notary Public. on this day personally appeared Mauricio Segovia, known to me to be the person Morse name is subscribed to the foregoing document and. being by me first duly sworn. declared that the Qatememzsdtereln comairied are wlthin his or her personal knowledge and are true and correct.

suascnaaso mo swoau TO ME ON 1/16/2025 ' " - l ,

“HE! ”a wmrymim Nata K, State of T: '

.5 ' 'i'' .‘AS. 53' madam Cause No. 493-07676-2024

THE STATE OF TEXAS, IN THE DISTRICT COURT 0F

§§§§§§§ Plainn'fi‘,‘

v. COLLIN COUNTY, TEXAS

MAY C. LAU, M.D., Defendant. 493m JUDICIAL DISTRICT

STATE’S NOTICE OF SUBPOENA DUCES TECUM To: UT Southwestern Medical Center c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201

Please take notice that pursuant to Tex. R. Civ. P. 205 gives you 10 days’ notice of its intent

to serve the attached subpoena duces tecum. The State of Texas has complied with all the

requirements in Tex. R. Civ. P. 205.

Please take notice that the Court has entered the attached Protective Order in this matter

expressly finding that attestations are not required. See Prot. 0rd. at 10.

January 16, 2025 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney Genera]

JAMES LLOYD Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar N0. 24071779

ROB FARQUI-IARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division PO. Box 12548 (MC-010) Austin, Texas 78711 Elisabet] 1.5K)?!” @93‘5319NE‘ .329"! KQIflEQBEQW‘*“:=?30€%§§:* see-star.» £2=zzi41§§331t§2§3gratis-£9333isi; F3 Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

CERTIFICATE OF SERVICE I hereby certify that on January 16, 2025, a copy of the foregoing document was served to

all counsel of record in accordance with the Texas Rules of Civil Procedure.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779 THE STATE 0F TEXAS SUBPOENA DUCES TECUM PURSUANT TO TEXAS RULES 0F CIVIL PROCEDURE 176 AND 205

CAUSE NO. 493-07676-2024 IN THE 493m JUDICIAL DISTRICT COURT OF COLLIN COUNTY, TEXAS

State of Texas vs. Defendant May C. Lau, MD.

TO ANY SHERIFF OR CONSTABLE OF THE STATE OF TEXAS OR OTHER PERSON AUTHORIZED TO SERVE AND EXECUTE SUBPOENAS AS PROVIDED IN RULE 176 T.R.C.P.

YOU ARE HEREBY COMMANDED TO SUMMON Children’s Health System of Texas c/o CT Corporation System at 1999 Bryan Street, Suite 900, Dallas, TX 75201, to provide documents to the

Ofl‘ice of the Attorney General 300 West 15th Street Austin, Texas 78701

SAID ABOVE NAMED IS FURTHER COMMANDED to produce the documents listed in the attachment WITHIN SEVEN DAYS OF RECEIPT OF THIS SUBPOENA with an accompanying business records affidavit for inspection and copying during normal business hours at the Office of the Attorney General or send the documents electronically or by certified mail to the Office of the Attorney General, 300 W. 15th Street, 9th Floor, Austin, TX 78701. If providing documents electronically, please provide them to Rozanne Lopez at Rozanne.Lopez@oag.texas.gov.

FAILURE BY ANY PERSON without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

DO NOT FAIL to return this writ to said Court, with return thereon, showing the manner of execution.

ISSUED onJanuary 16, 2025, at the request the request of the State of Texas. /s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY Deputy Chief, Consumer Protection Division State Bar No. 15092619

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

DAVID SHATTO Assistant Attorney General State Bar No. 24104114

Consumer Protection Division PO. Box 12548 (MC-010) Austin, Texas 78711 Enginesi‘mnaééeag-mas-352}: M?l¥:l§.¢l13?§1i§i@9§fia??? 3:45 .995- Bflfi‘mnbgazingécéi'zgeg-a. 3:?292’ 93nd1sheter’fiine‘ée”we 307' Telephone: (512) 963-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS SUBPOENA DUCES TECUM—DOCUMENTS REQUESTED

Produce documents relating to the care and treatment of includin medical and billin _ -, (DOB: , 8 s g records, P Ychotherap Y notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment of _ (DOB: -), including medical and billing records, psychotherapy notes, and correspondence fromjanuary 1, 2021, through the present.

Produce documents relating to the care and treatment of _ (DOB: —), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment of — (DOB: -, -), including medical January 1, 2021, through and the billing records, psychotherapy notes, and correspondence from present.

Produce documents relating to the care and treatment of _ (DOB: - -), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment of_ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment 0- (DOB:-), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment of _ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Produce documents relating to the care and treatment of — (DOB: _), including medical and billing records, psychotherapy notes, and correspondence fromJanuary 1, 2021, through the present.

10. Produce documents relating to the care and treatment of — (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

11. Produce documents relating to the care and treatment of _ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 12. Produce documents relating to the care and treatment of— (DOB: - -), including medical and billing records, psychotherapy notes, and correspondence from january 1, 2021, through the present.

13. Produce documents relating to the care and treatment of— (DOB: - -), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

14. Produce documents relating to the care and treatment of—(DOB: - - including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present. 15. Produce documents relating to the care and treatment of _ (DOB:_), including medical and billing records, psychotherapy notes, and correspondence fromjanuary 1, 2021, through the present.

16. Produce documents relating to the care and treatment of — (DOB: - -), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

17. Produce documents relating to the care and treatment of _ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

18. Produce documents relating to the care and treatment of _ (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

19. Produce documents relating to the care and treatment of— (DOB: _), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

of- 20. Produce documents relating to the care and treatment (DOB:_), including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

21. Produce documents relating to the care and treatment of — (DOB: -, _), January including medical and billing records, psychotherapy notes, and correspondence from 1, 2021, through the present. WITNESS SUBPOENA RETURN

Came to hand the day of , 2025, at __ o’clock, __ .M. and executed

the day of , 2025, at __ o’clock, _ .M. by delivering to the within named in person at in

County, TX, a true copy of this Subpoena, and tendering said Witness the sum of $ .

By Deputy: , County, TX.

Sheriff/ Constable: , County, TX.

OR

By: Person who is not a party to the suit and is not less than 18 years of age.

ACCEPTANCE OF SERVICE OF SUBPOENA BY WITNESS PER RULE 176 T.R.C.P.

I, the undersigned witness named in the Subpoena acknowledge receipt of a copy thereof, and hereby accept service of the attached subpoena, and will appear in said court on said date and time directed in this subpoena.

Rule 176. 8(a) Contempt. Failure by any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt ofthe courtfinm which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.

SIGNATURE DATE EXHIBIT C Cause No.

Nonparty Patient No .l, Nonparty Patient No .2, Nonparty Patient No .3, Nonparty Patient No .4, IN THE DISTRICT COURT OF Nonparty Patient No .5, Nonparty Patient No .6, DALLAS COUNTY, TEXAS Nonpalty Patient No .7, and Nonparty Patient No .8, IUDICIAL DISTRICT

Plaintiffs,

VS.

The State of Texas,

Defendant.

DECLARATION IN SUPPORT OF THE NONPARTY PATIENTS’ PETITION FOR MOTION FOR PROTECTION FROM DISCOVERY SUBPOENAS

1. I am an attorney at the law firm of Winston & Strawn LLP. I represent the

Petitioners (“Nonparty Patients”) in responding to the State of Texas’s subpoenas (“Subpoenas”)

to Children’s Health System of Texas and UT Southwestern Medical Center (“Hospital Systems”).

I am a member in good standing of the State Bar of Texas. Iprovide this declaration in support of

The Nonparty Patients’ Petition for Motion for Protection from Discovery Subpoenas (“Petition”).

I have personal knowledge of the facts stated herein, and I could and would testify completely

thereto if called as a witness in this matter.

2. Each of the Nonparty Patients is one of 21 individuals about whom the State has

sought documents Via the Subpoenas related to medical and mental health care and treatment

received at the Hospital Systems, including medical records, billing records, psychiatry notes, and

correspondence. 3. A true and correct copy of the subpoena to Children’s Health System of Texas is

attached as Exhibit A to the Petition, with redactions to safeguard the identities and confidential

health information of the patients identified therein.

4. A true and correct copy of the subpoena to UT Southwestern Medical Center is

attached as Exhibit B to the Petition, with redactions to safeguard the identities and confidential

health information of the patients identified therein.

5. The Subpoenas were accompanied by a Protective Order issued by the 493rd

Judicial District in Collin County, Texas. A true and correct copy of that Protective Order is

attached to the Petition as Exhibit E. To comply with § III(F) of the Protective, to safeguard the

identity of the patients at issue in the Collin County litigation, and to preserve the confidential

health information of the Nonparty Patients, the Petition has been filed using a generic reference

for the Nonparty Patients. Also consistent with the Protective Order, in the event the Court Wishes

to identify one or more of the Nonparty Patients, they may be identified in camera or as otherwise

ordered by the Court.

I declare under penalty of perjury that the foregoing is true and correct.

Executed in Montgomery County, State of Texas, on February 2, 2025.

/s/ William M. Logan EXHIBIT D CAUSE NO.

THE STATE OF TEXAS, § IN THE DISTRICT COURT OF Plaintifij § § § v § COLLIN COUNTY, TEXAS § § MAY C. LAU, M.D., § Defendant. § JUDICIAL DISTRICT PLAINTIFF’S VERIFIED ORIGINAL PETITION AND REQUEST FOR AN APPLICATION FOR TEMPORARY AND PERMANENT INJUNCTIONS

1. The debate in Texas on the legality of dangerous and experimental medical

procedures seeking to transition or affirm a child’s belief that their gender identity is inconsistent

with their biological sex is over.

2. Texas law prohibits surgeries, puberty blockers, and cross-sex hormones for the

purposes of transitioning a child’s biological sex or affirming a child’s belief that their gender

identity is inconsistent with their biological sex. Tex. Health 8c Safety Code § 161.702.

3. The Supreme Court of Texas held that the law was constitutional. State v. Loe, 692

S.W.3d 215 (Tex. 2024).

4. Today, enforcement begins against those who have violated the law by providing,

prescribing, administering, or dispensing cross-sex hormones to minors for the purposes of

transitioning their biological sex or affirming the child’s belief that their gender identity is

inconsistent with their biological sex.

5. Plaintiff, STATE OF TEXAS, by and through the Attorney General of Texas, KEN

PAXTON, complains of Defendant, MAY C. LAU, M.D. and will show Lau has engaged in

deceptive trade practices, including by misleading pharmacies, insurance providers, and/or patients by falsifying medical records, prescriptions, and billing records to represent that her

testosterone prescriptions are for something other than transitioning a child’s biological sex or

affirming a child’s belief that their gender identity is inconsistent with their biological sex.

6. Lau is a scofflaw who is putting the health and safety of minors at risk by prescribing

testosterone, a controlled substance, to biological female minors for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex in violation of Tex. Health 8c Safety Code § 161.702(3). See Tex. Occ. Code §

164.052(a) (24) (each violation separately violates the Texas Medical Practice Act); see also Tex.

Occ. Code § 164.0552 (each violation serves as an independent ground for revocation of Lau’s

medical license).

7. Lau is also violating Tex. Bus. 8c Com. Code §§ 17. 46(a), (b)(5), (24), by engaging

in false, misleading, and deceptive acts and practices to mislead pharmacies, insurance providers,

and/ or patients by falsifying medical records, prescriptions, and billing records to represent that

her testosterone prescriptions are for something other than transitioning a child’s biological sex or

affirming a child’s belief that their gender identity is inconsistent with their biological sex.

8. Lau must be held accountable for her use, on at least 21 minor patients, of these

illegal, dangerous, and experimental medical procedures for the purposes of transitioning their

biological sex or affirming their belief that their gender identities are inconsistent with their

biological sex.

I. PARTIES

9. Defendant is MAY C. LAU, M.D. (NPI# 1750351375), an employee of the

University of Texas Southwestern Medical Center (“UT Southwestern”) in Dallas, Texas. She holds hospital privileges at Childrens Medical Center Dallas and Children’s Medical Center Plano.

Lau may be served with process at UT Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390.

H. DISCOVERY CONTROL PLAN

10. Discovery in this case should be conducted under Level 3 pursuant to Tex. R. Civ.

P. 190.4. This case is not subject to the restrictions of expedited discovery under Tex. R. Civ. P.

169 because Texas seeks nonmonetary injunctive relief.

11. Additionally, Texas claims entitlement to monetary relief in an amount greater than

$1,000,000, including civil penalties, reasonable attomey’s fees, litigation expenses, restitution,

and costs.

III. JURISDICTION AND VENUE 12. Texas Occ. Code § 161.706(b) provides that venue is proper in “the county where

the violation occurred or is about to occur.”

13. Venue of this suit lies in Collin County, Texas pursuant to Texas Bus. 8c Com. Code

§ 17.47(b), because transactions forming the basis of this suit occurred in Collin County, Texas and

Lau’ s unlawful conduct occurred in Collin County, Texas.

IV. PUBLIC INTEREST

14. Lau violated TeX. Health 8c Safety Code § 161.702, Tex. Bus. 8c Com. Code §

17.46(a) and is engaged in unlawful practices, as set forth in this petition.

15. Texas has reason to believe that Lau is engaging in, has engaged in or is about to

engage in, the unlawful acts or practices set forth below. Texas has further reason to believe Lau

has caused injury, loss, and damage to Texas by endangering the health of its citizens. Therefore, the Consumer Protection Division of the Office of the Attorney General of the State of Texas is of

the opinion that these proceedings are in the public interest.

V. TRADE AND COMMERCE 16. At all times described below, Lau engaged in conduct, the purported practice of

medicine, which constitutes “trade” and “commerce” as defined in Tex. Bus. 8c Com. Code §

1145(6).

VI. NO NOTICE BEFORE SUIT

17. The Consumer Protection Division has reason to believe that Lau “is engaging in,

has engaged in, or is about to engage in any act or practice declared to be unlawful and that

proceedings would be in the public interest...” Tex. Bus. 8c Com. Code § 17.47(a).

18. The Consumer Protection Division did not contact Lau before filing suit to notify

her “in general of the alleged unlawful conduct” because it is the opinion of the Consumer

Protection Division that Lau likely “would destroy” or alter “relevant records if prior contact were

made.” Id.

VII. APPLICABLE LAW

19. Texas Bus. 8c Com. Code § 17.46(a) prohibits “false, misleading, or deceptive acts

or practices in the conduct of any trade or commerce.”

20. Texas Bus. 8c Com. Code § 17.47 authorizes the Consumer Protection Division to

bring an action for temporary and permanent injunction whenever it has reason to believe that

any person is engaged in, in has engaged in, or is about to engage in any act or practice declared

unlawful under Chapter 17 of the Business and Commerce Code. VIII. FACTUAL BACKGROUND

A. Texas Prohibit: the Provision of Puberty Blockers and Cross-Sex Hormones to Minors for the Treatment of Gender Dysphoria.

21. On May 17, 2023, the Legislature added Subchapter X to the Health and Safety

Code, entitled “Gender Transitioning and Gender Reassignment Procedures and Treatments for

Certain Children (SB 14).” Act of May 17, 2023, 88th Leg., R.S., ch. 335; Loe, 692 S.W.3d at 223.

22. Senate Bill 14 prohibits physician and health care providers from performing certain

procedures or treatments when performed to (1) “transition[] a child’s biological sex as

determined by the sex organs, chromosomes, and endogenous profiles of the child”; or (2)

“affirmfl the child’s perception of the child’s sex if that perception is inconsistent with the child’s

biological sex.” Tex. Health 8c Safety Code § 161.702.

23. The effective date for SB14 was September 1, 2023.

24. Senate Bill 14 added Tex. Health 8c Safety Code § 161.702(3), which prohibits

physicians from knowingly prescribing the following to transition a child’s biological sex or affirm

a child’s perception of their sex if it is different from their biological sex: “ (A) puberty suppression

or blocking prescription drugs to stop or delay normal puberty; (B) supraphysiologic doses of

testosterone to females; or (C) supraphysiologic doses of estrogen to males.”

25. Physicians were permitted to prescribe to patients already subject to a continuing

course of treatment that began prior to June 1, 2023, and who attended at least 12 mental health

counseling or psychotherapy sessions over a period of at least six months prior to starting

treatment, provided that the prescriptions were for the purpose of “wean[ing] off the prescription

drug over a period of time and in a manner that is safe and medically appropriate and that minimizes

the risk of complications.” Tex. Health 8c Safety Code § 161.703(b)-(c). 26. Senate Bill 14 also added Tex. Occ. Code § 164.052(a)(24), which proscribed

physicians from “perform[ing] a gender transitioning or gender reassignment procedure or

treatment in violation of [Tex. Health 8c Safety Code § 161.702].”

27. Finally, SB14 added Tex. Occ. Code § 164.0552, which commands that the Texas

Medical Board “shall revoke the license or other authorization to practice medicine of a physician

who violates [Tex. Health & Safety Code § 161.702].” (emphasis added).

B. The Texas Supreme Court Held That SB 14 is Constitutional. 28. Before SB 14 took effect several minors, parents of minors, and physicians brought

suit in Travis County, TX, alleging a variety of constitutional challenges to the law. Loe, 692

S.W.3d at 222.

29. On August 25, 2023, a Travis County District Court entered a temporary injunction

enjoining enforcement of SB 14. Id.

30. Texas appealed directly to the Texas Supreme Court, thereby dissolving the

temporary injunction. Id.

31. On September 1, 2023, the Texas Supreme Court allowed SB 14 to take effect

during the pendency of the appeal. Id.

32. On June 28, 2024, the Supreme Court of Texas reversed and vacated the trial

court’s Temporary Injunction Order after rejecting each of the plaintiffs’ constitutional challenges

to SB 14. Id. at 239. C. Lam is a Radical Gender Activist.

33. Lau “specializes in adolescent female and male sexual and reproductive health,

including gender dysphoria ....” Biography of May Lau, M.D., UT Southwestern (accessed

October 8, 2024), https://tinyurl.com/259556bc.

34. Lau serves as “Medical Director of the Adolescent and Young Adult clinic at

Children’s Medical Center Dallas.” Id.

35. Lau has published extensively advocating for the medical transition of children’s

biological sex, contributing to the following:

i. Tri Pham, ct al., Transition from Pediatric t0 Adult Care fbr Transgender Youth: A Qualitative Study of Patient, Parent, and Provider Perspectives, LGBT Health (May-Jun 2021), https://tinyurl.com/5n8jbc6n. ii. Bethany G. Hart, et al., Developinga Curriculum on TransgenderHealth Care for Physician Assistant Students, Journal of Physician Assistant Education (Mar. 2021), https://tinyurl.com/mvbhyp8e.

iii. Lauren R. Shaffer, et al., Gender-afiirming hormone therapy in cystic fibrosis — A case of new Pseudomonas infection, Respiratory Medicine Case Reports (2021), https://tinyurl.com/mv4jp85.

iv. Laura E. Kuper, et al., Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Aflirming Hormone Therapy, Pediatrics (2020), https://tinyurl.com/5n8s75v8.

Laura E. Kuper, et al. , Baseline Mental Health and Psychosocial Functioning of Transgender Adolescents Seeking Gender—Afiirming Hormone Therapy, Journal of Developmental and Behavioral Pediatrics (Oct/ Nov 2019), https: //tinyurl.com/4wxxzes5.

36. Approximately 20% of the publications listed in Lau’s biography relate to gender

transitioning. Biography ofMay Lau, M.D., https://tinyurl.com/259556bc. 37. On January 8, 2020, Lau and her physician’s assistant, Patti Pagels MPAS, PA-C,

gave a presentation entitled Transgender Care ofAdolescents and Adults, Youtube (Jan. 8, 2020),

https: //tinyurl.com/mkt4pzs3 wherein they asserted:

i. That Lau alters her patient’s medical records to reflect their preferred name, sex, and pronouns, which can change on a visit-to-visit basis, something that is apparently “fairly typical [and] kind of persists into adulthood” for her patients. 20:59-22:40.

ii. That “adolescents’ gender identity is fluid so from one day or one point in time they say no, I’m this, I’m female, but then realize later on that I’m male.” 28:08-28.

iii. That “we’re not sure about the safety and long-term effects of puberty suppression in youth with gender dysphoria we do know that this is safe to use in youth with precocious puberty, but we don’t know if we can translate those side effects and the long-term effects to those with gender dysphoria and who are using puberty suppression for those reasons.” 28:28-46.

iv. That “some of the consequences of hormonotherapy are permanent.” 29:57-30:09.

That biological females that take testosterone to transition their biological sex “will get some atrophy of the vagina [and thereafter for the duration of their life] they’ll need some sort of water-based lubricant if they’re going to still use the vagina as part of sex ....” 32:41-52.

Vi. That “it’s so important that these folks get identified in childhood because when they come to me and are 30 or 40 years old and they’ve been under the influence of their gender hormones all this time it’s very hard to reverse it. I can’t take somebody that’s, you know, five-foot ten and very muscular uh and make them a woman overnight even if they use the clothing and so forth “33:05-39.

vii. That “testosterone is a powerful hormone, so I tell them that the effect of estrogen is like a feather, you know, just it’s just a whiff and whereas testosterone you give a little bit [and] you get a lot of effect.” 33:39-59.

viii. That “I want you to look at the graphic to see that the number of surgeries has increased and continue to increase and many of our patients are getting them done. There are more surgeries for the affirm females than the affirm males and we may not know how many people actually are getting gender affirming surgery because some of them are going to Thailand, they’re going to Europe, they’re going to other counties to get this done because its much cheaper.” 37:37—38:13.

ix. “There’s a recent study May 2018 that suggests the timing of top surgery or breast surgery for affirm males should be based on physical and mental I health status of the youth not by a specific age and will tellyou that we have hadyouth in our clinic come in who have had top surgeiy before 1‘th have even started hormone treatment.” 39:39-40:05 (emphasis added).

38. Lau was previously associated with the now dissolved Gender Education and Care

Interdisciplinary Support (GENECIS) Program, which was dedicated to using medical

interventions to transition the biological sex of children or aflirm a child’s beliefs that their gender

identity is inconsistent with their biological sex. May Lau, M.D., and Patti Pagels MPAS, PA—C,

Transgender Care of Adolescents and Adults, Mid-Atlantic Chapter of the Medical Library

Association (J an. 8, 2020), https://tinyurl.com/mry8wtv9.

39. Ximena Lopez, M.D., the founder of the GENECIS, shuttered the program and

high-tailed it to California shortly after SB 14 was enacted. Paul Hunter, Texas ban on gender—

afi‘lrmlng care leaves trans teens without options, CBC News Guly 5, 2023),

https: //tinyurl.com/4r6c8kr5 (Lopez declaring that medically transitioning children is “one of the

most important things I’ve done in my life” and stating that she was leaving Texas because she

thinks the whole state is “crazy.”).

40. Lopez and Lau are co-authors on several publications advocating for the medical

transition of minors diagnosed with gender dysphoria. Biography of May Lau, M.D.,

https://tinyur1.com/259556bc.

41. Lau and the staff of GENECIS were thanked for assisting with a medical student’s

dissertation on transitioning minors from their biological sex. Antoinette Moore, Health Related Qualigy osz'fe ofTransgender Adolescents Undergoing Hormonal Transition orElective Pubertal Delay,

UT Southwestern (2018), https://tinyur1.com/3y6jwv7y. 42. Lau’ s practices, publications, and presentations betrays an entrenched

commitment to a gender ideology that desires to medically transition the biological sex of children

or aflirm the belief that a child’s gender identity is inconsistent with their biological sex.

IX. VIOLATIONS 0F SB 14.

43. Lau has knowingly violated TeX. Health 8c Safety Code § 161.702(3).

A. Cross—Sex Hormones to Transition Biological Sex or Afi‘irm a Child’s Beliefthat their Gender Identibl is Inconsistent with their Biological Sex.

44. High dose cross-sex hormones are commonly used by gender activists to transition

the biological sex of children or affirm a child’s belief that their gender identity is inconsistent with

their biological sex.

45. High dose cross-sex hormones are prescribed to induce a supraphysiologic state

where the hormone levels are greater than would otherwise normally be present in the child’s body.

46. As a result of the hormones, the child will develop secondary sex characteristics.

47. Testosterone is a cross-sex hormone that is prescribed to transition biological

females to biological females with irreversible male secondary sex characteristics.

48. Testosterone is a Schedule III controlled substance.

49. Radical gender activists within the medical profession rely on the so—called

“Standards of Care” promulgated by the World Professional Association of Transgender Health

(WPATH) as guidelines for transitioning the biological sex of children or affirming a child’s belief that their gender identity is inconsistent with their biological sex. See e.g. Selena Simmons-Duffin,

Rachel Levine calls state anti-LGBTQ hills disturbing and dangerous to trans youth, NPR (Apr. 29,

10 2022) (claiming that the standard for treating gender dysphofia is set by the WPATH),

https: //tinyurl.com/3jxymtum.

50. WPATH recommends that a doctor transitioning the biological sex of children or

affirming a child’s belief that their gender identity is inconsistent with their biological sex prescribe

enough testosterone to induce the same level that would be present in a biological male. Standards

of Care 8, WPATH pg. 110 (2023), https://tinyurl.com/32z3bnhr.

B. Lau’ s Testosterone Prescribing

51. WPATH recommends transitioning the biological sex of children or affirming a

child’s belief that their gender identity is inconsistent with their biological sex by prescribing

injectable testosterone cypionate at 100-200 mg. so as to induce a state of male puberty in a

biological female such that she will develop irreversible male secondary sex characteristics,

Standards of Care 8, WPATH App’x C, https://tinyurl.com/3223bnhr.

52. WPATH recommends “induction of male puberty” in a biological female minor by

prescribing testosterone esters at “25mg/m2/ 2 weeks (or alternatively half this dose weekly).

Increase by 25 25mg/m2/ 2 weeks every 6 months until adult dose and target testosterone levels

achieved.” Id.

53. WPATH alternatively recommends the following testosterone regime for biological

females to induce male secondary sex characteristics, “testosterone enanthate/cypionate 50-100

IM/SQweekly or 100-200 IM every 2 weeks.” Id.

54. A “testosterone cypionate injection is use[d] to treat males whose bodies do not

make enough natural testosterone, a condition called hypogonadism. Testosterone is a male

hormone responsible for the growth and development of the male sex organs and maintenance of

11 secondary sex characteristics. This medicine is not for use in female patients.”

TESTOSTERONE CYPIONATE, Mayo Clinic (accessed October 15, 2024) (emphasis added),

https://tinyurl.com/558b8fcv.

55. The Federal and Drug Administration warns that testosterone cypionate “is

contraindicated in pregnant women and not indicated for use in females.” TESTOSTERONE

CYPIONATE INJECTION, FDA Gune 2022) (emphasis added), https://tinyur1.com/4psvbdeb.

S6. Lau has violated the law by providing, prescribing, administering, or dispensing

testosterone to minor patients for the purposes of transitioning their biological sex or aflirming

their belief that their gender identity is inconsistent with their biological sex:

Patient Onel

57. Patient One resides in Collin County, TX.

58. Patient One was 17 years old during the relevant time.

59. Lau identifies Patient One as a biological female.

60. On October 2, 2023, after SB 14 went into efl‘ect, Lau wrote Patient One a

prescription for a 14—day supply of 200 mg/ ml of testosterone cypionate.

61. The prescriptions purpose is for transitioning her biological sex or affirming her

belief that her gender identity is inconsistent with her biological sex.

62. On October 12, 2023, Patient One filled the prescription at a pharmacy located in

Collin County, TX.

63. Later, Patient One turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone.

Pseudonyms are used throughout to protect the identity of the victim minor patients. 1

12 64. The prescriptions purpose is for transitioning her biological sex or affirming her

belief that their gender identity is inconsistent with her biological sex.

Patient Two

65. Patient Two resides in Collin County, TX.

66. Patient Two was 17 years old during the relevant time.

67. Lau identifies Patient Two as a biological female.

68. On October 9, 2023, after SB 14 went into effect, Lau wrote Patient Two a

prescription for a 90—day supply of 200 mg/ml of testosterone cypionate.

69. The prescriptions purpose is for transitioning her biological sex or affirming her

belief that her gender identity is inconsistent with her biological sex.

70. The same day, Patient Two filled the prescription at a pharmacy located in Collin

County, TX.

Patient Three

71. Patient Three resides in Denton County, TX.

72. Patient Three was 17 years old during the relevant time.

73. Lau identifies Patient Three as a biological male, but upon information and belief,

Patient Three may be a biological female.

74. On August 25, 2023, Lau wrote Patient Three a prescription for a 21-day supply of

200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

75. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

13 76. OnJanuary 7, 2024, 135-days after the prescription was written and after SB 14 went

into effect, Patient Three filled the prescription at a pharmacy located in Denton County, TX.

77. On February 23, 2024, Lau wrote Patient Three a prescription for a 30-day supply

of 200 mg/ ml of testosterone cypionate.

78. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

79. On February 25, 2024, Patient Three filled the prescription at a pharmacy located

in Denton County, TX.

80. Later, Patient Three turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone to them.

81. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

Patient Four

82. Patient Four resides in Dallas County, TX.

83. Patient Four was 16 during the relevant time.

84. Lau identifies Patient Four as a biological female.

85. On August 31, 2023, Lau wrote Patient Four two prescriptions for a 28-day supplies

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

86. The prescriptions purposes is for transitioning her biological sex or affirming her

belief that her gender identity is inconsistent with her biological sex.

87. On September 1, 2023, after SB 14 went into effect, Patient Four filled the

prescription at a pharmacy located in Travis County, TX.

14 88. On October 28, 2023, Patient Four refilled the prescription at a pharmacy located

in Travis County, TX.

89. On March 26, 2024, Lau wrote Patient Four two prescriptions for a 28-day supply

of 200 mg/ ml of testosterone cypionate.

90. On March 28, 2024, Patient Four filled the prescription at a pharmacy located in

Travis County, TX.

91. On July 26, 2024, Patient Four refilled the prescription at a pharmacy located in

Travis County, TX.

Patient Five

92. Patient Five resides in Collin County, TX.

93. Patient Five was 16 years old at the relevant time.

94. Lau identifies Patient Five as a biological male, but upon information and belief,

Patient Five may be a biological female.

95. On August 17, 2023, Lau wrote Patient Five a prescription for a 28-day supply of

200 mg/ ml of testosterone cypionate with orders to fill the prescription both before and after SB

14 took effect.

96. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

97. On October 7, 2023, after SB 14 went into effect, Patient Five filled the prescription

at a pharmacy located in Collin County, TX.

98. On November 14, 2023, Lau wrote Patient Five a prescription with five refills for

28-day supplies of 200 mg/ ml of testosterone cypionate.

15 99. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

100. The same day, Patient Five filled the prescription at a pharmacy located in Collin

County, TX.

101. On December 11, 2023, Patient Five refilled the prescription at a pharmacy located

in Collin County, TX.

102. On January 17, 2024, Patient Five refilled the prescription at a pharmacy located in

Collin County, TX.

103. On March 11, 2024, Patient Five refilled the prescription at a pharmacy located in

Collin County, TX.

104. On April 12, 2024, Patient Five refilled the prescription at a pharmacy located in

Collin County, TX.

105. OnJune 21, 2024, Lau wrote Patient Five multiple prescriptions for 22-day supplies

of 200 mg/ ml of testosterone cypionate.

106. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

107. On June 24, 2024, Patient Five filled the prescription a pharmacy located in Collin

County, TX.

108. OnJuly 13, 2024, Patient Five refilled the prescription a pharmacy located in Collin

County, TX.

109. On August 18, 2024, Patient Five refilled the prescription a pharmacy located in

Collin County, TX.

16 Patient Six

110. Patient Six resides in Collin County, TX.

111. Patient Six was 17 years old at the relevant time.

112. Lau identifies Patient Six as a biological male, but upon information and belief,

Patient Six may be a biological female.

113. On August 30, 2023, Lau wrote Patient Six one prescription with one refill for 84-

day supplies of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14

took effect.

114. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

115. On October 24, 2023, 55-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Six filled the prescription at a pharmacy located in Collin County, TX.

116. On January 22, 2024, Patient Six refilled the prescription at a pharmacy located in

Collin County, TX.

117. Later, Patient Six turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone to them.

118. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

Patient Seven

119. Patient Seven resided in Wise County, TX.

120. Patient Seven was 17 at the relevant time.

121. Lau identifies Patient Seven as a biological female.

17 122. On August 31, 2023, Lau wrote Patient Seven a prescription for an 84-day supply

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

123. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

124. On September 1, 2023, after SB 14 went into effect, Patient Seven filled the

prescription at a pharmacy located in Wise County, TX.

125. Later, Patient Seven turned 18 years old and, thereafter, Lau continued to provide,

prescribe, administer, or dispense testosterone to them.

126. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

Patient Eight

127. Patient Eight resides in Dallas County, TX.

128. Patient Eight was 16 years old at the relevant time.

129. Lau identifies Patient Eight as a biological male, but upon information and belief,

Patient Eight may be a biological female.

130. On August 28, 2023, Lau wrote Patient Eight a prescription for a 28—day supply of

200 mg/ ml of Depo-testosterone with orders to fill the prescription after SB 14 took effect.

131. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

132. On October 16, 2023, 61-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Eight filled the prescription at a pharmacy located in Dallas County, TX.

18 Patient Nine

133. Patient Nine resides in Dallas County, TX.

134. Patient Nine was 14 years old at the relevant time.

135. Lau identifies Patient Nine as a male, but upon information and belief, Patient Nine

may be a biological female.

136. On July 5, 2023, Lau wrote Patient Nine a prescription for a 21-day supply of 200

mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took efiect.

137. The prescriptions purpose is for transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

138. On October 27, 2023, 114-days after Lau wrote the prescription and after SB 14

went into effect, Patient Nine filled the prescription at a pharmacy located in Dallas County, TX.

Patient Ten

139. Patient Ten resides in Tarrant County, TX.

140. Patient Ten was 14 years old at the relevant time.

141. Lau identifies Patient Ten as a biological female.

142. On August 29, 2023, Lau wrote Patient Ten two prescriptions for either a 7-day or

28-day supply of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB

14 took effect.

143. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

144. On October 2, 2023, after SB 14 went into efiect, Patient Ten filled the prescription

at a pharmacy located in Tarrant County, TX.

19 145. On November 1, 2023, Patient Ten refilled the prescription at a pharmacy located

in Tarrant County, TX.

146. On December 4, 2023, Patient Ten refilled the prescription at a pharmacy located

in Tarrant County, TX.

147. On January 5, 2024, Patient Ten filled the second prescription at a pharmacy

located in Tarrant County, TX.

148. On February 12, 2024, Patient Ten refilled the prescription at a pharmacy located

in Tarrant County, TX.

Patient Eleven

149. Patient Eleven resides in Kaufman County, TX.

150. Patient Eleven was 14 years old at the relevant time.

151. Lau identifies Patient Eleven as a biological female.

152. On August 29, 2023, Lau wrote Patient Eleven four prescriptions for 28-day

supplies of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took

effect.

153. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

154. On September 5, 2023, after SB 14 went into effect, Patient Eleven filled the

prescription at a pharmacy located in Kaufman County, TX.

155. On October 15, 2023, Patient Eleven refilled the prescription at a pharmacy located

in Kaufman County, TX.

20 156. On November 17, 2023, Patient Eleven refilled the prescription at a pharmacy

located in Kaufman County, TX.

157. On January 7, 2024, Patient Eleven refilled the prescription at a pharmacy located

in Kaufman County, TX.

Patient Twelve

158. Patient Twelve resides in Rockwall County, TX.

159. Patient Twelve was 14 years old at the relevant time.

160. Lau identifies Patient Twelve as a biological female.

161. On August 31, 2023, Lau wrote Patient Twelve a prescription for a 90-day supply

of testosterone 1.62% Gel Pump with orders to fill the prescription after SB 14 took effect.

162. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

163. OnJanuary 19, 2024, 141-days after Lau wrote the prescription and after SB 14 took

effect, Patient Twelve filled the prescription at a pharmacy located in Rockwall County, TX.

Patient Thirteen

164. Patient Thirteen resides in Dallas County, TX.

165. Patient Thirteen was 15 years old at the relevant date.

166. Lau identifies Patient Thirteen as a biological female.

167. On July 11, 2023, Lau wrote Patient Thirteen several prescriptions for a 90-day

supply of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took

effect.

21 168. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

169. On October 13, 2023, 94-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Thirteen refilled the prescription at a pharmacy located in Dallas County, TX.

Patient Fourteen

170. Patient Fourteen resides in Denton County, TX.

171. Patient Fourteen was 15 years old at the relevant time.

172. Lau identifies Patient Fourteen as a biological female.

173. On August 21, 2023, Lau wrote Patient Fourteen a prescription for a 34-day supply

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

174. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

175. On October 27, 2023, 67-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Fourteen filled the prescription at a pharmacy located in Denton County, TX.

Patient Fifieen

176. Patient Fifteen resides in Dallas County, TX.

177. Patient Fifteen was 15 years old at the relevant time.

178. Lau identifies Patient Fifteen as a biological female.

179. On June 23, 2023, Lau wrote Patient Fifteen a prescription for a 21-day supply of

200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

180. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

22 181. On September 11, 2023, 80—days after Lau wrote the prescription and after SB 14

went into effect, Patient Fifteen filled the prescription at a pharmacy located in Dallas County, TX.

Patient Sixteen

182. Patient Sixteen resides in Tarrant County, TX.

183. Patient Sixteen was 15 years old at the relevant time.

184. Lau identifies Patient Sixteen as a biological female.

185. On August 23, 2023, Lau wrote Patient Sixteen a prescription for an 84-day supply

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

186. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

187. On January 7, 2024, 137-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Sixteen filled the prescription at a pharmacy located in Tarrant County, TX.

Patient Seventeen

188. Patient Seventeen resides in Potter County, TX.

189. Patient Seventeen was sixteen years old at the relevant time.

190. Lau identifies Patient Seventeen as a biological female.

191. On August 31, 2023, Lau wrote Patient Seventeen a prescription for a 42-day supply

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

192. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

193. On September 1, 2023, after SB 14 went into effect, Patient Seventeen filled the

prescription at a pharmacy located in Potter County, TX.

23 Patient Eighteen

194. Patient Eighteen resides in Collin County, TX.

195. Patient Eighteen was 16 years old at the relevant time.

196. Lau identifies Patient Eighteen as a biological male, but upon information and belief,

Patient Eighteen may be a biological female.

197. On August 24, 2023, Lau wrote Patient Eighteen a prescription for an 80-day

supplies of 200 mg/ ml of testosterone 12.5 mg/ 1.25 g with orders to fill the prescription after SB

14 took effect.

198. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

199. On October 27, 2023, 64-days after Lau wrote the prescription and after SB 14 went

into effect, Patient Eighteen filled the prescription at a pharmacy located in Saint Louis County,

MO.

Patient Nineteen

200. Patient Nineteen resides in Collin County, TX.

201. Patient Nineteen was 16 years old at the relevant time.

202. Lau identifies Patient Nineteen as a biological male, but upon information and

belief, Patient Nineteen may be a biological female.

203. On August 31, 2023, Lau wrote Patient Nineteen a prescription for a 14-day supply

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

204. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

24 205. On October 24, 2023, 54— days after Lau wrote the prescription and after SB 14 went

into effect, Patient Nineteen filled the prescription at a pharmacy located in Collin County, TX.

Patient Twenty

206. Patient Twenty resides in Dallas County, TX.

207. Patient Twenty was 17 years old at the relevant time.

208. Lau identifies Patient Twenty as a biological female.

209. On August 31, 2023, Lau wrote Patient Twenty a prescription for a 21-day supply

of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took effect.

210. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

211. On November 22, 2023, 83-days after Lau wrote the prescription and after SB 14

went into effect, Patient Twenty filled the prescription at a pharmacy located in Dallas County,

TX.

Patient Twenty-One

212. Patient Twenty-one resides in Dallas County, TX.

213. Patient Twenty-one was 17 years old at the relevant time.

214. Lau identifies Patient Twenty-one as a biological female.

215. On August 15, 2023, Lau wrote Patient Twenty-one a prescription for a 14-day

supply of 200 mg/ ml of testosterone cypionate with orders to fill the prescription after SB 14 took

effect.

216. The purpose is for transitioning their biological sex or affirming their belief that

their gender identity is inconsistent with their biological sex.

25 217. On September 10, 2023, after SB 14 went into effect, Patient Twenty-one filled the

prescription at a pharmacy located in Dallas County, TX.

218. Later, Lau identifies the now 18-year-old Patient Twenty-one, as a biological male. * * *

219. Paragraphs 58-219 describe 21 minor patients who Lau has unlawfully treated with

testosterone for the purposes of transitioning their biological sex or affirming their belief that their

gender identity is inconsistent with their biological sex in violation of SB 14.

220. Some of Lau’s medical records for the patients identified in the preceding

paragraphs indicate that the patients are male, but upon information and belief, all of these

patients are biological females and Lau is prescribing to them for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex. See also supra ‘1] 37(i) (Lau admitting that she commonly changes the biological sex

of her patients in her medical records).

221. Lau cannot circumvent SB 14 by writing prescriptions to her patients prior to the

SB 14 taking effect with orders to fill or refill the prescriptions afier it takes effect, see 22 Tex.

Admin. Code § 315.3(b)(2) (Schedule HI Controlled Substances can be refilled up to five times

within six months of the date of issuance), because a “prescription” order is not a singular discrete

act, but a continuing act of treatment that begins with the prescription being written and continues

through the pharmacist filling the prescription and the drug being used as directed by the patient,

or until the written prescription expires or is cancelled, and alternative] , because by issuing

prescriptions with orders to fill them after the effective date of SB 14 Lau is “providing” the

26 prescribed medication to the patient at the time they fill and use the prescription as directed, which

they could not do otherwise without the prescription.

222. Each and every prescription written by Lau after September 1, 2023, or filled or

taken as directed by a patient after September 1, 2023, for the purpose of transitioning the minor’s

biological sex or affirming their belief that their gender identity is inconsistent with their biological

sex violates Tex. Health 8c Safety Code § 161.702(3).

X. FALSE, MISLEADING, OR DECEPTIVE ACTS 223. Texas incorporates and adopts by reference the allegations contained in each and

every preceding paragraph of this Petition.

224. Lau, as alleged herein, has in the course of trade and commerce engaged in false,

misleading, and deceptive acts and practices declared unlawful in violation of Tex. Bus. 8c Com.

Code §§ 17. 46(a), (b)(5), (24).

225. Texas Bus. 8c Com. Code § 17.46(a) prohibits “false, misleading, or deceptive acts

or practices in the conduct of any trade or commerce.”

226. As illustrated in the representative example below, Lau deceptively misleads

pharmacies, insurance providers, and/ or the patients by falsifying patient medical records,

prescriptions, and billing records to indicate that the use of puberty blockers for minor patients are

for something other than transitioning their biological sex or affirming their belief that their gender

identity is inconsistent with their biological sex.

227. Lau also likely deceptively misled pharmacies, insurance providers and/ or the

patients by falsifying patient medical records, prescriptions and billing records to indicate the use

of Testosterone for minor Patients One through Twenty—one for something other than

27 transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

228. Texas Bus. 8c Com. Code § 17.46(b)(5) prohibits “representing that goods or

services have sponsorship, approval, characteristics, ingredients, uses, benefits, or quantities

Which they do not have or that a person has a sponsorship, approval, status, affiliation, or

connection which the person does not.”

229. As illustrated in the representative example below, Lau deceptively represents that

goods or services have approval, characteristics, uses, or benefits which they do not or that a person

has a sponsorship, approval, status, affiliation, or connection which the person does not have by

falsifying patient medical records, prescriptions, and billing records for something other than

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex.

230. Texas Bus. 8c Com. Code § 17.46(b)(24) prohibits “failing to disclose information

concerning goods or services which was known at the time of the transaction if such failure to

disclose such information was intended to induce the consumer into a transaction if such failure to

disclose such information was intended to induce the consumer into a transaction into which the

consumer would not have entered had the information been disclosed.”

231. As illustrated in the representative example below, Lau deceptively induces

pharmacies, insurance providers, and/ or the patients into entering into transactions by falsifying

patient medical records, prescriptions, and billing records to indicate that treatments are for

something other than transitioning a child’s biological sex or affirming their belief that their gender

identity is inconsistent with their biological sex.

28 A. Lam use: false diagnoses and billing codes on transgender patients.

Patient Twenty-Two

232. Patient Twenty-Two, a 15-year-old minor, was first seen by Lau in January 2023.

233. Lau represented that Twenty-two was identified in the medical records as a male at

the time.

234. Lau falsely billed Patient Twenty-Two’s insurance using the diagnostic code for an

endocrine disorder, unspecified (E349).

235. In fact, Lau diagnosed Twenty—two with gender dysphoria and began “treatment”

for that condition by prescribing and inserting a puberty blocker device in the patient for the

purposes of transitioning their biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

236. On August 3, 2023, Lau changed Twenty-two’s sex to female in the medical and

billing records—further proof that Lau was transitioning their biological sex or affirming their

belief that their gender identity is inconsistent with their biological sex.

237. Less than a week later, Twenty—two met with Lowell, the founder of Queer Med

and who exclusively treats transgender patients, see What We Do, QueerMed (accessed October 8,

2024), https://tinyurl.com/2rr2ff76, for a fertility preservation counseling visit.

238. Lowell used the same false diagnostic billing code for endocrine disorder,

unspecified (E349), when she was actually providing treatment to Patient Twenty-Two for the

purposes of transitioning their biological sex or affirming their belief that their gender identity is

inconsistent with their biological sex.

29 239. Two weeks later, on August 18, 2023, Twenty-two visited Lau who falsely billed for

the removal and reinsertion of a puberty blocker for the treatment of an endocrine disorder,

unspecified (E349) —when in fact Lau was using puberty blockers for the purposes of transitioning

their biological sex or affirming their belief that their gender identity is inconsistent with their

biological sex.

240. The same day, Twenty-two was seen by a different provider at Children’s Medical

Center of Dallas who correctly used billing codes for gender identity disorder, unspecified (F649).

241. Patient Twenty-Two had follow up visits with Lowell of QueerMed in January and

March 2024, where her diagnosis was again falsely billed as an endocrine disorder, unspecified

(E349).

242. Thus, even prior to September 1, 2023, and despite other providers correctly

diagnosing Twenty-two with gender identity disorder, unspecified (F649), Drs. Lau and Lowell

demonstrated a pattern of false, misleading, and deceptive acts by choosing to falsify Patient

Twenty-Two’s biological sex, medical records, diagnoses, treatment plan, prescriptions, and

billing records to conceal that they were transitioning Patient Twenty-Two’s biological sex or

affirming their belief that their gender identity is inconsistent with their biological sex.

B. Gender dysphoria is not an endocrine disorder.

243. “Insurance Coding Alternatives for Trans Healthcare,” Campaign for Southern

Equality (accessed October 8, 2024), https://tinyur1.com/5ce62v2d, purports to assist healthcare

providers with instructions on how to use false billing codes to provide medical treatments for the

purposes of transitioning a minor’ s biological sex or aflirming their belief that their gender identity

is inconsistent with their biological sex.

3O 244. The fact sheet claims that it is intended to “assist trans people in advocating for

themselves with their healthcare providers and insurance companies” and discusses “insurance

codes for trans healthcare that are commonly accepted and rejected.” Id.

245. The fact sheet notes certain billing codes that are commonly rejected by insurance

providers include the F64 set of codes for gender dysphoria or gender identity disorder. Id.

246. The fact sheet recommends billing for hormone replacement therapy to transition

a minor’s biological sex as an endocrine disorder, unspecified (E349).

247. Upon information and belief, Lau is using this diagnostic billing code to falsely

represent that she’s treating patients for an unspecified endocrine disorder, when in fact she is

transitioning their biological sex or affirming their belief that their gender identity is inconsistent

with their biological sex—something that is not an endocrine disorder.

248. An endocrine disorder results from the improper function of the endocrine system.

249. Children normally enter puberty reflecting their biological sex. There is no disorder

at all. Rather, the disorder results when a physician intervenes in a child’ s natural puberty to induce

through puberty blockers and cross—sex hormones a state of puberty naturally occurring in the

opposite sex. Such physician causes a disorder rather than treats one, by introducing

supraphysiological dose of a cross-sex hormone to force a child’s body (a biological reality) to fit

that child’s gender identity (a mental construct).

250. Here, Lau is engaging in false, misleading, or deceptive practices, by falsely

diagnosing and billing patients using the endocrine disorder, unspecified, code instead of the F64

gender related diagnosis codes to conceal that she is transitioning their biological sex or aflirming

31 their belief that their gender identity is inconsistent With their biological sex in violation of Tex.

Bus. 8c Com. Code §§ 17. 46(a), (b)(5), (24).

XI. APPLICATION FOR TEMPORARY AND PERMANENT INJUNCTIONS

251. Texas incorporates and adopts by reference the allegations contained in each and

every preceding paragraph of this Petition.

252. Texas has reason to believe that Lau is engaging in, has engaged in, or is about to

engage in acts and practices declared to be unlawful under Tex. Health 8c Safety Code § 161.702(3)

and Tex. Bus. 8c Com. Code §§ 17. 46(a), (b)(5), (24), and believes these proceedings to be in the

public interest.

253. Texas is entitled to, and seeks, temporary and permanent injunctions pursuant to

Tex. Health and Safety Code § 161.702 as well as Tex. Bus. 8c Com. Code § 17.47.

254. Cessation of unlawful conduct by Lau shall not render such court action moot under

any circumstances. Id.

255. Immediate injunctive relief is necessary to prevent continuing harm prior to trial.

256. In addition to the above-requested relief, pursuant to Tex. Civ. Prac. Rem. Code §

65.011 et seq. and Tex. R. Civ. P. 680 et seq., to preserve the status quo pending a full trial on the

merits, see Bumaru v. Ford Motor Co., 84 S.W.3d 198, 204 (Tex. 2002), the Texas Attorney

General’s Office request a temporary injunction against Lau that enjoins her from the following

until final resolution of this matter:

i. Prescribing supraphysiologic doses of testosterone and estrogen to minors for the purpose of transitioning their biological sex; and

ii. Deceptively misleading pharmacies, insurance providers, and/ or the patients as to the correct medical diagnosis by writing prescriptions and billing for treatments to transition a child’s biological sex under false

32 diagnoses, such as endocrine disorder, unspecified, rather than gender dysphoria (or other similarly related diagnosis).

XII. PRAYER FOR RELIEF

257. NOW THEREFORE Texas prays that Lau be cited to appear and that after due

notice and hearing, a temporary injunction be issued, and that upon final hearing a permanent

injunction be issued, restraining and enjoining Lau and all persons in active concert or participation

with her, who receive actual notice of the injunction by personal service or otherwise from engaging

in false, misleading or deceptive acts and practices declared to be unlawful by Tex. Health and

Safety Code § 161.702 and Tex. Bus. 8c Com. Code § 17. 46(a), (b)(5), (24), including but not

limited to:

i. Prescribing supraphysiologic doses of testosterone and estrogen to minors for the purpose of transitioning their biological sex;

ii. Deceptively misleading pharmacies, insurance providers, and/ or the patients as to the correct medical diagnosis by writing prescriptions and billing for treatments to transition a child’s biological sex under false diagnoses, such as endocrine disorder, unspecified, rather than gender dysphoria (or other similarly related diagnosis).

258. TEXAS FURTHER PRAYS that upon final hearing, this Court order:

i. Adjudge against Lau civil penalties in favor of the State in the amount of not more than $10,000 per violation of Tex. Bus. 8c Com. Code § 17. 46(a), (b)(5), (24);

ii. Order Lau to pay Texas ’ s attorneys ’ fees and costs of court pursuant to Tex. Gov’t Code § 402.006(c);

iii. Order Lau to pay both pre-judgment ad post-judgment interest on all money awards as provided by law; and

iv. Grant all other and further relief Texas may show itself entitled to.

33 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

JAMES LLOYD Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

MATTHEW KENNEDY State Bar No. 24092619 Deputy Chief, Consumer Protection Division

Consumer Protection Division Office of the Attorney General P.O. BOX 12548 Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Matt.Kennedy@oag.texas.gov Telephone: 512-463-2185 Facsimile: 512-473-8301 ATTORNEYS FOR TEXAS

34 DECLARATION

Pursuant to Tex. Civ. Rem. 8c Prac. Code § 132.0010), JOHNATHAN STONE submit

this unsworn declaration in lieu of a written sworn declaration, verification, certification, oath, or

affidavit required by Texas Rule of Civil Procedure 682. I am an employee of the following

governmental agency: Texas Office of the Attorney General. I am executing this declaration as part

of my assigned duties and responsibilities. I declare under penalty of perjury that the factual

statements in the foregoing are true and correct.

Executed in Travis County, State of Texas, on the 17th day of October, 2024.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

3S EXHIBIT E Flled: 1/13/2025 10:18 AM Michael Gould District Clerk Collin County. Texas By Elizabeth Anderson Deputy Envelope ID: 96128789 Cause N o. 493-07676-2024

The State of Texas, § In the District Court of Plaintzffi § § v. § Collin County, Texas § May C. Lau, M.D., § Defendant. § 493'“ Judicial District

PROTECTIVE ORDER Afier considering the parties’ motions, any responses thereto, and arguments of counsel, the

Court hereby enters the following protective order in Case Nos. 493-08026-2024 and 493-07676-

2024.

To adequately protect individually identifiable health information and other information

entitled to be kept confidential, the Court orders as follows:

I. Definitions:

(A) As used in this Order, the term “party” shall mean all named parties to any action

in the above-captioned litigation, including any named party added or joined to any complaint in

this action.

(B) The term “third-party” shall mean any individual, corporation, other natural

person or entity, or any state, federal, or local government agency.

(C) The term “documents” as used herein is intended to be comprehensive and

includes any and all maten'als in the broadest sense contemplated by Tex. R. Civ. P. 192.3(b), and

shall include all written, oral, recorded, or graphic material, however produced or reproduced,

including, but not limited to, all written or printed matter of any kind, computer data, all graphic

or manual records or representations of any kind, and electronic, mechanical, or electric records

or representations of any kind. (D) As used in this Order, the term “confidential health information” means

“protected health information” as defined in the Texas Medical Records Privacy Act (TMRPA),

Tex. Health & Safety Code Ch. 181 and the Health Insurance Portability and Accountability Act

(HIPAA) of 1 996, 45 C.F.R § 164.501 (“protected health information”) and 160.103 (“individually

identifiable health information”).

(E) The term “confidential information” means information (regardless of how it is

generated, stored or maintained) or tangible things that contain or reflect confidential, non-public,

proprietary, commercially sensitive, and/or private information of a n individual or entity.

confidential information includes, but is not limited to, confidential health information.

(F) The term “classified information” refers to all documents designated as

“confidential information” or “confidential health information.”

II. General Provisions:

(A) Production of Health Information That May Be Subject To 5 U.S.C. § 552a, to

45 C.F.R. §§ 164.102-164.534, or to 42 U.S.C. § 1306, or Other Privacy Protections.

Documents produced during discovery in the above-captioned litigation may contain information

subject to provisions of state and federal privacy laws governing health information. In order to

facilitate the production of these records and to protect their confidentiality, the requested or

subpoenaed parties are permitted to produce these documents to any party of the litigation in an

unredactcd form to the extent permitted by law. Upon producing these documents, the producing

party shall designate them as “confidential health information” in the manner set forth below. All

parties receiving these documents may use such desigiated records only for purposes of the above-

captioned litigation and may disclose them to non-parties to this litigation only as specified within

this Order and only if the non-party sigts the form of acknowledgment attached to this Order as

set forth below. (B) Designation of Material Subject to this Protective Order. To designate

COnfidential Information produced in Documentary form (c.g., paper or electronic Documents), the

Producing Party shall so designate on the material itself or in an accompany cover letter using the

following designations, as appropriate: “CONFIDENTIAL” or “CONFIDENTIAL HEALTH

INFORMATION - SUBJECT TO PROTECTIVE ORDER.” If only a portion or portions of the

material on a page qualifies for protection, and it is feasible and not unduly burdensome to do so, the

Producing Party also must clearly identify the protected portions and must specify, for each portion,

the protection being asserted. For testimony given in deposition or in other pretrial or trial 4

proceedings, that the Designating Party when practical identify on the record, before the close of the

deposition, hearing, or other proceeding, all protected testimony and specify the protection being

asserted. Alternatively, a Designating Party may specify, at the deposition or up to 21 days

aflerwards, that the entire transcript or any portion thereof shall be treated as “CONFIDENTIAL,”

or “CONFIDENTIAL HEALTH INFORMATION —— SUBJECT TO PROTECTIVE ORDER.”

Parties shall give the other Parties reasonable notice (a minimum of two business days) if they

reasonably expect a deposition, hearing or other proceeding to include Confidential Information so

that the other Parties can ensure that only authorized individuals who have signed the “Certification”

(Exhibit A) are present at those proceedings.

(C) Scope of Order. The terms and conditions of this Order shall govern all documents

designated as classified information. Should a document or record contain information that is

protected under the terms and conditions of this Order as well as the terms and conditions of any

other Protective Order entered in the above-captioned litigation, the terms and conditions of this

Order shall govern in the event of any conflict between the Orders.

III. Provisions Governing Use and Disclosure of Classified Information: (A) The parties may not use or disclose classified information for any purpose other

than use in the above-captioned litigation.

(B) Classified information may be disclosed only to the following qualified persons:

1. This Court and all persons assisting this Court in this action, including court reporters taking testimony involving such information, and necessary stenographic and clerical personnel;

Persons retained as consultants or experts for any party and principals and employees of the firms with which consultants or experts are associated;

Persons other than consultants or experts, who are employed by counsel to provide purely administrative assistance to counsel for any party for the purpose of this action, including litigation support services and outside copying services;

Any person who may testify as a witness at a deposition, hearing, mediation, trial, or other proceeding in this action, and for the purpose of assisting in the preparation or examination of the witness;

Any other person hereafier designated by written stipulation of the parties and, if applicable, the third-party who produced or supplied the confidential health information, or by further order of this Court; and

The parties, the parties’ counsel and their partners, associates, paralegals, and clerical and support personnel.

(C) No classified information may be disclosed to any person pursuant to the provisions

of paragraph III. (B) of this Order unless counsel first informs such person that pursuant to this

Order the material to be disclosed may only be used for purposes of preparing and presenting

evidence in this litigation and must be kept confidential. No classified information may be disclosed

to any person identified in this Order unless such person first is given a copy of this Order and

advised that the information contained in the document is classified information and informed that

an unauthorized disclosure of the information in the document may constitute contempt of this

Court. Each person to whom classified information is disclosed shall execute an acknowledgement

in the form of attached hereto as Exhibit A and shall agree to be bound by this Order prior to

receiving any classified information. Copies of the executed Certifications, and a current log of the

-4. materials containing confidential health information disclosed to each person executing a

Certification, shall be retained by counsel for the party or parties who disclosed the confidential

health information to such persons.

(D) No person, finn, corporation, or other entity subject to this Order shall give, show,

disclose, make available, or communicate classified information to any person, firm, corporation,

or other entity not expressly authorized by this Order to receive such classified information.

(E) Use of Classified Information in Court. In the event any party wishes to use

classified information in motions, affidavits, briefs, exhibits, or other documents and admitted

during proceedings in this action, such party shall take appropriate steps to safeguard the classified

information, such as redacting the personal identifiable information, including patient names,

names of family members, social security numbers, patient numbers, addresses, phone numbers,

email addresses, or other contact information. In the event this Court wishes to review the redacted

material, this Court may review the redacted material in camera or order that the documents or

transcript of any hearing containing classified information be filed under seal. Alternatively, the

parties may file such affidavits, briefs, exhibits, or documents under seal with this Court. The Clerk

of Court shall accept for filing under seal any documents or filings so marked by the parties

pursuant to this paragraph.

(F) Identification of Patients and Their Confidential Health Information. In the

event any party wishes to identify any patient or their confidential health information in motions,

affidavits, briefs, exhibits, or other documents and admitted during proceedings in this action, such

party shall take appropriate steps to safeguard the identities and confidential health information of

each patient, by referring to the patient through a generic reference, as follows: “Patient One,”

“Patient Two,” etc. In the event this Court wishes to know the identification of the patient, this

Court may review the identification of each patient in camera or order that the documents or

-5- transcript of any hearing containing the identities of the patient and their confidential health

information be filed under seal. Alternatively, the parties may file such affidavits, briefs, exhibits,

or documents under seal with this Court. The Clerk of Court shall accept for filing under seal any

documents or filings so marked by the parties pursuant to this paragraph.

IV. Challenging Classified Information Desigations:

(A) A party shall not be obligated to challenge the propriety of a classified information

desigiation at the time such designation is made and a failure to do so shall not preclude a

subsequent challenge to the designation. In the event that any party to this litigation disagrees at

any stage of these proceedings with the desigiation of any information as classified information,

the objecting party may invoke this Protective Order by objecting in writing to the party who

designated the document or information as classified information. The designating party shall then

have fourteen (l4) days to move the court for an order preserving the desiglated status of the

disputed information. The disputed information shall remain classified information unless and

until the court orders otherwise, except that the failure of the designating party to request and

obtain a setting seeking an order within thirty days of moving the court for an order shall constitute

a termination of the status of such item as classified information.

V. Destruction of Classified Information at Completion of Litigation:

(A) Within sixty (60) days afier the final resolution of the above-captioned action,

including resolution of all appellate proceedings, all documents and copies of documents in the

Attorney General’s possession, which are designated as containing classified information, as well

as notes, memoranda, and summaries taken or made of such documents that contain classified

information, shall either be returned to the producing party or third party or destroyed. (B) All counsel of record who received documents that contain classified information

shall certify compliance herewith and shall deliver the same to the producing party or third party

not more than sixty (60) days after the final resolution of this action. The return of documents or

certifications of destruction relating to documents produced by the State of Texas shall be provided

to Office of the Attorney General, Consumer Protection Division.

(C) This provision does not apply to patient medical records that are already existing in

the patient’s medical chart and may remain in the patient’s medical chart for the purpose of

continuing healthcare and must be preserved according to the physician’s obligations to the patient

and medical board.

VI. Miscellaneous Provisions:

(A) No Waiver. The failure to designate any materials shall not constitute a waiver of

the assertion that the materials are covered by this Protective Order.

(B) Third-Party Request or Demand for Disclosure. Should any party bound by this

Order receive a subpoena, civil investigative demand, or other process from a third-party seeking,

requesting, or requiring disclosure of classified information in any form, such person shall give

notice immediately to the producing party so that the producing party may seek appropriate relief,

if any. Notice shall be made within ten (10) days of receiving the request for production and shall be in writing. Notice to the State of Texas shall take the form of written notification to the Office

of the Attorney General, Consumer Protection Division. No person bound by this Order who

receives a subpoena, civil investigative demand, other process fiem a third-party seeking,

requesting, or requiring the disclosure of classified information shall produce or disclose such

documents or information unless and until a) ordered by a court having competent jurisdiction, or

b) such production or disclosure is in accordance with the provisions herein and is expressly consented to

by the producing party. (C) Inadvertent Failures to Designate. An inadvertent failure to desigmte qualified

information or items does not, standing alone, waive the designating party’s right to secure

protection under this Order for such material. Upon timely correction of a desigiation, the

receiving party must make reasonable efforts to assure that the material is treated in accordance

with the provisions of this Order.

(D) Storage and Maintenance of Classified Information. Classified information

must be stored and maintained by a receiving party at a location and in a secure manner that ensures

that access is limited to the persons authorized under this Order. Any person in possession of

classified information will maintain appropriate administrative, technical, and organizational

safeguards (“Safeguards”) that protect the security and privacy of classified information. The

Safeguards will meet or exceed relevant industry standards and limit the collection, storage,

disclosure, use of, or access to classified information solely to personnel and purposes authorized

by this Order.

(E) Inadvertent Production of Privileged Material. When a producing party gives

notice of receiving parties that certain inadvertently produced material is subject to a claim of

privilege or other protection, the obligations of the receiving parties are those set in the Texas

Rules of Civil Procedure, including Texas Rule of Civil Procedure 193.3(d). The production or

disclosure of any material that is attorney-client privileged, physician-patient privileged, work-

product-protected, or otherwise privileged under Texas law shall not result in the waiver of any

claim of privilege or work product protection associated with such information, regardless of the

circumstances of such production or disclosure.

(F) Unauthorized Disclosure of Classified Information. If a receiving party learns

that, by inadvertence or otherwise, it has disclosed classified information to any person or in any

circumstance not authorized under this Order, the receiving party must immediately (a) notify in

-3- writing the designating party of the unauthorized disclosures, (b) use its best efforts to retrieve all

unauthorized copies of the classified information, (c) inform the person or persons to whom

unauthorized disclosures were made of all the terms of this Order, and (d) request such person or

persons to execute the “Certification” that is attached hereto as Exhibit A. If a receiving party or

person authorized to access classified information (“Authorized Recipient”) discovers any loss of

classified information or a breach of security, including any actual or suspected unauthorized

access, relating to another party’s classified information, the receiving party or authorized recipient

shall: (l) promptly stop the unauthorized breach; (2) promptly (within 72 hours) provide written

notice to the designating party of such breach, including information regarding the size and scope

of the breach; and (3) investigate and make reasonable efforts to remediate the effects of the breach.

In any event, the receiving party or authorized recipient shall promptly take all necessary and

appropriate corrective action to terminate any unauthorized access.

(G) The Application of Other Privacy Provisions of Law. Notwithstanding any

provision of this Order to the contrary, in accordance with any applicable federal, state, or local

laws that afford heightened protection to certain categories of confidential health information

including, but not limited to records or diagnosis or treatment for alcohol or substance abuse,

certain sexually transmitted diseases such as HIV/AIDS, mental health, minors, and research

pertaining to genetic testing, the producing party may completely exclude fi'om production any

information afforded heightened protection by such federal, state, or local laws.

(H) Nothing in this Order shall affect the rights of the parties or third parties to object

to discovery on grounds other than those related to the protection of confidential health

information, nor shall it preclude any party or third-party fiom seeking further relief of protective

orders from this Court as may be appropriate under the Texas Rules of Civil Procedure. (I) Any person requiring further protection of confidential health information may

petition this Court for a separate order governing the disclosure of its information.

(J) The provisions of this Order shall survive the conclusion of this action.

VII. No Good Cause to Excuse Patient Notification:

This Court does not find that good cause exists to excuse the parties fiom the patient

notification requirements in Tex. R. Civ. P. 196.1(c); save and except, as to the identified limited

motion to transfer venue discovery (date, location of treatment, location of filling of prescription)

which the parties agree falls within l96.l(c)(2)(B). (Parties agree all other information will be wholly

redacted).

VIII. No Attestation Reguired:

This Court finds that the allegations in this suit involve the prescribing of puberty blockers

and/or cross-sex hormones for the purposes of transitioning a minor’s biological sex or affirming

their belief that their gender identity or sex is inconsistent with their biological sex in violation of

Tex. Health & Safety Code §161.702(3), and alleged falsification of medical records, prescriptions,

and billing records to intentionally conceal the allegedly unlawful conduct in violation of Tex. Bus.

& Com. Code §§ 17.46(a), (b)(5). See generally Tex. Orig. Pet.

The Court finds the attestation provision is not applicable in this cause, including but not

limited for the reason the information is not sought for a prohibited purpose. The parties are,

therefore, excused fi-om the attestation requirement contained in 45 C.F.R. § 164.509(a), to the extent

such requirements exist.

SIGNED on this I «a;Mg myorj ,2025. (g6 \xS -10- CHRIST A. OW LK DISTRICT COURT DGE 1(13\

-11- EXHIBIT A

.12- CERTIFICATION I certify that I have read the attached Agreed Protective Order (the Order), and I agree that

I will not use or disclose classified information or individually identifiable health information for

any purpose other than this litigation and that, within sixty days (60) after the final resolution of

this action, I will either return all classified information to the party that produced such information

or destroy such classified information. I will otherwise keep all classified information in

accordance with this Order. I agree that the 493rd District Court in Collin County Texas has

jurisdiction to enforce the terms of the Order, and I consent to jurisdiction of that Court over my

person for that purpose. I agree that the court where Texas v. Lau, No. 493-07676-2024 is pending

at the time of enforcement or where the trial in Texas v. Lau occurred has jurisdiction to enforce

the terms of the Order, and I consent to jurisdiction of that Court over my person for that purpose.

I will otherwise be bound by the strictures of the Order.

