ÿWPCü 6#† %Š 0(4¸ÌUFÛ 0l! 0DÑwÑ 0Jç 0T1 0^… 0Dã 0h' 0rÆ 0|Ç 0†C AOÉ 0D 0\ 1uì U,a 0d 0@ñ D31 U,d D/ B¿ BÜ U6ù B)/ DCX AM› U*è e   Ý3›v~«vÓ)˜HP LaserJet 4Si/4SiMX PS 600dpiPSCRIPTÀÌÀääÀÀÌ0ÙP ¿5Ê ¯;·^Ïø X($¡¡1# 3|x“<4šÛ 9Z ‹.Courier New Regular((3üÝ$¤¤Ý ƒ!ÝÝ  Ýà  àòòÚ  Ú0Ú  Úóó(#Ã$òòÚ  Ú0Ú  Úóó  2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô(3¯$¢¢Ý ƒ!ÝÝ  Ý26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  ÔƒLevel 1Level 2Level 3Level 4Level 52J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô$(Cþÿ<< Cÿÿ($$””ò òÚ  Ú1Ú  Úó ó2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô  ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)< Œ 9p`(ModernP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ("ÿÿ$££Ò  ÒÒ  Ò))))'ÿÿdxd< Œ 9p`(Monaco**'÷ÿ dxd düÿP Pd< Œ 9p`(Courier New% Line 7 d,,,,7Border 1dd$-Cþÿ << Gÿÿ< Œ 9p`(Arial Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€ÔÔ€+ÔÝ  ÝÝ ƒ"ÝÝ  Ýò òÔ€+ÔÓ  ÓÔ€/ÔÔ eee ÔFILEDÔ€/XÔó óÌò òÔ€/¼ÔÔ"USú ú, úÔÔ ƒ0 ÔÔ!  Ôó óÔ€/XÔÌÌò òCecil€Crowson,€Jr.Ô€+Ôó óÔ  ÔÌÔ€+ÂÔÔ€/ÔÔ eee Ôò òAppellate€Court€Clerkó óÔ  ÔÔ€+ÔÔ€+XÔ ÓÝ ƒ!ÝÑ#€d#ÑÔ€ÔÔ€+ÔÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  Ý€Ô€+ôÔ€Appellants€also€claimed€that€TCMC€was€negligent.€€The€trial€courtÏgranted€TCMC's€motion€for€summary€judgment.€€Initially,€appellants'€notice€ofÏappeal€included€TCMC,€but€the€trial€court€entered€an€order€of€voluntaryÏdismissal€as€to€TCMC€on€20€June€1995.Ô€+XÔ€€€Ì ‘Ý ƒ!ÝÑ#€d#ÑÔ€ÔÔ€+ÔÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  Ý€€Ô€+ôÔAppellants€argued€that€the€òòò òBraswellóóó ó€decision€supports€their€caseÏbecause€the€appellate€court€not€only€considered€whether€the€evidence€was€newlyÏdiscovered,€but€also€whether€it€produced€material€facts.€€This€is€a€correctÏstatement€of€the€court's€reasoning.€€The€problem€is€that€this€reasoning€onlyÏapplied€to€the€Carothers.€€In€a€separate€paragraph,€the€court€addressed€theÏissue€as€to€Sleadd€and€did€not€consider€whether€the€evidence€was€material.Ìà àIn€an€earlier€case,€the€Western€Section€concluded€that€the€trial€courtÏwas€correct€in€denying€a€motion€to€reconsider€where€the€evidence€was€in€theÏpossession€of€the€nonmoving€party€prior€to€the€hearing€on€the€motion€forÏsummary€judgment.€€òòò òJay€Wiley's€Imports,€Inc.€v.€Triangle€Imports,ÏInc.óóó ó,€1987€WL€12838,€at€*2„*3€(Tenn.€App.€12€May€1987).€€In€the€course€ofÏtheir€opinion,€the€court€specifically€distinguished€òòò òSchaefer€óóó óon€the€basis€ofÏnew€versus€old€evidence.€òòò òId.€óóó óat€*3.€ÌPtPtHHÚ(ÿáÿâùFG(üHHÚ(d'@Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA: T Monaco ÒÒ  BA: T Monaco ÒÝ ƒ!ÝÔ . ÔÔ€ÔÓ&€''X„d&ÓÑ#€''Xd#ÑÔ€+ÔÝ  ÝÑ\R AØ'\ÑÑ7€‹XXdÖdÈ7ÑÑ  ÑTOM€AND€KAREN€MOOREà àà àà à)à àÌà àà àà àà àà àà à)à àAppeal€No.Ìà àPlaintiffs/Appellants,à à)à à01A01„9507„CV„00295Ìà àà àà àà àà àà à)Ìv.à àà àà àà àà àà à)à àDavidson€County€CircuitÏà àà àà àà àà àà àà à)à àCourt€No.94C„1356ÌÙ€ÙßL€.1-;+'h|Ø‹â `€€LßLLOYD€A.€WALWYN,€M.D.,à àà à)Ìà àà àà àà àà àà à)Ìà àDefendant/Appellee.à àà à)ÌÌÌÌÌÌÔ€+¼ÔÌÌà@ àCOURT€OF€APPEALS€OF€TENNESSEEÔ€+XÔÌÌÔ€+¼Ôà@ àMIDDLE€SECTION€AT€NASHVILLEÌÌÌà@ àAPPEAL€FROM€THE€SIXTH€CIRCUIT€COURT€OF€DAVIDSON€COUNTYÌÌà@ àAT€NASHVILLE,€TENNESSEEÌÌÌà@ àTHE€HONORABLE€THOMAS€W.€BROTHERS,€JUDGEÔ€+XÔÌÌÌÌÌÌSHELLEY€I.€STILESÌ5214€Maryland€Way,€Suite€210ÌBrentwood,€Tennessee€37027ÌÌCHRISTOPHER€K.€THOMPSONÌ117€East€Main€StreetÌPost€Office€Box€916ÌMurfreesboro,€Tennessee€37133„0916Ìà àà àATTORNEYS€FOR€PLAINTIFFS/APPELLANTSÌÌROSE€P.