Trusted Legal Representation for Medical Malpractice Claims in Houston
Written by: Hastings Law Firm | Reviewed by: Tommy Hastings | Updated: May 11, 2026
What You Should Know About Healthcare Negligence Lawsuits in Houston:
- A poor outcome is not automatically malpractice. The legal question is whether the harm was preventable under accepted medical standards.
- Causation is often the most contested element. A claim requires proof that the specific error caused the specific injury.
- Texas law requires a qualified expert report early in the case. Missing the deadline can result in permanent dismissal.
- Liability can extend beyond the treating physician to hospitals, nursing staff, pharmacies, and diagnostic labs.
- Hospitals can face direct liability for institutional failures even when the doctor is an independent contractor.
- Non-economic damages are capped in Texas, but economic damages for medical costs, lost income, and future care have no limit.
- The statute of limitations is generally two years, with limited exceptions for delayed discovery and claims involving minors.
- Wrongful death claims allow surviving spouses, children, and parents to seek compensation when negligence caused a fatal outcome.
- Houston malpractice cases involving TMC institutions often require subspecialty expertise and significant litigation resources.
- Early preservation of medical records and facility documentation can determine whether a case moves forward.
A Medical Injury Focused Law Firm
When a doctor, surgeon, or hospital causes harm through negligence, the physical and emotional toll can be overwhelming. You may be dealing with unexpected medical bills, lasting pain, and the unsettling feeling that the people you trusted with your care let you down. Those feelings are valid, and you deserve answers.
At Hastings Law Firm, we focus exclusively on medical malpractice. Our team includes in-house nurse consultants, board-certified patient advocates, and former hospital staff who understand the medical systems we challenge. Founder Tommy Hastings is Board Certified in Personal Injury Trial Law, a distinction held by less than 2% of Texas attorneys.
If you believe you or a loved one was harmed by a medical error in Houston, we can review what happened and explain your options in a free, confidential evaluation.
What Constitutes Medical Malpractice Under Texas Law
Medical malpractice happens when a healthcare provider’s treatment falls below the accepted standard of care and that failure causes injury or death. The standard of care is the level of skill and judgment that a competent provider in the same specialty would apply under similar circumstances. Falling short of that standard is what transforms a poor outcome into a legal claim.
There is an important distinction between an adverse event and a preventable adverse event. An adverse event is any harm that occurs during medical treatment. A preventable adverse event is harm that resulted directly from a provider’s failure to follow accepted medical practices. Only the second category supports a malpractice claim.
Our Houston medical malpractice attorneys evaluate two questions in every case: whether the care fell below the standard, and whether that specific failure caused the injury. We work with qualified medical experts to answer both questions before pursuing a claim.
Beyond a Complication: Recognizing Medical Negligence
Not every injury that follows medical treatment is the result of negligence. Surgery carries inherent risk. Some conditions do not respond to treatment despite a provider’s best efforts. And certain outcomes, while devastating, fall within the range of known complications that were properly disclosed to the patient before a procedure.
The question that matters is whether the harm was preventable. A complication that occurs despite competent, attentive care is not malpractice. But when a provider makes a decision that a qualified peer would not have made, or fails to act when the situation called for action, and the patient is injured because of it, the legal threshold for negligence may be met.
Under Chapter 74 of the Texas Civil Practice and Remedies Code, specific procedural requirements govern how malpractice claims are filed in Texas, including the requirement to submit a qualified expert report early in the case. That report must identify the applicable standard of care, explain how the provider failed to meet it, and connect that failure to the patient’s injury.
Several patterns can indicate that what happened was negligence rather than an unavoidable complication:
- A never event occurred, such as surgery on the wrong body part or a foreign object left inside a patient after an operation
- A serious adverse outcome was not disclosed to the patient or investigated by the facility
- Test results or imaging that showed a developing problem were available in the medical record but not reviewed or acted on
- The patient was not informed of material risks before a procedure, raising a potential informed consent failure
- Institutional breakdowns like staffing shortages, communication gaps during shift changes, or missing safety protocols played a role in the injury
Hospital risk management teams and insurance carriers often respond to these claims by framing the outcome as an accepted complication. That response is a defense strategy, not a medical conclusion. It does not mean your case lacks merit.