Date [Printed Name]

[Signature]

-13- Exhibit H 1

2 TRIAL COURT CAUSE NO. 493-07676-2024 TRIAL COURT CAUSE NO. 493-08026-2024 3

4 THE STATE OF TEXAS, § IN THE DISTRICT COURT § 5 § Plaintiff, § 6 § VS. § 7 § 493RD JUDICIAL DISTRICT § 8 MAY C. LAU, M.D., § § 9 § Defendant. § COLLIN COUNTY, TEXAS 10

11 THE STATE OF TEXAS, § IN THE DISTRICT COURT 12 § § 13 Plaintiff, § § 14 VS. § § 493RD JUDICIAL DISTRICT 15 § M. BRETT COOPER, M.D., § 16 § § 17 Defendant. § COLLIN COUNTY, TEXAS

19 -----------------------------

21 -----------------------------

22 On the 26th day of February, 2025, the following 23 proceedings came on to be heard in the above-entitled and numbered cause before the Honorable Christine Nowak, 24 Judge presiding, held in McKinney, Collin County, Texas;

25 Proceedings reported by machine shorthand. 2

2 FOR THE STATE OF TEXAS:

SBOT: #24071779 PO Box 12548 5 Austin, Texas 78711 Phone: 512-936-2613 6 Johnathan.Stone@oag.texas.gov

SBOT: #24104114 PO Box 12548 9 Austin, Texas 78711 Phone: 512-936-2613 10 David.shatto@oag.texas.gov

SBOT: #24100550 PO Box 12548 13 Austin, Texas 78711 Phone: 512-936-2613 14 David.shatto@oag.texas.gov

15 FOR THE DEFENDANT, M. BRETT COOPER, M.D.: 16 MS. ANIKA HOLLAND 17 CA Bar#336071 WILLKIE FARR & GALLAGHER, LLP 18 333 Bush Street Floor 34 19 San Francisco, California 94104 Phone: 415-858-7411 20 Aholland@willkie.com

CA Bar#246943 333 Bush Street 23 Floor 34 San Francisco, California 94104 24 Phone: 415-858-7411 Sagnolucci@willkie.com 25 3

1 FOR THE DEFENDANT, MAY C. LAU, M.D.:

SBOT: #2414582 717 Texas Street 4 Suite 2800 Houston, Texas 77002 5 Phone: 713-221-2372 Ehudson@steptoe.com 6 MR. CRAIG SMYSER 7 SBOT: #18777575 STEPTOE, LLP 8 717 Texas Street Suite 2800 9 Houston, Texas 77002 Phone: 713-221-2372 10 Csmyser@steptoe.com

SBOT: #24116661 717 Texas Street 13 Suite 2800 Houston, Texas 77002 14 Phone: 713-221-2372 Wlegg@steptoe.com 15 MS. NICOLE LEBOEUF 16 SBOT: # LEBOEUF LAW, PLLC 17 325 North Saint Paul Street Suite 3400 18 Dallas, Texas 75201 Phone: 214-626-9803 19 Nicole@leboeuflaw.com

20 FOR THE NONPARTY PATIENTS: 21 MR. WILLIAM LOGAN 22 SBOT: #24106214 WINSTON & STRAWN, LLP 23 800 Capitol Street Suite 2400 24 Houston, Texas 77002 713-651-2766 25 Wlogan@winston.com 4

1 - AND -

SBOT: #24094869 2121 North Pearl Street 4 9th Floor Dallas, Texas 75201 5 214-453-6500 Jnewsome@winston.com 6

7 FOR THE CHILDREN'S HEALTH NONPARTY PATIENTS:

SBOT: #24037569 900 Jackson Street 10 Suite 100 Dallas, Texas 75202 11 214-712-9500 Cory.sutker@cooperscully.com 12

25 5

2 (MOTION HEARING)

3 2/26/25 Page Vol

4 Appearances.................................... 2 Proceedings................................... 6 5 Court's Ruling on Record Sealing.............. 56 6 Dr. Lau's Motion to Transfer Venue............ 57 7 State's Response.............................. 62 Dr. Lau's Response............................ 68 8 Nonparty Patients' Response................... 71 Court's Ruling................................ 72 9 Venue Discovery Agreements.................... 79 10 Production of Patient Records discussions..... 87 11 Adjournment................................... 101

12 Reporter's Certificate........................ 102

25 6

2 THE COURT: At this time we are going to be

3 on the record. We're going to be on the record in two

4 related cases, Cause Number 493-08026-2024, the State of

5 Texas versus Brett Cooper, and then as well, Cause

6 Number 493-07676-2024, the State of Texas versus May

7 Lau.

8 At this time if I could have an appearance

9 on behalf of counsel for the State of Texas.

10 MR. FARQUHARSON: This is Rob Farquharson

11 for the State.

12 MR. SHATTO: David Shatto for the State.

13 MR. STONE: Johnathan Stone for the State.

14 THE COURT: Thank you. Appearance on

15 behalf of counsel for Dr. Lau.

16 MR. SMYSER: Craig Smyser for Dr. May Lau,

17 and with me is Evelyn Hudson and Henry Legg.

18 THE COURT: Thank you. And appearance on

19 behalf of counsel for Dr. Cooper.

20 MS. HOLLAND: Anika Holland, and joining me

21 shortly is Simona Agnolucci.

22 THE COURT: Thank you. And we also have

23 counsel for our nonparty patients, if you could please

24 state your appearance for the record as well, sir.

25 MR. LOGAN: Yes, Your Honor. William Logan 7

1 from Winston & Strawn on behalf of the nonparty

2 patients.

3 THE COURT: Thank you. Please be seated.

4 Everyone, the acoustics in this courtroom,

5 as we discussed at the last proceeding that we had, are

6 tremendously poor, so I will ask for purposes of

7 argument today if you will stay seated at counsel table

8 throughout argument with the microphone pulled up.

9 That's going to be most important for over here at this

10 table because y'all are sharing a microphone. So if I

11 can just ask counsel for Dr. Lau, when you are speaking

12 if you will make sure you pull the microphone towards

13 you. And then counsel for Dr. Cooper, same thing. When

14 you're speaking, make sure you pull that microphone

15 close to you. Okay?

16 MR. SMYSER: I want to make sure I

17 understand because my life has been spent standing up

18 when I talk to judges and I want to make sure that I'm

19 not --

20 THE COURT: I'm expressly instructing you

21 that today you should fight all urges to do that and

22 remain seated. And, you know, we're all lawyers, so

23 that is a hard habit to break. So I certainly expect

24 all of you will do so at least once today. I fully

25 understand that. I'm asking merely for purposes of your 8

1 record. So that you can be certain that you get a good

2 record, we really need you close to the microphone so

3 the court reporter is able to take you down.

4 I'll also tell you, you know, if at any

5 point in time I call you down today, again, my goal is

6 to make sure you have an excellent record. And so if

7 you get to talking too fast, which we all do, myself

8 included, when we're on a roll, I will ask could you

9 please slow down just a little bit so we can ensure the

10 court reporter is able to take us down.

11 All right. We have a lot of things that

12 are set today and that were scheduled to discuss. So

13 I'm going to outline all of the things that the Court

14 believes are set and that I have reviewed in preparation

15 for today's hearing, and then after we've outlined that,

16 I will tell you what the Court's plan is for proceeding

17 and we can talk through things. Okay.

18 So starting with the State of Texas versus

19 Cooper, today we have set for hearing the motion to

20 transfer venue, which was filed on December 27th, 2024;

21 the response thereto by the State, which was filed on

22 January 27th, 2024, along with the declaration of

23 Mr. Stone which was filed on that same date. We have

24 the motion to strike Mr. Stone's declaration, which was

25 filed on February 19th of 2024 and then a reply filed in 9

1 support of the motion to transfer, which was similarly

2 filed on February 19th of 2024.

3 As discussed at the last hearing, there

4 were certain items that were filed on the docket that

5 contained the defendants' home addresses. Certainly,

6 none of us desire that information to be public

7 considering the privacy and safety concerns. And so

8 pending before the Court in Cooper is the motion to

9 permanently seal those court records that were

10 inadvertently filed with the home address. That was

11 filed on 1/13/2024. Public notice was properly provided

12 on January 27th, 2025.

13 Just here at the outset, it's the Court's

14 intention no matter where we are in the proceedings to

15 make a hard stop at 9 o'clock, which is the time for

16 those hearings. My bailiff will call the hall, and

17 having confirmed that there are no other persons present

18 from the public who are interested, we'll go ahead and

19 turn to those motions to seal, which I understand are

20 unopposed by all parties.

21 Okay. So that was everything I have set in

22 connection with the Cooper case. I'm just going to ask

23 for State to confirm, do you believe that those are the

24 items that are set and that the Court has reviewed all

25 items in connection therewith? 10

1 MR. SHATTO: That sounds correct, Judge.

2 THE COURT: Counsel for Mr. Cooper -- or

3 Dr. Cooper, I apologize.

4 MS. HOLLAND: I think that's correct, Your

5 Honor. I just want to make sure that the Court received

6 the State's amended petition, which I believe was filed

7 on Monday of this week.

8 THE COURT: Let me double-check. I did not

9 review an amended petition in connection with preparing

10 for today.

11 There has not been one docketed in this

12 case as of yet. Does the State have a copy?

13 MR. FARQUHARSON: I do not have a physical

14 copy. I can e-mail one to the Court if that's okay.

15 THE COURT: If you can approach and grab

16 Mr. Miller's card. If you will have it e-mailed to

17 Mr. Miller, the Court would be happy to review. At

18 present the clerk's office has not processed that. As

19 we discussed in the e-mails you received from

20 Ms. Patterson, it takes about 48 hours once something

21 hits the clerk's office for it to be processed and be

22 received by the Court. That's why we reached out and

23 said, if there is anything that you want us to review,

24 you need to make sure we had it by close of business on

25 Monday because otherwise it wouldn't have been processed 11

1 in enough time for today. All right. So we'll get that

2 e-mailed.

3 Turning to Dr. Lau, we have the motion to

4 transfer venue, which was filed December 6th of 2024;

5 the response to that motion to transfer venue, which was

6 filed January 27th of 2025. We have the declaration of

7 Mr. Stone, which again was filed on that same date.

8 There is the reply in support of the motion to transfer

9 venue, which was filed on February 19th of 2025, and

10 then as well, in discussion with Dr. Lau's motion to

11 transfer venue, we have the State's motion to compel,

12 which was filed on February 20th of 2025.

13 In connection with the State's motion to

14 compel, the Court has received in opposition by Dr. Lau

15 and as well the nonparty patients have filed a motion

16 for protection in connection with that.

17 In connection with Dr. Lau's case, have I

18 accurately stated everything that is set today, State?

19 MR. SHATTO: Your Honor, the State would

20 just like to make a note that it is my understanding

21 that the nonparty -- only some of the nonparties are

22 represented by this counsel, not all of them.

23 THE COURT: We're going to go over that in

24 just a second. He delineates his motion simply as

25 nonparty. So all I'm doing at present is delineating 12

1 the title of the document, not attributing his style to

2 all persons.

3 MR. SHATTO: Okay.

4 THE COURT: Does Dr. Lau's counsel believe

5 that I've accurately stated everything and what I needed

6 to review to be prepared for today?

7 MR. SMYSER: Yes, Your Honor with one

8 exception.

9 THE COURT: Okay.

10 MR. SMYSER: That exception relates to what

11 the Court has been recently informed of, that the State

12 filed an amended petition asserting a new cause of

13 action. We have filed today, moments ago, given that we

14 only had one business day notice before this hearing on

15 motion to transfer venue, an analysis of the venue

16 implications of that new cause of action, and with the

17 Court's permission, I will bring a written out -- a hard

18 copy to the Court and I have copies for counsel as well.

19 THE COURT: Yes. Let me also ask, since

20 you have prepared that, do you happen to have an extra

21 hard copy of the amended petition? Because certainly

22 the Court is going to need to look at both to be able to

23 evaluate.

24 MR. SMYSER: Alas --

25 THE COURT: You do not. 13

1 MR. SMYSER: -- much to my chagrin, I do

2 not.

3 THE COURT: Let me see. Did we send the

4 e-mail?

5 MR. FARQUHARSON: I'm working on it right

6 now. I just want to clarify, though, I'm not sure that

7 the amended petition is going to impact the venue of

8 this case. It's a new claim, yes, but I don't really

9 see how it relates to the venue.

10 THE COURT: Okay. Counsel is asserting it

11 is. So can you please provide a copy of your filing to

12 the State, in the event that they have not received it

13 yet, and if you will bring a copy forward to me as well

14 at this time.

15 MR. SMYSER: Yes, Your Honor, although I

16 will accept their representation on the record that it

17 does not impact the venue analysis, but we did refer to

18 the venue provision in that statute for the Court and

19 Counsel's understanding.

20 THE COURT: If you'll bring that forward.

21 MR. SMYSER: May I approach the bench?

22 THE COURT: Yes, you may.

23 Everyone, the Court's proposal for

24 addressing the motions that are set today is as follows:

25 The Court proposes to outline each of the parties' 14

1 respective positions from the motions to transfer venue

2 as the Court understands those positions.

3 Following that, the State, as it relates to

4 Dr. Lau, has alleged that outstanding discovery

5 responses impact their ability to respond, and so the

6 Court needs to have a discussion of the motion to compel

7 as it relates to the allegation that it impacts the

8 venue issues. We are not going to have a full hearing

9 on the motion to compel at present. We're going to take

10 up the motion to transfer venue.

11 But I just want everyone to be aware, we're

12 going to discuss the compel in the context of how does

13 it impact the venue allegations. After we conclude

14 argument on the venue issues, then we will turn and we

15 will discuss the motion to compel in its totality and

16 how we should proceed, if at all, as it relates to the

17 discovery.

18 Is there anybody who has any objection to

19 the Court approaching those motions in that manner?

20 Again, we're going to be -- we necessarily have to

21 discuss the compel in the context of the State's

22 assertion that it does impact their ability to respond,

23 but other than that, the Court intends to defer it until

24 we've concluded argument.

25 State, do you have any opposition? 15

1 MR. SHATTO: No, Your Honor.

2 THE COURT: Defense counsel?

3 MR. SMYSER: No, Your Honor. We agree with

4 the Court that the motion to transfer venue should be

5 the first item on the agenda.

6 MS. HOLLAND: Same here.

7 THE COURT: And I assume, nonparties, you

8 at the kids' table have no objection either?

9 MR. LOGAN: That's correct, Your Honor.

10 THE COURT: All right. So then we're going

11 to go ahead and begin, and I'm just going to outline the

12 Court's understanding. At present we're going to begin

13 with outlining Dr. Cooper's position in the motion to

14 transfer venue.

15 Dr. Cooper asserts venue is not proper here

16 in Collin County and that, in fact, it's proper in

17 Travis or Dallas County. In connection with that, both

18 parties agree that the Court should look to Texas Health

19 and Safety Code 161.702. Cooper alleges that he was

20 employed by UT Southwestern based in Dallas, saw

21 patients at that main facility in Dallas, and also a

22 satellite facility in Plano.

23 Dr. Cooper asserts that he's unable to

24 identify whether or not he saw patients at that Plano

25 facility because the patients were pseudomized. He also 16

1 asserts all other facts that matter occurred in Dallas;

2 all prescriptions, physician charges, insurance claims

3 issued in Dallas, and he bases that assertion on the

4 fact that the hospital's medical records software and

5 billing departments are located in Dallas.

6 Cooper asserts when he specifically denies

7 the venue facts -- or that because he has specifically

8 denied the venue facts by virtue of his declaration, the

9 burden shifts to the plaintiff to show prima facie

10 proof. Dr. Cooper asserts that Plaintiff has failed to

11 do so, requests to strike the Stone declaration, and

12 alleges it is insufficient to support the venue

13 arguments. He further asserts that even if venue for

14 his case is, in fact, proper in Collin, that his case

15 should be transferred along with Dr. Lau's because of

16 Local Rule 2.3.

17 The State's response is, in connection with

18 Dr. Cooper's case, that Patients 1, 7, 9, 10, 14, and 15

19 filled their prescriptions in Collin County and as well

20 live in Collin County, and that because testosterone is

21 a self-administered drug, that they would have to have

22 administered their prescriptions in Collin County. As

23 prima facie support, the State provides a declaration

24 that says that it has reviewed but it does not attach

25 PMP records. PMP stands for prescription monitoring 17

1 program.

2 The State relies on the text of the statute

3 and the words "dispense" and "administer" in connection

4 with their venue arguments. I omitted to state and I

5 will, Dr. Cooper's position is that 161.702, in

6 connection therewith, 161.706, constitutes a mandatory

7 venue provision. The State takes an alternative

8 position and argues that that is a permissive venue

9 provision and thus venue would be proper at their

10 election under either 161.072 or the Texas Business and

11 Commerce Code 17.47.

12 I think it's relevant here, so I'll go

13 ahead and read it for the record. 161.706, which is

14 entitled "Attorney General Enforcement," reads, subpart

15 A, "If the Attorney General has reason to believe that a

16 person is committing, has submitted, or is about to

17 commit a violation of Section 161.702, the Attorney

18 General may bring an action to enforce this subchapter

19 to restrain or enjoin the person from continuing to

20 commit or repeating the violation." Subpart B reads,

21 "Venue for an action brought under this section is in a

22 district court of Travis County or the county where the

23 violation occurred or is about to occur."

24 161.702, in a relevant part, reads as

25 follows: Subpart 3. "For the purpose of transitioning 18

1 a child's biological sex as determined by the sex

2 organs, chromosomes and indigenous profiles of the

3 child, or affirming the child's perception of the

4 child's sex if that perception is inconsistent with the

5 child's biological sex, a physician or healthcare

6 provider may not knowingly provide, prescribe,

7 administer, or dispense any of the following

8 prescription drugs that induce transient or permanent

9 infertility: A, puberty suppression or blocking

10 prescription drugs to stop or delay normal puberty; B,

11 supraphysiologic doses of testosterone to females, or

12 supraphysiologic doses of estrogen to males. The Court

13 believes those are the relevant provisions under the

14 Texas Health and Safety Code.

15 State, do you believe I've accurately, at a

16 50,000-foot view, stated your position in connection

17 with Dr. Cooper's motion to transfer venue?

18 MR. SHATTO: Yes, Your Honor.

19 THE COURT: All right. And Counsel for

20 Dr. Cooper, again at a 50,000-foot view, do you believe

21 I have accurately stated Dr. Cooper's position?

22 MS. HOLLAND: Yes, Your Honor.

23 THE COURT: So if we turn to Dr. Lau's

24 motion to transfer venue, Lau's position is virtually

25 identical to Dr. Cooper's save and except Dr. Lau 19

1 asserts that she has never ever seen a patient in Collin

2 County, that she saw patients exclusively in Dallas;

3 more specifically, that she practiced exclusively at

4 Children's, which is located only in Dallas. The

5 State's response is similar to that in connection with

6 the Cooper case. They cite that patients of Dr. Lau 1,

7 2, 5, 6, and 19 both filled their prescriptions in

8 Collin County and live in Collin County. They also cite

9 that an additional patient, while not filling the

10 prescription in Collin County, did live in Collin

11 County, being Patient 18.

12 One of the items that the State addresses

13 in connection with the various motions and that they

14 have alleged to the Court is that at present they have

15 been unable to sufficiently respond to the Lau motion to

16 transfer venue because they have not been able to

17 receive the discovery that has been requested.

18 So where I'd like to begin, again, is I'm

19 going to ask the State to address a very narrow issue.

20 If you can address the discovery and why you think that

21 the motion to compel borders on or relates to that

22 motion to transfer venue. I'm going to ask counsel for

23 Dr. Lau and Dr. Cooper to both respond to their

24 assertions. And then after the Court's heard argument

25 on that, we will transition to the larger motions to 20

1 transfer venue.

2 So in connection with that, I'm going to

3 hear from Dr. Cooper first, argument. State will be

4 able to respond. Then I'll hear from Dr. Lau next.

5 State will be able to respond.

6 So, State, at this time I would like to

7 hear from you in relation to your assertion that your

8 motion to compel relates to and is required to have

9 relief before I can rule on the motion to transfer

10 venue.

11 MR. FARQUHARSON: Thank you, Judge.

12 Yes, request for productions number 1

13 through 21 requested medical records. On the record on

14 January 13th, the parties all stipulated that they had

15 no objection to the production of redacted records to

16 show the location of treatments and prescriptions that

17 were provided. We submitted a request. We did not

18 expect -- so that stipulation was made.

19 However, on the record, Dr. Lau said that

20 she did not have medical records. The response that we

21 got in response to discovery was inconsistent with that.

22 It included HIPAA objections, and in order for there to

23 be a good faith HIPAA objection, they necessarily must

24 have the records. And given that they have stipulated

25 that they would not object to the production of those 21

1 records to show the location of the treatment and

2 prescriptions, we believe that those records are highly

3 relevant to the motion to transfer venue.

4 THE COURT: If I can hear a response at

5 this time.

6 MR. SMYSER: Yes, Your Honor. I'm afraid

7 counsel has overread our response when we make

8 objections. We do not have the records. We clearly do

9 not have the records and have stated that. The State of

10 Texas has to know that because they're both employees of

11 the State of Texas. Dr. Lau is an employee of the State

12 of Texas, the hospital is a State institution. They

13 know Dr. Lau does not have access to the records. She

14 does not, she cannot. We have provided information to

15 the Court indicating we requested the records from both

16 UT Southwestern and from Children's, and in both cases

17 that request was denied. We do not have the medical

18 records.

19 I would also note for purposes of procedure

20 that the State did not move for a continuance of this

21 hearing on the basis that they had inadequate

22 information. The facts are the facts. The facts are

23 Dr. Lau practices in Dallas. Dr. Lau lives in Dallas.

24 Dr. Lau has never practiced in Collin County, never

25 treated a patient in Collin County. Those facts aren't 22

1 changing. And the fact that they have not moved for a

2 continuance or asked before this hearing and before the

3 latest pleading they filed, a complaint about this

4 discovery issue indicates I don't think it is a serious

5 objection. I think it is an objection intended to delay

6 this hearing.

7 THE COURT: So, Counsel, let me ask just a

8 few questions. Are you here on the record today

9 representing that you're willing to stipulate and to

10 provide a stipulation in writing that Dr. Lau does not

11 have possession, access, control of any of the medical

12 records, defers to Children's Health and the nonparty

13 patients related to actual production, but

14 notwithstanding that, is able to affirmatively represent

15 that there will be no locations contained in those

16 records that lists anywhere other than Dallas County

17 based upon her own personal knowledge?

18 MR. SMYSER: I can -- I can enter a

19 stipulation to part of that, Your Honor. I can enter a

20 stipulation that, to her knowledge, none of the

21 treatments ever occurred in Collin County. I can say

22 that. I can say on the record and stipulate she does

23 not have access to the hospital records. I cannot --

24 because we have not completed our ESI review, I cannot

25 state that she might not have a random page here or 23

1 there of someone's medical records. I can't state that,

2 and I would not because I haven't looked at the

3 material. We haven't had a chance to complete that

4 review yet. Other than that, though, I can state as I

5 stated a moment ago.

6 THE COURT: All right. Dr. Cooper, I know

7 that the State's motion predominantly goes to Lau, but

8 as it relates to Dr. Cooper, let me go ahead and ask,

9 what is your response at this time?

10 MS. HOLLAND: Thank you, Your Honor. I

11 think I would just -- I would add that I think the State

12 overstates what was discussed here when we were all

13 together in January about seeking limited jurisdictional

14 discovery. I think the parties and the Court had

15 contemplated a waiver of the patient notification

16 requirement under Texas Rule of Civil Procedure

17 196.1(c). So that wouldn't be triggered if they sought

18 limited discovery just as to the location of treatment

19 and the prescriptions prescribed.

20 The discovery requests that Dr. Cooper has

21 received, which I believe are the same or very similar

22 to those that Dr. Lau has received from the State, don't

23 seek discovery in such a limited manner. They're quite

24 broad requests. So I think it would just be our

25 position that the State has not sought the limited 24

1 jurisdictional discovery that the parties contemplated

2 in January.

3 THE COURT: Would you agree with me,

4 though, that when the parties were together in January,

5 it was contemplated in connection with each of your

6 clients that likely it was necessary for the Court to

7 have an understanding of where each of the patients

8 received treatment? Dr. Lau has stated she's

9 affirmatively able to swear before the Court that she

10 saw no patients whatsoever in any facility within Collin

11 County, and that all patient visits, any prescription

12 she affixed her signature to would have been in Dallas

13 County. Dr. Cooper relies upon his declaration and

14 which in pertinent part states, "While UT Southwestern

15 is based in Dallas County, it also operates several

16 satellite campuses. During the time period at issue in

17 the State's verified original petition, I saw a number

18 of patients at one of these satellites, UT Southwestern

19 Pediatric group in Plano in Collin County." He goes on

20 to state that because the petition pseudomizes the

21 patients, it's impossible for him to discern where he

22 treated each of the patients that are listed.

23 I'll just note for purposes of the record

24 the reply in support of the motion to transfer was filed

25 on February 19th of 2024. At that time, though, 25

1 however, Dr. Cooper had been provided the identities of

2 the pseudomized. And so at present, the query that the

3 Court has is, is the declaration of Dr. Cooper still

4 accurate? Is it still appropriate? Can he truthfully

5 still deny that he saw no patients in Collin County?

6 MS. HOLLAND: Yes, Your Honor. So the

7 declaration is still valid. Dr. Cooper did receive the

8 State's initial disclosures that included a list of the

9 15 patients' names and residences. But he was unable

10 from just that list to identify the location where he

11 saw those patients. Sometime -- we went over it with

12 him. And sometimes he has seen patients at multiple

13 locations, and without the underlying medical records,

14 he was unable to determine where he saw those patients.

15 THE COURT: So is it your statement to the

16 Court here today that if there were discovery as it

17 relates to the location that Dr. Cooper saw patients,

18 that it is quite likely and possible that the patients

19 delineated in the petition were seen at one of the

20 satellite locations or the satellite location in Plano?

21 Is that your statement to the Court today?

22 MS. HOLLAND: Yes, Your Honor. We don't

23 know.

24 THE COURT: All right. State, anything

25 else as it relates to the motion to compel? 26

1 MR. FARQUHARSON: Yes, I want to -- a

2 couple points, one with respect to what Dr. Cooper's

3 counsel just said, and it applies to both cases, is that

4 we believe what would also be relevant to -- I think

5 we're sort of skimming over the idea that doctors do

6 telehealth visits, and so it would matter if telehealth

7 visits happened here and a patient was in Collin County

8 at the time of the telehealth visit. So I want to make

9 sure that we're clear in terms of when we say there was

10 no visits in Collin County, are we saying there was no

11 telehealth visits with Collin County patients? That's

12 my immediate response.

13 THE COURT: Okay.

14 MR. FARQUHARSON: With -- sorry.

15 THE COURT: Then can you address Dr. Lau

16 and Dr. Cooper's assertion that you have not filed a

17 separate request to continue today's hearing. You have

18 alleged that there is outstanding discovery, but is

19 there an obligation for you to formally and specifically

20 move to continue the Court's determination on the

21 motions to transfer venue?

22 MR. FARQUHARSON: I don't think so, Judge.

23 And the reason is because, in light of the

24 stipulation -- I think that in light of the fact that

25 Dr. Lau stipulated to the production of these records, I 27

1 think the Court can draw an inference against Dr. Lau

2 based on that refusal to comply with the stipulation.

3 And if I could respond to a couple other points that

4 Dr. Lau made.

5 THE COURT: So long as, again, we're

6 sticking with --

7 MR. FARQUHARSON: Yes.

8 THE COURT: You may proceed.

9 MR. FARQUHARSON: Number one, with respect

10 to the idea that they have not had time to review the

11 records that their client has given them, it has been

12 45 days since we served the discovery requests. So we

13 are beyond 30 days, and it is insufficient for them to

14 come to the Court today and say they have not -- they've

15 not reviewed the records.

16 THE COURT: And to that end, can I go ahead

17 and lay out some of the facts that I understand and just

18 make sure. The protective order that currently exists

19 in this case was entered on January 13th of 2025. The

20 State actually served their discovery requests a few

21 days prior to that, on January 9th of 2025. Is that

22 correct?

23 MR. FARQUHARSON: That is correct, Judge.

24 THE COURT: And then the State provided

25 patient identifying information to each of Dr. Cooper's 28

1 and Dr. Lau on January 17th. Is that correct?

2 MR. FARQUHARSON: That sounds correct.

3 THE COURT: The deadline that you assert to

4 respond to the discovery requests fell on February 10th?

5 MR. FARQUHARSON: That is right.

6 THE COURT: At present, no documents

7 whatsoever have been provided, not even those that

8 enable you to identify the location where any visits

9 occurred?

10 MR. FARQUHARSON: That is correct, Judge.

11 THE COURT: And then this motion was filed

12 on February 20th?

13 MR. FARQUHARSON: Yes.

14 THE COURT: Okay. Can you tell me, as it

15 relates to -- because one of the issues that we're going

16 to be discussing later and I think it's wise that the

17 Court ask the question now, what do you allege is the

18 proper time frame for the request? Obviously you've

19 addressed the weaning provisions, and so are you

20 alleging that the proper time frame is January 1, 2023?

21 MR. FARQUHARSON: No, Judge. I believe our

22 requests go back to January 1, 2021. But let me

23 confirm. I believe that the appropriate -- appropriate

24 time period is what we have requested in the request for

25 production. 29

1 THE COURT: Well, there's various different

2 times that you've provided in connection with the

3 request for production. There's some that are April,

4 some that are January. I'm trying to find my specific

5 notes on that. So at present, you don't have one set

6 time frame contained within your request, and what I'm

7 trying to ascertain, because I think that these other

8 parties are going to be interested in your position on

9 that is, what is the absolutely necessary time frame. I

10 mean, obviously, I think what we're all interested in is

11 how do we get information that you're entitled to

12 discover but for the, you know, most narrow and

13 appropriate time frame so that we can ensure that we are

14 protecting the patients and their records.

15 MR. FARQUHARSON: I think as a broad

16 statement and general rule, the most relevant would be

17 January 1, 2021, to present.

18 THE COURT: Okay. And tell me what is your

19 basis for alleging that it's January 1, 2021. Why is

20 that the appropriate time? Why is it not --

21 MR. FARQUHARSON: So, as the Court knows,

22 we have three claims. We have a DTPA claim.

23 THE COURT: Okay.

24 MR. FARQUHARSON: We have a SB 14 claim,

25 and as was referenced earlier, we have a new claim that 30

1 the treatment provided was not provided for a valid

2 medical purpose. I'm going to speak to the SB 14 claim

3 because that claim has the most clear timeline, but I

4 think it is -- the timeline is applicable to all of the

5 claims.

6 The SB 14 claim and the defenses thereto --

7 so first of all, with -- actually, I'm going to start

8 with the DTPA claim.

9 With the DTPA claim, we need records from

10 before and after the effectiveness of SB 14 because we

11 need to show the consistencies between the -- we've

12 alleged that there was false billing codes entered and

13 we need to show inconsistencies between the medical

14 records and the billing records. And we also need to

15 see those practices before and after the passage of SB

16 14. With respect to SB 14 specifically, the exception

17 that Dr. Lau has invoked in this case is that there

18 was -- that medication was provided as part of a weaning

19 process.

20 THE COURT: Correct.

21 MR. FARQUHARSON: That exception has three

22 important qualifiers to it. Number one, the

23 prescription drug has to be a part of a, quote,

24 continuing course of treatment that the child began

25 before June 1st, 2023. 31

1 THE COURT: Correct.

2 MR. FARQUHARSON: Second, the child

3 attended 12 or more sessions of mental health counseling

4 or psychotherapy. And third, during a six-month period

5 of at least six months before -- I want to emphasize

6 before -- six months before the course of treatment

7 began. So at an absolute bare minimum, that takes us to

8 January 1, 2022. And we think it's appropriate for the

9 Court to -- we don't think one year -- adding a year on

10 to that takes us to where we're beyond being narrowly

11 tailored. We think one year is an appropriate buffer

12 zone.

13 THE COURT: So why is January 1, 2022, not

14 the right place to start, and then after production

15 occurs, if you determine or ascertain based upon your

16 review of the records that you need to go back further,

17 we shouldn't revisit it, then?

18 MR. FARQUHARSON: If they are going to say

19 that they were weaning in January 1, 2022, we need to

20 know what they were doing before January 1, 2022, to

21 make sure that it was actually weaning.

22 THE COURT: But won't you not know that

23 until you get that actual initial tranche of records?

24 And so that's what I'm asking. Would it be more

25 appropriate to take it in two bites? To effectively 32

1 say, hey, here you go, January 1, 2022, and then if

2 after review of the records you identify that there are

3 certain patients that additional documents to ascertain

4 the weaning defense would be applicable to, that we

5 could revisit the issue then?

6 MR. FARQUHARSON: That would not be our

7 preference, but if that's what the Court decides to do,

8 I think that sounds like an appropriate...

9 THE COURT: So we're going to revisit this

10 issue, Counsel. Obviously one of the things I want you

11 to talk about because we are obviously going to be

12 discussing the time frame is whether or not you would be

13 amenable to approaching it in that manner and agreeing

14 to that time frame happening on all of the requests. So

15 January 1, 2022, and then returning if the State

16 identifies that there are additional records needed

17 related to any weaning defense for documents for a

18 specific patient prior to that time.

19 Okay. I think that answers the Court's

20 questions that I had outstanding related to -- we're

21 going to go ahead and hear argument on the motion to

22 transfer venue. And so again, we're going to be

23 beginning with Dr. Cooper. Dr. Cooper, I'll hear from

24 your counsel first, and then, State, I'll have you

25 respond. After we've concluded that, then we will turn 33

1 to Dr. Lau.

2 So, Dr. Cooper, Ms. Holland, at this time.

3 MS. HOLLAND: Thank you, Your Honor.

4 Dr. Cooper has specifically denied the

5 State's venue allegations and has moved to transfer the

6 case to Travis or Dallas County.

7 THE COURT: Okay. So go ahead and stop

8 there on the specific denial, because I think that goes

9 to the question I've already asked.

10 MS. HOLLAND: Yes.

11 THE COURT: So your specific denial is

12 based expressly on Dr. Cooper's assertion that the

13 patients are pseudomized and so he is unable to

14 ascertain the locations. So you've now received the

15 names and so the query I had is, okay, can he still

16 truthfully make that statement? And your response is,

17 well, Judge, we don't have access to all the records and

18 so we can't remember if he saw this patient in Dallas,

19 in Plano, or both. Am I -- is that a correct summary of

20 your statements?

21 MS. HOLLAND: That's correct, Your Honor.

22 And I would just add to that that, you know, I think the

23 conduct that the State has alleged that is the violation

24 of SB 14 is the act of prescribing. If you actually

25 look at the allegations in the petition, which have been 34

1 unchanged in the amended petition, those are still the

2 same allegations if you go through the patient-specific

3 allegations. Dr. Cooper is alleged to have written

4 these patients who reside in Collin County prescriptions

5 for testosterone. That is the conduct in question, and

6 this has been clarified through the State's position in

7 its briefing. And so we think that that also bolsters

8 Dr. Cooper's position that these prescriptions,

9 regardless of where the patient was treated by him, all

10 issued from Dallas by the nature of his employment at UT

11 Southwestern.

12 THE COURT: Okay. So I'm going to stop you

13 just right there. State, if you can respond to that

14 particular assertion. I'm looking at the petition at

15 present. They're asserting that your petition does not

16 allege that Dr. Cooper improperly provided care, only

17 that it is dispense and administer. So can you respond,

18 please.

19 MR. SHATTO: Yes, Your Honor. I'll find

20 that. One moment.

21 MS. HOLLAND: If I could just clarify, Your

22 Honor. We don't think that the State even alleged in

23 the petition that Dr. Cooper administered this

24 medication. That is something that was introduced via

25 their briefing. Similarly with the dispense argument, 35

1 that came up in briefing. We think what they've alleged

2 is the act of prescribing.

