Gilbert H. Olveda, Jr. and Brendalee Olveda North, Individually and as Representatives of the Estate of Frieda Hernandez, Deceased v. Rene A. Sepulveda, M.D.; Baptist Health System d/b/a St. Luke's Baptist Hospital and St. Luke's Baptist Hospital, An Assumed Name--Appeal from 131st Judicial District Court of Bexar County

Annotate this Case
CONCURRING AND DISSENTING OPINION
No. 04-03-00319-CV
Gilbert H. OLVEDA, Jr. and Brendalee Olveda-North,
Individually and as Representatives of the Estate of Frieda Hernandez, Deceased,
Appellants
v.
Rene A. SEPULVEDA, M.D. and Baptist Health System
d/b/a St. Luke's Hospital and St. Luke's Baptist Hospital, an Assumed Name,
Appellees
From the 131st Judicial District Court, Bexar County, Texas
Trial Court No. 2003-CI-04714)
Honorable John J. Specia, Jr., Judge Presiding (1)

Opinion by: Karen Angelini, Justice

Dissenting opinion by: Alma L. L pez, Chief Justice

Sitting: Alma L. L pez, Chief Justice

Paul W. Green, Justice

Karen Angelini, Justice

Delivered and Filed: May 26, 2004

I agree with the majority that Suresh's report was not sufficient to show that she was qualified to opine that the standard of care applicable to a urologist would require a urologist to diagnose preeclampsia. I disagree, however, that Suresh's report was insufficient to meet the requirements of 4590i with regard to Sepulveda's negligence in failing to monitor the fetus. Suresh's report states that the nurse "voiced concern about the fetal [heart rate monitoring] strip and fetal decelerations." The nurse accompanied the patient to the operating room and "again voiced concern over the patient's fetal strip." Suresh further notes, "In preeclampsia, the fetus is at increased risk owing to marginal placental function which may become inadequate in the presence of increased uterine activity. Pre-operatively, there was evidence of uterine contractions and fetal decelerations and despite the nurse voicing her concerns - electronic fetal monitoring and surveillance was abandoned on the patient's arrival to the operating room." Suresh states that Sepulveda's actions in "ignoring fetal well being also demonstrates substandard medical care."

The majority contends that because Suresh "never alleges that the fetus would have survived if properly monitored during surgery had preeclampsia remained undiagnosed," Suresh's opinion "fails to establish 'the causal relationship between [the breach] and the injury.'" However, Suresh states in her report that the "standard of care would have been to monitor uterine contractions and have continuous reading of [the fetal heart rate] by a qualified individual during the perianesthetic and perioperative period and to have arrangements for a stat cesarean section if the need arose." Thus, Suresh opines on causation because if the standard of care had been met, and the fetal heart rate had been monitored, a stat cesarean section could have been performed to save the fetus if the need arose. The failure to monitor the heart rate led to the failure to perform the stat cesarean section, thereby preventing the fetus from surviving.

Accordingly, I believe Suresh's report adequately summarizes the breach of the applicable standard of care with regard to the monitoring of the fetus and sets forth the causal relationship between the breach and the inability of the fetus to survive. Because the majority holds to the contrary, I respectfully dissent from this portion of the majority's opinion.

Alma L. L pez, Chief Justice

1. The Honorable Phylis J. Speedlin presided over the hearing on the motion to dismiss. However, the order granting the motion to dismiss was signed by the Honorable John H. Specia, Jr.

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