In Blan v. Ali, 7 S.W.3d 741 (Tex. App.--Houston [14th Dist.] 1999, no pet. h.), Blan, who had a history of systematic lupus erthematosus and a past stroke, was taken to the emergency room after being found slumped over in the shower. Id. at 743. Blan's cardiologist did not come to the emergency room but stayed in contact with the emergency room doctor by telephone. After a series of tests, Blan suffered another stroke. Id. The plaintiffs alleged that Blan's cardiologist was negligent in: (1) failing to properly investigate and monitor Blan's medical history and condition on initial evaluation; (2) failing to come to the hospital to personally examine Blan; (3) delaying the initiation of appropriate treatment, including steroids and/or anticoagulation therapy; (4) failing to obtain prompt examination of Blan by a neurologist; (5) delaying Blan's admission to the hospital's Intensive Care Unit. Id. The plaintiffs also alleged the emergency room doctor "was negligent in: (1) delaying treatment, including medications; (2) negligently monitoring Blan's condition; (3) delaying Blan's admission to the hospital." Id. Both doctors filed motions for summary judgment--one under the traditional summary judgment rule and the other under Rule 166a(i). Id. at 747. The issue under both motions was whether there was any issue of material fact on the elements of breach of the standard of care and proximate causation. Id. at 748. The plaintiffs responded with the affidavit of an expert doctor, who, after covering the applicable standard of care, went on to state: By their negligent acts and omissions, Drs. Ali and Bartasis allowed Mr. Blan's condition to deteriorate. Prompt recognition and treatment of Mr. Blan's condition would have led to appropriate treatment of his condition, and more likely than not have led to an improved outcome for Mr. Blan. It is further my opinion that Drs. Ali and Bartasis' negligence was a proximate cause of Mr. Blan's injuries. Id. The Fourteenth Court of Appeals held the affidavit was sufficient to raise a genuine issue of fact regarding the breach of the standard of care. Id. at 747. However, because the affidavit did not "identify what aspect of Blan's condition deteriorated as a result of the alleged negligent acts," "explain how or why the alleged negligent acts caused Blan's condition to deteriorate in that manner," "identify what better outcome could have been produced by different actions," or "explain how or why a different treatment could have produced an improved outcome," the court held the affidavit was conclusory and insufficient to raise a fact issue on the element of causation. Id. at 748.