€CANTRELLÌGARRETT€E.€ASHERÌParker,€Lawrence,€Cantrell€&€DeanÌ200€Fourth€Avenue€NorthÌFifth€FloorÌNashville,€Tennessee€37219Ìà àà àATTORNEYS€FOR€DEFENDANT/APPELLEEÌÌÌÌÌÌÌÌÌà@ àÔ€+¼ÔAFFIRMED€AND€REMANDEDÌÌÌÌÌÌà àà àà àà àà àà àà àSAMUEL€L.€LEWIS,€JUDGEÌÌÓÓà@ àÔ€+„ÔòòOPINIONóóÔ€+XÔÌà àThis€is€an€appeal€by€plaintiffs/appellants,€Tom€and€KarenÏMoore,€from€the€trial€court's€orders€granting€summary€judgment€inÏfavor€of€defendant/appellee,€Dr.€Lloyd€A.€Walwyn,€and€€denyingÏappellants'€motion€to€reconsider€the€grant€of€summary€judgmentÌÌà àThe€procedural€history€and€pertinent€facts€are€as€follows.€ÏOn€1€May€1993,€Mr.€Moore€fell€from€the€roof€of€a€house.€€He€wentÏto€the€emergency€room€at€Tennessee€Christian€Medical€CenterÏ("TCMC").€€Appellee€examined€Mr.€Moore€and€diagnosed€him€as€havingÏa€fractured€left€wrist€and€a€fractured€left€distal€tibia€andÏfibula.€€Appellee€treated€Mr.€Moore's€injuries€and€performedÏoperations€on€his€wrist€and€leg.€€Following€Mr.€Moore's€dischargeÏfrom€the€hospital,€appellee€followed€Mr.€Moore's€progress€throughÏscheduled€office€visits.ÌÌà àOn€16€June€1993,€Mr.€Moore€went€to€appellee's€office€for€oneÍsuch€visit.€€During€the€visit,€appellee€decided€that€he€needed€toÏremove€the€external€fixator€on€Mr.€Moore's€left€leg€and€apply€aÏlong€leg€cast.€€Appellee€was€to€perform€the€procedure€on€29€JuneÏ1993€at€TCMC,€but€Mr.€Moore€did€not€show€up€for€the€appointmentÏand€has€not€been€to€appellee's€office€since€the€June€16€visit.€ÏLater,€Mr.€Moore€developed€an€infection.€€As€a€result,€doctors,Ïother€that€appellee,€performed€nine€operations.ÌÌà àAppellants€filed€their€complaint€on€2€May€1994€alleging€thatÏappellee€negligently€failed€to€prescribe€antibiotics.× ƒ2 ××  ×€€ThisÏfailure,€they€argued,€caused€injuries€to€Mr.€Moore€which€requiredÏthe€nine€additional€surgical€procedures.€€In€response,€appelleeÏfiled€an€answer€and€a€counterclaim€which€he€later€voluntarilyÏdismissed.€€ÌÌà àOn€19€October€1994,€appellee€filed€a€motion€for€summaryÏjudgment.€€In€support€of€the€motion,€appellee€filed€his€ownÏaffidavit.€€Appellants€filed€their€response€opposing€the€motionÏand€attached€a€document€prepared€by€Dr.€Bruce€Schlafly€of€St.ÏLouis,€Missouri.€€Appellants€referred€to€this€document€as€aÏcounter„affidavit.€€The€document€included€a€letter€with€aÏcurriculum€vitae€("the€letter")€and€a€report€on€Mr.€Moore€("theÏreport").€€On€11€January€1995,€the€trial€court€granted€the€motionÍfor€summary€judgment.€€In€his€order,€the€trial€judge€stated€asÏfollows:€€ÌÓÓà8 àSpecifically,€the€Court€finds€that€there€is€no€genuineÏissue€as€to€a€material€fact€concerning€whether€theÏdefendants€deviated€from€the€recognized€standard€ofÏacceptable€professional€practice€in€the€care€andÏtreatment€of€the€plaintiffs.€€The€Court€additionallyÏfinds€that€there€is€no€genuine€issue€as€to€a€materialÏfact€on€the€issue€of€causation.ÌÌÓÓOn€7€February€1995,€appellants€filed€a€motion€to€reconsider€and€aÏsecond€affidavit€from€Dr.€Bruce€Schlafly.€€On€14€March€1995,€theÏtrial€judge€entered€an€order€denying€the€motion.ÌÌà àAppellants€filed€their€first€notice€of€appeal€on€13€AprilÏ1995€informing€the€court€that€they€were€appealing€the€March€order.€ÏSix€days€later,€the€trial€court€entered€final€judgment,€andÏappellants€filed€a€second€notice€of€appeal€in€regard€to€thisÏorder.