ÿWPCø ¦<´}¸3Š•Š3“rñ¾ÿë¼Ø÷˜¸^áå$ a(¬†·"ëˆ,×uƒºÁ‡I<³ ¬Éf „ÂÂu½¿n'Yšn‘—vG¡Á½f`æÅß·ˆ•¸ÅøJv½Úº4lÝ \y—d玶Ia¿3´ p`Ó‹ËŠ€Ðð÷¶bsS\ËSÕ+h¤Ùeùß ¦b %\^ b 0ˆnUNöwD4H\ zkÒå· m¹ #ÁÐ É‘ ÆZ Æ ÆæƬ 0DrN¶UN¸ãEéééééééééééééééééééééééébëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 0ëóóóó BÞÞ 0¤û D5Ÿ D-Ô 0K ASLÆŸ 0¤e 0D  A«M»ø¤ƒ+s (`£ª$¡¡Ñ€.ÑÑ8€½­»»d»»d8ÑÑ ý ÑÓ  Ó(í€"  Z6Times New Roman RegularÝ^p+  3|x ˜C:\PROGRA~1\COREL\WORDPE~1\TEMPLATE\CUSTOM~1\REVISE~1.WPTC:\Program Files\Corel\WordPerfect Office 2000\Template\Custom WP Templates\revised standard opinion.wptÿU‹ÿÀÀÀ˜HP LaserJet 8000 Series PSØÚØÚÚØØÚ0 ¿Ý ƒRM¥$ÝÓ  Óà  àòòÚ  Ú2Ú  ÚóóÔ€ôîi ò»»ÔÝ  ÝÔ_ÔThe€Trial€Court€record€reveals€that€this€word€should€be€'unauthorized'€not€'authorized'€€In€addition,€comparisonÐ ° Ðof€the€transcript€portions,€as€set€forth€by€Mr.€Bates,€with€the€actual€Trial€Court€record€quoted€hereinafter,€reveals€various€Ð tÄ Ðtypographical€errors€and€word€omissions.€Level 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5(#Ã$òòÚ  Ú0Ú  Úóó(ÆúI Z‹6Times New Roman Regular ÙÝ ƒRM¥$ÝÓ  Óà  àòòÚ  Ú1Ú  ÚóóÔ€ôîi ò»»ÔÝ  ÝÔ_ÔMr.€Bates€dismissed€his€claim€against€the€Oak€Ridge€Surgical€Group,€P.C.€on€July€10,€1999.€- ù-(|G2M¥$¤¤Ý ƒ£ª!ÝÑ€.ÑÑ8€œ»»d XXdì8ÑÑ ý ÑÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  ÚóóÔ€ôp ò»»Ô d(|3IN$££Ý ƒ£ª!ÝÑ€.ÑÑ8€œ»»d XXdì8ÑÑ ý ÑÓ  ÓÝ  ÝVVVV)ÿÿ!dxdx)!ÈÈÈÈdxdx( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó^_X`YEþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(|3IN$¢¢Ý ƒ£ª!ÝÑ€.ÑÑ8€œ»»d XXdì8ÑÑ ý ÑÓ  ÓÝ  Ý($$””ò òÚ  Ú1Ú  Úó óX[Z&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ£ª!ÝÑ€.ÑÑ8€Ü»»d dÈ8ÑÑ ý ÑÓ  ÓÝ  ÝÔ_ÔÑ  ÑÔ€¼Y‘»»»ÔÑ8€~¬XXdê»»d 8ÑÑ  Ñ€€€à@ü ü ìàÔ‡îB€î»¼Y‘ÔIN€THE€COURT€OF€APPEALS€OF€TENNESSEEˆÐ ° Ðà@WW$ìàAT€KNOXVILLEÔ#†¼Y‘»îîB€#ԈРÖ& ÐÓ  ÓJuly€10,€2001€SessionÐ üL ÐÔ‡X=X»¼Y‘ÔÌò òÔ#†¼Y‘»XX=õ#ÔALVIN€BATES€v.€DR.€JOSEPH€Ô_ÔMETCALFÔ_Ô,€IV,€d/b/a€OAK€RIDGEÐ úJ ÐSURGEONS,€P.C.Ô‡X=X»¼Y‘Ôó óÐ  ^ ÐÌà@@½½ìàò ò€Appeal€from€the€Circuit€Court€for€Anderson€CountyÐ  ^ Ðà@@øøìàNo.€98LA0448€James€B.€Scott,€Jr.,€JudgeÐ ú J ÐÌFILED€DECEMBER€3,€2001Ð Ò"  Ðà@@ìì*ìàßA€V) °°` d€÷E<½` AßÐ ¾  ÐÌà@@TTìàNo.€E2001„00358„Ô_ÔCOAÔ_Ô„R3„CVÐ ¹  ÐÌßA€V) °°` dE<` AßÐ ‘á  Ðó óÌÓ  Óà  àIn€this€appeal€from€the€Circuit€Court€for€Anderson€County,€the€Plaintiff/Appellant,€AlvinÐ ŒÜ ÐBates,€contends€that€the€Trial€Court€erred€in€failing€to€grant€him€a€directed€verdict€in€his€cause€ofÐ xÈ Ðaction€against€the€Defendant/Appellee,€Dr.€Joseph€Ô_ÔMetcalfÔ_Ô,€IV,€for€medical€malpractice€and€medicalÐ d´ Ðbattery.€€Mr.€Bates€further€contends€that€the€Trial€Court€committed€other€errors€with€respect€to€theÐ P  Ðadmission€and€exclusion€of€evidence€and€that€there€was€no€material€evidence€€to€support€the€jury'sÐ <Œ Ðverdict€in€favor€of€Dr.€Ô_ÔMetcalfÔ_Ô.€€We€affirm€the€judgment€of€the€Trial€Court€and€we€adjudge€costs€ofÐ (x Ðappeal€against€Mr.€Bates€and€his€surety.€€€€€Ð d ÐÓæÓÌò òTenn.€R.€App.€P.3€Appeal€as€of€Right;€Judgment€of€the€Circuit€Court€Affirmed;Ð ì< ÐCause€Remandedó óÐ Ø( ÐÌòòÓ  ÓÔ#†¼Y‘»àX=´#ÔÔ‡X=X.¼Y‘ÔHouston€M.€Ô_ÔGoddardÔ_Ô,€Ô_ÔP.J.Ô_Ôóó,€delivered€the€opinion€of€the€court.€€Herschel€P.€Franks,€J.,€filed€aÐ ° Ðconcurring€opinion.€€òòCharles€D.€Susano,€Jr.,€J.óó,€filed€a€dissenting€opinion.Ð œì ÐÌDavid€Randolph€Smith,€Nashville,€Tennessee,€and€James€P.€Smith,€Ô_ÔCrossvilleÔ_Ô,€Tennessee,€for€theÐ t Ä Ðappellant,€Alvin€Bates.€Ð `!°  ÐÌDebra€A.€Thompson,€Knoxville,€Tennessee,€for€the€appellee,€Dr.€Joseph€Ô_ÔMetcalfÔ_Ô,€IV.€Ð 8#ˆ" ÐÓçÓÌò òOPINIONó óÔ#†¼Y‘»XX= #ÔÔ‡X=X»¼Y‘ÔÐ %` $ ÐÌòòóóÔ#†¼Y‘»XX=Ý #ÔÔ‡X=X»¼Y‘ÔÓ  Óà0  àThis€appeal€arises€out€of€an€action€for€medical€battery€and€medical€malpractice€filed€by€the€Ðè&8"&(#(# ÐPlaintiff/Appellant,€Alvin€Bates,€against€the€Defendant/Appellee,€Dr.€Joseph€Ô_ÔMetcalfÔ_Ô,€IV€d/b/a€OakÐ Ô'$#' ÐRidge€Surgeons,€P.C.Ð À($( ÐÌà  àIn€May€of€1997€Mr.€Bates€consulted€Dr.€Ô_ÔMetcalfÔ_Ô,€a€medical€doctor€specializing€in€generalÐ ˜*è%* Ðsurgery,€because€he€was€experiencing€rectal€pain€and€bleeding.€€Upon€Dr.€Ô_ÔMetcalfÔ_Ô's€examination€andÐ „+Ô&+ Ðsubsequent€diagnosis€of€"thrombosed€internal€hemorrhoids"€Mr.€Bates€consented€to€aÐ p,À', ÐÔ_ÔhemorrhoidectomyÔ_Ô€which€Dr.€Ô_ÔMetcalfÔ_Ô€performed€on€May€15,€1997.Ð \-¬(-ý ÐÔ_Ô‡à  àMr.€Bates€returned€to€Dr.€Metcalf's€office€for€a€post„operative€check„up€on€May€28,€1997,Ð ° Ðat€which€time€Dr.€Metcalf€advised€him€to€continue€a€daily€self„€treatment€regimen€which€includedÐ œì Ðdiet€modification€and€application€of€Anusol,€a€medicated€cream.€€The€record€shows€that€Mr.€BatesÐ ˆØ Ðcontinued€this€program€of€self„treatment€for€the€next€four€and€one„half€months.Ð tÄ ÐÌà  àMr.€Bates€did€not€see€Dr.€Metcalf€again€until€September€24,€1997,€at€which€time€he€was€onceÐ L œ Ðagain€experiencing€pain€and€bleeding€as€he€had€prior€to€the€surgery€of€May€15.€€Dr.€Metcalf'sÐ 8 ˆ Ðexamination€on€this€visit€was€limited€because€of€Mr.€Bates's€extreme€discomfort€and,€although€Dr.Ð $ t ÐMetcalf€advised€Mr.€Bates€that€he€believed€his€symptoms€indicated€a€recurrence€of€€hemorrhoids,Ð  ` Ðhe€further€advised€him€that€the€pain€and€bleeding€could€be€caused€by€something€other€thanÐ ü L  Ðhemorrhoids€such€as€an€anal€fissure.€€Because€his€examination€had€been€restricted€as€a€consequenceÐ è 8  Ðof€Mr.€Bates's€discomfort,€Dr.€Metcalf€recommended€that€Mr.€Bates€allow€him€to€conduct€an€analÐ Ô$  Ðexamination€under€anesthesia.€In€his€notes€from€this€visit€Dr.€Metcalf€wrote,€"Signs€and€symptomsÐ À  Ðof€continued€hemorrhoidal€bleeding.€€The€patient€has€done€well€for€the€past€four€months.€I€feel€weÐ ¬ü  Ðneed€to€do€a€formal€anal€evaluation,€possible€further€hemorrhoidectomy."€€Ð ˜è  ÐÌà  àThe€record€shows€that€on€the€date€of€this€visit€Mr.€Bates€signed€a€consent€form€designatedÐ pÀ ÐREQUEST€FOR€SURGERY€which€included€the€following€statements:Ð \¬ ÐÌÒ€°ÒÒ€°Ò2.€€The€procedure(s)€necessary€to€be€performed€has(have)€been€explained€to€meÐ 4„ Ðand€I€understand€the€nature€of€the€procedure€to€be:€€Anal€Exam€and€possible€Ð  p ÐHemorrhoidectomyÐ  \ ÐÌ3.€€Procedure€as€scheduled:€Anal€Exam€and€possible€HemorrhoidectomyÐ ä4 ÐÌ4.€€It€has€been€explained€to€me€that,€during€the€course€of€the€operation,€unforseenÐ ¼  Ðconditions€may€require€additional€surgery€immediately.€€If€I€need€such€additionalÐ ¨ø Ðsurgery€during€my€operation,€I€permit€Dr.€Metcalf,€his€assistants,€or€his€designeesÐ ”ä Ðto€perform€such€medical€and€surgical€procedures€as€are€necessary.Ð €Ð ÐÌ5.€Dr.€Metcalf€has€discussed€and€explained€to€me€Ð X ¨ Ѐ€€€a.€The€nature€and€purpose€of€the€operation€or€procedure.Ð D!” Ѐ€€€b.€The€possibility€that€complications€may€arise€or€develop.Ð 0"€  Ѐ€€€c.€Significant€risks.Ð #l! Ѐ€€€d.€Available€alternative€methods€of€treatment.Ð $X" Ѐ€€€e.€Prognosis€if€no€treatment€is€received.Ð ô$D # Ѐ€€€f.€Other€______________________Ð à%0!$ ÐÒ°€ÒÒ°€ÒÌà  àDr.€Metcalf€testified€that€he€also€told€Mr.