ÿWPC …# VUFa %§ 0@­4í w@ 0„P 0DÔ   0J& 0Tp 0^Ä 0h" 0rŠ 0|ü 0†x 0þ 1uŽ 0d BgU6„B)ºDCã AM&U*s, D3ÉÔüv~Ð 0@NvÓŽ AOaư 0Dv D/º Bé˜HP LaserJet 4SiHPPCL5MS,ü,,,,,ü0nLdÒ<¾½Q 9Z ‹.Courier New RegularX(ù$¡¡Ó  ÓÓ  Ó ƒØ"x¡Ó 3|xJ 678D9E:+;<E=>?Ó€(4(3DX$¤¤Ý ƒù!ÝÓ  ÓÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  Úóó(#Ã$òòÚ  Ú0Ú  ÚóóH2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)P ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ d< Œ 9p`(Courier New% Line 7 d%%%%7Border 1dd€-&Cþÿ << Gÿÿ< Œ 9p`(Arial "Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€$ÔÓ  ÓÓ  ÓÝ  ÝÔ€(ÔÔ€(ÔÓ  ÓÔ YYY ÔFILEDÔ€(XÔÌÌò òJuly€2,€1997ÌÌCecil€Crowson,€Jr.ÌÔ€(ôÔAppellate€Court€Clerkó ó'ÿÿdxd ÊÝ ƒ!ÝÑ#€d#ÑÔ€$ÔÓ  ÓÓ  ÓÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝòòMs.€Davis€settled€the€claims€against€two€of€the€nurses,€Betty€SampsonÏand€Melinda›€œLatham›,€therefore,€this€appeal€concerns€the€remaining€five€nurses,ÏJean€Angelo,€Brenda€Rutherford,€Rhonda€Martin,€œVickie›€œKlinnert›,€and€SharonÏUnderwood€and€their€employer,€Harriman€City€Hospital.óóÌPtPtHHLÿôÿô XG(üHHLd'h("ÿÿ$££Ò  ÒÒ  ÒStyl{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 ÓßßßßßßßßßßßßßßßßßßÑGenevaÑÑ ÑÒ  h HD: Geneva ÒÒ  h HD: Geneva Ò€-‚ƒCþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5($$””ò òÚ  Ú1Ú  Úó ó„„'÷ÿ dxdüÿP PdÝ ƒ!ÝÔ . ÔÔ€$ÔÓ  ÓÓ  ÓÝ  ÝÑ ¸ ÑÑ Ü ÑÑ\R AØ'\ÑÑ  ÑÑ  ÑÑ\R AØ'\ÑÑ7€9ðXXdÖXXdÖ7ÑÙ€€ÙßR€')&A1-j|` Å `€€@ÿRß›Þ ÞÌà@ àIN€THE€COURT€OF€APPEALSÌÌÌÌÌÌÌÌœREBA›€V.€DAVIS€and€œTYLER›€WAYNE€€€)à àROANE€CIRCUITÌDAVIS€by€next€friend,€œREBA›€V.€€€)à àC.A.€NO.€03A01„9701„CV„00016ÌDAVIS,€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€Plaintiffs„Appellants€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ìvs.€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)à àHON.€RUSSELL€E.€SIMMONS,€JR.Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)à àJUDGEÌ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)ÌHARRIMAN€CITY€HOSPITAL,€THE€€€€€)ÌCITY€OF€HARRIMAN,€JEAN€ANGELO,€€)ÌBRENDA€RUTHERFORD,€BETTY€€€€€€€€)ÌSAMPSON,€RHONDA€MARTIN,€œMELINDA›€)à àAFFIRMED€AND€REMANDEDÌœLATHAM›,€SHARON€UNDERWOOD€and€€€€)ÌœVICKIE›€œKLINNERT›,€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€Defendants„Appellees€€)ÌÌÌÌÌDAVID€C.€LEE,€Lee,€Lee€&€Lee,€Knoxville,€for€Appellants.ÌÌÌHAROLD€D.€œBALCOM›,€JR.,€Kingston,€for€Appellee,€City€of€HarrimanÏHospital.ÌÌÌGERALD€œLARGEN›,€Kingston,€for€Appellees,€Jean€Angelo,€Brenda€Ruth…erford,€Rhonda€Martin,€Sharon€Underwood,€and€œVickie›€œKlinnert›.Ì̛̜ÌÓÓà@ àòòO€P€I€N€I€O€NóóÌÌà€ àMcMurray,€J.ÌÌà àThis€is€a€medical€malpractice€case.€€Plaintiff,€Reba€V.€DavisÏbrought€suit,€individually€and€on€behalf€of€her€infant€son,€Tyler,Ïagainst€Dr.€Elbert€Cunningham,€Harriman€City€Hospital€and€the€CityÏof€Harriman€for€injuries€sustained€by€Tyler€shortly€after€hisÏbirth.€€After€reaching€a€settlement€with€Dr.