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Case Law Database

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. ADJ11255525
Regular
Dec 02, 2019

GWENDOLYN JOHNIGAN vs. UC DAVIS MEDICAL CENTER

This case involves an applicant denied workers' compensation benefits for industrial injury to her right leg and knee, with the Workers' Compensation Appeals Board (WCAB) denying her petition for reconsideration. The WCAB adopted the administrative law judge's finding that the applicant did not sustain industrial injury, relying on a panel qualified medical evaluator's opinion that the work duties were insufficient to cause an injury. The applicant argued the medical evidence was not substantial and sought further development of the record. However, the WCAB found the applicant failed to meet her burden of proof with substantial medical evidence. A dissenting opinion argued the medical evidence was insubstantial and required further development.

Petition for ReconsiderationPanel Qualified Medical EvaluatorOrthopedistSubstantial Medical EvidenceFurther DevelopmentSupplemental ReportingDeposition TestimonyIndustrial InjuryRight LegRight Knee
References
4
Case No. 03-19-00770-CV
Regular Panel Decision
Jun 11, 2021

Robert Charles Lowry, M.D.// Cross Texas Medical Board v. Texas Medical Board// Cross-Appellee, Robert Charles Lowry, M.D.

This Texas Court of Appeals memorandum opinion concerns a disciplinary action by the Texas Medical Board against Dr. Robert C. Lowry. Dr. Lowry appealed the trial court's judgment affirming in part and reversing in part the Board's order, while the Board cross-appealed portions of the reversal. The core issues involved whether Dr. Lowry unlawfully associated with and employed a physician, Dr. Dennis Barson, whose license was suspended, for EEG interpretations, and alleged violations of professional medical standards and recordkeeping. The Court found substantial evidence supported that Dr. Barson was practicing medicine, and that Dr. Lowry associated with and employed him. It also found substantial evidence for Dr. Lowry's failure to maintain professional standards regarding a patient's pain management and an unsigned EEG report, and for a recordkeeping violation concerning a missing plan of care. However, the court affirmed the trial court's reversal of findings related to a missing medication list, requiring expert testimony not presented. The judgment was affirmed in part, reversed in part, and remanded to the Board for further proceedings consistent with the opinion.

Medical MalpracticeProfessional DisciplineTexas Medical BoardPhysician License SuspensionEEG InterpretationMedical Practice ActStandard of CareRecordkeeping ViolationsAppellate ReviewAdministrative Law
References
35
Case No. ADJ8734628 ADJ9086734
Regular
Aug 12, 2016

PATRICIA CRUZ MALDONADO vs. WHITE MEMORIAL MEDICAL CENTER, ADVENTIST HEALTH

This case involves White Memorial Medical Center's petition for reconsideration of a Joint Findings and Award finding that applicant Patricia Cruz Maldonado sustained lumbar spine injuries arising out of and occurring in the course of employment as a registered nurse. The defendant argued the findings were erroneous due to alleged inconsistencies in applicant's testimony and a lack of substantial medical evidence for a cumulative injury. The Workers' Compensation Appeals Board denied the petition, upholding the Administrative Law Judge's credibility determinations and finding substantial medical evidence, specifically from Dr. Edwin Haronian, supporting the cumulative trauma injury. The Board emphasized that the WCJ observed the witness and considered all admitted evidence, and that deposition testimony not offered into evidence could not be relied upon.

WCABPetition for ReconsiderationJoint Findings and AwardWCJcredibility determinationsubstantial medical evidencecumulative traumalumbar spineregistered nurseprimary treating physician
References
5
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. 03-07-00558-CV
Regular Panel Decision
Mar 12, 2009

John Bruce Payne, D.O. v. Texas State Board of Medical Examiners

John Bruce Payne, D.O., appealed a district court judgment affirming the Texas Medical Board's order revoking his medical license. The Board's disciplinary action stemmed from Payne's treatment of patient J.F., specifically allegations of performing unnecessary surgery, over-medication, and inadequate post-operative care arrangements. An administrative law judge (ALJ) found Payne violated several provisions of the Medical Practice Act, leading to the recommendation of license revocation. The district court affirmed the Board's decision, and the Court of Appeals, reviewing under the substantial evidence standard, upheld the district court's judgment. Consequently, the revocation of Payne's medical license was affirmed.

Medical License RevocationProfessional MisconductNegligent Medical CareAdministrative LawSubstantial Evidence ReviewDue ProcessPhysician DisciplineTexas Medical BoardNeurosurgeryPost-operative Care
References
16
Case No. ADJ9556841
Regular
Aug 15, 2016

SOFIA RIOS vs. TULARE REGIONAL MEDICAL CENTER, ALPHA FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of an award to Sofia Rios. The Board found that the Qualified Medical Evaluator did not engage in ex parte communication by sending a questionnaire and that his reports constituted substantial medical evidence. The employer's arguments that the doctor relied on personal anecdotes and an inaccurate assessment of lift team availability were rejected. The Board affirmed the original award based on the substantial evidence in the medical reports.

Workers' Compensation Appeals BoardPetition for ReconsiderationPanel Qualified Medical EvaluatorEx Parte CommunicationSubstantial Medical EvidenceLabor Code Section 5909TollingReasonable Medical ProbabilityInadequate Medical HistoriesCausation Analysis
References
5
Case No. M2010-01582-COA-R3-CV
Regular Panel Decision
Oct 21, 2011

Kevin Cox, D.V.M. v. Tennessee Board of Veterinary Medical Examiners

Kevin Cox, a licensed veterinarian, appealed an administrative decision by the Tennessee Board of Veterinary Medical Examiners. The Board sanctioned Dr. Cox for improperly prescribing medications to farms without establishing a proper veterinarian-client-patient relationship. The Chancery Court affirmed the Board's decision. The Court of Appeals reviewed the Board's findings, concluding that there was substantial and material evidence to support the six violations related to prescribing medications without examination and sufficient follow-up. The court also found that the Board's decision was not arbitrary or capricious, rejecting arguments about insufficient notice and bias. The imposition of Type A sanctions was also upheld due to the knowing and willful nature of the violations and potential public health threats, affirming the decisions of both the Board and the Chancery Court.

Veterinary Medical EthicsPrescription PracticesAdministrative Law AppealProfessional MisconductVeterinarian-Client-Patient RelationshipStandard of CareDue ProcessSanctionsTennessee Court of AppealsRegulatory Board Decision
References
18
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. M2010-00831-COA-R3-CV
Regular Panel Decision
Jun 27, 2011

Richard W. Feldman, M.D. v. Tennessee Board of Medical Examiners

This appeal arises from disciplinary proceedings against Dr. Richard W. Feldman by the Tennessee Board of Medical Examiners for numerous statutory and regulatory infractions related to his advertising of mesotherapy for weight loss. The Board found him guilty, revoked his license for at least one year, and assessed a monetary penalty. Dr. Feldman petitioned for judicial review, and the Chancery Court affirmed the Board's decision. On appeal, Dr. Feldman challenged the Board's decision, alleging insufficient evidence and improper exclusion of expert testimony. The Court of Appeals affirmed the Chancery Court's judgment, upholding the Board's findings and sanctions, concluding that substantial and material evidence supported the Board's decision and there was no abuse of discretion by the ALJ.

Disciplinary actionMedical advertisingMesotherapyWeight loss claimsProfessional conductLicense revocationExpert testimonyAdministrative lawJudicial reviewStandard of care
References
17
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