Trial News

A man convicted of aggravated assault who claimed a nurse fraudulently recorded information in a patient’s medical record related to the crime had to submit a medical expert report since he alleged a violation of the Texas Medical Liability Act, the Texas Supreme Court has ruled. In a case of first impression, the court resolved a split among its appellate courts as to what qualifies as a health care liability claim and is therefore subject to the medical liability statute’s requirements. (Baylor Scott & White, Hillcrest Med. Ctr. v. Weems, 2019 WL 1867916 (Tex. Apr. 26, 2019).)

Ruthen Weems sued a hospital for intentional infliction of emotional distress, claiming that his indictment rested on a falsified medical record that incorrectly described the nature of the assault victim’s gunshot wound. Weems argued that the victim had not been shot and that the nurse who recorded the information should have known that. Weems also claimed that a forensics expert who examined photos of the victim’s injury concluded that he could not have been shot. Weems did not provide an expert report, which the hospital argued was required under Texas law within 120 days after the defendant filed its answer since the plaintiff brought a medical negligence claim.

The trial court agreed and dismissed the plaintiff’s claims. He appealed, and the appellate court reversed, finding that “claims involving alteration and fabrication of medical records are not healthcare liability claims and, therefore, do not trigger the expert report requirement.” But due to a split among Texas appellate courts on this question, the hospital petitioned the state supreme court for review.

The Texas Medical Liability Act requires that plaintiffs submit an expert report “before litigation gets underway.” The court looked to “the underlying nature of the plaintiff’s claim rather than its label” in determining what claims fall under the act. There is a rebuttable presumption that a claim against a health care provider that is “based on facts implicating the defendant’s conduct during the course of a patient’s care, treatment, or confinement” is within the statute’s purview. In defining a health care liability claim, the act references claimants rather than patients, meaning that a plaintiff does not need to be the patient or the patient’s representative to fall within the statute’s parameters. The core question is whether the plaintiff’s claim rests on a “departure from accepted standards of medical care, or safety or professional or administrative services directly related to health care.”

The court concluded that maintaining accurate medical records is part of “professional or administrative services,” since licensing regulations require hospitals to do so and a provider’s license could be revoked for failing to maintain accurate and complete medical records. The court further determined that this duty is directly related to health care because it “has a manifestly close relationship with the treatment of a patient” since medical records are essential for administering care at the time and for future treatment.

While expert testimony may or may not be required to prove whether the victim suffered the gunshot wound underpinning the plaintiff’s conviction, that does not affect the requirement that an expert report be submitted since the plaintiff’s allegations rely on a violation of medical standards of care. The court also stated that whether the nurse’s actions were intentional or negligent is not relevant since the statute does not distinguish between the two for purposes of a health care liability claim.

Accordingly, the court reversed the lower court’s ruling and dismissed the plaintiff’s claim with prejudice. It also rejected the precedent the appellate court relied on that stated fabricated medical records did not form the basis of a health care liability claim.