€Bates€that€"whatever€I€found€under€the€analÐ ¸'#& Ðexamination,€that€if€it€could€be€fixed€at€that€time,€we€would€do€that.€€And€he€knew€that€an€analÐ ¤(ô#' Ðfissure€was€a€possibility.€€And,€therefore,€he€knew€that€fixing€an€anal€fissure€was€what€he€expectedÐ )à$( Ðme€to€do."€€Mr.€Bates€testified€that€Dr.€Metcalf€told€him€"€that€he€would€do€an€exam,€check€and€see,Ð |*Ì%) Ðfix€the€hemorrhoids."€€Mr.€Bates€did€not€recall€Dr.€Metcalf€telling€him€that€if€the€cause€of€theÐ h+¸&* Ðbleeding€was€something€that€he€could€simply€fix,€he€would€fix€it€and€he€denies€that€he€gave€Dr.Ð ° ÐMetcalf€consent€to€fix€the€problem€whatever€it€might€be.Ð œì ÐÌà  àOn€the€day€following€the€office€visit€of€September€24,€1997,€€Mr.€Bates€appeared€at€theÐ tÄ Ðemergency€room€of€the€Methodist€Medical€Center€because€of€his€rectal€pain€and€bleeding€and€wasÐ `° Ðagain€seen€by€Dr.€Metcalf€who€ordered€blood€work€and€arranged€for€a€colonscopy€which€wasÐ L œ Ðperformed€by€another€physician€the€next€day.Ð 8 ˆ ÐÌà  àAn€anal€exam€under€general€anesthesia€was€performed€by€Dr.€Metcalf€upon€Mr.€Bates€onÐ  ` ÐSeptember€30,1997.€€Upon€examining€Mr.€Bates's€anal€canal,€Dr.€Metcalf€discovered€that€the€causeÐ ü L  Ðof€Mr.€Bates's€pain€and€bleeding€was€not€hemorrhoids,€but€rather€a€large€anal€fissure.€€Dr.€Metcalf'sÐ è 8  Ðoperative€note€reflects€that€he€and€his€operative€team€"decided€at€this€time€that€an€internal€lateralÐ Ô$  Ðsphincterotomy€would€be€part€of€this€operation".€€It€is€not€disputed€that€a€€sphincterotomy,€whichÐ À  Ðinvolves€cutting€the€anal€sphincter,€is€the€appropriate€surgical€remedy€for€an€anal€fissure€such€as€theÐ ¬ü  Ðone€exhibited€by€Mr.€Bates.€€Dr.€Metcalf€testified€that€he€would€have€emphatically€recommendedÐ ˜è  Ðthat€Mr.€Bates€have€such€surgery€and€that€the€fissure€would€probably€not€have€healed€without€theÐ „Ô  Ðsurgery.€€Dr.€Metcalf€admits,€however,€€that€he€never€specifically€discussed€the€lateral€internalÐ pÀ Ðsphincterotomy€with€Mr.€Bates€prior€to€performing€the€operation.€Mr.€Bates€asserts€that€he€wouldÐ \¬ Ðnot€have€consented€to€the€lateral€internal€sphincterotomy€had€it€been€proposed€to€him.Ð H˜ ÐÌà  àAfter€returning€home€from€the€hospital€and€while€he€was€still€healing€from€the€surgery€ofÐ  p ÐSeptember€30,€Mr.€Bates€began€to€experience€fecal€incontinence.€€On€December€19,1997,€he€metÐ  \ Ðwith€Dr.€Metcalf€to€discuss€this€problem€and€was€referred€by€him€to€Dr.€Julio€Solla,€a€colon€andÐ øH Ðrectal€surgeon€with€the€Universtiy€of€Tennessee€Medical€Center€in€Knoxville.€€Dr.€Solla€determinedÐ ä4 Ðthat€Mr.€Bates's€incontinence€was€caused€by€an€abnormality€of€the€pudendal€nerves€which,€whenÐ Ð  Ðfunctioning€properly,€control€the€external€sphincter€muscle€which,€in€turn,€controls€fecal€continence.€Ð ¼  ÐDr.€Solla€offered€Mr.€Bates€the€option€of€a€colostomy€and€referred€him€for€a€second€opinion€to€Dr.Ð ¨ø ÐFrank€Opelka,€another€colon€and€rectal€surgeon,€affiliated€with€the€Ochsner€Clinic€in€New€Orleans,Ð ”ä ÐLouisiana.Ð €Ð ÐÌà  àIn€May€of€1999€Dr.€Opelka€examined€Mr.€Bates€and€presented€him€with€the€alternativeÐ X ¨ Ðremedies€€of€a€colostomy,€construction€of€€an€artificial€sphincter€or€an€operation€to€repair€his€internalÐ D!” Ðsphincter.€€Mr.€Bates€consented€to€the€final€option€and€on€June€3,€1999,€Dr.€Opelka€performedÐ 0"€  Ðsurgery€to€repair€Mr.€Bates's€internal€sphincter.€€Unfortunately,€this€surgery€was€not€successful€andÐ #l! ÐMr.€Bates€continues€to€suffer€from€incontinence.Ð $X" ÐÌà  àThe€present€lawsuit€commenced€on€September€30,€1998,€when€Mr€Bates€filed€a€òòpro€seóóÐ à%0!$ Ðcomplaint€€against€Dr.€Metcalf€d/b/a€Oak€Ridge€Surgeons,€P.C.׃×Ý ƒ#ÃÝòòÚ  Ú1Ú  ÚóóÝ  Ý×  ×€seeking€damages€for€injuriesÐ Ì&"% Ðallegedly€suffered€as€a€result€of€the€surgery€performed€by€Dr.€Metcalf€on€September€30,1997,€andÐ ¸'#& Ðasserting€that€Dr.€Metcalf€was€guilty€of€negligence€and€medical€malpractice€in€performing€suchÐ ¤(ô#' Ðsurgery.€€Ð )à$( Їà  àOn€May€24,€1999,€Mr.€Bates,€who€had€by€this€time€retained€his€present€legal€counsel,€filedÐ ° Ða€motion€to€amend€his€complaint€to€aver€that,€in€performing€the€lateral€internal€sphincterotomyÐ œì Ðwithout€his€consent,€Dr.€Metcalf€had€committed€medical€battery.€Mr.€Bates€further€moved€to€amendÐ ˆØ Ðhis€complaint€to€aver€that€Dr.€Metcalf€had€failed€to€obtain€informed€consent€to€perform€the€surgeryÐ tÄ Ðin€deviation€from€the€recognized€standard€of€professional€practice€in€violation€of€T.C.A.€29„26„118.€Ð `° ÐMr.€Bates€motion€to€amend€was€subsequently€approved€by€the€Court€at€trial.Ð L œ ÐÌà  àThe€jury€trial€of€Mr.€Bates's€claims€against€Dr.€Metcalf€began€on€July€11,€2000.€€At€the€closeÐ $ t Ðof€proof€the€Trial€Court€granted€Dr.€Metcalf€a€directed€verdict€with€respect€to€malpractice€inÐ  ` Ðperformance€of€the€surgical€procedure€itself€and€denied€Mr.€Bates€a€directed€verdict€on€the€issue€ofÐ ü L  Ðmedical€battery.€€Thereafter,€the€jury€found€that€Mr.€Bates€had€expressly€or€impliedly€authorizedÐ è 8  Ðsurgery€that€could€include€the€lateral€internal€sphincterotomy€performed€by€Dr.€Metcalf€and€that€aÐ Ô$  Ðmedical€battery€was,€therefore,€not€committed€in€this€case.€€The€jury€further€found€that€Dr.€MetcalfÐ À  Ðhad€obtained€informed€consent€by€disclosing€to€Mr.Bates€the€risks€and€alternatives€for€the€lateralÐ ¬ü  Ðinternal€sphincterotomy.€€On€August€1,€2000,€the€Trial€Court€entered€its€judgment€in€favor€of€Dr.Ð ˜è  ÐMetcalf€in€accord€with€the€jury's€verdict€€€€€€€Ð „Ô  ÐÌà  àOn€July€26,€2000,€Mr.€Bates€filed€a€motion€for€judgment€notwithstanding€the€verdict€or€inÐ \¬ Ðthe€alternative€new€trial.€€That€motion€was€denied€by€the€Trial€Court€by€order€entered€September€26,Ð H˜ Ð2000.€€On€October€20,€2000,€Mr.€Bates€filed€his€notice€of€appeal.Ð 4„ ÐÌà  àMr.€Bates€presents€eight€issues€for€our€review€in€this€case€which€we€restate€as€follows:Ð  \ ÐÌà  à1)€Whether€the€Trial€Court€erred€in€failing€to€grant€Mr.€Bates€a€directed€verdict€on€the€issueÐ ä4 Ðof€medical€battery.Ð Ð  ÐÌà  à2)€Whether€there€was€material€evidence€to€support€the€finding€of€the€jury€that€Mr.€BatesÐ ¨ø Ðimpliedly€consented€to€the€lateral€internal€sphincterotomy€performed€upon€him.Ð ”ä ÐÌà  à3)€Whether€there€was€material€evidence€to€support€the€finding€of€the€jury€that€Dr.€MetcalfÐ l¼ Ðobtained€informed€consent€to€perform€a€lateral€internal€sphincterotomy€upon€Mr.€Bates.Ð X ¨ ÐÌà  à4)€Whether€the€Trial€Court€erred€in€allowing€counsel€for€Dr.€Metcalf€to€cross€examine€Mr.Ð 0"€  ÐBates€with€regard€to€the€amendment€of€his€complaint€to€include€claims€charging€Dr.€Metcalf€withÐ #l! Ðnegligence€because€of€his€failure€to€obtain€informed€consent€and€charging€him€with€battery€for€hisÐ $X" Ðfailure€to€obtain€consent.Ð ô$D # ÐÌà  à5)€Whether€the€Trial€Court€erred€in€allowing€cross„examination€and€introduction€of€evidenceÐ Ì&"% Ðwith€regard€to€Mr.