ÌÌà àAppellants€presented€this€court€with€the€following€issue:€Ï"Whether€the€circuit€court€erred€in€granting€Walwyn's€motion€forÏsummary€judgment€and€in€denying€Moore's€motion€to€reconsider€byÏconcluding€that€there€was€no€genuine€issue€of€material€fact€forÏtrial€when€a€genuine€issue€of€an€outcome€determinative€fact€wasÏraised€by€counter„affidavits€of€Bruce€Schlafly,€M.D.,€anÏorthopaedic€surgeon."€€We€are€of€the€opinion€that€the€trial€courtÏdid€not€err.ÌÌò òI.à àMotion€for€Summary€Judgmentó óÌÌà àThe€courts€of€Tennessee€have€explained€the€law€of€summaryÏjudgment€in€great€detail.€€òòò òByrd€v.€Hallóóó ó,€847€S.W.2d€208€(Tenn.Ï1993).€€Upon€the€filing€of€a€motion,€the€moving€party€has€theÏburden€of€proving€that€there€are€no€genuine€issues€of€materialÏfact.€€òòò òId.óóó ó€at€215.€€The€moving€party€may€make€such€a€showing€inÏseveral€ways,€but€may€not€rely€solely€on€a€conclusory€statementÏthat€the€nonmoving€party€has€no€evidence.€€ò òòòId.óóó ó€at€215€&€n.5.€€OnceÏthe€moving€party€has€provided€the€court€with€a€properly€supportedÏmotion,€the€burden€shifts€to€the€nonmoving€party€to€show€theÏexistence€of€a€genuine€issue€of€material€fact€or€the€need€forÏfurther€discovery.€€òòò òId.óóó ó€at€215€&€n.€6.€€In€satisfying€its€burden,Ïthe€nonmoving€party€may€not€simply€rely€on€the€allegations€andÏdenials€in€the€pleadings.€€Instead,€the€party€must€produceÏevidence€that€establishes€the€existence€of€a€material€dispute.€ÏSuch€evidence€must€be€in€the€form€of€an€affidavit€or€in€the€formÏof€any€of€the€other€discovery€materials€listed€in€Tennessee€RuleÏof€Civil€Procedure€56.03.€€òòò òId.óóó ó€at€215.€€Further,€the€facts€reliedÏon€by€the€nonmoving€party€must€be€admissible€at€trial,€but€needÏnot€be€in€an€admissible€form.€€òòò òId.óóó ó€ÌÌà àIn€passing€upon€a€motion€for€summary€judgment,€the€trialÏjudge€must€"view€the€evidence€in€a€light€favorable€to€theÏnonmoving€party€and€allow€all€reasonable€inferences€in€his€favor."€Ïòòò òId.óóó ó€€If€the€trial€judge€decides€that€there€are€no€genuine€issuesÏof€material€fact€and€that€the€law€entitles€the€moving€party€to€aÍjudgment,€he€must€grant€the€motion.€€òòò òId.óóó ó€at€214.€€MoreÏspecifically,€medical€malpractice€claims€require€expert€testimonyÏas€to€the€issues€of€negligence€and€proximate€cause€"unless€the€actÏof€alleged€malpractice€lies€within€the€common€knowledge€of€aÏlayman."€€òòò òBowman€v.€Henardóóó ó,€547€S.W.2d€527,€530„31€(Tenn.€1977).€ÏAccordingly,€"in€those€malpractice€actions€wherein€expert€medicalÏtestimony€is€required€to€establish€negligence€and€proximate€cause,Ïaffidavits€by€medical€doctors€which€clearly€and€completely€refuteÏplaintiff's€contention€afford€a€proper€basis€for€dismissal€of€theÏaction€on€summary€judgment,€in€the€absence€of€proper€responsiveÏproof€by€affidavit€or€otherwise."€€òòò òId.óóó ó€at€531.ÌÌà àGiven€the€above,€it€is€plain€to€see€that€affidavits€are€veryÏimportant€tools€in€any€summary€judgment€proceeding,€particularlyÏwhen€the€underlying€claim€is€medical€malpractice.€€Affidavits,Ïhowever,€are€not€simple€statements€from€a€witness€or€expert.€€ToÏthe€contrary,€an€affidavit€is€"[a]€written€or€printed€declarationÏor€statement€of€facts,€made€voluntarily,€and€confirmed€by€the€oathÏor€affirmation€of€the€party€making€it,€taken€before€a€personÏhaving€authority€to€administer€such€oath€or€affirmation."€€Black'sÏLaw€Dictionary€58€(6th€ed.€1990);€òòò òsee€also€Grove€v.€Campbellóóó ó,Ï17€Tenn.€8€(1836).