ÿWPC  …# VUNa %¯ 0(µbÝw.å4 ' 6 0J> 0Tˆ 0^Ü 0h: 0r¢ 0| 0† 0 1u¦ U, 0dG U,« U>× B)DC> AMU*Î Bø"v~7vÓµ D3ˆ 0@» AOûÆJ 0D D/T Bƒ˜HP LaserJet 4Si/4SiMX PS 600dpiPSCRIPTÀÌÀääÀÀÌ0 (ÖÃ9 Z ‹6Times New Roman RegularX($¡¡- ù-JKULMENOÓ€Y DÒ 3|xY2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)< Œ 9p`(ModernP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ< Œ 9p`(Monaco< Œ 9p`(&Times New Roman% Line 7 d!!!!7Border 1dd€-"Cþÿ << Gÿÿ< Œ 9p`(Arial d Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€ÔÔ€ ÔÝ  ÝÔ€$ÔÔ€$ÔÓ  Óò òÔ YYY ÔFILEDÔ€$XÔÌÌJuly€31,€1996ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔ  Ôó óPtPtHHÚ(ÿáÿâùFG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA Op Monaco ÒÒ  BA Op Monaco Ò%%%%'ÿÿdxd("ÿÿ$££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  ÝÒ  ÒÒ „ ÒÑ  ÑÑ\R AØ'\ÑÑ€ÑÑ7€6XXdìdÈ7ÑÑ  ÑÑ  Ñ›SHEILA€PROFFITT,à àà àà àà à)ÌÙ€€ÙœßL€#&";+'h|èÑ` ç `€€Lß›à àà àà àà àà àà à)Ìà àPlaintiff/Appellant,à àà àà à)Ìà àà àà àà àà àà à)à àDavidson€CircuitÌà àà àà àà àà àà à)à àNo.€€95C„2416ÌVS.à àà àà àà àà àà à)Ìà àà àà àà àà àà à)à àAppeal€No.Ìà àà àà àà àà àà à)à à01A01„9604„CV„00144ÌPRISON€HEALTH€SERVICES,€INC.,à à)Ìà àà àà àà àà àà à)Ìà àDefendant/Appellee.à àà àà à)ÌÌÌà@ àIN€THE€COURT€OF€APPEALS€OF€TENNESSEEÌà@ àMIDDLE€SECTION€AT€NASHVILLEÌÌÌà@ àAPPEAL€FROM€THE€CIRCUIT€COURT€OF€DAVIDSON€COUNTYÌà@ àAT€NASHVILLE,€TENNESSEEÌÌà@ àHONORABLE€HAMILTON€V.€GAYDEN,€JR.,€JUDGEÌÌÌRONALD€W.€McNUTTÌWilliams€and€DinkinsÌ203€Second€Avenue,€NorthÌNashville,€Tennessee€37201ÌATTORNEY€FOR€PLAINTIFF/APPELLANTÌÌÌCYRUS€L.€BOOKERÌBooker€&€AssociatesÌFirst€American€Center,€Suite€1280Ì315€Deaderick€StreetÌNashville,€Tennessee€37238„1280ÌATTORNEY€FOR€DEFENDANT/APPELLEEÌÌÌœREVERSED›€AND€REMANDED.ÌÌÌà àà àà àà àà àHENRY€F.€TODDÌà àà àà àà àà àPRESIDING€JUDGE,€MIDDLE€SECTIONÌÌÌœCONCURS:›ÌœSAMUEL›€L.€LEWIS,€œJUDGEÌÌÌCONCURS€IN€SEPARATE€OPINION›ÌWILLIAM€C.€KOCH,€JR.,€JUDGEÌÌÌÌÌÌÌÌœÌSHEILA›€PROFFITT,à àà àà àà à)Ìà àà àà àà àà àà à)Ìà àPlaintiff/Appellant,à àà àà à)Ìà àà àà àà àà àà à)à àDavidson€ChanceryÌà àà àà àà àà àà à)à àNo.€€95C„2416ÌVS.à àà àà àà àà àà à)Ìà àà àà àà àà àà à)à àAppeal€No.Ìà àà àà àà àà àà à)à à01A01„9604„CV„00144ÌPRISON€HEALTH€SERVICES,€INC.,à à)Ìà àà àà àà àà àà à)Ìà àDefendant/Appellee.à àà àà à)ÌÌÌà@ àòòO€P€I€N€I€O€NóóÌÓÓÌà àThe€captioned€Plaintiff€has€appealed€from€a€summary€judgment€dismissing€her€suit€forÏfailure€of€the€Defendant€to€provide€needed€treatment€to€Plaintiff.€€The€complaint€alleges:ÌÓÓà àà à€€€€1.à àPlaintiff€is€a€citizen€of€Donelson,€Davidson€County,Ìà àà àTennessee.€€At€the€time€her€cause€of€action€arose€for€deliberateÌà àà à€indifference€to€serious€medical€needs€and€failure€to€exercise€Ìà àà àordinary€care€to€provide€medical€needs,€she€was€incarcerated€at€Ìà àà àthe€Tennessee€Prison€for€Women€in€Davidson€County,€Tennessee.ÌÌà àà à€€€€2.à àPlaintiff€was€dependent€upon€Prison€Health€Services€to€Ìà àà àprovide€for€her€medical€needs€while€incarcerated€in€Davidson€Ìà àà àCounty.€€€€ÌÌà àà à€€€€3.à àPlaintiff€Sheila€Proffitt€was€incarcerated€at€the€Bradley€Ìà àà àCounty€Justice€Center€with€a€broken€leg€and€a€leg€cast€prior€to€Ìà àà àher€arrival€at€the€Tennessee€Prison€for€Women€on€April€25,€1994.