€Bates's€consent€to€medical€procedures€other€than€the€lateral€internalÐ ¸'#& Ðsphincterotomy.Ð ¤(ô#' ÐÌà  à6)€Whether€the€Trial€Court€erred€in€excluding€the€expert€testimony€of€Dr.€Frank€OpelkaÐ |*Ì%) Ðbecause€he€is€not€licensed€to€practice€medicine€either€in€Tennessee€or€in€a€continuous€bordering€state.Ð h+¸&* Їà  à7)€Whether€the€Trial€Court€erred€in€allowing€cross„examination€of€Dr.€Clifford€Black€withÐ ° Ðregard€to€a€medical€malpractice€case€pending€against€him.Ð œì ÐÌà  à8)€Whether€the€Trial€Court€erred€in€instructing€the€jury€on€the€issue€of€medical€battery.Ð tÄ ÐÌà  àIn€addition€to€the€eight€issues€stated€above,€both€Dr.€Metcalf€and€Mr.€Bates€devote€portionsÐ L œ Ðof€their€briefs€to€the€issue€of€whether€Mr.€Bates's€incontinence€was€actually€caused€by€the€surgeryÐ 8 ˆ Ðperformed€by€Dr.€Metcalf€on€September€30,€1997.€€However,€the€ruling€of€the€Trial€Court€and€theÐ $ t Ðverdict€of€the€jury€with€respect€to€the€issues€of€medical€battery€and€informed€consent€forestalledÐ  ` Ðconsideration€of€this€issue€of€causation.€€As€this€issue€was€not€determined€at€trial,€it€is€not€appropriateÐ ü L  Ðthat€we€consider€it€in€this€appeal€and€we€decline€to€do€so.€€See€T.R.A.P.€3(a).Ð è 8  ÐÌà  àThe€first€issue€presented€by€Mr.€Bates€calls€upon€us€to€determine€the€propriety€of€the€TrialÐ À  ÐCourt's€denial€of€his€motion€for€a€directed€verdict.€€The€standard€of€review€with€respect€to€a€trialÐ ¬ü  Ðcourt's€ruling€on€a€motion€for€directed€verdict€is€well„settled.€As€we€stated€in€the€case€of€òòMaddux€v.Ð ˜è  ÐCargill,€Inc.óó,€777€S.W.2d€687€(Tenn.€Ct.€App.€1989)€at€page€691:Ð „Ô  ÐÌÒ€°ÒÒ€°Òà Ø àThe€rule€for€determining€a€motion€for€directed€verdict€requires€the€trialÐ \¬ Ðjudge€and€the€appellate€courts€to€look€to€all€of€the€evidence,€€take€the€strongestÐ H˜ Ðlegitimate€view€of€the€evidence€in€favor€of€the€opponent€of€the€motion,€and€allowÐ 4„ Ðall€reasonable€inferences€from€it€in€his€favor.€€The€court€must€discard€allÐ  p Ðcountervailing€evidence,€and€if€there€is€then€any€dispute€as€to€any€material,Ð  \ Ðdeterminative€evidence€or€any€doubt€as€to€the€conclusions€to€be€drawn€from€theÐ øH Ðwhole€evidence,€the€motion€must€be€denied.€€Ð ä4 ÐÌÒ°€ÒÒ°€Òà  àBefore€we€can€conclude€that€the€Trial€Court€erred€in€denying€Mr.€Bates's€motion€for€aÐ ¼  Ðdirected€verdict,€we€must€find€that€the€evidence€submitted€is€susceptible€to€the€sole€conclusion€thatÐ ¨ø ÐMr.€Bates€did€not€consent€to€a€lateral€internal€sphincterotomy€and€that€reasonable€minds€could€notÐ ”ä Ðdiffer€as€to€that€conclusion.€See€òòAlexander€v.€Armentrout,óó€24€S.W.3d€267€(Tenn.€2000).Ð €Ð ÐÌà  àTwo€questions€must€be€asked€in€determining€whether€a€medical€battery€has€been€committed:Ð X ¨ Ð(1)€€was€the€patient€aware€that€the€doctor€was€going€to€perform€the€procedure€in€question€and€,if€so,Ð D!” Ð(2)€did€the€patient€authorize€performance€of€such€procedure.€€A€plaintiff's€cause€of€action€may€beÐ 0"€  Ðclassified€as€a€medical€battery€only€when€the€answer€to€either€of€these€questions€is€in€the€negative.€Ð #l! ÐSee€òòBlanchard€v.€Kellum,€D.D.S.óó,€975€S.W.2d€522€(Tenn.1998).Ð $X" ÐÌà  àIn€the€case€òòsub€judice€óóDr.€Metcalf€testified€that€he€never€specifically€advised€Mr.€Bates€thatÐ à%0!$ Ðhe€might€perform€a€lateral€internal€sphincterotomy€upon€him€prior€to€doing€so€and€that€he€did€notÐ Ì&"% Ðconsider€performing€a€lateral€internal€sphincterotomy€until€he€conducted€the€anal€exam€on€SeptemberÐ ¸'#& Ð30,€1997.€€Also,€the€consent€form€signed€by€Mr.€Bates€with€respect€to€the€procedures€to€be€performedÐ ¤(ô#' Ðon€September€30,€1997,€does€not€mention€"lateral€internal€sphincterotomy"€or€any€other€proceduresÐ )à$( Ðother€than€"anal€exam€€and€possible€hemmorhoidectomy."€€Accordingly,€there€is€no€question€that€Dr.Ð |*Ì%) ÐMetcalf€€failed€to€obtain€specific€consent€to€perform€a€lateral€internal€sphincterotomy.€€Nevertheless,Ð h+¸&* ÐDr.€Metcalf€contends€that€Mr.€Bates€did€consent€to€the€lateral€internal€sphincterotomy€as€a€matterÐ ° Ðof€implication.€€Ð œì ÐÌà  àDr.€Metcalf€€testified€that,€prior€to€September€30,€1997,€he€and€Mr.€Bates€engaged€€inÐ tÄ Ðconversations€on€more€than€one€occasion€during€which€he€proposed€that€Mr.€Bates's€pain€andÐ `° Ðbleeding€might€be€the€result€of€an€anal€fissure.€€Dr.€Metcalf€also€testified€that€he€advised€Mr.€BatesÐ L œ Ðthat,€once€he€determined€the€cause€of€Mr.€Bates's€symptoms,€he€would€fix€the€problem€whatever€itÐ 8 ˆ Ðmight€be.€€Although€Mr.€Bates€agrees€that€the€possibility€of€an€anal€fissure€was€raised€by€Dr.€MetcalfÐ $ t Ðin€pre„operative€conversations,€he€denies€that€Dr.€Metcalf€advised€him€that€he€would€fix€the€problem€Ð  ` Ðwhatever€it€might€be.€€Mr.€Bates€further€argues€that€the€scope€of€the€procedure€which€Dr.€MetcalfÐ ü L  Ðwas€authorized€to€perform€on€September€30,€1997,€was€restricted€to€"an€anal€exam€and€possibleÐ è 8  Ðhemmorhoidectomy"€as€stated€in€the€signed€consent€form€and€that€the€parameters€of€consent€shouldÐ Ô$  Ðnot€be€extended€based€upon€alleged€pre„operative€conversations.€€In€support€of€this€argument€Mr.Ð À  ÐBates€cites€the€case€of€òòChurch€v.€Perales,€óó39€S.W.3d€149€(Tenn.€Ct.€App.€2000).Ð ¬ü  ÐÌà  àThe€plaintiff€patient€in€òòChurch€óóasserted€that€the€defendant€doctor€had€committed€medicalÐ „Ô  Ðbattery€by€performing€unauthorized€surgery€to€remove€her€ovaries,€uterine€tubes,€and€relatedÐ pÀ Ðligaments€when€she€had€stated€that€she€"didn't€want€nothing€done,€as€I€say,€except€have€my€bladderÐ \¬ Ðfixed€up."€€The€only€direct€evidence€that€the€plaintiff€had,€in€fact,€made€this€statement€to€theÐ H˜ Ðdefendant€was€apparently€the€plaintiff's€deposition€testimony€which,€through€her€oversight,€had€notÐ 4„ Ðbeen€made€part€of€the€appellate€record.€€Referring€to€the€omission€of€this€testimony€from€the€record,Ð  p Ðthe€Court€stated€that€the€plaintiff€"cannot€demonstrate€the€existence€of€a€material€factual€disputeÐ  \ Ðregarding€her€medical€battery€claim."€€The€Court€noted,€however,€that€the€medical€battery€claimÐ øH Ðwould€have€failed€even€without€the€omission€of€the€deposition€testimony€regarding€the€alleged€pre„Ð ä4 Ðoperative€conversation€because€the€plaintiff€had€executed€a€written€consent€form€expresslyÐ Ð  Ðconsenting€to€the€€€procedures€performed.€€Ð ¼  ÐÌà  àMr.€Bates€argues€that€the€òòChurch€óócase€and€the€case€òòsub€judiceóó,€in€essence,€involve€the€sameÐ ”ä Ðsituation€in€that€both€he€and€the€plaintiff€in€òòChurch€óósigned€a€consent€form€with€respect€to€which€factÐ €Ð Ða€reasonable€person€could€reach€but€one€conclusion.€€Mr.€Bates€contends€that,€just€as€the€onlyÐ l¼ Ðreasonable€conclusion€was€that€the€plaintiff€in€òòChurchóó€consented€to€the€surgery€performed€becauseÐ X ¨ Ðshe€executed€a€consent€form€specifically€describing€such€surgery,€the€only€reasonable€conclusion€inÐ D!” Ðthe€present€case€is€that,€since€Mr.€Bates€signed€a€consent€form€specifying€"anal€exam€and€possibleÐ 0"€  Ðhemorrhoidectomy",€he€did€not€consent€to€any€other€procedures.