Texas Law Changes Liability for Emergency Medical Care

September 1, 2019
Texas Law Changes Liability for Emergency Medical Care

    Effective September 1, 2019, the Texas Legislature changed the statute governing heightened liability protection afforded to physicians and healthcare providers who provide emergency medical care. House Bill 2362, purportedly drafted in response to the Supreme Court’s decision in Texas Health Presbyterian Hospital of Denton v. D.A., clarifies when the “willful and wanton negligence” standard of the Texas Medical Liability Act applies.

    In Texas Health Presbyterian Hospital of Denton v. D.A., the plaintiff (mother) was admitted to the hospital for labor induction. During the course of delivery, the baby’s shoulder became stuck on the mother’s pelvis. After repeated, failed attempts to dislodge the baby, the obstetrician reached into the birth canal and pulled the baby’s arms across his chest, dislodging the baby’s shoulder. The baby was delivered, but suffered injuries as a result of the final maneuver used to deliver the baby. The parents of the child filed a lawsuit naming the OB, his practice group, and the hospital as defendants. The OB argued Texas Civil Practice & Remedies Code Section 74.153 precluded the plaintiffs’ ordinary negligence claim. Section 74.153 requires a health-care-liability claimant to prove the defendant physician or health care provider breached the applicable standard of care with willful and wanton negligence if the claim arises out of the provision of emergency medical care. In other words, section 74.153 shields physicians and healthcare providers from liability predicated on claims of negligence, but not gross negligence. The sole issue in this limited permissive appeal was whether section 74.153 applied to emergency medical care provided in an obstetrical unit.

    After an exhaustive textual analysis, the Supreme Court held section 74.153 applied to an obstetrical unit without the patient seen previously in the Emergency Department. Due to the procedural posture of this case, the Court did not address whether the OB’s provision of medical care constituted “emergency medical care” as contemplated by section 74.153. Rather, the Court assumed, without deciding, the care at issue met the statutory definition of “emergency medical care,” in determining that section 74.153 applied to “emergency medical care” that originates in a hospital’s obstetrical unit. Because the Court did not decide whether the care at issue was truly “emergency medical care,” the Legislature further defined and limited the type of care that constitutes an emergency.

    The new amendments to section 74.153 provide clarity and resolve future ambiguities in terms of what circumstances the willful and wanton negligence standard applies. Most notably, the text of section 74.153 has been modified to reflect the Supreme Court’s interpretation of section 74.153 in Texas Health Presbyterian Hospital of Denton v. D.A. as applicable to emergency medical care originating in an obstetrical unit. Additionally, section 74.153 now expressly excludes the willful and wanton negligence standard in specific circumstances, such as non-emergency care occurring after the patient is stabilized or care unrelated to a medical emergency. Physicians and healthcare providers should remain vigilant as Texas courts apply this amended law to future cases, especially in light of the question left open by the Court in terms of what conduct constitutes “emergency medical care” under section 74.153.Effective September 1, 2019, the Texas Legislature changed the statute governing heightened liability protection afforded to physicians and healthcare providers who provide emergency medical care. House Bill 2362, purportedly drafted in response to the Supreme Court’s decision in Texas Health Presbyterian Hospital of Denton v. D.A., clarifies when the “willful and wanton negligence” standard of the Texas Medical Liability Act applies.

    In Texas Health Presbyterian Hospital of Denton v. D.A., the plaintiff (mother) was admitted to the hospital for labor induction. During the course of delivery, the baby’s shoulder became stuck on the mother’s pelvis. After repeated, failed attempts to dislodge the baby, the obstetrician reached into the birth canal and pulled the baby’s arms across his chest, dislodging the baby’s shoulder. The baby was delivered, but suffered injuries as a result of the final maneuver used to deliver the baby. The parents of the child filed a lawsuit naming the OB, his practice group, and the hospital as defendants. The OB argued Texas Civil Practice & Remedies Code Section 74.153 precluded the plaintiffs’ ordinary negligence claim. Section 74.153 requires a health-care-liability claimant to prove the defendant physician or health care provider breached the applicable standard of care with willful and wanton negligence if the claim arises out of the provision of emergency medical care. In other words, section 74.153 shields physicians and healthcare providers from liability predicated on claims of negligence, but not gross negligence. The sole issue in this limited permissive appeal was whether section 74.153 applied to emergency medical care provided in an obstetrical unit.

    After an exhaustive textual analysis, the Supreme Court held section 74.153 applied to an obstetrical unit without the patient seen previously in the Emergency Department. Due to the procedural posture of this case, the Court did not address whether the OB’s provision of medical care constituted “emergency medical care” as contemplated by section 74.153. Rather, the Court assumed, without deciding, the care at issue met the statutory definition of “emergency medical care,” in determining that section 74.153 applied to “emergency medical care” that originates in a hospital’s obstetrical unit. Because the Court did not decide whether the care at issue was truly “emergency medical care,” the Legislature further defined and limited the type of care that constitutes an emergency.

    The new amendments to section 74.153 provide clarity and resolve future ambiguities in terms of what circumstances the willful and wanton negligence standard applies. Most notably, the text of section 74.153 has been modified to reflect the Supreme Court’s interpretation of section 74.153 in Texas Health Presbyterian Hospital of Denton v. D.A. as applicable to emergency medical care originating in an obstetrical unit. Additionally, section 74.153 now expressly excludes the willful and wanton negligence standard in specific circumstances, such as non-emergency care occurring after the patient is stabilized or care unrelated to a medical emergency. Physicians and healthcare providers should remain vigilant as Texas courts apply this amended law to future cases, especially in light of the question left open by the Court in terms of what conduct constitutes “emergency medical care” under section 74.153.