ÿWPCç …#†VUNÜ %* 0(04Xl 0l{ 0Dç 0J+ 0Tu 0^É 0h' 0r 0| 0†} 0 1u“ U, 0d4 U,˜ U>Ä B)DC+ AMnU*»åv~vÓ› D3n B¡ 0@¾ AOþÆM 0D 0DW D/› BʘIBM Laser Printer 4019IBM4019ÈÈ,,,,ÈÈ0ÎÙP M*_ Æ¡ ^P(ÖÃ9 Z ‹6Times New Roman RegularX($¡¡3x23|x|((3üÝ$¤¤Ý ƒ!ÝÝ  Ýà  àòòÚ  Ú0Ú  Úóó(#Ã$òòÚ  Ú0Ú  Úóó2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ 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< Œ 9p`(Monaco< Œ 9p`(&Times New Roman% Line 7 d7Border 1dd€- Cþÿ << Gÿÿ< Œ 9p`(Arial Ý ƒ!ÝÔ€ÔÔ€ÔÝ  ÝÝ ƒ"ÝÝ  ÝÔ€"ÔÔ€"ÔÓ  ÓÔ YYY ÔFILEDÔ€"XÔÌÌò òDecember€12,€1995ÌÌCecil€Crowson,€Jr.ÌÔ€"ôÔAppellate€Court€Clerkó ó Ý ƒ!ÝÔ€ÔÔ€ÔÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝT.C.A.€ðð€63„24„101€was€amended€in€1993,€and€T.C.A.€ðð€63„24„101(2)€now€states:€ÌÌà8 à"Athletic€trainer"€means€a€person€with€specific€qualifications€as€set€forth€in€thisÏchapter,€who,€upon€the€advice,€consent€and€oral€or€written€prescriptions€of€aÏphysician,€carries€out€the€practice€of€prevention,€recognition,€evaluation,Ïmanagement,€disposition,€treatment,€or€rehabilitation€of€athletic€injuries,€and,€inÏcarrying€out€these€functions€the€athletic€trainer€is€authorized€to€use€physicalÏmodalities,€such€as€heat,€light,€sound,€cold,€electricity,€or€mechanical€devicesÏrelated€to€prevention,€recognition,€evaluation,€management,€disposition,Ïrehabilitation,€and€treatment;€€ÌÌWhile€we€do€not€believe€either€of€these€statutes€was€intended€by€the€legislature€to€define€the€duty€ofÏan€athletic€trainer,€we€do€believe€they€are€illustrative€in€determining€the€role€of€a€trainer€in€anÏathletic€program.€ÌÌ€ÌPtPtHHÚ(ÿáÿâùFG(üHHÚ(d'@Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA: T Monaco ÒÒ  BA: T Monaco Ò++++'ÿÿdxd d("ÿÿ$££Ò  ÒÒ  Ò€-‚ƒCþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5(3¯$¢¢Ý ƒ!ÝÝ  Ý($$””ò òÚ  Ú1Ú  Úó ó„„'÷ÿ dxdüÿP PdÝ ƒ!ÝÔ . ÔÔ€ÔÓ&€X„d&ÓÑ#€Xd#ÑÔ€ÔÝ  ÝÓ` Ü` p”XÓÑ\R AØ'\Ñà@ àò òIN€THE€COURT€OF€APPEALS€OF€TENNESSEE,€WESTERN€SECTIONÌà@ àAT€JACKSONÌà@ à_______________________________________________________ÌÌó óà à)ò òÌMICHAEL€RAY€PINSON,ó óà à)à àTennessee€Claims€CommissionÌà à)à àClaim€No.€60971Ì€€€€€Claimant/Appellee,à à)Ìà à)ÌVS.à à)à àC.A.€No.€02A01„9409„BC„00210Ìà à)Ìò òSTATE€OF€TENNESSEE,ó óà à)Ìà à)Ì€€€€€Defendant/Appellant.à à)Ìà à)Ì______________________________________________________________________________ÌÌFrom€the€Claims€Commission€of€State€of€Tennessee,€Western€Division.Ìò òHonorable€Martha€B.€Brasfield,€Commissioner€of€Claims€ó óÌÌÌÌò òBeauchamp€E.€Broganó ó,€General€Counsel€The€University€of€Tennessee,ÌÙ€€Ùò òßL€!# ;+'h|¯Ã` Å `€€LßRonald€C.€Leadbetteró ó,€Associate€General€CounselÌAttorneys€for€€Defendant/Appellant.ÌÌÌÌò òSidney€Gilreathó ó,Ìò òRichard€L.€Duncanó ó,ÌGILREATH€&€ASSOCIATES,€Knoxville,€TennesseeÌò òLee€Greeró ó,€ÌGREER€&€GREER,€Paris,€TennesseeÌAttorneys€for€Claimant/Appellee.ÌÌÌÌOPINION€FILED:ÌÌò òAFFIRMED€ÌÌÌà àFARMER,€J.ÌÌÌÌCRAWFORD,€P.J.,€W.S.€ó ó:€(Concurs)ÌÌò òHIGHERS,€J.€ó ó:€(Concurs)ÌÌÌÌÌÌÌÌÌÌÌÌÓ  ÓÓ` Ü` ˜XÓÓÓà àThe€Appellant,€State€of€Tennessee,€appeals€a€final€order€of€the€Tennessee€ClaimsÏCommission,€finding€Appellant€negligent€and€awarding€Appellee,€Michael€Ray€Pinson€(Pinson),Ïjudgment€for€€$300,000€for€injuries€sustained€by€Pinson€while€playing€football€for€the€UniversityÏof€Tennessee€at€Martin€(UTM).ÌÌà àIn€1983,€Pinson€received€a€football€scholarship€to€UTM.