ÿWPC …# VU:a %› 0(¡4ÉÝìw.ì 0J" 0Tl 0^À 0h 0r† 0|ø 0†t 0ú 1uŠ U,ÿ 0d+ U, U*» B)å DC AMQÝžv~{ BùvÓ D3é 0@ AO\Æ« 0Dq D/µ Bä˜HP LaserJet 4Si/4SiMX PS 600dpiPSCRIPTÀÌÀääÀÀÌ0 ,†r‰AZ‹"Arial RegularX($¡¡Gav 3|x ÿ     e Ó€ 2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô  ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)< Œ 9p`(ModernP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ< Œ 9p`(Monaco< Œ 9p`(Arial% Line 7 d 7Border 1dd€-!Cþÿ << Gÿÿ ÓÝ ƒ!ÝÔ€ÔÔ€ÔÝ  ÝÔ€ÔÓ  Óò òÔ YYY ÔFILEDÔ€XÔÌÌMay€3,€1996ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔ  Ôó óPtPtHHÚ(ÿáÿâùFG(üHHÚ(d'@ dStyl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA Op Monaco ÒÒ  BA Op Monaco Ò%%%%'ÿÿdxd("ÿÿ$££Ò  ÒÒ  Ò€-‚ƒCþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5($$””ò òÚ  Ú1Ú  Úó ó„„'÷ÿ dxdüÿP PdÝ ƒ!ÝÔ . ÔÔ€ÔÓ&€X„d&ÓÑ#€Xd#ÑÔ€ÔÝ  ÝÓ  ÓÑ\R AØ'\ÑÑ7€›XXdædÈ7Ñà@ àò òIN€THE€COURT€OF€APPEALS€OF€TENNESSEEÌà@ àWESTERN€SECTION€AT€NASHVILLEÌÌÌLISA€J.€PRINCE€and€husband,à àà à)ÌRICKY€PRINCE,à àà àà àà à)€€Ìà àà àà àà àà àà à)Ìà àà àó óPlaintiffs/Appellants,à àò ò)€€Coffee€Circuit€No.€24,504Ìà àà àà àà àà àà à)ÌVS.à àà àà àà àà àà à)€€Appeal€No.€01A01„9508„CV„00342ÌÙ€€ÙßL€"#!;+'h|½` ç `€€Lßà àà àà àà àà àà à)ÌCOFFEE€COUNTY,€TENNESSEEà à)Ìd/b/a€COFFEE€MEDICAL€CENTER,à à)Ìà àà àà àà àà àà à)Ìà àà àó óDefendant/Appellee.à àò ò)ó óÌÌÌà@ àAPPEAL€FROM€THE€CIRCUIT€COURT€OF€COFFEEÏCOUNTYÌà@ àAT€MANCHESTER,€TENNESSEEÌà@ àTHE€HONORABLE€GERALD€L.€EWELL,€SR.,€JUDGEÌÌÌÌò òRICK€L.€MOOREÌRUSSELL€D.€HEDGESÌJ.€BROOKS€FOXÌMOORE€&€HEDGESÌó óTullahoma,€TennesseeÌAttorneys€for€AppellantsÌÌÌÌò òROBERT€L.€TRENTHAMÌMARK€TYLER€SEITZÌTRABUE,€STURDIVANT€&€DEWITTÌó óNashville,€TennesseeÌAttorneys€for€Appelleeò òÌó óÌÌÌò òREVERSED€AND€REMANDEDÌÌÌÌÌÌó óà àà àà àà àà àà àà àà àà àò òALAN€E.€HIGHERS,€J.ÌÌÌÌCONCUR:ÌÌW.€FRANK€CRAWFORD,€P.J.,€W.S.ÌÌHEWITT€P.€TOMLIN,€JR.,€SR.€J.Ìó óÌÌÌÌÓÓà àThis€is€a€medical€malpractice€case.€€Plaintiffs,€Lisa€and€Ricky€Prince,€areÏhusband€Ñ7€›XXdæXXdæ7Ñand€wife.€€Lisa€Prince€("Plaintiff")€was€injured€during€out„patient€surgery,Ïallegedly€as€a€result€of€improperly€administered€anesthetic.€€€Initially,€the€suit€wasÏbrought€against€Coffee€Medical€Center,€Dr.€Ramprasand€(the€surgeon),€and€MichaelÏCruz€(the€nurse€›anesthetistœ).€€Dr.€Ramprasand€and€Cruz€settled€with€Plaintiffs€and€wereÏdismissed€prior€to€this€action.€€Plaintiff€alleges€on€appeal€that€Coffee€Medical€CenterÏ("CMC")€was€negligent€in€failing€to€establish€adequate€anesthetic€policies€andÏprocedures€and€in€failing€to€enforce€its€own€anesthesia€policies€and€procedures.€€TheÏtrial€court€granted€summary€judgment€in€favor€of€CMC€and€Plaintiff€has€appealed.€€ForÏthe€reasons€stated€below,€we€reverse.Ìà@ àÌà àDr.