Baylor Scott & White Health v. Roughneen
Dallas Court of Appeals, No. 05-18-00966-CV (June 9, 2020)
Justices Whitehill, Schenck, and Pedersen, III (Opinion, available here)
Doctors Conferring
Not all claims involving doctors and hospitals are health care liability claims subject to the procedural protections of TEX. CIV. PRAC. & REM. CODE Chapter 74. Roughneen involves a long-running dispute among various doctors and other health care providers. In 1999, Dr. Roughneen joined a group of physicians practicing cardiology, cardiothoracic surgery, and vascular surgery (CSANT). Dr. Roughneen left CSANT in 2005, and the following year he filed suit against the practice. The litigation ended in a settlement, with the CSANT physicians agreeing that “they would voluntarily recuse themselves from any voting, deliberation and/or decision-making relating to any peer review matters involving [Dr.] Roughneen.” Years later, when the doctors worked together at Heart Hospital and Baylor Grapevine, the CSANT doctors participated in purportedly “sham peer review proceedings” against Roughneen in alleged violation of their settlement agreement. Other disputes followed, resulting in claims and counterclaims for breach of contract, tortious interference, improper restraint of trade, and other causes of action. The CSANT parties filed a motion to dismiss under Chapter 74, arguing that Roughneen’s claims were health care liability claims and that he had failed to timely serve an expert report as required by the statute.

The trial court and the Dallas Court of Appeals both held that the claims were not health care liability claims under the statute and so the expert report requirement did not apply. The CSANT parties argued that all of Roughneen’s claims arose out of the peer review process and that “credentialing activities are an inseparable part of the medical services” a patient receives. The Court disagreed, noting that “at their heart, appellees’ complaints do not relate to how any patient was treated, but to how Dr. Roughneen was treated in the business of practicing medicine.” The Court distinguished a prior opinion holding that a claim that a faulty peer review process caused harm to a patient is a covered health care liability claim. In contrast, Dr. Roughneen’s causes of action did not involve any specific patient-physician relationship and were not rooted in the care and treatment of any patient. When claims against a health care provider “do not directly relate to any patient’s medical care, treatment, or confinement,” those claims are not health care liability claims. The motion to dismiss was, therefore, appropriately denied.