€€Pinson€decided€not€toÏplay€football€that€year,€and€did€not€enroll€at€UTM.€€In€August€1984,€Pinson€enrolled€at€UTM€andÏreported€to€football€camp€for€practice.€€He€passed€his€physical€examination€and€began€participatingÏin€practice.€€On€August€25,€1984,€Pinson€suffered€a€blow€to€the€head€during€a€football€practice.€ÏHe€walked€to€the€sidelines,€said€that€he€had€been€"kicked€in€the€head,"€and€collapsed€unconscious.€€ÌÌà àDuring€the€time€that€Pinson€was€unconscious,€the€UTM€athletic€trainer,€JamesÏRichard€Lyon€(Lyon),€examined€Pinson.€€Lyon's€personal€notes€from€the€day€of€Pinson's€injuryÏshow€that€Lyon€found€palsy€on€the€left€side€of€Pinson's€face,€no€control€of€the€left€side€of€hisÏbody,€unequal€pupils€and€no€response€to€pain,€sound€or€movement.€€These€notes€also€show€thatÏPinson€remained€unconscious€for€a€period€of€ten€minutes.ÌÌà àAfter€his€examination€of€Pinson,€Lyon€summoned€an€ambulance€which€transportedÏPinson€to€the€Volunteer€General€Hospital€in€Martin,€Tennessee.€€Lyon€did€not€personallyÏaccompany€Pinson€to€the€hospital€but€had€a€student€trainer€accompany€Pinson.€€Lyon€did€not€giveÏthe€trainer€any€instructions€about€the€information€that€the€trainer€should€give€the€emergency€roomÏdoctor.€€Hospital€records€show€that€the€trainer€informed€an€emergency€room€nurse€that€Pinson€lostÏconsciousness€for€about€two€minutes.€€Although€Lyon€visited€the€emergency€room€shortly€afterÏPinson€arrived,€Lyon€did€not€speak€to€a€doctor€about€the€neurological€signs€he€had€observed€on€theÍpractice€field.Ìà àÌà àAt€Volunteer€General,€Pinson's€head€was€X„rayed€and€found€to€be€normal.€€No€CTÏscan€was€ever€done.€€Pinson€was€assigned€to€Dr.€O.€K.€Smith€for€follow„up€care€and€was€admittedÏto€the€hospital€for€observation.€€Although€all€neurological€checks€were€normal,€hospital€recordsÏshow€that€Pinson€complained€of€headaches€to€the€hospital€staff.€€Pinson€complained€that€one€ofÏthese€headaches€was€so€severe€that€it€made€him€sick€to€his€stomach.€€ÌÌà àOn€August€26,€1994,€Dr.€Smith€telephoned€Lyon€and€told€him€that€Pinson€shouldÏnot€participate€in€football€practice€for€a€week€and€that,€if€any€further€trouble€arose,€Pinson€shouldÏreturn€to€Dr.€Smith€or€another€physician.€€€On€that€same€day,€Dr.€Smith€released€Pinson€to€Lyon,Ïand€Lyon€transported€Pinson€from€the€hospital€to€UTM.€€ÌÌà àWhen€Lyon€picked€up€Pinson,€he€complained€to€Lyon€of€a€headache.€€Lyon€did€notÏrecord€this€headache€in€the€UTM€records.€€On€August€27,€1984,€Pinson€complained€of€a€headacheÏand€was€given€Empirin€#4€by€Lyon.€€On€August€28,€1984,€Pinson€told€Lyon€that€he€had€aÏheadache,€but€that€it€was€milder€than€the€one€he€had€on€the€previous€day.€€Lyon's€notes€of€AugustÏ30,€1984,€which€refer€to€Pinson,€contain€the€statement€"Headache!".€€€ÌÌà àOn€September€3,€1984,€Lyon€contacted€Dr.€Ira€Porter,€the€UTM€team€physician.€ÏLyon€told€Dr.€Porter€that€Pinson€was€asymptomatic€for€a€concussion€on€September€3.€€Lyon€didÏnot€tell€Dr.€Porter€about€Pinson's€headaches€on€the€26th,€27th,€28th,€or€30th.€€Relying€on€Lyon'sÏreport€of€Pinson's€condition,€Dr.€Porter€concurred€with€Dr.€Smith's€prior€advice€that€Pinson€couldÏreturn€to€practice€if€there€were€no€further€problems.Ìà àÌà àOn€September€3,€1984,€Pinson€returned€to€practice.€€He€participated€in€practice,Ïtraveled€as€a€member€of€the€team€and€played€in€at€least€two€games.