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

Case No. 04-09-00148-CV
Regular Panel Decision
Dec 09, 2009

Central Texas Orthopedic Products, Inc. v. Andrew Espinoza and Howmedica Osteronics Corp. D/B/A Stryker Orthopedics

Central Texas Orthopedic Products, Inc. (CTOP) sued Andrew Espinoza for breach of contract and fiduciary duty, and Howmedica Osteonics Corp. d/b/a Stryker Orthopedics (Stryker) for tortious interference. The trial court granted partial summary judgment for Espinoza and Stryker, and a jury found Espinoza breached fiduciary duty but awarded no damages. On appeal, CTOP challenged the summary judgments and attorney's fees awarded to Espinoza. The appellate court found the trial court erred in applying the unclean hands doctrine to CTOP's claims as the alleged misconduct was separate from the disputed contract. The court also found a genuine issue of material fact regarding Espinoza's entitlement to compensation due to his alleged breach of fiduciary duty. Therefore, the appellate court reversed the trial court's judgment and remanded the case for further proceedings.

Breach of ContractBreach of Fiduciary DutyTortious InterferenceSummary JudgmentUnclean Hands DoctrineNon-Compete AgreementCompensation AgreementTexas Payday ActAppellate ReviewReversed and Remanded
References
15
Case No. MISSING
Regular Panel Decision

Fernandez v. North Shore Orthopedic Surgery & Sports Medicine, P.C.

Frank Fernandez, an x-ray technician, sued his former employer, North Shore Orthopedic Surgery & Sports Medicine, P.C., for retaliation under Title VII after filing a national origin discrimination complaint. A jury found in favor of Fernandez, awarding back pay, front pay, and punitive damages. North Shore subsequently moved for judgment as a matter of law, a new trial, and to modify the damage awards. The court denied North Shore's motions for judgment and a new trial, affirmed the jury's back pay award, but vacated and reduced the front pay award from $160,000 to $50,000, and the punitive damages award from $100,000 to $50,000.

RetaliationTitle VIIEmployment DiscriminationBack PayFront PayPunitive DamagesMitigation of DamagesFederal Rules of Civil ProcedureJudicial DiscretionEquitable Relief
References
27
Case No. 03-03-00435-CV
Regular Panel Decision
Jul 29, 2004

Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission/East Side Surgical Center Clinic for Special Surgery And Surgical and Diagnostic Center, L.P. v. East Side Surgical Center Clinic for Special Surgery/Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission

This case involves the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center, Clinic for Special Surgery, and intervenor Surgical and Diagnostic Center, L.P. (collectively "East Side") sued the Commission to invalidate certain default rules that applied when specific guidelines were absent. The district court declared one rule (133.304(i)) invalid and enjoined its enforcement, citing unlawful delegation of authority. On appeal, the Court of Appeals reversed the district court's judgment regarding the rule's invalidity and dissolved the injunction, citing a Texas Supreme Court decision finding no unlawful delegation. The court affirmed that East Side was not entitled to its usual and customary fee in the absence of specific guidelines.

Workers' CompensationAdministrative LawDelegation of AuthorityRulemakingAmbulatory Surgical CentersJudicial ReviewInsurance CarrierFee GuidelinesFair and Reasonable RatesStatutory Interpretation
References
38
Case No. ADJ11913752
Regular
Nov 19, 2019

LAURA DOW vs. UCSF, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns a dispute over the proper procedure for requesting a Qualified Medical Evaluator (QME) panel after a workers' compensation claim was denied. The Workers' Compensation Appeals Board (WCAB) granted removal, reversing a WCJ's decision. The WCAB found that the defendant's request for an orthopedic surgery QME panel was valid, initiated after the denial notice and statutory waiting period. They also determined that orthopedic surgery was an appropriate specialty, overriding the WCJ's order for a pain medicine panel. The parties are now directed to proceed with the orthopedic surgery QME panel.

QME panelPetition for RemovalOpinion and OrderFindings and OrdersMedical UnitPain MedicineOrthopedic SurgeryDenial NoticeQualified Medical EvaluatorLabor Code Section 4060
References
4
Case No. 08-06-00071-CV
Regular Panel Decision
Aug 30, 2007

Vincent Maes and Cynthia Maes and the Insurance Company of the State of Pennsylvania v. El Paso Orthopaedic Surgery Group

Vincent and Cynthia Maes and The Insurance Company of the State of Pennsylvania appealed the dismissal of a health care liability suit against El Paso Orthopaedic Surgery Group (EPOSG). The Maeses alleged negligence and vicarious liability against EPOSG after Vincent Maes suffered severe complications following back surgery by Dr. Paul Cho, an EPOSG neurosurgeon. The trial court dismissed all claims against EPOSG, finding the expert reports insufficient to address EPOSG's breach of the standard of care, even for vicarious liability claims. On appeal, the Court reviewed whether an expert report was necessary for vicarious liability claims and if the severance of claims against EPOSG was proper. The appellate court ultimately affirmed the trial court's judgment, upholding the dismissal of all claims against EPOSG and the severance.

Health Care LiabilityMedical MalpracticeExpert Report SufficiencyVicarious LiabilityRespondeat SuperiorDismissal with PrejudiceSeverance of ClaimsSpinal Surgery ComplicationsNeuroscienceOrthopedic Surgery Group Liability
References
17
Case No. MISSING
Regular Panel Decision

Maes ex rel. Maes v. El Paso Orthopaedic Surgery Group, P.A.

