CROSSOVER: Dallas Court of Appeals Tightens Chapter 74 ‘Good-Faith’ Expert Report Requirements—A Blueprint to Exclude Vague Medical Causation Proof

Texas A&M University–Commerce and Texas A&M University System v. Chandler Donaway, 05-25-00481-CV, March 30, 2026.

On appeal from 354th Judicial District Court, Hunt County, Texas

Synopsis

The Dallas Court of Appeals reversed an order overruling Chapter 74 objections and denying a partial motion to dismiss, holding the plaintiff’s expert report did not constitute an “objective good-faith effort” under Texas Civil Practice & Remedies Code § 74.351. The report failed to articulate—within its four corners—defendant-specific standards of care, how each defendant breached those standards, and a non-conclusory causal chain tying the alleged breaches to the complained-of injuries. The case is a reminder that vague medical causation proof is not merely “weak”—it is jurisdictionally fatal at the expert-report stage.

Relevance to Family Law

Family-law litigators increasingly litigate medical issues through a civil-procedure lens: psychological and substance-use evaluations, medication management, therapy compliance, medical decision-making in SAPCRs, and personal-injury-type claims that appear as reimbursement/economic-contribution disputes in divorce. This opinion is a blueprint for attacking “expert-ish” causation narratives that are long on conclusions and short on methodology—particularly when the opposing side attempts to leverage medical records, generalized risk statements, or “this likely caused that” language to influence conservatorship findings, protective orders, or disproportionate property division arguments.

Case Summary

Fact Summary

The plaintiff, a TAMUC student-athlete, injured his ankle during a 2022 football game. He alleged that training staff taped the ankle and allowed him to continue playing, followed by a season-long course of therapies and injections and delayed diagnostic imaging. After the season, an MRI revealed ligament tearing. Surgery followed in January 2023, and complications allegedly ensued, including a postoperative infection, washout procedures, antibiotics, and additional hospitalization. The plaintiff ultimately sought care elsewhere and claimed the infection management and overall course of treatment were mishandled, reducing his ability to return to competitive football.

He sued multiple defendants, including the treating orthopedic surgeon (not a party to this interlocutory appeal) and two university entities—Texas A&M University–Commerce (TAMUC) and the Texas A&M University System (TAMUS). As to the university defendants, he framed health care liability theories tied to the provision of therapies and use of tangible property in treatment (with a separate motor-vehicle transportation claim that the universities did not seek to dismiss as a Chapter 74 claim). The plaintiff served an orthopedic surgeon’s Chapter 74 expert report. The universities objected and sought partial dismissal. The trial court overruled objections and denied dismissal; the universities took an interlocutory appeal.

Issues Decided

• Whether the plaintiff’s Chapter 74 expert report constituted a “good faith effort” under Tex. Civ. Prac. & Rem. Code § 74.351 by adequately stating:
• the applicable standard of care,
• the breach of that standard, and
• causation
  as to TAMUC and TAMUS.
• Whether the trial court abused its discretion by overruling objections to the report and denying a partial motion to dismiss under § 74.351.

Rules Applied

• Tex. Civ. Prac. & Rem. Code § 74.351(a), (l), (r)(6): Expert report must provide a “fair summary” of opinions on standard of care, breach, and causation; dismissal required if report is not an objective good-faith effort.
• Abuse of discretion review for expert-report rulings:
• Am. Transitional Care Ctrs. of Tex. v. Palacios, 46 S.W.3d 873 (Tex. 2001)
• Bowie Mem’l Hosp. v. Wright, 79 S.W.3d 48 (Tex. 2002) (per curiam)
• Good-faith effort content requirements:
• Must (1) notify the defendant of the specific conduct at issue and (2) provide a basis for the trial court to conclude the claim has merit. Palacios, 46 S.W.3d at 879.
• Must explain reasoning; cannot be conclusory. Bowie, 79 S.W.3d at 52.
• Must be judged within the four corners; courts cannot “fill gaps” by inference. See Jelinek v. Casas, 328 S.W.3d 526 (Tex. 2010); Hollingsworth v. Springs, 353 S.W.3d 506 (Tex. App.—Dallas 2011, no pet.).
• Consider the report as a whole, not isolated quotes. Baty v. Futrell, 543 S.W.3d 689 (Tex. 2018).
• The opinion also frames Chapter 74’s “core purpose”: early elimination of frivolous health care liability claims while preserving potentially meritorious ones. See Samlowski v. Wooten, 332 S.W.3d 404 (Tex. 2011).

Application

Justice Rossini’s opinion reads like a methodical enforcement of the Palacios/Bowie/Jelinek line: the expert report must do the elemental work—defendant by defendant—inside the report itself. The court emphasized that “good faith” is not a sincerity test; it is an objective sufficiency standard. A report can be lengthy, cite records, and narrate treatment, yet still fail if it does not (1) identify the operative standard(s) of care applicable to each provider/defendant, (2) specify what each defendant did or failed to do that breached those standards, and (3) articulate a reasoned causal chain connecting the breach to the injury.