€Ramprasand,€Plaintiff's€physician,€admitted€her€to€CMC€on€June€19,€1989,€toÏundergo€same„day€surgery€for€release€of€carpal€tunnel€syndrome.€€Dr.€RamprasandÏwas€to€perform€the€surgery€and€Michael€Cruz,€a€certified€registered€nurse€anesthetist,Ïwas€to€administer€the€regional€anesthetic.€€Cruz€was€employed€by€Warren€AnesthesiaÏAssociates,€an€organization€with€which€the€CMC€had€a€contract€obligating€Warren€toÍprovide€anesthetic€services€to€CMC€patients.€ÌÌà àThe€procedure€for€administering€the€regional€anesthetic€entails€placing€aÏdouble€€tourniquet€in€the€area€of€the€elbow€while€injecting€the€anesthetic€agent€(.5%ÏXylocaine)€intravenously€into€the€patient's€arm.€€€The€hospital€pharmacy€was€closed€atÏthe€time€of€Plaintiff's€surgery,€and€the€standard€anesthetic,€a€.5%€single€dose€vial€ofÏXylocaine,€was€not€stocked€in€the€operating€room.€€€Consequently,€Cruz€compoundedÏhis€own€solution€of€.5%€Xylocaine.€ÌÌà àAfter€two€attempts€to€establish€a€tourniquet€cuff€on€Plaintiff,€Cruz€injected€theÏanesthetic€solution€that€he€had€prepared€into€Plaintiff's€arm.€Following€surgery,€theÏtourniquet€was€removed.€€Soon€thereafter,€multiple€blue€patches€appeared€onÏPlaintiff's€arm€and€no€pulse€registered€below€her€elbow.€€Plaintiff€was€taken€byÏambulance€to€St.€Thomas€Hospital€for€corrective€surgery.€ÌÌà àPlaintiff€was€diagnosed€at€St.€Thomas€Hospital€as€having€sustained€aÏcompartment€syndrome€and€peripheral€nerve€injury.€€At€St.€Thomas€Hospital€sheÏunderwent€a€fasciotomy,€where€a€surgical€incision€is€made€in€the€arm€to€relieveÏpressure€in€the€fascial€compartments.€€The€fasciotomy€left€an€open€wound€in€Plaintiff'sÏarm€that€required€skin€grafting€to€correct.€€Plaintiff€subsequently€underwent€severalÏskin€grafts,€extensive€physical€therapy,€and€other€surgical€procedures.€€Plaintiff€hasÏincurred€approximately€$140,000€in€medical€expenses.€ÌÌà àDr.€Ramprasand€and€Cruz€entered€into€a€settlement€with€Plaintiff,€which€resultedÏin€their€dismissal€from€the€suit.€€€CMC€filed€a€Motion€for€Summary€Judgment€based€onÏthe€fact€that€any€potential€liability€against€CMC€was€extinguished€by€the€dismissal€ofÏCruz€and€Dr.€Ramprasand€from€the€case.€CMC€reasoned€that€any€claims€against€itÏwould€be€based€upon€the€conduct€of€either€Dr.€Ramprasand€or€Cruz€and€that,Ïtherefore,€the€common€law€rule€providing€that€when€a€servant€is€released€from€liability,Ïthe€€master€is€also€released,€absolved€CMC€of€any€liability.€€CMC€also€argued€that€itÏwas€entitled€to€summary€judgment€because€the€Plaintiff€failed€to€allege€specific€acts€ofÏnegligence€in€the€original€complaint.€ÌÌà àConversely,€Plaintiff€alleged€that€Cruz€and€Dr.€Ramprasand€were€independentÏcontractors€and€that€the€claims€against€CMC€rested€solely€upon€independent€grounds,Ïrather€than€upon€derivative€liability€stemming€from€the€acts€of€Cruz€and€Dr.