€€In€addition,€for€the€purposes€of€summaryÏjudgment,€an€affidavit€"shall€be€made€on€personal€knowledge,€shallÏset€forth€such€facts€as€would€be€admissible€in€evidence,€and€shallÏshow€affirmatively€that€the€affiant€is€competent€to€testify€to€theÏmatters€stated€therein."€€Tenn.€R.€Civ.€P.€56.05€(1995).€€InÍmedical€malpractice€cases,€a€witness€is€not€competent€to€testifyÏas€to€the€elements€of€a€medical€malpractice€claim€unless€theÏwitness€is€"licensed€to€practice€in€the€state€or€a€contiguousÏbordering€state€a€profession€or€specialty€which€would€make€hisÏexpert€testimony€relevant€to€the€issues€in€the€case€and€hadÏpracticed€this€profession€or€specialty€in€one€of€these€statesÏduring€the€year€preceding€the€date€that€the€alleged€injury€orÏwrongful€act€occurred."€€Tenn.€Code€Ann.€ðð29„26„115(b)€(1980);€òòò òseeÏalso€Payne€v.€Caldwellóóó ó,€796€S.W.2d€142,€143€(Tenn.€1990)Ï(holding€that€the€competency€requirement€of€ðð29„26„115(b)€appliesÏto€all€of€the€elements€listed€in€ðð29„26„115(a)).€€The€failure€of€aÏdocument€to€meet€any€one€of€these€requirements€renders€it€uselessÏas€an€affidavit€for€summary€judgment.€€òòò òSee€Fowler€v.€HappyÏGoodman€Familyóóó ó,€575€S.W.2d€496,€498„99€(Tenn.€1978)€(holdingÏthat€an€affidavit,€which€failed€to€meet€the€requirements€ofÏTennessee€Rule€of€Civil€Procedure€56.05,€was€insufficient);€òòò òStateÏDep't€of€Human€Servs.€v.€Neilsonóóó ó,€771€S.W.2d€128,€130€(Tenn.ÏApp.€1989)€(finding€that€an€affidavit€on€information€and€belief€isÏnot€based€on€personal€knowledge€and€is€insufficient€unlessÏspecifically€provided€for€by€statute);€ò òòòMoncrief€v.€Fuquaóóó ó,€610ÏS.W.2d€720,€724„26€(Tenn.€App.€1979)€(holding€that€affidavits€wereÏinsufficient€where€affiants€were€not€competent€to€testify€inÏmedical€malpractice€case).ÌÌà àAppellee€filed€his€motion€for€summary€judgment€claiming€thatÏthere€were€no€genuine€issues€of€material€fact.€€In€support€of€hisÍmotion,€appellee€filed€his€own€affidavit€which€he€signed€and€hadÏnotarized.€€€Appellee€testified€as€follows:ÌÓÓà8 àI€am,€and€was€at€all€times€pertinent€to€this€lawsuit,Ïfamiliar€with€the€standard€of€acceptable€professionalÏpractice€in€my€specialty€in€this€community.€€I€haveÏpersonal€knowledge€of€the€facts€contained€in€thisÏaffidavit.ÌÌà àà8 à.€.€.€.€ÌÌà8 àà à7.à àBy€experience€and€training,€I€am€familiar€withÏthe€recognized€standard€of€professional€practice€inÏorthopaedic€surgery€in€Nashville,€Tennessee€and€similarÏcommunities.€€In€everything€I€did€in€Mr.€Moore's€case,€IÏacted€with€ordinary€and€reasonable€care€in€accordanceÏwith€such€standard.€€Furthermore,€no€deviation€from€theÏapplicable€standard€of€care€was€the€cause€of€any€damageÏor€condition€of€which€Mr.€Moore€may€complain€or€sufferÏin€this€case.ÌÌÓÓThis€testimony€and€the€other€testimony€found€in€the€affidavitÏsupported€appellee's€motion€and€shifted€the€burden€to€appellantsÏto€prove€the€existence€of€a€genuine€issue€of€material€fact.ÌÌà àIn€response,€appellants€filed€the€letter€and€the€reportÏmentioned€previously.€€Neither€of€these€documents,€however,Ïcreated€a€genuine€issue€of€material€fact.€€In€addition,€the€trialÏcourt€should€not€have€even€considered€these€documents€because€theÏtestimony€contained€in€them€was€not€admissible€and€the€documentsÏwere€neither€affidavits€nor€any€of€the€other€types€of€discoveryÏmaterials€listed€in€Tennessee€Rule€of€Civil€Procedure€56.03.ÌÌà àTo€explain,€the€testimony€contained€in€the€letter€and€theÏreport€was€inadmissible€as€evidence€to€establish€the€elements€ofÏthe€medical€malpractice€claim€because€it€failed€to€establish€thatÍDr.