In Columbia Med. Ctr. of Las Colinas, Inc. v. Hogue, 271 S.W.3d 238, 248 (Tex. 2008), the supreme court concluded evidence the hospital knew that the ability to perform "stat" echo-cardiograms (meaning immediate or as soon as possible) was necessary for its emergency department, but elected not to obtain echo-cardiogram capability on a stat basis even after being advised to do so, along with other evidence, was legally sufficient under a clear and convincing evidence standard to support the jury's conclusion that the hospital "acted with conscious indifference to an extreme risk of serious injury when it: (1) elected to outsource echo services without a guaranteed response time while providing emergency services; (2) failed to communicate this limitation to its medical staff so they could consider other options to treat critical care patients; (3) delayed obtaining the echo in spite of the serious risk to plaintiff's health." Hogue, 271 S.W.3d at 253.