ÏRamprasand.€€Specifically,€Plaintiff€alleged€that€CMC€was€negligent€in€failing€toÏenforce€its€own€anesthetic€policies€and€procedures€and€in€failing€to€establishÏanesthetic€procedures€that€"would€have€insured€that€those€with€limited€staff€privilegesÏcould€not€have€exceeded€their€authority€to€administer€anesthetics€to€the€Plaintiff,€LisaÏJ.€Prince."€€ÌÌà àIn€her€original€complaint€dated€June€18,€1990,€Plaintiff€alleged€that€CMC€wasÏnegligent€in€the€following€respects:ÌÓÓà8 àà8 à(a)€In€failing€to€provide€competent€medical€personnel,Ïincluding€doctors€and€nurses€for€the€examination€andÏtreatment€of€its€patient,€Plaintiff,€Lisa€J.€Prince,€following€theÍcompletion€of€her€surgery;Ìà8 àà8 à(b)€€In€failing€to€provide€properly€functioning€equipment€andÏgauges€necessary€for€the€performance€of€a€Bier€Block€andÏapplication€of€a€tourniquet.Ìà8 àà8 à(c)€€In€failing€to€provide€an€anesthesiologist€to€administerÏthe€anesthesia€and€tourniquet€to€Plaintiff€while€sheÏunderwent€surgery;Ìà8 àà8 à(d)€€By€otherwise€failing€to€exercise€that€degree€of€care€toÏwhich€the€Defendant€hospital€was€bound.€ÌÓÓÌà àAfter€filing€her€complaint,€Plaintiff€moved€to€amend€the€complaint€to€add€Dr.ÏRamprasand€as€a€defendant.€The€trial€court€granted€the€motion.€Thereafter,€on€May€19,Ï1994,€Plaintiff€again€moved€to€amend€her€complaint€in€order€to€add€specific€acts€ofÏnegligence€on€the€part€of€CMC,€which€are€as€follows:€€ÌÓÓà8 àà8 à(e)€€The€Coffee€Medical€Center€breached€its€duty€of€care€toÏits€patient,€Lisa€Prince,€by€failing€to€provide€a€physicianÏanesthesiologist€to€the€patient;€and€in€the€absence€of€aÏphysician€anesthesiologist,€the€Coffee€Medical€CenterÏfailed€to€assure€that€the€operating€surgeon,€Dr.€MitturÏRamprasand,€was€qualified€and€aware€of€his€obligation€toÏsupervise€the€nurse€anesthetist,€Mr.€Michael€Cruz.Ìà8 àà8 à(f)€€The€Coffee€Medical€center€breached€its€duty€of€care€to€itsÏpatient,€Lisa€Prince,€by€allowing€a€Certified€RegisteredÏNurse€Anesthetist€to€practice€anesthesiology€in€its€hospitalÏin€an€unsupervised€capacity.Ìà8 àà8 à(g)€€The€Coffee€Medical€Center€breached€its€duty€to€itsÏpatient,€Lisa€Prince,€by€failing€to€stock€the€appropriateÏanesthetic€at€the€time€of€her€surgery;€and€by€allowing€aÏregistered€nurse€to€independently€prepare,€compound€andÏdispense€drugs.Ìà8 àà8 à(h)€€The€Coffee€Medical€Center€breached€its€duty€to€itsÏpatient,€Lisa€Prince,€by€negligently€failing€to€assure€that€Mrs.ÏPrince's€anesthesia€care€was€supervised€by€an€appropriateÏphysician€with€special€knowledge€of€anesthesia.€ÌÌÌÓÓà àInitially,€the€trial€court€granted€Plaintiff's's€motion€to€amend,€but€later€vacated€itsÏdecision€and€denied€the€motion.