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

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. 13-15-00024-CV
Regular Panel Decision
Jul 06, 2015

Maria Zamarripa, as Temporary Guardian of the Estates of R. F. R. and R. J. R., Minors, and Olga Flores, as Temporary Administrator of the Estate of Yolanda Iris Flores v. Bay Area Health Care Group, Ltd. D/B/A Corpus Christi Medical Center, Hidalgo County EMS, and Hidalgo County Emergency Medical Service Foundation

This case involves an appeal by Maria Zamarripa and Olga Flores (Appellants) against Bay Area Health Care Group, Hidalgo County EMS, and Hidalgo County Emergency Medical Service Foundation (Appellees). The Appellants are challenging the trial court's orders that granted the Appellees' motions to dismiss. The core of the appeal centers on the qualifications of Nurse Spears as an expert witness and the sufficiency of expert reports regarding the standard of care, its breach, and causation in a medical malpractice claim involving Yolanda Iris Flores's injuries and death from placenta accreta and pre-term labor. Appellants argue that Nurse Spears is qualified, the expert reports adequately connect CCMC's alleged breach of care to the injuries, and alternatively, they are entitled to amend the reports. They pray for the reversal of the trial court's dismissal orders and a remand for further proceedings.

Medical MalpracticePlacenta AccretaPre-term LaborMedical NegligenceStandard of CareCausationExpert Witness QualificationsHospital LiabilityEmergency Medical Services (EMS)Wrongful Death
References
16
Case No. MISSING
Regular Panel Decision

NYSA-ILA Medical & Clinical Services Fund Ex Rel. Capo v. Catucci

The NYSA-ILA Medical & Clinical Services Fund, an employee medical services fund, sued Sabato Catucci and his three sons for allegedly withholding payments from Saleo Trucking Corporation to the fund. This action followed a prior judgment against the corporation for delinquent contributions. The plaintiff sought to hold the defendants personally liable under alter ego, breach of ERISA fiduciary duty, and embezzlement theories. The court granted summary judgment to the plaintiff on the breach of ERISA fiduciary duty claim against Sabato Catucci, finding him to be a fiduciary who misused plan assets. However, claims against his sons were dismissed due to lack of sufficient control over the corporation. The alter ego claim against Sabato Catucci will proceed to trial, and the embezzlement claim was dismissed for not supporting a private civil cause of action.

ERISA Fiduciary DutyAlter Ego LiabilityCorporate Veil PiercingDelinquent ContributionsSummary JudgmentEmployee Benefit PlanMultiemployer FundSelf-DealingCorporate ControlLabor Law
References
32
Case No. 08-11-00264-CV
Regular Panel Decision
Oct 08, 2014

Maria G. Thompson/Luis Marioni, D.C. v. Jaime Stolar, M.D., Alivio Medical Center, Alivio Treatment Centers, P.A. and Luis Marioni, D.C./Maria G. Thompson

This multi-party appeal originated from a medical and chiropractic malpractice lawsuit filed by Maria G. Thompson against Dr. Jaime Stolar, Dr. Luis Marioni, and Alivio Medical Center and Alivio Treatment Centers, P.A. Thompson alleged negligence resulting in severe knee injuries, including infection and fusions, following injections and treatment. A jury found Dr. Stolar and Dr. Marioni negligent, awarding damages. On appeal, the court reversed the judgment against Dr. Marioni due to insufficient evidence of causation but affirmed the judgment against Dr. Stolar. The court also upheld the denial of Thompson's claims regarding damages and apparent agency against Alivio.

Medical MalpracticeChiropractic MalpracticeKnee InjuryKnee InfectionSpontaneous FusionSurgical FusionNegligenceCausationDamages AssessmentApparent Agency
References
48
Case No. 11-10-00306-CV
Regular Panel Decision
Aug 23, 2012

CareFlite v. Rural Hill Emergency Medical Services, Inc.

CareFlite initiated a lawsuit seeking a writ of mandamus to compel Rural Hill Emergency Medical Services, Inc. to disclose information under the Texas Public Information Act (TPIA). Rural Hill counterclaimed, requesting a declaratory judgment that it was not a governmental body subject to the TPIA. The trial court granted Rural Hill's motion for summary judgment and denied CareFlite's. On appeal, CareFlite challenged this ruling, arguing that Rural Hill was supported by public funds through non-arms-length contracts and provided services traditionally offered by governmental bodies. The Eleventh Court of Appeals affirmed the trial court's decision, concluding that the contractual relationships between Rural Hill and the cities constituted arms-length transactions, thereby exempting Rural Hill from the TPIA's "governmental body" definition. The court also upheld the propriety of Rural Hill's declaratory judgment counterclaim.

Texas Public Information ActGovernmental BodyPublic FundsArms-length TransactionDeclaratory JudgmentSummary JudgmentAppellate ReviewEmergency Medical ServicesNonprofit CorporationContract Law
References
21
Case No. 11-10-00235-CV
Regular Panel Decision
Jul 19, 2012

Craig Carpenter v. Southwest Medical Examination Services, Inc.

