Medical Injury Claims in Texas: Chapter 74 Notice, Deadline, and Expert Report Basics

By Pacheco Couceiro

When a patient in Brownsville or the Rio Grande Valley is hurt during treatment at a clinic, hospital, nursing home, or other health care setting, Texas law treats the claim differently from a car crash or a fall at a store. Chapter 74 of the Texas Civil Practice and Remedies Code sets special rules for what it calls a health care liability claim: advance notice, a medical records authorization, a two-year deadline with a ten-year outer limit, an early expert report, and limits on certain damages. This article summarizes those rules as written in the statute. Sources were checked on November 13, 2026. This article does not evaluate any medical outcome, does not judge any provider, and does not predict any result.

What counts as a health care liability claim

Section 74.001(a)(13) defines a health care liability claim as a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, health care, or safety, or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant. The definition applies whether the claim sounds in tort or contract.

Section 74.001 lists many kinds of health care providers and health care institutions, including:

Registered nurses, dentists, podiatrists, pharmacists, chiropractors, and optometrists
Hospitals and hospital systems
Ambulatory surgical centers
Nursing homes and licensed assisted living facilities
Home and community support services agencies and hospices
Emergency medical services providers
End stage renal disease facilities

Physicians are covered separately. Because the definition is broad, the question of whether a claim falls under Chapter 74 is often one of the first issues in a case.

Step one under the statute: written notice 60 days before suit

Section 74.051(a) says any person asserting a health care liability claim shall give written notice of the claim by certified mail, return receipt requested, to each physician or health care provider against whom the claim is made at least 60 days before filing suit in a Texas court. The notice must be accompanied by the medical authorization form required by Section 74.052.

Key points in Section 74.051:

Later pleadings must state that the party fully complied with Sections 74.051 and 74.052.
Notice given under the chapter tolls the applicable statute of limitations for 75 days following the notice, for all parties and potential parties.
All parties may obtain complete and unaltered copies of the patient's medical records from any other party within 45 days of a written request.

The medical authorization form

Section 74.052 sets out the exact text of an authorization for release of protected health information. If the authorization does not accompany the notice, Section 74.052(a) says all further proceedings against the provider are abated until 60 days after the provider receives it. The form lists the treating physicians and providers and lets the patient name providers excluded from the authorization.

The deadline to file suit

Section 74.251(a) says a health care liability claim must be filed within two years from the occurrence of the breach or tort, or from the date the medical or health care treatment that is the subject of the claim, or the hospitalization, is completed. The same subsection gives minors under 12 until their 14th birthday to file or have a claim filed for them.

Section 74.251(b) adds a statute of repose: a claim must be brought no later than 10 years after the date of the act or omission that gives rise to it.

These rules differ from the general two-year personal injury rule covered in our article on the Texas personal injury statute of limitations. When the 75-day tolling in Section 74.051(c) applies, it extends the time, but the calculation depends on the facts and the dates in the records.

The expert report

Section 74.351 is one of the most important rules in the chapter. It says a claimant shall, not later than the 120th day after each defendant's original answer is filed, serve on that defendant one or more expert reports, with a curriculum vitae for each expert, for each physician or health care provider against whom a claim is asserted.

Section 74.351(r)(6) defines an expert report as a written report by an expert that provides a fair summary of the expert's opinions about:

The applicable standards of care
How the care provided failed to meet those standards
The causal relationship between that failure and the injury, harm, or damages claimed

Other parts of Section 74.351 say:

The deadline may be extended by written agreement of the affected parties.
A defendant must object to the sufficiency of a report within 21 days after it is served or after its answer is filed, whichever is later, or objections are waived.
If no report is served on time, the court, on the defendant's motion, shall dismiss the claim against that defendant with prejudice and award reasonable attorney's fees and costs to the defendant.
If a report was served but found deficient, the court may grant one 30-day extension to cure.
Separate experts may address different providers or different issues, such as liability and causation.
Until the report is served, discovery is stayed, except that the claimant may obtain information such as medical records through certain written discovery, depositions on written questions, and discovery from nonparties.

Emergency care has a different standard of proof

Section 74.153 says that for emergency medical care in a hospital emergency department, an obstetrical unit, or a surgical suite immediately following evaluation or treatment in an emergency department, the claimant may prove a departure from accepted standards only by showing, by a preponderance of the evidence, that the provider acted with willful and wanton negligence. Section 74.153(b) lists exceptions, including care provided after the patient is stabilized and receiving treatment as a nonemergency patient.

Limits on noneconomic damages

Subchapter G of Chapter 74 limits noneconomic damages. Section 74.301 sets a limit of $250,000 per claimant against physicians and providers other than institutions, $250,000 per claimant against a single health care institution, and, when judgment is against more than one institution, $250,000 per institution and $500,000 total per claimant. The statute addresses noneconomic damages; other categories of damages are governed by other sections.

Practical steps

1. Request your medical records

Ask each provider for a complete copy of your records and bills, and keep the request and response dates.

2. Write down the dates

Record the dates of treatment, hospitalization, discharge, and when you first noticed a problem.

3. Identify every provider

List each physician, nurse, facility, and agency involved, with addresses.

4. Watch the deadlines

Remember the two-year limit, the 60-day notice before suit, and the 120-day expert report after each defendant's answer.

5. Check licenses

The Texas Medical Board maintains license information for physicians and handles complaints about them. A board complaint is separate from a civil claim.

Frequently asked questions

Does Chapter 74 apply to nursing homes?

Section 74.001 lists nursing homes and licensed assisted living facilities among health care institutions, so claims against them may fall within Chapter 74 depending on the facts.

What if my child was injured?

Section 74.251(a) gives minors under 12 until their 14th birthday to file, subject to the 10-year repose period in Section 74.251(b).

What happens if a claim involves a death?

Chapter 74 covers claims that result in injury or death. Our article on Texas wrongful death and survival claims explains who may bring those claims.

Questions in Brownsville and the Rio Grande Valley

Pacheco Couceiro assists injured people and families in Brownsville and South Texas with personal injury matters. If you have questions about how the Chapter 74 notice, deadline, and expert report rules may apply to your medical records and dates of treatment, you can contact the office to review those records.

This article is general information, not legal advice. Reading it or contacting the office does not create an attorney-client relationship.

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