€€Ìà àà àPrior€to€her€departure,€she€was€examined€by€Pat€Younger,€M.D.,€Ìà àà àa€physician€of€the€Orthopedic€Group€of€Cleveland,€Inc.,€who€Ìà àà àdetermined€that€her€fracture€was€not€healing€and€that€her€Ìà àà àtransfixing€screws€should€be€removed€from€the€femur€to€promote€Ìà àà àhealing.ÌÌà àà à€€€€4.à àMs.€Proffitt€was€transferred€to€the€Tennessee€Prison€for€Ìà àà àWomen.€€During€her€April€25,€1994€initial€medical€evaluation,€Ìà àà àshe€was€examined€by€Dr.€Manning€who€indicated€she€would€be€Ìà àà àseen€by€an€orthopedic€specialist.ÌÌà àà à€€€€5.à àOn€June€10,€1994,€Ms.€Proffitt€was€evaluated€by€Patrick€Ìà àà àLeCorps,€M.D.€at€Meharry/Hubbard€Hospital.€€Dr.€LeCorps€Ìà àà àintended€to€conduct€an€x„ray€but€was€informed€by€the€officers€Ìà àà àescorting€her€that€there€was€no€authorization€for€that€diagnostic€Ìà àà àprocedure.ÌÌà àà à€€€€6.à àOn€July€21,€1994,€Plaintiffððs€attorney€called€the€prison€Ìà àà àto€speak€to€the€Assistant€Warden€to€emphasize€her€need€for€Ìà àà àtreatment.€€On€July€29,€1994,€plaintiff€saw€Donald€Boatwright,€Ìà àà àM.D.€at€the€prison,€who€informed€her€she€would€be€evaluated€Ìà àà àagain€by€the€orthopedic€specialist.ÌÌà àà à€€€€7.à àOn€August€12,€1994,€plaintiff€was€again€evaluated€Ìà àà àby€Dr.€Patrick€LeCorps€at€Meharry/Hubbard€Hospital.€€Dr.€Ìà àà àLeCorps€determined€that€Ms.€Proffitt€needed€surgery€to€Ìà àà àremove€two€bolts€at€the€knee€to€allow€the€femur€bone€to€Ìà àà àheal.€Despite€her€immediate€need€for€surgery€to€remove€the€Ìà àà àpins€because€her€bones€were€not€healing,€and€despite€Dr.€Ìà àà àLeCorpsðð€request€that€she€have€the€surgery,€Prison€Health€Ìà àà àServices€failed€to€arrange€the€surgery.ÌÌà àà à€€€€9.à àPlaintiff€was€recommended€for€parole€but€was€unable€Ìà àà àto€be€paroled€to€Samaritan€Recovery€Center€because€of€her€Ìà àà àuntreated€leg€condition.€€Therefore€her€parole€plan€was€denied€Ìà àà àon€August€22,€1994€by€Parole€Officer€Clara€Vaughn.€€Mr.€TomÌà àà àVance€wrote€to€the€Parole€Board€the€appended€letter.€€As€a€Ìà àà àresult,€the€Parole€Board€and€Parole€Officer€allowed€her€to€be€Ìà àà àparoled€in€November€into€the€custody€of€Mr.€and€Mrs.€Tom€Ìà àà àVance.ÌÌà àà à€€€€12.à àDefendant€Prison€Health€Services,€Inc.€is€liable€for€the€Ìà àà àactions€and€omissions€of€its€agents€that€violate€plaintiffððs€rights€Ìà àà àpursuant€to€the€common€law€doctrine€of€respondeat€superior.ÌÌà àà à€€€€14.à àDefendant€Prison€Health€Services,€Inc.,€through€its€Ìà àà àemployees€and€agents,€acted€with€deliberate€indifference€to€Ìà àà àSheila€Proffittððs€serious€medical€needs€in€violation€of€the€Ìà àà àEighth€Amendment€to€the€United€States€Constitution€and€Ìà àà à42€U.S.C.,€Section€1983.€€Defendant€Prison€Health€Services€Ìà àà àacted€under€color€of€state€law€by€virtue€of€its€performance€Ìà àà àof€state€functions€and€its€authority€under€state€law.ÌÓÓÌà àAlthough€the€complaint€does€not€expressly€allege€a€contractual€relationship€between€theÏState€of€Tennessee€and€the€Defendant,€the€above€quotations€raise€an€inference€that€the€suit€is€inÏpart€based€upon€violation€of€a€duty€imposed€by€a€contract€between€the€State€and€the€Defendant.€ÏThe€complaint€also€asserts€liability€for€deliberate€indifference€which€might€be€established€evenÏthough€no€violation€of€the€existing€contract€occurred.ÌÌà àDefendant€moved€for€summary€judgment€supported€by€affidavits€of€two€physicians.