Doctor's Good Samaritan Defense in Botched Intubation MedMal Suit Rejected
Chau vs. Jefferson Riddle (Tex. Feb. 15, 2008) (first, superseded opinion)
See subsequent opinion: Chau v. Riddle (Tex. May 16, 2008)(substituted opinion)
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Chau v. Jefferson Riddle, MD, No. 07-0035 (Tex. Feb. 15, 2008)(per curiam)
(HCLA, medical malpractice, Good Samaritan defense rejected, summary judgment improperly granted)
THAO CHAU AND HA DIEN DO, INDIVIDUALLY, AND ON BEHALF OF THEIR MINOR CHILD, S.D.D. v. JEFFERSON
RIDDLE, M.D. AND GREATER HOUSTON ANESTHESIOLOGY, P.A.;
From Harris County; 1st district (01-04-00551-CV, 212 S.W.3d 699, 09/28/06)
Pursuant to Texas Rule of Appellate Procedure 59.1, after granting the petition for review and without hearing oral
argument, the Court reverses the court of appeals' judgment and remands the case to that court.
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Terms: Health Care Liability Claim (HCLC), medical malpractice suit, defense
Other Texas Supreme Court Decisions in health care liability suits:
In Re McAllen Medical Center, Inc (Tex. May 16, 2008)(dismissal order by mandamus)
Hamilton v. Wilson, MD, No. 07-0164 (Tex. Mar. 28, 2008)(per curiam) (HCLC, sufficiency of expert report)
In Re Jorden, MD, No. 06-0369 (Tex. Mar. 28, 2008)(Brister) (HCLC, MedMal, permissibility of presuit discovery,
Rule 202 deposition)
See more --> Texas Supreme Court Opinions | Medical Malpractice Decisions of the Texas Supreme Court |
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Chau v. Riddle, MD (Tex. Feb. 15, 2008) [superseded opinion]
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PER CURIAM OPINION
Thao Chau and her family brought this healthcare liability suit against Dr. Jefferson Riddle and his professional
association, Greater Houston Anesthesiology, P.A., alleging that Riddle’s negligence in intubating Chau’s son, S.D.,
deprived him of oxygen and caused brain damage. The trial court granted the defendants’ motion for summary
judgment and a divided court of appeals affirmed, reasoning that Riddle conclusively established the Good
Samaritan defense. 212 S.W.3d 699, 711. We hold, however, that Riddle did not conclusively establish that he is
entitled to the Good Samaritan defense, and, accordingly, we reverse the court of appeals’ judgment.
Riddle was the on-call anesthesiologist for the labor and delivery suites at Memorial Hermann Southwest Hospital
on the night of October 29–30, 2001. While on his shift, Riddle was called upon to administer anesthesia to Chau
during her emergency cesarean section. When S.D., one of Chau’s twins, was delivered, he was not breathing.
After the nurses and residents present were unable to resuscitate S.D., Dr. Duc Le, Chau’s obstetrician and her
attending physician, asked Riddle to intubate S.D. It is undisputed that Riddle did so, then, allegedly without
performing all the immediate follow-up checks typically required by the standard of care and leaving the nurses and
residents to secure the tube, returned to Chau. The nurses and residents continued to attempt to resuscitate S.D.,
but they were unsuccessful. Twelve minutes after Riddle’s intubation, the neonatologist arrived and discovered that
the tube was in S.D.’s esophagus instead of his trachea. As soon as she moved the tube to S.D.’s trachea, he
began to breathe, but had suffered permanent brain damage in the interim.
In the trial court, Riddle and Greater Houston Anesthesiology (collectively “Riddle”) argued that because Riddle had
responded to the emergency of S.D. not being able to breathe, Texas’s Good Samaritan statute precluded any
liability for negligence.[1] Riddle moved for summary judgment, arguing both that he had conclusively proved he
was entitled to the affirmative Good Samaritan defense and that Chau had presented no evidence of duty or
causation. The trial court granted Riddle’s motion without specifying the grounds, and the court of appeals affirmed,
reasoning that Riddle had established the Good Samaritan defense as a matter of law. Id.
In this Court, Chau challenges the court of appeals’ holding that the trial court did not abuse its discretion in
enforcing a docket control order or in striking part of Chau’s expert testimony. We agree with the court of appeals’
resolution of those issues. However, we agree with Chau that the court of appeals erred in concluding that Riddle
conclusively established the Good Samaritan defense.
To prevail on his summary-judgment motion on the Good Samaritan affirmative defense, Riddle had the burden to
conclusively establish each of its elements. McIntyre v. Ramirez, 109 S.W.3d 741, 742, 748 (Tex. 2003). Under the
Good Samaritan statute, a medical professional assisting in an emergency in a hospital may be exempted from
liability for medical negligence under certain circumstances. See Tex. Civ. Prac. & Rem. Code § 74.001(c);
McIntyre, 109 S.W.3d at 744. However, that exemption from liability is subject to a number of exceptions, three of
which are at issue here. In pertinent part, the statute provides:
(b) This section does not apply to care administered:
(1) for or in expectation of remuneration;
. . .