€€€In€its€memorandum€opinion,€the€trial€court€reviewedÍthe€extensive€discovery€and€pleadings€that€had€occurred€in€the€case€and€held€thatÏjustice€did€not€mandate€the€granting€of€the€amendment.€€The€trial€court€stated:ÌÓÓà8 àà8 àIf,€as€counsel€for€the€plaintiffs€states€on€oral€argument,€theÏamendment€does€not€change€the€cause€or€causes€of€actionÏagainst€the€defendant,€Coffee€County€Hospital,€it€isÏunnecessary.€€If€it€does€change€or€add€the€cause€of€action,€itÏtriggers€additional€discovery€and€proof,€and€while€the€CourtÏis€aware€that€amendments€are€to€be€freely€granted,€it€is,€inÏthis€case,€the€opinion€of€the€Court€that€justice€does€notÏmandate€that€the€amendment€should€be€granted.ÌÌÓÓÌà àRule€15.01€Tenn.€R.€Civ.€P.€provides,€"A€party€may€amend€his€pleadings€once€asÏa€matter€of€course€at€any€time€before€a€responsive€pleading€is€served...[o]therwise€aÏparty€may€amend€his€pleadings€only€by€written€consent€of€the€adverse€party€or€byÏleave€of€court..."€€Although€the€rule€provides€that€permission€to€amend€may€be€liberallyÏgranted,€the€decision€to€amend€lies€within€the€sound€discretion€of€the€trial€court,€andÏwill€not€be€reversed€absent€a€showing€of€abuse€of€discretion.€€€òòWelch€v.€Thuanóó,€882ÏS.W.€2d€792,€793€(Tenn.€App.€1994);€€òòWilson€v.€Ricciardióó,€778€S.W.€2d€450,€453€(Tenn.ÏApp.€1989);€€òòMerriman€v.€Smithóó,€599€S.W.€2d€548,€559€(Tenn.€App.€1979).ÌÌà àThe€Tennessee€Supreme€Court€has€established€several€pertinent€factors€that€aÏtrial€court€should€consider€in€deciding€whether€to€grant€or€deny€a€motion€to€amend.€ÏThese€factors€include€"[u]ndue€delay€in€filing;€lack€of€notice€to€the€opposing€party;€badÏfaith€by€the€moving€party,€repeated€failure€to€cure€deficiencies€by€previousÏamendments,€undue€prejudice€to€the€opposing€party,€and€futility€of€amendment."€ÏòòMerrimanóó,€599€S.W.€2d€at€559.ÌÌà à€After€an€extensive€review€of€the€record,€we€do€not€find€any€indication€that€theÏtrial€court€abused€its€discretion€in€denying€the€motion€to€amend.€€Examining€this€caseÏin€the€light€of€the€above€delineated€factors,€we€find€ample€justification€for€the€action€ofÏthe€trial€court€in€denying€such€motion.€ÌÌà à€With€respect€to€Plaintiff's€allegations€that€CMC€was€negligent€in€failing€toÏimplement€proper€anesthetic€standards€and€procedures,€we€hold€that€the€originalÏallegation,€which€stated€that€CMC€was€negligent€"by€otherwise€failing€to€exercise€thatÏdegree€of€care€to€which€the€Defendant€hospital€was€bound,"€was€sufficient€to€put€CMCÏon€notice€of€Plaintiff's€claim.€€€Tennessee's€notice€pleading€requires€a€complaint€toÏcontain€only€minimum€general€facts€that€would€support€potential€cause€of€action€underÏTennessee€substantive€law.