€€Testimony€from€Pinson'sÍmother,€roommate€and€girlfriend,€indicated€that€Pinson€suffered€headaches€and€complained€ofÏdizziness,€nausea€and€blurred€vision€throughout€this€three€week€period€from€September€3€toÏSeptember€24.€€Lyon€did€not€report€any€of€these€symptoms€to€Dr.€Porter.€€On€September€24,ÏPinson€walked€to€the€sideline€during€a€practice,€stated€that€he€had€been€"kicked€in€the€head"€andÏcollapsed€unconscious.€€Ìà àPinson€was€eventually€taken€to€Jackson„Madison€County€General€Hospital€whereÏhe€underwent€brain€surgery.€€Surgeons€there€found€that€Pinson€had€sustained€a€chronic€subduralÏhematoma€of€three€to€four€weeks€duration€of€several€hundred€cubic€centimeters€and€an€acuteÏsubdural€hematoma€of€approximately€25„30€cubic€centimeters€and€a€shift€of€mid„line€structures€ofÏalmost€1.5€centimeters.€€Pinson€remained€in€a€coma€for€several€weeks€and€was€transferred€to€theÏLamar€Unit€of€Baptist€Hospital€in€Memphis€for€intensive€rehabilitative€treatment.€€As€a€result€of€hisÏinjuries,€Pinson€suffered€severe€and€permanent€neurological€damage.ÌÌà àPinson€brought€an€action€for€negligence€against€Appellant€before€the€TennesseeÏClaims€Commission.€€A€trial€upon€the€merits€was€held€before€Claims€Commissioner€Martha€B.ÏBrasfield.€€ÌÌà à€At€the€time€of€trial,€Pinson€was€a€hemiparetic.€€He€had€no€use€of€his€left€arm€andÏvery€little€use€of€his€left€leg.€€He€had€a€shunt€to€relieve€fluid€build„up€in€his€brain.€€He€also€sufferedÏfrom€severe€cognitive€problems€and€frequent€seizures.€€These€maladies€rendered€him€unable€toÏhold€a€job.€€Additionally,€Pinson€and€his€mother€had€incurred€approximately€$200,000€in€medicalÏbills€due€to€his€injury.ÌÌà àThe€expert€testimony€of€Dr.€Howard€L.€Ravenscraft€and€Dr.€Carol€Dooley€indicatedÏthat€if€any€one€of€the€physicians€at€Volunteer€General€Hospital€had€been€informed€of€theÏneurological€symptoms€that€Pinson€exhibited€on€August€25,€1984€(i.e.,€palsy€on€the€left€side€of€theÏface,€no€control€of€left€side€of€the€body,€and€the€fact€that€Pinson€was€hit€on€the€football€field,€thenÍwalked€to€the€sidelines€and€collapsed€unconscious)€they€would€have€likely€ordered€a€CT€scan€inÏaddition€to€the€x„rays€and€other€treatment€Pinson€received.€€It€is€undisputed€that€a€CT€scan€onÏAugust€25,€1984,€would€have€helped€to€reveal€the€original€subdural€hematoma.ÌÌà àThree€medical€experts,€Dr.€Ravenscraft,€Dr.€Dooley€and€Dr.€Harry€FriedmanÏtestified€that€Pinson's€actions€immediately€following€the€blow€to€his€head€would€have€been€highlyÏrelevant€information€in€Pinson's€treatment.€€The€fact€that,€prior€to€falling€unconscious,€Pinson€hadÏwalked€to€the€sideline€and€announced€that€he€had€been€hit€in€the€head€indicated€that€he€hadÏexperienced€a€"lucid€interval".€€A€lucid€interval€occurs€when€there€is€a€neurological€sequence€thatÏfollows€the€pattern€of€(1)€trauma,€(2)€consciousness,€and€(3)€loss€of€consciousness.€€A€lucidÏinterval€is€usually€a€sign€of€a€serious€head€injury.ÌÌà àExpert€testimony€also€revealed€that€the€length€of€time€Pinson€was€unconsciousÏcould€have€also€been€important€information€for€the€treating€physician.€€Dr.€Ravenscraft€and€Dr.ÏDooley€both€testified€that€a€doctor,€upon€being€informed€of€a€five€to€ten€minute€loss€ofÏconsciousness,€would€have€been€more€likely€to€schedule€a€CT€scan.€€Dr.€Smith€testified€that€if€heÏhad€been€informed€of€Pinson's€lucid€interval€and€ten€minute€loss€of€consciousness,€he€likely€wouldÏhave€ordered€a€CT€scan.