€€We€disagree€with€this€anaysis.Ð #l! ÐÌà  àWe€find€a€critical€distinction€between€òòChurch€óóand€the€case€before€us€in€that€the€plaintiff€inÐ ô$D # ÐòòChurchóó,€unlike€Mr.€Bates,€was€seeking€to€negate€her€signed€statement€of€consent.€€This€Court'sÐ à%0!$ Ðfinding€in€òòChurchóó€was€specific€and€limited€to€the€determination€that€"€the€existence€of€a€signedÐ Ì&"% Ðconsent€form€gives€rise€to€a€presumption€of€consent€in€the€absence€of€proof€of€misrepresentation,Ð ¸'#& Ðinadequate€disclosure,€forgery€or€lack€of€capacity"€€Our€holding€in€òòChurch€óódoesn't€preclude€theÐ ¤(ô#' Ðadmission€of€parole€evidence€to€show€that€the€patient€verbally€consented€to€proceduresòò€in€addition€óóÐ )à$( Ðto€those€specified€in€the€consent€form.Ð |*Ì%) ÐÐ h+¸&* Ðà  àGiven€Dr.€Metcalf's€attestation€that€he€advised€Mr.€Bates€before€surgery€that€he€would€fix€hisÐ ° Ðproblem€whatever€it€was,€it€is€our€finding€that€one€might€reasonably€conclude€that€Mr.€Bates€gaveÐ œì ÐDr.€Metcalf€implied€consent€to€perform€the€lateral€internal€sphincterotomy.€€Accordingly,€we€agreeÐ ˆØ Ðwith€the€Trial€Court's€ruling€denying€Mr.€Bates's€motion€for€a€directed€verdict€on€the€issue€of€medicalÐ tÄ Ðbattery.Ð `° ÐÌà  àThe€second€issue€raised€by€Mr.€Bates€questions€whether€there€was€material€evidence€toÐ 8 ˆ Ðsupport€the€jury's€finding€that€he€impliedly€consented€to€the€lateral€internal€sphincterotomy.€€OurÐ $ t Ðstandard€of€review€with€respect€to€the€findings€of€a€jury€is€clearly€stated€at€T.R.A.P.€13(d)€to€theÐ  ` Ðeffect€that€"Findings€of€fact€by€a€jury€in€civil€actions€shall€be€set€aside€only€if€there€is€no€materialÐ ü L  Ðevidence€to€support€the€verdict".€€See€also€òòFoster€v.€Bueóó,€749€S.W.2d€736€(Tenn.€1988).Ð è 8  ÐÌà  àAs€stated,€Dr.€Metcalf€testified€at€trial€that€he€advised€€Mr.€Bates€that€his€problem€might€beÐ À  Ðan€anal€fissure€and€that€he€would€fix€the€problem€whatever€it€might€be.€Such€testimony€necessarilyÐ ¬ü  Ðenters€into€consideration€of€the€issue€of€whether€Mr.€Bates€gave€consent€to€the€lateral€internalÐ ˜è  Ðsphincterotomy,€is€determinative€of€that€issue€and,€therefore,€constitutes€material€evidence.€€SeeÐ „Ô  ÐòòCamurati€v.€Sutton,€óó342€S.W.2d€732€(Tenn.€Ct.€App.€1960).€€Consequently€we€conclude€that€theÐ pÀ Ðjury's€finding€that€Mr.€Bates€consented€to€the€lateral€internal€sphincterotomy€is€supported€by€materialÐ \¬ Ðevidence.Ð H˜ ÐÌà  àThe€third€issue€presented€for€our€review€questions€whether€material€evidence€was€presentedÐ  p Ðin€this€case€supporting€the€jury's€verdict€that€Dr.€Metcalf€obtained€informed€consent€to€perform€aÐ  \ Ðlateral€internal€sphincterotomy€on€Mr.€Bates.Ð øH ÐÌà  àUnder€T.C.A.€29„26„118€a€plaintiff€patient€asserting€a€cause€of€action€based€upon€lack€ofÐ Ð  Ðinformed€consent€must€prove€by€expert€testimony€that€the€defendant€physician€did€not€supplyÐ ¼  Ðappropriate€information€to€the€patient€in€accordance€with€the€recognized€standard€of€acceptableÐ ¨ø Ðpractice.Ð ”ä ÐÌà  àWhether€the€information€provided€to€the€patient€is€appropriate€is€determined€by€the€natureÐ l¼ Ðof€the€treatment,€the€extent€of€risk€involved€and€the€standard€of€care€of€the€treating€physician.€€SeeÐ X ¨ ÐòòCardwell€v.€Bechtolóó,€724€S.W.2d€739€(Tenn.€1987).€€As€stated€by€the€Court€in€òòShadrick€v.€Cokeróó,Ð D!” Ð963€S.W.2d€726€(Tenn.€1998)€the€advice€required€of€the€physician€depends€upon€"the€usual€andÐ 0"€  Ðcustomary€advice€given€to€patients€in€similar€situations."Ð #l! ÐÌà  àThe€specific€question€propounded€to€the€jury€with€respect€to€informed€consent€in€this€caseÐ ô$D # Ðwas€as€follows:Ð à%0!$ ÐÌÒ€°ÒÒ€°Òà Ø àDid€Dr.€Metcalf,€in€accordance€with€the€recognized€standard€ofÐ ¸'#& Ðprofessional€practice€in€Oak€Ridge€or€a€similar€community,€disclose€to€AlvinÐ ¤(ô#' ÐBates€the€risks€and€alternatives€for€the€surgery€performed€on€September€30,€1997?€Ð )à$( Ðâ  €€€€€€€€€€€€€€€Ð |*Ì%) ÐÒ°€ÒÒ°€Òà  àMr.€Bates€asserts€that€in€answering€'yes'€to€this€question€the€jury€did€so€without€the€supportÐ ° Ðâ âof€material€evidence.€€We€disagree.Ð œì ÐÌà  àMr.€Bates€maintains€that€it€is€undisputed€that€Dr.€Metcalf€did€not€discuss€the€lateral€internalÐ tÄ Ðsphincterotomy€or€its€risks€and€alternatives€prior€to€surgery.€We€agree€that€€the€record€shows€that€Dr.Ð `° ÐMetcalf€did€not€specifically€relate€the€risks€and€alternatives€of€the€surgery€performed€€to€a€lateralÐ L œ Ðinternal€sphincterotomy.€However,€his€testimony€at€trial€constitutes€material€evidence€that€Dr.Ð 8 ˆ ÐMetcalf€did€discuss€the€risks€and€alternatives€of€a€hemorrhoidectomy€and€that€the€risk€ofÐ $ t Ðincontinence€was€included€among€the€risks€discussed.€€There€was€also€material€evidence€that€theÐ  ` Ðrisks€and€alternatives€of€a€hemmoroidectomy€are€the€same€as€those€of€a€lateral€internalÐ ü L  Ðsphincterotomy.€€Dr.€Anthony€Haley,€an€expert€witness€testifying€on€behalf€of€Dr.€Metcalf,€testifiedÐ è 8  Ðthat€the€risks€are€the€same€for€a€hemorrhoidectomy€and€a€lateral€internal€sphincterotomy€and€that€ifÐ Ô$  ÐMr.€Bates€was€advised€of€the€risks€of€hemorrhoidectomy€he€would€have€been€advised€of€the€sameÐ À  Ðrisks€that€are€associated€with€a€lateral€internal€sphincterotomy.€€In€addition€,€Dr.€Metcalf€testified€thatÐ ¬ü  Ða€lateral€internal€sphincterotomy€is€the€only€surgical€technique€for€repairing€an€anal€fissure€and€thatÐ ˜è  Ðthe€non„surgical,€or€conservative€treatment€for€hemorrhoids€is€the€same€as€it€is€for€an€anal€fissure€andÐ „Ô  Ðconsists€of€the€same€self„treatment€program€that€Mr.€Bates€had€already€employed€for€four€monthsÐ pÀ Ðwithout€success.€€Dr.€Haley€also€attested€that€the€conservative€treatment€received€by€Mr.€Bates€hadÐ \¬ Ðbeen€adequate€as€of€September€30,1997.€€We€conclude€that€it€is€sufficient€for€a€finding€of€informedÐ H˜ Ðconsent€that€Mr.€Bates€was€informed€of€€risks€and€alternatives€which€would€have€attended€a€lateralÐ 4„ Ðinternal€sphincterotomy€even€though€those€risks€and€alternatives€were€presented€to€him€inÐ  p Ðanticipation€that€he€would€be€undergoing€a€hemorrhoidectomy,€not€a€sphincterotomy.€Ð  \ ÐÌà  àWe€also€find€in€the€following€additional€testimony€of€Dr.€Haley€material€evidence€that€Dr.Ð ä4 ÐMetcalf's€disclosure€of€the€risks€and€alternatives€of€the€lateral€internal€sphincterotomy€were€in€accordÐ Ð  Ðwith€the€requisite€standard€of€practice:€Ð ¼  ÐÌÒ€°ÒÒ€°Òà Ø àQ:€Dr.€Haley,€earlier€I€asked€you€whether€or€not€you€had€formed€anÐ ”ä Ðopinion€within€a€reasonable€degree€of€medical€certainty€as€to€whether€or€not€Dr.Ð €Ð ÐMetcalf€had€deviated€from€the€standard€of€care€of€a€general€surgeon€practicing€inÐ l¼ ÐOak€Ridge,€Tennessee,€in€his€care€and€treatment€€of€Mr.€Bates.€€Do€you€rememberÐ X ¨ Ðmy€earlier€question?Ð D!” ÐÌà Ø àA:€Correct.Ð #l! ÐÌà Ø àQ:€Please€tell€the€judge€and€jury€what€your€opinion€is.Ð ô$D # ÐÌà Ø àA:€I€do€not€feel€like€he€deviated€from€the€standard€of€practice.