The Texas Supreme Court unanimously held last month that a corporation bringing a health care liability claim (“HCLC”) under Chapter 74 of the Texas Civil Practice & Remedies Code is a “claimant” within the statutory definition, and that the corporation’s allegations against Texas Health Resources (“THR”) alleged an HCLC based on standards of safety or administrative/professional services. The case, Coming Attractions Bridal & Formal, Inc. v. Texas Health Resources, No. 18-0591, 2020 WL 868060 (Tex., Feb. 21, 2020), arose of out the Ebola crisis in Texas in 2014, when Nurse Amber Vinson traveled to the bridal store in Ohio to try on wedding dresses and fell ill with Ebola after she returned home.
Although Nurse Vinson recovered, health authorities in Ohio learned of her visit and required the store to close and clean to prevent spread of the virus. The store re-opened but the business did not recover, and the owner eventually closed the store permanently. The bridal store then sued THR for negligence and faulted it for the loss of its business.
In the original petition, the bridal store alleged that THR controlled the Ebola response and managed the employees who experienced exposure to the virus at the hospital. The store alleged THR was negligent in a variety of ways, including failing to develop policies and procedures on how to respond to the presence of Ebola in the patient population, failing to ensure all its employees were properly trained on how to recognize, appreciate, contain, and treat the Ebola virus in the patient population, failing to train its nurses on proper protection from Ebola and to ensure they had proper personal protective equipment, failing to employ qualified people to manage Ebola patients, failing to instruct and warn its nurses about the dangers of travel and interacting with the public after being exposed to Ebola, and failing to protect the public from harm by exposing its nurses to the Ebola virus and then failing to prevent them from interacting with the public. The store claimed THR’s negligence proximately caused its loss of business.
THR strongly denied both the factual and legal allegations, asserting that the claim lacked legal merit and was based on incorrect facts. However, for purposes of Chapter 74, THR asserted that the allegations in the original petition asserted an HCLC and, therefore, the bridal store was required to serve it with an expert report. Under Chapter 74, a claimant asserting an HCLC must serve each defendant with an expert report and the expert’s CV to establish initially that the claim has merit and may proceed to the discovery phase. A core purpose of these provisions was to identify and eliminate frivolous HCLCs expeditiously, while preserving those of potential merit.
The bridal store did not serve any expert report on THR, so THR filed a motion to dismiss as permitted under the statute. The trial court determined the bridal store’s claim was not an HCLC and denied THR’s motion to dismiss. On appeal, the Dallas Court of Appeals reversed, concluding the allegations asserted an HCLC and that the bridal store could be a “claimant” under the statute.
The bridal store appealed, and the Texas Supreme Court unanimously affirmed. The newest Texas Supreme Court Justice, Hon. Jane Bland, wrote the Opinion for the Court.
The statute defines a “claimant” as “a person, including a decedent’s estate, seeking or who has sought recovery of damages in an HCLC. All persons claiming to have sustained damages as the result of the bodily injury or death of a single person are considered a single claimant.” Tex. Civ. Prac. & Rem. Code § 74.001(a)(2). The bridal store contended that “person” meant only human beings, not entities like corporations, in part because of the use of “bodily injury” in the second sentence of the definition.
The Texas Supreme Court disagreed because both the Legislature and the common law have defined “person” to include corporations. As to the second sentence, the Court said it neither restricts the definition of “person” to a human being nor limits a claimed injury to a bodily injury. Rather, the definition expressly contemplates that claimants can be legal entities by including, as an example, a decedent’s legal estate. Therefore, the bridal store was a “claimant” within the meaning of the statute, if it had asserted an HCLC.
The Court next addressed whether the bridal store had alleged an HCLC. The bridal store argued it had not, because its allegations did not have a substantial nexus with the hospital’s health care provider duties and because it sought only economic damages. THR argued the bridal store asserted an HCLC concerning an alleged departure from standards of safety with a nexus to health care.
The Court held that a hospital’s alleged negligence in controlling the spread of a virus to its nursing staff and the public implicates safety standards directly related to health care—the care and treatment of an infected patient. As the bridal store expressly alleged, Nurse Vinson’s infection with the virus implicates whether the hospital developed and implemented training, treatment, and infection control policies. The bridal store also had alleged that THR had failed to protect the nurses from exposure to Ebola and failed to warn the nurses against interacting with the public.
The Court held that the risk of contamination that Nurse Vinson presented to the public implicates the execution of THR’s health care provider duties. The question of contagion and its prevention in a hospital setting directly relates to public health and health care. And, the bridal store claimed injury by or through Nurse Vinson’s physical injury, which resulted, it alleges, from THR’s negligence in failing to protect its employees from the Ebola outbreak.
Therefore, the Court said, a substantive nexus exists between this health care provider duty and the bridal store’s claimed injury (i.e., its store was exposed to the virus through Nurse Vinson, contaminated, and forced to close). These allegations implicate “safety or professional and administrative services directly related to health care”—that is, avoiding transmission of a communicable disease—and, therefore, the bridal store asserted an HCLC.
The Court also rejected the bridal store’s economic-damages-only argument. The Court recognized that the definition of “health care liability claim” did not qualify the type of “injury” required for an HCLC or limit it to bodily injury. See Tex. Civ. Prac. & Rem. Code § 74.001(a)(13) (“Health care liability claim” means “a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant, whether the claimant’s claim or cause of action sounds in tort or contract.”).
Finally, the Court recognized that the bridal store’s claim is the type that would require expert testimony to prove the elements. To prevail at trial, the Court said, the bridal store would have to establish through expert medical testimony that THR’s training, treatment, and infection control policies departed from the appropriate standards of care, and that these departures proximately caused contamination of the shop, posing a health danger to its patrons. Because only medical experts could discuss THR’s departure from safety standards associated with treating and preventing the spread of the Ebola virus, the bridal store had to get an expert report.
In such a report, a qualified expert would detail the hospital’s failure to implement appropriate Ebola treatment, training, and infection-control policies, and the circumstances necessary for an infected person to contaminate a store. The causal link that the expert must supply is the link between THR’s negligence and the contamination of the store—and the corresponding risk that the disease will spread—not to the loss of business that allegedly stemmed from this contamination. Expert testimony about lost business value (as argued by the bridal store) is beyond the scope of the Act.
For all these reasons, the Court affirmed the judgment of the Court of Appeals. The Court of Appeals had dismissed the claim with prejudice and remanded the case for a determination of THR’s reasonable attorneys’ fees and costs, as required by section 74.351(b).