Introduction. In the recent motor vehicle collision case of Hills v. Donis, the Houston Court of Appeals overturned a judgment awarding the Plaintiffs $145,460 for past medical expenses because the Plaintiffs failed to present competent medical expert testimony proving that their injuries were caused by the collision. 14-18-00566-CV, 2020 WL 206187, (Tex. App.—Houston [14th Dist.] Jan. 14, 2020, no pet.).

Background. The Plaintiffs were passengers in a rear-end motor vehicle collision. The Plaintiffs sought to recover damages, from the party at fault, only for Plaintiffs’ medical expenses incurred as a result of injuries sustained in the collision. The Plaintiffs did not seek to recover other types of damages typically claimed for mental anguish, pain and suffering.

The Plaintiffs sustained neck and back soft tissue injuries. The Plaintiffs proved up the medical billing records by using Section 18.001 affidavits. This is a section of the Texas Civil Practice and Remedies Code that allows a party to prove up the reasonableness and necessity of medical expenses incurred by submitting affidavits that comply with this statute. In addition to medical bills that were attached to these affidavits, Plaintiffs apparently introduced letters from the treating doctor stating Plaintiff’s injuries were caused by the collision. However, Plaintiffs did not present any deposition or live testimony from the treating doctor.

At the conclusion of the trial, the trial court entered an award in favor of Plaintiffs for past medical expenses totaling $145,460. The Defendant appealed.

Analysis by Court of Appeals. The Court of Appeals, found that the evidence presented at trial failed to show that the medical care provided to Plaintiffs was for injuries caused by the collision. The court recognized that uncontroverted Section 18.001 affidavits could be used as a procedural device to prove that the charges for medical care were reasonable and necessary. “Section 18.001 affidavits do not, however, establish the requisite causal link between the occurrence and the plaintiff’s medical expenses.” Hills v. Doris, supra, at *4.

Expert testimony is generally necessary to establish causation of medical conditions that are “outside the common knowledge and experience of jurors.” See Guevara v. Ferrer, 247 S.W.3d 662, 665 (Tex. 2007). In limited cases, however, lay testimony may support a causation finding that links an event with a person’s physical condition. Id. at 666. “This exception applies only in those cases in which general experience and common sense enable a layperson to determine the causal relationship with reasonable probability.” Kelley v. Aldine Indep. Sch. Dist., No. 14-15-00899-CV, 2017 WL 421980, at *2 (Tex. App.—Houston [14th Dist.] Jan. 31, 2017, pet. denied) (citing Guevara, 247 S.W.3d at 666; Morgan v. Compugraphic Corp., 675 S.W.2d 729, 733 (Tex. 1984)). In such cases, “lay testimony establishing a sequence of events which provides a strong, logically traceable connection between the event and the condition is sufficient proof of causation.” Id. (quoting Morgan, 675 S.W.2d at 733).

Hills v. Doris, supra, at 3.

The Court stated that the types of  injuries for which the Plaintiffs sought compensation such as cervical and lumbar radiculitis were neither common nor basic. Thus, the Plaintiffs needed medical expert testimony to prove that their injuries were caused by the collision. The Plaintiffs pointed to the letters from the treating doctor as  evidence of causation. The Court found that the conclusory letters constituted no evidence of causation.

To constitute competent evidence of causation, a medical expert’s opinion must be reliable and rest in reasonable medical probability. Crye, 907 S.W.2d at 500. “This rule applies whether the opinion is expressed in testimony or in a medical record, as the need to avoid opinions based on speculation and conjecture is identical in both situations.” Id. [he treating doctor’s] opinions are not competent evidence of causation because his opinions are conclusory. An expert’s bare proclamation that this one event caused another is not enough to establish causation; “the expert must go further and explain, to a reasonable degree, how and why the breach caused the injury based on the facts presented.” Jelinek v. Casas, 328 S.W.3d 526, 539–40 (Tex. 2010). [The treating doctor’s] letters do not provide any data or facts from which [the treating doctor] could have formed an opinion that the diagnosed injuries were caused by a motor vehicle accident. Absent such facts, [the treating doctor’s] letters are unreliable speculation, which we conclude does not constitute evidence in support of the trial court’s judgment.”

Hills v. Doris, supra, at *4.

Court’s decision. As a result of Plaintiff’s’ failure to prove that their injuries were caused by the motor vehicle collision, the Court of Appeals overturned the trial court’s judgment in favor of the Plaintiffs and rendered that the Plaintiffs take nothing. This was no doubt a stinging lost for the Plaintiffs.

Lessons learned. No matter whether a party is providing up damages in a personal injury dispute or a business dispute competent evidence, which often must include expert testimony, must be presented to support an award of damages. (See previous article–Court overturned $95 million dollar verdict because plaintiffs failed to prove damages caused by breach of fiduciary duties. This is why it is important to retain experienced trial counsel well-versed on the law of damages, before engaging in costly litigation.