€Cunningham,€theÏphysician€who€delivered€Tyler,€Ms.€Davis€amended€her€complaint€toÏinclude€allegations€of€negligence€against€the€attendant€HarrimanÏCity€Hospital€nurses.œ× ƒ+ ××  ×›ÌÌà àThe€defendants€moved€for€summary€judgment.€€The€court€grantedÏsummary€judgment€on€the€ground€that€the€plaintiff€had€failed€toÏpresent€proof,€in€contravention€of€that€offered€by€the€defendants,Ïthat€any€alleged€œnegligence€on€the€part€of€the€defendants,€was€aÏproximate€cause€of€Tyler's€injuries.€€Ms.€Davis€has€appealed€andÏchallenges€the€propriety€of€the€summary€judgment.€We€affirm€theÏjudgment€of€the€trial€court.Ìà àÌà àThe€only€issue€presented,€as€stated€in€the€plaintiff's€brief,Ïis€"whether€material€evidence€exist[s]€in€the€record€sufficient€toÏoverturn€the€Trial€Court's€granting€of€summary€judgment€as€to€theÏfive€nurses,€and€consequently€their€employer?"ÌÌà àOur€standard€of€review€in€considering€the€propriety€of€summa…ry€judgment€is€as€follows:ÌÓÓÌÒ  ÒÒ ° ÒÒ  ÒÒ  Òà àThe€standards€governing€an€appellate€court's€reviewÏof€a€trial€court's€action€on€a€motion€for€summary€judg…ment€are€well€settled.€€Since€our€inquiry€involvesÏpurely€a€question€of€law,€no€presumption€of€correctnessÏattaches€to€the€trial€court's€judgment,€and€our€task€isÏconfined€to€reviewing€the€record€to€determine€whetherÏthe€requirements€of€Tenn.R.Civ.P.€56€have€been€met.ÏòòCowden›€v.€Sovran€Bank/Central€Southóó,€816€S.W.2d€741,€744Ï(Tenn.€1991).€œTenn.R.Civ.P.›€56.03€provides€that€summaryÍjudgment€is€only€appropriate€where:€(1)€there€is€noÏgenuine€issue€with€regard€to€the€material€facts€relevantÏto€the€claim€or€defense€contained€in€the€motion,€òòByrd€v.ÏHallóó,€847€S.W.2d€208,€210€(Tenn.€1993);€and€(2)€theÏmoving€party€is€entitled€to€a€judgment€as€a€matter€ofÏlaw€on€the€undisputed€facts.€€òòAnderson€v.€StandardÏRegister€Coóó.,857€S.W.2d€555,€559€(Tenn.€1993).€€TheÏmoving€party€has€the€burden€of€proving€that€its€motionÏsatisfies€these€requirements.€€òòDownen€v.€Allstate€Ins.ÏCo.óó,€811€S.W.2d€523,€524€œ(Tenn.€1991).›ÌÌà àThe€standards€governing€the€assessment€of€evidenceÏin€the€summary€judgment€context€are€also€well€estab…lished.€€Courts€must€view€the€evidence€in€the€light€mostÏfavorable€to€the€nonmoving€party€and€must€also€draw€allÏreasonable€inferences€in€the€nonmoving€party's€favor.ÏòòByrdóó,€847€S.W.2d€at€210„11.€€Courts€should€grant€aÏsummary€judgment€only€when€both€the€facts€and€the€con…clusions€to€be€drawn€from€the€facts€permit€a€reasonableÏperson€to€reach€only€one€conclusion.€€òòIdóó.ÌÌÒ ° ÒÒ  ÒÒ ° ÒÒ ° ÒòòÓÓCarvell€v.€Bottomsóó,€900€S.W.2d€23,€26€(Tenn.€1995).€€Ìà àÌà àThe€material€facts€are€undisputed.€€Dr.€Cunningham€deliveredÏTyler€by€caesarian€section€on€June€12,€œ1991,›€at€10:39€P.M.€€TylerÏexhibited€a€normal€and€healthy€appearance,€and€vital€œsigns€were›Ïwithin€the€normal€ranges€except€for€relative€tachypnea€(fasterÏbreathing€rate€than€normal).