Major Hospitals and Medical Facilities in Houston
Houston is home to the Texas Medical Center, the largest medical complex in the world. The TMC covers 2.1 square miles in south-central Houston and includes more than 60 member institutions, 21 hospitals, and over 9,200 patient beds. It employs more than 106,000 people and records over 10 million patient encounters every year. More than 180,000 surgeries are performed annually across the complex, and roughly 26,000 babies are delivered each year.
The anchor institutions within the TMC include Memorial Hermann-Texas Medical Center, one of the busiest Level I Trauma Centers in the country and home to the Life Flight air ambulance service. Houston Methodist Hospital is internationally recognized for cardiovascular care, neurology, and organ transplantation. The University of Texas MD Anderson Cancer Center is consistently ranked as one of the top cancer treatment facilities in the world. Texas Children’s Hospital is the largest children’s hospital in the country. Ben Taub Hospital, part of the Harris Health System, serves as a major safety-net hospital and teaching facility for Baylor College of Medicine. CHI St. Luke’s Health operates multiple campuses across the Houston metro, including the Baylor St. Luke’s Medical Center campus within the TMC. The Woman’s Hospital of Texas is one of the highest-volume delivery hospitals in the state.
Outside the TMC, Houston’s healthcare footprint extends across Harris County and the surrounding suburbs through large for-profit systems. HCA Houston Healthcare operates 13 hospitals throughout the greater Houston area, including facilities in Kingwood (a 451-bed Level II Trauma Center), Clear Lake, Tomball, Pearland, Conroe, Cypress, and the West Houston corridor. Memorial Hermann also maintains a network of hospitals outside the TMC, including locations in Katy, Sugar Land, The Woodlands, and Southeast Houston.
The Houston metro has also experienced a rapid expansion of freestanding emergency rooms and ambulatory surgical centers, particularly along the outer suburban corridors in Fort Bend, Montgomery, and Galveston counties. These facilities handle everything from minor injuries to time-sensitive emergencies, and they carry the same legal obligation to meet the accepted standard of care as any hospital-based department.
The concentration of high-acuity specialty care in Houston means malpractice claims here often involve complex medical questions that require subspecialty expertise to evaluate. According to the Agency for Healthcare Research and Quality’s Chartbook on Patient Safety, adverse drug events and hospital-acquired conditions remain among the most frequent sources of preventable patient harm in U.S. hospitals, and high-volume facilities are not immune to those patterns.
How Our Houston Medical Lawyers Identify Liable Parties in Malpractice Cases
Liability in a malpractice case can extend well beyond the physician who provided direct care. Hospitals, nursing staff, pharmacists, diagnostic laboratories, and long-term care facilities can all bear responsibility depending on the facts. Identifying every responsible party determines the full scope of accountability and the potential recovery.
As Houston medical malpractice lawyers, we investigate every individual and institution involved in a patient’s care. Potential defendants may include:
- Physicians and surgeons who made errors in diagnosis, treatment planning, or surgical technique
- Hospitals and health systems that failed to maintain safe staffing levels, enforce protocols, or properly credential their medical staff
- Nurses and support staff who did not adequately monitor a patient, failed to document changes in condition, or did not escalate concerns to a physician
- Pharmacists and pharmacies that dispensed incorrect medications or missed a contraindication, which is a medical reason a specific drug should not have been given
- Diagnostic laboratories that returned inaccurate test results, contributing to a misdiagnosis or delayed treatment
- Nursing homes and long-term care facilities where neglect or inadequate care caused harm to residents
A common issue in Houston cases involves physicians who practice at a hospital but are not employed by it. Emergency physicians, anesthesiologists, radiologists, and hospitalists are frequently independent contractors. Under the Texas Supreme Court’s ruling in Bush v. Columbia Medical Center/HCA, a hospital can face direct institutional liability for its own systemic failures, including inadequate safety protocols, poor oversight, and staffing decisions, even when the treating physician was not a hospital employee.
This matters in Houston because the TMC institutions and the HCA Houston Healthcare system both rely heavily on contracted physician groups. Patients often have no idea their doctor has no employment relationship with the hospital whose name is on the building. If the institution’s own failures contributed to the harm, the hospital itself can be held accountable.
Under 26 Texas Administrative Code § 509.54, healthcare facilities are required to maintain detailed medical records. We review those records closely, including medication administration logs, nursing notes, and monitoring data, to identify where breakdowns occurred and who bears responsibility.
