ÿWPC6% …# VUNa %¯ 0Nµ 0Í bÐ w@Ø 4 , 0D; ^ bÝ b? 0JG 0T‘ 0^å 0hC 0r« 0| 0†™ 0 1u¯U,$ 0dPU,´U>àB) BGDCd D3§ AMÚU*' 0@QC‘ŒÔF`š¦v~@vÓ¾ AO‘#Æà# 0D¦$ D/ê$ B%˜HP LaserJet 4Si/4SiMX PS 600dpiPSCRIPTÀÌÀääÀÀÌ0 (í€"  Z ‹6Times New Roman Regular¼(&öy$¡¡Ó  ÓÙñÓ Ù(}(2tR$¤¤Ý ƒöy!ÝÓ  ÓÙñÓ ÙÝ  ÝÒ°ÒÒ„°ÒÔ€X4âX¼¼Ôà ` àòòÚ  Ú0Ú  Úóó- ù- lmDnDopqDrDstÓ€~Gav x ‹6Ti3|x~(#Ã$òòÚ  Ú0Ú  ÚóóTheresa Stanbury v. Brian Bacardi - Concurring Opinion Ì ) ' IB011C30IB011C2 93CStanburyBacardiFrazorCurrey- ù-2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)< Œ 9p`(ModernP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ< Œ 9p`(Monaco< Œ 9p`(&Times New Roman% Line 7 d d''''7Border 1dd(((('ÿÿdxd€-)Cþÿ << Gÿÿ< Œ 9p`(Arial("ÿÿ$££Ò  ÒÒ  Ò 9Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€ÔÔ€&ÔÔ€&¼ÔÓ  ÓÝ  ÝÔ€,ÔÔ€,ÔÓ  Óò òÔ YYY ÔFILEDÔ€,XÔÌÌApril€26,€1996ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔ  Ôó ó ‚Ý ƒ!ÝÑ#€d#ÑÔ€ÔÔ€&ÔÔ€&¼ÔÓ  ÓÝ  ÝÝ ƒ$ÝÒ  ÒÒ „ ÒÔ€&XÔà àòòÚ  ÚÚ  ÚóóÝ  ÝThe€facts€of€this€case€do€not€support€Ms.€Stanburyððs€claim€that€Dr.€BacardiÏfraudulently€concealed€her€injury.€€It€was€evident€to€Ms.€Stanbury€as€soon€as€she€regainedÏconsciousness€that€Dr.€Bacardi€had€performed€surgery€for€which€she€had€not€consented.€€ThereÏwas€no€way€that€Dr.€Bacardi€could€have€concealed€from€Ms.€Stanbury€that€he€had€operated€onÏher€left€foot€in€addition€to€her€right€foot.Ì <Ý ƒ!ÝÑ#€d#ÑÔ€ÔÔ€&ÔÔ€&¼ÔÓ  ÓÝ  ÝÝ ƒ$ÝÒ  ÒÒ „ ÒÔ€&XÔà àòòÚ  ÚÚ  ÚóóÝ  ÝAct€of€May€21,€1975,€ch.€299,€ðð€15(a),€1975€Tenn.€Pub.€Acts€662,€671.Ì Ý ƒ!ÝÑ#€d#ÑÔ€ÔÔ€&ÔÔ€&¼ÔÓ  ÓÝ  ÝÝ ƒ$ÝÒ  ÒÒ „ ÒÔ€&XÔà àòòÚ  ÚÚ  ÚóóÝ  ÝDuring€its€deliberations,€the€jury€sought€clarification€concerning€question€three€on€theÏverdict€form€that€asked€ð ðDid€the€Defendant,€Brian€Bacardi,€deviate€from€the€recognizedÏstandard€of€care€for€podiatrists€in€this€community€by€negligently€performing€surgicalÏprocedures€on€December€11,€1991,€and/or€April€3,€1992,€on€the€Plaintiff,€Theresa€Stanbury?ðð€ÏThe€trial€court€agreed€with€the€juryððs€characterization€that€this€question€concerned€ð ðthe€fact€thatÏsurgery€was€performed,€not€how€it€was€performed,€not€how€successful€it€was.ðð€€The€trial€courtÏalso€instructed€the€jury€that€ð ðas€far€as€the€operation€itself,€thatððs€not€part€of€the€lawsuit.ððÌPtPtHHÚ(ÿáÿâùFG(üHHÚ(d'@Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA:Op Monaco ÒÒ  BA:Op Monaco 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€&ÔÔ€&¼ÔÓ  ÓÝ  ÝÒ  ÒÒ „ ÒÑ Ü ÑÑ „ ÑÑ\R AØ'\ÑÑ  ÑÑ€ÑÑ7€ÞѼ¼ddÈ7ÑÑ  ÑÑ  Ñ›à@ àÔ€&„Ôò òIN€THE€COURT€OF€APPEALS€OF€TENNESSEEÌà@ àMIDDLE€SECTION€AT€NASHVILLEÌÌÔ€&¼ÔÌó óÌTHERESA€STANBURY€and€spouse,à àà à)ÌJOHN€H.€STANBURY,à àà àà àà à)Ìà àà àà àà àà àà àà à)Ìà àPlaintiffs/Appellees,à àà àà à)Ìà àà àà àà àà àà àà à)à àDavidson€CircuitÌà àà àà àà àà àà àà à)à àNo.€93C„1265ÌVS.à àà àà àà àà àà àà à)Ìà àà àà àà àà àà àà à)à àAppeal€No.Ìà àà àà àà àà àà àà à)à à01„A„01„9509„CV„00420ÌÙ€€ÙœßL€+.);+'h|¥ÿÉ` ç `€€Lß›BRIAN€E.€BACARDI€and€HOSPITALà à)ÌCORPORATION€OF€AMERICA€d/b/aà à)ÌCENTENNIAL€MEDICAL€CENTER,à à)Ìà àà àà àà àà àà àà à)Ìà àDefendants/Appellants.à àà àà à)ÌÌÌÑ€ÑÑ7€^Ò»»d¼¼d7ÑÌÔ€&„Ôà@ àò òOPINIONó óÌà@ àòòò òCONCURRING€IN€PART€&€DISSENTING€IN€PARTó óóóÌÌÌÓ€ÓÔ€&¼Ôà àI€concur€with€the€majorityððs€decision€that€Theresa€Stanburyððs€lack€ofÏinformed€consent€claim€is€time„barred.