€ÏThe€affidavit€of€Donald€Boatwright,€M.D.,€states:ÌÓÓà àà à€€€€My€speciality€is€Internal€Medicine.€€I€serve€as€Medical€Ìà àà àDirector€at€the€Tennessee€Prison€for€Women€(ð ðTPWðð),€and€Ìà àà àhave€served€in€said€position€during€all€time€relevant€to€the€Ìà àà àtime€period€encompassed€in€this€affidavit.€€I€am€not€an€employee€Ìà àà àof€PHS,€but€rather€serve€as€an€independent€contractor€under€Ìà àà àcontract€with€PHS.ÌÌà àà à€€€€3.à àMs.€Proffitt€arrived€at€TPW€on€or€about€April€25,€1994.€€Ìà àà àI€am€aware€that€part€of€Ms.€Proffittððs€complaints€related€to€a€Ìà àà àrequest€that€a€pin€and/or€screw€(ð ðscrewsðð)€be€removed€from€Ìà àà àher€leg.€€The€screws€had€been€placed€prior€to€Ms.€Proffittððs€Ìà àà àarrival€at€TPW,€as€part€of€the€procedure€for€repairing€a€Ìà àà àfracture€of€Ms.€Proffittððs€leg.ÌÌà àà à€€€€4.à àX„rays€were€taken€of€Ms.€Proffittððs€knee.€€A€request€Ìà àà àwas€made€for€approval€of€surgery€to€remove€the€screws.€€A€Ìà àà àrequest€was€made€for€Dr.€LeCorps€to€see€Ms.€Proffitt€for€an€Ìà àà àorthopedic€consult.ÌÌà àà à€€€€5.à àThe€request€for€surgery€to€remove€the€screws€was€Ìà àà àapproved€on€May€27,€1994.€€In€scheduling€the€surgery,€Ìà àà àconsideration€is€given€to€the€priority€given€to€the€needed€Ìà àà àprocedure.€€To€the€extent€other€inmates€are€in€need€of€Ìà àà àsurgical€procedures,€surgery€for€a€particular€inmate€may€Ìà àà àbe€delayed€if€there€is€no€medical€urgency€in€performing€Ìà àà àthe€procedure€which€has€been€approved.ÌÌà àà à€€€€6.à àMs.€Proffitt€was€scheduled€to€see€Dr.€LeCorps€on€Ìà àà àJune€10,€1995€(sic).€€Dr.€LeCorps€requested€additional€Ìà àà àx„rays,€and€scheduled€Ms.€Proffitt€for€a€return€visit.€€The€Ìà àà àrequested€additional€x„rays€were€taken€in€June,€1994.ÌÌà àà à€€€€7.à àMs.€Proffitt€had€a€return€visit€to€Dr.€LeCorps€in€Ìà àà àJuly,€1994.ÌÌà àà à€€€€8.à àMs.€Proffitt€advised€medical€personnel€on€July€23,€Ìà àà à1994,€that€she€was€scheduled€to€appear€before€the€Parole€Ìà àà àBoard€on€August€22,€1994.ÌÌà àà à€€€€9.à àThe€surgery€approved€for€Ms.€Proffitt€was€not€a€Ìà àà àhigh€priority€procedure.€€Ms.€Proffitt€was€released€from€Ìà àà àprison€in€November,€1994,€and€the€surgery€had€not€been€Ìà àà àscheduled€prior€to€her€release.€€There€was€no€refusal€on€Ìà àà àthe€part€of€PHS€to€approve€the€surgery.€€The€surgery€was€Ìà àà àapproved,€but€was€not€scheduled€prior€to€Ms.€Proffittððs€Ìà àà àrelease€from€prison.ÌÌà àà à€€€€10.à àThe€delay€in€performing€surgery€did€not€constitute€Ìà àà àdeliberate€indifference€or€medical€malpractice€or€negligence.€€Ìà àà àMs.€Proffittððs€condition€was€not€such€that€her€medical€Ìà àà àcondition€was€made€worse€by€delaying€surgery.ÌÌà àà à€€€€11.à àTo€my€knowledge,€at€no€time€have€any€medical€Ìà àà àpersonnel€at€TPW€exhibited€indifference,€deliberate€or€Ìà àà àotherwise,€to€any€of€Ms.€Proffittððs€medical€needs.ÌÌà àà à€€€€12.à àThe€medical€care€rendered€to€Ms.€Proffittððs€medical€Ìà àà àneeds€were€met€during€the€period€of€her€incarceration€at€Ìà àà àTPW.ÌÓÓÌà àThe€affidavit€contains€evidence€that€the€need€for€surgery€was€confirmed€on€May€27,Ï1994,€and€that€no€surgery€was€scheduled€prior€to€Plaintiffððs€release€on€parole€in€November,Ï1994,€six€months€later.€€The€only€explanation€given€for€the€delay€is€that€ð ðconsideration€is€givenÏto€the€priority.