Evidence Required in a Texas Medical Malpractice Claim
To hold a healthcare provider legally responsible in Texas, a patient must establish four elements: duty of care, breach of duty, causation, and damages. Every viable malpractice claim rests on this framework, and each element must be supported by credible evidence.
- Duty of care: A provider-patient relationship existed. When a doctor, nurse, or hospital agrees to treat you, they accept a legal obligation to deliver care that meets accepted medical standards. That duty extends to every member of the care team involved in your treatment.
- Breach of duty: The provider’s actions or inaction fell below what a competent professional in the same field would have done under similar conditions. In cases involving diagnostic failures, this can involve anchoring bias, where a provider fixates on an early diagnosis and disregards symptoms or test results that point to a different condition.
- Causation: The breach must be directly linked to the injury. Demonstrating that a provider made an error is not sufficient on its own. We have to prove that the specific error produced the specific harm. This is frequently the most heavily contested element in malpractice litigation.
- Damages: The patient suffered real, measurable losses. These include physical harm, financial costs like medical bills and lost income, and non-economic losses like pain and emotional suffering.
If any one of these elements cannot be established, the claim does not move forward. That is why our team conducts a detailed medical and legal investigation before filing, building the evidentiary foundation for each element from the outset.
The Role of Expert Testimony in a Houston Medical Injury Lawsuit
No medical malpractice case in Texas can proceed without qualified expert testimony. The expert’s role is to define the applicable standard of care, explain how the provider failed to meet it, and draw the causal connection between that failure and the patient’s injury.
Under Chapter 74, Section 74.351 of the Texas Civil Practice and Remedies Code, the patient must serve a written expert report within 120 days after the date each defendant files an original answer. The report must address the standard of care, the breach, and causation with enough specificity to satisfy the court. If the report is not filed on time or does not meet the statutory threshold, the court can dismiss the case with prejudice, which means the claim cannot be refiled.
The expert must be a qualified professional practicing in the same or a closely related specialty. A claim involving a missed cancer diagnosis, for example, may require an oncologist or the relevant subspecialist to explain how a proper differential diagnosis, the systematic process of evaluating and ruling out conditions based on symptoms and test results, should have been conducted.
“Cases aren’t won by the lawyer with the fanciest tie, but by the lawyer who works the hardest and cares the most.”
– Tommy Hastings, founding attorneyA Houston Malpractice Law Firm That Gets Results
Hastings Law Firm was founded in 2005 by Tommy Hastings, a board certified personal injury attorney who has spent his entire career representing patients and families harmed by medical negligence. He is one of the only attorneys in Texas who still handles medical malpractice cases exclusively, and that focus shapes every part of how this firm operates.
The preparation and intensity we bring to every case has earned us a reputation that defense attorneys and insurance carriers recognize. Medical malpractice is all we do, and that matters when you’re going up against hospitals, insurance carriers, and defense teams with unlimited resources.
Experienced & Dedicated Medical Injury Lawyers Near You
Patients and families across the Greater Houston area trust Hastings Law Firm because we combine deep medical knowledge with aggressive litigation strategy. Tommy has obtained millions of dollars in compensation for his clients, and the attorneys and medical professionals on our team bring that same standard to every case we take on.
The Texas Statute of Limitations for Medical Malpractice Claims
Texas law requires medical malpractice lawsuits to be filed within two years of the date the injury occurred or the date it was discovered. If that deadline passes, the right to bring a claim is almost always lost, no matter how strong the evidence.
The baseline rule is two years from the date of the negligent act. Three exceptions can change that timeline:
- Discovery rule: When an injury is not immediately apparent, the two-year clock may start on the date the patient discovered, or reasonably should have discovered, the harm. A retained surgical instrument that causes symptoms months or years after an operation is a common example.
- Minors: For children under the age of 12, Texas law provides until the child’s 14th birthday for a claim to be filed on their behalf.
- Statute of repose: Texas imposes an absolute 10-year outer limit. Regardless of when the injury was discovered, no malpractice claim can be filed more than 10 years after the date of the negligent act. Exceptions to this cutoff are extremely limited.
These deadlines apply even when a settlement is ultimately reached. The claim itself must be initiated within the statutory window. Waiting too long is one of the most common reasons otherwise strong cases are never heard.