€Schlafly€met€the€competency€requirements€of€Tennessee€CodeÏAnnotated€section€29„26„115(b).€€òòò òSeeóóó ó€Tenn.€R.€Evid.€601€(1995).€ÏAlthough€specifically€required€by€that€section,€the€documents€didÏnot€prove€that€Dr.€Schlafly's€profession€or€specialty€"would€makeÏhis€expert€testimony€relevant€to€the€issues€in€the€case"€or€thatÏDr.€Schlafly€practiced€his€specialty€in€Tennessee€or€a€contiguousÏstate€"during€the€year€preceding€the€date€that€the€alleged€injuryÏor€wrongful€act€occurred."€€Tenn.€Code€Ann.€€ðð29„26„115(b)€(1980).€ÏFor€these€same€reasons,€the€letter€and€the€report€failed€to€meetÏthe€requirements€of€Tennessee€Rule€of€Civil€Procedure€56.05€andÏwere€not€proper€opposing€affidavits.ÌÌà àIn€addition,€the€letter€was€not€an€affidavit€because€a€notaryÏdid€not€properly€authenticate€Dr.€Schlafly's€signature.€€TheÏreport€is€the€only€document€properly€sworn€to€by€Dr.€Schlafly.€ÏThis€attestation,€however,€does€not€apply€to€the€letter€becauseÏthe€notary€witnessed€the€signing€of€the€report€on€14€December€1994Ïand€Dr.€Schlafly€dated€the€letter€15€December€1994.ÌÌà àDespite€these€apparent€flaws€in€the€report,€appellees€arguedÏthat€it€was€sufficient€to€withstand€the€motion.€€Even€if€we€foundÏthat€the€report€was€proper€evidence€for€use€on€summary€judgment,Ïwe€would€still€have€to€uphold€the€decision€of€the€trial€courtÏbecause€the€report€failed€to€establish€a€genuine€issue€of€materialÏfact€as€to€deviation€from€the€acceptable€standard€of€care€andÏcausation.ÌÌà àTo€prove€medical€malpractice,€a€plaintiff€must€establish€thatÏthe€defendant's€actions€fell€below€the€standard€of€acceptableÏprofessional€practice€in€the€defendant's€profession€or€specialityÏand€in€the€defendant's€community€or€in€a€similar€community.€€Tenn.ÏCode€Ann.€ðð29„26„115(a)(1),(2)€(1980).€€Further,€in€this€case,Ïappellants€needed€expert€testimony€to€establish€this€elementÏbecause€the€malpractice€was€not€in€the€common€knowledge€of€laymen.€ÏAppellants,€however,€failed€to€satisfy€their€burden.€€ÌÌà àTo€explain,€in€the€report€Dr.€Schlafly€stated€as€follows:ÌÓÓà8 àHowever€with€a€closed€fracture,€the€standardÏrecommendation€is€to€start€antibiotics€intravenously€inÏthe€operating€room€immediately€prior€to€the€start€of€theÏoperation.€.€.€.Ì€€Ìà8 àIn€my€opinion,€intravenous€antibiotics€should€have€beenÏgiven€at€the€time€of€the€operation€of€5/2/93,€as€well€asÏthe€operation€of€5/5/93.€€.€.€.€€In€my€opinion,€it€fellÏbelow€the€standard€of€care€for€a€surgeon€to€do€theseÏoperations€without€standard€antibiotic€prophylaxis.ÌÌÓÓThis€statement€does€not€describe€the€standard€in€Nashville€orÏexplain€that€it€is€the€standard€in€a€similar€community.€€Moreover,Ïthe€statement€does€not€even€describe€a€"standard€of€acceptableÏprofessional€practice."€€Tenn.€Code€Ann.€ðð€29„26„115(a)(1)€(1980).€ÏFor€example,€Dr.€Schlafly€used€the€term€"recommendation."€€ThisÏterm€suggests€that€a€doctor€has€a€choice€as€to€whether€to€useÏprophylactic€antibiotics.€€It€does€not€suggest€a€standard€that€aÏdoctor€must€follow.€ÌÌà àAt€the€end€of€the€report,€Dr.€Schlafly€described€severalÏarticles€that€advocated€the€use€of€prophylactic€antibiotics.€ÏUnfortunately,€Dr.€Schlafly's€synopsis€of€these€articles€failed€toÏestablish€a€standard€for€the€court€to€apply€in€this€case.