Chapter 74 Expert Report and Curriculum Vitae - Texas Health Care Liability Claim

CHAPTER 74 EXPERT REPORT AND CURRICULUM VITAE — TEXAS HEALTH CARE LIABILITY CLAIM

TABLE OF CONTENTS

1. Caption and Cover Sheet
2. Introduction and Purpose
3. Expert Qualifications Statement
4. Materials Reviewed
5. Factual Summary
6. Standard of Care
7. Breach of the Standard of Care
8. Causation
9. Injury, Harm, and Damages
10. Opinions Stated to a Reasonable Degree of Medical Probability
11. Reservation of Right to Supplement
12. Signature
13. Curriculum Vitae of Expert
14. Service Letter and Certificate of Service
15. Texas Practice Notes
16. Sources and References

1. CAPTION AND COVER SHEET

CAUSE NO. [________________________________]

IN THE DISTRICT COURT OF

[COUNTY] COUNTY, TEXAS

[___] JUDICIAL DISTRICT

EXPERT REPORT OF [EXPERT NAME], [DEGREE], PURSUANT TO TEX. CIV. PRAC. & REM. CODE § 74.351

(Served on Defendant [DEFENDANT NAME] on [DATE] — within 120 days of original answer filed [DATE OF ANSWER])

2. INTRODUCTION AND PURPOSE

I, [EXPERT FULL NAME], [DEGREE / TITLE], have been retained by counsel for Plaintiff [PLAINTIFF NAME] to render expert opinions in the above-styled cause. This report is submitted pursuant to Tex. Civ. Prac. & Rem. Code § 74.351 and is intended to satisfy the requirements of subsection (r)(6), namely to provide a fair summary of my opinions, as of the date of this report, regarding:

• (a) the applicable standard of care;
• (b) the manner in which the care rendered by [DEFENDANT NAME] failed to meet that standard; and
• (c) the causal relationship between that failure and the injury, harm, or damages claimed by Plaintiff.

This report is directed to Defendant [DEFENDANT NAME] specifically. To the extent my opinions also bear on other Defendants, separate reports addressed to those Defendants are being served contemporaneously.

3. EXPERT QUALIFICATIONS STATEMENT

3.1. Education and licensure. I received my [M.D. / D.O. / R.N. / Pharm.D. / D.D.S. / D.P.M. / OTHER DEGREE] from [INSTITUTION] in [YEAR]. I completed [INTERNSHIP, RESIDENCY, FELLOWSHIP] in [SPECIALTY] at [INSTITUTION] and I am board-certified by [BOARD] in [SPECIALTY] since [YEAR]. I have been continuously licensed to practice [medicine / nursing / pharmacy / dentistry / podiatry] in [STATE(S)] since [YEAR].

3.2. Active practice. At the time of the events giving rise to this claim and at the time of this report, I have been actively engaged in the practice of [SPECIALTY], devoting approximately [#] hours per week to direct patient care at [FACILITY] and approximately [#] hours per week to [teaching residents at an accredited school of medicine / consulting with other physicians upon request]. As such, I qualify as one engaged in the "practice of medicine" within the meaning of Tex. Civ. Prac. & Rem. Code § 74.401(b).

3.3. Knowledge of applicable standards. Through my training, board certification, continuing medical education, and active clinical practice, I am thoroughly familiar with the accepted standards of medical care for the diagnosis, care, and treatment of the [CONDITION / PROCEDURE] at issue in this case.

3.4. Qualification to opine — § 74.401 (physician defendant). I am a physician who (i) was practicing medicine at the time the claim arose and continue to practice at the time of this report, (ii) have knowledge of the accepted standards of medical care for the diagnosis, care, or treatment of the illness, injury, or condition involved in this claim, and (iii) am qualified on the basis of training and experience to offer expert opinions regarding those accepted standards. I therefore satisfy the requirements of Tex. Civ. Prac. & Rem. Code § 74.401(a).

3.5. Qualification to opine — § 74.402 (institutional / non-physician HCP defendant). I have been actively practicing [FIELD] in the same field of practice as the defendant [NURSE / PHARMACIST / DENTIST / OTHER], have knowledge of the accepted standards of care for that field, and am qualified on the basis of training and experience to offer expert opinions on those standards. I therefore satisfy Tex. Civ. Prac. & Rem. Code § 74.402.