If you are unsure whether your deadline has passed, speaking with a Houston medical malpractice lawyer as soon as possible is the safest step you can take.
Compensation Available in a Texas Medical Malpractice Case
Patients harmed by medical negligence can recover compensation in two primary categories: economic damages for financial losses and non-economic damages for the personal toll of the injury. Texas law treats these categories differently, and the distinction shapes how we build every case.
| Damage Type | What It Covers | Cap in Texas |
|---|---|---|
| Economic Damages | Past and future medical expenses, lost wages, diminished earning capacity, rehabilitation costs, home modifications, in-home care and nursing needs | No cap |
| Non-Economic Damages | Physical pain and suffering, mental anguish, emotional distress, disfigurement, loss of consortium, loss of enjoyment of life | $250,000 against all physicians/providers combined; $250,000 per healthcare institution (up to $500,000 for two or more institutions); aggregate maximum of $750,000 when both providers and multiple institutions are involved |
| Punitive Damages | Available in rare cases involving gross negligence or willful misconduct | Subject to separate statutory limits |
Economic damages cover the direct financial impact of the injury. For patients with severe or permanent injuries, these losses can be substantial, encompassing everything from surgeries and long-term rehabilitation to daily living assistance and lost earning capacity.
Calculating future medical costs often requires input from life care planners, professionals who develop long-term care projections based on a patient’s diagnosis and expected needs. The International Academy of Life Care Planners’ Standards of Practice outlines the methodology used to create these projections, which are then presented as evidence during settlement negotiations or at trial.
Non-economic damages address losses that do not carry a specific dollar value but are no less real. Pain, emotional distress, physical impairment, and the disruption of relationships and daily life all fall into this category.
Texas Tort Reform, enacted in 2003, placed the caps shown above on non-economic damages. A jury can award any amount it considers fair, but the judge will reduce the non-economic portion to the statutory limit. Economic damages are not capped, which is why our Houston medical malpractice attorneys focus heavily on documenting every financial loss, current and projected, from the beginning of the case. That approach ensures the caps do not define the outcome.
Where Houston Medical Malpractice Lawsuits Are Filed
Where your case is filed depends on where the treatment took place. Most Houston-area malpractice cases originate in Harris County and are filed at the Harris County Civil Courthouse in downtown Houston. Harris County has one of the largest civil court systems in Texas, with numerous district courts handling medical liability cases.
Patients treated at facilities in surrounding counties file in those respective jurisdictions. Fort Bend County cases are filed at the Fort Bend County Justice Center in Richmond. Montgomery County cases, including those involving facilities in The Woodlands and Conroe, are filed at the Montgomery County Courthouse in Conroe. Galveston County and Brazoria County each have their own courthouse systems as well.
Houston is unique in Texas because it is served by two state appellate courts with overlapping jurisdiction. Appeals from Harris County trial courts may go to either the First Court of Appeals of Texas or the Fourteenth Court of Appeals of Texas, both based in Houston. Cases are assigned to one of the two courts by rotation rather than subject matter, meaning either court may hear a malpractice appeal.
Our attorneys file and appear in courts across Harris County and the surrounding jurisdictions regularly. That experience with local rules, judicial expectations, and procedural practices in each county affects how we prepare cases and manage timelines from the start.
Wrongful Death Claims Due to Medical Error in Houston
When medical negligence results in a patient’s death, surviving family members may file a wrongful death claim to recover compensation for their losses. Under Texas law, a wrongful death action can be brought by the deceased patient’s spouse, children, or parents.
These claims seek compensation for the financial and personal losses the family has suffered, including lost financial support, loss of companionship and guidance, mental anguish, and funeral and burial expenses.
A related but separate claim, known as a survival action, addresses the pain and suffering the patient experienced before death. While a wrongful death claim focuses on the harm to the family, a survival action focuses on what the patient endured. Both can be pursued in the same case.
In some wrongful death cases, the underlying negligence involves what is known as a failure to rescue. This is a clinical term describing a provider’s failure to recognize and respond to a patient’s deteriorating condition in time to prevent death or catastrophic injury. Warning signs like changes in vital signs, lab results trending in a dangerous direction, or nursing assessments that were never escalated to a physician can all point to a failure to rescue.
