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

Case No. 02-23-00220-CV
Regular Panel Decision
Apr 17, 2025

Bianco Brain and Spine, PLLC and Nikhil Kanti Patel, M.D. v. Larry Jones and Shelley Jones

This case concerns a medical malpractice claim brought by Larry and Shelley Jones against Bianco Brain and Spine, PLLC and Dr. Nikhil Kanti Patel. Mr. Jones suffered a cauda equina injury during spine surgery performed by Dr. Patel. The jury found Dr. Patel negligent, and his negligence proximately caused Mr. Jones's injury. On appeal, Dr. Patel challenged the legal and factual sufficiency of the evidence. The Court affirmed the judgment against Dr. Patel, finding sufficient evidence to support the jury's finding that Dr. Patel's intraoperative surgical technique (removing existing hardware before stabilizing the L3-L4 junction) breached the standard of care and caused the injury. Bianco Brain and Spine, PLLC was sued under a theory of respondeat superior. The Court reversed the judgment imposing liability on Bianco, holding that the Joneses waived their independent ground of recovery for respondeat superior by failing to submit a jury question on this claim, and the evidence of Dr. Patel's employment status was not conclusive.

Medical MalpracticeMedical NegligenceSpine SurgeryCauda Equina InjuryRespondeat SuperiorVicarious LiabilityLegal SufficiencyFactual SufficiencyExpert TestimonyProximate Cause
References
87
Case No. 2021 NY Slip Op 03090
Regular Panel Decision
May 13, 2021

Matter of Ozoria v. Advantage Mgt. Assn.

Crucita Ozoria, a home health aide, was injured in September 2017 and filed a workers' compensation claim, which was established for back and neck injuries. After initial treatments, her physician referred her for surgery. An independent medical examination by Sidhwani concluded she no longer needed causally-related treatment, leading to a suspension of benefits by the WCLJ. A neurosurgeon, Ratzker, requested authorization for cervical spine surgery, which the carrier denied based on reports from Cash and Storrs. The WCLJ upheld the denial and found no further causally-related disability after November 7, 2018. The Workers' Compensation Board affirmed this decision. On appeal, the Appellate Division, Third Department, found that claimant was denied due process by not having the opportunity to cross-examine the carrier's consultants regarding the surgery denial, as this issue was not properly before the WCLJ at the initial hearing. The court modified the Board's decision by reversing the denial of the C-4 authorization request for surgery and remitted the matter for further proceedings to allow claimant to present evidence or cross-examine the consultants on this specific issue.

Workers' CompensationHome Health AideCervical SpineLumbar Disc HerniationMedical AuthorizationDue ProcessIndependent Medical ExaminationCausally-Related DisabilityCross-ExaminationProcedural Error
References
5
Case No. 14-04-00819-CV; 14-04-01103-CV
Regular Panel Decision
Sep 08, 2005

in Re: Universal Computer Consulting Holding, Inc.

Relators, Universal Computer Consulting Holding, Inc., Universal Computer Consulting, Ltd., and Dealer Computer Services, Inc., filed an appeal and a petition for writ of mandamus after the trial court denied their motion to compel arbitration against Hillcrest Ford Lincoln-Mercury, Inc. The dispute arose from two contracts between DCS and Hillcrest containing arbitration provisions. Hillcrest argued the provisions were unconscionable due to fraudulent inducement, a Michigan forum selection clause, limited remedies, a shortened statute of limitations, and potential prohibitive arbitration costs. The appellate court found that Hillcrest failed to prove either procedural or substantive unconscionability. Additionally, the court ruled that the non-signatories, UCCH and UCC, could compel arbitration under equitable estoppel because Hillcrest's allegations involved substantially interdependent and concerted misconduct by both the non-signatories and the signatory. Consequently, the appellate court conditionally granted the petition for writ of mandamus and dismissed the interlocutory appeal, instructing the trial court to vacate its order and compel arbitration.

ArbitrationMandamusInterlocutory AppealUnconscionabilityForum Selection ClauseChoice of LawStatute of LimitationsEquitable EstoppelNon-SignatoriesContract Law
References
31
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. 05-18-00394-CV
Regular Panel Decision
Aug 26, 2019

Quality Metrics Partners, LLC, Clearview Diagnostics, LLC, CGK Consulting, LLC, CGK Medical Management, LLC, CGK Medical Ventures, LLC, Brodie Flanders, Michael Morales, Michael Knall, Anthony Kim, and Christopher R. Peyton v. Greg Blasingame Capricia Larson Gabby Consulting, LLC And DX Power Moves Consulting, LLC

Appellants challenged the trial court’s denial of their consolidated motions to compel arbitration. The dispute involves a series of contractual relationships, including a Representative Marketing Agreement, an alleged oral contract, and a Distribution Agreement containing an arbitration provision. The Court determined that QMP and Clearview are intended third-party beneficiaries of the Distribution Agreement, extending the arbitration clause's benefits to their agents. Consequently, all direct claims against the QMP Appellants, as well as their related tort claims, fall within the broad scope of the arbitration provision. The Court reversed the trial court's order and remanded the case for all disputes between the parties to proceed to arbitration.

ArbitrationContract DisputeThird-Party BeneficiaryNon-Signatory ArbitrationScope of ArbitrationFraudulent InducementNegligent MisrepresentationTort ClaimsIndependent ContractorMarketing Services
References
13
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. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
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

Domino v. Professional Consulting, Inc.

Gregory Domino, a carpenter employed by Carlin Contracting Co., Inc., was injured while working on a Village of Mount Kisco water treatment facility, allegedly due to the installation of floor panels hoisted by a crane owned by Smedley Crane Service, Inc. He and his wife commenced an action for personal injuries against Professional Consulting, Inc. (PCI), the construction manager, and Smedley. The Supreme Court initially granted summary judgment to PCI, finding it was not a "contractor" or "owner" under Labor Law sections 240(1) or 241, nor liable under Labor Law section 200 or common-law negligence due to lack of supervisory authority. The appellate court affirmed this part of the decision, noting PCI's contracts expressly precluded it from supervising the work or safety procedures. However, the Supreme Court erred in granting summary judgment to Smedley, as Smedley failed to establish it lacked authority to control or supervise the crane's rigging activity, thus the appellate court reversed that portion of the decision.

Construction AccidentLabor LawSummary JudgmentReargumentConstruction Manager LiabilityCrane OperationWorker SafetyAgency LawStatutory LiabilityPremises Liability
References
12
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