3.6. Qualification to opine on causation — § 74.403. I am a physician licensed to practice medicine and otherwise qualified under the Texas Rules of Evidence to render opinions on the causal relationship between the alleged departure from the standard of care and the injury, harm, or damages claimed. I therefore satisfy Tex. Civ. Prac. & Rem. Code § 74.403(a).

3.7. No conflict. I have no familial, financial, or business relationship with any party that would affect my impartial expert opinions in this matter, save for the fee arrangement disclosed in my retention agreement.

4. MATERIALS REVIEWED

In forming the opinions stated below, I have reviewed the following materials:

• ☐ Plaintiff's medical records from [FACILITY] for the date(s) [DATE RANGE];
• ☐ Operative report dated [DATE] authored by [SURGEON];
• ☐ Anesthesia record dated [DATE];
• ☐ Imaging studies (DICOM and radiologist reports): [CT / MRI / X-RAY / OTHER] dated [DATE];
• ☐ Laboratory results: [CBC, BMP, COAGS, OTHER] dated [DATE];
• ☐ Nursing notes, flowsheets, and medication-administration records;
• ☐ Pathology and autopsy reports (if applicable);
• ☐ Prior and subsequent medical records relevant to the condition at issue;
• ☐ Plaintiff's Original Petition;
• ☐ Plaintiff's pre-suit notice and § 74.052 authorization;
• ☐ Defendant's curriculum vitae and credentialing file (where produced);
• ☐ Applicable peer-reviewed literature, professional society guidelines (e.g., [ACOG / ACS / SCCM / AHA / ASA / AAFP]), and clinical practice standards;
• ☐ [OTHER MATERIAL].

5. FACTUAL SUMMARY

5.1. On [DATE], Plaintiff, a [AGE]-year-old [MALE / FEMALE / OTHER] with a past medical history of [PMH], presented to [FACILITY] with [CHIEF COMPLAINT / SYMPTOMS].

5.2. Plaintiff was evaluated by Defendant [NAME], who [DESCRIBE EVALUATION, ORDERS, IMPRESSIONS].

5.3. [Continue chronological factual summary, anchored to medical-record citations and times of day where possible.]

5.4. Plaintiff was discharged / transferred / coded on [DATE] with the outcome described below.

6. STANDARD OF CARE

6.1. The standard of care applicable to a [SPECIALTY] treating a patient presenting with [CONDITION] in [YEAR] in a [community / academic / tertiary] setting in Texas requires the following:

• ☐ Obtain a complete history and perform a directed physical examination;
• ☐ Order and timely review [SPECIFIC LABS / IMAGING / MONITORING];
• ☐ Recognize and respond to [CLINICAL FINDING / RED FLAG] within [TIMEFRAME];
• ☐ Provide informed consent disclosing [MATERIAL RISKS] consistent with the Texas Medical Disclosure Panel List A/B for the procedure;
• ☐ Perform the procedure using [STANDARD TECHNIQUE] with appropriate [PERIOPERATIVE PRECAUTIONS];
• ☐ Monitor post-procedure for [COMPLICATIONS] with [MONITORING MODALITY] at [INTERVALS];
• ☐ Consult or refer to [SPECIALTY] when [INDICATION] is present;
• ☐ Document care contemporaneously and completely;
• ☐ [OTHER].

6.2. These standards are reflected in [CITATION TO LITERATURE / GUIDELINES] and are the standards that a reasonably prudent [SPECIALTY] would have followed under the same or similar circumstances.

7. BREACH OF THE STANDARD OF CARE

7.1. Based on my review of the records, Defendant [NAME] breached the standard of care described above in the following specific respects:

• 7.1.1. [BREACH #1 — e.g., Failed to order a CT angiogram despite Plaintiff's clinical presentation being consistent with pulmonary embolism, including tachycardia of 120, oxygen saturation of 89% on room air, and Wells score of 6.0.]
• 7.1.2. [BREACH #2 — with citation to the medical record and timestamp.]
• 7.1.3. [BREACH #3.]

7.2. Each of these breaches represents a failure by Defendant [NAME] to act as a reasonably prudent [SPECIALTY] would have acted under the same or similar circumstances.