ðð€€Also€relevant€is€that€employees€of€Defendant€were€aware€of€the€possibility€ofÏparole,€and€that€the€affiant€was€an€independent„contract€employee€of€Defendant€who€could€andÏshould€have€supported€his€conclusory€statements€with€œevidence€that›€other€more€urgent€surgeryÏprevented€Plaintiffððs€needed€surgery€for€approximately€six€months..ÌÌà àThe€affidavit€of€Craig€Underwood€states:ÌÓÓÌà àà à€€€€1.à àI€am€currently€a€Regional€Manager€for€Prison€Health€Ìà àà àServices,€Inc.ÌÌà àà à€€€€2.à àPrior€to€occupying€my€current€position,€I€was€the€Ìà àà àHealth€Services€Administrator€at€the€Tennessee€Prison€for€Ìà àà àWomen€in€Davidson€County,€Tennessee€(ð ðTPWðð)€and€had€Ìà àà àbeen€so€employed€from€June€15,€1991,€until€December€15,€Ìà àà à1994.ÌÌà àà à€€€€3.à àI€am€aware€of€the€medical€complaints€of€Plaintiff,€Ìà àà àSheila€Proffitt,€Inmate€No.€210324,€as€part€of€my€duties€and€Ìà àà àresponsibilities€at€TWP.ÌÌà àà à€€€€4.à àI€am€aware€that€part€of€Ms.€Proffittððs€complaints€Ìà àà àrelated€to€a€request€that€a€pin€and/or€screw€(ð ðscrewsðð)€be€Ìà àà àremoved€from€her€leg.€€The€screws€had€been€placed€prior€to€Ìà àà àMs.€Proffittððs€arrival€at€TPW,€as€part€of€the€procedure€for€Ìà àà àrepairing€a€fracture€of€Ms.€Proffittððs€leg.ÌÌà àà à€€€€5.à àA€request€was€made€for€approval€of€surgery€to€Ìà àà àremove€the€screws.€€The€request€was€approved€on€May€Ìà àà à27,€1994.€ÌÌà àà à€€€€6.à àOnce€approval€is€obtained€for€surgery,€the€decision€Ìà àà àrelating€to€scheduling€the€surgery€is€primarily€a€medical€Ìà àà àdecision.€€In€scheduling€the€surgery,€consideration€is€given€Ìà àà àto€the€priority€given€to€the€needed€procedure.€€To€the€extent€Ìà àà àother€inmates€are€in€need€of€surgical€procedures,€surgery€for€Ìà àà àa€particular€inmate€may€be€delayed€if€there€is€no€medical€Ìà àà àurgency€in€performing€the€procedure€which€as€been€approved.ÌÌà àà à€€€€8.à àThe€surgery€approved€for€Ms.€Proffitt€was€not€a€high€Ìà àà àpriority€procedure.€€Ms.€Proffitt€was€released€from€prison€in€Ìà àà àNovember,€1994,€and€the€surgery€had€not€been€performed€Ìà àà àprior€to€her€release.ÌÌà àà à€€€€9.à àThere€was€no€refusal€on€the€part€of€PHS€to€approve€Ìà àà àthe€surgery.€€The€surgery€was€approved,€but€was€not€scheduled€Ìà àà àprior€to€Ms.€Proffittððs€release€from€prison.ÌÌà àà à€€€€10.à àPHS€does€not€engage€in€any€pattern€of€practice€whereby€Ìà àà àthe€profit€motive€prevails€over€the€medical€needs€of€inmates,€Ìà àà àresulting€in€necessary€medical€care€being€denied€to€inmates.€€Ìà àà àPHS€did€not€engage€in€any€such€practice€with€respect€to€the€Ìà àà àtreatment€rendered€to€Ms.€Proffitt.ÌÌà àà à€€€€11.à àMedical€staff€at€TPW€are€required€to€treat€patients€on€the€Ìà àà àbasis€of€all€known€medical€conditions,€and€may€not€fail€to€do€so€Ìà àà àin€retaliation€for€any€conduct€or€actions€on€the€part€of€an€inmate.€€Ìà àà àPHS€does€not€have€any€policy€or€custom€which€permits€any€of€its€Ìà àà àemployees€to€exhibit€deliberate€indifference€to€the€medical€needs€Ìà àà àof€an€inmate.€€PHS€does€not€have€any€policy€or€custom€whereby€Ìà àà ànecessary€medical€care€is€denied€inmates€because€profit€motive€Ìà àà àprevails€over€medical€needs.ÌÌà àà à€€€€12.à àThe€state€of€Tennessee€retains€final€authority€relatingÌà àà àto€the€medical€care€rendered€to€inmates€who€are€confined€to€Ìà àà àthe€custody€of€the€Tennessee€Department€of€Corrections€and€Ìà àà àhoused€at€TPW.