Chapter 74 of the Texas Civil Practice and Remedies Code, known as the Texas Medical Liability Act, governs every medical malpractice case in the state. If you are considering a claim, the statute controls four things that decide whether you can recover at all: when you must file, what notice you must send first, the expert report you must produce early in the case, and how much money you can be awarded at the end. Miss any single requirement and the claim is usually gone for good.
The statute applies broadly. It covers treatment, failure to treat, and any departure from accepted standards of medical care or safety by a physician or health care provider, whether your theory is negligence or breach of contract.1State of Texas. Texas Code Civil Practice and Remedies Code 74.001 – Definitions “Health care provider” is defined widely and sweeps in nurses, dentists, podiatrists, pharmacists, hospitals, and nursing homes alongside licensed physicians.
The Two-Year Filing Deadline
Section 74.251(a) gives you two years to sue, measured from the date of the treatment or the date the course of treatment causing the injury ended, whichever is later. Texas does not apply a general discovery rule to these claims. The clock runs from the medical act, not from when you realized something went wrong.
There is one recognized exception. When a foreign object is left inside a patient’s body, Texas courts have held that the state constitution’s open-courts provision gives the patient a reasonable chance to discover the injury and sue even after two years have passed. Nothing else stops the clock.
A ten-year statute of repose sits on top of the two-year limit. Section 74.251(b) bars any claim filed more than ten years after the negligent act, and the foreign-object exception cannot push past that wall.
Children Under 12
If the patient was younger than 12 when the negligence occurred, the filing deadline extends to the child’s 14th birthday. The ten-year repose still applies, which can produce odd results. Negligence at age five gives the family until the child turns 15, so the 14th-birthday rule controls. Negligence at age one causes the repose period to expire at age 11, cutting the claim off before the child ever reaches 14. Pediatric cases need both deadlines calculated side by side.
Pre-Suit Notice and the Authorization Form
You cannot walk straight into court. Section 74.051 requires written notice of the claim, sent by certified mail with return receipt requested, to every physician and provider you plan to sue, at least 60 days before you file suit. Sending the notice tolls the statute of limitations for 75 days, which gives both sides time to investigate.2State of Texas. Texas Code Civil Practice and Remedies Code 74.051 – Notice
Every notice must include a medical authorization form for release of protected health information, using the exact language set out in Section 74.052.3State of Texas. Texas Code Civil Practice and Remedies Code 74.052 – Authorization Form for Release of Protected Health Information The form has to be interpreted consistently with HIPAA and authorizes the provider to obtain and disclose records tied to the claimed injury.
If the authorization is missing or incomplete, the provider can halt the case until 60 days after a proper form is delivered. If you later modify or revoke it, the provider can pause the case again until a compliant replacement arrives.3State of Texas. Texas Code Civil Practice and Remedies Code 74.052 – Authorization Form for Release of Protected Health Information Courts enforce this strictly. Sloppy authorizations regularly stall cases at the starting line.
The Expert Report: 120 Days
Most Texas medical malpractice cases are won or lost on the expert report. Section 74.351 requires you to serve a report, along with the expert’s current curriculum vitae, on each defendant or their attorney within 120 days after that defendant files an original answer.4State of Texas. Texas Code Civil Practice and Remedies Code 74.351 – Expert Report
The report must do three things: give a fair summary of the standard of care that applied, explain how the defendant fell short of it, and describe the causal connection between that failure and your injury. All three are required. A report that handles standard of care and breach but skims over causation is deficient and open to challenge.
Who Can Write the Report
Against a physician, Section 74.401 requires the expert to be a physician who was practicing when the claim arose or when the testimony is given, has knowledge of the standards of care for the condition involved, and is qualified by training or experience to give the opinion.5State of Texas. Texas Code Civil Practice and Remedies Code 74.401 – Qualifications of Expert Witness in Suit Against Physician Training residents at an accredited medical school and serving as a consulting physician both count as practicing medicine.