€€However,€I€have€prepared€thisÏseparate€opinion€for€two€reasons.€€First,€the€majority€has€œerroneouslyÏdismissed€Ms.›€Stanburyððs€claims€regarding€advising€and€performingÏunnecessary€surgery€which€stand€on€a€footing€different€from€her€lack€ofÏinformed€consent€claim.€€Second,€it€is€time€to€hold€unequivocally€that€theÏcontinuing€treatment€doctrine€has€been€completely€subsumed€into€theÏdiscovery€rule.ÌÌà@ àò òI.ó óÌÌà àMs.€Stanbury€is€an€assembly€line€worker€at€Saturn€Corporation€inÏColumbia.€€In€1991€she€developed€a€corn€on€the€fifth€toe€of€her€right€foot€thatÏcaused€her€discomfort€when€she€was€required€to€stand€for€ten€hours€duringÏher€shift.€€A€physician€removed€the€corn€and€recommended€that€she€consult€aÏpodiatrist.€€Accordingly,€Ms.€Stanbury€met€with€Dr.€Brian€Bacardi€onÏNovember€22,€1991.€€After€a€cursory€examination,€Dr.€Bacardi€recommendedÏa€minor€surgical€procedure€to€prevent€her€fifth€toe€on€her€right€foot€fromÏlaying€on€top€of€her€fourth€toe.€€Dr.€Bacardi€assured€Ms.€Stanbury€that€herÏrecovery€time€would€be€short€and€that€her€work€schedule€would€not€beÏinterrupted.ÌÌà àMs.€Stanbury€signed€two€consent€forms€prior€to€her€December€11,€1991Ïsurgery.€€One€document€on€Dr.€Bacardiððs€stationery€entitled€a€ð ðSurgeryÏInformerðð€contained€a€brief€discussion€of€the€general€risks€and€complicationsÏof€surgery€but€did€not€identify€the€nature€of€the€surgery€Dr.€Bacardi€plannedÏto€perform.€€The€second€document€was€a€Centennial€Medical€Center€formÏentitled€ð ðConsent€for€Operation,€Administration€of€Anesthesia,€and€OtherÏProcedures.ðð€€In€the€space€provided€for€describing€the€operation€to€beÏperformed,€someone€hand€wrote:€ð ðBilateral€Osteotomy,€Bilateral€RepairÏTailor€Bunion,€Bilateral€Arthroplasty,€Bilateral€Realignment€Digit€4€and€5,ÏBilateral€Removal€œ5th›€Toenail.ðð€€Ms.€Stanbury€insists€that€no€one€explained€theÏnature€of€these€procedures€and€that€she€did€not€know€that€she€had€consented€toÏsurgical€procedures€on€both€her€feet€or€to€anything€other€than€the€minorÏprocedure€Dr.€Bacardi€had€described€in€his€office€several€weeks€earlier.ÌÌà àDr.€Bacardi€performed€extensive€surgery€on€both€feet€while€Ms.ÏStanbury€was€under€a€general€anesthetic.€€During€the€mid„afternoon,€Ms.ÏStanbury€was€released€from€the€hospital€in€a€wheelchair€with€both€feet€heavilyÏbandaged.€€Ms.€Stanbury€described€her€feet€as€ð ð[t]wo€big€white€blobs.ðð€WhenÏDr.€Bacardi€removed€the€surgical€dressing€during€her€first€office€visit€onÏDecember€20,€1991,€Ms.€Stanbury€stated€that€she€was€in€ð ðcomplete€and€utterÏshockðð€and€that€she€ð ðcouldnððt€believe€all€that€had€been€œdone.€›€There€were€soÏmany€stitches€and€so€many€things,€it€was€just€unbelievable.ðð€€She€also€noticedÏthat€the€fifth€toe€on€her€right€foot€was€not€touching€the€floor€but€rather€wasÏsticking€straight€up€in€the€air.€€ÌÌà àMs.€Stanbury€had€four€more€office€visits€with€Dr.€Bacardi€betweenÏJanuary€10€and€March€17,€1992.€€On€April€3,€1992,€Dr.€Bacardi€performedÏadditional€surgery€to€attempt€to€correct€the€misalignment€of€the€fifth€toe€onÏMs.€Stanburyððs€right€foot.€€During€a€post„operative€office€visit€on€May€5,Ï1992,€Dr.€Bacardi€informed€Ms.€Stanbury€that€there€was€nothing€more€heÏcould€do€for€her€and€that€it€would€take€approximately€one€year€for€her€feet€toÏfully€heal.ÌÌà àMs.€Stanbury€and€her€husband€filed€a€malpractice€action€against€Dr.