€€ÌÌà àà à€€€€13.à àAt€no€time€have€I,€or€any€other€medical€personnel€at€Ìà àà àTPW,€exhibited€indifference,€deliberate€or€otherwise,€to€any€Ìà àà àmedical€needs€of€Ms.€Proffitt.ÌÌà àà à€€€€14.à àTo€my€knowledge,€all€of€Ms.€Proffittððs€medical€needs€Ìà àà àwere€met€during€the€period€of€her€incarceration€at€TPW.€ÌÓÓÌà àIt€is€noteworthy€that€the€affiant€was€an€employee€of€Defendant€and€that€the€affidavitÏattempts€to€shift€liability€to€the€State€by€a€conclusory€statement€that€is€not€supported€byÏdocumentary€evidence.ÌÓÓÌà àPlaintiff€filed€the€affidavit€of€Charles€A.€Rosenberg,€M.D.€which€states:ÌÌà àà à€€€€Charles€A.€Rosenberg,€M.D.,€first€being€sworn€according€to€Ìà àà àlaw,€deposes€and€says:€I€am€a€physician€with€specialty€in€internal€Ìà àà àmedicine€and€have€served€as€a€consultant€and€expert€witness€in€Ìà àà àthe€field€of€delivery€of€health€services€in€prisons€and€jails.ÌÌà àà à€€€€The€level€of€medical€care€provided€this€inmate€at€TPW€was€Ìà àà àinadequate,€unacceptable,€and€below€that€of€the€community€Ìà àà àstandard.€€Indeed,€the€care€provided€in€this€respect€appeared€so€Ìà àà àcursory€as€to€be€considered€deliberately€indifferent€to€this€inmateððs€Ìà àà àserious€medical€needs.€€The€inescapable€conclusion€arrived€at€by€Ìà àà àthis€reviewer€is€that€the€decision€to€deprive€this€inmate€from€Ìà àà àreceiving€this€clearly€indicated€orthopedic€care€was€motivated€by€Ìà àà ànon„medical€reasons.€€An€incarcerated€inmate,€at€whatever€level€Ìà àà àof€custody,€city,€county,€state€or€federal,€is€a€ward€of€the€Ìà àà àcorrectional€authority€in€charge,€which€is€responsible€for€delivery€Ìà àà àof€community„level€health€care,€as€well€as€security.€€A€contract€Ìà àà àhealth€care€provider€(such€as€PHS),€as€an€agent€of€the€correctional€Ìà àà àauthority€in€charge,€must€meet€a€similar€standard.€€Such€a€standard€Ìà àà àwas€not€met€in€this€case.ÌÓÓÌà àOn€appeal,€Defendant€insists€that€this€affidavit€is€inadmissible€because€the€affiant€is€notÏqualified€under€the€geographical€qualifications€of€TCA€ðð€29„26„115(b).€€It€does€not€appearÏfrom€the€record€that€this€objection€was€presented€to€the€Trial€Court.€€Ordinarily€a€rule€ofÏevidence€not€invoked€is€waived.òò€€Burchett€v.€Stephensóó,€Tenn€App.€1990,€794€S.W.2d€745;ÏòòWachovid€Bank€&€Trust€Coóó.òò€NA€v.€Glassóó,€Tenn.€App.€1978,€57€5€S.W.2d€950.€€However,Ïthe€judgment€of€the€Trial€Court€states:ÌÓÓÌà àà à€€€€€Plaintiffððs€failure€to€provide€competent€expert€proof€in€support€ofÌà àà àPlaintiffððs€claims€„„„ððÌÓÓÌà àThis€may€indicate€that€the€Trial€Court€excluded€the€Rosenberg€affidavit€sua€sponte.€€InÏany€event,€as€will€appear€hereafter,€the€competence€of€that€evidence€is€not€determinative€of€thisÏappeal.€€ÌÌà àThe€deposition€of€Dr.€Patrick€J.€LeCorps€states:ÌÓÓà àà à€€€€Q.à àNow,€with€respect€to€the€May€27th,€1994€authorization,€Ìà àà àwhat€does€it€say€with€regard€to€when€the€surgery€is€to€be€Ìà àà àscheduled?ÌÌà àà à€€€€A.à àItððs€to€be€scheduled€within€three€weeks€unless€symptoms€Ìà àà àbecome€more€serious€or€the€patientððs€condition€changes.ÌÌà àà à€€€€Q.à àDo€you€know€whether€the€standard€that€the€Department€Ìà àà àof€Correction€applies€for€operations€such€as€this€is€a€standard€of€Ìà àà àmedical€need?ÌÌà àà à€€€€A.