€€I€think€heÐ Ì&"% Ðdid€exactly€what€any€competent€general€surgeon€would€have€done€at€the€time€heÐ ¸'#& Ðwas€there.Ð ¤(ô#' ÐÒ°€ÒÒ°€ÒÌà  àAnd€elsewhere€Dr.€Haley€testified:Ð |*Ì%) ÐÐ h+¸&* ÐÒ€°ÒÒ€°ÒQ:€Dr.€Haley,€in€your€opinion,€within€a€reasonable€degree€of€medical€certainty,€doÐ ° Ðyou€think€in€this€case€that€Dr.€Metcalf€€obtained€Mr.€Bates'€informed€consent€toÐ œì Ðperform€a€spincterotomy€[sic]?Ð ˆØ ЀÌA:€Yes,€I€do.Ð `° ÐÒ°€ÒÒ°€ÒÌà  àIt€is€our€determination€that€the€jury's€finding€that€Dr.€Metcalf€had€informed€consent€toÐ 8 ˆ Ðperform€a€lateral€internal€sphincterotomy€is€supported€by€material€evidence€€and€Mr.€Bates's€assertionÐ $ t Ðto€the€contrary€is€without€merit.Ð  ` ÐÌà  àThe€fourth€issue€which€we€address€questions€whether€the€Trial€Court€erred€in€allowing€cross„Ð è 8  Ðexamination€of€Mr.€Bates€as€to€his€original€òòpro€se€óócomplaint€and€its€amendment.€€Mr.€Bates€arguesÐ Ô$  Ðthat€cross„examination€should€not€have€been€allowed€regarding€the€fact€that€the€original€complaintÐ À  Ðdid€not€assert€claims€as€to€medical€battery€or€informed€consent€and€the€fact€that€such€claims€wereÐ ¬ü  Ðonly€raised€after€he€retained€his€present€attorney€in€the€case.€€Mr.€Bates€contends€that€such€cross„Ð ˜è  Ðexamination€was€irrelevant€to€any€issue€in€the€case,€unfairly€prejudiced€the€case€against€him€andÐ „Ô  Ðconstituted€an€òòad€hominem€óóattack€upon€his€attorney.€€We€are€compelled€to€disagree€with€theseÐ pÀ Ðcontentions.Ð \¬ ÐÌà  àMaterial€issues€before€the€jury€in€the€case€consisted€of€whether€Mr.€Bates€consented€to€theÐ 4„ Ðlateral€internal€sphincterotomy€which€was€performed€upon€him€by€Dr.€Metcalf€and€whether€Dr.Ð  p ÐMetcalf€provided€him€with€adequate€information€to€obtain€informed€consent.€€In€addressing€theseÐ  \ Ðissues€it€was€incumbent€upon€the€jury€to€consider€the€credibility€of€Mr.€Bates's€assertions€that€he€hadÐ øH Ðnot€consented€to€the€lateral€internal€sphincterotomy€and€had€not€received€adequate€informationÐ ä4 Ðregarding€that€operation.€€The€original€complaint€filed€by€Mr.€Bates€on€September€30,€1998,€assertsÐ Ð  Ðthat€Dr.€Metcalf€committed€medical€malpractice€by€performing€the€sphincterotomy€in€a€negligent€Ð ¼  Ðmanner,€by€failing€to€properly€recognize€the€resulting€injury€and€by€failing€to€properly€take€allÐ ¨ø Ðreasonable€steps€available€to€repair€the€damage.€€There€is€no€assertion€in€the€original€complaint€thatÐ ”ä ÐMr.€Bates€did€not€consent€to€the€surgery€performed€or€that€he€did€not€receive€sufficient€informationÐ €Ð Ðabout€the€surgery€to€give€informed€consent.Ð l¼ ÐÌà  àRelevant€evidence€is€"evidence€having€any€tendency€to€make€the€existence€of€any€fact€thatÐ D!” Ðis€of€consequence€to€the€determination€of€the€action€more€probable€or€less€probable€than€it€wouldÐ 0"€  Ðbe€without€the€evidence."€€See€T.R.E.€Rule€401.Ð #l! ÐÌà  àWe€agree€with€Mr.€Bates's€statement€that€the€fact€that€he€didn't€know€the€law€as€to€medicalÐ ô$D # Ðbattery€or€informed€consent€proves€nothing.€€However,€he€need€not€have€had€knowledge€of€the€lawÐ à%0!$ Ðto€assert€that€he€did€not€give€Dr.€Metcalf€permission€to€perform€the€surgery€he€received.€€It€isÐ Ì&"% Ðreasonable€to€conclude€that,€if€Dr.€Metcalf€performed€an€operation€on€Mr.€Bates€without€consent€Ð ¸'#& ÐMr.€Bates€would€have€included€this€assertion€in€his€original€complaint€and,€although€not€dispositive€Ð ¤(ô#' Ðof€the€issue,€€the€fact€that€he€did€not€include€it€is€relevant€on€the€question€of€whether€he€did€give€suchÐ )à$( Ðconsent.€€Accordingly,€we€€find€that€cross„examination€of€Mr.€Bates€regarding€his€original€complaintÐ |*Ì%) Ðwas€relevant€to€the€issues€in€this€case.€Ð h+¸&* Їà  àUnder€T.R.E.€Rule€403€"although€relevant,€evidence€may€be€excluded€if€its€probative€valueÐ ° Ðis€substantially€outweighed€by€the€danger€of€unfair€prejudice."€€Although€Mr.€Bates€contends€thatÐ œì Ðcross„examination€regarding€the€original€complaint€was€unfairly€prejudicial,€he€offers€no€specificÐ ˆØ Ðreason€for€this€contention€and€we€find€nothing€in€the€record€which€would€lead€us€to€that€conclusion.€Ð tÄ ÐSimilarly,€although€Mr.€Bates€asserts€that€the€cross„examination€regarding€his€original€complaint€andÐ `° Ðarguments€of€Dr.€Metcalf's€attorney€constituted€an€òòad€hominem€óóattack€upon€his€attorney€he€has€notÐ L œ Ðreferred€us€to€sufficient€supporting€evidence€in€the€record€to€substantiate€this€assertion.Ð 8 ˆ ÐÌà  àIn€view€of€the€above€we€find€that€the€Trial€Court€did€not€abuse€its€discretion€by€allowing€theÐ  ` Ðcross„€examination€of€Mr.€Bates€with€respect€to€his€original€òòpro€se€óócomplaint.€We€further€find€that€Ð ü L  ÐMr.€Bates's€assertion€that€statements€made€by€Dr.€Metcalf's€attorney€constituted€an€òòad€hominemÐ è 8  Ðóóattack€upon€his€own€attorney€are€without€merit.Ð Ô$  ÐÌà  àThe€fifth€issue€presented€for€our€review€questions€whether€the€Trial€Court€erred€in€allowingÐ ¬ü  Ðcross„examination€regarding€Mr.€Bates's€consent€to€other€surgery€and€treatment.€€Mr.€Bates€contendsÐ ˜è  Ðthat€allowance€of€evidence€with€respect€to€other€consent€forms€and€other€consent€proceduresÐ „Ô  Ðconstitutes€inadmissible€propensity€proof€and€improper€character€evidence.Ð pÀ ÐÌà  àThe€law€is€well„settled€that€the€failure€of€a€litigant€to€make€a€timely,€€specific€objection€to€theÐ H˜ Ðintroduction€of€evidence€as€inadmissible€at€the€time€of€trial€precludes€that€litigant€from€challengingÐ 4„ Ðsuch€evidence€on€appeal.€€See€T.R.E.€€Rule€103(a)(1)and€òòAdams€v.€Manisóó,€859€S.W.2d€323€(Tenn.Ð  p ÐCt.€App.€1993).€€Our€review€of€the€record€shows€that€there€was€no€objection€at€trial€to€theÐ  \ Ðimpropriety€of€cross„examining€Mr.€Bates€regarding€his€consent€to€other€surgery€and€medicalÐ øH Ðprocedures€€or€to€the€introduction€as€€evidence€of€€other€consent€forms€he€had€signed.€€Accordingly,Ð ä4 Ðwe€find€that€Mr.€Bates€has€waived€his€right€to€raise€this€issue€on€appeal.Ð Ð  ÐÌà  àThe€sixth€issue€presented€for€our€review€questions€whether€the€Trial€Court€erred€when€itÐ ¨ø Ðexcluded€the€causation€testimony€of€Mr.€Bates's€expert€witness,€Dr.€Frank€Opelka.€€Mr.€Bates€arguesÐ ”ä Ðthat€the€Trial€Court€erred€in€its€exclusion€of€Dr.€Opelka's€testimony€on€the€basis€that€he€is€notÐ €Ð Ðlicensed€to€practice€medicine€in€Tennessee€or€in€a€contiguous€bordering€state.€€Mr.€Bates€argues€thatÐ l¼ Ðthe€testimony€of€Dr.€Opelka€should€have€been€admitted€to€prove€causation€so€that€the€jury€couldÐ X ¨ Ðunderstand€the€actual€risks€of€a€lateral€internal€sphincterotomy€by€showing€that€what€could€happenÐ D!” Ðdid€happen.Ð 0"€  ÐÌà  àThe€standard€of€review€with€respect€to€the€admission€of€expert€testimony€was€stated€in€theÐ $X" Ðrecent€case€of€òòState€v.€Coleyóó,€32€S.W.3d€831,€(Tenn.€2000)€at€page€833€as€follows:Ð ô$D # ÐÌÒ€°ÒÒ€°ÒDeterminations€of€the€admissibility€of€expert€testimony€are€made€within€the€soundÐ Ì&"% Ðdiscretion€of€the€trial€court.€€òòState€v.€Ballardóó,€855€S.W.2d€557,€562€(Tenn.