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Raines v. Stephens2/23/2005
This is a medical malpractice case involving bladder injuries resulting from a "bungled" hysterectomy performed on Billie Lynn Raines. Billie and Richard Raines sued Dr. Ronald D. Stephens under former article 4590i of the Texas Medical Liability and Insurance Improvement Act of Texas (the "Act"). Dr. Stephens challenged the sufficiency of the Raines' expert report for failure to include the required causation element and that the expert was not qualified. The trial court dismissed the cause of action against Dr. Stephens with prejudice. The Raines appeal in two issues: trial court abused discretion in finding (1) the expert report did not include the causation requirement and (2) the expert was not qualified.
We will overrule issue one and will not need to address issue two. We will affirm the judgment.
BACKGROUND
Facts
Billie, a 35-year-old woman was suffering from abnormal menstrual bleeding (metrorrhagia and menorrhagia). She saw Dr. Stephens, a general family physician, and wanted a hysterectomy to fix her problem. She told Dr. Stephens that she had been on oral contraceptives for a year, but they had caused weight gain. She also told him that she had an ultrasound and uterine scope performed. Her mother and sister had also already had hysterectomies. Dr. Stephens referred Billie to Dr. Ramirez, a general surgeon. Dr. Ramirez performed a hysterectomy, and during the surgery, he removed a large portion of Billie's bladder and transsected her ureters causing permanent injuries to her bladder. Billie alleges that she will never regain normal bladder function. According to her expert, Billie had an endometrial polyp that was the cause of her bleeding, and it could have been removed with dilation and curettage, thereby avoiding the hysterectomy.
Petition
The Raines sued Dr. Stephens stating in their petition:
DR. STEPHENS' NEGLIGENCE
15. Dr. Stephens practiced below the standard of reasonable medical care in failing to investigate the cause of Mrs. Raines' complaints of metrorrhagia and menorrhagia. In this respect, Plaintiffs would show that Dr. Stephens was negligent as follows:
(1) In failing to perform a pre-operative endometrial biopsy or hysteroscopy with fractional D&C to evaluate the source of the persistent uterine bleeding problems experienced by Mrs. Raines. Had Dr. Stephens performed this simple procedure, he would have discovered what was later revealed in the pathology report post-surgery that a "sizeable, somewhat pedunculated endometrial polyp was present." Significance of the presence of this polyp is that such endometrial polyps commonly cause metrorrhagia and often cause menorrhagia. Had Stephens investigated the cause of Mrs. Raines' symptoms and followed standard medical practice, he would have discovered the polyp, addressed that problem, and avoided the surgical procedure which turned out to be disastrous for Mrs. Raines.
(2) Dr. Stephens failed to remove the endometrial polyp and place Mrs. Raines on oral contraceptives for two to three months to see if normal menstrual cycles would resume before resorting to the hysterectomy procedure. Had the proper diagnostic work up been performed by Dr. Stephens, the standard of care would have led him to remove the endometrial polyp, place Mrs. Raines on oral contraceptives for two or three months, most likely allowing Mrs. Raines to resume her normal menstrual cycles, and avoid the hysterectomy procedure.
MRS. RAINES' INJURIES
16. As a direct and proximate result of the negligence of Drs. Ramirez and Stephens, as set forth above, Mrs. Raines suffered severe, permanent and li
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