à àWell,€all€I€know€is€that€when€a€case€is€not€consideredÌà àà àurgent€or€an€emergency,€then€PHS€approved€the€cases€betweenÌà àà àtwo€and€four€weeks.ÌÌà àà à€€€€Q.à àDo€you€know€why€that€was€not€done€in€this€particularÌà àà àcase?ÌÌà àà à€€€€A.à àI€donððt€really€know€exactly€why.€€No.ÌÌà àà à€€€€à à€€€€Q.à àIs€there€any€medical€reason€why€it€should€not€have€beenÌà àà àdone€within€three€weeks€or€four€weeks?ÌÌà àà à€€€€A.à àNo,€not€that€I€know€of.ÌÌà àà à€€€€Q.à àTo€your€knowledge,€how€did€Prison€Health€Services€Ìà àà àreceive€income€or€profits€for€medical€services?ÌÌÓ  Óà àà àà àà à„€„€„ÌÓ  Óà àà à€€€€A.à àThey€have€a€contract€with€the€state.€€Then€the€state€„„€Ìà àà àyou€know,€the€states€want€to€have€a€budget,€so€they€contract€Ìà àà àthe€Prison€Health€Services€to€take€care€of€the€medical€problems€Ìà àà àof€the€inmates.€€They€have€a€straight€fee€every€year.€€The€prison€Ìà àà àhas€now€„„€they€contract€some€physicians€to€provide€the€care.ÌÌà àà à€€€€Q.à àWould€you€get€paid€by€Prison€Health€Services?ÌÌà àà à€€€€A.à àYes.€€Since€I€was€just€a€consultant,€I€would€bill€for€my€Ìà àà àservices€PHS,€yes.€€I€would€bill€PHS€for€my€services.à àÌÌÓÓÌà àThe€deposition€of€Dr.€Donald€Boatwright€contains€little€explicit€information,€butÏapparently€attempts€to€shift€the€blame€for€delay€to€the€failure€of€Dr.€LeCorps€to€requestÏauthorization€to€proceed€with€the€needed€surgery.€€The€deposition€does€authenticate€anÏð ðAuthorization€of€Serviceðð€from€Defendantððs€Utilization€Review€Coordinator€€to€Dr.ÏBoatwright€under€date€of€May€27,€1994.€€It€states:ÌÓÓÌà àà à€€€€Based€upon€the€medical€information€that€you€haveÌà àà àprovided€the€Tennessee€Womenððs€Prison€Jail/Prison,Ìà àà àthe€removal€of€pins€and€screw€has€been€approved.ÌÌà àà à€€€€An€appointment€has€been€approved€for€the€removalÌà àà àof€pin€and€screws€from€the€knee€as€an€outpatient€ÌÓÓà àà àservice.ÌÓÓà àà à€€€€Please€schedule€within€03€weeks€unless€symptomsÌà àà àbecome€more€severe€or€the€patientððs€condition€changes.ÌÌà àà à€€€€Authorization€for€payment€of€service€is€only€duringÌà àà àthe€period€of€actual€confinement€of€the€inmate€under€Ìà àà àthe€custody€of€the€Tennessee€Womenððs€Prison€Jail/Prison.€€Ìà àà àPayment€is€based€upon€current€reasonable€and€customary€Ìà àà àcharges€of€Blue€Cross/Blue€Shield,€Medicare,€Medicaid,€Ìà àà àor€current€negotiated€rates.ÌÌà àà à*€€€All€further€tests,€treatments,€procedures€and€or€admission€Ìà àà àor€extended€hospitalization€must€be€pre„authorized€to€ensure€Ìà àà àpayment€of€service.ÌÓÓÌà àOn€appeal,€no€presumption€of€correctness€follows€a€summary€judgment€which€is€aÏruling€of€law€and€not€of€fact.òò€€Roberts€v.€Robertsóó,€Tenn€App.€1992,€843€S.W.2d€427.ÌÌà àIt€is€the€burden€of€a€party€seeking€a€summary€judgment€to€show€uncontradicted€factsÏwhich€entitle€the€movant€to€judgment€as€a€matter€of€law.òò€€Tucker€v.€Metropolitan€Governmentóó,ÏTenn.€App.€1984,€686€S.W.2d€87;òò€Read€v.€Thomasóó,€Tenn.€App.€1984,€679€S.W.2d€467.ÌÌà àIn€determining€whether€or€not€a€genuine€issue€of€fact€exists€in€a€summary€judgmentÏcase,€the€Court€must€look€at€all€the€evidence,€take€the€strongest€legitimate€view€of€the€evidenceÏin€favor€of€the€opponent€of€the€motion€and€indulge€all€reasonable€inferences€in€favor€of€theÏopponent;€and,€if€there€is€any€doubt€as€to€the€conclusion€to€be€drawn€from€the€whole€evidence,Ïthe€motion€must€be€denied,€òòDooley€v.