€€ÌÌà àDr.€Friedman,€Dr.€Ravenscraft€and€Dr.€Dooley€testified€that€if€the€chronic€subduralÏhematoma€had€existed€from€three€to€four€weeks€prior€to€September€24,€1984€it€would€have€causedÏsignificant€headaches.€€They€further€testified€that€if€the€chronic€subdural€hematoma€had€beenÏproperly€diagnosed€prior€to€September€24,€1984,€Pinson€still€would€have€undergone€correctiveÏbrain€surgery,€but€would€have€very€likely€led€a€normal€life.ÌÌà à€Commissioner€Brasfield€found€that€Lyon€had€a€duty€(1)€to€report€Pinson'sÏneurological€signs€which€he€observed€on€August€25,€1984€to€a€medical€doctor,€and€(2)€to€reportÍPinson's€subsequent€headaches€to€a€medical€doctor€as€Dr.€Smith€had€instructed.€€She€found€LyonÏnegligent€(1)€in€not€reporting€his€observations€of€Pinson's€condition€on€August€25,€1984,€to€theÏemergency€room€physicians,€and€(2)€in€not€reporting€Pinson's€complaints€of€headaches€to€Dr.ÏSmith€or€Dr.€Porter,€following€Pinson's€first€injury.ÌÌà àCommissioner€Brasfield€ruled€that€Lyon's€negligence€was€the€proximate€cause€ofÏPinson's€injuries€since€Lyon's€negligence€caused€Pinson's€chronic€subdural€hematoma€not€to€beÏproperly€diagnosed.ÌÌà àCommissioner€Brasfield€awarded€damages€to€Pinson€in€the€amount€of€$1,500,000.€ÏShe€took€notice€of€the€fact€that€other€individuals€had€been€sued€in€the€Circuit€Court€of€WeakleyÏCounty€for€their€negligence€in€the€treatment€of€Pinson.€€Commissioner€Brasfield€found€thatÏAppellant€was€liable€for€thirty€percent€(30%)€of€Pinson's€damages,€or€$450,000.€€She€did€notÏapportion€any€fault€to€Pinson.€€Pursuant€to€T.C.A.€ðð€9„8„307(e),€she€found€that€Pinson€wasÏentitled€to€a€judgment€against€Appellant€in€the€amount€of€$300,000.ÌÌà àAppellant€presents€the€following€issues€for€review:ÌÌÌÓÓà8 àà àI.€€Did€the€Claims€Commission€err€in€finding€that€the€UTÏathletic€trainer€had€a€duty€to€initiate€a€transfer€of€medical€informationÏto€Claimant's€physicians?ÌÌà8 àà àII.€€Did€the€Claims€Commission€err€in€finding€that€the€UTÏathletic€trainer€breached€his€duty€to€report€head€injury€symptoms€ifÏsuch€duty€existed?ÌÌà8 àà àIII.€€Did€the€Claims€Commission€err€in€finding€that€anyÏbreach€of€duty€by€the€UT€athletic€trainer€was€the€proximate€cause€ofÏClaimant's€injuries?€ÌÌÌÌÓÓà àUnder€the€law€in€this€state,€no€claim€for€negligence€can€succeed€in€the€absence€ofÍany€one€of€the€following€elements:€€(1)€a€duty€of€care€owed€by€the€defendant€to€the€plaintiff;€(2)Ïconduct€falling€below€the€applicable€standard€of€care€amounting€to€a€breach€of€that€duty;€(3)€anÏinjury€or€loss;€(4)€causation€in€fact;€and€(5)€proximate,€or€legal€cause.€€ò òòòHaynes€v.€HamiltonÏCountyóó,€ó ó883€S.W.2d€606,€611€(Tenn.€1994);ò ò€òòPerez€v.€McConkeyóó,€ó ó872€S.W.2d€897,€905Ï(Tenn.€1994);ò ò€òòBradshaw€v.€Danielóó,€ó ó854€S.W.2d€865,€869€(Tenn.€1993)ò ò;€€òòMcClenahan€v.ÏCooleyóó,€ó ó806€S.W.2d€767,€774€(Tenn.€1991).ò ò€ó ó€ÌÌà àThis€Court's€review€of€the€Claims€Commission's€decision€that€the€requiredÏelements€of€negligence€exist,€in€this€case,€must€be€ò òòòde€novoó óóó€with€a€presumption€of€correctnessÏunless€the€preponderance€of€the€evidence€is€to€the€contrary.€€T.R.A.P.€13(d);€ò òòòUnion€CarbideÏCorp.€v.€Huddlestonóó,€ó ó854€S.W.2d€87,€91€(Tenn.€1993);€òòò òBeare€v.€Stateó óóó,€814€S.W.2d€715,Ï717€(Tenn.€1991).