Ross v. St. Lukes Episcopal Hospital
Texas Supreme Court, No. 13-0439 (May 1, 2015)
Opinion by Justice Johnson
Concurrence by Justice Lehrmann
Just because you fall down in a hospital does not mean you have a health care liability claim. The Texas Supreme Court put any remaining doubt on that issue to bed in Ross v. St. Luke’s Episcopal Hospital. The Court took the opportunity to clarify its 2012 holding in Texas West Oaks Hospital, L.P. v. Williams, in which it held that a safety-standards-based claim against a health care provider does not have to be directly related to the provision of health care in order to fall within the protections of Chapter 74 of the Texas Civil Practice & Remedies Code. After Williams, lower courts have disagreed about how strong a connection, if any, a safety-standards claim must have to health care in order to be considered a health care liability claim (“HCLC”). The Court granted review in this case to resolve the conflict.

The Ross case involved claims by a woman who was visiting a patient at the hospital and slipped and fell near the entry of the hospital where workers were buffing and cleaning the floor. After reviewing the facts of the case and the wording and intent of Chapter 74, the Court concluded that “for a safety standards-based claim to be an HCLC there must be a substantive nexus between the safety standards allegedly violated and the provision of health care.” It went on to caution that the “nexus must be more than a ‘but for’ relationship.” The pivotal issue, wrote the Court, is whether “the standards on which the claim is based implicate the defendant’s duties as a health care provider, including its duties to provide for patient safety.” The Court then articulated seven factors that should be considered in making that determination, including whether the claimant was a patient or health care provider, whether the event took place in a patient area, whether the alleged negligence occurred in connection with protecting patients from harm, and whether the safety standards at issue arise from professional duties of a health care provider. Applying those factors to the case at hand, the Court concluded the claim was not an HCLC. Accordingly, the trial court erred in holding plaintiff was required to serve an expert report to avoid dismissal of her suit.