8. CAUSATION

8.1. To a reasonable degree of medical probability, each of the breaches identified in Section 7 was a substantial factor in bringing about, and was a but-for cause of, Plaintiff's injuries. The causal mechanism is as follows:

• 8.1.1. Had Defendant [NAME] [ORDERED THE INDICATED TEST / RECOGNIZED THE FINDING / ACTED WITHIN THE STANDARD TIME WINDOW], in reasonable medical probability [Plaintiff would have been diagnosed earlier / received timely intervention / avoided the complication].
• 8.1.2. Specifically, [describe the medical mechanism — e.g., earlier administration of tPA within the 4.5-hour window would, to a reasonable medical probability, have resulted in NIH Stroke Scale improvement of at least X points and avoided the dense hemiparesis that Plaintiff now has].
• 8.1.3. The intervening time between the breach and the injury was [TIMEFRAME], which is consistent with the natural progression of the underlying disease as documented in [LITERATURE CITATION].

8.2. Without this breach, in reasonable medical probability, the injuries described in Section 9 would not have occurred or would have been substantially less severe.

9. INJURY, HARM, AND DAMAGES

9.1. As a direct result of the breaches identified above, Plaintiff sustained:

• ☐ [Permanent neurologic deficit / loss of organ function / amputation / death];
• ☐ Need for additional surgeries or procedures, including [LIST];
• ☐ Prolonged hospitalization of [#] additional days;
• ☐ Permanent functional impairment, including inability to [ACTIVITY];
• ☐ Ongoing pain, mental anguish, and disfigurement;
• ☐ [OTHER INJURY].

9.2. These injuries are causally related to the breaches discussed above and would not have occurred but for those breaches.

10. OPINIONS STATED TO A REASONABLE DEGREE OF MEDICAL PROBABILITY

All opinions stated in this report are stated to a reasonable degree of medical probability based on my training, experience, review of the materials listed in Section 4, and review of the applicable medical literature and professional standards.

11. RESERVATION OF RIGHT TO SUPPLEMENT

The opinions expressed in this report are those formulated as of the date hereof and are based on the information presently available to me. I expressly reserve the right to supplement, modify, or amend these opinions as additional information — including additional medical records, deposition testimony, or expert input — becomes available, consistent with Tex. Civ. Prac. & Rem. Code § 74.351 and Tex. R. Civ. P. 195.

12. SIGNATURE

Signed this [____] day of [_______________], 20[____].

[________________________________]

[EXPERT FULL NAME], [DEGREE]

[TITLE / POSITION]

[INSTITUTION / PRACTICE]

[ADDRESS]

[CITY, STATE ZIP]

Telephone: [NUMBER]

Email: [EMAIL]

13. CURRICULUM VITAE OF EXPERT

CURRICULUM VITAE — [EXPERT NAME], [DEGREE]

Personal information

• Name: [EXPERT NAME]
• Office address: [ADDRESS]
• Telephone: [NUMBER]
• Email: [EMAIL]

Education

Licensure

Board certification

Hospital appointments and clinical positions

Academic appointments

Professional society memberships

• ☐ [Society 1] — [Year-Year]
• ☐ [Society 2] — [Year-Year]

Publications (selected)

• [Author], et al., "[Title]," [Journal] [Vol] ([Year]).
• [Additional publications.]

Presentations and continuing medical education

• [Title], [Venue], [Year].

Prior expert testimony

• [Case caption], [Court / Cause No.], [Year] — [Plaintiff / Defendant].

Honors and awards

• [Honor], [Institution], [Year].

14. SERVICE LETTER AND CERTIFICATE OF SERVICE

TRANSMITTAL LETTER

[LAW FIRM LETTERHEAD]

[DATE]

VIA E-SERVICE THROUGH eFileTexas / [email protected]

[DEFENSE COUNSEL NAME]

[FIRM NAME]

[ADDRESS]

Re: [STYLE OF CASE]; Cause No. [____]; In the [___] Judicial District Court of [COUNTY] County, Texas — Service of Chapter 74 Expert Report and Curriculum Vitae

Dear Counsel:

Pursuant to Tex. Civ. Prac. & Rem. Code § 74.351(a), enclosed please find the Expert Report of [EXPERT NAME], [DEGREE], dated [DATE], together with the curriculum vitae of the same expert, served on your client, [DEFENDANT NAME], this date. Service is made within 120 days after [DEFENDANT] filed its Original Answer on [DATE OF ANSWER].

Any objections to the sufficiency of the report must be served not later than the 21st day after the date of service in compliance with § 74.351(a).