We examine medical records, continuous monitoring data, and nursing documentation to determine whether those warning signs were present and whether the care team responded appropriately. In high-volume Houston facilities where patient-to-nurse ratios are stretched, these failures are not uncommon.
Tommy Hastings and our team approach wrongful death cases with the sensitivity they require. No legal outcome can undo your loss. But holding the responsible parties accountable can provide financial security for your family and help prevent the same failure from affecting another patient.
Why Houston Medical Malpractice Litigation Requires Specialized Counsel
The Texas Medical Center draws patients from across Texas and nationally for complex, high-acuity procedures that many community hospitals are not equipped to perform. Cardiac surgery, organ transplantation, advanced cancer treatment, high-risk obstetrics, and pediatric specialty care all concentrate within the TMC at a scale that exists nowhere else in the country.
When something goes wrong in that setting, the medical questions are often more complicated than in a standard malpractice case. A single patient’s care may involve multiple specialists, residents, fellows, attending physicians, and institutional protocols that intersect in ways that make identifying the point of failure difficult without deep clinical knowledge. The medical records in these cases can span thousands of pages across multiple departments and facilities.
The defense teams at TMC institutions are also among the most experienced and well-funded in Texas. These hospitals retain specialized medical malpractice defense firms, many of which have decades of experience defending claims at these specific institutions. They know the records systems, the expert witnesses, and the procedural strategies that work in Harris County courts.
That level of defense requires a plaintiff’s team with equivalent medical knowledge and litigation resources. A general personal injury firm, even a successful one, will be outmatched in a case against a TMC institution. The medical complexity alone demands attorneys who work with in-house clinical staff, maintain relationships with subspecialty experts, and understand how to reconstruct a timeline of care across multiple departments and providers.
Our team was built for exactly this kind of case. Our in-house nurses and medical consultants analyze records from the same systems these hospitals use. Our attorneys have tried cases against major hospital systems and their defense counsel. And because we handle medical malpractice exclusively, we bring the same depth of preparation to every case, whether the claim involves a community clinic in Katy or a teaching hospital in the Texas Medical Center.
Houston and Surrounding Communities We Represent
We represent patients and families harmed by medical negligence across the greater Houston metro. Our clients come from communities throughout the region, including the Inner Loop neighborhoods, Bellaire, West University Place, the Heights, Montrose, Midtown, and the Medical Center area, as well as suburban communities across Harris County and the surrounding counties.
In the suburbs, we serve clients in Katy, Sugar Land, Missouri City, Pearland, League City, Clear Lake, Pasadena, Baytown, Humble, Kingwood, Spring, The Woodlands, Conroe, Tomball, Cypress, and Richmond.
Cases originating in Harris County are filed in downtown Houston. Those arising in Fort Bend, Montgomery, Galveston, Brazoria, and Chambers counties are filed in their respective courthouses. All of these jurisdictions are served by the First and Fourteenth Courts of Appeals, both based in Houston.
Our team handles the full process from investigation through resolution, regardless of where in the Houston metro the injury occurred.
Talk to a Houston Healthcare Malpractice Attorney About Your Case
If you or someone in your family was harmed by a healthcare provider or facility in Houston or anywhere in the greater Houston metro, we can help you understand what happened and whether negligence played a role. Your first conversation with our team is free, confidential, and carries no obligation. We’ll review the facts of your situation, explain your legal options, and give you an honest assessment of whether your case has merit. If we move forward together, you pay no attorney fees or costs unless we recover compensation on your behalf. Call or use the contact form on this page to schedule your free case review.
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Houston Medical Injury Claim Questions
Key Medical Malpractice Terms:
- Standard of care
- The benchmark of skill, judgment, and treatment that a reasonably competent healthcare provider in the same specialty would deliver under comparable circumstances. In Texas medical malpractice cases, the patient must demonstrate that the provider’s care fell below this benchmark and that the shortfall directly caused the injury.
- Anchoring bias
- A pattern of clinical reasoning in which a physician becomes attached to an initial diagnosis and does not adequately reassess as new symptoms, lab values, or imaging findings become available. When anchoring bias contributes to a missed or delayed diagnosis that results in patient harm, it can serve as evidence that the provider breached the standard of care.
- Differential diagnosis
- The systematic clinical process of evaluating a patient’s symptoms and test results to distinguish between possible conditions and arrive at the correct diagnosis. In a malpractice claim, expert testimony may focus on whether the provider conducted an adequate differential diagnosis or failed to consider conditions that the available evidence should have prompted them to evaluate.