€1993).€Ð ¸'#& ÐThe€standard€of€review€on€appeal€is€whether€the€trial€court€abused€its€discretionÐ ¤(ô#' Ðin€excluding€the€expert€testimony.€€The€abuse€of€discretion€standard€contemplatesÐ )à$( Ðthat€before€reversal€the€record€must€show€that€a€judge€"applies€an€incorrect€legalÐ |*Ì%) Ðstandard,€or€reached€a€decision€which€is€against€logic€or€reasoning€that€caused€anÐ h+¸&* Ðinjustice€to€the€party€complaining."€€òòState€v.€Shirleyóó,€6€S.W.3d€243,€247€(Tenn.Ð ° Ð1999);€€òòState€v.€Shuckóó,€953€S.W.2d€662,€669€(Tenn.€1997).Ð œì ÐÒ°€ÒÒ°€Òòò€óó€€òò€óó€€Ð ˆØ ÐÌà  àAs€we€stated€above,€the€jury€did€not€reach€the€issue€of€whether€the€lateral€internalÐ `° Ðsphincterotomy€was€the€cause€of€Mr.€Bates's€incontinence.€It€is,€therefore,€not€appropriate€that€weÐ L œ Ðaddress€questions€presented€regarding€the€propriety€of€excluding€testimony€to€the€extent€that€suchÐ 8 ˆ Ðtestimony€was€offered€to€prove€this€matter€of€causation.Ð $ t ÐÌà  àWe€agree€that€expert€testimony€like€that€of€Dr.€Opelka€is€unnecessary€to€sustain€a€cause€ofÐ ü L  Ðaction€for€medical€battery€because€whether€the€patient€was€aware€that€the€doctor€was€going€toÐ è 8  Ðperform€the€procedure€in€question€and€whether€the€patient€consented€to€such€procedure€are€withinÐ Ô$  Ðthe€common€knowledge€of€a€lay€witness.€€See€òòBlanchard€v.€Kellumóó,€975€S.W.2d€522€(Tenn.€1998).€Ð À  ÐHowever,€Mr.€Bates€urges€that€Dr.€Opelka€'s€testimony€should€have€been€admitted€so€that€the€juryÐ ¬ü  Ðcould€understand€the€risk€involved€in€the€surgery€performed.€€Evidence€regarding€degree€of€risk€isÐ ˜è  Ðnot€relevant€to€the€issue€of€medical€battery€but€rather€to€the€standard€of€care€with€respect€to€the€issueÐ „Ô  Ðof€informed€consent€which€requires€a€determination€of€the€risks€that€the€medical€procedure€entailsÐ pÀ Ðand€whether€the€patient€was€advised€of€those€risks.€€T.C.A.€29„26„115(b)€mandates€that€an€expertÐ \¬ Ðwitness€testifying€as€to€the€standard€of€care€in€a€medical€malpractice€action€be€licensed€to€practiceÐ H˜ Ðmedicine€in€Tennessee€or€in€a€contiguous€bordering€state.€€There€is€nothing€in€the€record€to€show€thatÐ 4„ ÐDr.€Opelka€was€licensed€in€either€Tennessee€or€in€a€state€bordering€Tennessee€and€the€exclusion€ofÐ  p Ðhis€testimony€was,€therefore,€appropriate.€Mr.€Bates's€assertion€that€the€Trail€Court€should€haveÐ  \ Ðwaived€€the€contiguous€state€requirement€is€without€merit.€€A€trial€judge€has€wide€discretion€in€theÐ øH Ðmatter€of€the€qualification€of€an€expert€witness.€€See€òòOtis€v.€Cambridge€Mut.€Fire€Ins.€Co.óó,€850€S.W.Ð ä4 Ð2d€439€(Tenn.€1992).€€We€find€nothing€in€the€record€to€indicate€that€the€Trial€Court€abused€itsÐ Ð  Ðdiscretion€by€refusing€Mr.€Bates's€request€for€a€waiver€of€the€rule.Ð ¼  ÐÌà  àThe€seventh€issue€presented€for€our€review€questions€whether€the€Trial€Court€erred€when€itÐ ”ä Ðallowed€cross„examination€of€Mr.€Bates's€expert€witness,€Dr.€Clifford€Black,€with€respect€to€aÐ €Ð Ðmedical€malpractice€lawsuit€pending€against€him€and€with€respect€to€whether€he€had€ever€violatedÐ l¼ Ðthe€standard€of€care€in€his€treatment€of€a€patient.Ð X ¨ ÐÌà  àMr.€Bates€argues€on€appeal€that€cross„examination€of€Dr.€Black€regarding€the€medicalÐ 0"€  Ðmalpractice€case€pending€against€him€"injected€a€completely€collateral,€confusing€and€prejudicialÐ #l! Ðelement€into€the€case€in€violation€of€Rules€401,€403€and€608(b)€and€prompted€a€mini„trial."€€Mr.Ð $X" ÐBates€further€contends€that€the€trial€judge€was€required€to€conduct€a€jury„out€hearing€under€RuleÐ ô$D # Ð608(b)€and€"impermissibly€allowed€such€hearsay."€€Mr.€Bates€also€contends€that€the€cross„Ð à%0!$ Ðexamination€of€Dr.€Black€should€have€been€disallowed€based€upon€the€doctrine€of€equitable€estoppelÐ Ì&"% Ðand/or€judicial€estoppel.Ð ¸'#& ÐÌà  àThe€trial€record€shows€that€counsel€for€Mr.€Bates€objected€to€cross„examination€regardingÐ )à$( Ðthe€malpractice€action€pending€€against€Dr.€Black€as€follows:Ð |*Ì%) ÐÐ h+¸&* ÐÒ€°ÒÒ€°ÒQ:€Now,€Dr.€Black,€you€are€currently€involved€in€a€lawsuit€in€which€you€are€aÐ ° Ðdefendant?Ð œì ÐÌA:€That's€correct.Ð tÄ ÐÌMR.€DAVID€SMITH:€Your€Honor,€I€object€to€this€as€collateral€and€don't€see€thatÐ L œ Ðit€has€any€place€„„€I€mean,€I€just€„„€I€think€it's€unduly€time„consuming€andÐ 8 ˆ Ðirrelevant,€the€fact€that€he€has€been€sued.€I€don't€€think€there€has€been€any€resultÐ $ t Ðin€the€lawsuit€and,€you€know,€I€don't€think€„„€I€think€it€is€just€prejudicial.Ð  ` ÐÒ°€ÒÒ°€ÒÌà  àNowhere€in€the€objection€at€trial€is€it€asserted€that€allowance€of€cross„examination€of€Dr.Ð è 8  ÐBlack€regarding€the€malpractice€case€would€result€in€confusion,€would€prompt€a€mini„trial€or€wouldÐ Ô$  Ðresult€in€admission€of€hearsay€evidence.€€As€previously€stated,€this€Court€will€not€consider€groundsÐ À  Ðfor€objection€raised€for€the€first€time€on€appeal.€€See€T.R.E.€Rule€103(a)(1)€and€òòAdamsóó€òòv.€Manisóó,859Ð ¬ü  ÐS.W.2d€323€(Tenn.€Ct.€App.€1993).Ð ˜è  Ðà  àSimilarly,€the€trial€record€shows€the€following€objection€to€the€cross„examination€of€Dr.Ð „Ô  ÐBlack€as€to€whether€he€had€ever€violated€the€standard€of€care€with€respect€to€a€patient:Ð pÀ ÐÌÒ€°ÒÒ€°ÒYour€Honor,€I€object.€That's€„„€it's€not€inconsistent€and€it's€hearsay.Ð H˜ ÐÌÒ°€ÒÒ°€Òà  àCounsel€did€not€raise€prejudice€as€a€ground€for€this€objection€at€trial€and,€therefore,€we€willÐ  p Ðnot€consider€such€as€a€ground€for€objection€in€this€appeal.Ð  \ ÐÌà  àThe€cross„examination€complained€of€by€Mr.€Bates€with€respect€to€the€pending€medicalÐ ä4 Ðmalpractice€action€against€Dr.€Black€elicited€testimony€from€Dr.€Black€regarding€his€own€treatmentÐ Ð  Ðof€a€patient€who€had€presented€various€symptoms€consisting€of€fever,€night€sweats,€weight€loss€andÐ ¼  Ðmigratory€thrombophlebitis,€a€condition€involving€blood€clots€in€various€areas€of€the€body.€€Dr.Ð ¨ø ÐBlack€testified€that€he€suggested€to€his€patient€that€he€would€like€to€perform€a€diagnostic€procedureÐ ”ä Ðwhich€would€allow€him€to€determine€the€cause€of€these€symptoms.€€In€the€course€of€performing€thisÐ €Ð Ðprocedure,€Dr.€Black€detected€an€abnormality€which€prompted€him€to€make€an€incision€to€open€theÐ l¼ Ðpatient's€abdomen€and€remove€what€was€subsequently€identified€to€be€a€malformed,€ectopic€kidney.Ð X ¨ ÐQuestions€directed€to€Dr.€Black€on€cross„examination€inquired€whether€he€had€consent€to€removeÐ D!” Ðthe€kidney€even€though€the€patient€had€not€specifically€authorized€him€to€do€so.€€Dr.€Black€hadÐ 0"€  Ðpreviously€testified€under€direct€examination€that€Dr.€Metcalf€had€violated€the€standard€of€careÐ #l! Ðbecause€he€did€not€have€consent€to€perform€a€lateral€internal€sphincterotomy.€€Dr.€Black€attested€thatÐ $X" Ðhis€opinion€in€this€regard€was€based,€in€part,€upon€the€fact€that€Dr.€Metcalf€had€not€discussedÐ ô$D # Ðperforming€the€lateral€internal€sphincterotomy€with€Mr.€Bates€and€also€upon€the€fact€that€the€consentÐ à%0!$ Ðform€did€not€specify€that€Dr.