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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 03-17-00357-CV
Regular Panel Decision
Nov 21, 2017

George Allibone, M.D. v. Scott Freshour, in His Official Capacity as the Interim Executive Director of the Texas Medical Board Juanita Garner, Investigator of the Texas Medical Board And the Texas Medical Board

George Allibone, M.D., appealed the denial of his petition for a protective order against an administrative subpoena issued by the Texas Medical Board. The subpoena sought patient medical and billing records for an investigation into complaints against Allibone. He contended the trial court erred by failing to issue findings of fact and conclusions of law and by abusing its discretion in finding the subpoena reasonable and relevant. The appellate court found Allibone waived his complaint regarding missing findings. It also concluded the trial court did not abuse its discretion, citing the Board's need for complete records for investigation and Allibone's failure to prove the unconstitutionality of the statute requiring compliance. The trial court's order was affirmed.

Medical Board InvestigationAdministrative SubpoenaPhysician RecordsConstitutional RightsDue ProcessJudicial Review of Agency ActionAbuse of DiscretionFourth AmendmentTexas LawProfessional Licensing
References
50
Case No. MISSING
Regular Panel Decision

Yklik Medical Supply, Inc. v. Allstate Insurance

Plaintiff Yklik Medical Supply, Inc., a medical supply provider, sued Allstate Insurance Company to recover $317 in unpaid medical bills for equipment supplied to its assignor, Tammy Agosto. Yklik moved for summary judgment, asserting proper bill submission and Allstate's failure to timely pay or deny the claim. Allstate argued that the charges exceeded the Workers' Compensation fee schedule and that a partial payment had been made. The court found that Yklik established a prima facie case. The central issue was whether Allstate's fee schedule defense was precluded due to its failure to issue a timely denial within 30 days as mandated by Insurance Law § 5106 (a) and 11 NYCRR 65-3.5. The court ruled that since Allstate waited 56 days to send its denial, it was precluded from raising the fee schedule defense, and therefore, summary judgment was granted to the plaintiff.

No-fault insurancesummary judgmenttimely denialfee schedulepreclusion ruleinsurance lawmedical supplybilling practicespersonal injury protectionassignor
References
19
Case No. 2-06-016-CV
Regular Panel Decision
Mar 15, 2007

Shioleno Industries, Inc. AND Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC D/B/A Medical Center of Arlington v. Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC D/B/A Medical Center of Arlington AND Shioleno Industries, Inc.

Shioleno Industries, Inc. appealed a summary judgment granted in favor of Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC d/b/a Medical Center of Arlington (the Hospital). The case originated from the Hospital's alleged failure to disclose an employee's positive drug and alcohol test results to Shioleno after an on-the-job injury. Shioleno contended that this omission led to increased workers' compensation premiums and expenses in unemployment benefit disputes. The appellate court affirmed the trial court's judgment, ruling that Shioleno failed to provide a valid authorization for the disclosure of medical information. Consequently, the Hospital had no legal duty to disclose the results and could not be held liable for negligence, breach of contract, or Deceptive Trade Practices Act (DTPA) violations.

Summary JudgmentMedical RecordsDisclosure AuthorizationHealth & Safety CodeNegligenceBreach of ContractDTPADrug TestingAlcohol TestingEmployer Liability
References
13
Case No. 02-22-00072-CV
Regular Panel Decision
Jul 27, 2023

BioTE Medical, LLC v. John Carrozzella, MD, JCMD Medical Services, Inc., Dan Deneui, and Terri Deneui

This case addresses whether a contractual "residual benefit" clause, requiring a post-termination fee for using a competing treatment method, constitutes a covenant not to compete under Texas law. Appellant BioTE Medical, LLC, licensed a pellet-based bioidentical hormone replacement therapy (BHRT) method. Appellee JCMD Medical Services, Inc., a former customer, terminated its agreement and began using a competitor's BHRT without paying the residual-benefit fee. BioTE Medical sued JCMD for breach of contract. The trial court granted summary judgment to JCMD, finding the clause unenforceable either as a noncompete or a violation of public policy. The appellate court reversed, holding that the residual-benefit clause is not a covenant not to compete as it does not restrict JCMD from competing with BioTE Medical, but rather from using a competitor's product. The court also declined to invalidate the clause on uncodified public policy grounds, deferring to the Legislature's policy determinations.