€€TheÏfirst€article,€published€in€1974,€described€a€study€which€foundÏthat€the€use€of€€prophylactic€antibiotics€reduced€the€threat€ofÏpostoperative€infection€from€5%€to€2.8%.€€The€second€articleÏreported€that€many€orthopaedic€surgeons€used€prophylacticÏantibiotics,€and€the€third€article€described€the€recommendedÏprophylactic€regimen.€€The€articles,€however,€do€not€describe€theÏstandard€in€Nashville€or€a€similar€community.€€Further,€they€doÏnot€clearly€set€forth€a€particular€standard,€but€instead,€seem€toÏdescribe€one€alternative.ÌÌà àA€second€element€necessary€to€a€medical€malpractice€claim€isÏcausation.€€Tenn.€Code€Ann.€ðð29„26„115(a)(3)€(1980).€€There€areÏtwo€forms€of€causation€required€to€sustain€a€medical€malpracticeÏaction.€€These€are€cause€in€fact€and€proximate€cause.€€ò òòòKilpatrickÏv.€Bryantóóó ó,€868€S.W.2d€594,€598€(Tenn.€1993).€€Cause€in€factÏ"means€that€the€injury€or€harm€would€not€have€occurred€'but€for'Ïthe€defendant's€negligent€conduct."€òòò òId.óóó ó€at€598.€€To€establishÏsuch,€the€plaintiff€must€show€within€a€reasonable€degree€ofÏmedical€certainty€that€the€injury€was€a€probability.€€òòò òId.€óóó ó€at€602.€ÏIn€this€case,€the€report€failed€to€provide€the€expert€testimonyÏneeded€to€contradict€appellee's€affidavit€because€it€failed€toÏestablish€within€a€reasonable€degree€of€medical€certainty€that€theÍfailure€to€use€the€antibiotics€probably€caused€Mr.€Moore'sÏinjuries.€€ÌÌà àIn€the€report,€Dr.€Schlafly€stated€as€follows:€€ÌÓÓà8 àIt€is€entirely€possible€that€Mr.€Moore€developed€€hisÏbone€infection€because€the€fracture€was€seeded€withÏbacteria€at€the€time€of€surgery,€bacteria€whichÏprophylactic€antibiotics€could€have€eradicated.€.€.€.Ìà8 àÌà8 à.€.€.€.Ìà8 àÌà8 àOf€course,€infections€can€have€many€different€causes,Ïbut€I€believe€that€the€omission€of€intravenous€Ïantibiotics€(except€for€the€single€dose),€during€the€MayÏhospitalization€at€Tennessee€Christian€Medical€Center,Ïwas€probably€a€contributory€factor€in€the€laterÏdevelopment€of€Mr.€Moore's€bone€infection,€as€best€as€IÏcan€determine€from€the€medical€records€available€to€me.ÌÌÓÓArguably,€this€statement€satisfied€the€probability€requirement€ofÏcause€in€fact.€€Nevertheless,€it€failed€to€state€that€theÏconclusion€was€with€a€reasonable€degree€of€medical€certainty.€€Dr.ÏSchlafly's€statement€that€the€conclusion€was€"as€best€as€[heÏcould]€determine€from€the€medical€records€available€to€[him]"Ïfailed€to€provide€the€court€with€the€degree€of€certainty€requiredÏby€the€case€law.€€This€is€further€supported€by€the€fact€that€Dr.ÏSchlafly€did€not€have€all€of€the€medical€records€available€to€him.€ÏIn€the€report,€he€admits€that€he€did€not€review€the€actual€x„raysÏor€the€"records€listing€the€drugs€used€in€the€operating€room€orÏthe€recovery€room."€€From€Mr.€Moore's€bill,€Dr.€SchlaflyÏdiscovered€that€someone€gave€Mr.€Moore€an€antibiotic€injection€onÏ2€May€1993,€but€he€did€not€have€the€records€detailing€the€actualÏtime€of€the€injection.€€Note€that€one€of€the€operations€performedÍby€appellee€occurred€on€this€date.€€The€importance€of€this€lack€ofÏinformation€is€without€question.€€Dr.€Schlafly's€conclusion€isÏthat€the€failure€of€appellee€to€administer€prophylacticÏantibiotics€caused€the€infection€which€led€to€Mr.€Moore'sÏsubsequent€operations;€yet,€he€makes€this€conclusion€withoutÏhaving€reviewed€all€of€the€records€describing€which€medicationsÏappellee€administered€to€Mr.€Moore.ÌÌà àIn€summary,€the€report€and€the€letter€failed€to€provide€theÏproof€necessary€to€overcome€appellee's€motion€for€summaryÏjudgment.