Strategically, the opinion tightens the screws on a common plaintiff-side move: substituting generalized medical hindsight (“an MRI should have been ordered,” “treatment was inappropriate,” “delays worsened outcome”) for an actual causation explanation (“had X occurred by date Y, it would more likely than not have prevented Z, because…”). The court reiterated that reviewing courts cannot supply missing links by inference—if causation is left to implication, the report is deficient. And, critically for multi-defendant cases, the report must not blur separate entities into a single monolithic “provider.” Defendant-specific standards, breaches, and causation matter—especially where the defendants are separate legal entities with different roles.

The result is a usable template for defense objections: force the plaintiff to identify what the university defendants allegedly controlled, which acts are attributable to them rather than the physician, and how those acts caused the pleaded injuries (as opposed to merely being part of the narrative). If the report doesn’t allocate responsibility and explain the causal mechanism, it does not cross the § 74.351 threshold.

Holding

The Dallas Court of Appeals held the expert report was deficient because it did not address Chapter 74’s required elements—standard of care, breach, and causation—with sufficient specificity to constitute an objective good-faith effort under Tex. Civ. Prac. & Rem. Code § 74.351.

The court therefore reversed the trial court’s order overruling the universities’ objections and denying their partial motion to dismiss, and remanded for further proceedings consistent with the opinion.

Practical Application

Texas family-law litigators should read this as a procedural discipline case: courts (and savvy opposing counsel) are increasingly intolerant of expert narratives that never lock into (1) a defined standard, (2) a concrete deviation, and (3) a reasoned causation explanation. That discipline applies directly to the kinds of “medical causation” arguments that show up in family court under different labels.

• Custody and medical decision-making disputes: When a party uses a counselor, psychiatrist, pediatrician, or evaluator to imply that the other parent “caused” a child’s deterioration, insist on the same structure—standard/benchmark, specific conduct, and a causal chain that is not post hoc.
• Substance-use and medication issues: If an expert opines that a parent’s medication regimen “impairs parenting,” the Donaway logic supports pressing for the “how” and “why,” not just the conclusion.
• Property division and reimbursement claims with medical overlays: Claims that one spouse’s conduct “caused” medical disability (and therefore diminished earning capacity) can be attacked where the proof is vague, generalized, or not tethered to a methodology.
• Protective orders / high-stakes temporary orders: Even when the formal Chapter 74 framework does not apply, Donaway’s four-corners discipline is persuasive when you are urging the judge to discount conclusory expert letters submitted on short notice.

Checklists

Building a Defense Objection to Vague Causation Proof (Family or Civil)

• Identify whether the “expert” states a standard/benchmark (what should have happened) versus a narrative (what did happen).
• Force actor specificity: who, exactly, had the duty—party, agent, third-party provider, or institution?
• Flag conclusory phrases (“contributed to,” “likely caused,” “exacerbated,” “failed to properly manage”) that lack:
• timing,
• mechanism, and
• outcome differential (what would have changed absent the breach).
• Demand a reasoned causal chain:
• breach → physiological/psychological mechanism → specific injury/impairment → functional impact relevant to the disputed issue (best interest, earning capacity, etc.).
• Argue against judicial “gap-filling”:
• if the link requires inference, it is not proven; it is asserted.

Vetting Your Own Expert Before You File (Plaintiff-Side Family Strategy)

• Ensure the report/affidavit is organized explicitly as:
• Standard(s) / Benchmark(s)
• Breach (by actor)
• Causation (mechanism + why more likely than not)
• Make the expert allocate opinions by respondent (parent A vs parent B; clinic vs therapist; evaluator vs treating provider).
• Include dates and decision points: what should have been done when, and what harm flows from that failure.
• Remove “record-dump” sections that do not advance standard/breach/causation.

Cross-Examination Outline When Opponent Uses a Conclusory Expert Letter

• “Show me where you define the applicable standard you’re applying.”
• “Identify the exact act/omission you attribute to this party (not a third party).”
• “Explain the mechanism—how does that act produce the complained-of condition?”
• “What alternative causes did you rule in/out, and on what basis?”
• “What would you expect to see in the records if your causation theory were correct—and do we see it?”

Citation

Texas A&M University–Commerce and Texas A&M University System v. Donaway, No. 05-25-00481-CV (Tex. App.—Dallas Mar. 30, 2026) (mem. op.).

Full Opinion

Read the full opinion here

Family Law Crossover

Weaponize Donaway in divorce and custody litigation by reframing the opponent’s medical narrative as a three-element sufficiency problem: if their therapist letter, evaluator addendum, or physician affidavit never clearly states the benchmark standard, the specific departure by the targeted parent, and a reasoned causal mechanism tying that departure to a best-interest factor (or to claimed economic harm), you can argue the court is being asked to “fill gaps” with inference—exactly what Dallas condemns in the Chapter 74 context. The practical payoff is procedural: it supports motions to strike/limit expert affidavits, tightens Daubert/Robinson-style reliability attacks, and gives trial courts a principled basis to discount conclusory “medical causation” opinions that are often used to drive temporary orders, supervised possession, or disproportionate divisions.

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