Health & Medical in Texas

Texas Medical Liability Act § 74.251 provides two years from the breach, with a ten-year absolute repose period. An expert report from a same-specialty physician must be served within 120 days of filing under § 74.351. Failure to timely serve the report results in mandatory dismissal and fee awards.

Texas caps non-economic damages at $250,000 per defendant physician and $250,000 per defendant health care institution, with a maximum aggregate of $500,000 per claimant for institutional defendants under Tex. Civ. Prac. & Rem. Code § 74.301. These caps are among the strictest in the country and significantly limit recoverable damages in Texas malpractice cases.

Under Tex. Civ. Prac. & Rem. Code § 74.351, within 120 days of filing a medical malpractice lawsuit, plaintiffs must serve each defendant with a written expert report from a physician in the same specialty. The report must address the standard of care, the breach, and causation. If the report is deemed inadequate, the court may dismiss the case and award attorney's fees to the defendant.

Complaints against Texas physicians may be filed with the Texas Medical Board online at tmb.state.tx.us. The TMB investigates and may impose probation, suspend, or revoke a physician's license. TMB proceedings are separate from civil litigation and do not compensate patients.

Texas enacted comprehensive medical malpractice tort reform in 2003 (HB 4), which imposed the $250,000 non-economic damage cap, the 120-day expert report requirement, and other procedural hurdles. Since 2003, the number of malpractice lawsuits filed in Texas has decreased significantly, and malpractice insurance premiums have generally stabilized. Critics argue that the caps may make it difficult for patients with legitimate but lower-value claims to find attorneys willing to take their cases, since the limited potential recovery may not justify the substantial litigation costs. Understanding these dynamics is important when evaluating whether pursuing a malpractice claim in Texas is feasible.

Claims against public hospitals in Texas (such as county hospitals or university teaching hospitals) are subject to the Texas Tort Claims Act, which imposes additional limitations including damage caps of $250,000 per person and $500,000 per occurrence, a six-month notice of claim requirement, and sovereign immunity limitations. These caps are separate from and in addition to the MICRA-style malpractice caps under Chapter 74. Claims against private hospitals are subject only to the Chapter 74 requirements. This means a patient injured at a public hospital could face significantly lower damage caps and stricter procedural requirements than one injured at a private facility.