€€€A€complaint€is€generally€sufficient€if€it€states€factsÏsupporting€any€theory€of€relief,€even€if€the€theory€is€different€from€that€upon€which€theÏplaintiff€intended€to€rely.€€LÔ€ôÔAWRENCEÔ€XÔ€A.€PÔ€ôÔIVNICKÔ€XÔ,€TÔ€ôÔENNESSEEÔ€XÔ€CÔ€ôÔIRCUITÔ€XÔ€CÔ€ôÔOURT€Ô€XÔPÔ€ôÔRACTICEÔ€XÔ€ððÏ7„2,€at€244„45€(3rd€ed.€1991).€€Consequently,€to€permit€Plaintiff€to€amend€her€complaintÏin€€order€to€allege€that€CMC€was€negligent€in€failing€to€establish€adequate€anestheticÏpolicies€and€procedures€would€be€a€futile€effort€because€it€is€unnecessary.ÌÌà àà àTo€the€extent€that€Plaintiff€attempts€to€amend€her€complaint€in€order€toÏstate€a€negligent€credentialing€claim€against€CMC,€we€agree€with€the€trial€court€thatÏgranting€the€amendment€would€result€in€substantial€prejudice€to€CMC.€€Plaintiff'sÏmotion€to€amend€was€filed€more€than€four€years€after€her€original€complaint€was€filed.€ÍIt€is€our€opinion€that€the€general€allegation€of€failure€to€exercise€due€care€did€not€serveÏto€place€CMC€on€notice€of€Plaintiff's€intent€to€pursue€a€negligent€credentialing€claim.€AÏclaim€for€negligent€credentialing€is€distinct€from€a€malpractice€action€and€requiresÏseparate€elements€of€proof.€€The€trial€court€did€not€abuse€its€discretion€in€prohibitingÏPlaintiff€from€pursuing€a€new€avenue€of€liability€in€litigation€that€has€been€pending€forÏover€four€years€in€light€of€the€fact€that€Plaintiff€was€previously€allowed€to€amend€herÏcomplaint€and€voluminous€discovery,€motions,€and€pleadings€have€been€filed.ÌÌà àThe€next€issue€for€review€is€whether€the€trial€court€erred€in€granting€CMC'sÏmotion€for€summary€judgment.ÌÌà àSummary€judgment€is€to€be€rendered€by€a€trial€court€only€when€it€is€shown€thatÏthere€is€no€genuine€issue€as€to€any€material€fact€and€the€moving€party€is€entitled€to€aÏjudgment€as€a€matter€of€law.€€Tenn.€R.€Civ.€P.€56.03.€€When€a€motion€for€summaryÏjudgment€is€used€defensively,€the€plaintiff€must€present€evidence€sufficient€to€establishÏthe€essential€elements€of€the€claim€on€which€he€will€bear€the€burden€of€proof€at€trial.€ÏòòBlair€v.€Allied€Maintenance€Corp.óó,€756€S.W.€2d€267,€269„270€(Tenn.€App.€1988)€€InÏruling€on€a€motion€for€summary€judgment,€the€trial€court€and€the€Court€of€Appeals€mustÏconsider€the€matter€in€the€same€manner€as€a€motion€for€a€directed€verdict€made€at€theÏclose€of€the€plaintiff's€proof.€All€of€the€evidence€must€be€viewed€in€the€light€mostÏfavorable€to€the€opponent€of€the€motion€and€all€legitimate€conclusions€of€fact€must€beÏdrawn€in€favor€of€the€opponent.€€It€is€only€when€there€is€no€disputed€issue€of€materialÏfact€that€a€summary€judgment€should€be€granted€by€the€trial€court€and€sustained€by€theÍCourt€of€Appeals.€€òòByrd€v.€Hallóó,€€847€S.W.€2d€208,€211€(Tenn.€1993).€€If€the€courtÏentertains€any€doubt€as€to€whether€a€genuine€issue€of€material€fact€exists,€it€is€theÏcourt's€duty€to€overrule€the€motion.