In Barko v. Genzel, 123 S.W.3d 457, 460 (Tex. App.--Eastland 2003, no pet.), the patient sued an emergency room physician doctor for failing to timely diagnose and treat her large disc re-herniation, during emergency room visits on October 26 and 27, 1999. Barko, 123 S.W.3d at 458. The emergency room doctor referred the patient to a neurosurgeon who examined the patient on October 28 and repaired the injury on October 29, the same day the patient suffered a miscarriage. Id. In affirming the dismissal of the malpractice suit against the emergency room doctor, the appellate court reasoned that the report failed to link the miscarriage to the doctor's care and also failed to indicate whether the patient would have satisfactorily recovered from the back injury but for the doctor's alleged negligence. Id. at 460-61. Thus, the report failed to establish a causal link between the failure to timely diagnose and either the miscarriage or the permanent neurological damage. Id. In sum, the plaintiff alleged that her emergency room physician negligently failed to diagnose and treat her disc re-herniation, which she asserted led to permanent neurological damage and a miscarriage. Barko, 123 S.W.3d at 458. The court held that the report was insufficient to satisfy the statutory requirements because it: (1) did not indicate that the plaintiff would have recovered from the back injury but for the doctor's negligence; (2) did not state that the back surgery would have been avoided but for the doctor's negligence; (3) did not make any attempt to eliminate either the back injury itself or the attempt to surgically repair it as a potential cause of the permanent neurological damage. Id. at 460-61.