ÏBacardi€and€Hospital€Corporation€of€America€on€April€30,€1993.€€TheyÏalleged€that€Dr.€Bacardi€had€been€negligent€in€advising€her€to€have€surgery,€inÏperforming€the€surgery€itself,€and€in€providing€her€with€post„operative€care.€ÏThey€also€asserted€that€Dr.€Bacardi€had€performed€unnecessary€surgery,€thatÏhe€had€failed€to€obtain€her€consent€to€the€surgery€he€performed€on€DecemberÏ11,€1991,€that€he€had€ignored€her€complaints€of€pain€and€infection,€and€that€heÏhad€falsified€his€office€notes€to€conceal€Ms.€Stanburyððs€real€condition.€€Dr.ÍBacardi€responded€by€denying€wrongdoing€and€by€asserting€that€all€the€claimsÏwere€barred€by€the€statute€of€limitations.ÌÌà àThe€trial€court€directed€a€verdict€for€Dr.€Bacardi€at€the€close€of€theÏplaintiffsðð€proof€on€the€theories€of€negligent€post„operative€care,€ignoring€Ms.ÏStanburyððs€complaints€of€pain€and€infection,€and€intentionally€falsifying€hisÏoffice€notes.€€It€submitted€the€issues€concerning€lack€of€informed€consent,Ïadvising€and€performing€unnecessary€surgery,€and€negligently€performing€theÏsurgery€to€the€jury.€€During€the€juryððs€deliberations,€however,€the€trial€courtÏwithdrew€the€claim€for€negligently€performing€the€surgery€from€the€jury.€ÏThe€jury€returned€a€verdict€awarding€Ms.€Stanbury€$211,000€and€Mr.ÏStanbury€$10,000.ÌÌà@ àò òII.ó óÌÌà àUntil€December€1974,€negligence€actions€against€health€care€providers,Ïlike€all€other€actions€for€injuries€to€the€person,€were€required€to€be€filedÏwithin€one€year€after€the€date€of€the€wrongful€act€that€caused€the€plaintiffððsÏinjury.€€òòAlbert€v.€Sherman,óó€167€Tenn.€133,€œ135,›€67€S.W.2d€140,€141€(1934);ÏòòBodne€v.€Austinóó,€156€Tenn.€353,€œ364„65,›€2€S.W.2d€100,€103€(1928);€Tenn.ÏCode€Ann.€ðð€28„304.€€The€two€most€common€exceptions€to€this€rule€involvedÏcontinuing€torts€and€the€fraudulent€concealment€of€the€injury.× ƒ/ ××  ×ÌÌà àThe€Eastern€Section€of€this€court€adopted€the€continuing€tort€principleÏin€1938€in€a€case€involving€an€employee€who€became€disabled€by€breathingÏchemical€particles€in€his€employerððs€plant€over€an€extended€period€of€time.€ÏNoting€that€the€employer€had€a€duty€to€protect€its€employees€from€breathingÏthese€particles,€the€court€held€that€the€employer€had€committed€ð ðoneÏcontinuous€tort,€beginning€with€the€employment€and€ending€only€at€the€time€ofÏtotal€disability€of€the€employee€and€œthe€termination›€of€his€employment.ðð€ÏòòTennessee€Eastman€Corp.€v.€Newman,óó€22€Tenn.€App.€270,€279,€121€S.W.2dÏ130,€135€(1938).€€Accordingly,€the€Eastern€Section€held€that€the€employeeððsÏaction€against€the€employer€was€timely€since€it€was€filed€within€one€year€of€theÏonset€of€his€disability€and€the€termination€of€his€employment.€€òòTennesseeÏEastman€Corp.€v.€Newman,óó€22€Tenn.€App.€at€œ279,›€121€S.W.2d€at€135.ÌÌà àTwenty„two€years€later,€the€Middle€Section€of€this€court€extended€theÏcontinuing€tort€principle€to€medical€malpractice€actions.€€In€a€case€involving€aÏsurgical€sponge€that€was€negligently€left€in€a€patientððs€body€for€ten€years,€theÏcourt€held€that€the€statute€of€limitations€would€be€tolled€for€the€duration€of€theÏdoctor„patient€relationship€when€the€plaintiff€proved€continuing€negligentÏtreatment€by€the€physician.€€òòFrazor€v.€Osborne,óó€57€Tenn.€App.€10,€œ19„20,›€414ÏS.W.2d€118,€122„23€(1966).