Contract lawCovenants Not to Compete ActResidual benefit clausePublic policyBioidentical hormone replacement therapy (BHRT)Breach of contractSummary judgmentAppellate reviewTexas lawBusiness and Commerce Code
References
33
Case No. MISSING
Regular Panel Decision
Mar 09, 2001

Convenient Medical Care, P.C. v. Medical Business Associates, Inc.

Plaintiff, a professional medical corporation, entered into a billing services contract with defendant, a medical billing service provider, in early 1997. The agreement was terminated by plaintiff in 1998 due to alleged failures by the defendant in timely billing worker's compensation patients and delays in returning billing records. Defendant subsequently moved for summary judgment on its counterclaims for breach of contract and an account stated, which the Supreme Court denied. On appeal, the appellate court modified the lower court's order, reversing the denial of summary judgment for defendant's breach of contract counterclaim and granting summary judgment to the defendant on the issue of liability. The court found plaintiff's arguments and evidence insufficient to defeat the defendant's prima facie showing for summary judgment, but denied summary judgment for an account stated due to discrepancies in claimed amounts.

Breach of ContractSummary JudgmentMedical Billing ServicesNegligenceCounterclaimsAppellate ReviewContract TerminationWorker's Compensation PatientsEvidentiary ProofMerger Clause
References
10
Case No. MISSING
Regular Panel Decision
Feb 03, 1992

Medical Designs, Inc. v. Medical Technology, Inc.

This case involves a patent infringement lawsuit filed by Medical Designs, Inc. (MDI) against Medical Technology, Inc. (MTI) and Gary Bledsoe, asserting infringement of two patents: U.S. Patent No. 4,407,276 and U.S. Patent Des. 269,379. The defendants counterclaimed, arguing patent invalidity and unenforceability. The court found that claims 1-7 of the ’276 patent were anticipated under 35 U.S.C. § 102 by prior art, and claims 1-8 were obvious under 35 U.S.C. § 103. Furthermore, the entire ’276 patent was deemed unenforceable due to inequitable conduct by MDI's patent attorney for intentionally omitting material prior art from the Patent and Trademark Office. While the ’379 design patent was found valid and enforceable, MDI failed to prove infringement. Consequently, the court awarded attorneys' fees and damages to MTI and Bledsoe against MDI and Floyd Hutson.

Patent infringementUtility patentDesign patentPatent invalidityPatent unenforceabilityPrior artObviousnessAnticipationInequitable conductAttorney's fees
References
20
Case No. 03-03-00381-CV
Regular Panel Decision
Aug 12, 2004

Robert S. Howell, D.C. First Rio Valley Medical, P.A. Keith Gilbert William Maxwell And Gilbert & Maxwell, P.L.L.C. v. Texas Workers' Compensation Commission Envoy Medical Systems, L.L.C. Texas Mutual Insurance Company State Office of Risk Management and Continental Casualty Insurance Company

This case addresses whether a healthcare provider must exhaust administrative remedies within the workers' compensation system before pursuing payment disputes in court, and the district court's jurisdiction to issue an anti-suit injunction. Appellants, including Robert S. Howell, D.C., and First Rio Valley Medical, P.A., challenged the constitutionality of IRO fees and an injunction preventing them from filing numerous billing dispute lawsuits in Cameron County. The Court of Appeals affirmed that administrative remedies must be exhausted and upheld the constitutionality of the IRO fees. It also upheld the anti-suit injunction to prevent vexatious litigation. The court reversed and remanded the $13,000 sanctions against the law firm in part for recalculation, but affirmed the $3,200 sua sponte sanctions.

