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 Feb. 15, 2008) (first, superseded opinion)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)
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)
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.

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 |


Chau v. Riddle, MD (Tex. Feb. 15, 2008) [superseded opinion]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. §

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


[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.