Supreme Court
Bush v. Columbia Med. Ctr. of Arlington Subsidiary, L.P.
- Case number: 23-0460
- Legal category: Medical Liability
- Subtype: Expert Reports
- Set for oral argument: September 12, 2024
Case Summary
The issue in this case is the sufficiency of an expert report supporting a health care liability claim against a hospital directly under Chapter 74 of the Civil Practice and Remedies Code.
Ireille Williams-Bush died from pulmonary embolism—a massive blood clot in her lungs—soon after she was discharged from Columbia Medical Center’s emergency department. She had presented to the ER with chest pain, shortness of breath, and severe fainting. The ER physicians diagnosed Ireille with cardiac-related conditions, never screened her for pulmonary embolism, and discharged her in stable condition with instructions to follow up with a cardiologist.
Ireille’s husband, Jared Bush, sued the hospital for medical negligence. Bush served the hospital with an expert report prepared by a cardiologist, who opined that the hospital should have had a testing protocol to rule out pulmonary embolism and other emergency conditions prior to discharge. The expert also opined that having this protocol would have resulted in a proper diagnosis and precluded Ireille’s discharge and eventual death.
The hospital objected to the expert report and moved to dismiss Bush’s claim. The trial court denied the motion, but the court of appeals reversed and directed the trial court to dismiss the claim with prejudice. The court of appeals held that the report is conclusory, and therefore insufficient, on the element of causation. Relying on Supreme Court caselaw, the court of appeals reasoned that the report fails to explain how a hospital policy—which can only be implemented by medical staff—could have changed the decisions, diagnoses, and orders of Ireille’s treating physicians.
Bush petitioned the Supreme Court for review, arguing that the court of appeals misinterpreted the Court’s caselaw to impose too high a burden for causation in a direct-liability claim and that the report is sufficient because it provides a fair summary of the causal link between the hospital’s failure and Ireille’s death. The Supreme Court granted the petition.
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