The 15th Court of Appeals has reversed a trial court order denying a hospital’s motion to dismiss claims by two radiologists who worked at the facility that the hospital’s negligenced caused their skin cancer.
Shannon Medical Center v. Michael Sickels and James Christopher Cole (No. 15-25-00167-CV; August 25, 2026) arose from a radiation exposure case. Plaintiffs, both radiologists, worked at the medical center for 20 years. Both developed skin cancer and underwent several invasive surgical procedures to treat the cancer. They sued the medical center for negligence, negligence per se, and gross negligence, alleging that the center failed “to properly monitor, warn, report, control, and restrict Radiologists from excessive radiation exposure” and “to maintain proper procedures for performing these duties.” They further alleged that the center didn’t provide suitable protective equipment and clothing and committed various statutory and regulatory violations. The center answered and subsequently filed a motion to dismiss Plaintiffs’ claims because the claims were health care liability claims and Plaintiffs failed to serve an expert report within 120 days of Defendant’s answer. The trial court denied the motion. Defendant appealed.
In an opinion by Justice Farris, the court of appeals reversed and rendered. In addition to its assertion that Plaintiffs’ claims were HCLCs, Defendant argued that the carve out to Chapter 74 for employee actions against employers didn’t apply, and that the required expert was not filed. First, the court addressed whether Chapter 74 applied to Plaintiffs’ claims. Plaintiffs argued that their claims did not have “a substantial nexus with the provision of health care” and, consequently, didn’t meet the statutory definition of an HCLC. Observing that there was a rebuttable presumption that Plaintiffs’ claims were HCLCs, the court first determined that “Plaintiffs’ allegations taken together establish that Shannon’s violations of radiation safety standards implicate [Defendant’s] conduct during the course of patients’ care and treatment.” Plaintiffs tried to deflect the issue by alleging that their injuries resulted from radiation exposure by virtue of the machinery they used, but they also acknowledged “that their injuries occurred by providing or assisting with the provision of health care to patients.” While Plaintiffs didn’t receive health care, Chapter 74 “does not limit its reach to persons receiving or having received health or medical care—it applies to ‘claimants’” (citations omitted). The presumption thus applied.
Next, the court determined that a substantive nexus existed between Defendant’s alleged violations of safety standards and the provision of health care. As the court observed, “[t]he pivotal issue in a safety standards-based claim is whether the standards on which the claim is based implicate the defendant’s duties as a health care provider, including its duties to provide for patient safety.” SCOTX established a seven-factor, non-exclusive test for determining whether the required “substantive nexus” exists. The court ruled that four of the seven factors favored Defendant, two favored Plaintiffs, and one was inapplicable. “The above factors are non-exclusive,” the court noted, “but they on balance support the conclusion that ‘a substantive nexus’ exists between the [Defendant’s] alleged violation of radiation safety standards and the provision of health care, implicating [Defendant’s] duties as a health care provider and so making them HCLCs.” Plaintiffs didn’t meet the burden to overcome the presumption.
As to the employee exemption, Plaintiffs failed to show that they were Defendant’s employees. The question boiled down to “whether [Defendant] exercised the right of control over [Plaintiffs’] work at [Defendant].” Determining the right to control likewise invokes a multi-factor test. Here the test went against Plaintiffs for several reasons. They had employment contracts with Shannon Clinic, an entity separate from Defendant. The clinic exercised a degree of control over Plaintiffs, including the time for which they are employed and the method of payment. Their contracts state that they are employees of the clinic, not Defendant. Based on this evidence, the court concluded that Defendant didn’t exercise the degree of control of Plaintiffs’ work sufficient to make them Defendant’s employees.
Having decided that Plaintiffs’ claims were HCLCs and that the exception didn’t apply, the court quickly disposed of the case on the basis that Plaintiffs didn’t serve an expert report within the statutory period. The court reversed and rendered judgment for Defendant.
