Lawsuit alleges Texas system hiring physicians as professors to dodge malpractice claims

What began as a medical malpractice lawsuit against a Texas urologist has evolved into a broader accusation, The Texas Tribune reported Feb. 23. 

A recent lawsuit alleges that the University of Texas at Tyler Health Science Center — the health science education branch of the university's Tyler campus — is fraudulently hiring physicians as medical school professors to protect them from lawsuits. In reality, these physicians allegedly are not working as professors for the university but are practicing within its for-profit health system, UT Health East Texas. 

Under Texas law, physicians employed by a government entity like the state medical school are "generally not subject" to malpractice suits, according to the Tribune. Patients can sue the physician's employer, but for a significantly smaller payout. 

The lawsuit began with Michael Simington, a 67-year-old patient who saw Ruben Garcia, MD, a urologist, in October 2019. Dr. Garcia ordered a biopsy, which showed prostate cancer, but did not share the diagnosis with Mr. Simington until March 2021.

By that time, the cancer had spread. Mr. Simington's attorney, Reid Martin, hired a urologist from the University of California Los Angeles to review the case; the urologist determined that the delayed diagnosis may have cost Mr. Simington eight to 10 years of life.

But when Mr. Simington attempted to sue Dr. Garcia for medical malpractice in 2021, he learned that he was employed by the University of Texas at Tyler Health Science Center as a clinical assistant professor of surgery — not by UT Health East Texas, which acquired four urology clinics owned by Dr. Garcia in 2019 and was branded on his white coat, website and brick-and-mortar signage. 

This distinction shields Dr. Garcia from most medical malpractice suits, according to his attorneys. Mr. Simington could not sue him directly and must instead sue his employer, the university. Since the university is a state entity, Mr. Simington would have to inform the state of his intent to sue within six months and prove the incident involved "tangible personal property" — unlikely conditions to be met for a missed diagnosis. 

Even if he was able to meet the conditions, the most Mr. Simington's lawsuit could win is $250,000. Under typical medical malpractice statutes, it could win up to $250,000 in non-economic damages against a physician but an unlimited amount — potentially millions — in economic damages. Mr. Simington died in spring 2023.

"I didn't realize until I looked into it," Mr. Martin told the Tribune. "But the way they've set up [UT Health East Texas], there's no way to hold the doctors working here accountable."

In 2017, East Texas Medical Center, a nine-hospital system, was purchased to form UT Health East Texas. Though the system was created in partnership with UT Tyler Health Science Center, most of its funding came from Nashville, Tenn.-based Ardent Health Services, the fourth-largest privately held hospital operator in the country. Ardent invested nearly $350 million to purchase the properties and promised another $125 million in system improvements, according to the Tribune

Although UT Health East Texas is affiliated with a public university, it is still a for-profit system. Ardent owns 70% and manages daily operations, while the university owns 30%, and its president chairs the corporate board. 

Now, there are more than 90 physician clinics under UT Health East Texas. Since 2018, more than 200 physicians have been hired as professors at the university while practicing at the system, the Tribune found. 

Amid questions from Tribune reporters, UT Health East Texas updated its website to say certain providers are "employed as a clinical faculty physician at the University of Texas Health Science Center at Tyler under the UT Tyler School of Medicine."

The university declined the Tribune's request for comment on the litigation but said in a statement that its healthcare venture "has been exceptionally successful and significantly enhanced medical education and healthcare for East Texas." It did not return Becker's request for further comment. 

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