Collini v. Pustejovsky

Collini v. Pustejovsky, 280 S.W.3d 456 (Tex. App.--Fort Worth 2009, no pet.), was a medical-malpractice case in which the court held that the plaintiff's expert report failed to demonstrate his qualifications to opine concerning the causal relationship between the prolonged use of the drug Reglan and the development of tardive dyskinesia, a condition that causes involuntary movement of the limbs, face, or tongue. In that case, the expert's report failed to state that he had any experience or training regarding Reglan or tardive dyskinesia, but the plaintiff argued that his qualifications could be established by the fact that Reglan's manufacturer had disclosed tardive dyskinesia as a known complication and the report also reflected that three physicians had diagnosed the plaintiff with dyskinesia related to her Reglan use. Id. at 466. Citing Rule 703 and Gammill v. Jack Williams Chevrolet, Inc, 972 S.W.2d 713, 728 (Tex. 1998), the court noted that the expert's report did not provide any background on the experience or training of those physicians which would signal to the trial court that their opinions were reliable. Id. The court also distinguished other cases in which courts had held that an expert may rely on the opinions of other experts whose qualifications to render reports or diagnoses had been demonstrated. Id. In Collini v. Pustejovsky, the expert's report adequately described the alleged physical harm (sleep disturbances, hand tremors, and leg restlessness) and stated the conclusions of that expert and four others that the patient's tardive dyskinesia was related to the use of the drug Reglan that was prescribed by the defendant. Id. at 459, 467. The report provided no details as to how the Reglan caused the symptoms or how the specific prescriptions (beyond the taking of Reglan generally) attributed to the harm. Id. at 467. The court reasoned that "while the manufacturer's warning (that Reglan should not be prescribed for more than twelve weeks) coupled with the causation opinions of the four doctors (though conclusory) may create a reasonable inference that the defendant doctor's prolonged prescription of Reglan caused the patient's condition, we are not permitted to rely on that inference in reviewing the expert's report." Id. Because the expert's report failed to adequately address the link between the doctor's alleged breach of the standard of care and the patient's tardive dyskinesia that allegedly resulted, the court held that the report was insufficient. Id. at 467-68.