€€Dr.€Cunningham€instructed€the€nursesÏon€duty€to€"follow€closely"€Tyler's€progress.€€Dr.€CunninghamÏreturned€to€check€on€Tyler€at€10:55€and€11:15€P.M.€€Dr.€CunninghamÍtestified€to€the€following€regarding€Tyler's€condition€at€11:15ÏP.M.:ÌÓÓÌÒ  ÒÒ ° ÒÒ  ÒÒ  Òà àWell,€the€respiratory€rate€at€that€time€was€56Ïwhich€is€a€little€high€but€not€terribly€alarming.€ÏTemperature€was€normal€and€heart€rate€was,€I€believe,Ï156.€€So€it€was€just€one€of€these€things,€this€baby€isÏhaving€a€little€bit€of€trouble€getting€started,€theÏlungs€are€not€expanding,€loosening€up€quite€as€rapidlyÏas€we€would€like,€but€still€seemed€to€be€okay.ÌÌÌÒ ° ÒÒ  ÒÒ ° ÒÒ ° ÒÓÓà àThe€record€indicates€that€nothing€eventful€occurred€for€theÏnext€3€hours,€and€that€Tyler€was€generally€"resting€quietly"€withÏeven€respiration.€€At€around€3:45€A.M.,€the€attending€nurses€notedÏthat€respiration€was€about€80€per€minute,€well€above€the€normalÏrate,€and€that€Tyler€was€exhibiting€cyanosis€(bluish€coloration)Ïaround€the€extremities€and€mouth.€€The€nurses€administered€"blows"Ïof€oxygen,€which€entailed€turning€on€an€oxygen€tank€connected€to€aÏcatheter,€and€holding€the€catheter€in€the€general€vicinity€of€theÏinfant's€nose€and€mouth€to€help€him€breathe€more€easily.€€TheÏnurses€also€summoned€Dr.€Cunningham.€€At€3:55€A.M.,€Dr.€CunninghamÏobserved€the€situation€and€instructed€the€nurses€to€"just€watchÏ[the]€infant€closely."€€€€ÌÌà àAt€4:00€A.M.,€the€nurses€administered€more€oxygen.€The€nurs…es'€notes€indicate€that€at€5:30€A.M.,€Tyler€was€cyanotic€in€colorÏand€had€"floppy€arms."€€More€blows€of€oxygen€were€given,€whichÏimproved€his€color.€€The€nurses'€notes€show€that€Dr.€CunninghamÏchecked€on€Tyler's€condition€at€7:00€A.M.,€at€which€time€theÏattending€nurses€informed€him€that€Tyler's€color€had€been€"dusky."€ÏDr.€Cunningham€opined€at€the€time€that€Tyler's€condition€wasÏ"probably€transitional."€€From€approximately€7:20€A.M.,€Tyler'sÏcondition€deteriorated,€œand›€he€began€exhibiting€more€alarmingÏsymptoms€of€respiratory€distress.ÌÌà àDr.€Cunningham€testified€that€by€8:45€A.M.,€"it€became€appar…ent€to€[him]€that€Tyler€œwas›€not€improving"€and€he€made€the€deci…sion€to€transfer€him€to€East€Tennessee€Children's€Hospital.€€TheÏchildren's€hospital€pediatric€team€arrived€around€10:15€A.M.,€andÏtransferred€Tyler€œby›€ambulance€at€12:30€P.M.€€Dr.€Cunningham'sÏdischarge€diagnosis€was:€"Tachypnea€of€newborn€with€progressiveÏdeterioration€of€general€condition,€acidosis€and€shock„like€state,Ïetiology€undetermined.€€Possible€septicemia€or€possible€congenitalÏheart€defect€was€entertained€as€diagnosis€when€it€left."ÌÌà àAs€a€result€of€Tyler's€deteriorating€condition€and€respirato…ry€difficulties,€he€suffered€brain€damage€and€is€seriously€handi…capped.€€Neither€Dr.