Professional Negligence Law Reporter

The Texas Supreme Court held that reversal of a plaintiff verdict was warranted where the plaintiffs failed to demonstrate that the actions of a pediatrician and a physician assistant (PA) were the proximate cause of their teenage daughter’s death by suicide.

A.W. died by suicide at age 14. Her parents sued a pediatrician and a PA, alleging negligence and gross negligence. The plaintiffs asserted that the PA had performed an inadequate workup of A.W., failed to use a standardized depression screening questionnaire, improperly prescribed Celexa after a single visit, and refilled the prescription without authorization.

Suit also claimed that the defendants had failed to follow up with A.W. Psychiatrist Fred Moss testified that the defendant’s negligence had caused A.W.’s death, particularly the failure to expose her suicidal tendencies. A jury found in favor of the plaintiffs, concluding that the defendants had proximately caused A.W.’s death.

An intermediate appellate court affirmed the verdict.

Reversing, the state high court noted that in a medical negligence case, a plaintiff must offer evidence that the defendant’s negligence was a substantial factor in causing the alleged injury and that but for the negligence, the plaintiff would not have been injured. In cases involving multiple defendants, the court added, a jury must consider whether each provider’s individual negligence was a substantial factor in the plantiff’s alleged injuries and whether the combined negligence was a but-for cause of injury.

Applying these principles here, the court found that expert Moss’s testimony failed to do more than speculate that but for the defendants’ negligent care, A.W. would not have died by suicide. Moss’s conclusions, the court said, are not based on facts in the record, and he could not identify a particular treatment or combination of treatments that would have prevented A.W.’s suicide. Moss’s assumptions about what A.W. might have done had she had received counseling and follow-up care are merely speculative, the court said, adding that the record revealed that A.W. had declined to go to counseling.

Therefore, the court concluded that Moss had presented no factual, verifiable basis for concluding what A.W. might have done had the defendant providers acted differently. Although the court acknowledged that professional negligence may lead to suicide, it found that negligence may not substitute for legally sufficient evidence of causation.

Consequently, the court entered judgment for the defendants.

Citation: Pediatrics Cool Care v. Thompson, 2022 WL 1509741 (Tex. May 13, 2022).