3 MR. SHATTO: The State believes that, you

4 know, it's not just where they were seen. It's where

5 the prescription was filed and where it was taken.

6 But at paragraph 186, the State states that each and

7 every prescription written by Cooper after September

8 1st, 2023 --

9 THE REPORTER: Counsel, I'm going to ask

10 you to slow down. And can you move the microphone

11 closer to you, please?

12 MR. SHATTO: Absolutely.

13 So the State's position is that it's not

14 just where -- where the patient was seen but it's also

15 where that prescription was filled and taken.

16 THE COURT: Understood. But we have -- we

17 have information before the Court related to where the

18 prescriptions were filled and where the patients live.

19 At present what we don't have is the information of

20 where Dr. Cooper saw patients; correct?

21 MR. SHATTO: Correct.

22 THE COURT: The issue that the Court is

23 focused on is are you alleging, as well, that the

24 location where the patient was seen would matter?

25 MR. SHATTO: That's certainly another 36

1 factor that goes to this. But paragraph 186 of our

2 petition states that each and every prescription written

3 by Cooper after September 1st, 2023, or filled or taken

4 as directed after September 1st, 2023, is a violation of

5 SB 14.

6 THE COURT: And so to clarify, because

7 they're alleging, well, it doesn't matter where he's

8 physically located when he says, hey, I'm prescribing

9 this, because of the electronic database of the hospital

10 that no matter where he was -- Montana, Dallas, Plano --

11 that always any prescriptions would be prescribed in

12 Dallas County. I assume that your position is different

13 and that prescribing is location where he is present at

14 the time?

15 MR. SHATTO: It is the position of the

16 State that he may be prescribing those in that position

17 but he's directing them to Collin County and then

18 they're subsequently filled in Collin County. And the

19 ultimate responsibility of the dispensing of the

20 medicine is the prescribing practitioners that occurs in

21 Collin County.

22 THE COURT: Can you clarify when you say

23 he's directing them to Collin County? What do you mean

24 by that?

25 MR. SHATTO: If he's sitting in an office 37

1 in Dallas County and he puts in the electronic medical

2 system he's sending that prescription to the pharmacy

3 that is requested by the patients. That pharmacy is in

4 Collin County. He has directed that prescription from

5 Dallas to Collin County. It was then subsequently

6 filled in Collin County and the patients took the

7 medicine pursuant to his directions.

8 THE COURT: In Collin County?

9 MR. SHATTO: In Collin County.

10 THE COURT: All right. Counsel, I'll allow

11 you to proceed at this time.

12 MS. HOLLAND: Thank you. I have a couple

13 of points in response to that. I think it would be

14 helpful for the Court to look at the statutory

15 language --

16 THE COURT: I've got it right here.

17 MS. HOLLAND: Great.

18 -- defining prescribe. So this is the

19 Texas Controlled Substances Act, Section 481.001(40),

20 and that defines prescribe as the act of a practitioner

21 to authorize a controlled substance to be dispensed to

22 an ultimate user. I think this language is clear that

23 prescribing and dispensing are separate actions, and the

24 State is essentially conflating those two actions by

25 saying it matters both where they were written and where 38

1 they were filled, whereas the statutory language focuses

2 on where the act of authorization occurred.

3 I would also like to address for a moment

4 this ultimate responsibility language which is not in

5 the statute. The state is referencing Texas Occupations

6 Code Section 562.056. I really think that this is --

7 this is kind of the same red herring because this deals

8 with dispensing mediation, not prescribing it. And if

9 you look at what the State is actually alleging for

10 these patients it's that he wrote prescriptions. His --

11 for the reasons that we've stated, that must have

12 occurred in Dallas. I'm also just not aware of any case

13 law applying this provision of the Texas Occupations

14 Code in the way --

15 THE COURT: Are you aware of any case law

16 that states that the court is supposed to rely upon

17 where an electronic database is present to find that's

18 where a prescription was written?

19 MS. HOLLAND: No, Your Honor.

20 THE COURT: So that's just the assertion

21 y'all are taking. You don't have any authority

22 supporting that position?

23 MS. HOLLAND: That's correct.

24 THE COURT: All right. You may continue.

25 MS. HOLLAND: I would also like to back up 39

1 a step. We have been talking exclusively about SB 14

2 and the act of prescribing. And I just want to explain

3 why we think that that's proper and why we think that

4 venue here should be determined solely by reference to

5 SB 14. And that is because it's a mandatory venue

6 provision, whereas the --

7 THE COURT: Let me stop you just for a

8 second because one of the other questions I have for the

9 State is you don't respond to their argument about what

10 the language is, and so are you conceding that this

11 provision in the Texas Health and Safety Code is a

12 mandatory venue provision?

13 MR. SHATTO: I don't think the State is

14 conceding to that. I think the State states that it

15 doesn't matter. We have venue is proper under both

16 statutes.

17 THE COURT: Well, I think Texas law is

18 exceedingly clear that where a mandatory venue provision

19 applies, the Court must apply the mandatory venue

20 provision. I cannot look to the permissive venue

21 provision, and that's why I'm making that inquiry. Are

22 you continuing to contend or are you contending that

23 these provisions, 161.702, and then the accompanying

24 venue provision, 161.706, is a permissive or mandatory

25 venue? 40

1 MR. SHATTO: To that point, Your Honor, I

2 don't think we are agreeing that it is a mandatory

3 provision, but we believe that the State has venue under

4 that provision. So if the Court determines that to be

5 the case, then we're okay in Collin County as well.

6 THE COURT: Okay. But I don't think that

7 specifically answers my question. What is your exact

8 position on is this statute -- and I'm looking at

9 161.706. Is it your assertion here today that subpart B

10 constitutes a mandatory venue provision, or does it

11 constitute a permissive venue?

12 MR. SHATTO: The State would argue that it

13 is a mandatory.

14 THE COURT: So then if it's mandatory, then

15 that provision is the one that governs the Court's

16 analysis here today. And so we're only going to be

17 talking about that provision. And so with that,

18 Dr. Cooper, you may continue.

19 MS. HOLLAND: Thank you, Your Honor. I

20 would just add one thing, which is that the new claim

21 that was added under the Health and Safety Code also has

22 a permissive venue provision for Attorney General

23 enforcement actions. It provides that they should be

24 brought -- sorry, not should -- but they may be brought

25 in Travis County. 41

1 THE COURT: And I believe that the State

2 has already conceded and stated here today that they

3 don't believe that their new claim has any impact

4 whatsoever on the venue analysis, so I don't think

5 there's any need to discuss that.

6 MS. HOLLAND: Thank you, Your Honor. I

7 just wanted to make that clear.

8 THE COURT: Anything further?

9 MS. HOLLAND: Yes. Yes, Your Honor. I

10 think what I would like to draw the Court's attention to

11 here is a fundamental failure of the State to provide

12 prima facie proof after Dr. Cooper specifically denied

13 venue allegations. The State did not seek

14 jurisdictional discovery in this case. They didn't come

15 to us and ask for discovery on an expedited basis. They

16 just kind of let the case continue and supplied a wholly

17 conclusory and insufficient attorney declaration as

18 their prima facie proof. We've moved to strike that

19 that as improper and we would ask the Court to

20 disregard.

21 And I think the other thing I'll just add

22 is that even if the pharmacy records that underlie that

23 declaration were supplied to the Court, that still

24 wouldn't show the relevant facts, which is where the

25 prescriptions were written. 42

1 I think another thing I would like to say

2 here is that --

3 THE COURT: But you've also admitted you

4 don't know where they were actually written.

5 MS. HOLLAND: And let me -- let me get to

6 my next point, Your Honor, which is that there is no

7 need for further discovery here because Travis County is

8 expressly provided for as a mandatory venue, one of the

9 two options in the statute. Your Honor could transfer

10 this case to Travis County today no matter what the

11 facts show, no matter whether Dr. Cooper saw some

12 patients --

13 THE COURT: But you agree with me that the

14 venue provision equally says that "or the county where

15 the violation occurred." And so if the violation

16 occurred here in Collin County, then this is the county

17 of proper venue and the Court should defer to the

18 plaintiff's choice; would you not agree?

19 MS. HOLLAND: No, I would not agree, Your

20 Honor, because --

21 THE COURT: So what in this venue provision

22 says I have to send it to Travis County?

23 MS. HOLLAND: So, Your Honor, I think the

24 point that I'm disagreeing with is that Plaintiff still

25 gets first choice. I think that the way that -- 43

1 THE COURT: So play this out with me just

2 for a second.

3 MS. HOLLAND: Yes.

4 THE COURT: Let's assume that a violation

5 related to Dr. Cooper did, in fact, occur here in Collin

6 County. I fully understand that you are strenuously

7 disputing that. I'm just saying, let's say that this

8 thread, "Venue for an action brought under this section

9 is in the district court of Travis County or," and if we

10 were to agree that a violation did occur here, it would

11 be Travis County or Collin County. Why would it be

12 proper for me to transfer this case to Travis County if,

13 in fact, Collin is a place where a violation occurred or

14 is about to occur?

15 MS. HOLLAND: I think, Your Honor, the

16 answer is that we don't know that at this point when the

17 Court needs to make the ruling. And because Dr. Cooper

18 has specifically denied these allegations, the burden is

19 on the State to provide prima facie proof that venue is

20 proper here. It has failed to do that. And so on the

21 record before the Court, that's just -- that's not the

22 reality that we're dealing with at this point, and

23 Travis County is expressly provided for as one of the

24 options and so it would be proper.

25 One other small point on that, which is 44

1 that in the State's response, it discusses that the

2 State does not consent to venue in Travis County, and I

3 would just like to explain that consent is not part of

4 the statute for SB 14. That's part of the DTPA, but

5 we've all agreed at this point that the DTPA does not

6 govern. So the State's consent to Travis County really

7 just isn't relevant.

8 If I could make one final point, Your

9 Honor. I think if we look at the example of Patient 7,

10 it is a really good illustration of why the State's

11 venue theories don't make sense. You know, they're

12 trying to hang their hats on where the medication was

13 administered and where it was -- the prescriptions were

14 filled. Patient 7 is alleged to live in Collin County,

15 and the State alleges that Dr. Cooper wrote them a

16 prescription in September '23 -- 2023. Patient 7 filled

17 one of those prescriptions at a pharmacy located in

18 Illinois. So under the State's theory, would a court in

19 Illinois be a proper form? It just -- it doesn't make

20 sense. So I think that that --

21 THE COURT: Can I ask how you have or know

22 that information?

23 MS. HOLLAND: It's in the petition, Your

24 Honor.

25 THE COURT: Okay. 45

1 MS. HOLLAND: I think that the location of

2 the pharmacies is contained within the underlying

3 pharmacy records, the PMP records.

4 THE COURT: Have you received access to

5 those?

6 MS. HOLLAND: No, Your Honor. No, Your

7 Honor. That is just my guess.

8 THE COURT: Any additional points?

9 MS. HOLLAND: One moment.

10 No, Your Honor, that's all.

11 THE COURT: Thank you. State, I'll hear

12 from you at this time.

13 MR. FARQUHARSON: Yes, Your Honor. Thank

14 you. I have a couple of points here. One, just so you

15 know, paragraph 45 of the petition states that Cooper

16 has violated the law by providing, prescribing,

17 administering, or dispensing testosterone to minor

18 patients for these purposes. Beyond that, I think that

19 defense is incorrect in that they have specifically

20 denied all of our venue facts. The venue facts that are

21 important here are that these patients live in Collin

22 County and that they fill these prescriptions in Collin

23 County. Those two points have not actually been in

24 dispute.

25 The question, I think, that's been raised 46

1 is how important those two facts are. But every single

2 one of our allegations rise and fall directly from those

3 two venue facts that have not actually been disputed.

4 And because of that these facts must be taken as true

5 and our allegations at this point also need to be taken

6 as true. We have yet to receive medical records. We

7 would love to have medical records so that I can prove

8 up these facts, but we don't have those -- we don't have

9 access to those at this time.

10 Furthermore, Defendants' focus on the

11 hyperlocality of what the physicians are doing is simply

12 too narrow in this case. In addition to the facts above

13 and to the facts we already have, Lau and Cooper, is

14 their continuing course of care has extended to Collin

15 County. They did this by, as previously discussed,

16 directing these prescriptions to Collin County. They

17 did this by having that pharmacist, who again, ultimate

18 responsibility is the prescribing physician's ultimate

19 responsibility to dispense this medicine in Collin

20 County --

21 THE COURT: And so let me ask a couple

22 questions in that regard. So is it your assertion here

23 today that Dr. Lau or Dr. Cooper picked up a phone,

24 called a pharmacy in Collin County and said, I want this

25 prescription filled? Or is it your assertion whenever 47

1 they saw the patient, they signed a prescription slip,

2 put it in their records, and they likely did not have

3 any knowledge of where the prescription ultimately would

4 be filled or where the pharmacy was that the

5 prescription would be filled?

6 MR. SHATTO: So obviously I don't know what

7 the physicians did themselves specifically. If I may

8 speak frankly, I was a paramedic for five years; I

9 worked in the ER for five years. In those instances, we

10 would either hand out a prescription and the patient

11 would take that prescription wherever they wanted. In

12 that instance, there is no reason to think that a

13 physician would know where that prescription went.

14 There was other instances where the physician would call

15 the pharmacy and direct it to them.

16 Here what's being stated is that this is a

17 controlled substance that is being entered into some

18 sort of electronic medical record and, if that's the

19 case, is going to be directed to that pharmacy. It is

20 appropriate to, not knowing all ins and outs, presume

21 that the physician is putting in the system this is

22 going to go to Collin County per that patient's wish at

23 that time. Otherwise, every pharmacy in the state or

24 the country may have access to those same prescriptions,

25 and that just doesn't seem like an accurate way to do 48

1 business or a clean way to do business.

2 THE COURT: So you're alleging that the

3 doctor themselves typed in the pharmacy and thus had

4 personal knowledge. You're saying from your own

5 experience in the medical field, that's what you believe

6 is the possibility?

7 MR. SHATTO: Yes, Your Honor, that the

8 physician transmitted it -- typed it in while they were

9 in Dallas County and transmitted it to these other

10 pharmacies in Collin County.

11 THE COURT: Okay. Where are the PMP

12 records?

13 MR. SHATTO: We have access to them in

14 our -- in our system.

15 THE COURT: Okay. Can you tell the Court,

16 in connection with Texas Rule of Civil Procedure 87, why

17 the records -- the PMP records were not provided to the

18 Court or opposing counsel in support of the declaration?

19 MR. SHATTO: Yes, I think Rob is going to

20 take that toady.

21 MR. FARQUHARSON: I'm looking very quickly

22 at Rule 87 to make sure.

23 THE COURT: Sounds great. I've got it

24 right here too.

25 MR. FARQUHARSON: Judge, I would note we -- 49

1 we notified opposing counsel of the records in our

2 disclosures. That's what the disclosure rule requires

3 us to do. They did not make a follow-up request for it

4 beyond Dr. Cooper did submit some discovery requests to

5 us recently. Those responses are not yet due.

6 THE COURT: Okay. So I'm going read the

7 applicable line. "Prima facie proof is made when the

8 venue facts are properly pleaded in an affidavit and any

9 duly proved attachments to the affidavit are filed fully

10 and specifically setting forth the facts supporting such

11 pleading." I think that's the relevant language.

12 So the query that the Court has is: Why

13 were the attachments, the PMP records themselves, not

14 provided to the Court so that I could evaluate it.

15 MR. FARQUHARSON: I don't think we -- I

16 don't think that's required of us, simply, and we

17 provided an affidavit as to those records. And in the

18 event that the Court needs something beyond that, we

19 believe we can prove it up otherwise.

20 THE COURT: Okay. And so when you say you

21 believe you can prove it up otherwise, the declaration

22 itself merely says, "The records pulled from the State's

23 PMP database support the State's factual allegations."

24 So when you say we can prove it otherwise, it's, Judge,

25 we can provide you the PMP records, or what would this 50

1 otherwise be?

2 MR. FARQUHARSON: We will present testimony

3 or we would also be happy to provide redacted versions

4 of the PMP records to the Court. At the time that this

5 was happening, we believed that the privacy interests

6 weighed in favor of not attaching those to those

7 pleadings.

8 THE COURT: So similar to the questions

9 I've been asking Dr. Cooper, things have changed,

10 patients are no longer pseudomized. And so at present,

11 in light of the fact that we have a protective order, is

12 it appropriate for the State to provide those?

13 MR. FARQUHARSON: It would be.

14 THE COURT: Anything further, sir?

15 MR. SHATTO: I do not.

16 MR. FARQUHARSON: No, Your Honor.

17 THE COURT: All right. Then we'll go ahead

18 and turn to Dr. Lau's 's motion.

19 MR. LOGAN: Your Honor, very briefly, you

20 know, as we do represent some of the nonparty patients

21 that are at issue in the Cooper litigation as well,

22 nothing's become ripe there that we filed with the

23 Court. We do just want to state for the record that we

24 disagree very, very strongly with the characterization

25 of that discovery as the new discovery. The first 51

1 request was for all records for one of our patients for

2 the last four years.

3 THE COURT: And certainly, Counsel, we're

4 going to discuss today the motion to compel and the

5 requests and whether or not they should be reformed. I

6 guess since you stood up, I'll go ahead and ask. You

7 represent a certain number of the patients, and

8 certainly for the Court to evaluate this motion, it may

9 be that there is certainly discovery that is necessary.

10 And so the query I've got is: Are the patients going to

11 oppose providing the information so that the Court can

12 actually evaluate the location of any telehealth visits,

13 any actual physical patient visits, or where

14 prescriptions were written?

15 MR. LOGAN: Your Honor, I'm very happy you

16 asked that question. So the patients are only asking

17 and only asking in a protective order, for instance,

18 that the framework the State set forth in R.K.-Ramirez

19 is followed, which, as Your Honor just alluded to,

20 usually requires that records that are going to be

21 produced are produced in camera for the Court to review

22 first.

23 It also generally requires that the

24 requests are actually targeted to a specific issue in

25 the litigation, not simply all of our clients' records 52

1 for the last four years. But more specifically to the

2 Court's question just now, we've asked the State to

3 confer on this. We reached out to the State before we

4 filed for protective order and said we would like to

5 confer on these requests. The State hasn't even given

6 us the courtesy of a response, much less conferred with

7 us.

8 THE COURT: Part of the reason we're all

9 together for so much time today is we are going to

10 confer on all of these issues and make sure that we are

11 able to address everyone's concerns.

12 So I think what you're telling me is,

13 because I think your specific requests were that you

14 wanted the ability to redact the identity, to allow the

15 patients to review and to confirm the redactions; is

16 that correct?

17 MR. LOGAN: Yes, Your Honor. And also to

18 make sure that the requests aren't improperly seeking

19 materials beyond what's necessary for this case.

20 THE COURT: At least as an initial matter,

21 what the Court is telling you based upon the

22 allegations, I need to know the location of telehealth

23 visits, the physical location of patient visits, and the

24 location of the doctor when the prescriptions were

25 written. I'm hearing you say, Judge, so as long as the 53

1 patients' identities are wholly redacted, we are

2 comfortable ensuring that that information is provided

3 to the parties. Am I hearing you correctly?

4 MR. LOGAN: Yes, Your Honor, you're hearing

5 that correctly. As long as the appropriate redactions

6 are made and protect our clients' identities, that's

7 fine.

8 THE COURT: And you're permitted an

9 opportunity to review all of the redactions?

10 MR. LOGAN: Yes, Your Honor, correct.

11 THE COURT: Thank you very much. I

12 appreciate it.

13 MR. FARQUHARSON: I just want to add one

14 thing. With respect to the -- we dispute a lot of that.

15 But with respect to the PMP records, a potential

16 solution here would be we would be willing to file those

17 with the Court right now and make an oral motion to

18 seal. If all parties are agreed to those being sealed,

19 then I think that solves the problem.

20 THE COURT: Okay. So you here today are

21 orally advising the Court you're willing to file the PMP

22 records as redacted to request them to be temporarily

23 sealed, to subsequently request a permanent sealing

24 hearing on those records, and you're asking whether or

25 not the parties are opposed to the Court receiving 54

1 those.

2 MR. FARQUHARSON: Correct.

3 THE COURT: Defense counsel.

4 MR. SMYSER: Your Honor, we're not opposed

5 to the Court receiving them. That still is inadequate

6 under Rule 87. It doesn't prove up the records, it just

7 proves we got these. It needs more than that. So we --

8 but we do not, of course, oppose the Court looking at

9 them either.

10 THE COURT: Okay. Ms. Holland.

11 MS. HOLLAND: We're not opposed to the

12 records being sealed or to the Court receiving them.

13 THE COURT: All right. Thank you.

14 Dr. Lau, I'll hear from you at this time.

15 MR. SMYSER: Your Honor, one point of

16 order. The Court said earlier that they wanted to stop

17 at 9 o'clock, hard stop, for the notice. So before --

18 THE COURT: I appreciate it. I have lost

19 track of time.

20 So, everyone, before we move to Dr. Lau's

21 motion to transfer venue, let's go ahead and have the

22 hearing as it relates to sealing.

23 Mr. Miller.

24 MS. PATTERSON: Judge, he has called the

25 hall. 55

1 THE COURT: Okay. And do we have the

2 parties on the other cause present?

3 MS. PATTERSON: Yes, ma'am.

4 THE COURT: Let me go ahead -- we're going

5 to do two things really quickly. Mr. Miller, you have

6 called the hall; correct?

7 THE BAILIFF: Yes, Judge.

8 THE COURT: Okay. So in connection with

9 each of these causes, the Court will just note for

10 purposes of the record we are set here today on the

11 request to seal certain records in each of Dr. Lau and

12 Dr. Cooper's case. The Court previously temporarily

13 sealed them because they contained the home address. At

14 this time I would like -- are there any persons of the

15 public who are present who have any opposition to the

16 Court sealing the records for the stated reason?

17 I see no persons present stating an

18 opposition. I'll have our record reflect no opposition

19 was voiced, notwithstanding the opportunity for the

20 public to do so. If I can just have the counsel for

21 each of the defendants confirm you request the sealing

22 and do not oppose.

23 MS. HUDSON: Dr. Lau confirms.

24 MS. HOLLAND: Dr. Cooper confirms.

25 MR. SHATTO: The State confirms. 56

1 THE COURT: And then nonparty counsel?

2 MR. LOGAN: We confirm as well, Your Honor.

3 THE COURT: All right. At this time the

4 Court grants the sealing request, and I'll check to see

5 whether or not I have orders already. If so, I will

6 sign them; if not, I'll ask counsel for y'all to

7 provide.

8 We've been going for about an hour. I have

9 one additional matter that I need to take up that's

10 going to take me about two minutes. If everybody wanted

11 to make a bathroom break, you may do so very quickly and

12 then we'll resume with where we're at. Okay?

13 (Recess taken)

14 THE COURT: At this time we are going to be

15 back on the record. We've had some additional counsel

16 join us, and so at this time I'm going to ask those

17 persons who are additional counsel that have now joined

18 us, if you'll stand and state your appearance for the

19 record.

20 MS. NEWSOME: Jervonne Newsome with Winston

21 & Strawn here on behalf of the nonparty patients.

22 THE COURT: Thank you.

23 MR. SUTKER: Your Honor, Cory Sutker for

24 nonparty Children's.

25 THE COURT: And then we have one 57

1 additional. Were you going to put your appearance on

2 the record?

3 MR. SMYSER: Yes, Your Honor. Simona

4 Agnolucci for Dr. Cooper.

5 THE COURT: Thank you.

6 All right. So with the additional counsel,

7 thank y'all for joining us. We're going to go ahead and

8 turn now to Dr. Lau's motion to transfer venue. Again,

9 I think the Court previously outlined its understanding

10 of the pleadings, and the parties haven confirmed that

11 the Court has accurately summarized.

12 So with that, Counsel, I'll turn this over

13 to you.

14 MS. HUDSON: Thank you, Your Honor. Evelyn

15 Hudson for Dr. Lau.

16 Venue in Collin County is improper. As

17 Dr. Cooper's counsel has discussed, and we won't repeat

18 at length here, the only allegations of violations of

19 this statute are for prescribing. A violation is what

20 would take it out of Travis County, and the State has

21 alleged only violations that can have obtained in Dallas

22 County.

23 Dr. Lau --

24 THE COURT: Is your position on that

25 related to the argument that it doesn't matter where a 58

1 doctor is when they prescribe something, it only matters

2 where the electronic records system is, and it's been

3 y'all's position that, okay, great, even if Dr. Lau was

4 in Collin County -- and I'm not saying that you are

5 saying that -- but even if she had been, it wouldn't

6 matter because the records systems for the hospitals are

7 in Dallas and so when these prescriptions are processed,

8 it is always in Dallas no matter where the prescribing

9 doctor is physically located?

10 MS. HUDSON: Your Honor, in our case,

11 Dr. Lau is physically located in Dallas. However, we

12 would not contest that argument made by Dr. Cooper's

13 counsel that the electronic databases are also relevant

14 for the purposes of where the prescription occurred.

15 However, for our case specifically, it has been our

16 contention and continues to be our contention that

17 because Dr. Lau has physically prescribed these

18 medications only from Dallas County, venue is proper in

19 Dallas County under a plain reading of the venue

20 statute. And a plain reading is exactly what's

21 required. The same Texas Supreme Court case that

22 confers mandatory -- this being a mandatory venue

23 provision, also outlines that we are required to read

24 venue statutes as their plain language.

25 THE COURT: Can I interrupt just for a 59

1 second. I would like to come back to the verification

2 filed by Dr. Lau. Okay. So if I'm looking at the

3 verification, which is found on page 6 of 7 of

4 Defendant's motion to transfer venue, the specific

5 assertion is, "I do not practice medicine in Collin

6 County and have never traveled to Collin County for any

7 purpose associated with my medical practice since July

8 of 2016." There is not a specific assertion that she

9 never saw patients in Collin County nor never prescribed

10 any medications while in Collin County, and so I want to

11 just -- want to specifically inquire about that.

12 Are you telling the Court on the record

13 here today, well, Judge, when we made the verification

14 and she said I don't practice medicine in Collin County,

15 prescribing a medicine to a patient or treating a

16 patient would be considered practice of medicine, and so

17 with that statement, what we're saying is we have sworn

18 to the Court under oath there were never any

19 prescriptions that she wrote in Collin County, there

20 were never any patients that she saw in Collin County?

21 MS. HUDSON: Yes, Your Honor. To my

22 knowledge, that is correct.

23 THE COURT: So there -- the devil's in the

24 details, "to my knowledge."

25 MS. HUDSON: Yes, Your Honor. 60

1 THE COURT: Because the Court's got to make

2 the decision based on the actual facts.

3 MS. HUDSON: Yes.

4 THE COURT: And so do you know the actual

5 facts, or is the reality that, at present, no one really

6 knows because the defendants haven't reviewed the

7 medical records either?

8 MS. HUDSON: Dr. Lau has sworn in her

9 affidavit, and we believe that your interpretation is

10 correct, that she has never prescribed in Collin County

11 nor treated patients in Collin County.

12 THE COURT: You may proceed.

13 MS. HUDSON: I would like to address one of

14 the things the State said explicitly in its argument

15 earlier, that to -- when a prescription is sent, it is

16 sent, and I quote, per that patient's wish to a

17 prescriber or to a pharmacist. And so it is not, as the

18 State argues, the agency of Dr. Lau prescribing or

19 providing through a pharmacy but rather a third-party

20 act of both the pharmacist and the patient.

21 The patient is selecting where that

22 prescription or treatment is filled. And this is

23 important not only because, of course, third-party acts

24 are insufficient here to accomplish a first-party

25 violation, but also because it would lead to an absurd 61

1 result.

2 It would permit the State to simply allege

3 or find venue in any of the counties in Texas or, as

4 Dr. Cooper's counsel has argued, in any state in which

5 the prescription has been filled. We have a patient as

6 well, just as Dr. Cooper's counsel, who filled their

7 prescription in Missouri. And so in any case, that

8 result is absurd and we want to encourage doctors to

9 continue to provide treatment where that treatment is

10 appropriate and necessary, and we believe that here that

11 result should not obtain.

12 We would also like to note on the record

13 that we similarly object to the affidavit the State

14 supplied in support of its response in opposition to our

15 motion to transfer venue.

16 THE COURT: You haven't filed a joinder or

17 a motion strike at present, though, have you?

18 MS. HUDSON: We have not. We noted the

19 objection in our reply. And we noted it for the same

20 reasons that Dr. Cooper's counsel has noted it, but

21 would like to highlight the deficiency in addition under

22 Rule 87 but also because affidavits cannot rest on

23 inferences and implications under the law and the

24 affidavit contains allegations that patients would have

25 self-administered, and that cannot be the personal 62

1 knowledge of the affiant, Attorney Stone.

2 THE COURT: Anything further, Counsel?

3 MS. HUDSON: We're comfortable with hearing

4 the State's response and responding further.

5 THE COURT: All right. State, at this

6 time.

7 MR. SHATTO: Yes, Your Honor. The State

8 continues to state that the venue facts that are

9 important here are that the patients live in Collin

10 County or the patients filled their prescriptions there.

11 We believe that all of the other allegations flow

12 continuously from there and are appropriate to have

13 venue here in Collin County.

14 But on another -- kind of to expand on

15 this, there's a case that didn't make it into our

16 arguments that discusses the continuing course of care

17 of physicians. I have four copies here. We have ended

18 up with more people than I might have expected, and I

19 can certainly pass them out. This is a Supreme Court of

20 Texas case called Rowntree v. Hunsucker and it discusses

21 kind of a summary of the course of treatment type of

22 ideas that the courts have dealt with. And there's two

23 kind of excerpts that I think are illustrated here.

24 THE COURT: Counsel, can you read that cite

25 into the record so that we'll all have it for later. 63

1 MR. SHATTO: Yes, Your Honor. Rowntree v.

2 Hunsucker, H-U-N-S-U-C-K-E-R, that is at 833 S.W.2d 103,

3 and Texas 1992.

4 THE COURT: And if you wouldn't mind

5 providing counsel for Dr. Cooper and Dr. Lau a copy at

6 this time.

7 MR. SHATTO: So from these cases, they kind

8 of review each of the cases and as the court says,

9 Common to all cases here, the plaintiff who takes

10 medication significantly beyond the period contemplated

11 by the physician's prescription without further

12 attention from the physician is not being treated by

13 that physician but is self-treatment.

14 That's not the case here. These patients

15 are filling the prescriptions soon after they've been

16 written them and then they're taking it within the

17 prescription period there.

18 The Court goes on to say that these cases

19 stand for the proposition that a physician may establish

20 a course of treatment by enlisting the aid of the

21 patient to self-administer a medication but only if the

22 physician controls the treatment and continues to render

23 medical services. So here also, the testosterone is a

24 Schedule III controlled service that can only be

25 obtained by a physician who prescribes, dispenses, or 64

1 otherwise allows that prescription to be filled. And

2 these medications are being filled soon after they've

3 been written, in Collin County, and it is our allegation

4 that the physicians have enlisted the patient to

5 self-administer that medication as a part of that

6 continuing course of care.

7 Now, the one part of this is only if the

8 physician controls treatment and continues to render

9 medical services. This is one of the reasons why it's

10 important for us to get medical records because we need

11 to see those visits, the follow-ups, and so on and so

12 forth. But to note -- and the same will apply to

13 Cooper, but specifically here in Lau, Patient 5 had two

14 additional prescriptions after this initial prescription

15 after the SB 14 time period, which would indicate to the

16 State at least some level of continuing course of

17 treatment for those patients. And so for those reasons,

18 you know, we think that the Court clearly -- or I'm

19 sorry, the physician's course of care extends into

20 Collin County.

21 And then in terms of kind of where the

22 prescriptions are filled, I do have another case here

23 that didn't make it in the record but -- but maybe the

24 easier example is just kind of a criminal hypothetical.

25 You know, the drug dealer of some sort sells fentanyl in 65

1 Dallas County, and then that individual drives to Collin

2 County, takes that fentanyl and dies because of an

3 overdose, but that individual is going to be liable in

4 Collin County. It's a similar idea here.

5 THE COURT: And, Counsel, I'll ask you the

6 same question that I asked your opposing counsel.

7 You're advancing arguments here today. In connection

8 with the interpretation of prescribe, which I think is

9 where we're going, do you have any actual authority

10 other than the reference to that each the pharmacist and

11 the doctor are coequally responsible in connection with

12 a prescription and then subsequent dispensation?

13 MR. SHATTO: Well, the Texas Occupations

14 Code states that the ultimate responsibility is the

15 prescribing practitioner's ultimate responsibility of

16 the dispensing of that medication. But I would say that

17 the statute itself also says where the prescribing --

18 administering, prescribing --

19 THE COURT: It says provide, prescribe,

20 administer, or dispense.

21 MR. SHATTO: Yeah. And so beyond the

22 prescribing issue, there's also providing, right. These

23 medications could not be provided to these patients in

24 Collin County if they were not able to -- if they were

25 not sent there by the physicians, and these 66

1 prescriptions can go nowhere without the doctor's

2 signature.

3 THE COURT: Okay. So I just want to drill

4 down on this because I think the language is obviously

5 very important. In connection with administer, the

6 State's argument is there was a prescription written for

7 the patients, the patients filled their prescription and

8 then went to their homes in Collin County and they

9 self-administered. Obviously, the opposing party's

10 allegation is you don't have personal knowledge as to

11 whether or not any prescriptions that were filled were

12 actually administered; correct?

13 MR. SHATTO: Correct.

14 THE COURT: Okay. And then as to dispense,

15 you're arguing when the pharmacist filled the

16 prescription, that that filling of the prescription,

17 because it ultimately originated with the doctor, is

18 still the responsibility of the doctor and so the

19 doctors is encompassed within dispense?

20 MR. SHATTO: Yes, Your Honor, I guess

21 argument that the pharmacist is an agent of the

22 physician.

23 THE COURT: Okay. Why are there two

24 different words? Why is there prescribe, and why is

25 there dispense if that is the case? Isn't it often, 67

1 perhaps at urgent cares or others, that doctors

2 themselves dispense drugs at the facility kind of in an

3 immediate fashion? So isn't the -- is the intention

4 with dispense to cover those situations where the

5 doctors are actually handing over the medication and not

6 sending it off to a pharmacist to fill? Wouldn't -- so

7 is the dispense language only for the person who is

8 actually handing over the medication?

9 MR. SHATTO: So that may be the case. I

10 think the argument is that a pharmacist can't prescribe

11 the medicine but they can also be held liable for the

12 act of dispensing that medication if they knew what that

13 purpose was if that purpose was illegal. So the -- so

14 that would just kind of cover the nonprescribing

15 pharmacist who is dispensing the medicine.