€Everettóó,€Tenn.€App.€1990,€805€S.W.2d€380.ÌÌà àThe€complaint€alleges€two€causes€of€action€for€the€same€injury,€(1)€Violation€of€duty€toÏprovide€remedial€surgery€within€a€reasonable€time€as€required€by€contract,€and€(2)€IndependentÏof€contract,€failure€to€provide€remedial€surgery€in€deliberate€indifference€to€the€needs€ofÏPlaintiff.ÌÌà àThe€rules€relating€to€motions€for€summary€judgment€place€no€burden€of€producingÏevidence€upon€the€opponent€of€the€motion€except€as€contradiction€or€rebuttal€of€evidenceÍoffered€by€the€proponent€which,€if€uncontradicted€or€unrebutted,€entitle€the€movant€to€judgmentÏas€a€matter€of€law.ÌÌà àIn€this€case,€the€first€inquiry€must€be,€does€the€evidence€supporting€the€motion€forÏsummary€judgment,€if€uncontradicted€and€unrebutted,€entitle€the€Defendant€to€summaryÏjudgment€as€to€either€or€both€of€the€œgrounds›€stated€in€the€complaint.€€The€gravamen€of€theÏcomplaint€is€the€failure€of€the€Defendant€to€provide€medical€service,€rather€than€the€quality€ofÏservices.ÌÌà àThe€defendant€recognized€this€distinction,€and€undertook€to€show€that€the€long€delay€inÏdelivery€of€authorized€services€was€not€wrongful€because€of€priorities.€€However,€theÏconclusory€affidavit€of€a€physician€that€the€needs€of€plaintiff€were€not€high€priority,€thatÏconsideration€is€given€to€priority€of€need€and€that€surgery€may€be€delayed€by€need€to€performÏother€surgery€of€higher€priority€is€not€sufficient€to€exonerate€Defendant€of€blame€for€delay€as€aÏmatter€of€law.€€Uncontradicted€evidence€that€needs€of€higher€priority€actually€did€renderÏdefendant€unable€to€supply€the€service€sooner€might€suffice,€but€such€specific€and€definitiveÏevidence€was€not€offered.ÌÌà àDefendant€relies€upon€T.C.A.€ðð€29„26„115€which€provides€in€pertinent€part€as€follows:ÌÓÓà àà à€€€ò òClaimantððs€burden€in€malpractice€action€„€Expert€Ìà àà àtestimony€„€Presumption€of€negligence€„€Jury€instructions.ó 󀄀Ìà àà à(a)€In€a€malpractice€action,€the€claimant€shall€have€the€burden€Ìà àà àof€proving€by€evidence€as€provided€by€subsection€(b):ÌÌà àà à€€€€(1)à àThe€recognized€standard€of€acceptable€professional€Ìà àà àpractice€in€the€profession€and€the€specialty€thereof,€if€any,€that€Ìà àà àthe€defendant€practices€in€the€community€in€which€he€practices€Ìà àà àor€in€a€similar€community€at€the€time€the€alleged€injury€or€Ìà àà àwrongful€action€occurred;ÌÌà àà à€€€€(2)à àThat€the€defendant€acted€with€less€than€or€failed€to€act€Ìà àà àwith€ordinary€and€reasonable€care€in€accordance€with€such€Ìà àà àstandard;€andà àÌà àà àÌà àà à€€€€(3)à àAs€a€proximate€result€of€the€defendantððs€negligent€act€or€Ìà àà àomission,€the€plaintiff€suffered€injuries€which€would€not€otherwise€Ìà àà àhave€occurred.ÌÌà àà à€€€€(b)à àNo€person€in€a€health€care€profession€requiring€licensure€Ìà àà àunder€the€laws€of€this€state€shall€be€competent€to€testify€Ìà àà àin€any€court€of€law€to€establish€the€facts€required€to€be€Ìà àà àestablished€by€subsection€(a)€unless€he€was€licensed€to€Ìà àà àpractice€in€the€state€or€a€contiguous€bordering€state€a€Ìà àà àprofession€or€specialty€which€would€make€his€expert€Ìà àà àtestimony€relevant€to€the€issues€in€the€case€and€which€Ìà àà àwould€make€his€expert€testimony€relevant€to€the€issues€Ìà àà àin€the€case€and€had€practiced€this€profession€or€specialty€Ìà àà àin€one€of€these€states€during€the€year€preceding€the€date€Ìà àà àthat€the€alleged€injury€or€wrongful€act€occurred.