Texas Supreme Court Holds Hospitals Accountable for Patient Safety Failures
At Van Wey, Metzler & Williams, we’re proud to share a major legal victory, not just for our clients, but for patients across Texas. After years of litigation and appeals, the Texas Supreme Court has issued a favorable opinion in Bush v. Columbia Medical Center of Arlington d/b/a Medical City Arlington and HCA Inc., reaffirming a patient’s right to hold hospitals accountable for failing to implement and enforce reasonable policies and protocols to keep patients safe.
In a landmark 7-2 decision, the Texas Supreme Court just made it clear: Hospitals cannot hide behind doctors to avoid responsibility for preventable harm.
This ruling is a turning point for patients' rights in our state.
Read the full opinion here:
The Case at a Glance
Our client, Jared Bush, tragically lost his wife, Ireille Williams-Bush, a 35-year-old mother of two, after she was discharged from Medical City Arlington despite classic symptoms of a pulmonary embolism, a dangerous and often fatal blood clot in the lungs. Despite her symptoms, the hospital allegedly failed to implement a "Triple Rule Out" protocol, which is a standard procedure for evaluating life-threatening conditions like pulmonary embolisms, aortic dissections, and heart attacks.
We filed a lawsuit against the doctors and the hospital on behalf of Jared and his children arguing that the hospital’s failure to adopt and enforce appropriate screening protocols contributed directly to his wife’s death. The hospital argued that since doctors are ultimately responsible for making the diagnosis, they did not belong in the lawsuit. Although the trial court twice agreed with our position, and found our preliminary expert report was adequate, the 2nd Court of Appeals dismissed the case against the hospital. That is, until the Texas Supreme Court stepped in.
What the Texas Supreme Court Said
The Supreme Court reversed the 2nd Court of Appeals, holding that the expert report was sufficient at the preliminary Chapter 74 stage and took the court of appeals to task for “exceed[ing] the scope of the fair-summary standard.” In its opinion, the Texas Supreme Court held that:
- A hospital can be held directly liable for failing to implement systems and protocols that help prevent life-threatening misdiagnoses, even when the treatment is carried out by independent-contractor physicians.
- Hospital policies, standing orders or protocols may guide treatment paths without mandating them or running afoul of the prohibition of the corporate practice of medicine.
- The Court rejected the notion that the report had to explain how hospital policies could override physician decisions. Hospitals are responsible for administrative policies that guide non-physician staff, not for practicing medicine directly.
For years, hospital systems have attempted to shield themselves from direct liability through procedural dismissals and overly narrow interpretations of Texas’s expert report statute known as Chapter 74. This ruling makes it clear that when hospitals fail to implement and enforce reasonable policies and protocols to keep patients safe, they can be held directly liable for the injuries they cause.
How Hospitals Control Patient Care (And Why They Try to Avoid Blame)
The major hospital systems in Texas are billion-dollar corporations that grow larger and more powerful every year. Hospitals establish policies, protocols and procedures for how interdisciplinary teams of providers communicate and assess patients in order to provide appropriate care and treatment. They decide which equipment, staffing, and patient safety measures are put in place. Yet when something goes wrong, they often claim, “We don’t practice medicine, it’s the doctor’s fault, not ours."
This legal strategy has allowed hospitals to insulate themselves from liability, often leaving grieving families with no recourse ... until now.
Why This Matters for Future Patients
When medical tragedies occur, hospitals often try to shift blame solely onto doctors, claiming they have no control over how physicians practice medicine. But the truth is, hospitals dictate the policies, protocols, and resources that shape patient care. When hospitals cut corners, patients suffer.
With this opinion, the Texas Supreme Court has made its stance clear: enough is enough.
This ruling sets an important precedent for medical malpractice cases in Texas:
- Hospitals must take responsibility for their own systemic failures, and not just blame doctors.
- Attorneys representing patients across Texas can help clients move past dismissal traps by hospital systems and fight for justice and accountability for their clients.
- Families can challenge systemic negligence. Most importantly, this ruling ensures that hospitals, not just individual doctors, are held accountable when their policies (or lack thereof) lead to patient harm.
Patients in Texas are a Little Bit Safer Today
For too long, hospital systems have escaped responsibility while patients and families paid the price. This ruling changes that.
“This isn’t just a win for one family, it’s a win for every patient in Texas,” said Brady Williams, partner at Van Wey, Metzler & Williams. “The Texas Supreme Court has made it clear that hospitals have a duty to implement and enforce policies that keep patients safe. When they don’t, they can be held accountable.”
Justice starts with holding the right people accountable. That's where we come in.
At Van Wey, Metzler & Williams, we’re using this momentum to fight even harder for families harmed by medical negligence. If you or someone you love has experienced serious injury due to hospital error, contact us. We’ll stand with you…all the way to the Supreme Court if necessary.