16 THE COURT: Counsel, if you will continue.

17 MR. SHATTO: Overall, you know, the State

18 simply believes that venue is proper here in Collin

19 County. We don't think that that's been properly

20 challenged, our venue facts haven't been properly

21 challenged, and that -- and that it is proper here. But

22 I think this also does bring up the fact that we do --

23 that the medical records will ultimately provide the

24 information of venue as to where these things actually

25 occurred. 68

1 THE COURT: Thank you. Response.

2 MS. HUDSON: Yes, Your Honor, I have

3 several responses. First, as to this case which we have

4 just been provided, it appears on initial review that

5 this is not a case about location. It is not a case

6 about a relationship establishing venue or jurisdiction.

7 Instead, it is a case about a statute of limitations in

8 summary judgment. So the course of continuing care is a

9 timing issue in this case, it appears, not relevant to

10 this case. And of course, with further review, we would

11 be happy to supplement our analysis that supports our

12 analysis of this course of care argument that has just

13 been raised today.

14 Additionally, we would like to challenge

15 the State's characterization initially in its -- in its

16 rebuttal that the statute prohibits, quote, otherwise

17 allowing the filling of prescription medications. That

18 is not in SB 14. Otherwise allowing is not a violation

19 of the statute and should not be the basis upon which

20 this Court decides venue.

21 Additionally, I would like to drill into

22 some of the definitions of these terms of violations

23 because although we did look at the definition of

24 prescribing, I think since we've brought up dispensing

25 and providing those would be similarly helpful. So to 69

1 provide under the Occupations Code means to supply one

2 or more unit doses of a nonprescription drug or a

3 dangerous drug to a patient. Dispense means to prepare,

4 package, compound, or label in the course of

5 professional practice a prescription drug or a device

6 for delivery to an ultimate user of the user's -- or the

7 user's agent under a practitioner's lawful order.

8 Neither of these are encompassed by the

9 facts as pled as to any of the patients that were

10 alleged to be the sources of the violations that Dr. Lau

11 incurred. Instead, the petition sets forth and the

12 arguments have reaffirmed that even to the extent the

13 State uses the terms "providing" or "dispensing," what

14 it means is that Dr. Lau wrote a prescription. And so

15 the State's justification for venue on those terms as

16 violations is an entire -- it's a red herring, Your

17 Honor. It is inapplicable here.

18 Additionally, I would like to turn to the

19 Occupations Code where the State referenced that it is

20 the doctor's responsibility to ensure that the

21 prescription is properly dispensed. The State is

22 referencing a statute, which I have printed here in

23 full, that actually relates to the professional

24 responsibility, duties of a pharmacist.

25 In fact, that section which they have 70

1 quoted is part of the definition of a valid patient -- a

2 valid -- to be a valid prescription, it must be issued

3 for a legitimate medical purpose, blah, blah, blah.

4 It's defining a valid prescription. It is not saying or

5 conferring an affirmative duty upon a prescriber. In

6 fact, this statute has never before been used to confer

7 such a duty.

8 Instead, this scheme is purposed and the

9 legislature's intent is to define a pharmacist's duties.

10 And so we also object to the use of that statute to

11 justify the State's argument that Dr. Lau is in any way

12 responsible for where patients selected to have their

13 prescriptions filled and where pharmacists elected to

14 fill them.

15 Finally, Your Honor, as an additional

16 point, we take issue with the comparison of these

17 doctors to criminals. It is inappropriate for the State

18 to have made such a comparison. These doctors have had

19 no complaints against their behavior and, in fact --

20 THE COURT: And I'll just stop you. I

21 don't think that the State intended any disrespect. I

22 think that they were just looking for a location

23 analysis or analogy. Certainly the Court did not

24 infer from that. And I'll just state I don't think

25 there's any need to go further. That's not how the 71

1 Court is viewing the situation.

2 MS. HUDSON: On that note, we would -- we

3 would continue to argue as we have, as Dr. Cooper's

4 counsel has, that the very plain language of this

5 statute and the violation alleged meet that where the

6 prescription has happened is where the violation is and

7 where venue is proper and otherwise would be proper in

8 Travis County. So we -- we request transfer to either

9 of those counties.

10 THE COURT: Thank you. I know you wanted

11 to make a statement earlier. Are there any additional

12 statements that you want to make at this time, or do you

13 feel that you've appropriately stated your position,

14 Counsel for the nonparty patients?

15 MR. LOGAN: Your Honor, the only thing I

16 would add is that to the extent we ultimately do end up

17 discussing limited jurisdictional discovery, obviously

18 the nonparty patients are going to be limited to time

19 commensurate with the allegations and limited in scope

20 commensurate with what's necessary for venue. That's

21 all, Your Honor.

22 THE COURT: Thank you. Counsel for the

23 nonparty hospital, do you have any statements you want

24 to make at this time?

25 MR. SUTKER: No, Your Honor. 72

1 THE COURT: All right. Then having

2 provided everybody an opportunity to speak, the Court

3 finds as this time as follows: The Court denies

4 Cooper's request to strike the declaration. However, I

5 do take the motions to transfer under advisement at this

6 time.

7 I order the State to produce the PMP

8 records, and I order the parties as well to supplement

9 the record with additional location information. I

10 think we exhaustively discussed in January that that

11 information would be relevant to the Court's decision

12 here today. In particular, Cooper's specific denial

13 relies upon the fact that the parties -- or the patients

14 were pseudomized. But that is no longer the case and it

15 has not been the case since January 17th.

16 The motions are not postured for the Court

17 to properly assess and resolve here today. I do believe

18 that we've all agreed on a few things, though. We've

19 all agreed that 161.7106 is, in fact, a mandatory venue

20 provision, and as a result of that, venue for this

21 action is abundantly proper in Travis, as defense

22 counsel has alluded to, and the parties have variously

23 alleged that either Dallas or Collin County is also

24 proper. The Court intends to get this right, and so I

25 believe that the record at present does not properly 73

1 permit me to evaluate or assess.

2 We're going to talk about the time frame.

3 State, you said you have the PMP records

4 and that you intend to supplement the record today?

5 MR. FARQUHARSON: Yes, Judge, we can do --

6 sorry, I keep wanting to stand up.

7 We can that do that either through any of

8 the methods that we've offered to the Court.

9 THE COURT: I think, because we need it to

10 be provided to the opposing parties as well, that it's

11 probably best for you to file a motion supplementing,

12 affixing the records, and then you orally move to

13 temporarily seal today, which, again, the Court's

14 granted, so that you can as well set a public sealing

15 hearing on that just so that we can ensure that we're

16 hitting all of the requisites in connection with putting

17 those documents in the record.

18 MR. FARQUHARSON: We will do that.

19 THE COURT: Okay. I think we need to talk,

20 obviously, with the nonparty patients and then the

21 hospital as it relates to the Court's further directive,

22 which is that the parties are to supplement the record

23 with additional location information. The Court's

24 intention here is just to properly assess where the case

25 should be, and I do think that there's additional data 74

1 that the Court has to have to be able to do so.

2 At present, Dr. Cooper and Dr. Lau have

3 alleged that they are not in possession, custody or

4 control or have access to any of the patient medical

5 records other than perhaps a stray record that

6 inadvertently is kept in their files. And so the

7 reality is, is the two folks that I'll be looking to to

8 ascertain how can we get the information and in what

9 time frame we can get it is going to be the two of you.

10 I don't know if you're prepared to discuss that with me

11 at present or if we need to take a brief recess so that

12 in light of the Court's rulings you can assess how you

13 would like to respond.

14 MR. LOGAN: Your Honor, for the nonparty

15 patients, we think it would be a good idea to take a

16 brief recess, but we would also note for the Court that,

17 you know, the Dallas County district court has taken

18 jurisdiction over subpoenas that have been issued to the

19 hospital in this case. The nonparty patients challenged

20 them there in accordance with the Texas Rules of Civil

21 Procedure. So that Court has a hearing set in the Lau

22 matter for March 13 --

23 THE COURT: And I just don't know that this

24 Court --

25 MR. LOGAN: March 12th, sorry. 75

1 THE COURT: -- can wait, and I think that

2 there is discovery that's pending here that makes it

3 proper for this Court to push the issue as well. And so

4 I certainly understand and I'm not -- while I'm not

5 trying to infringe upon the jurisdiction of Dallas

6 County, if that's where the individuals live such that

7 that makes it the appropriate location for them to

8 challenge those specific subpoenas, there are other

9 jurisdictional requests that I think are outstanding.

10 And while Dr. Lau and Dr. Cooper don't have

11 access to the particular records, I think we could

12 charge them with personal knowledge, and I guess then

13 the query becomes how do we help them, you know, refresh

14 their recollection of their personal knowledge. So I

15 would encourage y'all to discuss that.

16 I feel that because of how long this motion

17 has been pending already, I'm certainly not inclined to

18 delay. And this is meant as no aspersion on Dallas

19 County, but oftentimes proceedings there may take a

20 slightly longer time than they might here in Collin

21 County.

22 MR. LOGAN: Yes, Your Honor, understood.

23 And just to correct the record, it was March 12th that

24 they have the hearing.

25 THE COURT: Thank you. 76

1 MR. SUTKER: Your Honor, from the

2 hospital's perspective, we are kind of caught in the

3 middle of two district courts, but I understand what the

4 Court's trying to accomplish. I would just need more

5 direction on what the parties believe is necessary to

6 show location because --

7 THE COURT: Well, I think that's why I

8 outlined those categories earlier. So I don't know if

9 you took notes over those categories, but that's why I

10 was doing it. Counsel is not wrong. I was very heavily

11 forecasting. I think those are the categories and so I

12 think there is no opposition.

13 We had discussed at the outset that, you

14 know, there was no need for identity of any patients to

15 get the location information, and I don't think -- and,

16 Counsel, if I'm misrepresenting, please, you know, speak

17 up. But I think we exhaustively discussed at our

18 initial hearing that for the Court to evaluate the

19 location information; no one was requesting identity

20 information. The State was abundantly clear, we don't

21 need that. We would be comfortable with designating

22 them as patient, which is one of the reasons as well I

23 asked for y'all to confer to make sure our patient

24 designations are the same.

25 So I don't think anyone is intending to try 77

1 and get any information regarding, you know, the actual

2 treatment, the diagnosis, the patient identification.

3 We just need the location information so that the Court

4 can evaluate and make this decision.

5 MR. LOGAN: And, Your Honor, we will confer

6 about that. This is, honestly, the first we've learned

7 of the first hearing and what was said there. As

8 mentioned before, the State hasn't conferred with us,

9 but we're glad to learn that. That's definitely --

10 sounds like we're heading in the right direction.

11 THE COURT: Okay.

12 MR. FARQUHARSON: Judge, that's the second

13 time it's been raised that we have not conferred with

14 them --

15 THE COURT: The Court is abundantly clear

16 on the course of conversation, and I don't think we have

17 to delve into whether there was a proper meet and confer

18 or there was not a meet and confer. The fact of the

19 matter is, is we're all here today to muddle through all

20 of these issues and the Court's intention is to provide

21 an environment that is conducive to moving all

22 disagreements forward.

23 All right. So with that, we're going to go

24 ahead and stand down and be off the record. And what I

25 am going to ask -- do you need us on the record? We're 78

1 going to go back on the record just for a second and,

2 Counsel, your remark.

3 MR. SMYSER: Yes. Right now, Friday we

4 have scheduled our motion to dismiss under Rule 91a.

5 THE COURT: Correct.

6 MR. SMYSER: And I understand that it has

7 been -- I think the Court's desire that that motion be

8 decided after the motion to transfer venue.

9 THE COURT: Set for hearing after.

10 MR. SMYSER: Or set for a hearing after.

11 And the Court is obviously aware that Rule 91a has a

12 45-day --

13 THE COURT: I'm not intending to move our

14 hearings that are set for Friday. I just want to get

15 the facts that I feel like I need so that I can properly

16 rule on these motions.

17 MR. SMYSER: Okay. Thank you, Your Honor.

18 My only suggestion adding on to that is, as far as

19 Dr. Lau is concerned, we believe the facts are as

20 Dr. Lau has stated them --

21 THE COURT: Understood.

22 MR. SMYSER: -- in terms of her location.

23 Thank you.

24 THE COURT: Anybody else who wants to say

25 something while we are on the record? No. Okay. Then 79

1 we're going to be off.

2 (Recess taken)

3 THE COURT: All right, everybody. At this

4 time we are going to be back on the record. We've had

5 significant discussion off the record related to

6 discovery and any possibility for agreements. At

7 present, we have reached an agreement as it relates to

8 the venue discovery.

9 So the Court's going to state the agreement

10 it believes has been reached on the record. I'm going

11 to ask counsel for the hospital, after I have stated

12 what I believe is the agreement, for you to clarify any

13 particular points. And then following that, I will ask

14 State, defense counsel, nonparty counsel to make any

15 additional clarifications.

16 Following that, I'm going to permit the

17 State to make one additional point related to SB 14.

18 Then we're going to adjourn again to allow the State and

19 defense counsel to confer regarding the pending motion

20 to compel so that they can advise the Court whether

21 they're requesting to go forward with the motion today

22 or to defer it to Friday when I similarly have hearings

23 set in this case.

24 All right. The parties, first and

25 foremost, the State is going to provide a master key by 80

1 close of business on the 27th. We have agreed as it

2 relates to the nonparty counsel that the master key will

3 only be provided as to those persons that the nonparty

4 counsel represents.

5 As it relates to venue, the parties have

6 agreed that we're going to do limited discovery related

7 to approximately six to ten patients. What we're

8 initially proposing is that we're going to do a test

9 case. The State is going to provide the total list of

10 either six to ten patients by close of business today,

11 being February 26th. Today as well, they will identify

12 the patient that they desire to be included in the test

13 case. Counsel for the hospital that is present today

14 will assemble and prepare to produce all records related

15 to that test case by February 28th when we are all back

16 together. How we are contemplating doing that is that

17 the records will be redacted, and you will bring with

18 you copies of both the redacted and the full records for

19 the hospital and the Court to review in camera. Counsel

20 for the other parties will only receive the redacted set

21 after the Court has had an opportunity to conduct an in

22 camera review. And that is just for purposes of

23 ensuring all identity information has been caught. The

24 Court is going to be your check on making sure we've

25 gotten that done. 81

1 The documents proposed to be produced

2 related to those six patients are: Treatment that has

3 occurred in Plano; telemedicine and office visits on the

4 dates certain provided in the petition; prescriptions,

5 specifically testosterone cypionate and testosterone

6 enanthate. I can't pronounce it either. And that as

7 well, the pharmacies where the prescriptions were filled

8 and/or sent.

9 Hospital, at this time I will ask for you

10 to confirm, has the Court correctly stated the agreement

11 or clarifications?

12 MR. SUTKER: One clarification with respect

13 to treatment that has occurred in Plano. My

14 understanding is I'm producing information to show that

15 that treatment was conducted in Plano.

16 THE COURT: Correct. No --

17 MR. SUTKER: And so the medical opinions

18 and decision-making will be part of the redactions.

19 THE COURT: Correct. Diagnosis will not be

20 provided, any treatment notes not provided. The Court

21 is merely trying to ascertain the location of the visits

22 in connection with this venue discovery.

23 MR. SUTKER: Then with that clarification,

24 Your Honor, I believe that's all accurate.

25 THE COURT: One additional point. We all 82

1 agree that after the discussion on Friday, if we are all

2 fine that, yes, we've struck the appropriate balance

3 here, what we're proposing is that the remaining

4 patients and their records related to the venue issue

5 would be produced by March the 7th, and we're going to

6 further discuss whether there will be any subsequent

7 review following that production on the 7th by nonparty

8 counsel for the patients but we've not yet determined or

9 made that determination.

10 Okay. Coming to the State next, because I

11 have one lawyer back here who definitely wants to weigh

12 in on a request for clarification.

13 MR. STONE: Yes, Your Honor.

14 THE COURT: All right. So, Counsel, at

15 this time I'm turning to the State.

16 MR. STONE: Yes. With respect to the

17 prescription, we would like it to include the

18 prescription, the address where it was transmitted to,

19 the pharmacy, and the instructions because we believe

20 the instructions go to one of our claims about if

21 there's an instruction to self-administer at home, we

22 believe that would then be relevant. So I just want to

23 clarify that we would like the instruction portion of

24 that included for the prescriptions. That is all, Your

25 Honor. Other than that, we agree. 83

1 THE COURT: Thank you. And I believe

2 you've made that clear, so I don't think that that's a

3 new statement.

4 Okay. I'm going to come to defense

5 counsel, so Lau and Cooper. Any request for

6 clarification, or have I accurately stated the

7 agreement?

8 MR. SMYSER: One clarification, minor

9 clarification, Your Honor. The list we're talking

10 about, the master key, is going to be a master key of

11 the tying the identity of the patient to the number of

12 that patient in the petition; is that correct?

13 THE COURT: Correct.

14 MR. SMYSER: Thank you.

15 THE COURT: All right. Any other

16 clarifications?

17 MS. HOLLAND: Nothing further.

18 THE COURT: Okay. Counsel.

19 MR. LOGAN: Your Honor, one point of

20 clarification from us. I believe the Court mentioned

21 the production would be on March 7th.

22 THE COURT: Ultimately. Not for the test

23 case. The test case is going to be the 28th.

24 Thereafter, if we agree on the 28th that, yes, we have

25 struck the right balance, we've addressed everyone's 84

1 concerns and we can go forward, then thereafter, the

2 hospital would be obligated to produce by the 7th. I

3 have not yet determined whether or not then the

4 documents would be produced to the parties or they would

5 come to you for your clients. We're going to address

6 that issue on Friday.

7 MR. LOGAN: Understood. That was the

8 clarification I was seeking. Not necessarily produced

9 to the parties on March 7th --

10 THE COURT: Prepared to produce. He is

11 ready and could hand those over if the Court orders him

12 to do so.

13 MR. LOGAN: Thank you.

14 THE COURT: Okay. Any additional

15 clarifications?

16 MR. LOGAN: No. Subject to their

17 clarifications, none, Your Honor. Thank you.

18 THE COURT: All right. The Court finds

19 that that is the agreement. We've all clarified to the

20 extent necessary. I find that all of you are bound by

21 this agreement, and I'll obviously see you back here on

22 Friday for us to discuss further.

23 As well, I can't recall whether I put this

24 on the record or not. There have been changes to our

25 existing protective order. And to be clear, the Court 85

1 entered a protective order right off the bat in this

2 case, but there are requests by counsel for the nonparty

3 patients to make additions to that protective order. So

4 I have directed and I hereby order you, sir, to provide

5 your proposed changes to the protective order. So the

6 specific language, by close of business today, being the

7 26th.

8 I direct the parties to meet and confer and

9 see whether they can reach an agreement on that language

10 by close of business tomorrow. And then when y'all are

11 here on the 28th, if we all agree, then I want y'all to

12 bring to me an agreed amended protective order. I will

13 enter it before we start the remainder of the hearings.

14 If we do not have agreement, the Court will take up on

15 Friday when we are all together the disputes on the form

16 of the protective order. Okay?

17 With that, unless anybody tells me they

18 have anything additional -- oh, SB 14. You had one

19 additional point you wanted to place upon the record. I

20 apologize. I almost forgot you.

21 MR. SHATTO: No worries, Your Honor. We

22 appreciate it.

23 The State's position on the language and

24 the distinctions are as follows: A prescription is a

25 violation even if it isn't filled. If a prescription is 86

1 filled, then the drug is provided, which is a different

2 violation. And then administered means the physician

3 physically injects the patient. And then dispensed

4 means the physician gives the medication to the patient

5 at her office but not does inject them. And that's the

6 States's position on kind of how those different

7 distinctions work.

8 THE COURT: Thank you for that

9 clarification. I appreciate it.

10 All right. So at this time we're going to

11 stand in recess again. We have the motion to compel

12 still left to address, and we need to decide whether

13 we're going to do that today or defer to Friday. And so

14 what I'm going to do is ask counsel for the State, and

15 then for the defendants, Ms. Patterson will show y'all

16 into the jury room so you have ample room to do that.

17 She'll check on y'all in about 15 to 20 minutes just to

18 see if you need additional time, and then we'll provide

19 an opportunity, obviously, in connection with the

20 patient records, which is not the totality of the

21 discovery, to talk with the other counsel who is

22 present. And with that, we'll be off the record again.

23 (Recess taken)

24 THE COURT: All right. We're going to be

25 back on the record. We are back on the record having 87

1 taken an opportunity to substantively meet and confer.

2 The remaining motion that is set before the Court here

3 today is the State's motion to compel. The parties

4 have, after conferring, reached certain agreements to

5 carry the bulk of the discovery discussions to Friday as

6 it relates to ESI. However, we are going to

7 specifically address two items here on the record at

8 this time, being RFP No. 27 directed to Dr. Lau and as

9 well, generally, RFPs 1 through 21, which relate to

10 patient records.

11 We've had a really substantive discussion

12 here in the courtroom related to the production of

13 patient records, and I believe that we have all agreed

14 that the parties are going to agree to rolling

15 production in connection with this cause. So we have

16 all agreed that rolling production number 1, that the

17 Court will order the hospitals to make -- and we're

18 going to discuss further any nonpatient requests as it

19 relates to the protective order on Friday. So I'm not

20 getting rid of that concern -- are going to relate to

21 treatment records by Dr. Lau and Dr. Cooper for each of

22 the patients identified in the lawsuit dating back to

23 either the first date of treatment that Dr. Cooper or

24 Dr. Lau had; or if the treatment predated, the initial

25 date would be January 1, 2022. 88

1 And so just to be clear, if Dr. Lau began

2 treating a patient in 2010, we are not dragging the

3 records all the way back. The oldest date and time that

4 we're going to be looking for, at least in this initial

5 roll, is January 1, 2022. If the initial or first date

6 of treatment is not until 2023, then that's when the

7 first date of record would be.

8 As well, in connection, separate and apart

9 from roll one, the parties have agreed to a few

10 additional items between Dr. Lau and the State. Dr. Lau

11 is going to provide search terms by February 28th when

12 we're back here together and as well at that time is

13 going to provide us an estimated production date for

14 Dr. Lau's records that are not the patient records, her

15 other discovery, and the total number of documents,

16 again, on February the 28th. In addition, they'll

17 identify the source of the materials for Dr. Lau's

18 production.

19 I think we've discussed exhaustively but

20 I'll just memorialize for the record, Dr. Lau's counsel

21 is representing they do not have medical records in her

22 possession save and except for perhaps a stray medical

23 record, which they would assert that they should not

24 have in their possession and that having in it in her

25 possession would be an error or an accident and they 89

1 would maintain that those records, the patient or the

2 hospital would have the right to assert privileges.

3 I'm going to go ahead and ask at this time,

4 State, do you think that I've accurately stated the

5 agreements that are reached with Dr. Lau's counsel and

6 as well, the totality of what we're contemplating as

7 roll one?

8 MR. FARQUHARSON: That sounds correct

9 except that the records -- you referenced treatment

10 records. We believe the agreement also includes billing

11 records.

12 THE COURT: And I -- related to Lau and

13 Cooper. We're just trying to make sure that we're not

14 trying to encompass or reach any times that they would

15 have been seen by other physicians, other medical

16 providers. And so to the extent I didn't make that

17 clear, thank you for that clarification.

18 Okay. Coming over to defense counsel. So,

19 Counsel for Dr. Lau, did I correctly state the

20 agreement?

21 MR. SMYSER: You did, Your Honor. One

22 clarification, though.

23 THE COURT: Always.

24 MR. SMYSER: Because I'm not sure whether

25 Dr. Lau has any health records, I don't know if she did 90

1 it would be on accident or error, so just that clarity

2 there.

3 THE COURT: Okay. But you have represented

4 to the Court it's not y'all's legal possession that she

5 should have possession, custody, or access of any of the

6 medical records. I just want to make sure we're all

7 clear on that point.

8 MR. SMYSER: That's precisely right, Your

9 Honor.

10 THE COURT: All right. Good.

11 And then, Counsel for Dr. Cooper, as it

12 relates to roll one, you're in agreement with the stated

13 agreement regarding the contents of roll one?

14 MS. HOLLAND: Yes, Your Honor.

15 THE COURT: Okay. I'm coming over here.

16 Counsel for the hospital, is there anything you want to

17 have placed upon the record?

18 MR. SUTKER: With respect to, I guess, the

19 medical records issue as it relates to my client, what

20 doctors bill for and what hospitals bill for are

21 different, and I don't know that the bill

22 distinguishes -- I don't think what these two doctors

23 bill for would necessarily --

24 THE COURT: You're saying --

25 MR. SUTKER: -- in a Children's bill -- 91

1 THE COURT: -- Judge, when we're trying to

2 get just to Dr. Lau and Dr. Cooper, when I'm looking at

3 billing records standing here today, I don't know if the

4 records delineate. Is that what you're saying?

5 MR. SUTKER: Right. Dr. Lau and Dr. Cooper

6 aren't Children's employees, and it would be billed

7 through Children's.

8 Now, I'm not opposed to producing the

9 bills. I mean, I don't think the bills give much

10 information anyway. But I'm just saying just so that

11 everybody's on the same page, if I provide Children's

12 bills, they may not be what everybody is looking for.

13 THE COURT: Are you able to bring a sample

14 with you on Friday so perhaps we might be able to better

15 understand what it is that you're talking about? It's

16 hard sometimes to obviously --

17 MR. SUTKER: Yeah, I can bring a sample for

18 whatever the test patient ends up being.

19 THE COURT: Okay. Why don't you do that.

20 And then we'll all be able to look and say, there is no

21 problems here, let's get that out the door; or there is

22 a concern, let's talk through it. Okay?

23 All right. Counsel, you go ahead and grab

24 the microphone.

25 MR. SMYSER: Your Honor, the point of 92

1 clarification that we would make is what we were asked

2 to confer about, what we did confer about with the State

3 were the RFPs to Dr. Lau, and the discovery propounded

4 on Dr. Lau, which was the subject of our motion for

5 protective order and their motion to compel.

6 So to the extent this is now carrying over

7 into the subpoenas to the hospital, you know, I would

8 just want to state once again for the record that the

9 Dallas County courts have already asserted jurisdiction

10 over those, and that's, you know, not what we understood

11 that we reached an agreement with. It's about the

12 request to Dr. Lau about the materials that were in his

13 custody and control.

14 THE COURT: Okay. Counsel, you had a

15 comment?

16 MR. LOGAN: Yes, Your Honor. I just want

17 to make sure the Court knows that the billing records

18 need to be physician-patient privileged as well because

19 they're going to contain ICD codes that tell you

20 everything that happened. It's tantamount to getting

21 the medical records when you get the billing records.

22 So I want to make sure that we all are on the same page

23 about what the privileges that need to apply to the

24 billing records, too.

25 THE COURT: It sounds like we're going to 93

1 get a sample so we can make sure that we can all

2 correctly identify.

3 MR. LOGAN: Yes, Your Honor.

4 THE COURT: Your -- I duly note what you

5 have said. I don't know that the Court necessarily

6 agrees because of the requests that are pending here,

7 and obviously the goal in what I was trying to get is it

8 doesn't behoove your clients not to try to see where you

9 have commonality with the State. And so the Court

10 believed that its direction was can you try and see

11 where you've got commonality, because ultimately,

12 whether here or in Dallas, there will be discovery; and

13 certainly, whether it's here or in Dallas, narrowing the

14 issues the judge has to decide is always very well

15 appreciated.

16 And so I think you're correct, I have

17 misunderstood. And I thought that you were saying on

18 behalf of the patients as it relates to roll one, I

19 wouldn't have an objection, and so we would be

20 continuing to maintain the objections as it relates to

21 any other documents and to continue, whether here or in

22 Dallas County, talking through those issues and

23 conferring since obviously one of the objections you've

24 raised here and there is lack of conference.

25 So what you're saying is, Judge, there is, 94

1 in fact, no agreement by my clients as it relates to any

2 agreement to produce patient records on roll one, being

3 very clear that the protective order would be amended,

4 or am I misunder- -- or are you saying, Judge, once I

5 get the appropriate protections, and I'm not saying I'm

6 going to be opposing that, I just have to be very clear

7 that I've got to get that protective order in place.

8 MR. LOGAN: Yes, Your Honor. So let me

9 respond in two parts.

10 THE COURT: Okay.

11 MR. LOGAN: One is, we have conferred and

12 certainly reached the agreement as far as whatever's in

13 Dr. Lau's custody and control, and that's the discussion

14 that we understood we had with opposing counsel and the

15 agreements we came to. As to the subpoenas to the

16 hospital and the records that the hospital might have,

17 the construct that Your Honor has in place seems like it

18 might satisfy the concerns that have been expressed here

19 or potentially in Dallas County. The big underlying

20 issue, the one that makes us very hesitant to just say

21 on the record this sounds great --

22 THE COURT: Is the protective order.

23 MR. LOGAN: -- we do need to make sure that

24 that mechanism that we have in the paperwork, which is

25 the same mechanism we've requested in Dallas County, is 95

1 incorporated before we agree officially.

2 THE COURT: And so can I make sure I -- you

3 are saying, Judge, we agree contingent upon entry of a

4 protective order that we agree to. Is that what you're

5 saying?

6 MR. LOGAN: Two points of clarification.

7 THE COURT: Absolutely.

8 MR. LOGAN: The answer is conditionally,

9 yes, because we do have 20-something patients that we

10 would need to confer with and make sure that they would

11 agree, for instance, to, you know, withdraw in Dallas

12 County if we got the correct protections here. But with

13 that caveat, it does sound like if we're getting the

14 same framework protection we're requesting there, that

15 that's an agreement we can reach.

16 THE COURT: All right. Thank you so much

17 for that clarification.

18 Okay. Anything else that anyone needs to

19 place upon the record? No? Okay.

20 Then we are going to be off the record yet

21 again.

22 (Recess taken)

23 THE COURT: At this time we're going to be

24 back on the record. We took a further recess for the

25 parties to begin discussing what might be tranches two 96

1 and three. At present, the State has previewed to the

2 other parties what they would be requesting. The

3 parties are going to go back to their respective

4 corners, talk with their teams about it, and see about

5 alternatives they might be able to propose or how they

6 might be able to structure going forward.

7 Beyond that, the Court does want to

8 memorialize, I asked all parties who are present today

9 to engage in a meet and confer related to discovery, and

10 certainly the Court here today does not find that the

11 engagement in that process waives or otherwise obviates

12 anyone's arguments or defenses in connection with this

13 cause.

14 As well, the Court would make a judicial

15 statement here today that to the extent that was argued

16 in a different court, this Court would find that with

17 disfavor given that I have expressly stated no one is

18 arguing -- no one is waiving any arguments by virtue of

19 participating in a substantive meet-and-confer process.

20 I do believe that in addition to that, we

21 have counsel for Dr. Lau that would like to make a

22 statement. Previously you had indicated you would try

23 to get estimated production date, your total number of

24 docs by Friday. Your team has made you aware that they

25 think that's not going to happen. You wanted the Court 97

1 to be aware. The Court has strongly encouraged your

2 team to do its level best to give us some idea on Friday

3 and to give us the date certain as to when they will

4 have that information. And given when the requests were

5 served, I don't think that it would be reasonable to say

6 14 days from today is when we get that base information,

7 what's our page count, and kind of what -- when do we

8 think we could process everything. I really need that

9 before then.

10 Okay. Dr. Cooper's counsel, you had one

11 additional item you wanted to place upon the record?

12 MS. HOLLAND: Yes, Your Honor. Thank you

13 for the clarification that you made earlier. I just

14 wanted to add that Dr. Cooper doesn't waive his motion

15 to transfer venue by any agreements previously reached

16 regarding discovery time frames.

17 THE COURT: Certainly, and absolutely not.

18 Okay. Over here, anything else that you

19 would like to place upon the record?

20 MR. LOGAN: No, Your Honor. Subject to the

21 Court's note that we're not waiving anything, including

22 things in our Dallas County actions, there is nothing

23 else for us to put on the record.

24 THE COURT: Okay.

25 MR. SUTKER: Just our agreement that we 98

1 will move the hospital's motion for protection with

2 regards to --

3 THE COURT: You did help me remember.

4 Thank you. We're set to begin at 9:00 a.m. at present

5 on Friday. We will set it on the docket formally so all

6 members of the public are also aware that we are going

7 to bump our hearings from 9:00 a.m. to 8:30, just so we

8 have those additional 30 minutes available to us. At

9 that time we're moving all remaining issues related to

10 the motion to compel. We have each of the motions to

11 dismiss and the motions for protection that are set. So

12 we do have a lot of ground to cover -- your face is

13 saying --

14 MR. STONE: Your Honor, there's also a gag

15 order, I think, that is --

16 THE COURT: I'm not aware that that was

17 set.

18 Ms. Patterson, was that set?

19 MS. PATTERSON: I believe so, Judge. I'm

20 trying to get there.

21 Will you please remind me which cause

22 number that was in.

23 MS. HOLLAND: That's 493-08026-2024. And I

24 believe that's been set for 9:00 a.m.

25 MS. PATTERSON: I believe it was filed on 99

1 2/20.

2 MS. HOLLAND: Let me just double-check

3 that.

4 MS. PATTERSON: 2/21 -- no, that's the

5 notice of hearing. It was filed on 2/19.

6 THE COURT: Did you tell them we would give

7 them a hearing on that one, though, and add it to the

8 docket?

9 MS. PATTERSON: I did.

10 THE COURT: Okay. Ms. Patterson's already

11 told you that we'll hear it, then we will. That's a lot

12 for us to get through. I will tell you, if we don't get

13 through everything, that gag order one is the one that

14 would fall off because I think that we are poised on the

15 discovery issues. The motion to dismiss has been set

16 for a really long time. So I just want to be abundantly

17 clear with everyone. We will set it, but if we do not

18 reach all of the motions, that is the one that I would

19 say, I'm sorry, we'll just have to reset and do this one

20 on another day. Okay? All right.

21 Anything else that we need to discuss?

22 MR. LOGAN: One other point, which is the

23 Court has asked us and ordered us earlier today to, by

24 the close of business, send --

25 THE COURT: That's going to be tight for 100

1 you because it's 4 o'clock right now.

2 MR. LOGAN: Yes, Your Honor. This

3 associate doesn't move quite that fast.

4 THE COURT: Okay. What time do you think

5 is reasonable?

6 MR. LOGAN: I can get it to them by

7 6 o'clock.

8 THE COURT: Okay. Then let's go ahead and

9 -- so when do you think you'll get it to the opposing

10 parties?

11 MR. LOGAN: That's who I meant sending it

12 to.

13 THE COURT: Oh, okay. Sorry. I thought

14 you were saying you were going to talk to your associate

15 by 6:00 so --

16 MR. LOGAN: Oh, no, no, no. I am the

17 associate.

18 THE COURT: Oh, okay. I think that's

19 imminently reasonably. I kept y'all here for a lot

20 longer than probably anybody thought that they were

21 going to be here today. So 6 o'clock is fine with

22 everybody; right? I see lots of nods in agreement.

23 Okay. You're golden, 6 o'clock.

24 I will tell you, not to put any pressure on

25 you, but I think that's kind of the linchpin. So I'm 101

1 really encouraging you to do a really good job on your

2 language. And, folks, everybody please talk tomorrow

3 about this, and what we're looking for is something that

4 we can make work.