Craig Carpenter, an injured employee, sued Southwest Medical Examination Services, Inc., Liberty Insurance Corporation (workers' compensation carrier), and Dr. Stumhoffer for common-law bad faith, statutory bad faith, and fraud, stemming from alleged damages due to delayed benefit payments. The dispute arose after the initial designated doctor, Dr. Stumhoffer, whose administrative services were provided by Southwest, concluded Carpenter's knee surgery was for a preexisting condition. Following a Benefit Review Conference, a second designated doctor, Dr. Zeeck, determined the surgery was work-related, and Liberty subsequently approved benefits. The trial court granted Southwest's motion for partial summary judgment, which Carpenter challenged on appeal. The Eleventh Court of Appeals affirmed the summary judgment, citing the Texas Supreme Court's ruling in Texas Mutual Insurance Co. v. Ruttiger, which established that the Workers' Compensation Act provides the exclusive dispute procedures for such claims, thereby precluding common-law bad faith and other statutory claims against carriers and their affiliates. The court also noted Southwest's lack of a direct contractual relationship with Carpenter, likening its position to that of an independent adjuster.

Workers' Compensation LawSummary Judgment AffirmationAppellate ProcedureBad Faith Insurance ClaimFraud AllegationsTexas Labor CodeExclusive Statutory RemedyDesignated Doctor DisputeMedical Condition Pre-existingAdministrative Dispute Resolution
References
14
Case No. 2019-03-0154
Regular Panel Decision
Aug 01, 2019

Adams, Terry V. v. East Tennessee Personal Care Service, LLC

The employee, Terry V. Adams, was injured in a car accident while transporting a client for East Tennessee Personal Care Service (ETPCS). Despite reporting the accident and requesting medical attention due to a pre-existing condition, ETPCS significantly delayed authorizing treatment and paying her emergency room bills. Ms. Adams filed a Petition for Benefit Determination, arguing unreasonable delay. The Court found ETPCS failed to timely provide medical treatment and pay bills, referring the case for penalties and ultimately ordering ETPCS to provide ongoing medical treatment to Ms. Adams.

Medical BenefitsExpedited HearingDelayed TreatmentPenalty AssessmentCar AccidentPersonal AideEmployer LiabilityPre-existing ConditionMRIPhysical Therapy
References
2
Case No. 12-15-00014-CV
Regular Panel Decision
Jun 03, 2015

East Texas Medical Center D/B/A East Texas Medical Center Emergency Medical Services v. Jody Delaune Individually and as Personal Representative of the Estate of Crystal Delaune, and as Next Friend of D. D., D. D. and D. A. D., Minors

The appellant, East Texas Medical Center (ETMC), appeals a judgment finding it negligent for failing to train its EMS providers. The core issue revolves around whether ETMC adequately trained its employees on patient restraint protocols in a behavioral emergency, which allegedly led to the death of Crystal Delaune. ETMC argues that there is legally insufficient evidence to establish proximate cause because the EMS providers were previously found not negligent. Additionally, ETMC contends the appellee's expert testimony on the standard of care and breach was conclusory and based on improper inference-stacking. The appellant seeks a reversal of the verdict and a take-nothing judgment.

Negligent TrainingProximate CauseLegal Sufficiency of EvidenceStandard of CareEmergency Medical ServicesAppellate ReviewSummary JudgmentEmployee MisconductMedical Negligence DefenseExpert Witness Testimony
References
51
Case No. 2016-07-0264
Regular Panel Decision
Nov 18, 2016

Beene, Marshall v. Metro Services, Inc.

Marshall Beene, an employee of Metro Services, Inc., suffered an injury after falling from a ladder. Metro Services accepted compensability for right elbow, rotator cuff, and shoulder injuries, but challenged a cervical spine injury. The Court of Workers' Compensation Claims held an expedited hearing to address Mr. Beene's requests for additional medical benefits and temporary disability benefits. The court granted authorization for Mr. Beene to receive treatment from Dr. Gregory Ball for his compensable right-upper extremity injury and also awarded temporary partial disability benefits starting March 4, 2016. However, the request for authorized treatment by Dr. Todd Bonvallet for his cervical spine injury was denied, as medical evidence indicated it was not primarily work-related.

Workers' CompensationMedical BenefitsTemporary DisabilityExpedited HearingCervical Spine InjuryRight Elbow InjuryRotator Cuff InjuryComplex Regional Pain SyndromeMaximum Medical ImprovementAuthorized Treating Physician
References
4
Case No. No. CIV.A. G-96-441
Regular Panel Decision
Jan 12, 1998

Alcorn v. STERLING CHEM. INC. MED. BENEFITS PLAN

Plaintiffs, including Otis Alcorn (as next friend for Juanita Revels), Meditrust Financial Services, and New Medico Associates, sued Sterling Chemicals Incorporation Medical Benefits Plan for denied medical treatment claims under ERISA. Juanita Revels, after a severe head injury in 1986, received rehabilitation, but the Plan denied coverage for later treatments from 1990, deeming them not "medically necessary." Both parties moved for summary judgment. The court, applying an abuse-of-discretion standard, found that the Plan administrator acted reasonably and did not abuse its discretion in determining that the treatments were not medically necessary. This decision was based on multiple claim reviews and the opinions of several physicians. Consequently, the Court granted the Defendant's motion for summary judgment and dismissed all of the Plaintiffs' claims with prejudice.

ERISAEmployee BenefitsMedical NecessitySummary JudgmentAbuse of DiscretionPlan AdministratorFifth CircuitFactual DeterminationHealth InsuranceBenefit Denial
References
28
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