Texas West Oaks Hospital v. Williams

The Texas Supreme Court recently expanded Health Care Liability Claims (HCLCs) coverage under the Texas Medical Liability Act (TMLA) to include claims by non-patients against health care providers. In Texas West Oaks Hospital v. Williams, 371 S.W.3d 171 (Tex. 2012), a technician at a mental hospital had an altercation with a patient, which resulted in injuries to the technician and the death of the patient. The patient’s estate sued the hospital and the technician, and the technician filed a cross-claim against the hospital for negligence, alleging, among other things, that the hospital failed to ensure the safety of its employees. In response, the hospital argued that the technician’s claims were HCLCs and, because the technician did not provide an expert report as required by the TMLA, his claims were barred. The Texas Supreme Court agreed, dismissed the technician’s claims, and held for the first time that a non-patient’s claim against a hospital qualifies as an HCLC, and therefore, must comply with the TMLA.

The Court relied heavily on a recent amendment to the TMLA: the word “patient” was replaced with the word “claimant.” It reasoned that this amendment evidenced legislative intent to broaden the coverage of the statute. It then discussed the three elements of an HCLC: (1) a health care provider is the defendant; (2) the claim concerns the “treatment, lack of treatment, or a departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care,” id. at 180, and (3) the alleged departure proximately caused the plaintiff’s injuries. The court focused on the second element and noted that the alleged negligence in health care is sufficiently related to a physician-patient relationship because health care inevitably involves the care of a patient. Additionally, the court concluded that the statute did not intend the phrase “directly related to health care” to refer to “safety,” because the two phrases were not in close proximity. See id. at 184 (construing TEX. CIV. PRAC. & REM. CODE § 74.001(a)(13) (West 2003)).

The dissent called the majority’s opinion a “strained” reading of the statute that contradicts the statute’s plain language, purpose, and common sense. The dissent pointed out that this was not an HCLC because a claim does not become an HCLC merely because of some potential relationship with a patient, but because it is founded on the breach of a duty owed to a patient. The dissent further argued that the majority relied too heavily on the amendment of the word “patient” in the statute. Additionally, the dissent argued the holding was inconsistent with expert provisions, Texas precedent, and mandated jury instructions. Finally, the dissent claimed the majority’s holding undermined the legislative goals in enacting the TWCA because it rewards non-subscribers by making it more difficult for their employees to file claims.

Regardless, no longer must an HCLC be brought by a patient. The inevitable result is that statutory requirements—specifically expert testimony—will be required to maintain a negligence claim against an employer if the employer happens to be a health care provider.

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A special thanks to Jamie Vaughan for her invaluable assistance in preparing this post.

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