5 Here's the thing. Everybody knows this.

6 Nobody's going to be perfectly happy, right? Nobody's

7 going to love the language, but it's going to work. And

8 so that's what we really need to focus on is how can we

9 positively move the case forward knowing that there's

10 not an absolute win for anyone. Okay. So with that,

11 we'll be off the record.

12 (Proceedings concluded)

25 102

COUNTY OF COLLIN ) 3

4 I, Ashley Boyd, Official Court Reporter in and for

5 the 493rd District Court of Collin County, State of

6 Texas, do hereby certify that the above and foregoing

7 contains a true and correct transcription of all

8 portions of evidence and other proceedings requested in

9 writing by counsel for the parties to be included in

10 this volume of the Reporter's Record, in the

11 above-styled and numbered cause, all of which occurred

12 in open court or in chambers and were reported by me.

13 I further certify that this Reporter's Record of

14 the proceedings truly and correctly reflects the

15 exhibits, if any, admitted by the respective parties.

16 I further certify that the total cost for the

17 preparation of this Expedited Reporter's Record is $280

18 and was paid by OFFICE OF THE ATTORNEY GENERAL.

19 WITNESS MY OFFICIAL HAND this the 9th day of March,

20 2025.

22 /s/ Ashley Boyd Ashley Boyd, Texas CSR 11998 23 Expiration Date: 09/30/2025 Official Court Reporter 24 493rd District Court 2100 Bloomdale Road 25 Collin County, Texas McKinney, Texas Exhibit I Cause No. DC—25-01823 Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient N0. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient N_o. 5, Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, Nonparty Patient No. 8, 95TH JUDICIAL DISTRICT Nonparty Patient N0. 9, Nonparty Patient No. 10, and Nonparty Patient No. 1 l,

Plaintifis,

vs.

The State of Texas,

Defendant.

@ {'PRQPGSED} ORDER DENYING THE STATE’S PLEA TO THE JURISDICTION AND PLEA IN ABATEMENT Pending before the Court is the State’s plea to the jurisdiction of this Court and plea in

abatement. Having considered the pleadings, record evidence, and the parties’ arguments, the

Court'fmds that the State’s pleas are hereby DENIED.

So ORDERED and SIGNED this Blkday OWZOZS;

The Hon. Judge Monica‘ Purdy 95th Judicial District Court Dallas County, Texas Exhibit J Cause No. 493-07676-2024 Filed: 2/27/2025 10:46 PM Michael Gould District Clerk The State of Texas, Collin County, Texas By Sarah Beasley Deputy Envelope ID: 97901008 Plaintiff, IN THE DISTRICT COURT OF vs. COLLIN COUNTY, TEXAS May C. Lau, M.D., 493RD JUDICIAL DISTRICT Defendant.

THE NONPARTY PATIENTS’ VERIFIED EXPEDITED MOTION TO STAY PRODUCTIONS FROM THE HOSPITAL SYSTEMS

To the Honorable Judge of this Court:

The Nonparty Patients respectfully move for an order partially staying any productions

from Children’s Health System of Texas and UT Southwestern Medical Center (the “Hospital

Systems”) under the State’s subpoenas in this case, and any orders compelling such productions,

and would respectfully show as follows:

1. At the Court’s direction, the Nonparty Patients have conferred over the last two

days with the State and the other parties about discovery in this case, with the Court’s assurance

that doing so would not waive any of the party or nonparties’ rights in any forum. Through those

conferences, the Nonparty Patients have been shocked to learn that the scope of the discovery

requests the State is making is extraordinary. The State has told the Nonparty Patients’ counsel

that it is entitled to essentially all their medical records, from every provider at the Hospital

Systems—even facially unrelated providers, like orthopedists. It has told the Nonparty Patients’

counsel that it is demanding the identity of their current providers. It has told the Nonparty

Patients’ counsel that it does not believe Nonparty Patients should be able to object to interrogatory

responses from doctors that would otherwise disclose private health information. And it has

1 admitted to Nonparty Patients’ counsel that it does not have accurate mailing addresses for all the

patients (including unrepresented patients in this case whom the State was obligated under

Texas Law to serve with copies of subpoenas and requests) such that the State cannot agree to

provide fulsome notice in this case to patients for fear of inadvertent disclosure to the wrong

address. With what the Nonparty Patients have learned about the State’s positions, they do not

believe the State is capable of finding middle ground and is instead going to persist in demanding

the evisceration of their privileges over their medical records. But the broad disclosure of medical

records desired by the State and the loss of legal rights of third-party patients in Dallas County

cannot be the cost of expediency here. The Nonparty Patients therefore must seek a stay of

production from the Hospital Systems here so that (as promised under Texas Law) their request

for protection in Dallas County can be adjudicated before the Hospital Systems make any

productions, beyond the limited venue discovery already ordered. 1

2. The State served subpoenas on the Hospital Systems requesting the production of

documents, including medical records for the Nonparty Patients. Ex. A; Ex. B.

3. Those subpoenas were served in Dallas County. Ex. A; Ex. B.

4. Consistent with Texas Rule of Civil Procedure 176.6(e), which provides that

persons affected by subpoenas may seek protection in the county where the subpoenas were served,

the Nonparty Patients sought protection from the State’s subpoenas to the Hospital Systems in

Dallas County District Court on February 2, 2025. Ex. C; Ex. D.

1 Nonparty Patients are appearing here for the limited purpose of seeking protection from party discovery and in no way waive their rights to seek protection from third-party subpoenas in the districts where such third-party subpoenas are served, including Nonparty Patients’ petition for protection from third-party subpoenas filed in Nonparty Patients No. 1, et al, vs The State of Texas, Cause No. DC-25-01823 in the 95th Judicial District, Dallas County District Court. 2 5. The Dallas County District Court has set a hearing on the Nonparty Patients’

request for protection for March 12, 2025. Ex. E.

6. To the Nonparty Patients’ knowledge, the State has not requested an expedited

hearing in Dallas County. If the State desires an expedited hearing in Dallas County, the Nonparty

Patients are agreeable, ready, and willing to appear at the earliest date possible. Ex. F. Counsel for

the Nonparty Patients asked the State if it would be willing to join a request for an expedited

hearing in the Dallas County District Court and the State was unable to commit. Ex. F. The

Nonparty Patients conferred with the State on February 7 about its subpoena requests in the Lau

litigation and the State committed to trying to propose narrower requests tailored to the Nonparty

Patients represented by counsel. Three weeks later, it still has not proposed such narrowed requests

or revisited the topic at all. See Ex. G at 3 (“With that said, and as I expressed during our meeting,

now that we have the identity of your clients, we will review the requests to determine whether

they can be narrowed with respect to any of your clients.” (Farquharson, R.)). The State’s demand

here to proceed with the utmost expediency at the expense of the Nonparty Patients’ privacy and

legal rights is not consistent with its conduct in Dallas County, where it has resisted progress at

every opportunity.

7. The State has filed no motion to compel the Hospital Systems to produce materials

in this Court. The only motion the State has filed to compel in this case, as far as Nonparty patients

know, is a motion to compel party discovery from Dr. Lau (e.g., under Requests for Production,

Interrogatories, and Requests for Admissions). The State filed that motion on February 20, 2025,

long after the Nonparty Patients had sought protection in Dallas County. The Nonparty Patients

have filed a motion for protection from this Court against Dr. Lau producing privileged material

in response to that party litigation in this case. As far as the Nonparty Patients are aware, there is

3 no pending motion before this Court seeking to compel production from the Hospital Systems

under the State’s subpoenas that have been challenged in the Dallas County District Court.

8. Hearings were noticed in this case for February 26, 2025, regarding the State’s

motion to compel party discovery and the Nonparty Patients’ motion for protection from that party

discovery, among other disputes between the parties, including about proper venue. Ex. G; Ex. H.

No representatives from the Hospital Systems initially appeared at the hearing. However, counsel

Children’s Health System of Texas was contacted and subsequently appeared. UT Southwestern

Medical Center did not appear.

9. Despite the discovery portion of the hearing having been set to discuss party

discovery in the case, the Court asked the parties, including counsel for the Nonparty Patients, to

confer on a framework for the potential production of material from the Hospital Systems. Counsel

for the Nonparty Patients notified the Court about the pending requests for protection in Dallas

County District Court and asserted that Dallas County District Court had jurisdiction over the

subpoenas to the Hospital Systems to adjudicate those requests for protection. This Court

explained to the parties and the Nonparty Patients that they would need to confer on these issues

in either court and instructed them to begin doing so at the hearing. The Court further clarified on

the record that it did not intend for any party to waive its arguments in any forum by participating

in the conferences on discovery at the hearing.

10. During the hearing, the Court sua sponte issued oral orders for the production of

certain limited venue discovery from Children’s Health System of Texas, in the form of copies of

the visit records and prescriptions specifically identified in the State’s petition for patients the State

also identified in its petition as residing in Collin County, with the further provision that those

materials would be redacted to exclude any personally identifiable information for the patient or

4 extraneous medical treatment information and would generally only expose information sufficient

to show where the treatment occurred, whether it was a telehealth visit, and any instructions to the

patient about how the prescription should be administered.

11. Beyond this limited venue discovery, the Court further discussed with the parties

the potential future production of materials from the Hospital Systems in tranches, including

medical records of the Nonparty Patients.

12. The Nonparty Patients genuinely appreciate the Court’s guidance in facilitating a

conference with the State on a framework for the Hospital Systems producing medical records.

However, the Nonparty Patients have a clear legal right to seek protection from the subpoenas in

Dallas County District Court, which is where the records are maintained and where the State served

its subpoenas. Tex. R. Civ. P. 176.6(e). Once the Nonparty Patients sought protection from the

Dallas County District Court from the subpoenas, the Hospital Systems ceased having an

obligation to respond to the subpoenas until the Dallas County District Court issues an order. Id.

(“A person need not comply with the part of a subpoena from which protection is sought under

this paragraph unless ordered to do so by the court.”); In re Creuzot, No. 05-24-00450-CV, 2024

WL 4784362, at *4 (Tex. App.—Dallas Nov. 14, 2024, no pet.) (“Pursuant to rule 176.6, a motion

for protective order stays a request for testimony and production of records until such time as the

trial court rules on the motion.”). The Hospital Systems cannot produce the documents voluntarily

because the Nonparty Patients own the privilege (Tex. R. Evid. 509; Tex. R. Evid. 510), and the

Nonparty Patients have instructed them not to produce the privileged materials. Ex. I; Ex. J.

13. During the hearing, counsel for the State enthusiastically exclaimed to the Court

that it “will win” in Dallas County. Counsel for the Nonparty Patients disagree. But either way,

the Nonparty Patients are due their day in court and the protections afforded them under the Texas

5 Rules of Civil Procedure, including the clear and indisputable right to challenge the subpoenas in

the district where they were served. And the Dallas County District Court is due the opportunity

to adjudicate the disputes fairly before it. Absent an order form this Court staying production by

the Hospital Systems, the Nonparty Patients’ clear legal right and the Dallas County District

Court’s plain jurisdiction will be effectively denied. The Nonparty Patients accordingly, and

respectfully, request that the Court stay any further production by the Hospital Systems, beyond

the limited venue discovery already ordered, until the Dallas County District Court rules on the

Nonparty Patients’ pending request for protection from the State’s subpoenas.

PRAYER FOR RELIEF

14. For the foregoing reasons, the Nonparty Patients respectfully request that the Court

set this Motion for hearing and, after the hearing, issue an order granting the relief requested herein.

DATED: February 27, 2025 Respectfully submitted,

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com Thanh D. Nguyen Texas Bar No. 24126931 tdnguyen@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500

William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 651-2600

ATTORNEYS FOR NONPARTY PATIENTS

6 CERTIFICATE OF CONFERENCE

Counsel for the Nonparty Patients has personally conferred with counsel for the parties by

video conference on February 27, 2025. Counsel for the State indicated that it opposes the relief

sought herein and objected to the Notice given. Counsel for Dr. Lau and Dr. Cooper have indicated

that they do not oppose the relief sought herein.

Certified to the Day of February 27, 2025, by:

/s/ William M. Logan William M. Logan Texas Bar No. 24106214

CERTIFICATE OF SERVICE

I hereby certify that on February 27, 2025, an electronic copy of this motion was served to

counsel of record.

/s/ William M. Logan

7 Exhibit A Exhibit B Exhibit C FILED FILED PER ATTY 2/3/2025 12:00 AM FELICIA PITRE DISTRICT CLERK DALLAS CO., TEXAS Belinda Hernandez DEPUTY

DC-25-01823 Cause No. __________________

Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient No. 5, Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, and Nonparty Patient No. 8, 95th ______ JUDICIAL DISTRICT

Plaintiffs,

vs.

The State of Texas,

Defendant.

THE NONPARTY PATIENTS’ PETITION FOR MOTION FOR PROTECTION FROM DISCOVERY SUBPOENAS

To the Honorable Judge of this Court:

Pursuant to Texas Rule of Civil Procedure 176.6(e), Plaintiffs (“Nonparty Patients”) 1 move

for protection from discovery subpoenas (Exhibits A and B) (“Subpoenas”) that the State of Texas

served on Children’s Health System of Texas and UT Southwestern Medical Center (“Hospital

Systems”). Ex. C ¶¶ 3–4. Nonparty Patients would respectfully show the Court as follows:

I. INTRODUCTION

1. The State has brought a lawsuit in the 493rd Judicial District in Collin County,

Texas (the “Lau Litigation”), alleging in its Petition (attached as Exhibit D) that Dr. May C. Lau

violated provisions in Senate Bill 14 (“SB14”) and engaged in false, misleading, or deceptive acts

1 Pursuant to the Collin County District Court’s Protective Order § III(F) (attached as Exhibit E),

the Nonparty Patients have filed this Motion using a generic reference to avoid disclosing their identities as patients related to that litigation. Ex. C ¶ 5. Consistent with the Protective Order, the Nonparty Patients may be identified in camera or as otherwise ordered by the Court. Id. 1 by providing gender affirming care to teenage patients. Ex. D ¶¶ 23, 43. On Monday, January 27,

the State served sweeping Subpoenas in Dallas County on the Hospital Systems, demanding

private medical records of 21 individuals, including the Nonparty Patients. Ex. A at 7; Ex. B at 7.

The State’s requests broadly seek all “documents relating to the care and treatment [of the

nonparty],” irrespective of any relevance to the underlying litigation. Ex. A at 7; Ex. B at 7. The

non-limiting examples in the State’s requests underscore that the Subpoenas are invasive and target

sensitive medical records, including psychotherapy notes. Ex. A at 7; Ex. B at 7.

2. The Texas Rules of Evidence codify a longstanding physician-patient privilege that

precludes such discovery. Tex. R. Evid. 509; Tex. R. Evid. 510. This privilege acknowledges that

meaningful healthcare requires allowing patients to talk freely with their doctors on sensitive topics

without fear of disclosure, or repercussions from the State. See, e.g., R.K. v. Ramirez, 887 S.W.2d

836, 843 (Tex. 1994) (“The basis for the privileges is twofold: (1) to encourage the full

communication necessary for effective treatment, … and (2) to prevent unnecessary disclosure of

highly personal information.”). The State’s requests in the Subpoenas—which are untethered to

any issue of consequence in the Lau litigation—cannot plausibly satisfy the narrow exceptions to

that privilege, and the requests are impermissibly broad, unduly burdensome, and unnecessarily

target irrelevant information. The Nonparty Patients have thus filed this Petition in Dallas County,

where the Subpoenas were served, seeking protection from the discovery sought.

II. JURISDICTION

3. The Court has jurisdiction over this matter under Texas Rules of Civil Procedure

176.6 and 192.6(a). A “[p]erson affected by the subpoena, may move for a protective order under

Rule 192.6(b) … in a district court in the county where the subpoena was served.” Tex. R. Civ. P.

176.6(e). The Nonparty Patients are not parties to the Lau Litigation but are each a nonparty patient

about whom the State has sought medical records and other information from the Hospital Systems 2 in the Subpoenas. Ex. C ¶ 2. The Nonparty Patients thus have standing to seek “an order protecting

[Movant] from the discovery sought” because each is “a person affected by the subpoena.” Tex.

Tex. R. Civ. P. 176.6(e); R. Civ. P. 192.6(a). The Hospital Systems were both served the

Subpoenas in Dallas County, where this Court is situated, via their common registered agent, CT

Corporation System, at 1999 Bryan St, Suite 900, Dallas, TX 75201. Ex. A at 2; Ex. B at 2.

III. BACKGROUND

4. In the Lau Litigation, the State’s allegations largely center on Dr. Lau purportedly

prescribing medicines to teenage patients, including testosterone. Ex. D ¶ 56. The State alleges

that such care became unlawful under SB14 on September 1, 2023. Id. ¶¶ 23, 222. The State also

alleges that Dr. Lau engaged in false, misleading, or deceptive practices after or around the

enactment of SB14, purportedly to mislead pharmacies, insurance providers, or patients into

believing that the patients’ testosterone treatments were for purposes other than gender-affirming

care to circumvent the restrictions in SB14. Id. ¶¶ 226-27.

5. On January 27, 2024, the State served the Subpoenas on the Hospital Systems.

Ex. A; Ex. B. The Subpoenas are substantially identical. Ex. A; Ex. B. Each includes the same

requests for production for 21 nonparty patients:

Produce documents relating to the care and treatment of [a patient] …, including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Ex. A at 7; Ex. B at 7. There are no accompanying instructions or definitions that would limit the

requested production in a meaningful way, such as only to materials that would be of legal

consequence in the Lau Litigation. The only limitation in time is ambiguous. It is unclear whether the

requests are limited to “documents … from January 1, 2021, through present,” or whether that

timeframe applies only to “correspondence from January 1, 2021, through present.” In either event,

there is no apparent, meaningful relationship between the nonparty patients’ medical records

3 (including highly sensitive materials, like psychotherapy notes) from 2021 or earlier and the State’s

allegations about Dr. Lau’s actions in or around the enactment of SB14 in September 2023.

6. Despite the obvious gravity of the privacy rights threatened by the Subpoenas for

21 nonparty patients, the State has inexplicably demanded compliance from the Hospital Systems

within seven days from when the Subpoenas were served on January 27, 2024 (Ex. A at 5; Ex. B

at 5), effectively denying many of the 21 nonparty patients a reasonable opportunity to obtain

counsel and seek advice on their legal rights before compliance is due.

IV. ARGUMENT AND AUTHORITIES

7. The Court should enter an order preventing the Hospital Systems from producing

the materials sought in the Subpoenas because the State’s requests are overly broad, seek irrelevant

materials, and demand materials that are protected from disclosure under the Physician-Patient

Privilege (Tex. R. Evid. 509) and the Mental Health Information Privilege (Tex. R. Evid. 510).

Courts may enter orders protecting individuals from discovery by subpoena to prevent an invasion

of personal rights, including privacy and privileges. Tex. R. Civ. P. 192.6(b); Tex. R. Civ. P.

176.6(e), 176.7. Courts also have the authority to limit the scope of discovery based on the needs

and circumstances of the case. Tex. R. Civ. P. 192 cmt. 7.

8. Under the Physician-Patient Privilege, “a patient has a privilege to refuse to disclose

and to prevent any other person from disclosing: (1) a confidential communication between a

physician and the patient that relates to or was made in connection with any professional services

the physician rendered the patient; and (2) a record of the patient’s identity, diagnosis, evaluation,

or treatment created or maintained by a physician.” Tex. R. Evid. 509(c). Similarly, under the

Mental Health Information Privilege, “a patient has a privilege to refuse to disclose and to prevent

any other person from disclosing: (A) a confidential communication between the patient and a

4 professional; and (B) a record of the patient’s identity, diagnosis, evaluation, or treatment that is

created or maintained by a professional.” Tex. R. Evid. 510(b)(1).

9. It is self-evident from the State’s Subpoenas that the documents sought are subject

to the Physician-Patient Privilege and the Mental Health Information Privilege. Each request asks

for “document relating to the care and treatment” of the nonparties, such as “medical … records,”

“psychotherapy notes,” and “correspondence” with the nonparty patients, including Movant. Ex. A

at 7; Ex. B at 7; Ex. C ¶ 2. Documents relating to the care and treatment of the nonparties, medical

records, psychotherapy notes, and correspondence between the Hospital Systems, the nonparty

patients, and healthcare providers will necessarily include confidential communications between

the nonparty patients and their physicians and/or professionals, along with records of the nonparty

patients’ identities, diagnoses, evaluations, and treatments that were created or maintained by

physicians and/or mental health professionals. See generally In re Irvin, No. 05-98-01771-CV,

1998 WL 908955, at *4 (Tex. App.—Dallas Dec. 31, 1998, no pet.) (finding abuse of discretion

and granting mandamus when district court ordered production of mental health records).

10. There is no exception to the Physician-Patient Privilege or the Mental Health

Information Privilege that would plausibly apply to the broad requests in the Subpoenas. If the

State is suggesting that it is entitled to the nonparty patients’ medical records because some

information therein may be relevant to a party’s claim or defense in the Lau Litigation it is wrong.

The State’s expansive requests cannot fit under such an exception. The exception to the Physician-

Patient Privilege and Mental Health Information Privilege that applies when a party relies on a

patient’s medical condition (often referred to as the “patient-litigant exception”) is narrow,

particularly for nonparty patients. See R.K. v. Ramirez, 887 S.W.2d 836, 843 (Tex. 1994). As the

Texas Supreme Court has explained, it is not enough that there are allegations in the lawsuit for

5 which a condition of the nonparty patient may be relevant—rather, “[t]he scope of the exception

should be tied in a meaningful way to the legal consequences of the claim or defense.” Id. at 842.

11. In other words, for the patient-litigant exception to apply, discovery must be

directed to information about a patient’s condition that is “a ‘part’ of a claim or defense,” and

“must itself be a fact to which the substantive law assigns significance.” Id. Generally, this means

the discovery must be directed to a condition about which “the jury must make a factual

determination.” Id. at 843. Even then, the exception applies “only to the extent necessary to satisfy

the discovery needs of the requesting party” when balanced against the privacy interests of the

patients and requires in camera review of each document so that “any information not meeting this

standard remains privileged and must be redacted or otherwise protected.” Id.

12. The State’s Subpoenas cannot remotely meet this standard. The Subpoenas’

requests are not directed to any specific condition whatsoever. They are broad requests to entire

Hospital Systems for all medical records and psychiatry notes about any condition or treatment,

without any bounds or guidance based on the underlying lawsuit. Nor are the requests reasonably

limited in time. At best, they seek all the Nonparty Patients’ medical records, including psychiatry

notes, for the past four years. Potentially, they seek all the Nonparty Patients’ medical records,

including psychiatry notes, since birth. Either way, they are untethered in time and scope from the

Lau Litigation, which involves acts around or after SB14 was enacted in September 2023. These

requests are thus too broad in scope and time to satisfy the patient-litigant exception. See R.K., 887

S.W.2d at 843 (requiring “the request for records and the records disclosed are closely related in

time and scope to the claims made … to avoid any unnecessary incursion into private affairs”).

13. The Court should therefore enter an order protecting the Nonparty Patients from

disclosure under the Subpoenas, including because the requests are not restrictively tailored to

6 maintain the privilege for records and communications that would not be subject to the patient-

litigant exception, if it applied at all. See id.; c.f. Groves v. Gabriel, 874 S.W.2d 660, 661 (Tex.

1994) (“However, a trial court’s order compelling release of medical records should be

restrictively drawn so as to maintain the privilege with respect to records or communications not

relevant to the underlying suit.”).

14. Alternatively, if the Court does not enter an order protecting the Nonparty Patients

from the Subpoenas in whole, Movant respectfully requests an opportunity to review any proposed

productions from the Hospital Systems to evaluate the documents produced for privilege before

they are provided to the State. For claims of privilege, “the documents themselves may constitute

the only evidence substantiating the claim of privilege.” Weisel Enterprises, Inc. v. Curry, 718

S.W.2d 56, 58 (Tex. 1986). The Nonparty Patients thus require a reasonable opportunity to review

any documents that the Hospital Systems would produce to the State so that they may “segregate

and produce the documents to the court” for in camera review to ensure that only relevant materials

subject to the applicable privilege exception are produced, with appropriate redactions. See id.

(providing for in camera review); R.K., 887 S.W.2d at 843 (“Even when a document includes some

information meeting this standard, any information not meeting this standard remains privileged

and must be redacted or otherwise protected.”) (“[W]hen requested, the trial court must perform

an in camera inspection of the documents produced to assure that the proper balancing of interests,

which we have described, occurs before production is ordered.”).

15. For example, the State has no apparent interest in receiving documents that contain

personally identifiable information about the Nonparty Patients, and that information should be

redacted in any production. Nor does the State have any apparent interest in the Nonparty Patients’

medical records from before SB14 was enacted in September 2023. After all, the State’s

7 allegations in the Lau Litigation turn on the actions after SB14 became law, and neither the

identities of Dr. Lau’s patients, nor their medical records and communications before

September 2023, are facts of consequence that must be adjudicated.

16. Apart from the Nonparty Patients’ privilege assertions, the requests in the

Subpoenas are overbroad, directed to irrelevant information, and not proportional to the needs of

the case. For instance, there are no limitations to exclude from production materials unrelated to

the allegations against Dr. Lau. The State’s expansive requests instead presumably encompass all

care the Nonparty Patients have received from any provider affiliated with the Hospital Systems,

potentially without any meaningful limitation in time, no matter how attenuated or divorced that

care is from the Lau Litigation. The State’s requests would potentially encompass, for instance, all

unrelated physical and mental healthcare (including communications with providers other than

Dr. Lau, emergency room visits, vaccinations, and pharmacy records) at the Hospital Systems,

without any apparent limitation whatsoever to restrict the requests to the subject matter of the Lau

Litigation or a relevant timeframe.

17. Given the extraordinary breadth of the requests and the attendant high likelihood

that irrelevant materials would be produced, if the Court does not enter an order protecting the

Nonparty Patients from production under the Subpoenas in whole, the Nonparty Patients request

the opportunity to review any proposed production for relevance and, if appropriate, request that

the Court conduct an in camera inspection of materials proposed for production that the Nonparty

Patients identify as irrelevant to the Lau Litigation. See, e.g., Weisel Enterprises, 718 S.W.2d at

58 (holding in camera review appropriate in situations when the documents’ contents are the only

evidence of discoverability).

8 V. CONCLUSION

18. The State has overstepped the bounds of permissible nonparty discovery. Its

Subpoenas to the Hospital Systems plainly seek materials about the Nonparty Patients that are

protected from disclosure under the Physician-Patient Privilege and the Mental Health Information

Privilege. The requests are also overbroad, seek irrelevant information, and are not proportional to

the needs of the case, as they are not meaningfully restricted in time or subject matter to the

allegations underpinning the Lau Litigation. The Court should therefore enter a protective order

preventing the Hospital Systems from producing discovery in response to the Subpoenas or,

alternatively, provide the Nonparty Patients an opportunity to review any proposed production and

segregate documents for in camera review for relevance and privilege before they are produced.

VI. PRAYER FOR RELIEF

19. For the foregoing reasons, the Nonparty Patients respectfully request that the Court

set this Motion for hearing and, after the hearing, issue an order granting the relief requested herein.

DATED: February 2, 2025 Respectfully submitted,

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500

William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 651-2600

ATTORNEYS FOR NONPARTY PATIENTS

9 CERTIFICATE OF CONFERENCE

Counsel for movants has personally attempted to contact counsel for respondent as follows:

by email on February 2, 2025, at 6:03 PM. Counsel has not yet received a response. An emergency

exists of such a nature that further delay would cause irreparable harm to movants, as follows:

Counsel has only just been retained, and given the State’s expedited request for compliance with

the subpoenas by tomorrow (Monday, February 3), there is no opportunity to wait for a response

from the State before seeking relief as production of movants’ privileged records may be imminent.

Counsel for movants will continue attempting to confer with respondent in good faith.

Certified to the Day of February 2, 2025, by:

/s/ William M. Logan William M. Logan Texas Bar No. 24106214

CERTIFICATE OF SERVICE

I hereby certify that on February 2, 2025, an electronic copy of this Petition was served to

counsel of record for the State of Texas that are listed on the relevant subpoenas, as follows:

Jonathan Stone — Jonathan.Stone@oag.texas.gov Matthew Kennedy — Matt.Kennedy@oag.texas.gov Rob Farquaharson — Rob.Farquharson@oag.texas.gov David Shatto — David.Shatto@oag.texas.gov

I further certify that a copy of this Petition and citation are being served via registered or

certified mail, return receipt requested, to the above-listed counsel at the following address listed

for compliance on the relevant subpoenas:

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869

10 Exhibit D FILED 2/20/2025 4:41 PM FELICIA PITRE DISTRICT CLERK DALLAS CO., TEXAS Martin Reyes DEPUTY

Cause No. DC-25-01823

Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient No. 5, Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, Nonparty Patient No. 8, 95TH JUDICIAL DISTRICT Nonparty Patient No. 9, Nonparty Patient No. 10, and Nonparty Patient No. 11,

Plaintiffs,

vs.

The State of Texas,

Defendant.

THE NONPARTY PATIENTS’ AMENDED PETITION FOR PROTECTION FROM DISCOVERY SUBPOENAS

To the Honorable Judge of this Court:

Pursuant to Texas Rule of Civil Procedure 176.6(e), Plaintiffs (“Nonparty Patients”) 1 move

for protection from discovery subpoenas (Exhibits A and B) (“Subpoenas”) that the State of Texas

served on Children’s Health System of Texas and UT Southwestern Medical Center (“Hospital

Systems”). Ex. C ¶¶ 3–4. Nonparty Patients would respectfully show the Court as follows:

I. INTRODUCTION

1. The State has brought a lawsuit in the 493rd Judicial District in Collin County,

Texas (the “Lau Litigation”), alleging in its Petition (attached as Exhibit D) that Dr. May C. Lau

1 Pursuant to the Collin County District Court’s Protective Order § III(F) (attached as Exhibit E), the Nonparty Patients have filed this Motion using a generic reference to avoid disclosing their identities as patients related to that litigation. Ex. C ¶ 5. Consistent with the Protective Order, the Nonparty Patients may be identified in camera or as otherwise ordered by the Court. Id. 1 violated provisions in Senate Bill 14 (“SB14”) and engaged in false, misleading, or deceptive acts

by providing gender affirming care to teenage patients. Ex. D ¶¶ 23, 43. On Monday, January 27,

the State served sweeping Subpoenas in Dallas County on the Hospital Systems, demanding

private medical records of 21 individuals, including the Nonparty Patients. Ex. A at 7; Ex. B at 7.

The State’s requests broadly seek all “documents relating to the care and treatment [of the

nonparty],” irrespective of any relevance to the underlying litigation. Ex. A at 7; Ex. B at 7. The

non-limiting examples in the State’s requests underscore that the Subpoenas are invasive and target

sensitive medical records, including psychotherapy notes. Ex. A at 7; Ex. B at 7.

2. The Texas Rules of Evidence codify a longstanding physician-patient privilege that

precludes such discovery. Tex. R. Evid. 509; Tex. R. Evid. 510. This privilege acknowledges that

meaningful healthcare requires allowing patients to talk freely with their doctors on sensitive topics

without fear of disclosure, or repercussions from the State. See, e.g., R.K. v. Ramirez, 887 S.W.2d

836, 843 (Tex. 1994) (“The basis for the privileges is twofold: (1) to encourage the full

communication necessary for effective treatment, … and (2) to prevent unnecessary disclosure of

highly personal information.”). The State’s requests in the Subpoenas—which are untethered to

any issue of consequence in the Lau litigation—cannot plausibly satisfy the narrow exceptions to

that privilege, and the requests are impermissibly broad, unduly burdensome, and unnecessarily

target irrelevant information. The Nonparty Patients have thus filed this Petition in Dallas County,

where the Subpoenas were served, seeking protection from the discovery sought.

II. JURISDICTION

3. The Court has jurisdiction over this matter under Texas Rules of Civil Procedure

176.6 and 192.6(a). A “[p]erson affected by the subpoena, may move for a protective order under

Rule 192.6(b) … in a district court in the county where the subpoena was served.” Tex. R. Civ. P.

176.6(e). The Nonparty Patients are not parties to the Lau Litigation but are each a nonparty patient 2 about whom the State has sought medical records and other information from the Hospital Systems

in the Subpoenas. Ex. C ¶ 2. The Nonparty Patients thus have standing to seek “an order protecting

[Movant] from the discovery sought” because each is “a person affected by the subpoena.” Tex.

Tex. R. Civ. P. 176.6(e); R. Civ. P. 192.6(a). The Hospital Systems were both served the

Subpoenas in Dallas County, where this Court is situated, via their common registered agent, CT

Corporation System, at 1999 Bryan St, Suite 900, Dallas, TX 75201. Ex. A at 2; Ex. B at 2.

III. BACKGROUND

4. In the Lau Litigation, the State’s allegations largely center on Dr. Lau purportedly

prescribing medicines to teenage patients, including testosterone. Ex. D ¶ 56. The State alleges

that such care became unlawful under SB14 on September 1, 2023. Id. ¶¶ 23, 222. The State also

alleges that Dr. Lau engaged in false, misleading, or deceptive practices after or around the

enactment of SB14, purportedly to mislead pharmacies, insurance providers, or patients into

believing that the patients’ testosterone treatments were for purposes other than gender-affirming

care to circumvent the restrictions in SB14. Id. ¶¶ 226-27.

5. On January 27, 2024, the State served the Subpoenas on the Hospital Systems.

Ex. A; Ex. B. The Subpoenas are substantially identical. Ex. A; Ex. B. Each includes the same

requests for production for 21 nonparty patients:

Produce documents relating to the care and treatment of [a patient] …, including medical and billing records, psychotherapy notes, and correspondence from January 1, 2021, through the present.

Ex. A at 7; Ex. B at 7. There are no accompanying instructions or definitions that would limit the

requested production in a meaningful way, such as only to materials that would be of legal

consequence in the Lau Litigation. The only limitation in time is ambiguous. It is unclear whether the

requests are limited to “documents … from January 1, 2021, through present,” or whether that

timeframe applies only to “correspondence from January 1, 2021, through present.” In either event,

3 there is no apparent, meaningful relationship between the nonparty patients’ medical records

(including highly sensitive materials, like psychotherapy notes) from 2021 or earlier and the State’s

allegations about Dr. Lau’s actions in or around the enactment of SB14 in September 2023.

6. Despite the obvious gravity of the privacy rights threatened by the Subpoenas for

21 nonparty patients, the State has inexplicably demanded compliance from the Hospital Systems

within seven days from when the Subpoenas were served on January 27, 2024 (Ex. A at 5; Ex. B

at 5), effectively denying many of the 21 nonparty patients a reasonable opportunity to obtain

counsel and seek advice on their legal rights before compliance is due.