€€Accordingly,€the€continuing€tort€principleÏbecame€known€as€the€continuing€treatment€doctrine€in€the€context€of€medicalÏmalpractice€cases.ÌÌà àAt€about€the€same€time,€other€victims€of€malpractice€were€urging€theÏcourts€to€adopt€œa›€discovery€rule€that€would€œdelay›€the€accrual€of€the€cause€ofÏaction€until€œa›€plaintiff€discovered€his€or€her€injury.€€This€court€repeatedlyÏdeclined€to€depart€from€the€traditional€rule€that€a€medical€malpracticeÍplaintiffððs€cause€of€action€œaccrues›€on€the€date€that€the€wrongful€act€causing€theÏinjury€occursœ.›€€òòClinard€v.€Pennington,óó€59€Tenn.€App.€128,€œ136,›€438€S.W.2dÏ748,€752€œ(1968);›€òòHall€v.€De€Saussure,óó€41€Tenn.€App.€572,€œ580,€297›€S.W.2dÏ81,€œ85›€(1956).€€ÌÌà àThe€Tennessee€Supreme€Court€adopted€the€discovery€rule€on€DecemberÏ9,€1974,€in€a€medical€malpractice€case€where€the€continuing€treatment€doctrineÏwas€unavailable€because€the€doctor„patient€relationship€had€terminatedÏapproximately€three€years€before€suit€was€filed.€€The€Court€held€that€a€causeÏof€action€for€medical€malpractice€ð ðaccrues€and€the€statute€of€limitationsÏcommences€to€run€when€the€patient€discovers,€or€in€the€exercise€of€reasonableÏcare€and€diligence€for€his€own€health€and€welfare,€should€have€discovered€theÏresulting€injury.ðð€€òòTeeters€v.€Currey,óó€518€S.W.2d€512,€517€(Tenn.€1974).€ÏThe€Court€did€not€address€the€relationship€between€the€newly€adoptedÏdiscovery€rule€œand›€the€continuing€treatment€doctrine.€€However,€JusticeÏHarbisonððs€separate€concurrence€implied€that€the€statute€of€limitationsÏcontinued€to€be€tolled€as€long€as€œthe€doctor„patient›€relationship€continued€evenÏif€the€patient€discovered€the€injury.€€òòTeeters€v.€Currey,óó€518€S.W.2d€at€518.ÌÌà àApproximately€six€months€later€the€General€Assembly€œincluded›€theÏòòTeeters€v.€Curreyóó€discovery€rule€in€the€Medical€Malpractice€Review€BoardÏand€Claims€Act€of€1975.œ× ƒ0 ××  ×›€€Now€codified€at€Tenn.€Code€Ann.€ðð€29„26„116(a)(2)€(1980),€the€legislative€version€of€the€discovery€rule€provides€thatÏð ð[i]n€the€event€the€alleged€injury€is€not€discovered€within€the€said€one€(1)€yearÏperiod,€the€period€of€œlimitation›€shall€be€one€(1)€year€from€the€date€of€suchÏdiscovery.ðð€€Thus,€the€statute€of€limitations€for€medical€malpractice€actions€isÍtolled€during€the€period€that€the€plaintiff€has€not€discovered€that€a€wrong€hasÏoccurred.€òòHoffman€v.€Hospital€Affiliates,€Inc.,óó€652€S.W.2d€341,€344€(Tenn.Ï1983).€€Discovery€takes€place€when€the€plaintiff€is€aware€of€facts€sufficient€toÏput€a€reasonable€person€on€notice€that€he€or€she€has€suffered€an€injury€as€aÏresult€of€wrongful€conduct.€€òòRoe€v.€Jefferson,óó€875€S.W.2d€653,€657€(Tenn.Ï1994).€€These€facts€include€the€occasion,€the€manner,€and€the€means€by€whichÏthe€breach€of€duty€that€produced€the€injury€occurred€and€the€identity€of€theÏperson€who€breached€the€duty.€€òòFoster€v.€Harris,óó€633€S.W.2d€304,€œ305€(Tenn.›Ï1982);€òòHathaway€v.€Middle€Tenn.€Anesthesiology,€P.C.,óó€724€S.W.2d€355,€359Ï(Tenn.€Ct.€App.€1986).€€ÌÌà àThe€courts€did€not€address€the€relationship€between€the€discovery€ruleÏand€the€continuing€treatment€doctrine€until€1986€when€the€Eastern€Section€ofÏthis€court€heard€an€appeal€involving€the€dismissal€of€a€malpractice€action€forÏthe€over€prescription€of€addictive€drugs.