Background
Irma Rodriguez, who has type 2 diabetes, began seeing rheumatologist Dr. Anam Aslam Shaikh for polymyalgia rheumatica in March 2022. Shaikh prescribed prednisone, a corticosteroid. Several months later, Rodriguez’s cataracts worsened and she developed diabetic retinopathy that caused vision loss in one eye.
Rodriguez sued Shaikh for medical negligence, alleging that Shaikh prescribed prednisone without adequately adjusting or monitoring Rodriguez’s diabetes care, considering non-steroid alternatives, or warning her that increased blood sugar could lead to vision loss. After the trial court limited ophthalmologist Dr. Matthew McMenemy’s initial expert report to causation, Rodriguez submitted an amended report from McMenemy and a supplemental report from Dr. Alex Lechin, a physician board-certified in critical care, internal medicine, pulmonary medicine, and sleep medicine.
Shaikh objected that neither expert was qualified to address the standard of care applicable to a rheumatologist treating polymyalgia rheumatica. The trial court overruled the objections and denied Shaikh’s motion to dismiss, and Shaikh appealed.
The Court’s Holding
The First Court of Appeals affirmed. It held that the trial court acted within its discretion in finding Lechin qualified to opine on the applicable standard of care. The relevant inquiry was not whether Lechin shared Shaikh’s rheumatology specialty, but whether his expertise covered the specific subject of his opinions.
Lechin’s report described more than 36 years of experience treating patients who chronically use corticosteroids for autoimmune conditions, including prescribing corticosteroids to diabetic patients. It also stated that polymyalgia rheumatica is not treated exclusively by rheumatologists and may be managed by internists or primary-care physicians. Because Rodriguez’s claim centered on prescribing prednisone to a diabetic patient and monitoring the patient and her glucose levels afterward, the report demonstrated Lechin’s practical knowledge of what physicians ordinarily do under comparable circumstances.
Because Lechin’s report was sufficient, the court did not decide whether McMenemy’s amended report independently satisfied the statutory requirements.
Key Takeaways
- A medical expert need not practice in the defendant physician’s specialty if the expert has relevant practical knowledge of the specific medical issue addressed.
- Lechin’s experience prescribing corticosteroids to diabetic patients with autoimmune diseases supported his qualifications to address prednisone-related monitoring and care.
- When a plaintiff serves multiple expert reports, one sufficient report can support denial of dismissal without requiring the court to evaluate every additional report.
Why It Matters
The decision applies Texas’s instruction that expert-qualification requirements should not be drawn too narrowly. In a malpractice claim involving medication risks that cross specialty lines, the decisive question is whether the expert’s training and experience concern the particular treatment and risks at issue, not whether the expert holds the same specialty as the defendant.
The ruling leaves Rodriguez’s claims pending in the trial court; it does not decide whether Shaikh was negligent or whether prednisone caused Rodriguez’s vision loss.