€€Most€important,€the€documents€were€not€affidavits€norÏwere€they€any€of€the€other€types€of€discovery€materials€mentionedÏin€Tennessee€Rule€of€Civil€Procedure€56.03.€€Further,€theÏtestimony€contained€in€both€documents€was€inadmissible€because€itÏdid€not€establish€that€Dr.€Schlafly€was€competent€under€TennesseeÏCode€Annotated€section€29„26„115(b).€€Thus,€the€appellants€couldÏnot€use€his€testimony€to€establish€the€existence€of€genuine€issueÏof€material€fact.€€In€addition,€the€record,€considered€as€anÏaffidavit,€failed€to€establish€a€material€dispute€as€to€deviationÏfrom€the€standard€of€care€and€causation.€€Therefore,€the€trialÏcourt€did€not€err€in€granting€appellee's€motion€for€summaryÏjudgment.ÌÌò òII.à àMotion€to€Reconsideró óÌÌà àAppellant's€next€issue€is€whether€the€trial€court€properlyÍdenied€their€motion€to€reconsider.€€In€his€order€denying€theÏmotion,€the€judge€stated€as€follows:ÌÓÓà8 àThe€Court€finds€that€the€Plaintiffs€have€submitted€andÏrely€upon€the€affidavit€of€Bruce€Schlafly,€M.D.,€inÏsupport€of€their€Motion€to€Reconsider.€€The€Court€findsÏthat€the€Plaintiffs€relied€upon€affidavit€testimony€fromÏthis€same€witness€in€opposition€to€the€Defendants'ÏMotions€for€Summary€Judgment.€€The€Court€further€finds,Ïthat,€in€this€proceeding,€the€Plaintiffs€have€not€made€aÏsufficient€showing€as€to€why€the€affidavit€testimony€ofÏDr.€Schlafly€in€support€of€the€Motion€to€ReconsiderÏcould€not€have€been€submitted€earlier€in€response€to€theÏDefendants'€Motions€for€Summary€Judgment€and€why€theÏtestimony€of€the€same€witness€should€be€considered€againÏin€this€proceeding.€€Therefore,€the€Court€specificallyÏfinds€that€the€affidavit€testimony€of€Dr.€SchlaflyÏrelied€upon€to€support€the€Motion€to€Reconsider€is€notÏentitled€to€consideration.ÌÌÓÓWe€are€of€the€opinion€that€the€trial€court€was€correct.€€TheÏTennessee€Rules€of€Civil€Procedure€do€not€provide€for€a€"motion€toÏreconsider."€€Nevertheless,€this€court€reviews€such€motions€inÏlight€of€their€substance,€not€their€form.€€òòò òBemis€Co.€v.€Hinesóóó ó,Ï585€S.W.2d€574,576€(Tenn.€1979).€€In€this€case,€we€will€treat€theÏmotion,€which€cites€to€Tennessee€Rule€of€Civil€Procedure€59.04,€asÏa€motion€to€alter€or€amend.ÌÌà àAppellants€argued€that€the€trial€court€erred€when€it€failedÏto€consider€the€second€affidavit€of€Dr.€Schlafly.€€In€their€brief,Ïappellants€cited€òòò òSchaefer€v.€Larsenóóó ó,€688€S.W.2d€430€(Tenn.€App.Ï1984),€and€quoted€the€following€passage:ÌÓÓà8 àWe€are€of€the€opinion€that€when€a€summary€judgement€hasÏbeen€granted€because€the€case€at€that€point€presents€noÏfacts€upon€which€a€plaintiff€can€recover,€but€prior€toÏthat€judgment€becoming€final,€the€plaintiff€is€able€toÏproduce€by€motion€facts€which€are€material€and€are€inÏdispute,€the€motion€to€alter€or€amend€the€judgmentÍshould€be€looked€upon€with€favor.€.€.€.ÌÌÓÓòòò òSchaefer€v.€Larsenóóó ó,€688€S.W.2d€430,€433€€(Tenn.€App.€1984).€ÏThis€case,€however,€fails€to€support€appellants'€argument.€€ToÏbegin€with,€the€court€did€not€even€address€the€issue€presented€inÏthis€case€because,€unlike€the€present€trial€judge,€the€judge€inÏòòò òSchaeferóóó ó€considered€the€late€filed€affidavit€in€making€hisÏdecision.€€Further,€the€òòò òSchaeferóóó ó€court€held€that€the€trial€courtÏshould€look€upon€the€motion€with€"favor,"€not€that€it€must€grantÏthe€motion.€€ÌÌà àAppellants€also€cited€òòò òRichland€City€Country€Club€v.