ÌIt€is€the€Appellant's€burden€to€establish€that€a€preponderance€of€the€evidence€is€contrary€to€theÏCommissioner's€findings.€€òòò òBeare,€óóó ó814€S.W.2d€at€717.€€€ÌÌà àFirst,€Appellant€argues€that€Pinson's€negligence€claim€must€fail€because€UTMÏathletic€trainer€Lyon€had€no€affirmative€duty€to€inform€Pinson's€doctors€about€the€neurologicalÏsigns€exhibited€by€Pinson€directly€after€his€first€injury.€€Appellant€argues€that€Lyon€had€a€duty€toÏreport€these€signs€only€if€requested€to€do€so€by€a€physician.ÌÌà àLyon€testified€that€the€standard€of€care€of€an€athletic€trainer€was€only€to€accuratelyÏreport€to€a€physician€information€which€the€physician€requested,€including€any€observed€physicalÏsymptoms.€€Lyon€further€testified€that€it€was€the€trainer's€duty€to€follow€the€physician's€orders€inÏtreating€an€athlete.€€Appellant€argues€that€the€record€is€devoid€of€any€evidence€that€an€athletic€trainerÏhas€a€duty€to€seek€out€and€volunteer€information€to€a€physician€or€guess€what€information€aÏphysician€might€need€for€purposes€of€evaluating€or€treating€an€injured€athlete.€€Appellant€furtherÏpoints€out€that€there€is€no€statutory€duty€that€would€require€a€trainer€to€volunteer€information€to€anÍathlete's€doctor.€€Ìà àAs€support€for€its€argument,€Appellant€cites€T.C.A.€ðð€63„24„101(1),€a€statuteÏdealing€with€the€certification€of€athletic€trainers€with€the€Board€of€Medical€Examiners.€€T.C.A.€ððÏ63„24„101(1)€provides€in€pertinent€part:ÌÌÓÓà8 à"Athletic€Trainer"€means€a€person€with€specific€qualifications€as€setÏforth€in€this€chapter,€who€is€employed€by€and€works€with€an€athleticÏteam€and€who,€òòupon€the€advice€and€consent€of€his€team€physicianóó,Ïcarries€out€the€practice€of€prevention€or€physical€rehabilitation,€orÏboth,€of€injuries€incurred€by€participating€athletes€at€his€educationalÏinstitution€,€.€.€.€€In€carrying€out€these€functions,€the€athletic€trainerÏis€authorized€to€use€whatever€physical€modalities€òòas€are€deemedÏnecessary€by€a€team€physicianóó;ÌÌÌÌÓÓT.C.A.€ðð€63„24„101(1)€(1990)€(emphasis€added).× ƒ$ ××  ×€ÌÌà àTo€begin€our€analysis,€we€note€that€the€trial€court€typically€has€the€exclusiveÏresponsibility€to€determine€whether€the€law€will€recognize€a€duty€imposed€on€the€defendant€for€theÏplaintiff's€benefit.€€òòò òRoberts€v.€Robertson€County€Bd.€of€Educ.ó óóó,€692€S.W.2d€863,€869Ï(Tenn.€App.€1985);€òòò òDill€v.€Gamble€Asphalt€Materialsó óóó,€594€S.W.2d€719,€721€(Tenn.€App.Ï1979).€€Here,€the€Claims€Commissioner€held€that€Lyon€had€a€duty€(1)€to€report€Pinson'sÏneurological€signs€which€he€observed€on€August€25,€1984€to€a€medical€doctor,€and€(2)€to€reportÍPinson's€subsequent€headaches€to€a€medical€doctor€as€Dr.€Smith€had€instructed.€ÌÌà àUpon€reviewing€the€record,€we€believe€that€a€duty€arose€from€the€fact€that,€as€aÏcollege€athlete,€Pinson€enjoyed€a€"special€relationship"€with€UTM.€€òòò òKleinknect€v.€GettysburgÏCollegeó óóó,€989€F.2d€1360,€1372€(3rd€Cir.€1993).€€Accordingly,€we€hold€that€UTM€and€itsÏemployee,€Lyon,€had€a€duty€to€exercise€reasonable€care€under€the€circumstances.€€òòò òSee€Doe€v.ÏLinder€Const.€Co.,€Inc.,ó óóó€845€S.W.2d€173,€196€(Tenn.€1992).€€Here,€Pinson€was€notÏengaged€in€his€own€private€affairs€at€UTM€at€the€time€of€his€injury.€€ò òòòId.ó óóó€€Instead,€he€wasÏparticipating€in€a€scheduled€athletic€practice€for€an€intercollegiate€team€sponsored€by€UTM€underÏthe€supervision€of€UTM€employees.