IV. ARGUMENT AND AUTHORITIES

7. The Court should enter an order preventing the Hospital Systems from producing

the materials sought in the Subpoenas because the State’s requests are overly broad, seek irrelevant

materials, and demand materials that are protected from disclosure under the Physician-Patient

Privilege (Tex. R. Evid. 509) and the Mental Health Information Privilege (Tex. R. Evid. 510).

Courts may enter orders protecting individuals from discovery by subpoena to prevent an invasion

of personal rights, including privacy and privileges. Tex. R. Civ. P. 192.6(b); Tex. R. Civ. P.

176.6(e), 176.7. Courts also have the authority to limit the scope of discovery based on the needs

and circumstances of the case. Tex. R. Civ. P. 192 cmt. 7.

8. Under the Physician-Patient Privilege, “a patient has a privilege to refuse to disclose

and to prevent any other person from disclosing: (1) a confidential communication between a

physician and the patient that relates to or was made in connection with any professional services

the physician rendered the patient; and (2) a record of the patient’s identity, diagnosis, evaluation,

or treatment created or maintained by a physician.” Tex. R. Evid. 509(c). Similarly, under the

Mental Health Information Privilege, “a patient has a privilege to refuse to disclose and to prevent

any other person from disclosing: (A) a confidential communication between the patient and a 4 professional; and (B) a record of the patient’s identity, diagnosis, evaluation, or treatment that is

created or maintained by a professional.” Tex. R. Evid. 510(b)(1).

9. It is self-evident from the State’s Subpoenas that the documents sought are subject

to the Physician-Patient Privilege and the Mental Health Information Privilege. Each request asks

for “document relating to the care and treatment” of the nonparties, such as “medical … records,”

“psychotherapy notes,” and “correspondence” with the nonparty patients, including Movant. Ex. A

at 7; Ex. B at 7; Ex. C ¶ 2. Documents relating to the care and treatment of the nonparties, medical

records, psychotherapy notes, and correspondence between the Hospital Systems, the nonparty

patients, and healthcare providers will necessarily include confidential communications between

the nonparty patients and their physicians and/or professionals, along with records of the nonparty

patients’ identities, diagnoses, evaluations, and treatments that were created or maintained by

physicians and/or mental health professionals. See generally In re Irvin, No. 05-98-01771-CV,

1998 WL 908955, at *4 (Tex. App.—Dallas Dec. 31, 1998, no pet.) (finding abuse of discretion

and granting mandamus when district court ordered production of mental health records).

10. There is no exception to the Physician-Patient Privilege or the Mental Health

Information Privilege that would plausibly apply to the broad requests in the Subpoenas. If the

State is suggesting that it is entitled to the nonparty patients’ medical records because some

information therein may be relevant to a party’s claim or defense in the Lau Litigation it is wrong.

The State’s expansive requests cannot fit under such an exception. The exception to the Physician-

Patient Privilege and Mental Health Information Privilege that applies when a party relies on a

patient’s medical condition (often referred to as the “patient-litigant exception”) is narrow,

particularly for nonparty patients. See R.K. v. Ramirez, 887 S.W.2d 836, 843 (Tex. 1994). As the

Texas Supreme Court has explained, it is not enough that there are allegations in the lawsuit for

5 which a condition of the nonparty patient may be relevant—rather, “[t]he scope of the exception

should be tied in a meaningful way to the legal consequences of the claim or defense.” Id. at 842.

11. In other words, for the patient-litigant exception to apply, discovery must be

directed to information about a patient’s condition that is “a ‘part’ of a claim or defense,” and

“must itself be a fact to which the substantive law assigns significance.” Id. Generally, this means

the discovery must be directed to a condition about which “the jury must make a factual

determination.” Id. at 843. Even then, the exception applies “only to the extent necessary to satisfy

the discovery needs of the requesting party” when balanced against the privacy interests of the

patients and requires in camera review of each document so that “any information not meeting this

standard remains privileged and must be redacted or otherwise protected.” Id.

12. The State’s Subpoenas cannot remotely meet this standard. The Subpoenas’

requests are not directed to any specific condition whatsoever. They are broad requests to entire

Hospital Systems for all medical records and psychiatry notes about any condition or treatment,

without any bounds or guidance based on the underlying lawsuit. Nor are the requests reasonably

limited in time. At best, they seek all the Nonparty Patients’ medical records, including psychiatry

notes, for the past four years. Potentially, they seek all the Nonparty Patients’ medical records,

including psychiatry notes, since birth. Either way, they are untethered in time and scope from the

Lau Litigation, which involves acts around or after SB14 was enacted in September 2023. These

requests are thus too broad in scope and time to satisfy the patient-litigant exception. See R.K., 887

S.W.2d at 843 (requiring “the request for records and the records disclosed are closely related in

time and scope to the claims made … to avoid any unnecessary incursion into private affairs”).

13. The Court should therefore enter an order protecting the Nonparty Patients from

disclosure under the Subpoenas, including because the requests are not restrictively tailored to

6 maintain the privilege for records and communications that would not be subject to the patient-

litigant exception, if it applied at all. See id.; c.f. Groves v. Gabriel, 874 S.W.2d 660, 661 (Tex.

1994) (“However, a trial court’s order compelling release of medical records should be

restrictively drawn so as to maintain the privilege with respect to records or communications not

relevant to the underlying suit.”).

14. Alternatively, if the Court does not enter an order protecting the Nonparty Patients

from the Subpoenas in whole, Movant respectfully requests an opportunity to review any proposed

productions from the Hospital Systems to evaluate the documents produced for privilege before

they are provided to the State. For claims of privilege, “the documents themselves may constitute

the only evidence substantiating the claim of privilege.” Weisel Enterprises, Inc. v. Curry, 718

S.W.2d 56, 58 (Tex. 1986). The Nonparty Patients thus require a reasonable opportunity to review

any documents that the Hospital Systems would produce to the State so that they may “segregate

and produce the documents to the court” for in camera review to ensure that only relevant materials

subject to the applicable privilege exception are produced, with appropriate redactions. See id.

(providing for in camera review); R.K., 887 S.W.2d at 843 (“Even when a document includes some

information meeting this standard, any information not meeting this standard remains privileged

and must be redacted or otherwise protected.”) (“[W]hen requested, the trial court must perform

an in camera inspection of the documents produced to assure that the proper balancing of interests,

which we have described, occurs before production is ordered.”).

15. For example, the State has no apparent interest in receiving documents that contain

personally identifiable information about the Nonparty Patients, and that information should be

redacted in any production. Nor does the State have any apparent interest in the Nonparty Patients’

medical records from before SB14 was enacted in September 2023. After all, the State’s

7 allegations in the Lau Litigation turn on the actions after SB14 became law, and neither the

identities of Dr. Lau’s patients, nor their medical records and communications before

September 2023, are facts of consequence that must be adjudicated.

16. Apart from the Nonparty Patients’ privilege assertions, the requests in the

Subpoenas are overbroad, directed to irrelevant information, and not proportional to the needs of

the case. For instance, there are no limitations to exclude from production materials unrelated to

the allegations against Dr. Lau. The State’s expansive requests instead presumably encompass all

care the Nonparty Patients have received from any provider affiliated with the Hospital Systems,

potentially without any meaningful limitation in time, no matter how attenuated or divorced that

care is from the Lau Litigation. The State’s requests would potentially encompass, for instance, all

unrelated physical and mental healthcare (including communications with providers other than

Dr. Lau, emergency room visits, vaccinations, and pharmacy records) at the Hospital Systems,

without any apparent limitation whatsoever to restrict the requests to the subject matter of the Lau

Litigation or a relevant timeframe.

17. Given the extraordinary breadth of the requests and the attendant high likelihood

that irrelevant materials would be produced, if the Court does not enter an order protecting the

Nonparty Patients from production under the Subpoenas in whole, the Nonparty Patients request

the opportunity to review any proposed production for relevance and, if appropriate, request that

the Court conduct an in camera inspection of materials proposed for production that the Nonparty

Patients identify as irrelevant to the Lau Litigation. See, e.g., Weisel Enterprises, 718 S.W.2d at

58 (holding in camera review appropriate in situations when the documents’ contents are the only

evidence of discoverability).

18. The State has overstepped the bounds of permissible nonparty discovery. Its

Subpoenas to the Hospital Systems plainly seek materials about the Nonparty Patients that are

protected from disclosure under the Physician-Patient Privilege and the Mental Health Information

Privilege. The requests are also overbroad, seek irrelevant information, and are not proportional to

the needs of the case, as they are not meaningfully restricted in time or subject matter to the

allegations underpinning the Lau Litigation. The Court should therefore enter a protective order

preventing the Hospital Systems from producing discovery in response to the Subpoenas or,

alternatively, provide the Nonparty Patients an opportunity to review any proposed production and

segregate documents for in camera review for relevance and privilege before they are produced.

VI. PRAYER FOR RELIEF

19. For the foregoing reasons, the Nonparty Patients respectfully request that the Court

set this Motion for hearing and, after the hearing, issue an order granting the relief requested herein.

DATED: February 20, 2025 Respectfully submitted,

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500

William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 651-2600

ATTORNEYS FOR NONPARTY PATIENTS

Counsel for movant and counsel for respondent have personally conducted a conference at

which there was a substantive discussion of every item presented to the Court herein and despite

best efforts the counsel have not been able to resolve those matters presented.

Certified to the Day of February 20, 2025, by:

/s/ William M. Logan William M. Logan Texas Bar No. 24106214

CERTIFICATE OF SERVICE

I hereby certify that on February 20, 2025, an electronic copy of this Amended Petition

was served to counsel of record for the State of Texas on the relevant subpoenas, as follows:

Jonathan Stone — Jonathan.Stone@oag.texas.gov Matthew Kennedy — Matt.Kennedy@oag.texas.gov Rob Farquaharson — Rob.Farquharson@oag.texas.gov David Shatto — David.Shatto@oag.texas.gov

I further certify that a copy of this Amended Petition is being served via registered or

certified mail, return receipt requested, to the above-listed counsel at the following address listed

for compliance on the relevant subpoenas:

Consumer Protection Division P.O. Box 12548 (MC-010) Austin, Texas 78711

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869

10 Exhibit E Cause No. DC-25-01823

Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient No. 5, Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, Nonparty Patient No. 8, 95TH JUDICIAL DISTRICT Nonparty Patient No. 9, Nonparty Patient No. 10, and Nonparty Patient No. 11,

Plaintiffs,

vs.

The State of Texas,

Defendant.

NOTICE OF HEARING

TAKE NOTICE that Nonparty Patients’ Amended Petition for Protective Order has been

set for an in-person oral hearing on the 12th day of March, 2025, beginning at 3:00 p.m. before the

95th Judicial District Court of Dallas County, Texas, George L. Allen, Sr. Courts Building, 600

Commerce Street, 6th Floor New Tower, Dallas, TX 75202.

DATED: February 24, 2025 Respectfully submitted,

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500

1 William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 651-2600

ATTORNEYS FOR NONPARTY PATIENTS

CERTIFICATE OF SERVICE

I hereby certify that on February 24, 2025, an electronic copy of this Amended Petition

was served to counsel of record for the State of Texas as listed on the relevant subpoenas, as

follows:

Jonathan Stone — Jonathan.Stone@oag.texas.gov Matthew Kennedy — Matt.Kennedy@oag.texas.gov Rob Farquaharson — Rob.Farquharson@oag.texas.gov David Shatto — David.Shatto@oag.texas.gov

I further certify that a copy of this Notice is also being served via Texas E-File.

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869

2 Exhibit F Cause No. 493-07676-2024

The State of Texas,

Plaintiff, IN THE DISTRICT COURT OF vs. COLLIN COUNTY, TEXAS May C. Lau, M.D., 493RD JUDICIAL DISTRICT Defendant.

DECLARATION IN SUPPORT OF THE NONPARTY PATIENTS’ VERIFIED EXPEDITED MOTION TO STAY PRODUCTIONS FROM THE HOSPITAL SYSTEMS

1. I am an attorney at the law firm of Winston & Strawn LLP. I represent 11 Nonparty

Patients in responding to the State of Texas’s First Requests for Production (“RFPs”), First

Requests for Admissions (“RFAs”) and First Set of Interrogatories served on Dr. May C. Lau. I

am a member in good standing of the State Bar of Texas. I provide this declaration in support of

the Nonparty Patients’ Verified Expedited Motion to Stay Productions from Children’s Health

System of Texas and UT Southwestern Medical Center (the “Hospital Systems”) under the State’s

subpoenas in this case. I have personal knowledge of the facts stated herein, and I could and would

testify completely thereto if called as a witness in this matter.

2. Each of the Nonparty Patients is 1 of 22 individuals about whom the State has

sought documents or information related to medical and mental health care and treatment received.

3. A true and correct copy of the State’s Subpoena Duces Tecum served on the

Children’s Health System of Texas is attached as Exhibit A.

4. A true and correct copy of the State’s Subpoena Duces Tecum served on the UT

Southwestern Medical Center is attached as Exhibit B.

2 5. A true and correct copy of the Nonparty Patients’ Petition for Motion for Protection

from Discovery Subpoenas is attached as Exhibit C.

6. A true and correct copy of the Nonparty Patients’ Amended Petition for Protection

from Discovery Subpoenas is attached as Exhibit D.

7. A true and correct copy of the Notice of Hearing regarding Nonparty Patients’

Amended Petition for Protective Order is attached as Exhibit E.

8. A true and correct copy of the Notice of Hearing regarding the State’s Motion to

Compel Defendant’s Discovery Responses is attached as Exhibit G.

9. A true and correct copy of the Notice of Hearing regarding the Nonparty Patients’

Motion for Protection is attached as Exhibit H.

10. A true and correct copy of correspondence with the counsel of Children’s Health

System of Texas is attached as Exhibit I.

11. A true and correct copy of correspondence with the General Counsel of UT

Southwestern Medical Center is attached as Exhibit J.

12. I verify that the facts set forth in the Motion are true based on my personal

knowledge, including from my personal attendance at the hearing in this Court on February 26,

2025, and my personal participation when meeting and conferring with counsel for the State.

I declare under penalty of perjury that the foregoing is true and correct.

Executed in Montgomery County, State of Texas, on February 27, 2025.

/s/ William M. Logan William M. Logan

3 Exhibit G Cause No. 493-07676-2024

THE STATE OF TEXAS., § IN THE DISTRICT COURT OF Plaintiff, § § v. § COLLIN COUNTY, TEXAS § MAY C. LAU, M.D., § Defendant. § 493rd JUDICIAL DISTRICT

NOTICE OF HEARING

PLEASE TAKE NOTICE that the following has been set for an in-person hearing on

Wednesday, February 26, 2025, at 1:30 p.m., in the 493rd District Court, located in the Russell A.

Steindam Courts Building, 2100 Bloomdale Rd., McKinney, TX 75071:

1. Plaintiff the State of Texas’ Motion to Compel Defendant’s Discovery Responses.

Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

AUSTIN KINGHORN Deputy Attorney General for Civil Litigation

JOHNATHAN STONE Chief, Consumer Protection Division

/s/ Rob Farquharson ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550 DAVID SHATTO Assistant Attorney General State Bar No. 24104114

CHRISTOPHER M. MOLAK Assistant Attorney General State Bar No. 24133132

Office of the Attorney General of Texas Consumer Protection Division 300 W. 15th St. Austin, Texas 78701 Phone: (214) 290-8811 Fax: (214) 969-7615 Johnathan.Stone@oag.texas.gov Rob.Farquharson@oag.texas.gov David.Shatto@oag.texas.gov Christopher.Molak@oag.texas.gov Telephone: (512) 936-2613 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

Certificate of Service

I hereby certify that on the 21st day of February 2025, a copy of the foregoing document

was served to all counsel of record in accordance with the Texas Rules of Civil Procedure.

/s/ Rob Farquharson ROB FARQUHARSON Assistant Attorney General

2 Exhibit H Cause No. 493-07676-2024

The State of Texas,

Plaintiff, IN THE DISTRICT COURT OF vs. COLLIN COUNTY, TEXAS May C. Lau, M.D., 493RD JUDICIAL DISTRICT Defendant.

NOTICE OF HEARING ON THE NONPARTY PATIENTS’ MOTION FOR PROTECTION FROM THE STATE’S FIRST REQUESTS FOR PRODUCTION, FIRST SET OF INTERROGATORIES, AND FIRST REQUESTS FOR ADMISSIONS

PLEASE TAKE NOTICE that the NonParty Patients’ Motion for Protection will be heard

on the 26th day of February at 8:30 a.m. before the 493rd Judicial District Court, Russell A.

Steindam Courts Building, 2100 Bloomdale Road, McKinney, TX 75071

DATED: February 25, 2025 Respectfully submitted,

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com Thanh D. Nguyen Texas Bar No. 24126931 tdnguyen@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500

William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 651-2600

1 ATTORNEYS FOR NONPARTY PATIENTS

CERTIFICATE OF SERVICE

I hereby certify that on February 25, 2025, an electronic copy of this motion was served to

counsel of record for Dr. Lau and the State via Texas E-file and in accordance with the Texas

Rules of Civil Procedure.

/s/ William M. Logan

2 Exhibit I From: McConnell, Greg To: Jackie.Cooper@cooperscully.com Cc: Logan, William; Newsome, Jervonne D.; Phillips, David J.; Nguyen, Thanh Dinh Subject: FW: The State of Texas v. Lau, Cause No. 493-07676-2024 Date: Thursday, February 13, 2025 3:12:48 PM Attachments: Non Party Patient No. 1 v State of TX - Petition for Motion for Protective Order w-exhibits.pdf

Jackie – Thanks for reaching out about the Dr. Lau subpoenas.

We sent this email and attachment to counsel at Norton Rose who we were told represents Children’s Health in this matter. We’ll forward any materials to you going forward. Our Petition was assigned to Judge Purdy.

Regards, Greg

Gregory A. McConnell Chief Pro Bono Officer Winston & Strawn LLP 2121 North Pearl Street, Suite 900 Dallas, TX 75201 M: +1 312-404-3645 Bio | VCard | Email | winston.com Pronouns: He, Him, His

From: Logan, William Sent: Sunday, February 2, 2025 10:26 PM To: yvonne.puig@nortonrosefulbright.com Cc: McConnell, Greg ; Newsome, Jervonne D. ; Phillips, David J. Subject: The State of Texas v. Lau, Cause No. 493-07676-2024

Hi Yvonne,

We hope all is well. We write regarding the subpoena for medical records issued to Children’s Health Systems of Texas in the above-referenced case. We understand that you represent Children’s Health Systems of Texas regarding that subpoena. If this is not the case, please let us know. We have recently been retained to represent eight of the individual patients whose medical information is subject to that subpoena. Consistent with the Collin County Court’s Protective Order § III(F) protecting the identities of the patients in the underlying lawsuit, we are generally referring to our clients in generic terms as Nonparty Patient Nos. 1–8.

We wanted to make you aware that we have filed a timely petition in the Dallas County District Court seeking a protective order preventing the discovery sought in the subpoena, including based on asserting claims of privilege over the materials in Children’s Health Systems of Texas’s possession under Tex. R. Evid. 509 and Tex. R. Evid. 510. A service copy of that petition with its exhibits is attached, pursuant to Tex. R. Civ. P. 176.6(e). Please confirm that, consistent with Tex. R. Civ. P. 176.6(e), Children’s Health Systems of Texas will not produce any materials in response to the subpoenas absent a court order otherwise.

Thanks, William

William Logan Associate Attorney Winston & Strawn LLP 800 Capitol St., Suite 2400 Houston, TX 77002-2925 T: +1 713-651-2600 D: +1 713-651-2766 F: +1 713-651-2700 Email | winston.com Pronouns: He, Him, His From: Cooper, Jackie To: Logan, William Cc: nonparty-patient-counsel; Sutker, Cory Subject: RE: The State of Texas v M. Brett Cooper, M.D., Cause No. 493-08026-2024 Date: Monday, February 24, 2025 3:10:07 PM

Hi William. We will not be producing any patient records absent a court order. If you are able to set emergency hearings in Dallas, please let me know.

Thank you. Jackie

From: Logan, William Sent: Thursday, February 20, 2025 4:06 PM To: Cooper, Jackie Cc: nonparty-patient-counsel ; Sutker, Cory Subject: Re: The State of Texas v M. Brett Cooper, M.D., Cause No. 493-08026-2024

Hi Jackie,

We're currently working to set hearings on our requests for protective orders regarding the Lau and Cooper litigation subpoenas. To determine whether we need to request emergency hearings, we wanted to confirm that Children’s Health System of Texas won't be producing documents under those subpoenas while the objections are pending and that no production is imminent. Are you able to confirm that for us?

Thanks, William

From: Logan, William Sent: Thursday, February 20, 2025 11:40:48 AM To: Cooper, Jackie Cc: nonparty-patient-counsel ; Sutker, Cory Subject: Re: The State of Texas v M. Brett Cooper, M.D., Cause No. 493-08026-2024

Thank you for the update, Jackie. We'll let you know when/if ours are set.

From: Cooper, Jackie Sent: Thursday, February 20, 2025 11:37:26 AM To: Logan, William Cc: nonparty-patient-counsel ; Sutker, Cory Subject: RE: The State of Texas v M. Brett Cooper, M.D., Cause No. 493-08026-2024 Hi William. We have filed objections and motions for protection in connection with the subpoenas to Dr. Lau and Dr. Cooper in Collin County. They have not been set for hearing yet.

Thanks, Jackie

From: Logan, William Sent: Wednesday, February 19, 2025 6:02 AM To: Cooper, Jackie Cc: nonparty-patient-counsel Subject: The State of Texas v M. Brett Cooper, M.D., Cause No. 493-08026-2024

Hi Jackie,

We represent patients whose medical records we understand have been subpoenaed from Children’s Health System of Texas in the above-referenced matter. We understand that you represent Children’s Health System of Texas regarding the State’s subpoena. If this is wrong, please let us know.

Our clients are invoking their privileges under Texas Rules of Evidence 509 and 510 and by this communication are instructing the system not to produce the requested records. We have asked to confer with the State regarding the subpoena and intend to seek a protective order if the requests are not withdrawn.

Please let us know if it would help to discuss.

Thanks, William

William Logan Associate Attorney Winston & Strawn LLP 800 Capitol St., Suite 2400 Houston, TX 77002-2925 T: +1 713-651-2600 D: +1 713-651-2766 F: +1 713-651-2700 Email | winston.com Pronouns: He, Him, His The contents of this message may be privileged and confidential. If this message has been received in error, please delete it without reading it. Your receipt of this message is not intended to waive any applicable privilege. Please do not disseminate this message without the permission of the author. Any tax advice contained in this email was not intended to be used, and cannot be used, by you (or any other taxpayer) to avoid penalties under applicable tax laws and regulations. Exhibit J From: Erin Sine To: Logan, William Cc: McConnell, Greg; Newsome, Jervonne D.; Phillips, David J. Subject: RE: The State of Texas v. Lau, Cause No. 493-07676-2024 Date: Monday, February 3, 2025 10:32:27 AM

Hello,

I acknowledge receipt. UT Southwestern has not yet retained counsel in this matter, and I will provide that information when it is available.

The University of Texas Southwestern Medical Center has not been served with a subpoena. CT Corporation is the registered agent for UT Southwestern Health Systems, Inc., a separate non-profit corporation. CT Corporation is not authorized to accept service for the University and rejected the subpoena at issue. I have notified the Texas Attorney General’s Office of the same.

Kind regards,

Erin M. Sine, J.D. Vice President & General Counsel Office of Legal Affairs UT Southwestern Medical Center 5323 Harry Hines Blvd. Dallas, TX 75390-9008 ph: (214) 648-2281 fax: (214) 648-8805 erin.sine@utsouthwestern.edu

This E-mail, and any files transmitted with it, is considered confidential and intended solely for the use of the individual or entity to which addressed. This communication may contain material protected by attorney-client and/or attorney work product privileges or other privileged, confidential, proprietary or trade secret information entitled to protection or exempt from disclosure under applicable law. If you are not the intended recipient or person responsible for delivering this communication to the intended recipient, be advised that you have received this communication in error and that any use, dissemination, forwarding, printing or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the sender immediately.

From: Logan, William Sent: Sunday, February 2, 2025 10:33 PM To: Erin Sine Cc: McConnell, Greg ; Newsome, Jervonne D. ; Phillips, David J. Subject: The State of Texas v. Lau, Cause No. 493-07676-2024 Hi Erin, We hope all is well. We write regarding the subpoena for medical records issued to UT Southwestern Medical Center in the above-referenced case. We understand that you are the correct legal contact regarding that subpoena. If this is

Hi Erin,

We hope all is well. We write regarding the subpoena for medical records issued to UT Southwestern Medical Center in the above-referenced case. We understand that you are the correct legal contact regarding that subpoena. If this is not the case, please let us know. We have recently been retained to represent eight of the individual patients whose medical information is subject to that subpoena. Consistent with the Collin County Court’s Protective Order § III(F) protecting the identities of the patients in the underlying lawsuit, we are generally referring to our clients in generic terms as Nonparty Patient Nos. 1–8.

We wanted to make you aware that we have filed a timely petition in the Dallas County District Court seeking a protective order preventing the discovery sought in the subpoena, including based on asserting claims of privilege over the materials in UT Southwestern Medical Center’s possession under Tex. R. Evid. 509 and Tex. R. Evid. 510. A service copy of that petition with its exhibits is attached, pursuant to Tex. R. Civ. P. 176.6(e). Please confirm that, consistent with Tex. R. Civ. P. 176.6(e), UT Southwestern Medical Center will not produce any materials in response to the subpoenas absent a court order otherwise.

Thanks, William

William Logan Associate Attorney Winston & Strawn LLP 800 Capitol St., Suite 2400 Houston, TX 77002-2925 T: +1 713-651-2600 D: +1 713-651-2766 F: +1 713-651-2700 Email | winston.com Pronouns: He, Him, His

The contents of this message may be privileged and confidential. If this message has been received in error, please delete it without reading it. Your receipt of this message is not intended to waive any applicable privilege. Please do not disseminate this message without the permission of the author. Any tax advice contained in this email was not intended to be used, and cannot be used, by you (or any other taxpayer) to avoid penalties under applicable tax laws and regulations. UT Southwestern Medical Center The future of medicine, today. Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Jamie Vargo on behalf of Jervonne Newsome Bar No. 24094869 JVargo@winston.com Envelope ID: 97901008 Filing Code Description: Motion (No Fee) Filing Description: Nonparty Patients' Verified Expedited Motion to Stay Status as of 2/28/2025 1:35 PM CST

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

Clayton Watkins 24103982 clayton.watkins@oag.texas.gov 2/27/2025 10:46:58 PM SENT

David G. Shatto david.shatto@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Ian Bergstrom Ian.Bergstrom@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Christopher Molak christopher.molak@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Amy Pletscher amy.pletscher@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Associated Case Party: MayCLau

Name BarNumber Email TimestampSubmitted Status

Craig Smyser csmyser@steptoe.com 2/27/2025 10:46:58 PM SENT

Alexander Wolf awolf@steptoe.com 2/27/2025 10:46:58 PM SENT

Nicole LeBoeuf 791091 nicole@leboeuflaw.com 2/27/2025 10:46:58 PM SENT

W. Henry Legg wlegg@steptoe.com 2/27/2025 10:46:58 PM SENT

Amy S.Ooi amy@leboeuflaw.com 2/27/2025 10:46:58 PM SENT

Drew Padley dpadley@steptoe.com 2/27/2025 10:46:58 PM SENT

Evelyn M.Hudson ehudson@steptoe.com 2/27/2025 10:46:58 PM SENT

Case Contacts

Name BarNumber Email TimestampSubmitted Status

William Logan 24106214 wlogan@winston.com 2/27/2025 10:46:58 PM SENT Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Jamie Vargo on behalf of Jervonne Newsome Bar No. 24094869 JVargo@winston.com Envelope ID: 97901008 Filing Code Description: Motion (No Fee) Filing Description: Nonparty Patients' Verified Expedited Motion to Stay Status as of 2/28/2025 1:35 PM CST

Case Contacts

William Logan 24106214 wlogan@winston.com 2/27/2025 10:46:58 PM SENT

Jervonne Newsome 24094869 jnewsome@winston.com 2/27/2025 10:46:58 PM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Emily Samuels emily.samuels@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Melinda Pate melinda.pate@oag.texas.gov 2/27/2025 10:46:58 PM SENT

Deb Hardy dhardy@steptoe.com 2/27/2025 10:46:58 PM SENT

Admin Leboeuflaw admin@leboeuflaw.com 2/27/2025 10:46:58 PM SENT

Tina White tiwhite@steptoe.com 2/27/2025 10:46:58 PM SENT

Steptoe Docketing docketing@steptoe.com 2/27/2025 10:46:58 PM SENT

Houston Docketing ecf_houston@winston.com 2/27/2025 10:46:58 PM SENT

Greg McConnell GMcConne@winston.com 2/27/2025 10:46:58 PM SENT

Jamie Vargo JVargo@winston.com 2/27/2025 10:46:58 PM SENT

Thanh Nguyen TDNguyen@winston.com 2/27/2025 10:46:58 PM SENT

Delvary Turnipseed delvary.turnipseed@cooperscully.com 2/27/2025 10:46:58 PM SENT

Cory Sutker Cory.Sutker@cooperscully.com 2/27/2025 10:46:58 PM SENT

Jackie Cooper Jackie.Cooper@cooperscully.com 2/27/2025 10:46:58 PM SENT Exhibit K Filed: 2/28/2025 1:24 PM Michael Gould District Clerk Collin County, Texas By Sarah Beasley Deputy Envelope ID: 97928698 Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Envelope ID: 97928698 Filing Code Description: Court Action-Signed Order Filing Description: ORDER Status as of 2/28/2025 1:39 PM CST

Associated Case Party: The State of Texas

Name BarNumber Email TimestampSubmitted Status

David G. Shatto david.shatto@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Abby Smith abby.smith@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Ian Bergstrom Ian.Bergstrom@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Christopher Molak christopher.molak@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Amy Pletscher amy.pletscher@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Associated Case Party: MBrettCooper

Name BarNumber Email TimestampSubmitted Status

Avishay Moshenberg 24083532 avi.moshenberg@lmbusinesslaw.com 2/28/2025 1:24:20 PM SENT

Nicholas Lawson Nick.Lawson@lmbusinesslaw.com 2/28/2025 1:24:20 PM SENT

Jervonne Newsome jnewsome@winston.com 2/28/2025 1:24:20 PM SENT

Thanh D.Nguyen tdnguyen@winston.com 2/28/2025 1:24:20 PM SENT

William Logan wlogan@winston.com 2/28/2025 1:24:20 PM SENT

Docket South ecf_houston@winston.com 2/28/2025 1:24:20 PM SENT

Anika Holland AHolland@willkie.com 2/28/2025 1:24:20 PM SENT

Simona Agnolucci sagnolucci@willkie.com 2/28/2025 1:24:20 PM SENT

Barrington Dyer bdyer@willkie.com 2/28/2025 1:24:20 PM SENT

Zoe Packman zpackman@willkie.com 2/28/2025 1:24:20 PM SENT

Emma Rodriguez erodriguez@willkie.com 2/28/2025 1:24:20 PM SENT

Isabella Corbo icorbo@willkie.com 2/28/2025 1:24:20 PM SENT Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Envelope ID: 97928698 Filing Code Description: Court Action-Signed Order Filing Description: ORDER Status as of 2/28/2025 1:39 PM CST

Associated Case Party: MBrettCooper

Isabella Corbo icorbo@willkie.com 2/28/2025 1:24:20 PM SENT

Remy Carreiro rcarreiro@willkie.com 2/28/2025 1:24:20 PM SENT

Case Contacts

Name BarNumber Email TimestampSubmitted Status

Pauline Sisson pauline.sisson@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Emily Samuels emily.samuels@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Melinda Pate melinda.pate@oag.texas.gov 2/28/2025 1:24:20 PM SENT

Jackie Cooper Jackie.Cooper@cooperscully.com 2/28/2025 1:24:20 PM SENT

Cory Sutker Cory.Sutker@cooperscully.com 2/28/2025 1:24:20 PM SENT

Winston Office nonparty-patient-counsel@winston.com 2/28/2025 1:24:20 PM SENT

Delvary Turnipseed delvary.turnipseed@cooperscully.com 2/28/2025 1:24:20 PM SENT Exhibit L FILED 2/28/2025 2:34 PM FELICIA PITRE DISTRICT CLERK DALLAS CO., TEXAS Nia Searl DEPUTY

Cause No. DC-25-01823

Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient No. 5, Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, Nonparty Patient No. 8, 95TH JUDICIAL DISTRICT Nonparty Patient No. 9, Nonparty Patient No. 10, and Nonparty Patient No. 11,

Plainfifis,

vs.

The State of Texas,

Defendant.

FIRST AMENDED NOTICE OF HEARING TAKE NOTICE that Nonparty Patients’ Motion for Protection has been set for oral

hearing on the 6th day of March, 2025, beginning at 3:00 pm. before the 95th Judicial District Court

of Dallas County, Texas, George L. Allen, Sr. Courts Building, 600 Commerce Street, 6th Floor

New Tower, Dallas, TX 75202.

You are invited to attend.

DATED: February 28, 2025 Respectfillly submitted,

/s/ Jervorme D. Newsome J ervonne D. Newsome Texas Bar No. 24094869 jnewsome@winston.com WINSTON & STRAWN LLP 2121 N. Pearl St., 9th Floor Dallas, TX 75201 Telephone: (214) 453-6500 William M. Logan Texas Bar No. 24106214 wlogan@winston.com WINSTON & STRAWN LLP 800 Capitol Street, Suite 2400 Houston, TX 77002 Telephone: (713) 65 1-2600

ATTORNEYS FOR NONPARTY PATIENTS

CERTIFICATE OF SERVICE I hereby certify that on February 28, 2025, an electronic copy of this First Amended Notice

of Hearing was served to counsel of record for the State of Texas as listed on the relevant

subpoenas, as follows:

Johnathan Stone — Jonathan.Stone@oag.texas.gov Matthew Kennedy — Matt.Kennedy@oag.texas. gov Rob Farquaharson — Rob.Farquharson@oag.texas. gov David Shatto — David.Shatto@oag.texas.gov

I fiirther certify that a copy of this Notice is also being served via Texas E-File.

