In Franka v. Velasquez, 216 S.W.3d 409 (Tex. App.--San Antonio 2006, pet. granted), the San Antonio Court of Appeals addressed a shoulder dystocia case. See 216 S.W.3d at 410-11. In that case, the plaintiff's expert report noted that the doctors used a vacuum extractor during delivery; thus, the doctors moved to dismiss under Texas Civil Practice and Remedies Code section 101.106(f) arguing that suit could have been brought against their governmental entity employer because a vacuum extractor constituted tangible personal property. Id. at 411. The court of appeals disagreed, holding that there was no evidence that the vacuum extractor caused the shoulder injuries. Id. at 412-13. Franka v. Velasquez, dealt with injuries sustained by an infant during a complicated delivery. After having reviewed the petition and the evidence presented, the San Antonio court affirmed the trial court's denial of the physicians' motion to dismiss pursuant to Tex. Civ. Prac. & Rem. Code Section 101.106(f). Id. at 413. The court pointed to the expert report's note of specific departures from the standard of care in the following respects: (1) failure to recognize risks of disorder; (2) use of continuous traction after problems were detected; (3) failure to use proper maneuvers; (4) failure to provide the mother with sufficient information regarding the risks in the use of a vacuum extractor. Id. at 411-12. Although the physicians argued that the child's injuries were caused by use of tangible personal property (i.e., the vacuum extractor), the court was unconvinced, due to the fact that the vacuum extractor was not used after the head was delivered and all of the evidence showed that the injuries to the child occurred after the head was delivered. Id. at 411. After the head was delivered using the vacuum extractor and during the time at which the injuries were sustained, the physicians used only their hands to deliver the infant. Id. Ultimately, the Franka court concluded that the claims against the physicians were claims of medical negligence and, therefore, could not be brought against the hospital under the Texas Tort Claims Act (TTCA); accordingly, the physicians were not entitled to dismissal under Section 101.106(f). Id. at 412.