€€ÌÌà àWhether€UTM€breached€its€duty€turns€upon€whether€UTM€and€Lyon€exercised€theÏappropriate€standard€of€care€in€their€treatment€of€Pinson.€€We€believe€that€the€evidenceÏpreponderates€toward€the€Claims€Commissioner's€finding€that€Lyon€did€not€exercise€theÏappropriate€standard€of€care€in€his€treatment€of€Pinson.€€In€Tennessee,€the€applicable€standard€ofÏcare€may€be€established€by€the€defendant's€own€admissions.€òòò ò€Tutton€v.€Pattersonó óóó,€714€S.W.2dÏ268,€270€(Tenn.€1986).€€ÌÌà àApplying€the€standard€of€care€for€an€athletic€trainer€offered€by€Lyon€himself€at€trial,Ïwe€find€that€Lyon€breached€his€duty€when,€contrary€to€the€instructions€of€Dr.€Smith,€Lyon€failed€toÏreport€Pinson's€headaches€to€a€physician€before€allowing€Pinson€to€return€to€practice.€€It€isÏundisputed€that€Dr.€Smith€instructed€Lyon€that€Pinson€was€not€to€return€to€contact€for€one€weekÏand€to€report€if€any€further€trouble€arose.€€Dr.€Smith€further€instructed€Lyon€to€report€any€signs€ofÏa€head€injury,€including€headaches,€to€Dr.€Smith€or€to€another€physician.ÌÌà àIt€is€further€undisputed€that€on€September€3,€Lyon€telephoned€Dr.€Porter,€andÏdiscussed€Pinson's€condition.€€During€that€telephone€conversation,€Porter€asked€Lyon€"if€[Pinson]Íwas€having€headaches,€visual€problems,€visual€disturbances,€vomiting,€drowsiness,€weakness."€ÏLyon€told€Dr.€Porter€that€Pinson€was€asymptomatic€for€a€head€injury€on€September€3.ÌÌà àAppellant€contends€that€Lyon€did€not€breach€any€duty€owed€to€Pinson€becauseÏPinson€was€asymptomatic€for€a€concussion€on€September€3.€€Appellant€argues€that€Lyon€did€notÏhave€a€duty€to€disclose€any€information€about€Pinson's€previous€complaints€on€August€26th,€27th,Ï28th€or€30th€to€Dr.€Porter€because€Dr.€Porter€inquired€only€as€to€Pinson's€condition€on€SeptemberÏ3.ÌÌà àWe€are€unpersuaded€by€Appellant's€argument.€€On€August€26,€Dr.€Smith€instructedÏLyon€to€report€any€further€signs€of€head€injury,€including€headaches,€to€a€physician.€€EvidenceÏpresented€at€trial€showed€that€Pinson€suffered€headaches€from€August€26€until€the€date€of€hisÏsecond€injury€on€September€24.€€Lyon's€testimony€and€notes€from€this€time€period€indicate€thatÏLyon€was€aware€of€these€headaches.€€On€September€3,€Dr.€Porter€asked€Lyon€if€Pinson€wasÏexperiencing€any€signs€of€head€injury.€€Despite€overwhelming€evidence€that€Pinson€wasÏexperiencing€headaches€and€that€Lyon€knew€about€them,€Lyon€responded€that€Pinson€was€notÏexhibiting€any€signs€of€a€serious€head€injury.€€It€flies€in€the€face€of€reason€for€Lyon,€as€a€certifiedÏathletic€trainer,€to€suggest€that€he€had€no€duty€to€report€Pinson's€prior€headaches€to€Dr.€Porter€onÏSeptember€3,€particularly€when€he€had€been€instructed€by€Dr.€Smith€to€inform€a€doctor€of€anyÏfurther€symptoms€of€a€head€injury.€€€€€€€€€€€€€€Ìà àAppellant€contends€that€Lyon€told€Dr.€Porter€that€Pinson€had€a€headache€on€AugustÏ27,€and€that€Dr.€Porter€authorized€Lyon€to€give€Pinson€Empirin€#4€on€that€date.€€Appellant€furtherÏcontends€that€Dr.€Porter€spoke€with€Pinson€at€a€football€practice€on€August€30.€€Dr.€Porter€deniedÏthat€he€ever€had€any€such€conversations€with€Lyon€about€Pinson.€€As€such,€there€was€a€sharpÏconflict€in€the€testimony€of€the€witnesses€as€to€whether€Lyon€had€actually€informed€Dr.€Porter€ofÏPinson's€headaches.€€The€Claims€Commissioner€found€that€Lyon€had€never€contacted€Dr.