SAN ANTONIO (Legal Newsline) - A woman who sued a doctor for releasing her husband from the hospital while he was still at risk of bleeding to death can proceed with her lawsuit after an appeals court rejected a challenge to the plaintiff’s expert reports.
Zulema Cabrera sued Dr. Pradyumna Mummady after husband, David, died from an uncontrolled bleeding following throat surgery. David Cabrera went into Laredo Medical Center in May 2019 for a tonsillectomy and adenoidectomy but had blood coming from his mouth after surgery. Several days later Mummady ordered him out of the intensive care unit without checking his blood levels for signs of bleeding and anemia.
Ten days after he was discharged from the hospital, the patient started hemorrhaging from his nose and mouth and died in the ambulance on the way to the hospital. His autopsy noted a cut to an artery and concluded he died from blood loss.
In order to comply with Texas law, Zulema supplied an expert report by Dr. Glenn Rothman attributing his death to Dr. Mummady’s failure to monitor critical blood levels. The defendant challenged the reports as failing to show causation, but the trial court denied the motion.
The Fourth Court of Appeals, in am Aug. 25 decision, upheld the lower court’s decision.
Two elements are required to show causation under Texas law, the appeals court noted: Foreseeability and cause in fact, commonly known as but-for causation. In other words, the injury had to be foreseeable by a doctor of suitable skill and the injury wouldn’t have happened but for the doctor’s actions or inactions.
Zulema hired Dr. Glenn Rothman, who criticized Dr. Mummady for failing to note the patient’s low hemocrit and hemoglobin values before discharging him from the ICU. Dr. Mummady, a pulmonologist, also failed to examine David for active bleeding or clots, the plaintiff expert said.
Dr. Mummady said the report didn’t adequately link the patient’s death from bleeding 10 days later to his care in the hospital. But the appeals court disagreed.
The plaintiff “as not required to marshal all the evidence as to causation or prove the entire case,” the appeals court ruled. “Her burden was merely to serve a report explaining `how and why’ Mummady’s negligence caused David’s death, in a good faith effort to show causation was `going to be proven,’ in compliance with applicable statutory requirements.”
The defendant cited other cases that could be distinguished on the facts, the appeals court said. One decision rejected an expert report that merely said the patient had “the possibility of a better outcome,” without explaining how the doctor caused injury.