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Case Update: Slip & Falls are not Chapter 74 Health Care Liability Claims in Texas

by E. Dale Burrus, JD, LLM on May 1st, 2015

On May 1, 2015, the Texas Supreme Court addressed the much debated issue of how far Chapter 74 reaches. In Ross v. St. Luke’s Episcopal Hospital the Court held that a hospital visitor’s slip-and-fall claim is not a Chapter 74 health care liability claim (HCLC).

Lezla Ross, a visitor to St. Luke’s Episcopal Hospital, sued the hospital on a premises liability theory after she slipped and fell near the lobby exit doors. The trial court and court of appeals concluded Ross’s claim was an HCLC subject to Chapter 74’s expert report requirement. The Court disagreed holding Ross did not assert an HCLC because the record did not demonstrate a relationship between the safety standards Ross alleged the hospital breached—standards for maintaining the floor inside the lobby exit doors—and the provision of health care, other than the location of the occurrence and the hospital’s status as a health care provider.

Relying on the Court’s decision in Texas West Oaks v. Williams the hospital asserted Ross’s claim was an HCLC and moved for dismissal because she failed to serve a Chapter 74 expert report. The trial court agreed and dismissed Ross’s slip-and-fall claim. On appeal, the Fourteenth Court of Appeals concluded that under Williams it is not necessary for any connection to exist between health care and the safety standard on which a claim is based in order for the claim to come within Chapter 74.

The pivotal issue in a safety standards-based liability claim 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. To determine whether Ross’s safety standards-based claim was an HCLC, the Court conducted a seven-prong analysis:

  1.  Did the alleged negligence of the defendant occur in the course of the defendant’s performing tasks with the purpose of protecting patients from harm;
  2. Did the injuries occur in a place where patients might be during the time they were receiving care, so that the obligation of the provider to protect persons who require special, medical care was implicated;
  3. At the time of the injury was the claimant in the process of seeking or receiving health care;
  4. At the time of the injury was the claimant providing or assisting in providing health care;
  5. Is the alleged negligence based on safety standards arising from professional duties owed by the health care provider;
  6. If an instrumentality was involved in the defendant’s alleged negligence, was it a type used in providing health care; or
  7. Did the alleged negligence occur in the course of the defendant’s taking action or failing to take action necessary to comply with safety-related requirements set for health care providers by governmental or accrediting agencies?

The Court’s answer to all seven questions was “no.” The record did not show that the cleaning and buffing of the floor near the exit doors was for the purpose of protecting patients. Nor did the record reflect that the area where Ross fell was one where patients might be during their treatment so that the hospital’s obligation to protect patients was implicated by the condition of the floor at that location. Ross was not seeking or receiving health care, nor was she a health care provider or assisting in providing health care at the time she fell. There was no evidence the negligence alleged by Ross was based on safety standards arising from professional duties owed by the hospital as a health care provider. There was also no evidence that the equipment or materials used to clean and buff the floor were particularly suited to providing for the safety of patients, nor did the record demonstrate that the cleaning and buffing of the floor near the exit doors was to comply with a safety-related requirement set for health care providers by a governmental or accrediting authority.

 The Court decided Ross’s claim was based on safety standards that had no substantive relationship to the hospital’s providing of health care so it was not an HCLC. Because her claim was not an HCLC she was not required to serve an expert report to avoid dismissal of her suit. The Court reversed and remanded.

Over the past few years, the scope of claims falling within Chapter 74 has significantly broadened. The Ross decision demonstrates the Court is clarifying the types of claims that are and are not HCLCs.

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