€Cunningham€nor€subsequent€treating€physiciansÏwere€able€to€definitively€determine€a€cause€or€origin€of€hisÏmedical€condition.€€ÌÌà àAs€noted€above,€after€reaching€settlement€with€Dr.ÏCunningham,€Ms.€Davis€amended€the€complaint€on€Tyler's€behalf€toÏinclude€allegations€of€negligence€by€the€nurses€in€attendance€andÏMs.€Brenda€Rutherford,€the€hospital's€Director€of€Nursing.€€FiveÏof€the€defendants,€Nurses€Jean€Angelo,€Brenda€Rutherford,€RhondaÏMartin,€Vickie€Klinnert,€and€Sharon€Underwood€moved€for€summaryÏjudgment.€€€Ìà àIn€opposition€to€the€motion€for€summary€judgment,€Ms.€DavisÔ% € ÔÏfiled€the€affidavit€of€Ms.€Christine€Busch,€an€œR.N.,›€licensed€inÏVirginia.€œIn›€her€affidavit,€Nurse€Busch€stated€that€the€defendantsÏbreached€the€standard€of€care€required€of€nurses€in€communityÏhospitals€such€as€Harriman€on€several€occasions,€including€"fail[ing]€to€recognize€in€Tyler€Wayne€Davis,€symptoms€of€respiratoryÍdistress€œsyndrome€..."›€€The€trial€court€correctly€noted€that€NurseÏBusch's€affidavit€was€sufficient€to€create€a€genuine€issue€ofÏmaterial€fact€on€the€question€of€the€defendants'€alleged€negli…gence.€€ÌÌà àMs.€Davis'€counsel€stipulated,€however,€that€Nurse€Busch€wasÏnot€qualified€to€give€expert€testimony€on€medical€causation,€andÏthat€she€was€not€being€offered€as€a€causation€witness.€€Ms.€DavisÏpresented€the€deposition€testimony€of€Dr.€Joseph€B.€Philips,€œIII,›Ïfor€proof€on€the€causation€issue.€€The€trial€court€found€theÏœfollowing:›ÌœÒ ° ÒÒ  ÒÌÓÓÒ  ÒÒ  Òà àThe›€Court€finds€that€the€parties€have€not€disputedÏthe€opinion€of€the€plaintiff's€expert€witness,€Dr.ÏJoseph€B.€Philips,€III,€that€the€causation€of€the€plain…tiff's€injury€was€the€failure€to€more€aggressivelyÏintervene€to€diagnose€and€treat€the€plaintiff.€€He€alsoÏindicated€that€the€medical€person€responsible€to€diag…nose€and€institute€treatment€was€Dr.€Cunningham.€Ìà àœÌà àDr.›€Cunningham€in€his€deposition€indicated€that€heÏwas€kept€fully€aware€of€the€condition€of€the€patient€byÏthe€defendant€nurses,€and€that€it€was€his€responsibilityÏto€diagnose€and€institute€appropriate€treatment€whichÏincluded€the€administering€of€oxygen.Ìà àœÌà@ à*€€€€€*€€€€€*ÌÌà àThe€Court€finds€from€the€above€that€any€breach€ofÏthe€standard€of€care€by€the€nurse€defendants€was€not€theÏcause€of€any€personal€injury€to€the€plaintiff€and€thatÏthe€Motion€for€Summary€Judgment€should€be€sustained.€ÌÌÌÌÒ  ÒÒ ° ÒÒ ° ÒÒ ° ÒÓÓà àT.C.A.€ðð€29„26„115€requires€a€claimant€to€prove€that€theÏdefendant's€negligence€was€the€cause€of€his€or€her€injuries.€€ItÏprovides€in€pertinent€part€as€follows:ÌÓÓÌÒ  ÒÒ ° ÒÒ  ÒÒ  Òà à(a)€In€a€malpractice€action,€the€claimant€shallÏhave€the€burden€of€proving€by€evidence€as€provided€byÏsubsection€(b):ÌÌà@ à*€€€€€*€€€€€*ÌÌà à(3)€as€a€proximate€result€of€the€defendant's€negli…gent€act€or€omission,€the€plaintiff€suffered€injuriesÏwhich€would€not€otherwise€have€occurred;ÌÌà@ à*€€€€€*€€€€€*ÌÌÌÒ ° ÒÒ  ÒÒ ° ÒÒ ° ÒÓÓà àFor€summary€judgment€purposes,€once€a€plaintiff€is€faced€withÏa€properly€supported€motion,€he€or€she€must€present€evidence€atÏleast€sufficient€to€raise€a€genuine€issue€of€material€fact€as€toÏwhether€the€defendants'€alleged€negligence€was€the€proximate€causeÏof€her€injuries.