€€Even€though€the€patient€filed€suitÏwithin€one€year€after€the€professional€relationship€with€his€physician€ended,Ïthe€Eastern€Section€held€that€the€continuing€treatment€doctrine€wasÏœinapplicable›€because€another€physician€had€informed€him€more€than€one€yearÏbefore€the€suit€was€filed€that€he€was€taking€too€many€drugs.€€òòFrench€v.€Fetzer,óóÏC.A.€No.€43,€slip€op.€at€œ3›€(Tenn.€Ct.€App.€Feb.€20,€1986).€€The€TennesseeÏSupreme€Court€granted€the€patientððs€application€for€permission€to€appeal€andÏlater€issued€a€per€curiam€œopinion›€affirming€the€Eastern€Sectionððs€decision,Ïstating:€ð ðwe€find€œthere›€is€no€question€but€that€plaintiff€had€actual€knowledge€ofÏhis€malpractice€claim€no€later€than€February,€1982€.€.€.€and€that€the€subsequentÏtreatment€of€plaintiff€by€defendant€was€in€fact€a€continuation€and€did€notÏinvolve€new€or€different€drugs.ðð€€òòFrench€v.€Fetzer,óó€C.A.€No.€43,€slip€op.€at€œ2›Ï(Tenn.€June€22,€1987)€(per€curiam€opinion€not€for€publication).€ÌÌà àThree€years€later,€the€Western€Section€of€this€court€addressed€theÏrelationship€between€the€discovery€rule€and€the€continuing€tort€principle€in€aÏcase€involving€an€employee€who€claimed€to€have€been€injured€by€prolongedÏuse€of€a€defective€tractor.€€The€Western€Section€statedÌÓÓà8 àà8 àWe€believe€that€the€ð ðcontinuous€tortðð€doctrine€mustÏbe€applied€in€conjunction€with€the€ð ðdiscovery€rule.ðð€ÏThus,€in€a€case€involving€a€continuing€tort,€the€causeÏof€action€accrues€at€the€time€the€professionalÏrelationship€or€course€of€treatment€is€œterminated›Ïunless,€under€the€ð ðdiscovery€rule,ðð€the€cause€ofÏaction€is€deemed€to€have€accrued€at€a€different€pointÏin€time.€€A€plaintiff€is€not€entitled€to€a€newÏlimitations€period€to€begin€with€the€appearance€ofÏeach€new€injury€or€complication.ÌÌÓ€ÓòòKenton€v.€United€Technology,óó€Shelby€Law€No.€71,€slip€op.€at€œ6›€(Tenn.€Ct.ÏApp.€March€26,€1990)€(no€Tenn.€R.€App.€P.€11€application€filed).€ÏAccordingly,€the€court€held€that€the€employeeððs€suit€was€barred€because€he€hadÏdiscovered€his€injury€more€than€one€year€before€filing€suit.ÌÌà àOne€year€later,€the€Middle€Section€of€this€court€œrecognized€similarÏreasoning€in€a€medical€malpractice€case.€€The€court€held€that€the€jury€shouldÏdecide€whether€ð ðthe€plaintiff€knew€of€the€malpractice€for€a€period€prior€to€suitÏexceeding€the€statutory€limitations€period.ðð€€òòHiggins€v.€Estate€of€Crecraft,óóÏApp.€No.€01„A„01„9008„CV„00311,€slip€op.€at€13€(Tenn.€Ct.€App.€Feb.€21,Ï1991)€(no€Tenn.€R.€App.€P.€11€application€filed).€€The€Western€SectionÏreached€a€similar€result€three€months€later€in€a€case€involving€lack€ofÏinformed€consent€for€hip€replacement€surgery.€€òòHoush€v.€Morris,óó€818€S.W.2dÏ39,€43„44€(Tenn.€Ct.€App.€1991).€€ÌÌà àTwo€years€later,€the€Middle€Section€invoked€the€continuing€treatmentÏrule€to€save€a€patientððs€cause€of€action€against€her€psychiatrist€from€a€summaryÏjudgment€based€on€the€one„year€statute€of€limitations.€€òòRoe€v.€Jefferson,óó€App.ÏNo.€01„A„01„9212„CV„00476,€slip€op.€at€17€(Tenn.€Ct.€App.€April€16,€1993).€ÏThe€Supreme€Court,€however,€reversed€the€decision€because€it€found€that€theÏpatient€had€discovered€the€psychiatristððs€wrongful€conduct€before€theirÏprofessional€relationship€ceased€and€more€than€one€year€before€suit€was€filed.€ÏòòRoe€v.€Jefferson,óó€875€S.W.2d€at€658.€€The€Western€Section€applied€the€òòRoe€v.