€€€òòId.óó€€This€court€may€not€weigh€the€evidence€whenÏevaluating€a€motion€for€summary€judgment.€€òòId.óó€€When€it€is€necessary€that€the€evidenceÏbe€weighed,€a€trial€should€ensue€because€such€issues€are€not€properly€capable€ofÏresolution€on€the€basis€of€affidavits€alone.€€òòId.óó€at€216.ÌÌà àThe€duty€of€a€hospital€is€to€exercise€such€reasonable€care€toward€patients€asÏthe€patients'€conditions€require.€€òòKeeton€v.€Maury€County€Hospitalóó,€713€S.W.€2d€314,Ï316€(Tenn.€App.€1986).€€In€order€to€recover,€a€plaintiff€must€show€that€the€hospitalÏviolated€that€standard€of€care.€€òòId.óó€at€317.€€The€burden€of€proof€is€on€the€plaintiff€toÏprove€the€standard€of€care,€violation€of€that€standard,€and€causation.€€T.C.A.€ðð€29„26„115.€€Unless€the€alleged€malpractice€lies€within€the€ordinary€knowledge€of€a€layman,Ïthere€must€be€expert€testimony€as€to€the€standard€of€care,€breach€of€that€standard,€andÏcausation.€€òòCoyle€v.€Prietoóó,€822€S.W.2d€596,€598€(Tenn.€App.€1991);€òòStokes€v.€Leungóó,Ï651€S.W.2d€704,€706€(Tenn.€App.€1982).ÌÌà àCMC€supported€its€motion€for€summary€judgment€with€the€affidavit€of€JaneÏHamby,€R.N.,€who€stated€that€CMC's€nursing€staff€complied€fully€with€the€recognizedÏstandard€of€acceptable€practice€for€nurses€and€that€the€tourniquet€functioned€properly.€ÌÌà àIn€opposition€to€CMC's€motion€for€summary€judgment,€Plaintiff€filed€the€affidavitsÏand€deposition€testimony€of€three€experts.€€€Dr.€James€A.€Ramsey,€an€anesthesiologistÍwho€treated€Plaintiff€while€she€was€hospitalized€at€St.€Thomas€Hospital,€€is€a€boardÏcertified€anesthesiologist€who€practices€in€Nashville,€Tennessee.€€He€executed€twoÏaffidavits,€one€of€which€states€in€pertinent€part€as€follows:ÌÓÓà8 àà8 àThe€Coffee€Medical€Center€was€negligent€in€failing€toÏassure€that€Michael€Cruz,€Certified€Registered€NurseÏAnesthetist,€was€supervised€by€an€appropriate€physicianÏwith€special€knowledge€of€anesthesia.€ÌÌDr.€Ramsey€stated€in€another€affidavit€as€follows:ÌÌà8 àà8 àIn€my€opinion,€the€injury€to€Lisa€Prince€would€not€haveÏoccurred€if€the€Coffee€Medical€Center€had€not€breached€itsÏduty€of€care€that€it€owed€to€its€patient€Lisa€Prince,€andÏassured€that€the€operating€surgeon€was€qualified€toÏsupervise€the€nurse€anesthetist,€and€further,€assured€thatÏthe€operating€surgeon€realized€his€obligation€to€superviseÏthe€nurse€anesthetist...€ÌÌÓÓà àÌà àDr.€William€Bradley€Worthington,€another€anesthesiologist€who€cared€forÏPlaintiff€testified€that€in€the€present€situation,€the€standard€of€care€required€the€surgeonÏto€be€responsible€for€supervising€the€€CRNA.€€ÌÌà à€James€L.€Massey,€II,€professor€of€hospital€and€health€administration€atÏGovernors€State€University€in€Illinois,€was€the€third€expert€to€testify€for€Plaintiff.