/s/ Jervonne D. Newsome Jervonne D. Newsome Texas Bar No. 24094869 Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Jamie Vargo on behalf of Jervonne Newsome Bar No. 24094869 JVargo@winston.com Envelope ID: 97934948 Filing Code Description: Notice Of Hearing / Fiat Filing Description: AMENDED - MOTION PROTECT Status as of 3/3/2025 8:22 AM CST

Associated Case Party: NONPARTY PATIENT NO. 1

Name BarNumber Email TimestampSubmitted Status Jervonne Newsome JNewsome@winston.com 2/28/2025 2:34:32 PM SENT William Logan WLogan@winston.com 2/28/2025 2:34:32 PM SENT

Case Contacts

Name BarNumber Email TimestampSubmitted Status David Phillips DPhillips@winston.com 2/28/2025 2:34:32 PM SENT Jamie Vargo JVargo@winston.com 2/28/2025 2:34:32 PM SENT Houston Docket ecf_houston@winston.com 2/28/2025 2:34:32 PM SENT Exhibit M FILED 3/3/2025 11:33 PM FELICIA PITRE DISTRICT CLERK DALLAS CO., TEXAS Sabrina Applewhite DEPUTY

Cause No. DC-25-01823

Nonparty Patient No. 1, § IN THE DISTRICT COURT OF Nonparty Patient No. 2, § Nonparty Patient No. 3, § Nonparty Patient No. 4, § Nonparty Patient No. 5, § Nonparty Patient No. 6, § Nonparty Patient No. 7, and § DALLAS COUNTY, TEXAS Nonparty Patient No. 8, § Plaintiffs, § § v. § § The State of Texas, § Defendant. § 95TH JUDICIAL DISTRICT

THE STATE OF TEXAS’S VERIFIED EMERGENCY PLEA TO THE JURSIDICTION AND PLEA IN ABATEMENT

The State of Texas (the State) has not waived sovereign immunity from lawsuits brought

under Tex. R. Civ. P. 176.6 and 192.6. And, even if it had, this Court must abate this proceeding

because a related and first-filed matter with dominant jurisdiction is already pending before the

493rd District Court in Collin County, Texas. Plaintiff Nonparty Patients’ (Represented Patients)

Second Amended Petition for Protection from Discovery Subpoenas is a clumsy attempt to provoke

conflict between the 95th District Court and the 493rd District Court. Represented Patients are

trying to manipulate the Courts into rendering conflicting rulings by having them both

independently rule on the same evidentiary objections and privilege assertions, regarding the same

medical, prescribing, and billing records, impacting the same records custodians, in the same

ongoing proceeding. This Court should decline to do so and either dismiss this proceeding for lack

of jurisdiction or, alternatively, abate the proceeding where another court has dominant

jurisdiction.

1 BACKGROUND

On October 17, 2024, the State filed suit in the 493rd District Court in Collin County, Texas,

against Defendant May C. Lau, M.D.

Lau evaded service for a month, necessitating an order for substituted services.

On January 13, 2025, the parties entered a protective order ensuring the privacy of the

protected health information of all impacted patients.

On January 16, 2025, the State noticed it’s intent to serve nonparty subpoenas on

Children’s Health System of Texas (Childrens) and the University of Texas Southwestern Medical

Center (UT Southwestern Medical Center) seeking patient medical, prescribing, and billing

records relating to the claims and defenses in the ongoing suit. Subpoenas were subsequently

served on same.

On February 3, 2025, Represented Patients filed the instant suit in Dallas County seeking

protection from the subpoenas issued to Childrens and UT Southwestern Medical Center.

On February 18, 2025, the State was served with the Dallas County suit.

On February 24, 2025, the Represented Patients filed a motion seeking protection from

party discovery in the Collin County proceeding. Specifically, they demanded (without

intervening) the opportunity to review and make objections to the discovery propounded by the

State and to assert privileges over the discovery responses from the physician defendants.

The same day, Represented Patients noticed a hearing seeking a final judgment in the Dallas

County suit for March 12, 2025. The hearing is scheduled to occur before the State’s Answer

deadline of March 17, 2025.

2 On February 26, 2025, the Collin County District Court held an all-day hearing on

numerous pending motions in the Lau and related Cooper matters. Counsel for the Represented

Patients was present and participated the entire day, negotiating and working with the State and

parties to narrow the scope of requested medical, prescribing, and billing records. The Court

determined that records should be released in limited sequential tranches based on the needs of the

case. It directed the parties and interested nonparties to confer on an agreeable method of

production.

On February 27, 2025, the Represented Patients filed a motion to stay discovery in the

Collin County proceedings pending a ruling in the Dallas County proceedings.

On February 28, 2025, the Collin County District Court held a half-day hearing on

numerous pending motions in the Lau and related Cooper matters. Counsel for the Represented

Patients was present and participated the entire time, negotiating a production schedule that

ensured the rights and interests of the patients were properly protected.

Counsels for the State, Cooper, Lau, Childrens, and the Represented Patients reached an

agreement on the process for production of the first tranche of records. The scope of the records

is limited to the medical, prescribing, and billing records relating to testosterone and puberty

blockers prescribed by Lau and Cooper from January 1, 2022, through the present. See Ex. A. To

ensure the patients’ privacy rights are protected, Childrens and UT Southwestern Medical Center

will release records for the represented patients to their counsel to assert privileges and objections.

For unrepresented patients, their records will be released to counsel for the physicians to assert the

physician-patient privilege on the patients’ behalf. See Tex. R. Evid. 509-510. Records will only be

produced to the State after all patients—represented and unrepresented—have had the

3 opportunity to mark for redaction privileged information and produce a privilege log. Ex. A. The

Collin County District Court will then conduct an in-camera inspection of the privilege assertions

and set a hearing within 14 days to consider any challenges to the privilege assertions. Id. The

parties will reconvene thereafter to discuss the scope of a second tranche of records, if necessary.

Despite Collin County providing Represented Patients with the relief sought in Dallas

County, and after actively participating in the negotiations narrowing the scope of the record

requests and creating the process to ensure maximum protection of the patient’s rights, counsel for

Represented Patients refused to agree to the final terms—manufacturing the bad-faith and

pretextual grounds that the State did not agree with them on the proper legal standard governing

the physician-patient privilege in Tex. R. Evid. 509, and the mental-health information privilege in

Tex. R. Evid. 510.

The Collin County Court ultimately entered a ruling directing the limited sequential

production over the objections of Represented Patients. Ex. A. The State thereafter orally moved

for protection in the Collin County suit from the Dallas County suits filed by the Represented

Patients. The Court declined to consider the motion at that time but noted that it would consider

taking it up at the previously scheduled hearing on March 4, 2025, if necessary.

Three hours later, after the hearing in Collin County where they received the very relief that

they purportedly sought in their Dallas County suit, Represented Patients filed an Amended Notice

of Hearing in the Dallas County suit for March 6, 2025. This hearing seeks a final judgment

protecting them from production by Childrens and UT Southwestern Medical Center before the

State’s Answer is due on March 17, 2025. It also seeks a ruling from the Dallas County Court to

4 Childrens and UT Southwestern Medical Center that will directly contravene the existing

production ruling in the first-filed Collin County suit.

Today, Monday, March 3, 2025, the State filed in Collin County a brief in support of its oral

emergency request for protection from the Dallas County proceedings and requested that the

matter be heard tomorrow.

In response, the Represented Patients emailed the Dallas County court seeking an “urgent”

same-day hearing and final judgment before the Collin County District Court could consider the

State’s request for protection. The Dallas County Court declined to do so; instead, advising the

parties that the March 6, 2025, hearing would proceed as scheduled.

At 7:30 p.m., Represented Patients filed a Second Amended Petition for Protection from

Discovery Subpoenas falsely alleging that the State waived sovereign immunity from suit.

EMERGENCY

An emergency exists because on February 28, 2025, counsel for Represented Patients

noticed a hearing seeking entry of a final judgment for March 6, 2025, before the State’s deadline to

Answer on March 17, 2025. Represented Patients scheduled their hearing without conferring with

counsel for the State. Counsel for the Represented Patients had orally agreed to have the State’s

Plea to the Jurisdiction heard at the same time as their Request for Protection. But, on March 1,

2025, counsel for Represented Patients sent an email reneging on this agreement, insisting that only

their Request for Protection be heard at the hearing on March 6, 2025. The State will be materially

prejudiced if final relief is granted to the Represented Patients before the State has even had the

opportunity to Answer.

5 The State will be materially prejudiced if this Court proceeds with this matter without

considering its Plea to the Jurisdiction and Plea in Abatement. This Court lacks jurisdiction, Collin

County has dominant jurisdiction, and proceeding in Dallas County will resulting in inconsistent

obligations and conflicting rulings. The State must be afforded an opportunity to raise these

concerns before the Court grants relief to the Represented Patients.

Finally, the relief sought by Represented Patients in Dallas County has already been granted

by the Collin County District Court, see Ex. A, thereby obviating any need to continue the present

action.

PLEA TO THE JURISDICTION

A plea to the jurisdiction challenges the court’s authority to determine the subject matter

of the controversy. Bland Indep. Sch. Dist. v. Blue, 34 S.W.3d 547, 553–54 (Tex. 2000). Subject

matter jurisdiction is “never presumed and cannot be waived.” Tex. Ass’n of Bus. v. Tex. Air Ctr.

Bd., 852 S.W.2d 440, 443–44 (Tex. 1993). “When a plea to the jurisdiction challenges the pleadings,

[the court] determine[s] if the pleader has alleged facts that affirmatively demonstrate the court’s

jurisdiction to hear the cause.” Tex. Dep’t of Parks & Wildlife v. Miranda, 133 S.W.3d 217, 226 (Tex.

2004). “If the pleadings affirmatively negate the existence of jurisdiction, then a plea to the

jurisdiction may be granted without allowing the plaintiffs an opportunity to amend.” Id. at 227.

“A waiver of sovereign immunity requires clear and unambiguous statutory

language.” Texas Off. of Comptroller of Pub. Accts. v. Saito, 372 S.W.3d 311, 313 (Tex. App. 2012)

(emphasis added); Tex. Gov’t Code § 311.034.

I. Represented Patients’ Claims are Barred by Sovereign Immunity.

6 Sovereign immunity deprives a court of subject-matter jurisdiction in suits against the

State. Miranda, 133 S.W.3d at 224. It is the long-established principle that “no state can be sued in

her own courts without her consent, and then only in the manner indicated by that consent.” Tooke

v. City of Mexia, 197 S.W.3d 325, 331 (Tex. 2006) (cleaned up). For a plaintiff to overcome a

defendant’s assertion of sovereign immunity, “the plaintiff must affirmatively demonstrate the

court’s jurisdiction by alleging a valid waiver of immunity.” Dall. Area Rapid Transit v. Whitley, 104

S.W.3d 540, 542 (Tex. 2003).

Represented Patients have not and cannot point to “clear and unambiguous language”

waiving sovereign immunity for suits brought under Tex. R. Civ. P. 176.6 and 192.6. Represented

Patients confusingly argue that the Texas Rules of Civil Procedure waives sovereign immunity by

citing to cases that predate the Texas Rules of Civil Procedures adoption in 1941. These cases,

instead, merely stand for the proposition that the State waives sovereign immunity in suits that it

initiates (and here that suit is in Collin County—not the present suit in Dallas County).

Represented Patients also cite to the holding in In re Google LLC, 2025 WL 258715 (Tex. App. ̶ 15th

Dist., Jan. 16, 2025, pet. imminent) allowing the defendant in a suit brought by the State to depose

a representative for the State. It is unclear how Represented Patients think this case law supports

their position. It instead demonstrates exactly what the State contends, that sovereign immunity is

only waived in the proceeding brought by the State.

The State files thousands of lawsuits every year—yet Represented Patients can point to no

statutes nor any case law showing that the State waives sovereign immunity from suits brought

under Tex. R. Civ. P. 176.6 and 192.6. In the lone instance of waiver that undersigned counsel are

aware of, Allibone, the Texas Medical Board affirmatively chose to waive sovereign immunity in a suit

7 brought under Tex. R. Civ. P. 176.6 and 192.6. See Allibone v. Freshour, 2017 WL 5663607, at *2 n.4

(Tex. App. Nov. 21, 2017). 1 Allibone is the exception that proves the rule—there is no general

waiver of sovereign immunity for suit brought under Tex. R. Civ. P. 176.6 and 192.6. Id. The State

is decidedly not waiving sovereign immunity in this suit; consequently, the Court must dismiss this

suit for lack of jurisdiction.

PLEA IN ABATEMENT

As a general rule, “the court in which suit is first filed acquires dominant jurisdiction to the

exclusion of other coordinate courts.” In re J.B. Hunt Transport, Inc., 492 S.W.3d 287, 299–300

(Tex. 2016) (orig. proceeding). (quoting Curtis v. Gibbs, 511 S.W.2d 263, 267 (Tex. 1974) (orig.

proceeding)). When two suits are inherently interrelated, the court in which the second action was

filed must grant a plea in abatement unless an exception to the general rule applies. Id. at 294.

1 The merits holding in Allibone proves the State’s need to review all medical records relating to the care and treatment of the patients in this action. Allibone, 2017 WL 5663607. In Allibone, the Third Court of Appeals affirmed the district court’s ruling that the scope of the Texas Medical Board’s subpoenas seeking the “entire” medical, billing, and prescribing records for two patients was reasonable because the complete medical records are needed to contextualize the care and treatment provided to the patients. Id. at *5. The Medical Director of the Texas Medical Board testified that when reviewing records “it becomes quite obvious that the full and complete medical record is required for review. There’d be no way to vindicate or dismiss an investigation or a complaint if [the Board was] not able to review the underlying records to determine whether the standard of care was met or violated.” Id. He further testified that it was “quite obvious and apparent that the physician is exactly the wrong person to determine which portions of the medical record are relevant and which portions should be withheld from the investigation.” Id. The Medical Director explained, “[A] physician who has a vested interest in the outcome should not be the gatekeeper of records that the Board can look at ... in the course of its investigation.” Id. Finally, concerning billing records, the Medical Director testified that the Board “can rely quite heavily on billing records to determine the accuracy of the medical records that were submitted to the Board to make sure that we’ve got a full and complete set of medical records.” The Third Court of Appeals agreed with the district court that the subpoenas seeking the “entire” record of the two patients was “in all respects reasonable in scope and valid.” Id. The same is true in the instant action. Should this Court find, wrongly, that Allibone stands for the proposition there is a general waiver of sovereign immunity for actions brought under Tex. R. Civ. P. 176.6 and 192.6, then it should also find, correctly, that the “entire” medical, billing, and prescribing records for the patients are needed to contextualize their care and treatment in the State’s suit alleging fraudulent billing, violation of state law prohibiting the prescribing of puberty blockers and cross-sex hormones to minors for the purposes of transitioning their biological sex or affirming their belief that their gender is different from their biological sex, and for prescribing testosterone and puberty blockers without a valid medical purposes.

8 “Filing a plea in abatement is the proper method for drawing a court’s attention to another court’s

possible dominant jurisdiction.” In re Puig, 351 S.W.3d 301, 305 (Tex. 2011) (orig. proceeding).

A method to assert a claim of dominant jurisdiction is through a plea in abatement in the

second-filed suit. See In re Puig, 351 S.W.3d 301, 305 (Tex. 2011) (per curiam) (orig. proceeding). If

the party asserting dominant jurisdiction establishes that the doctrine applies, the trial court in the

second-filed suit has no discretion to deny the plea unless the party resisting abatement establishes

an exception to the rule of dominant jurisdiction. See In re J.B. Hunt, 492 S.W.3d at 294 (concluding

real parties’ evidence “[fell] well below the legal standards” to establish exception to dominant

jurisdiction); see also In re Red Dot Bldg. Sys., Inc., 504 S.W.3d 320, 322–23 (Tex. 2016) (per curiam)

(orig. proceeding); In re Tex. Christian Univ., 571 S.W.3d 384, 389, 391 (Tex. App.—Dallas 2019,

orig. proceeding). Because the dominant jurisdiction doctrine applies and Represented Patients

have not demonstrated the existence of an exception, this Court should grant an abatement pending

resolution of the first-filed suit in Collin County.

I. The Collin County and Dallas County suits are inherently interrelated.

Generally, a plea in abatement must be granted when an inherent interrelation of the subject

matter exists in two pending lawsuits. Perry v. Del Rio, 66 S.W.3d 239, 252 (Tex. 2001). Abatement

of a suit due to the pendency of a prior suit is based on the principles of comity, convenience, and

the necessity for an orderly procedure in the trial of contested issues. Miles v. Ford Motor Co., 914

S.W.2d 135, 138 (Tex. 1995).

The first question to address in the dominant-jurisdiction analysis is whether there is an

inherent interrelationship between the two cases—in this case, between the first-filed suit in the

493rd District Court in Collin County and the second-filed suit in the 95th District Court in Dallas

9 County. See J.B. Hunt Transp., 492 S.W.3d at 292; In re Happy State Bank, No. 02-17-00453-CV,

2018 WL 1918217, at *4 (Tex. App.—Fort Worth Apr. 23, 2018, orig. proceeding) (mem. op.). If

yes, then dominant jurisdiction applies and, absent an exception, the second-filed suit must be

abated. J.B. Hunt Transp., 492 S.W.3d at 292; see Happy State Bank, 2018 WL 1918217, at *7. If not,

then both suits may proceed. J.B. Hunt Transp., 492 S.W.3d at 292; see generally Happy State Bank,

2018 WL 1918217, at *4.

In determining whether the suits are inherently interrelated, courts are guided by the

compulsory counterclaim rule, Tex. R. Civ. P. 97(a), and joinder of a party rule, Tex. R. Civ. P. 39.

Wyatt v. Shaw Plumbing Co., 760 S.W.2d 247 (Tex. 1988); In re J.B. Hunt Transp., Inc., 492 S.W.3d

at 292.

The Court should find that the Collin County and Dallas County proceedings are inherently

interrelated. A counterclaim is compulsory if it meets the following six characteristics: (1) it is

within the jurisdiction of the court; (2) it is not at the time of the filing of the answer the subject of

a pending action; (3) the action is mature and owned by the defendant at the time of filing the

answer; (4) it arises out of the transaction or occurrence that is the subject matter of the opposing

party’s claim; (5) it is against an opposing party in the same capacity; and (6) it does not require

for its adjudication the presence of third parties over whom the court cannot acquire jurisdiction.

See Tex. R. Civ. P. 97(a); see also Ingersoll-Rand Co. v. Valero Energy Corp., 997 S.W.2d 203, 207 (Tex.

1999). There is no dispute, that undersigned are aware of, that these conditions exist in the

proceedings at issue. The subpoenas issued to Childrens and UT Southwestern Medical Center

arise from, and are related to, the claims and defenses in the first-filed suit pending in Collin

County.

10 The Collin County and Dallas County suits are, moreover, inherently interrelated due to

the substantial risk of conflicting rulings creating “inconsistent obligations” on the parties,

Childrens, and UT Southwestern Medical Center. Encore Enterprises, Inc. v. Borderplex Realty Tr.,

583 S.W.3d 713, 724 (Tex. App. 2019) (applying Rule 39(a) in a dominant jurisdiction analyses). The

Collin County District Court has already directed Childrens and UT Southwestern Medical Center

to produce documents relating to the claims in the ongoing proceedings. See Ex. A. A ruling from

the Dallas County District Court that Childrens and UT Southwestern Medical Center do not have

to produce records, after being directed to do so by the Collin County District Court, will

necessarily create “inconsistent obligations.” These inconsistent obligations will only be

compounded exponentially if judges in Dallas County and Collin County are both reviewing the

same sets of medical, prescribing, and billing records in the same proceeding and making evidentiary

rulings on privileges and objections.

Finally, abatement is in the interest of justice. The relief sought by the Represented Patients

in the Dallas County suit is to have the opportunity to assert privileges before records are produced

to the State. That is exactly the relief they were granted in the Collin County proceeding. See Ex.

A. That counsel for the represented patients continues to pursue a suit in Dallas County after they

already obtained the relief sought in Collin County demonstrates bad faith, wastes judicial

resources, and unnecessarily drives up litigation costs.

This Court should abate this proceeding where Collin County has dominant jurisdiction.

II. There is no exception to the “first-filed” rule.

Exceptions to this “first-filed” rule may apply when its justifications fail, such as when the

first court does not have the full matter before it, when conferring dominant jurisdiction on the first

11 court will delay or even prevent a prompt and full adjudication, or “when the race to the courthouse

was unfairly run.” Perry, 66 S.W.3d at 252. A plaintiff who filed the first suit may be estopped from

asserting the dominant jurisdiction of the first court if it is found that he is guilty of inequitable

conduct. Hiles v. Arnie & Co., 402 S.W.3d 820, 825–26 (Tex. App.—Houston [14th Dist.] 2013, pet.

denied).

A race to the courthouse by itself is not inequitable conduct. In re Texas Christian Univ., 571

S.W.3d 384, 392 (Tex. App. 2019). In fact, one of the justifications for the first-filed rule is “simple

fairness: in a race to the courthouse, the winner’s suit should have dominant jurisdiction.” In re

J.B. Hunt Transport, Inc., 492 S.W.3d at 296 (citing Perry, 66 S.W.3d at 252); Lee v. GST Transp.

Sys., LP, 334 S.W.3d 16, 18 (Tex. App.—Dallas 2008, pet. denied).

No exception in the present case exists, nor have Represented Patients alleged that one

does. Accordingly, the Collin County case is first filed, the dominant jurisdiction doctrine applies,

and this Court should abate the present matter pending resolution of the Collin County matter.

PRAYER

For the reasons stated above, the State prays that the Court dismiss the Represented

Patients’ lawsuit and all claims and causes of action stated therein with prejudice and render

judgment that Represented Patients take nothing, that the Attorney General recover its reasonable

and necessary attorneys’ fees and costs of court, and for all other relief, at law and in equity, to

which it may show itself to be justly entitled. Alternatively, the State asks the Court to abate this

proceeding pending resolution of the first-filed Collin County suit and for all other relief, at law and

in equity, to which it may show itself to be justly entitled, including attorneys’ fees.

12 Dated: March 3, 2025 Respectfully submitted,

Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

AUSTIN KINGHORN Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

Consumer Protection Division Office of the Attorney General P.O. Box 12548 Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Rob.Farquharson@oag.texas.gov Telephone: (512) 463-2185 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

13 CERTIFICATE OF SERVICE

I hereby certify that on the 3rd day of March 2025, a copy of the foregoing document was

served to all counsel of record in accordance with the Texas Rules of Civil Procedure.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

DECLARATION

Pursuant to Tex. Civ. Rem. & Prac. Code § 132.001(f), JOHNATHAN STONE submit

this unsworn declaration in lieu of a written sworn declaration, verification, certification, oath, or

affidavit required by Texas Rule of Civil Procedure 682. I am an employee of the following

governmental agency: Texas Office of the Attorney General. I am executing this declaration as part

of my assigned duties and responsibilities. I declare under penalty of perjury that the factual

statements in the foregoing are true and correct.

Executed in Travis County, State of Texas, on the 3rd day of March 2025.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

14 Cause No. DC-25-01823

Nonparty Patient No. 1, § IN THE DISTRICT COURT OF Nonparty Patient No. 2, § Nonparty Patient No. 3, § Nonparty Patient No. 4, § Nonparty Patient No. 5, § Nonparty Patient No. 6, § Nonparty Patient No. 7, and § DALLAS COUNTY, TEXAS Nonparty Patient No. 8, § Plaintiffs, § § v. § § The State of Texas, § Defendant. § 95TH JUDICIAL DISTRICT

THE STATE OF TEXAS’S VERIFIED EMERGENCY PLEA TO THE JURSIDICTION AND PLEA IN ABATEMENT

EXHIBIT A Filed: 2/28/2025 1:24 PM Michael Gould District Clerk Collin County, Texas By Sarah Beasley Deputy Envelope ID: 97928698 Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Johnathan Stone on behalf of Johnathan Stone Bar No. 24071779 johnathan.stone@oag.texas.gov Envelope ID: 98017369 Filing Code Description: Plea To Jurisdiction Filing Description: DEFENDANT VERIFIED EMERGENCY AND PLEA TO ABATEMENT Status as of 3/5/2025 10:55 AM CST

Case Contacts

Name BarNumber Email TimestampSubmitted Status

David Walsh dwalsh@katxlaw.com 3/3/2025 11:33:37 PM SENT

David Phillips DPhillips@winston.com 3/3/2025 11:33:37 PM SENT

Jamie Vargo JVargo@winston.com 3/3/2025 11:33:37 PM SENT

Houston Docket ecf_houston@winston.com 3/3/2025 11:33:37 PM SENT

Associated Case Party: NONPARTY PATIENT NO. 1

Name BarNumber Email TimestampSubmitted Status

Jervonne Newsome JNewsome@winston.com 3/3/2025 11:33:37 PM SENT

William Logan WLogan@winston.com 3/3/2025 11:33:37 PM SENT

Thanh D.Nguyen tdnguyen@winston.com 3/3/2025 11:33:37 PM SENT

Evan D.Lewis edlewis@winston.com 3/3/2025 11:33:37 PM SENT

Olivia A.Wogon owogon@winston.com 3/3/2025 11:33:37 PM SENT

Associated Case Party: THE STATE OF TEXAS

Name BarNumber Email TimestampSubmitted Status

Rob Farquharson rob.farquharson@oag.texas.gov 3/3/2025 11:33:37 PM SENT

David G. Shatto david.shatto@oag.texas.gov 3/3/2025 11:33:37 PM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 3/3/2025 11:33:37 PM SENT

Melinda Pate melinda.pate@oag.texas.gov 3/3/2025 11:33:37 PM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 3/3/2025 11:33:37 PM SENT

Emily Samuels emily.samuels@oag.texas.gov 3/3/2025 11:33:37 PM SENT Exhibit N Cause No. DC—25-01823 Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient N0. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient N_o. 5, Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, Nonparty Patient No. 8, 95TH JUDICIAL DISTRICT Nonparty Patient N0. 9, Nonparty Patient No. 10, and Nonparty Patient No. 1 l,

Plaintifis,

vs.

The State of Texas,

Defendant.

@ {'PRQPGSED} ORDER DENYING THE STATE’S PLEA TO THE JURISDICTION AND PLEA IN ABATEMENT Pending before the Court is the State’s plea to the jurisdiction of this Court and plea in

abatement. Having considered the pleadings, record evidence, and the parties’ arguments, the

Court'fmds that the State’s pleas are hereby DENIED.

So ORDERED and SIGNED this Blkday OWZOZS;

The Hon. Judge Monica‘ Purdy 95th Judicial District Court Dallas County, Texas Exhibit O FILED 3/6/2025 3:52 PM FELICIA PITRE DISTRICT CLERK DALLAS CO., TEXAS Shelia Bradley DEPUTY

Cause No. DC-25-01823

Nonparty Patient No. 1, § IN THE DISTRICT COURT OF Nonparty Patient No. 2, § Nonparty Patient No. 3, § Nonparty Patient No. 4, § Nonparty Patient No. 5, § Nonparty Patient No. 6, § Nonparty Patient No. 7, and § DALLAS COUNTY, TEXAS Nonparty Patient No. 8, § Plaintiffs, § § v. § § The State of Texas, § Defendant. § 95TH JUDICIAL DISTRICT

THE STATE OF TEXAS’S NOTICE OF APPEAL

Pursuant to Texas Rules of Appellate Procedure 25.1(a) and 26.1(b), Defendant the State

of Texas gives notice of an appeal of the trial court’s oral denial of Defendants’ Plea to the

Jurisdiction and Plea in Abatement on March 6, 2025.

The State is entitled to an interlocutory appeal pursuant to Civil Practice and Remedies

Code § 51.014(a)(8), which allows for an immediate appeal from an order that denies a plea to the

jurisdiction.

The State appeals to the Fifteenth Court of Appeals. This is an accelerated appeal as

provided by Texas Rule of Appellate Procedure 28.1. This is not a parental termination or child

protection case, as defined in Rule 28.4.

Pursuant to Texas Civil Practice and Remedies Code § 51.014(b), all further

proceedings in this court are stayed pending resolution of the State’s appeal. This

interlocutory appeal meets all the prerequisites for the automatic stay to apply. See Tex. Civ. Prac.

& Rem. Code § 51.014(a)(8), (b), (c)(1). Pursuant to Tex. Civ. Prac. & Rem. Code § 6.001, as governmental officers, Defendants are not required to file a supersedeas bond for court costs. The

State’s appeal is therefore perfected upon the filing of the notice of appeal.

Dated: March 6, 2025 Respectfully submitted,

KEN PAXTON Attorney General of Texas

BRENT WEBSTER First Assistant Attorney General

RALPH MOLINA Deputy First Assistant Attorney General

AUSTIN KINGHORN Deputy Attorney General for Civil Litigation

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

ROB FARQUHARSON Assistant Attorney General State Bar No. 24100550

Consumer Protection Division Office of the Attorney General P.O. Box 12548 Austin, Texas 78711 Johnathan.Stone@oag.texas.gov Rob.Farquharson@oag.texas.gov Telephone: (512) 463-2185 Facsimile: (512) 473-8301

ATTORNEYS FOR TEXAS

2 CERTIFICATE OF SERVICE

I hereby certify that on the 6th day of March 2025, a copy of the foregoing document was

served to all counsel of record in accordance with the Texas Rules of Civil Procedure.

/s/ Johnathan Stone JOHNATHAN STONE Chief, Consumer Protection Division State Bar No. 24071779

3 Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Johnathan Stone on behalf of Johnathan Stone Bar No. 24071779 johnathan.stone@oag.texas.gov Envelope ID: 98165074 Filing Code Description: Notice Of Appeal - CT. Of Appeals Filing Description: DEFENDANT-DESIGNATION REQUESTED AT TIME OF ACCEPTANCE BY 4PM 3/7/2025 Status as of 3/7/2025 9:20 AM CST

Case Contacts

Name BarNumber Email TimestampSubmitted Status

David Walsh dwalsh@katxlaw.com 3/6/2025 3:52:36 PM SENT

David Phillips DPhillips@winston.com 3/6/2025 3:52:36 PM SENT

Jamie Vargo JVargo@winston.com 3/6/2025 3:52:36 PM SENT

Houston Docket ecf_houston@winston.com 3/6/2025 3:52:36 PM SENT

Associated Case Party: THE STATE OF TEXAS

Name BarNumber Email TimestampSubmitted Status

Pauline Sisson pauline.sisson@oag.texas.gov 3/6/2025 3:52:36 PM SENT

David G. Shatto david.shatto@oag.texas.gov 3/6/2025 3:52:36 PM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 3/6/2025 3:52:36 PM SENT

Emily Samuels emily.samuels@oag.texas.gov 3/6/2025 3:52:36 PM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 3/6/2025 3:52:36 PM SENT

Melinda Pate melinda.pate@oag.texas.gov 3/6/2025 3:52:36 PM SENT

Associated Case Party: NONPARTY PATIENT NO. 1

Name BarNumber Email TimestampSubmitted Status

Jervonne Newsome JNewsome@winston.com 3/6/2025 3:52:36 PM SENT

William Logan WLogan@winston.com 3/6/2025 3:52:36 PM SENT

Thanh D.Nguyen tdnguyen@winston.com 3/6/2025 3:52:36 PM SENT

Evan D.Lewis edlewis@winston.com 3/6/2025 3:52:36 PM SENT

Olivia A.Wogon owogon@winston.com 3/6/2025 3:52:36 PM SENT Exhibit P Cause No. DC-25-01823

'Nonparty Patient No. 1, Nonparty Patient No. 2, Nonparty Patient No. 3, Nonparty Patient No. 4, IN THE DISTRICT COURT OF Nonparty Patient No. 5, :Nonparty Patient No. 6, DALLAS COUNTY, TEXAS Nonparty Patient No. 7, Nonparty Patient No. 8, 95TH JUDICIAL DISTRICT Nonparty Patient No. 9, Nonparty Patient No. 10, and Nonparty Patient No. 1 1,

Plaintifi's,

vs.

The State of Texas,

Defendant.

{Paar-95m ORDER After the Court denied the State of Texas’s Verified Emergency Plea to the Jurisdiction

and-Plea in Abatement, the Court heard argument on the Nonparty Patients’ Petition for a Motion

for a Protective Order during the same hearing.

While that argument unfolded, the State represented that it had filed an interlocutory appeal

challenging the Court’s ruling on jurisdiction and abatement. In light of this development: the

C'ourt- hereby ORDERS that any and all production obligations with respect to the State’s

subpoenas served on Children’s Medical Center and UT Southwestern Medical Center (the

“Hospital Systems”) are hereby STAYED in their entirety. The Hospital Systems shall not produce

any documents to the State until the interlocutory appeal reaches a final resolution. W (a, 2025. -

Hon. Monica CWPurdy 95th Judicial istrict Court Dallas County, Texas Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Johnathan Stone on behalf of Johnathan Stone Bar No. 24071779 johnathan.stone@oag.texas.gov Envelope ID: 98570743 Filing Code Description: Response Filing Description: 20250317 State's Reply ISO Emerg Mtn Stay Discovery_refiled Status as of 3/18/2025 10:31 AM CST

Case Contacts

Name BarNumber Email TimestampSubmitted Status

David Walsh 791874 dwalsh@katxlaw.com 3/18/2025 10:14:53 AM SENT

Pauline Sisson pauline.sisson@oag.texas.gov 3/18/2025 10:14:53 AM SENT

David Phillips DPhillips@winston.com 3/18/2025 10:14:53 AM SENT

Emily Samuels emily.samuels@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Melinda Pate melinda.pate@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Jamie Vargo JVargo@winston.com 3/18/2025 10:14:53 AM SENT

Houston Docket ecf_houston@winston.com 3/18/2025 10:14:53 AM SENT

Associated Case Party: Nonparty Patient No. 1

Name BarNumber Email TimestampSubmitted Status

William Logan 24106214 wlogan@winston.com 3/18/2025 10:14:53 AM SENT

Evan Lewis 24116670 edlewis@winston.com 3/18/2025 10:14:53 AM SENT

Jervonne Newsome 24094869 jnewsome@winston.com 3/18/2025 10:14:53 AM SENT

Thanh Nguyen tdnguyen@winston.com 3/18/2025 10:14:53 AM SENT

Olivia Wogon owogon@winston.com 3/18/2025 10:14:53 AM SENT

Jonathan Hung JOHung@winston.com 3/18/2025 10:14:53 AM SENT

Associated Case Party: State of Texas

Name BarNumber Email TimestampSubmitted Status

David G. Shatto david.shatto@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Rob Farquharson rob.farquharson@oag.texas.gov 3/18/2025 10:14:53 AM SENT Automated Certificate of eService This automated certificate of service was created by the efiling system. The filer served this document via email generated by the efiling system on the date and to the persons listed below. The rules governing certificates of service have not changed. Filers must still provide a certificate of service that complies with all applicable rules.

Johnathan Stone on behalf of Johnathan Stone Bar No. 24071779 johnathan.stone@oag.texas.gov Envelope ID: 98570743 Filing Code Description: Response Filing Description: 20250317 State's Reply ISO Emerg Mtn Stay Discovery_refiled Status as of 3/18/2025 10:31 AM CST

Associated Case Party: State of Texas

Rob Farquharson rob.farquharson@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Johnathan Stone johnathan.stone@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Ian Bergstrom Ian.Bergstrom@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Abby Smith abby.smith@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Amy Pletscher amy.pletscher@oag.texas.gov 3/18/2025 10:14:53 AM SENT

Christopher Molak christopher.molak@oag.texas.gov 3/18/2025 10:14:53 AM SENT