€Porter.€€ÌÌà àWhether€Lyon€reported€Pinson's€headache€to€Dr.€Porter€prior€to€September€3€was€aÏquestion€of€fact€before€the€trial€court.€€Where€issues€in€a€case€turn€upon€the€truthfulness€ofÏwitnesses,€the€trier€of€fact€in€a€non€jury€case€has€the€opportunity€to€observe€the€witnesses€and€theirÏmanner€and€demeanor€while€testifying€and€is€in€a€far€better€position€than€this€Court€to€decide€thoseÏissues.€€òòò òState€ex€rel.€Balsinger€v.€Town€of€Madisonvilleóó,€ó ó222€Tenn.€272,€435€S.W.2dÏ803€(1968);ò ò€€òòTown€of€Alamo€v.€Forcum„James€Co.óó,€ó ó205€Tenn.€478,€327€S.W.2d€47Ï(1959);ò ò€òòLeek€v.€Powell,óóó ó€884€S.W.2d€118€(Tenn.€App.€1994).ò ò€€ó óThe€weight,€faith€and€credit€toÏbe€given€to€any€witness'€testimony€lies€in€the€first€instance€with€the€trier€of€fact€and€the€credibilityÏaccorded€will€be€given€great€weight€by€the€appellate€court.€€ò òòòIdó ó.óó€€We€do€not€find€that€the€evidenceÏpreponderates€against€the€Commissioner's€finding.ò òÌó óÌà àBecause€we€have€held€that€Lyon€had€a€duty€to€convey€requested€information€to€aÏphysician,€we€believe€it€unnecessary€to€decide€whether€Lyon€had€a€duty€to€convey€his€unsolicitedÏobservations€of€Pinson's€condition€to€the€emergency€room€staff€immediately€after€Pinson's€firstÏinjury.€€Ìà àAppellant,€as€its€final€issue,€argues€that€UTM's€and€Lyon's€conduct€was€not€theÏproximate€cause€of€Pinson's€injuries.€€In€Tennessee,€a€three„pronged€test€is€applied€to€determineÏproximate€cause:€€ÌÌÓÓà8 àà à(1)€the€tortfeasor's€conduct€must€have€been€a€"substantialÏfactor"€in€bringing€about€the€harm€being€complained€of;€andÌÌà8 àà à(2)€there€is€no€rule€or€policy€that€should€relieve€theÏwrongdoer€from€liability€because€of€the€manner€in€which€theÏnegligence€has€resulted€in€the€harm;€and€ÌÌà8 àà à(3)€the€harm€giving€rise€to€the€action€could€have€reasonablyÏbeen€foreseen€or€anticipated€by€a€person€of€ordinary€intelligence€andÏprudence.€€òòò òÌÌÌÌÓÓBoling€v.€Tennessee€State€Bankó óóó,€890€S.W.2d€32,€36€(Tenn.€1994)€(quoting€òòò òMcClenahanÏv.€Cooleyó óóó,€806€S.W.2d€767,€775€(Tenn.€1991)).ÌÌà àThe€court€in€ò òòòLindsey€v.€Miami€Development€Corpó óóó,€689€S.W.2d€856,€861Ï(Tenn.€1985)€cited€Dean€Prosser€with€approval€stating:€ÌÌÒ ° ÒÒ ` ÒÓÓà0 àà àThe€plaintiff€must€introduce€evidence€which€affords€aÏreasonable€basis€for€the€conclusion€that€it€is€more€likely€than€not€thatÏthe€conduct€of€the€defendant€was€a€cause€in€fact€of€the€result.€€AÏmere€possibility€of€such€causation€is€not€enough;€€and€when€theÏmatter€remains€one€of€pure€speculation€or€conjecture€or€theÏprobabilities€are€at€best€evenly€balanced,€it€becomes€the€duty€of€theÏcourt€to€direct€a€verdict€for€the€defendant€.€.€.ÌÌà0 àà àThe€plaintiff€is€not,€however,€required€to€prove€the€caseÏbeyond€a€reasonable€doubt.€€The€plaintiff€need€not€negative€entirelyÏthe€possibility€that€the€defendant's€conduct€was€not€a€cause€and€it€isÏenough€to€introduce€evidence€from€which€reasonable€persons€mayÏconclude€that€it€is€more€probable€that€the€event€was€caused€by€theÏdefendant€than€that€it€was€not€.€.€.€€ÌÌÌÌÓÓòòò òLindseyó óóó,€689€S.W.2d€at€861„62€(quoting€òòò òProsser€&€Keeton,€Tortsó óóó,€ðð€41,€p.Ï269€(5th€€ed.€1984)).€€ÌÌÒ ° ÒÒ ° Òà àIn€the€instant€case,€Dr.€Joseph€R.€Rowland,€a€neurosurgeon,€testified€that€onÏSeptember€24,€1984€he€treated€Pinson€for€a€chronic€subdural€and€an€acute€subdural€hematoma.