Vincent and Cynthia Maes, as next friend of their minor daughter Isabel, and The Insurance Company of the State of Pennsylvania (ICTSP), appealed a summary judgment granted in favor of El Paso Orthopaedic Surgery Group, P.A. (EPOSG). Isabel's claim was for loss of parental consortium due to her father Vincent Maes's alleged disabling injury following surgery performed by an EPOSG employee, Dr. Paul Cho, in 2001. Vincent Maes's initial lawsuit against EPOSG was dismissed with prejudice in 2004, and the two-year statute of limitations for his underlying claim expired in 2003. EPOSG moved for summary judgment, arguing Isabel's claims were time-barred and barred by the prior dismissal of her father's underlying claim. The appellate court affirmed the summary judgment, concluding that Isabel's derivative loss of parental consortium claims were extinguished by both the running of the statute of limitations on her father's claim and its prior dismissal with prejudice.

medical malpracticeloss of parental consortiumstatute of limitationssummary judgmentderivative claimshealthcare liabilityminor's claimsprior litigationdismissal with prejudiceTexas Civil Practice and Remedies Code
References
26
Case No. 08-11-00331-CV
Regular Panel Decision
Oct 31, 2012

Vincent Maes and Cynthia Maes, as Next Friend of Isabel G. Maes, a Minor Child and the Insurance Company of the State of Pennsylvania v. El Paso Orthopaedic Surgery Group, P. A.

Vincent Maes sustained a spinal injury in 2000 from a motor vehicle accident, leading to a lumbar laminectomy in 2001 by Dr. Paul Cho, an employee of El Paso Orthopaedic Surgery Group, P.A. (EPOSG). Following the surgery, Mr. Maes allegedly experienced severe neurological issues. In 2010, Vincent and Cynthia Maes, acting as next friend for their minor daughter Isabel, along with The Insurance Company of the State of Pennsylvania (ICTSP), filed a lawsuit against EPOSG, asserting claims for Isabel's loss of parental consortium and alleging vicarious liability for Dr. Cho's negligence. EPOSG sought summary judgment, contending that Isabel's claims were time-barred by the two-year statute of limitations applicable to Mr. Maes's original claim and also by the prior dismissal of Mr. Maes's claim with prejudice in 2004. The trial court granted summary judgment in favor of EPOSG. The appellate court affirmed the trial court's decision, ruling that claims for loss of parental consortium are derivative in nature and are consequently extinguished when the statute of limitations on the injured parent's underlying claim expires or when that underlying claim is dismissed with prejudice.

Medical MalpracticeParental ConsortiumSummary JudgmentStatute of LimitationsDerivative ClaimsDismissal with PrejudiceTexas Civil Practice and Remedies CodeHealth Care LiabilityMinor's ClaimsAppellate Review
References
28
Case No. MISSING
Regular Panel Decision

Lawliss v. Quellman

Plaintiff sustained a right shoulder injury at work, leading his orthopedic specialist to recommend immediate surgery for a ruptured biceps. However, his employer's workers' compensation carrier disputed the need for surgery and mandated an independent medical examination (IME) by the defendant, an orthopedic specialist. The defendant reported to the carrier that surgery was unnecessary, advocating physical therapy instead. This advice resulted in the carrier denying surgery, and the plaintiff's subsequent physical therapy proved ineffective, as did delayed surgery, allegedly causing an 80% loss of shoulder use. Consequently, plaintiff initiated a medical malpractice action against the defendant, asserting that the negligent advice given during the IME caused the detrimental delay in his treatment. The Supreme Court denied the defendant's motion for summary judgment, a decision which the appellate court affirmed, citing the presence of factual questions regarding an implied physician-patient relationship, negligence, and foreseeable reliance.

medical malpracticeindependent medical examinationphysician-patient relationshipsummary judgmentworkers' compensationappellate decisionorthopedic injurynegligent advicedelayed surgeryloss of use
References
10
Case No. ADJ11861160
Regular
Oct 25, 2019

ADRIANA MARTINEZ vs. AVITUS, AMERICAN ZURICH INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case involves a dispute over the selection of Qualified Medical Evaluator (QME) panels for an applicant with claimed injuries to multiple body parts. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for removal, rescinded the prior decision, and found that the applicant's chiropractic QME panel request was proper while the defendant's orthopedic surgery panel request was improper. The WCAB determined that chiropractic medicine is the appropriate specialty and struck the orthopedic surgery panel, ordering the parties to proceed with the chiropractic QME. The WCAB clarified that while chiropractors cannot perform surgery or prescribe medication, they are qualified to evaluate injuries within their scope of practice.

QME panel disputeremoval petitionchiropractic specialtyorthopedic surgery specialtyLabor Code 4062.2Medical Directoradministrative law judgeWorkers' Compensation Appeals Boardproper panel selectioninvalid panel request
References
9
Case No. MISSING
Regular Panel Decision

Hawkins v. Center for Spinal Surgery

Demica Hawkins, a Black former Accounts Payable Coordinator, sued her employer, The Center for Spinal Surgery (CSS), alleging race discrimination, retaliation, and FMLA interference. The lawsuit stemmed from denied pay raises, disciplinary actions, and ultimately her termination while on pregnancy leave, which Hawkins claims was discriminatory and retaliatory. CSS filed a renewed motion for summary judgment, and Hawkins filed a partial motion for summary judgment. The court granted in part and denied in part CSS's motion, dismissing Hawkins' pregnancy discrimination and certain retaliation claims. However, Hawkins' retaliatory discharge and FMLA interference claims related to her 2013 termination will proceed to trial due to genuine disputes of material fact regarding CSS's motivations.

Race DiscriminationRetaliationFMLA InterferenceSummary JudgmentEmployment LawTitle VIIPregnancy Discrimination ActMcDonnell Douglas FrameworkHonest Belief RulePretext
References
64
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