- Contraindication
- A specific condition, allergy, or medication interaction that makes a particular drug or treatment inadvisable for a patient because it poses a risk of harm. Administering a medication despite a documented contraindication, such as a known drug allergy or a dangerous interaction with another prescription, can constitute a breach of the standard of care.
- Institutional negligence
- A legal theory that holds a hospital or healthcare facility directly responsible for its own systemic failures, such as unsafe staffing levels, inadequate credentialing of physicians, poorly maintained equipment, or absent safety protocols. Unlike claims against individual providers, institutional negligence targets the organizational decisions that created conditions for patient harm.
- Informed consent
- The legal obligation of a healthcare provider to explain the material risks, expected benefits, and available alternatives of a proposed treatment or procedure before the patient agrees to undergo it. When a provider fails to disclose a known risk and the patient suffers harm from that undisclosed risk, the deficiency in the consent process itself can support a malpractice claim.
- Never event
- A serious, clearly preventable medical error that should not occur when established safety protocols are properly followed. Examples include performing surgery on the wrong body part, operating on the wrong patient, or leaving a surgical instrument inside a patient. The occurrence of a never event is broadly regarded as strong evidence that the standard of care was violated.
- Sentinel event
- An unexpected event during medical care that results in death, permanent injury, or serious risk of either outcome. Healthcare facilities are expected to investigate sentinel events internally to identify systemic failures, and the results of those investigations can become relevant evidence in a malpractice claim.
- Retained surgical item
- A sponge, instrument, needle, or other object accidentally left inside a patient’s body after surgery. Classified as a never event, a retained surgical item can lead to infection, internal damage, chronic pain, and the need for additional operations. Its presence is considered a clear failure of surgical counting and safety protocols.
- Failure to rescue
- A clinical concept describing a care team’s failure to detect and respond to a patient’s deteriorating condition in time to prevent death or catastrophic injury. In malpractice litigation, failure to rescue claims focus on whether warning signs such as declining vital signs, abnormal lab trends, or worsening symptoms were present in the record and whether the care team acted on them appropriately.
- Survival action
- A legal claim brought on behalf of a deceased patient’s estate that seeks compensation for the pain, suffering, and losses the patient experienced between the time of injury and death. A survival action is distinct from a wrongful death claim, which addresses the losses suffered by surviving family members. Both claims can be pursued in the same case.
- Expert testimony
- Testimony provided by a qualified medical professional who reviews the facts of a malpractice case and offers opinions on whether the provider met the standard of care, how the standard was breached, and how that breach caused the patient’s injury. Texas law requires a written expert report to be served within 120 days of each defendant’s original answer, and failure to meet this requirement can result in dismissal of the case.
- Statute of repose
- A hard legal deadline that prevents a malpractice claim from being filed after a set number of years following the date of the negligent act, regardless of when the patient discovered the injury. In Texas, the statute of repose for medical malpractice is 10 years, and the exceptions to this outer limit are extremely narrow.
- Contingency fee
- A fee structure in which the attorney’s compensation is calculated as a percentage of the recovery obtained for the client, with no payment required upfront. If the case does not result in a recovery, the client owes no attorney fees. This arrangement allows patients and families to pursue malpractice claims without assuming financial risk.
- Texas Civil Practice and Remedies Code, Chapter 74 | Texas Legislature Online
- Texas Civil Practice and Remedies Code § 74.351, Expert Report | Texas Legislature Online
- Chartbook on Patient Safety | Agency for Healthcare Research and Quality
- 26 Texas Administrative Code § 509.54, Medical Records Requirements | Legal Information Institute
- Standards of Practice | International Academy of Life Care Planners
- Texas Medical Center Campus | Texas Medical Center
- HCA Houston Healthcare | HCA Houston Healthcare
- Memorial Hermann Health System | Memorial Hermann
- Houston Methodist Hospital | Houston Methodist
- Licensee Complaint Form | Texas Medical Board
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If you think that medical negligence, a dangerous drug, or a failed medical product caused harm to you or someone you love, our team is standing by to offer guidance. We’ll explain your options under current laws and help you move forward with clarity and understanding. Case reviews are free and 100% confidential.