€ÏDr.€Rowland€testified€that€the€chronic€hematoma€was€of€three€to€four€weeks€duration€and€that€theÏacute€subdural€hematoma€was€of€one€to€five€hours€duration.€€Dr.€Rowland€testified€that€the€acuteÏclot€was€caused€by€direct€trauma€to€the€brain€or€by€bleeding€from€the€membrane€of€the€chronicÏsubdural€hematoma.ÌÌà àIt€is€impossible€and€unnecessary€to€determine€from€the€record€whether€Pinson'sÏpermanent€neurological€injuries€stemmed€from€damage€to€his€brain€from€the€acute€or€chronicÏsubdural€hematoma.€€The€Claims€Commissioner€found€that€Pinson's€first€injury€would€have€beenÏproperly€diagnosed€and€treated€if€Lyon€had€reported€the€neurological€symptoms€exhibited€byÏPinson€from€August€26€to€September€24.€€Dr.€Dooley€testified€that€if€Lyon€had€reported€Pinson'sÍheadaches,€Pinson€would€have€been€subjected€to€a€neurological€consult€and€a€CT€scan.€€It€isÏundisputed€that€this€CT€scan€would€have€helped€reveal€Pinson's€injured€brain.€€If€Pinson's€injuryÏhad€been€properly€diagnosed€prior€to€September€24,€1984,€it€is€undisputed€that€Pinson€wouldÏlikely€have€had€little€or€no€permanent€neurological€deficit.ÌÌà àIt€is€clear€from€the€record€that€Pinson's€chronic€subdural€hematoma€made€theÏoccurrence€of€an€acute€subdural€hematoma€much€more€probable.€€Dr.€Dooley€testified€that€the€stateÏof€Pinson's€brain€due€to€the€chronic€subdural€hematoma€between€September€3€and€September€24Ïwas€"extremely€swollen€and€very€fragile."€€Dr.€Dooley€explained€that€a€trivial€amount€of€traumaÏcould€have€caused€the€acute€subdural€hematoma€to€develop.€€Thus,€regardless€of€whether€Pinson'sÏpermanent€injuries€were€caused€by€the€chronic€or€acute€subdural,€it€is€clear€that€Lyon's€conductÏcontributed€significantly€to€Pinson's€overall€injury.€€€Ìà àÌà àAccordingly,€we€hold€that€Lyon's€negligence€in€not€reporting€Pinson's€headachesÏto€a€physician,€after€having€been€instructed€to€do€so,€was€more€likely€than€not€a€substantial€factorÏin€the€misdiagnosis€of€Pinson's€head€injury.€€We€further€believe€that€Pinson's€permanent€injuriesÏcould€have€reasonably€been€foreseen€or€anticipated€by€a€person€of€ordinary€intelligence€andÏprudence.€€It€seems€extremely€foreseeable€that€withholding€requested€information€from€a€teamÏphysician€could€result€in€permanent€injury€to€a€football€player,€who€had€collapsed€unconscious€theÏprevious€week.€€Finally,€we€are€unaware€of€any€public€policy€that€would€require€us€to€hold€aÏuniversity€unaccountable€when€the€negligence€of€its€employee€results€in€severe€injuries€to€anÏathlete.€€Therefore,€we€hold€that€Lyon's€negligence€in€not€reporting€Pinson's€headaches€was€aÏproximate€cause€of€Pinson's€permanent€injuries.ÌÌà àIn€summation,€we€find€that€UTM€and€its€employee,€Lyon,€had€a€duty€to€exerciseÏreasonable€care€under€the€circumstances€in€respect€to€Pinson.€€We€further€find€that€UTM€breachedÏthis€duty€when€Lyon€failed€to€exercise€the€appropriate€standard€of€care€of€an€athletic€trainer.€ÍFinally,€we€find€that€UTM's€breach€of€duty€is€a€proximate€cause€of€Pinson's€permanent€injuries.ÌÌà àThe€judgment€of€the€Claims€Commission€is€affirmed.€€Costs€are€taxed€to€Appellant,Ïfor€which€execution€may€issue€if€necessary.ÌÌÓ` Ü` È“XÓÓÓà à________________________________Ìà àFARMER,€J.ÌÌÌÌ______________________________ÌCRAWFORD,€P.J.,€W.S.€(Concurs)ÌÌÌÌ______________________________ÌHIGHERS,€J.€(Concurs)