ÏJeffersonóó€holding€when€it€held€that€a€patientððs€malpractice€action€against€herÏpsychotherapist€accrued€when€she€discovered€that€the€defendantððs€conduct€wasÏwrong,€not€when€her€relationship€with€the€defendant€ended.€€òòClifton€v.€Bass,óóÏ908€S.W.2d€205,€210€(Tenn.€Ct.€App.€1995).ÌÌà àThe€cases€decided€since€1986€indicate€that€the€continuation€of€aÏprofessional€relationship€no€longer€plays€a€role€in€determining€when€a€causeÏof€action€for€professional€malpractice€accrues.€€The€Tennessee€Supreme€CourtÏremoved€any€doubt€about€this€when€it€held€that€a€cause€of€action€for€legalÏmalpractice€accrues€when€a€client€learns€of€his€or€her€injury€and€that€theÏinjury€was€caused€by€the€lawyerððs€negligence.€òòCarvell€v.€Bottoms,óó€900€S.W.2dÏ23,€28€(Tenn.€1995).€€Accordingly,€the€Court€held€that€clients€must€sue€theirÏlawyers€for€malpractice€within€one€year€after€discovering€their€injury,€even€ifÏtheir€lawyer€is€still€representing€them.€€òòCarvell€v.€Bottoms,óó€900€S.W.2d€at€30.€€ÌÌà àThe€rule€in€both€medical€and€legal€malpractice€actions€is€now€the€same.€ÏNotwithstanding€the€existence€of€an€ongoing€professional€relationship,€a€causeÏof€action€for€professional€malpractice€accrues€and€the€statute€of€limitationsÏbegins€to€run€when€the€patient€or€the€client€discovers,€or€reasonably€shouldÍhave€discovered,€that€he€or€she€has€been€injured€by€the€negligent€conduct€ofÏhis€or€her€lawyer€or€health€care€provider.€€The€fact€that€the€lawyer€or€healthÏcare€provider€continues€representing€or€treating€the€client€or€patient€will€notÏtoll€the€running€of€the€statute€of€limitations€once€the€injury€has€beenÏdiscovered.ÌÌà@ àò òIII.ó óÌÌà àDeciding€that€Ms.€Stanburyððs€lack€of€informed€consent€claims€wereÏuntimely€cannot€end€our€inquiry€in€this€case.€€Ms.€Stanbury€also€claimed€thatÏDr.€Bacardi€performed€the€surgery€on€her€feet€in€a€negligent€manner,€that€heÏnegligently€advised€her€to€undergo€unnecessary€surgery,€and€that€heÏperformed€unnecessary€surgery€on€her€feet.€€I€will€take€these€claims€in€turn.€€ÌÌÓ  ÓÓÓòòò òA.Ìà àNegligent€Performance€of€Surgeryó óóóÌÓ  ÓÓ€ÓÌà àMs.€Stanbury€claimed€that€Dr.€Bacardi€performed€the€surgery€on€herÏfeet€in€a€negligent€manner.€€The€trial€court€declined€to€grant€the€doctorððsÏmotion€for€a€directed€verdict€on€the€issue€at€the€close€of€Ms.€Stanburyððs€proof;Ïhowever,€it€effectively€withdrew€the€issue€from€the€jury€after€deliberationsÏbegan€when€the€jury€requested€clarification€of€portions€of€the€verdict€form.× ƒ1 ××  ×€ÍWhile€I€have€serious€misgivings€about€the€manner€in€which€the€trial€courtÏdisposed€of€this€issue,€the€trial€courtððs€conduct€was,€at€most,€harmless€error.ÌÌà àConsidering€the€record€as€a€whole,€I€am€unable€to€find€any€proofÏpresented€by€Ms.€Stanbury€tending€to€show€that€Dr.€Bacardi€performed€herÏsurgery€in€a€negligent€manner.€€The€only€expert€testimony€remotelyÏaddressing€this€issue€was€that€of€Dr.€James€Rogers,€a€board€certifiedÏpodiatrist,€who€testified€on€Ms.€Stanburyððs€behalf.€€Dr.€Rogers€stated€thatÏthere€was€a€misalignment€of€the€bone€where€Dr.€Bacardi€performed€theÏarthroplasty€on€Ms.€Stanburyððs€right€foot€that€did€not€exist€before€the€surgery,Ïbut€he€did€not€opine€that€the€misalignment€was€caused€by€Dr.€BacardiððsÏnegligent€surgical€technique.ÌÌà àDr.€Rogersððs€testimony€does€not€establish€that€Dr.