€CRCÏEquities,€Inc.óóó ó,€832€S.W.2d€554€(Tenn.€App.€1991),€in€support€ofÏtheir€argument.€€€As€with€òòò òSchaeferóóó ó,€this€case€does€not€supportÏappellants'€argument.€€The€€òòò òRichland€Cityóóó ó€court€found€as€follows:€Ï"Considering€the€fact€that€the€affidavits€were€filed€after€theÏhearing€on€the€original€motion,€we€are€of€the€opinion€that€thisÏalone€should€not€have€precluded€their€consideration."€€€€òòò òRichlandÏCity€Country€Club€v.€CRC€Equities,€Inc.óóó ó,€832€S.W.2d€554,€557„58€(Tenn.€App.€1991).€€The€court€then€quoted€the€portion€of€the€Ïòòò òSchaefer€óóó óopinion€quoted€above.€€Analyzing€these€statementsÏtogether,€it€is€clear€that€a€trial€court€may€decide€to€notÏconsider€an€affidavit,€filed€after€the€court€has€granted€a€motionÏfor€summary€judgment,€as€long€as€the€reason€for€the€decision€isÏmore€than€the€fact€that€the€party€filed€the€affidavit€late.€€ÌÌà àA€second€opinion€written€after€òòò òSchaeferóóó ó€helps€to€clarifyÍthis€issue.€€òòò ò€Braswell€v.€Carothersóóó ó,€863€S.W.2d€722,€730€(Tenn.ÏApp.€1993).€€In€ò òòòBraswellóóó ó,€the€trial€court€granted€summaryÏjudgment€to€the€Carothers€and€to€Sleadd.€€The€plaintiffs€filed€aÏmotion€to€rehear€and€to€reconsider€the€judgment€in€favor€of€theÏCarothers€and€a€motion€to€vacate€Sleadd's€judgment.€€The€trialÏcourt€denied€the€motions,€and€the€plaintiffs€appealed.€€òòò òId.€óóó óatÏ724„25.€€The€court€of€appeals€addressed€the€trial€courts'Ïdisposition€of€the€motions€separately.€€As€to€Sleadd,€the€courtÏfound€that€the€new€evidence€offered€by€the€plaintiffs€"was€,€orÏshould€have€been,€available€to€counsel€prior€to€the€hearing€on€theÏmotion€and€[could€not]€truly€be€considered€'newly€discovered.'"€Ïòòò òId.€óóó óat€730.ò òòò€€óóó óThe€court€then€concluded€that€the€trial€judge€did€notÏerr€in€failing€to€vacate€the€summary€judgment€in€favor€of€Sleadd.€Ïòòò òId.€€óóó óThus,€a€court€may€uphold€its€summary€judgment€decision€if€theÏmoving€party's€evidence€is€not€"newly€discovered."× ƒ3 ××  ×ò òòò€€óóó óÌÌà àIn€support€of€their€motion,€the€appellants€relied€on€theÏletter,€the€report,€and€the€affidavit.€€As€previously€discussed,Íthe€letter€and€the€report€were€in€an€improper€form,€and€theÏtestimony€was€inadmissible.€The€affidavit€attached€to€appellants'Ïmotion€to€reconsider€was€not€new€evidence.€€The€only€differenceÏbetween€the€report€and€the€letter€and€the€affidavit€was€that€theÏaffidavit€contained€all€of€the€appropriate€"buzz"€words€found€inÏthe€statutes€and€rules.€€Dr.€Schlafly€did€not€state€that€heÏreceived€other€records€or€more€information€regarding€the€caseÏwhich€was€not€available€to€him€before.€€Also,€there€were€noÏaffidavits€from€appellants'€attorneys€suggesting€that€they€couldÏnot€have€obtained€this€information€earlier.€€The€second€affidavitÏwas€nothing€more€than€the€first€affidavit€dressed€up.€€Clearly,Ïthe€trial€judge€did€not€abuse€his€discretion€in€deciding€not€toÏconsider€the€affidavit€nor€did€he€err€in€sustaining€the€motion€forÏsummary€judgment.ÌÌà àTherefore,€it€follows€that€the€judgment€of€the€trial€court€isÏin€all€things€affirmed€and€the€case€is€remanded€to€the€trial€courtÏfor€any€further€necessary€proceedings.€€Costs€on€appeal€are€taxedÏto€the€plaintiffs/appellants.ÌÌÓÓà àà àà àà àà àà àà à______________________________Ìà àà àà àà àà àà àà àSAMUEL€L.€LEWIS,€JUDGEÌÌConcur:ÌÌÌ______________________________ÌHENRY€F.€TODD,€P.J.,€M.S.ÌÌÌÌÌDISSENTING€OPINIONÌWILLIAM€C.€KOCH,€JR.,€J.