Administrative RemediesExhaustion DoctrineWorkers' CompensationMedical Payment DisputesIRO FeesDeclaratory JudgmentAnti-Suit InjunctionVexatious LitigationSanctionsJury Trial Right
References
115
Case No. 13-09-00350-CV
Regular Panel Decision
Jan 21, 2010

Gulf Coast Medical Center, LLC, Tony Todd, Crna, Dan Madsen, M.D. and South Texas Medical Clinics, P.A. v. Jacqueline Temple and Marcus Banks, Individually and as Representatives of the Estate of Markasia Banks, a Minor Child

Appellants, Gulf Coast Medical Center, LLC, Tony Todd, CRNA, Dan Madsen, M.D., and South Texas Medical Clinics, P.A., appealed the trial court's denial of their motions to dismiss. The underlying suit was filed by appellees Jacqueline Temple and Marcus Banks, alleging negligence in the care and treatment of their deceased minor child, Markasia Banks. The core issue on appeal was the appellees' failure to timely serve an expert medical report as required by the Texas Civil Practice and Remedies Code. The Court of Appeals determined that the appellees' claims were 'health care liability claims' and that the expert report was indeed untimely, and that an abatement due to a failure to provide medical authorization did not extend the deadline. The court also affirmed the constitutionality of the expert report requirement. Consequently, the appellate court reversed the trial court's judgment, granted the appellants' motions to dismiss, and remanded the case for the award of attorney's fees and costs to the appellants.

Health Care Liability ClaimExpert Medical ReportMotion to DismissTimeliness of ReportAbatementMedical MalpracticeNegligenceDue ProcessTexas ConstitutionAppellate Review
References
32
Case No. 03-05-00032-CV
Regular Panel Decision
May 04, 2007

Board of Medical Examiners for the State of Texas and Donald W. Patrick, M.D., J.D., as Executive Director of the Board of Medical Examiners for the State of Texas v. Vivian Adaobi O. Nzedu, M.D.

The Texas State Board of Medical Examiners denied Dr. Vivian Nzedu's medical license application, citing her failure to pass the USMLE within the statutorily permitted attempts. The Board included an examination attempt made prior to the effective date of the 'three-attempts statute' (September 1, 1993). The trial court initially sided with Dr. Nzedu, ruling that pre-1993 attempts should not be counted. However, the appellate court reversed this decision, concluding that counting pre-statute examination attempts is not an unconstitutional retroactive application of the Medical Practice Act, as it merely draws upon antecedent facts and does not impair a vested right. The court deferred to the Board's reasonable interpretation of the statute. The case was remanded for a determination of attorneys' fees.

Medical LicensingUSMLEStatutory InterpretationRetroactivityVested RightsAdministrative LawTexas Medical Practice ActPhysician LicensureExamination RequirementsAppellate Review
References
24
Case No. 2016-08-1486
Regular Panel Decision
Nov 30, 2018

Nance, Amy v. JCSD Emergency Medical Group d/b/a Medic One Response

Ms. Nance, an emergency medical technician, injured her left upper extremity while moving a patient. After conservative treatment, she was diagnosed with cubital tunnel syndrome and later recommended for a cervical spine evaluation by Dr. Cole. Medic One denied the requested benefits, claiming misrepresentation and non-work-related activity. The Court found Ms. Nance likely to prevail for medical benefits, ordering Medic One to authorize a cervical spine evaluation and allow her to select a specialist. However, Ms. Nance was not found eligible for temporary disability benefits due to insufficient medical proof of disability.

Workers' CompensationMedical BenefitsTemporary Disability BenefitsCubital Tunnel SyndromeCervical Spine EvaluationMedical MisrepresentationCausal ConnectionExpedited HearingPermanent ImpairmentTreating Physician
References
3
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