€Bacardi€performedÏthe€surgery€negligently.€€Finders€of€fact€cannot€infer€negligence€from€a€badÏresult.€€òòSee,€e.g.,óó€òòJohnson€v.€Lawrence,óó€720€S.W.2d€50,€56€(Tenn.€Ct.€App.Ï1986);€òòRedwood€v.€Raskind,óó€49€Tenn.€App.€69,€75„76,€350€S.W.2d€414,€417Ï(1961);€òòsee€alsoóó€Tenn.€Code€Ann.€ðð€29„26„115(d)(1980)€(the€jury€in€aÏmalpractice€action€shall€be€instructed€that€injury€alone€does€not€give€rise€to€aÏpresumption€of€the€defendantððs€negligence).€€Thus,€in€medical€malpracticeÏcases,€a€plaintiff€cannot€establish€a€doctorððs€negligence€merely€by€showing€thatÏan€operation€produced€a€bad€result,€€òòButler€v.€Molinski,€óó198€Tenn.€124,€133„34,€277€S.W.2d€448,€452€(1955),€or€even€that€aggravation€followed€theÏdoctorððs€treatment.€€òòPoor€Sisters€of€St.€Francis€v.€Long,óó€190€Tenn.€434,€440,Ï230€S.W.2d€659,€662€(1950).ÌÌÓÓà@ àò òB.Ìà@ àòòThe€Unnecessary€Surgery€Claimsóóó óÌÌÌÓ€Óà àMs.€Stanbury€also€claimed€that€Dr.€Bacardi€negligently€advised€her€toÏundergo€surgery€for€the€corn€on€her€right€fifth€toe€and€that€he€also€performedÏunnecessary€surgery€elsewhere€on€both€of€her€feet.€€Dr.€Bacardi€asserted€thatÏthese€claims,€like€the€informed€consent€claims,€were€time„barred€because€Ms.ÏStanbury€filed€suit€more€than€one€year€after€her€surgery.€€Dr.€BacardiððsÏargument€is€without€merit€because€the€running€of€the€statute€of€limitationsÏwith€regard€to€Ms.€Stanburyððs€unnecessary€surgery€claims€involves€facts€andÏcriteria€that€are€quite€different€from€those€involved€with€the€informed€consentÏclaims.ÌÌà àThe€majority€has€decided€to€dismiss€Ms.€Stanburyððs€unnecessary€surgeryÏclaims€because€she€ð ðdoes€not€rely€upon€this€aspect€of€the€ruleðð€in€her€brief€andÏbecause€she€cited€no€evidence€that€she€ð ðdid€not€discover€or€should€notÏreasonably€[have]€discovered€that€the€surgery€was€unnecessary€at€least€oneÏyear€before€this€suit€was€filed.ðð€€I€find€this€reasoning€both€curious€and€entirelyÏunpersuasive€for€three€reasons.€€First,€Dr.€Bacardi,€as€the€party€seeking€toÏdismiss€Ms.€Stanburyððs€claims€based€on€the€statute€of€limitations,€had€theÏburden€of€demonstrating€that€Ms.€Stanburyððs€claims€were€time„barred.€ÏSecond,€Dr.€Bacardiððs€statute€of€limitations€argument€with€regard€to€Ms.ÏStanburyððs€unnecessary€surgery€claims€is€legally€wrong.€€Third,€Ms.€Stanbury,Ïas€the€appellee,€is€under€no€obligation€to€respond€to€arguments€not€made€byÏthe€appellant.ÌÌà àWe€must€deal€with€this€issue€head€on€because€the€juryððs€damage€award€isÏbased€on€a€general€verdict€that€could€have€been€based€on€its€conclusion€thatÏMs.€Stanbury€had€not€consented€to€all€the€surgery€that€Dr.€Bacardi€performedÍor€that€Dr.€Bacardi€had€recommended€and€performed€unnecessary€surgery€orÏboth.€€Thus,€even€if€Ms.€Stanburyððs€informed€consent€claims€are€time„barred,Ïshe€may€still€be€entitled€to€recover€on€the€unnecessary€surgery€claims€unlessÏthey€too€are€time„€barred.ÌÌà àDisposing€of€the€statute€of€limitations€issue€with€regard€to€Ms.ÏStanburyððs€unnecessary€surgery€claims€requires€an€understanding€of€the€natureÏof€the€claims€themselves.€€Ms.€Stanbury€claimed€that€Dr.€Bacardi€deviatedÏfrom€the€standard€of€care€for€podiatrists€by€failing€to€follow€a€conservativeÏtreatment€regime€before€recommending€surgery€on€both€her€feet.€€Given€thatÏher€chief€complaint€was€pain€associated€solely€with€her€right€fifth€toe,€sheÏpresented€expert€testimony€that€Dr.