€€òòKilpatrick€v.€Bryantóó,€868€S.W.2d€594€(Tenn.Ï1993);€òòWhite€v.€Methodist€Hosp.€Southóó,€844€S.W.2d€642€(Tenn.€App.Ï1992).€€Thus,€as€Ms.€Davis€has€noted€in€her€brief,€"the€questionÍherein€is€whether€Dr.€Philips'€testimony€combined€with€that€ofÏNurse€Busch€establish[es]€causation€against€the€five€nurses,€andÏconsequently€their€employer€under€the€doctrine€of€respondeatÏsuperior."ÌÌà àDr.€Philips€testified€by€deposition€as€follows:ÌÓÓÌÒ ° ÒÒ ½ ÒÒ  ÒÒ ½ Òà0 àà àQ:à àAt€this€time,€Doctor,€if€you€would,€would€you€goÏahead€and€state€for€us€your€opinions?€€And€we€canÏlist€those,€the€opinions€you€have€in€this€case€basedÏupon€your€review€of€these€records€and€then€we€canÏkind€of€go€back€and€take€each€one€and€look€at€theÏbasis€for€those€opinions,€if€you€can€do€that€for€us.ÌÌMR.€WAITE:€Objection.ÌÌà0 àà àA:à àWell,€my€overall€opinion€is€that€all€of€the€individ…uals€caring€for€this€infant€ignored€a€collection€ofÏsymptoms€that€should€have€been€sufficient€to€triggerÏearlier€and€more€aggressive€intervention€to€diagnoseÏand€stabilize€this€infant€and€prevent€what€ultimate…ly€happened.ÌÌà0 àà àQ:à àOkay.€€Any€other€opinions?ÌÌMR.€WAITE:€Objection.ÌÌà0 àà àA:à àWell,€it's€my€opinion€that€òòfailure€to€appropriatelyÏdiagnose€and€treat€this€infant€earlier€caused€theÏsevere€brain€injuryóó€that€the€child€suffered€and€thatÏis€responsible€for€why€the€child€is€profoundlyÏinjured€today.€€ÌÌà@ à*€€€€€*€€€€€€*ÌÌà0 àà àQ:à àWhen€you€say€all€ignored€the€collection€of€symptoms,Ïwho€are€you€referring€to€when€you€say€"all"?ÌÌà0 àà àA:à àThose€individuals€who€were€caring€for€the€infant,Ïthe€nursing€staff€and€Dr.€Cunningham.ÌÌà@ à*€€€€€*€€€€€*ÌÌà0 àà àQ:à àAll€right.€€Let's€go€back€and€see€if€we€can€now€inÏterms€of€what€you've€seen€in€the€chart€that€evi…denced€signs€of€respiratory€distress€and€you'veÏindicated€when€the€records€show€each€particular€signÏwas€charted€which€you€consider€to€be€clinicallyÏsignificant.Ì€€Ìà0 àLet's€take€that€information€and€get€your€opinion€asÏto€when€these€constellation€or€accumulation€of€signsÏwere€clinically€significant€enough€to€where€youÏbelieve€Dr.€Cunningham€should€have€intervened€andÏthen€we€can€talk€about€the€intervention€after€we€doÏthat.ÌÌà0 àà àA:à àWell,€I€believe€that€by€four€A.M.›€on€the€morningÏfollowing€birth,€which€is€about€five€and€a€halfÏhours€of€age,€the€infant€was€being€given€blows€ofÏoxygen€in€order€to€relieve€cyanosis€and€œhad€had›€someÏsigns€of€respiratory€distress€in€addition€to€thatÏand€in€addition€had€the€elevated€temperatures.