(quoting Haynes & Boone v. Bowser Bouldin, Ltd., 896 S.W.2d 179, 182 (Tex.1995) (quoting Rourke v. Garza, 530 S.W.2d 794, 801 (Tex.1975)))). 47 . Trinity Universal Ins. Co. v. Bleeker, 966 S.W.2d 489, 491 (Tex.1998); see also Doe v. Boys Clubs of Greater Dallas, Inc., 907 S.W.2d 472, 481 (Tex.1995) (“A producing cause is a substantial factor which brings about the inju ry and without which the injury would not have occurred.”); Union Pump, 898 S.W.2d at 775 (noting that causation in fact is common to both proximate and producing cause, and that "[clause in fact means that the defendant’s act or omission was a substantial factor in bringing about the injury which would not otherwise have occurred”); Prudential Ins. Co. of Am. v. Jefferson Assocs., Ltd., 896 S.W.2d 156, 161 (Tex.1995)
holding that a physicians negligence need only be a proximate cause not the proximate cause of plaintiffs injury holding that allegation of procedural injury does not affect the issues of injury in fact or causation holding that negligence must be the proximate cause of injury holding that the element of actual causation in fact common to both proximate and producing cause requires proof that an act or omission was a substantial factor in bringing about injury which would not otherwise have occurred holding omission in the jury instruction of element of offense requires a new trial