As a result, Chand's report does not explain how and why Parmar's alleged negligence in failure to timely diagnose the perforation caused Colburn's injuries, as opposed to postoperative leak or the perforation itself, whenever and however it was caused. See St. Joseph Reg'l Health Ctr. v. Gonzales, No. 10-17-00088-CV, 2017 WL 2623055, at *1 (Tex. App.—Waco June 14, 2017, pet. denied) (mem. op.) (citing Van Ness, 461 S.W.3d at 142 ("An expert must explain, based on facts set out in the report, how and why the breach caused the injury." (citing Tenet Hosps., Ltd. v. Barnes, 329 S.W.3d 537, 543 (Tex. App.—El Paso 2010, no pet.) ("There can be no analytical gap between a breach of the standard of care and the ultimate harm.")))); see also Gunn v. McCoy, 554 S.W.3d 645, 665 (Tex. 2018); Mooring v. Britton, No. 07-20-00253-CV, 2021 WL 537205, at *3 (Tex. App.—Amarillo Feb. 12, 2021, pet. filed) (mem. op.) (finding an expert report insufficient on causation because, "[w]ithout an understanding of why and when the bleeding began," the court of appeals could not determine that the patient's "hemorrhagic shock was more likely than not caused by a negligent act of or omission by [the doctor]"); Anderson, 2017 WL 4079595, at *4 (finding expert report deficient because it failed to consider other significant risk factors or equally plausible cause of plaintiff's injury).

While the additional surgeries, the complications, and eventual death follow one another in time, and may in some respects be linked by proximity, based on the four corners of the reports, we cannot, without impermissible inferences and assumptions, determine from the reports that the alleged negligence of Dr. McMillan proximately caused the infection and Harris's death. See Courtney, 2017 Tex. App. LEXIS 6844, at **8-10 (concluding that an expert report had not adequately addressed how a 2012 surgery caused death after a 2015 surgery where plaintiff alleged no negligence in the intervening 2015 surgery and provided no factual support connecting the death and the 2012 surgery); St. Joseph Reg'l Health Ctr. v. Gonzales, No. 10-17-00088-CV, 2017 Tex. App. LEXIS 5444, at *10 (Tex. App.—Waco June 14, 2017, pet. filed) (mem. op.) (citing Regent Health Care Ctr. of El Paso, L.P. v. Wallace, 271 S.W.3d 434, 441 (Tex. App.—El Paso 2008, no pet.) (causation opinion "premised solely upon [] close temporal proximity" was deficient as to causation); see also Zamarripa, 2017 Tex. LEXIS 523, at *12 (explaining that an expert report must make a good-faith effort to explain how proximate cause will be proved). Accordingly, I conclude that Appellee's expert reports are still deficient and do not establish how Dr. McMillan's alleged breach proximately caused Harris's death.