€€ByÏthat€time,€òòby€four€œA.M.,›€something€more€than€order…ing€a€blood€sugar€should€have€been€done.óó€ÌÌœà0 àà àQ:à àNow,›€is€it€correct€to€say€that€you€believe€that€byÏfour€o'clock€in€the€morning€the€record€reflects€thatÏthere€were€enough€signs€and€symptoms€of€respiratoryÏdistress€that€òòDr.€Cunningham€should€have€taken€someÏaction?€€Is€that€correct?óóÌÌœA:à àYes.›€€Ìà àÌœà@ àÌà@ à*€€€€€*€€€€€*Ì›ÌÌœà0 àà àQ:à àWhat›€treatment€would€you€believe€should€have€beenÏinstituted€at€that€point?ÌÌœà0 àà àA:à àThe›€principal€treatment€probably€would€have€been€theÏadministration€of€supplemental€oxygen.ÌÌœQ:à àOkay.›€€How€about€fluids?€€ÌÌœà0 àà àA:à àAs›€well€as€the€placement€of€an€intravenous€line€andÏadministration€of€intravenous€antibiotics.ÌÌœà0 àà àQ:à àòòHad›€that€occurred€at€or€about€5:30€œA.M.,›€do€you€œhaveÏan›€opinion€based€upon€reasonable€medical€probabilityÏthat€this€infant€would€not€have€suffered€permanentÏneurological€injuryóó?ÌÌœA:à àòòI›€think€that€is€œcorrectóó.ÌÌ(All€emphasis€added).›ÌÌÌÒ ° ÒÒ ½ ÒÒ ° ÒÒ ° ÒÓÓœà àThe›€record€reveals€that€although€the€staff€nurses€were€al…lowed€to€administer€blows€of€oxygen€on€an€emergency€basis,€theyÏwere€not€authorized,€absent€a€physician's€order,€to€perform€theÏ"administration€of€supplemental€oxygen"€as€Dr.€Philips€opinedÏshould€have€been€done.€€Dr.€Philips'€testimony€supports€the€defen…dant€nurses'€argument€that€it€was€Dr.€Cunningham,€and€not€theÏnursing€staff,€who€was€responsible€for€the€diagnosis€and€treatmentÏwhich€Dr.€Philips€says€should€have€œoccurred€and€that€the€negli…gence€of€the€nurses€or€their€deviation€from€the€standard€of€careÏwas€not€the€cause€of›€harm€to€œTyler.€€Dr.€Philips€further€deposedÏas€follows:›ÌÓÓ€ÌÒ  ÒÒ ° ÒÒ  ÒÒ  Òœà0 àà àQ:à àWith›€regard€to€your€opinion€that€there€was€a€fail…ure€to€diagnose€and€treat€Tyler€Davis€which€causedÏthe€serious€neurological€injury,€is€it€a€correctÏstatement€that€Dr.€Cunningham€was€the€medicalÏperson€who€was€charged€with€the€responsibility€toÏdiagnose€any€conditions€and€institute€treatment?ÌÌMR.€WAITE:€Objection.ÌÌTHE€WITNESS:€I€want€to€hear€that€again,€please.ÌÌ(Requested€portion€of€record€read).ÌÌœA:à àHe›€was€the€medical€person,€yes.ÌÌœà@ à*€€€€€*€€€€€*›ÌÌœà0 àà àQ:à àCan›€you€set€your€own€parameters€as€to€how€you€wouldÏfeel€comfortable€answering€that€question?ÌÌœà0 àà àA:à àNow,›€let€me€make€sure€I€know€what€you're€asking€me.€ÏYou're€asking€me€can€nurses€render€diagnoses€andÏprescribe€treatments.ÌÌœà0 àà àQ:à àRight.Ì›€Ìœà0 àà àA:à àIn›€newborn€intensive€care€or€in€newborns.ÌÌœà0 àà àQ:à àRight.›€ÌÌœà0 àà àA:à àSome›€can,€those€with€special€training.ÌÌœQ:à àOkay.›ÌÌœà0 àà àA:à àMost›€floor€nurses,€shift€nurses€are€œnot.Ì›ÌÌÌÒ ° ÒÒ  ÒÒ ° ÒÒ ° ÒÓÓœà àMs.›€Davis€presented€no€evidence€suggesting€that€any€of€theÏdefendant€nurses€had€"special€training"€or€authorization€to€renderÏdiagnoses€or€prescribe€treatments.