€Metcalf€would€be€performing€a€lateral€internal€sphincterotomy.€€It€isÐ Ì&"% Ðour€finding€that€cross„examination€of€Dr.€Black€regarding€the€collateral€matter€of€€the€medicalÐ ¸'#& Ðmalpractice€lawsuit€pending€against€him€was€properly€allowed€for€the€purpose€of€impeachment€byÐ ¤(ô#' Ðcontradiction.€€See€òòState€v.€Mooney,óó€an€unpublished€opinion€of€the€Tennessee€€Court€of€CriminalÐ )à$( ÐAppeals€filed€in€Knoxville€on€April€18,€1996.€€Dr.€Metcalf€was€entitled€to€cross„€examine€Dr.€BlackÐ |*Ì%) Ðto€show€that€it€was€inconsistent€and€contradictory€for€him€to€maintain€that€Dr.€Metcalf€had€violatedÐ h+¸&* Ðthe€standard€of€care€by€performing€surgery€that€was€not€specifically€authorized€while€he,€Dr.€BlackÐ ° Ðhad€not€violated€the€standard€of€care€for€ostensibly€doing€the€same€thing.Ð œì ÐÌà  àMr.€Bates's€assertion€that€the€Trial€Court€violated€T.R.E.€Rule€608€is€inapposite.€€Rule€608Ð tÄ Ðis€not€applicable€to€Dr.€Blacks's€testimony€regarding€the€medical€malpractice€lawsuit€because€RuleÐ `° Ð608€relates€only€to€evidence€referring€to€character€for€truthfulness€or€untruthfulness.€€Dr.€Black'sÐ L œ Ðtestimony€does€not€relate€to€Dr.€Black's€character€for€truthfulness€or€untruthfulness€but€rather€to€theÐ 8 ˆ Ðconsistency€of€his€definition€of€€the€standard€of€care.Ð $ t ÐÌà  àMr.€Bates's€contention€that€allowance€of€the€cross„examination€of€Dr.€Black€with€respect€toÐ ü L  Ðthe€medical€malpractice€case€pending€against€him€violated€T.R.E.€Rules€401€and€403€is€withoutÐ è 8  Ðmerit.€€There€is€no€question€that€the€cross„examination€testimony€of€Dr.€Black€was€relevant€underÐ Ô$  ÐRule€401€because€it€aided€the€jury€in€assessing€the€credibility€of€his€prior€direct€testimony€regardingÐ À  Ðconsent€and€the€standard€of€care€to€which€a€doctor€in€this€community€must€conform.€As€to€theÐ ¬ü  Ðassertion€that€allowance€of€Dr.€Black's€testimony€constituted€prejudicial€error,€we€note€that€underÐ ˜è  ÐTennessee€law€a€party€seeking€to€exclude€evidence€on€the€ground€of€prejudice€bears€a€significantÐ „Ô  Ðburden€of€proof€that€the€danger€of€unfair€prejudice€substantially€outweighs€the€probative€value€ofÐ pÀ Ðsuch€evidence.€€See€òòWhite€v.€Vanderbilt€Universityóó,€21€S.W.3d€215€(Tenn.€Ct.€App.€1999)€€Mr.€BatesÐ \¬ Ðpresents€no€argument€as€to€how€the€probative€value€of€Dr.€Black's€testimony€is€substantiallyÐ H˜ Ðoutweighed€by€the€danger€of€prejudice.Ð 4„ ÐÌà  à€Mr.€Bates's€argument€that€the€Trial€Court€should€have€disallowed€cross„examination€of€Dr.Ð  \ ÐBlack€pursuant€to€the€doctrine€of€equitable€estoppel€and/or€judicial€estoppel€is€based€upon€a€pleadingÐ øH Ðfiled€in€òòDawna€Rae€Braton€and€Ryan€Charles€Bratton€v.€Afam€Ikejiani,€M.D.,€óóan€unrelated€caseÐ ä4 Ðbefore€the€Eighth€Circuit€Court€for€Davidson€County.€€Mr.€Bates's€attorney€attests€that€StateÐ Ð  ÐVolunteer€Mutual€Insurance€Company,€the€liability€insuror€insuring€the€defendant€doctor€in€theÐ ¼  ÐòòBratton€óócase,€also€insures€Dr.€Metcalf€in€the€case€òòsub€judice.óó€€Mr.€Bates€submits€a€copy€of€a€motion€Ð ¨ø Ðòòin€limineóó€filed€by€the€defendant€in€òòBratton€óówhich€moves€to€prohibit€cross„examination€of€expertÐ ”ä Ðwitnesses€for€the€defense€about€previous€medical€malpractice€cases€against€those€witnesses.€Mr.Ð €Ð ÐBates's€attorney€attests€by€affidavit€that€this€motion€was€agreed€to€by€the€parties€in€òòBrattonóó.€Mr.€BatesÐ l¼ Ðargues€that€State€Volunteer€Mutual€Insurance€Company€is€the€potential€real€party€in€interest€in€bothÐ X ¨ ÐòòBrattonóó€and€the€case€before€us€and€contends€that€the€positions€taken€in€the€two€cases€are€inconsistentÐ D!” Ðwith€respect€to€the€same€issue€of€cross„examination€.€Mr.€Bates€argues€that€equitable€and/or€judicialÐ 0"€  Ðestoppel€is€"designed€to€protect€the€courts€from€entertaining€inconsistent€positions€of€parties€in€theÐ #l! Ðcourts"€and,€on€that€basis,€the€cross„examination€of€Dr.€Black€should€have€been€disallowed.€€WeÐ $X" Ðdisagree.Ð ô$D # ÐÌà  àWe€find€that€Mr.€Bates's€argument€is€without€merit,€if€for€no€other€reason€than€that€theÐ Ì&"% Ðmotion€òòin€limineóó€in€òòBratton€óówas€not€filed€until€April€2,€2001,€whereas€Dr.€Black€was€cross„examinedÐ ¸'#& Ðregarding€the€malpractice€case€against€him€on€July€12,€2000.€At€the€time€of€Dr.€Black's€cross„Ð ¤(ô#' Ðexamination€the€òòBratton€óómotion€òòin€limineóó€was€not€of€record€and,€therefore,€could€not€have€supportedÐ )à$( Ðan€objection€to€allowance€of€Dr.€Black's€cross„examination.€€€€€€€€€€€€€Ð |*Ì%) ÐÐ h+¸&* Ðà  àThe€final€question€we€must€address€in€this€appeal€is€whether€the€Trial€Court€erred€in€itsÐ ° Ðinstructions€to€the€jury€on€the€issue€of€medical€battery.€€Mr.€Bates€asserts€that€the€Trial€CourtÐ œì Ðinstructed€the€jury€that€in€order€to€find€a€medical€battery€it€must€decide€whether,€under€the€same€orÐ ˆØ Ðsimilar€circumstances,€a€reasonable€person€would€have€consented€to€a€lateral€internalÐ tÄ Ðsphincterotomy.€€€Mr.€Bates€correctly€maintains€that,€while€an€objective€standard€is€appropriate€inÐ `° Ðdetermining€whether€there€was€informed€consent,€it€is€not€appropriate€in€determining€whether€thereÐ L œ Ðwas€a€medical€battery.€€The€controlling€factual€issues€in€a€claim€for€medical€battery€are€whether€theÐ 8 ˆ Ðpatient€knew€the€surgery€was€going€to€be€performed€and€whether€the€patient€authorized€the€physicianÐ $ t Ðto€perform€such€surgery.€€In€a€claim€for€medical€battery€the€focus€is€not€on€what€a€reasonable€manÐ  ` Ðwould€have€done€but€on€the€patient's€knowledge€and€awareness.€€See€òòChurch€v.€Peralesóó,€39€S.W.3dÐ ü L  Ð149€(Tenn.€Ct.€App.€2000).Ð è 8  ÐÌà  àIn€support€of€his€argument€that€the€Trial€Court€erred€in€its€instructions€to€the€jury€€Mr.€BatesÐ À  Ðquotes€two€segments€of€the€trial€record.€€The€first€of€these€is€set€forth€by€Mr.€Bates€as€follows:Ð ¬ü  ÐÌÒ€°ÒÒ€°ÒIf€a€medical€battery€is€committed,€then€Dr.€Metcalf€is€responsible€for€the€damagesÐ „Ô  Ðproven€to€have€been€suffered.€€These€damages€and€issues€must€be€proven€by€aÐ pÀ Ðpreponderance€of€the€evidence.€€If€the€jury€should€find€from€the€proof€that€theÐ \¬ ÐDefendant€performed€a€lateral€internal€sphincterotomy€without€the€consent€of€theÐ H˜ Ðplaintiff,€then€in€that€event€Defendant€is€responsible€for€any€injury€caused€by€theÐ 4„ Ðtreatment€of€the€Plaintiff.€€You€must€decide,€based€upon€the€evidence€provided,Ð  p Ðwhether€a€reasonable€person€in€the€patient's€position€would€have€consented€to€theÐ  \ Ðtreatment€in€question€if€adequately€conformed€of€all€significant€perils,€that€is,Ð øH Ðwhether€a€reasonable€person€like€Mr.€Bates€or€in€Mr.€Bates€position,€would€haveÐ ä4 Ðconsented€to€the€lateral€internal€sphincterotomy€had€the€risks€of€information€beenÐ Ð  Ðdiscussed€with€him.€€A€medical€battery€occurs€when€a€physician€performs€anÐ ¼  Ðauthorized׃ ×Ý ƒ#ÃÝòòÚ  Ú2Ú  ÚóóÝ  Ý×  ×€procedure.Ð ¨ø ÐÒ°€ÒÒ°€ÒÌà  àThe€second€segment€of€the€trial€record€pertaining€to€the€Trial€Court's€instructions€to€the€juryÐ €Ð Ðis€set€forth€by€Mr.