A recent Texas Supreme Court decision is a reminder of the importance of detail in expert reports and testimony. Lawyers and experts may need to go far beyond what they think is reasonable in providing details, especially when the expert opinion is necessary to support a claim for relief.
Needle Inserted into the Optic Nerve
In Baty v. Futrell, an eye surgery patient sued a certified registered nurse anesthetist (“CRNA”), claiming that the CRNA inserted a needle into her optic nerve while administering an anesthetic during cataract surgery, causing permanent vision loss in that eye. While this case addressed the adequacy of an expert report under the Texas Medical Liability Act, its history provides lessons for all who use experts in litigation.
As required by Texas law, the plaintiff submitted to the trial court an expert report from a physician. That report stated that the CRNA failed to comply with the standard of care, because the CRNA should have administered the anesthetic without inserting the needle into the optic nerve. The trial court dismissed the plaintiff’s case, ruling that the report lacked sufficient detail. A mid-level court of appeals upheld the trial court’s decision.
Divided Supreme Court Reinstates the Case
The Texas Supreme Court reversed, ruling that the expert report’s conclusion that the CRNA failed to comply with the standard of care by inserting the needle into the optic nerve was adequate. However, two Supreme Court judges dissented, and stated that the trial court was within its discretion to dismiss the case, because the report did not go into detail as to how a needle could be inserted into the space behind the globe of the eye without striking the optic nerve. According to the dissent, while the trial court might have been within its discretion not to dismiss the case, it was within the trial court’s discretion to dismiss it, given the lack of detail.
Provide Lots of Detail
Although the plaintiff eventually had her case reinstated, the case reminds us that trial court judges may insist on a high level of detail for expert reports or testimony to be sufficient to support a claim for relief; many appellate court judges give wide discretion to trial judges to dismiss cases due to inadequately detailed expert opinions. While it may seem obvious that a CRNA should avoid inserting a needle into the optic nerve, several Texas judges in this dispute determined that the trial court was within its power to dismiss the case, because the expert report did not describe in detail how to insert the needle without striking the optic nerve.