Against a non-physician provider, Section 74.402 requires an expert practicing in the same field, with knowledge of the relevant standards and qualifying training or experience.6State of Texas. Texas Code Civil Practice and Remedies Code 74.402 – Qualifications of Expert Witness in Suit Against Health Care Provider For causation opinions, Section 74.403 generally demands a physician, with limited exceptions allowing dentists, podiatrists, and chiropractors to give causation opinions in cases against practitioners in their own fields.7State of Texas. Texas Code Civil Practice and Remedies Code 74.403 – Qualifications of Expert Witness on Causation in Health Care Liability Claim
A judge can admit an expert who does not tick every statutory box if the court states a good reason on the record, but that is a gamble. Hiring an expert who clearly qualifies is the safer plan.
What Happens If You Miss the Deadline
If no expert report is served within 120 days, the court must dismiss the claim with prejudice on the defendant’s motion and award the defendant reasonable attorney’s fees and court costs.4State of Texas. Texas Code Civil Practice and Remedies Code 74.351 – Expert Report Dismissal with prejudice is permanent. You cannot refile.
The only safety valve is narrow. If you served a report on time and the court finds it deficient, the court may grant one 30-day extension to cure the problem.4State of Texas. Texas Code Civil Practice and Remedies Code 74.351 – Expert Report That fix only works when a report actually exists. It does nothing for a claimant who never served one.
Discovery Is Frozen Until the Report
Section 74.351(s) stays most discovery until the expert report is served. You can still request medical and hospital records, use written discovery aimed at health care documents, take depositions on written questions, and pursue nonparty discovery.4State of Texas. Texas Code Civil Practice and Remedies Code 74.351 – Expert Report All claimants together are limited to two depositions before the report is served.
In practical terms, you cannot depose the defendant doctor or send broad interrogatories until your expert report is in hand. The legislature designed the stay so providers would not have to fund full-scale litigation discovery for claims that cannot clear the expert-report bar.
Caps on Non-Economic Damages
Chapter 74 limits recovery for non-economic losses such as physical pain, mental anguish, disfigurement, and loss of companionship. Section 74.301 sets tiered caps based on who is being sued:8State of Texas. Texas Code Civil Practice and Remedies Code 74.301 – Limitation on Noneconomic Damages
- Against individual physicians or providers: $250,000 per claimant, no matter how many individuals are named.
- Against a single health care institution: $250,000 per claimant.
- Against multiple health care institutions: $250,000 per institution, with a combined cap of $500,000 per claimant.
The most a claimant can recover in non-economic damages is $750,000: $250,000 from the individual providers collectively and $500,000 from the institutional defendants collectively. A jury verdict above these numbers gets reduced by the judge to fit.
Economic damages are not capped. Past and future medical bills, lost earnings, and the cost of ongoing care can be recovered in full as long as you can document them.
Wrongful Death and Survival Cases
When a patient dies from medical negligence, Section 74.303 applies a different cap. Total damages in a wrongful death or survival action are limited to $500,000 per claimant as a base figure, adjusted for inflation using the Consumer Price Index for urban wage earners against the index value from August 29, 1977.9State of Texas. Texas Code Civil Practice and Remedies Code 74.303 – Limitation on Damages As of early 2026, the inflation-adjusted cap sits at roughly $2.6 million per claimant.
This cap works differently from the one in Section 74.301. It covers total damages, including economic and exemplary damages, but it excludes the cost of necessary medical, hospital, and custodial care already provided or reasonably needed in the future to treat the injury.9State of Texas. Texas Code Civil Practice and Remedies Code 74.303 – Limitation on Damages Those medical costs are outside the cap and can substantially raise the total recovery in catastrophic cases.
Both caps can appear in the same case. Section 74.301 limits non-economic damages in every health care liability claim. Section 74.303 caps total damages, but only in wrongful death and survival actions, and its ceiling moves with inflation. Working out how the two interact for a specific claim is rarely something to attempt without a lawyer.