€Bates€as€follows:Ð l¼ ÐÌÒ€°ÒÒ€°ÒIssues€of€implied€consent.€€Members€of€the€jury,€the€standard€to€be€applied€in€theÐ D!” Ðconsent€malpractice€case€is€an€objective€standard.€€An€objective€standard€is€basedÐ 0"€  Ðupon€the€facts€presented€to€you,€the€jury€and€known€to€the€Plaintiff,€Mr.€Bates,€atÐ #l! Ðthe€time€that€the€consent€form€was€signed.€€You€may€consider€all€of€the€facts,Ð $X" Ðincluding€the€Plaintiff's€education,€state€of€health,€both€mental€and€physical,€age,Ð ô$D # Ðand€experience€at€the€time€of€signing€the€consent€form.€€A€Plaintiff's€hindsight€isÐ à%0!$ Ðnot€the€test.€€Mr.€Bates€is€held€to€a€standard€of€a€reasonable€prudent€person€andÐ Ì&"% Ðwhat€that€person€would€have€done€under€the€same€or€similar€circumstances€asÐ ¸'#& Ðdeveloped€at€this€trial.€€The€plaintiff's€testimony€at€trial€is€not€controlling.€€YouÐ ° Ðmay€consider€the€consent€form,€the€language€used€in€the€form,€conversation,€andÐ œì Ðall€other€facts€presented€to€the€plaintiff€at€the€time€of€signing€the€consent€form"€Ð ˆØ Ѐ€€€€€€€€Ð tÄ ÐÒ°€ÒÒ°€Òà  àOur€review€of€the€trial€record€reveals€that€Mr.€Bates€has€reformatted€€the€foregoing€segments,Ð `° Ðby€eliminating€the€paragraph€indentations€as€they€appear€in€the€trial€transcript.€€The€first€of€the€aboveÐ L œ Ðquoted€segments€is€actually€set€forth€in€the€trial€transcript€as€follows:Ð 8 ˆ ÐÌÒ€°ÒÒ€°Òà Ø àIf€a€medical€battery€is€committed,€then€Dr.€Metcalf€is€responsible€for€theÐ  ` Ðdamages€proven€to€have€been€suffered.€€These€damages€issues€must€be€proven€byÐ ü L  Ða€preponderance€of€the€evidence.Ð è 8  ÐÌà Ø àIf€the€jury€should€find€from€the€proof€that€the€defendant€performed€theÐ À  Ðlateral€internal€anal€sphincterotomy€without€the€consent€of€the€plaintiff,€then€inÐ ¬ü  Ðthat€event€the€defendant€is€responsible€for€any€injury€caused€by€the€treatment€ofÐ ˜è  Ðthe€plaintiff.Ð „Ô  ÐÌà Ø àYou€must€decide,€based€upon€the€evidence€provided,€whether€a€reasonableÐ \¬ Ðperson€in€a€patient's€position€would€have€consented€to€the€treatment€in€questionÐ H˜ Ðif€adequately€informed€of€all€significant€perils,€that€is,€whether€a€reasonableÐ 4„ Ðperson€like€Mr.€Bates€or€in€Mr.€Bates'€position€would€have€consented€to€have€theÐ  p Ðlateral€sphincterotomy€had€the€risks€of€information€been€discussed€with€him.Ð  \ ÐÌà Ø àA€medical€battery€occurs€when€a€physician€performs€an€unauthorizedÐ ä4 Ðprocedure.€€A€medical€battery€may€occur€when€a€physician€performs€a€procedureÐ Ð  Ðthat€the€patient€was€unaware€that€the€doctor€was€going€to€perform.Ð ¼  ÐÒ°€ÒÒ°€ÒÌà  àThe€second€segment€from€the€Trial€Court's€instructions€to€the€jury€referenced€by€Mr.€BatesÐ ”ä Ðactually€appeared€in€the€trial€transcript€as€follows:Ð €Ð ÐÌÒ€°ÒÒ€°Òà Ø àIssues€of€implied€consent.Ð X ¨ ÐMembers€of€the€jury,€the€standard€to€be€applied€in€the€consent€malpractice€caseÐ D!” Ðis€an€objective€standard.€€An€objective€standard€is€based€upon€the€facts€presented€Ð 0"€  Ðto€you€the€jury€and€known€to€the€plaintiff,€Mr.€Bates,€at€the€time€that€consent€formÐ #l! Ðwas€signed.Ð $X" ÐÌà Ø àYou€may€consider€all€of€the€facts,€including€the€plaintiff's€education,€stateÐ à%0!$ Ðof€health,€both€mental€and€physical,€age,€and€experience€at€the€time€of€signing€theÐ Ì&"% Ðconsent€form.Ð ¸'#& Ðà Ø àA€plaintiff's€hindsight€is€not€the€test.€€Mr.€Bates€is€held€to€a€standard€of€aÐ ¤(ô#' Ðreasonable€prudent€person€and€what€that€person€would€have€done€under€the€sameÐ )à$( Ðor€similar€circumstances€as€developed€at€this€trial.Ð |*Ì%) ÐÔ_ÔÐ h+¸&* Ðà Ø àThe€plaintiff's€testimony€at€trial€may€be€considered€but€the€testimony€is€notÐ ° Ðcontrolling.€€You€the€jury€may€consider€the€consent€form,€the€language€used€in€theÐ œì Ðform,€conversation,€and€all€other€facts€presented€to€the€plaintiff€at€the€time€ofÐ ˆØ Ðsigning€the€consent€form.Ð tÄ ÐÒ°€ÒÒ°€ÒÌà  àMr.€Bates€maintains€that€it€was€appropriate€to€omit€the€paragraph€format€in€setting€forth€theseÐ L œ Ðsegments€of€the€trial€transcript€because€"the€jury€was€read€the€charge€and€the€clear€flow€of€theÐ 8 ˆ Ðlanguage€unmistakably€applied€an€objective€standard€to€the€medical€battery€issue."€€We€disagree€andÐ $ t Ðfind€that€such€reformatting€introduces€an€element€of€confusion€into€the€Trial€Court's€instructions€thatÐ  ` Ðis€not€justified€by€the€record.€€€Mr.€Bates€has€presented€no€proof€that€the€trial€transcript€is€not€a€trueÐ ü L  Ðaccount€of€the€trial€proceedings€and€the€paragraph€format€is€part€of€that€account.€€We€assume€thatÐ è 8  Ðthe€division€of€the€Trial€Court's€instructions€into€paragraphs€was€prompted€by€the€pauses€andÐ Ô$  Ðinflections€which€ordinarily€evince€the€presence€of€paragraphs€in€oral€communication.€Each€of€theÐ À  Ðparagraphs€quoted€expresses€a€separate€thought€and€we€find€that€the€expression€of€several€paragraphsÐ ¬ü  Ðas€one€paragraph€implies€an€apparent€confusion€in€the€instructions€which€is€not€supported€by€theÐ ˜è  Ðrecord.Ð „Ô  ÐÌà  àWe€recognize€that,€although€the€second€of€the€above€quoted€segments€begins€with€the€topicÐ \¬ Ðstatement€€'Issues€of€implied€consent',€the€first€paragraph€thereafter€describes€an€objective€standard€Ð H˜ Ðwhich€is€properly€applied€in€determining€whether€there€was€òòinformedóó€consent€and€not€òòimpliedÐ 4„ Ðóóconsent.€However,€elsewhere€in€its€instructions€the€Trial€Court€clearly€instructs€the€jury€that€theÐ  p Ðreasonable€person/objective€standard€is€the€applicable€standard€with€regard€to€the€issue€of€òòinformedÐ  \ Ðóóconsent:Ð øH ÐÌÒ€°ÒÒ€°Òà Ø àIn€an€informed€consent€case,€the€issues€to€be€determined€are,€one,€what€isÐ Ð  Ðthe€appropriate€information€which€should€be€supplied€to€a€patient€concerningÐ ¼  Ðwhether€to€consent€to€the€procedure€and,€two,€was€the€information€supplied€to€theÐ ¨ø Ðpatient€and,€three,€if€the€information€had€been€supplied,€would€a€reasonable€personÐ ”ä Ðin€plaintiff's€position€have€made€a€different€treatment€decision?€€€€Ð €Ð ÐÒ°€ÒÒ°€ÒÌà  àWe€find€that€the€Trial€Court€adequately€clarified€the€ambiguity€of€its€instructions€as€to€theÐ X ¨ Ðapplicable€standard€for€determining€whether€there€was€informed€consent€in€this€case€and€we€furtherÐ D!” Ðfind€that€any€error€in€the€instructions€in€that€regard€was,€thereby,€rendered€harmless.€Ð 0"€  ÐÌà  àFor€the€foregoing€reasons€the€judgment€of€the€Trial€Court€is€affirmed€and€the€cause€isÐ $X" Ðremanded€for€collection€of€costs€below.€€Costs€of€appeal€are€adjudged€against€Mr.€Bates€and€hisÐ ô$D # Ðsurety.Ð à%0!$ Ðà  à€€€€€Ð Ì&"% Ðà0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà h à€€€€€€€€€€€€€€à  à€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ð ¸'#& Ѐ€€€€Ð ¤(ô#' Ð_________________________________________Ð)à$(À(#À(# Ѐ€€€€€€à0  àà0` (#(#à€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€HOUSTON€M.€Ô_ÔGODDARDÔ_Ô,€PRESIDING€JUDGEà @’" à€€€Ð|*Ì%)` (#` (# Ѐ€€Ð h+¸&* ÐÔ_Ô€€€€€€€€€€€€€€€