€€This€Ìà àà àrule€shall€apply€to€expert€witnesses€testifying€for€the€Ìà àà àdefendant€as€rebuttal€witnesses.€€The€court€may€waive€Ìà àà àthis€subsection€when€it€determines€that€the€appropriate€Ìà àà àwitness€otherwise€would€not€be€available.Ìà àà àÌœÌÓÓ›à àThis€statute€is€applicable€only€where€the€suit€is€based€upon€failure€to€exerciseÏprofessional€care€and€skill.€€As€previously€pointed€out,€the€complaint€is€not€based€upon€aÏviolation€of€professional€standards€of€skill€or€care€in€performing€professional€services,€butÏupon€a€delay€in€providing€such€services.ÌÌà àIn€òòRural€Educational€Assoc.€v.€Bushóó,€42€Tenn.€App.€34,€298€S.W.2d€761.€€(1956),Ïthis€Court€held:ÌÓÓà àà à€€€€Professional€or€expert€testimony€was€not€necessary€to€Ìà àà àestablish€that€leaving€a€sponge€in€Plaintiffððs€body€was€Ìà àà ànegligence.€€Any€layman€would€know€that€fact.€€Ìà àà à42€Tenn.€App.€At€47.ÌÓÓÌà àFollowing€the€reasoning€of€the€quoted€authority,€ð ðany€layman€(that€is,€any€reasonableÏnon€expert),€would€know€that€a€six€months€delay€in€providing€approved€surgery€for€a€painfulÏcondition€is€negligence€unless€excused€by€conditions€which€required€the€delay.ÌÌà àThe€absence€of€expert€testimony€as€required€by€the€statute€does€not€justify€a€summaryÏjudgment€in€cases€where€an€ordinary€layman€would€be€authorized€to€find€fault€under€the€facts.€ÏMoreover,€the€evidence€offered€by€Defendant€does€not€satisfy€the€requirement€of€the€œstatue›€asÏto€conformity€with€the€statutory€professional€standards€for€scheduling€surgery.ÌÌà àUnder€the€circumstances€of€the€present€case,€the€Defendant€did€not€satisfy€its€burden€ofÏshowing€that€the€unreasonable€delay€in€providing€surgery€to€Plaintiff€was€without€its€œfault›€as€aÏmatter€of€law.€€This€being€true,€the€Plaintiff€was€not€under€a€burden€to€offer€contradictory€orÏrebuttal€evidence,€and€the€issue€of€the€competency€of€Plaintiffððs€professional€witness€becomesÏmoot.ÌÌà àThe€lack€of€satisfactory€and€conclusive€evidence€explaining€the€long€and€faciallyÏunreasonable€delay€in€providing€surgery€for€Plaintiff€also€prevents€a€summary€judgment€inÏrespect€to€the€charge€of€deliberate€indifference;€for,€under€the€evidence€in€this€record,€a€juryÏcould€properly€find€that€the€long€delay€in€scheduling€surgery€amounted€to€deliberateÏindifference€to€the€prolonged€pain€of€Plaintiff,€for€which€Defendant€might€be€liable€underòò€WestÏv.€Atkinsóó,€487€U.S.€42,€54€(1988).ÌÌà àThe€evidence€in€this€record€does€not€establish€without€dispute€that€Defendant€is€notÏliable€to€Plaintiff€on€either€of€the€grounds€of€Plaintiffððs€suit.€€ÌÌà àThe€summary€judgment€in€favor€of€the€Defendant€is€reversed€and€vacated.€€Costs€ofÏthis€appeal€are€assessed€against€the€Defendant.€€The€cause€is€remanded€to€the€Trial€Court€forÏfurther€proceedings.ÌÌREVERSED€AND€REMANDEDÌÓÓà àà àà àà àà àà à_______________________________________Ìà àà àà àà àà àà àHENRY€F.€TODDÌà àà àà àà àà àà àPRESIDING€JUDGE,€MIDDLE€SECTIONÌÌÌœCONCURS:›ÌÌÌ_____________________________________ÌSAMUEL€L.€LEWIS,€JUDGEÌ̛̜̜CONCURS€IN€SEPARATE€OPINION›ÌWILLIAM€C.€KOCH,€JR.,€JUDGE