€€Mr.ÏMassey€testified€that€CMC€was€negligent€in€credentialing€Dr.€Ramprasand€andÏMichael€Cruz.€€€Mr.€Massey€also€testified€that€CMC€breached€the€standard€of€care€forÏhospitals€through€failing€to€review,€update,€and€abide€by€the€medical€staff€by„laws€onÏcredentialing,€by€failing€to€establish€rules€and€regulations€for€anesthesia€services€andÏsurgeon€supervision€of€CRNA's,€by€failing€to€make€certain€that€all€surgeons€wereÍqualified€sufficiently€in€anesthesia,€€by€failing€to€establish€policies€and€procedures€forÏanesthesia€services,€by€failing€to€insure€that€pre„surgical€checks€by€nurses€were€made,Ïand€by€failing€to€establish€proper€controls€on€the€use€of€equipment.€€ÌÌà àBecause€we€have€ruled€that€Plaintiff€may€not€pursue€her€negligent€credentialingÏtheory€of€recovery,€Massey's€testimony€relating€to€a€claim€for€negligent€credentialing€isÏimmaterial.€€However,€Massey€also€stated€in€his€affidavit€that€CMC€deviated€from€theÏstandard€of€care€through€its€"[f]ailure€to€specify€that€each€surgeon€has€a€responsibilityÏto€supervise€anesthesia,"€its€"[f]ailure€to€have€policies€and€procedures€for€anesthesia,"Ïand€its€"[f]ailure€to€provide€Lisa€J.€Prince€with€a€preanesthesia€evaluation."€€Massey'sÏaffidavit€provides:€€ÌÓÓà8 àà8 àCoffee€Medical€Center€in€this€case€failed€to€implement€theÏproper€standards€both€internally€and€nationally...[I]t€is€myÏopinion€that€those€causal€factors€would€have€been€avoidedÏif€proper€hospital€procedures€and€credentialing€had€been€inÏplace.€€As€a€direct€result€of€Coffee€Medical€Center's€breachÏof€the€appropriate€hospital€standards€Lisa€Prince€sustainedÏinjury.€€ÌÓÓà àÌà àÌà àIt€is€inappropriate€for€this€Court€to€weigh€the€evidence€in€evaluating€a€motion€forÏsummary€judgment.€€When€the€above€evidence€is€viewed€in€a€light€most€favorable€toÏPlaintiff€and€all€countervailing€evidence€is€discarded,€a€genuine€issue€of€material€factÏexists€in€the€present€case.ÌÌà àAccordingly,€we€are€of€the€opinion€that€the€affidavits€and€testimony€offered€byÍPlaintiff€in€opposition€to€CMC's€motion€for€summary€judgment€establish€that€thereÏexists€a€genuine€issue€of€material€fact,€thereby€rendering€summary€judgmentÏinappropriate.€€The€order€granting€CMC€summary€judgment€is€reversed€and€this€caseÏis€remanded€to€the€trial€court€for€such€other€and€further€proceedings€as€may€beÏnecessary.€€Costs€on€appeal€are€assessed€equally€against€the€parties.ÌÌÌÓÓà àà àà àà àà àà àà àà àòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ïà àà àà àà àà àà àà àà àóóHIGHERS,€J.ÌÌÌÌCONCUR:ÌÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÌCRAWFORD,€P.J.,€W.S.ÌÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÌTOMLIN,€Sr.€J.ÌÌÌÌ