Sincerely,

[________________________________]

[ATTORNEY NAME]

State Bar No. [####]

Counsel for Plaintiff

CERTIFICATE OF SERVICE

I certify that on [DATE], a true and correct copy of the foregoing Expert Report and Curriculum Vitae was served on all counsel of record by [e-service through eFileTexas / hand delivery / certified mail, return receipt requested] in accordance with Tex. R. Civ. P. 21a.

[________________________________]

[ATTORNEY NAME]

15. TEXAS PRACTICE NOTES

• No "certificate of merit." Texas does not have a separate certificate-of-merit affidavit comparable to those used in some sister states; § 74.351 is the operative gatekeeping mechanism for HCLCs. (Texas's separate certificate-of-merit statute, § 150.002, applies only to claims against licensed or registered design professionals — architects, engineers, surveyors, landscape architects — not to physicians.)
• 120-day clock. Runs from each defendant's original answer. Nonsuit and re-service do not restart the clock as to a previously-served defendant (Univ. of Tex. Health Sci. Ctr. v. Mata, 380 S.W.3d 96 (Tex. 2012) and progeny). Plead the answer date and serve well before day 120.
• "No report" vs. "deficient report." A report that does not address one of the three statutory elements (standard of care, breach, causation) as to a particular defendant is "no report at all" as to that defendant — no cure period available. Only reports that address all three elements but do so imperfectly are eligible for the 30-day cure under § 74.351(c) (Scoresby v. Santillan, 346 S.W.3d 546 (Tex. 2011)).
• Objection deadline. Defendant must serve objections to the sufficiency of the report not later than the 21st day after the report is served, or objections are waived. § 74.351(a). Identify objection deadlines on the docket.
• Each defendant separately. Reports must address each defendant's conduct individually. A report that lumps defendants together is inadequate (Bowie Mem'l Hosp. v. Wright, 79 S.W.3d 48 (Tex. 2002)).
• Vicarious liability. When the only theory against an entity is vicarious, the report addressing the agent's conduct typically suffices as to the principal (Gardner v. U.S. Imaging, Inc., 274 S.W.3d 669 (Tex. 2008)).
• Discovery stay. Until the report is served, only the limited discovery enumerated in § 74.351(s) is permitted (typically: medical records, billing records, witness statements, and depositions to authenticate medical records).
• Interlocutory appeal. Orders denying a motion to dismiss for inadequate report are immediately appealable under § 51.014(a)(9); orders granting one 30-day extension under § 74.351(c) are NOT (§ 51.014(a)(9), as amended).
• Inflation note. § 74.351 thresholds and procedures have been substantially unchanged since the 2003 House Bill 4 enactment and 2005 / 2013 amendments. Practitioners should monitor each legislative session at https://capitol.texas.gov for amendments.

16. SOURCES AND REFERENCES

• Tex. Civ. Prac. & Rem. Code § 74.351 — https://statutes.capitol.texas.gov/Docs/CP/htm/CP.74.htm
• Tex. Civ. Prac. & Rem. Code § 74.401 — https://statutes.capitol.texas.gov/Docs/CP/htm/CP.74.htm
• Tex. Civ. Prac. & Rem. Code § 74.402 — https://statutes.capitol.texas.gov/Docs/CP/htm/CP.74.htm
• Tex. Civ. Prac. & Rem. Code § 74.403 — https://statutes.capitol.texas.gov/Docs/CP/htm/CP.74.htm
• American Transitional Care Centers of Texas, Inc. v. Palacios, 46 S.W.3d 873 (Tex. 2001)
• Bowie Memorial Hospital v. Wright, 79 S.W.3d 48 (Tex. 2002)
• Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010)
• Scoresby v. Santillan, 346 S.W.3d 546 (Tex. 2011)
• Ogletree v. Matthews, 262 S.W.3d 316 (Tex. 2007)
• Gardner v. U.S. Imaging, Inc., 274 S.W.3d 669 (Tex. 2008)
• Univ. of Tex. Health Sci. Ctr. at Houston v. Mata, 380 S.W.3d 96 (Tex. 2012)
• Bohannan v. Winston, 238 S.W.3d 569 (Tex. App. — Houston [14th Dist.] 2007)
• Texas Rules of Civil Procedure — https://www.txcourts.gov/rules-forms/rules-standards/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Texas, working with the actual retained expert, must review and customize this report before service. The form of report shown is a structural framework only — substantive opinions must originate with a qualified expert who has personally reviewed the records and applied his or her clinical judgment. Statutes and case law change frequently; verify all authorities before relying on them.