## Facts

- Stephen Farmer, a chronic-pain patient, was treated by Dr. Matt Sloan, who prescribed controlled substances.
- As a condition of receiving narcotics, Farmer signed a contract requiring him to take only medications prescribed by Sloan and submit to random drug testing; a violation could terminate the physician-patient relationship.
- Farmer’s employer, TXU, removed him from full-duty work and retained Concentra Integrated Services, Inc. to monitor his treatment and disability status.
- A random urine drug screen ordered by Sloan was positive for a controlled substance not prescribed by Sloan, and Sloan decided Farmer violated the narcotic contract and terminated the treatment relationship.
- Before Farmer received Sloan’s termination letter, Sloan’s staff communicated the failed drug screen and termination decision to Concentra, and TXU learned the information and confronted Farmer.
- TXU terminated Farmer’s employment and benefits.
- Farmer and his wife sued Sloan and Sloan’s professional association, alleging privacy/confidentiality-based claims based on the disclosure to Concentra/TXU.
- The defendants moved to dismiss under Texas Civil Practice and Remedies Code § 74.351(b) for failure to serve an expert report; the trial court dismissed most claims but refused to dismiss the breach-of-confidentiality claim.

## Issues

1. Whether a physician’s alleged breach of patient confidentiality, based on disclosure of treatment-related information to an employer’s administrator, is a “health care liability claim” under Texas Civil Practice and Remedies Code Chapter 74.
2. If so, whether § 74.351(b) required dismissal with prejudice for failure to timely serve an expert report, plus an award of reasonable attorney’s fees and costs.

## Decision

- The court of appeals reversed the trial court’s order denying dismissal of the breach-of-confidentiality claim.
- The court held the confidentiality claim was a “health care liability claim” under Chapter 74 and therefore subject to § 74.351(b)’s expert-report requirement.
- Because no timely expert report was served, the court rendered judgment dismissing the remaining claim with prejudice.
- The court remanded solely to determine reasonable attorney’s fees and court costs owed to the defendants under the statute.

## Legal Principles

- Chapter 74’s definition of a “health care liability claim” is governed by the nature of the complained-of conduct (a claimed departure from accepted standards of medical/health care, or professional or administrative services directly related to health care), not by the plaintiff’s label for the cause of action.
- A physician’s duty of confidentiality arises from the physician-patient relationship and is directly related to the rendition of health care; an alleged breach implicates professional standards applicable to health care providers.
- When a claim qualifies as a health care liability claim, § 74.351(b) requires a timely expert report; noncompliance mandates dismissal with prejudice and an award of reasonable attorney’s fees and costs.

## Conclusion

The court treated the alleged disclosure of treatment-derived information as conduct directly related to health care and therefore within Chapter 74, making an expert report mandatory; the plaintiffs’ failure to serve a report required dismissal with prejudice and a remand limited to calculating statutory fees and costs.


Sloan v. Farmer, 217 S.W.3d 763 (Tex. App.—Dallas 2007, pet. denied)