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

Case No. 03-17-00352-CV
Regular Panel Decision
Aug 22, 2018

Vista Medical Center Hospital Vista Healthcare, Inc. And Surgery Specialty Hospital, Inc.// State Office of Risk Management v. State Office of Risk Management// Vista Medical Center Hospital Vista Healthcare, Inc. And Surgery Specialty Hospital, Inc.

This case involves cross-appeals stemming from a dispute over the appropriate reimbursement for medical services provided by Vista Medical Center Hospital and its affiliates to injured employees covered by the State Office of Risk Management (SORM) under Texas workers’ compensation statutes. The district court had affirmed 23 administrative orders that required SORM to make additional payments to Vista, a decision which SORM challenged on appeal citing insufficient evidence. Vista, in turn, cross-appealed the district court's denial of prejudgment interest. The appellate court found substantial evidence supported the administrative law judges' conclusion that SORM's original reimbursement model was unfair and unreasonable, and that Vista's proposed methodology was valid. Consequently, the court affirmed the district court's judgment but modified it to include the prejudgment interest that Vista was statutorily entitled to.

Workers' CompensationMedical ReimbursementAdministrative LawAppellate ReviewSubstantial EvidencePrejudgment InterestTexas LawHealthcare ProvidersInsurance DisputesFee Guidelines
References
23
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. 14-07-00925-CV
Regular Panel Decision
Feb 24, 2009

Latoya Basey v. Davita Inc., D/B/A Total Renal Care, Nelda Boatwright and Fresenius Medical Care Holding Inc., D/B/A Fresenius Medical Care North America D/B/A Northwest Houston Dialysis, and Biomedical Applications of Texas, Inc.

Latoya Basey appealed a take-nothing summary judgment in a disability discrimination and tort case against her former employer, DaVita, Inc., and potential employer, Fresenius Medical Care Holding, Inc. Basey claimed DaVita fired her after a work-related back injury and that Fresenius refused to hire her due to her injury and prior discrimination charge. The trial court granted summary judgment without specifying grounds. The appellate court affirmed, finding Basey failed to provide evidence of disability for her discrimination and failure-to-accommodate claims, and lacked evidence of causation for her retaliation claims.

Disability DiscriminationRetaliationSummary JudgmentWorkers' CompensationEmployment LawCausal LinkTexas Court of AppealsADAFailure to AccommodateEmployment Termination
References
11
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. 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. 03-18-00232-CV
Regular Panel Decision
Aug 28, 2018

Joseph Cotropia M.D. v. Texas Medical Board and in His Official Capacity Only, Sherif Zaafran, President of the Texas Medical Board

Appellant Joseph Cotropia, M.D., challenged the Texas Medical Board's revocation of his license to practice medicine. The Board's decision stemmed from his failure to adequately supervise advanced practice nurses at two pain management clinics, resulting in substandard patient care and operation of an uncertified clinic. Dr. Cotropia argued against being held strictly liable for the APNs' actions, the clinic's certification status, the admissibility of expert testimony, and alleged due process violations. The appeals court reviewed the Board's findings under a substantial-evidence standard. Ultimately, the court found no error in the district court's judgment and affirmed the revocation of his license.

Medical License RevocationPhysician SupervisionAdvanced Practice NursesPain Management ClinicStandard of CareMedical Practice ActAdministrative LawDue ProcessExpert TestimonyTexas Medical Board
References
15
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. 2016-02-0027
Regular Panel Decision
Mar 09, 2016

Gray, Kimberly v. Fresenius Medical Care

Kimberly Gray, an employee, sought an expedited hearing regarding her entitlement to medical treatment and a second opinion for her right elbow injury sustained while working for Fresenius Medical Care. She had been treating with Dr. Michael Bratton, who placed her at maximum medical improvement (MMI) on August 17, 2015, and determined a 1% permanent partial impairment. Ms. Gray requested a second opinion due to continued pain, but Fresenius Medical Care refused, stating there was no statutory basis requiring them to provide it without a physician's referral. The Court found that Ms. Gray was not entitled to the requested relief as she did not present sufficient evidence to likely prevail at a hearing on the merits, and her request for additional medical benefits was denied.

Workers' CompensationExpedited HearingMedical BenefitsSecond OpinionMMIPermanent Partial ImpairmentRight Elbow InjuryOrthopedic SurgeonStatutory InterpretationBurden of Proof
References
3
Case No. 11-06-00145-CV
Regular Panel Decision
Nov 08, 2007

Hendrick Medical Center v. Amanda Burns Smith

The case concerns an on-the-job electrical shock injury sustained by Amanda Burns Smith, an employee of Hendrick Medical Center, a nonsubscriber to workers' compensation insurance. Smith sued Hendrick for negligence, alleging failure to provide a safe workplace and proper equipment, among other claims. A jury found in Smith's favor, but Hendrick appealed the verdict, challenging the legal and factual sufficiency of the evidence for negligence. The Eleventh Court of Appeals determined that the evidence was legally insufficient to support the jury's finding of negligence. Consequently, the appellate court reversed the trial court's judgment, rendering a decision that Smith take nothing from her claims against Hendrick Medical Center.

NegligenceEmployer LiabilitySafe Workplace DutyElectrical Shock InjuryWorkers' Compensation NonsubscriberLegal Sufficiency of EvidenceAppellate ReviewPremises LiabilityDuty to WarnCommon Knowledge Risk
References
14
Case No. MISSING
Regular Panel Decision

Queens Blvd. Medical, P.C. v. Travelers Indemnity Co.

The plaintiff, Queens Blvd. Medical, P.C., sought $950 in first-party no-fault benefits for biofeedback medical services provided to its assignor for lower back and chronic pain syndrome. The central issue at trial was the medical necessity of these services under Insurance Law § 5102 (a) (1). The plaintiff established a prima facie case with expert testimony from a board-certified neurologist affirming the medical appropriateness of biofeedback. The defendant insurance company failed to present admissible evidence to disprove medical necessity, as its expert was deemed incompetent to testify on biofeedback for back pain. Consequently, the court granted the plaintiff's motion for a directed verdict, awarding judgment for $950 along with statutory costs, interest, and attorney's fees.

No-fault benefitsMedical necessityBiofeedback treatmentExpert testimonyDirected verdictInsurance lawChronic pain syndromeBack injuryCPT codesBurden of proof
References
9
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