€Bacardi€should€have€first€attempted€toÏalleviate€her€symptoms€using€conservative€treatment€measures€such€as€shavingÏthe€corn,€wearing€wider€shoes,€or€using€shoe€padding.ÌÌà àA€doctor€cannot€be€held€responsible€for€choosing€between€two€or€moreÏrecognized€courses€of€treatment.€€òòMcPeak€v.€Vanderbilt€Univ.€Hosp.,óó€33€Tenn.ÏApp.€76,€79,€229€S.W.2d€150,€151€(1950).€€Presuming€a€careful€diagnosis,€aÏdoctorððs€honest€mistake€in€electing€to€perform€surgery€is€a€matter€of€judgmentÏupon€which€a€negligence€action€ordinarily€cannot€be€predicated.òò€€Burnett€v.ÏLayman,óó€133€Tenn.€323,€328,€181€S.W.€157,€158€(1915).€€Both€of€Ms.ÏStanburyððs€experts€testified,€however,€that€performing€surgery€on€Ms.ÏStanbury€without€first€attempting€more€conservative€treatments€was€not€aÏrecognized€alternative€treatment€regime.€€Thus,€electing€to€perform€surgeryÏwithout€first€attempting€more€conservative€treatments€was€a€deviation€fromÏthe€standard€of€care€for€podiatrists€and€was€also€prima€facie€evidence€of€Dr.ÏBacardiððs€malpractice.ÌÌà àThe€statute€of€limitations€on€Ms.€Stanburyððs€unnecessary€surgery€claimsÏcould€not€have€started€to€run€until€she€discovered€or€reasonably€should€haveÏdiscovered€ð ðthe€occasion,€the€manner,€and€the€means€by€which€a€breach€ofÏduty€occurred€that€produced€[her]€injuries.ðð€€òòRoe€v.€Jefferson,óó€875€S.W.2d€atÏ656.€€Thus,€Ms.€Stanbury€would€have€had€to€discover€that€her€surgery€wasÏunnecessary€before€her€cause€of€action€accrued.€€The€fact€that€Ms.€StanburyÏwas€asymptomatic€except€for€the€corn€on€her€right€fifth€toe€is€not,€in€and€ofÏitself,€evidence€that€the€surgery€was€unnecessary.€€Since€Ms.€Stanbury€was€aÏlay€person,€I€would€find€that€she€did€not€discover€that€Dr.€Bacardi€hadÏperformed€unnecessary€surgery€until€another€competent€health€care€providerÏinformed€her€that€her€surgery€had€been€unnecessary.ÌÌà àThus,€unlike€the€majority€who€are€content€to€dismiss€the€entire€case€onÏstatute€of€limitations€grounds,€I€would€hold€that€Ms.€Stanburyððs€unnecessaryÏsurgery€claims€were€timely.€€Prior€to€April€30,€1992€„€one€year€before€theÏfiling€of€the€complaint€„€Ms.€Stanbury€knew€that€Dr.€Bacardi€had€performedÏmore€surgery€than€she€had€consented€to€and€that€she€had€experiencedÏunanticipated€complications.€€She€had€no€reason€to€know€that€the€surgery€thatÏDr.€Bacardi€performed€on€her€right€fifth€toe€or€elsewhere€on€either€of€herÏfeet€was€unnecessary.€€Thus,€even€though€the€statute€of€limitations€on€herÏinformed€consent€claim€had€started€to€run,€the€statute€of€limitations€on€herÏnegligent€surgery€claims€had€not.ÌÌà@ àò òIV.ó óÌÌà àI€would€find€that€the€trial€court€committed€reversible€error€byÏsubmitting€Ms.€Stanburyððs€time„barred€informed€consent€claims€to€the€jury.€ÏAccordingly,€I€would€vacate€the€judgment,€but€unlike€the€majority,€I€wouldÏnot€dismiss€Ms.€Stanburyððs€suit€in€its€entirety.€€Since€her€unnecessary€surgeryÏclaims€are€not€time„barred,€I€would€remand€them€for€a€new€trial€on€theseÏclaims€alone.€€She€is€not€entitled€to€a€second€bite€at€the€apple€with€regard€to€allÏthe€other€theories€of€recovery€that€either€were€time„barred€or€were€notÏproven€during€the€first€trial.ÌÌÓÓÌà àà àà àà àà àà à________________________________Ìà àà àà àà àà àà àWILLIAM€C.€KOCH,€JR.,€JUDGE