Texas Medical Malpractice — Requirements & Limits

Medical malpractice claims in Texas carry a higher burden of proof, stricter procedural requirements, and tighter deadlines than ordinary personal injury cases. The plaintiff must prove that a healthcare provider deviated from the accepted standard of care and that this deviation — not the underlying illness or condition — caused the harm.

Not every bad outcome is malpractice. To have a valid claim, four elements must be established:

In virtually all medical malpractice cases, expert testimony is required to establish both the standard of care and the breach. The expert must be a qualified medical professional — typically a practitioner in the same specialty as the defendant. Without a qualified expert willing to testify, the case cannot proceed.

Texas imposes specific procedural requirements on medical malpractice claims that must be satisfied before or at the time of filing:

• Expert Affidavit: This is a post-filing expert report requirement, separate from the pre-suit notice under §74.051. Plaintiff must serve on each defendant or that defendant's attorney one or more expert reports, with a curriculum vitae of each expert listed, not later than the 120th day after the date that defendant's original answer is filed (or a later date required under §74.353); the date for serving the report may be extended by written agreement of the affected parties. The report must provide a fair summary of the expert's opinions on the applicable standard of care, the manner in which the care failed to meet it, and the causal relationship to the injury claimed. If no report is served within that period, the court must, on the affected physician's or health care provider's motion, award that provider reasonable attorney's fees and court costs and dismiss the claim against it with prejudice, subject to the cure provision: where elements of a served report are found deficient, the court may grant one 30-day extension to cure. §74.351
• Pre Suit Notice: At least 60 days before filing suit, plaintiff must give written notice to each health care provider against whom a claim is being made. §74.051

Medical malpractice in Texas has specific deadline rules that differ from the general personal injury Statute of limitations §74.251.

2 years from occurrence of breach or last date of relevant course of treatment (§74.251(a)). 10-year statute of repose (§74.251(b)). Noneconomic damages capped at $250K per provider, $500K total (§74.301).

The general personal injury statute of limitations is 2 years §16.003.

Statute of repose §74.251

Texas imposes a 10-year statute of repose — an absolute outer limit that cannot be extended by the discovery rule or tolling. 10-year statute of repose for medical malpractice from date of act or omission (§74.251(b)). Claimants under 12 have until their 14th birthday (§74.251(b)).

Texas imposes caps on certain categories of medical malpractice damages:

• $250,000 per health care provider, $500,000 total for all providers (Applies to physicians, health care providers, and health care institutions separately. No cap on economic damages.) §74.301

• Surgical errors — wrong site, retained instruments, nerve damage, anesthesia errors
• Misdiagnosis or delayed diagnosis — failure to diagnose cancer, heart attack, stroke, or infection in time to prevent progression
• Medication errors — wrong drug, wrong dose, dangerous drug interactions, failure to check patient history
• Birth injuries — failure to monitor fetal distress, improper use of forceps or vacuum, delayed C-section
• Failure to treat — correct diagnosis but inadequate treatment, premature discharge, failure to refer to a specialist
• Failure to obtain informed consent — performing a procedure without adequately explaining risks and alternatives

Texas follows modified comparative fault — damages are reduced by the injured person's percentage of fault, but if the injured person is 51% or more at fault, they recover nothing.

This rule applies in medical malpractice just as in other personal injury cases. The defense may argue the patient contributed to the harm — by failing to follow post-operative instructions, not disclosing relevant medical history, or delaying follow-up care.

• Request your complete medical records — you have a legal right to them. Do this before anything else.
• Do not delay — the combination of filing deadlines, pre-suit requirements, and the time needed for expert review means that early action is essential.
• Continue treating with other providers — mitigating your injuries is both medically necessary and legally important.
• Document the timeline — note when symptoms appeared, what you were told by providers, and when you first suspected something went wrong.