(c) If the scene of an emergency is in a hospital or other health care facility or means of medical transport, a person
who in good faith administers emergency care is not liable in civil damages for an act performed during the
emergency unless the act is wilfully or wantonly negligent, provided that this subsection does not apply to care
administered:
(1) by a person who regularly administers care in a hospital emergency room unless such person is at the scene of
the emergency for reasons wholly unrelated to the person’s work in administering health care; or
(2) by an admitting or attending physician of the patient or a treating physician associated by the admitting or
attending physician of the patient in question.
Tex. Civ. Prac. & Rem. Code § 74.001(b)–(c).
Thus, a doctor performing his or her work in an emergency room, a doctor associated by the admitting or attending
physician, and a doctor who charges for his or her services are all precluded from the statute’s protection. Chau
contends Riddle falls under each of these exceptions. Because we agree that there is at least an issue of material
fact as to whether Riddle was “associated by the admitting or attending physician,” we need not consider whether
Riddle regularly administers care in an emergency room or charged for his services. Id. § 74.001(c)(2).
Assuming, as the parties do, that Riddle administered emergency care to S.D., Riddle did so as part of the labor
and delivery team. As such, there is at least a question of fact as to whether he was “associated by the admitting or
attending physician.” See id. Le, the leader of the labor and delivery team and the only attending physician present,
directed Riddle to intubate S.D., and Riddle did so. In distinguishing between which medical personnel were
attending to Chau and which were attending to S.D., the court of appeals ignored Chau’s expert’s testimony that the
labor and delivery team is expected to share in the care of both the mother and the newborn. Furthermore, another
witness testified that the role of the anesthesiologist in labor and delivery suites at Memorial Hermann includes
intubating non-breathing newborns if a neonatologist is not present. There is some evidence that Riddle was a part
of the team administering care to Chau and S.D. In sum, there is evidence that intubating newborns in this situation
is part of Riddle’s job as the on-call anesthesiologist in the labor and delivery suites. Thus, the court of appeals
erred in affirming summary judgment for Riddle on his affirmative defense.
Our application of the statute in this case is consistent with the legislative purpose behind extending the Good
Samaritan defense to medical professionals in hospital settings. The statute is intended to increase the incentives
for physicians to respond voluntarily to medical emergencies, even if they occur in a hospital. McIntyre, 109 S.W.3d
at 745. The exclusions built into the statute ensure that medical professionals are only entitled to the defense if
their actions are truly voluntary, not simply part of the professional’s ordinary duties. See Tex. Civ. Prac. & Rem.
Code § 74.001(b) –(c). As such, this case can be distinguished from McIntyre, where we upheld the doctor’s
assertion of the Good Samaritan defense. There, Douglas McIntyre, an obstetrician, was in the hospital visiting one
of his patients when he responded to a page over the intercom requesting that a doctor immediately assist with
Debra Ramirez’s delivery. Unlike in this case, McIntyre was not part of Ramirez’s labor and delivery team, was not
on-call, and was not expected to respond to such an emergency. Instead, he was going about his scheduled
appointments when he voluntarily came to another patient’s aid. McIntyre, 109 S.W.3d at 743, 749.[2] In contrast,
there is evidence here that it was part of Riddle’s job as the anesthesiologist in the delivery room to intubate a
newborn if the circumstances required.
Given the legislative purpose behind the Good Samaritan defense and the fact that Riddle was part of the labor
and delivery team, we cannot agree with the court of appeals’ conclusion that Riddle established his entitlement to
the defense as a matter of law. Accordingly, without hearing oral argument, we grant the petition for review, reverse
the court of appeals’ judgment, and remand to the court of appeals to consider whether the summary judgment
should be affirmed on alternative grounds. See Tex. R. App. P. 59.1.
Opinion Delivered: February 15, 2008
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[1] At the time of these events, the Good Samaritan statute was codified at Texas Civil Practice and Remedies Code
section 74.001. It has since been heavily amended and is now found at Texas Civil Practice and Remedies Code
section 74.151. All references to the Good Samaritan statute in this opinion will be to section 74.001 as it stood in
2001. See Act of June 16, 1985, 69th Leg., R.S., ch. 962, 1985 Tex. Gen. Laws 3325, amended by Act of June 19,
1993, 73d Leg., R.S., ch. 960, 1993 Tex. Gen. Laws 4193–94, amended by Act of June 18, 1999, 76th Leg., R.S.,
ch. 679, 1999 Tex. Gen. Laws 3251.
[2] In McIntyre, we addressed only the remuneration exception to the Good Samaritan defense; we did not discuss
whether McIntyre fit into the “associated by” exception. McIntyre, 109 S.W.3d 741.