€€ÌÌà àSignificantly,€the€record€shows€that€Dr.€Cunningham€wasÏpresent€and€observing€Tyler's€medical€situation€at€3:55€AM.€€HisÏonly€order€to€the€nurses€at€that€time€was€to€"just€watch€infantÏclosely."€€Dr.€Cunningham€testified€that€the€nursing€staff€œhad›Ïinformed€œhim€that›€they€had€administered€blows€of€oxygen€intermit…tently,€and€that€œhe›€was€notified€every€time€Tyler€was€given€œoxy…gen.›€€The€following€portions€of€Dr.€Cunningham's€deposition€testi…mony€are€significant€with€regard€to€the€communication€betweenÏhimself€and€the€defendant€nurses:ÌÓÓÌÒ  ÒÒ ° ÒÒ  ÒÒ  Òœà0 àà àQ:à àAnd›€during€this€entire€timeframe€from€œthe›€time€ofÏeleven€œo'clockð"ðor›€can€we€actually€start€it,€IÏguess,€10:55€when€you€first€saw€the€child;€based€onÏthis€late€entry€in€your€testimony,€had€the€nursesÏcommunicated€in€your€opinion€the€information€to€youÏthat€was€necessary€for€you€to€make€a€proper€diagno…sis€of€what€was€occurring€with€Tyler€Davis?ÌÌœA:à àYes.›ÌÌœà@ à*€€€€€*€€€€€*›ÌÌœà0 àà àA:à àI›€was€kept€acutely€aware€of€the€baby's€condition„„ÌÌœQ:à àOkay.›ÌœÌà0 àà àA:à àð"ðby›€the€nurses.€€The€nurses€were€all€very€attentiveÏand€very€concerned€the€whole€time.ÌÌœà@ à*€€€€€*€€€€€*›ÌÌœà0 àà àQ:à àOkay.›€€Were€you€advised€at€5:45€that€the€respira…tions€of€the€child€were€that€high?€ÌÌœà0 àà àA:à àI›€don't€know,€but€I€was€advised€multiple€timesÏduring€that€night€that€the€respirations€were€chang…ing€up€and€down€from€time€to€time.ÌÌœQ:à àOkay.›ÌÌœà0 àà àA:à àAnd›€the,€quote,€normal€parameters€of€respirationsÏvary€between€65€and€30€and€then€10€percent€eitherÏabove€or€beyond€that€is€not€really€terribly€excit…ing€at€that€time.ÌÌœQ:à àAll›€right.ÌÌœà0 àà àA:à àBut›€I€was€aware€of€the€condition€of€the€baby€almostÏminute€by€minute.ÌÌÌÒ ° ÒÒ  ÒÒ ° ÒÒ ° ÒÓÓœà àDr.›€Cunningham's€testimony€that€the€nurses€provided€him€withÏall€the€essential€information€he€needed€to€make€an€appropriateÏdiagnosis€is€undisputed.€€Further,€he€testified€that€"I€never€leftÏthe€œhospital€...€I›€was€always€immediately€available."ÌÌà àFrom€the€foregoing€testimony,€and€our€review€of€the€entireÏrecord€in€this€case,€we€find€that,€œtaking€into€consideration›€allÏthe€œevidence€in€the€light€most€favorable€to€the€plaintiff›€andÏdrawing€all€reasonable€inferences€œin€her›€œfavor,›€we€concur€with€theÏjudgment€of€the€trial€court€that€the€injuries€sustained€by€TylerÏwere€proximately€caused€by€Dr.€œCunningham's€deviation€from€theÏaccepted€standard€of€care›€and€not€by€any€negligence€on€the€part€ofÏthe€defendant€œnurses.€The€plaintiff€has€failed€to€meet€the€burdenÏplaced€upon€her€by€T.C.A.€ðð€29„26„115(a)(3).ÌÌà àAccordingly,€the›€trial€court's€judgment€is€affirmed€and€theÏcase€remanded€for€such€other€and€further€action€as€may€be€neces…sary.€€Costs€on€appeal€are€taxed€and€assessed€to€the€appellant.€€ÌÌÓÓà àà àà àà àà àà àà à___________________________Ìà àà àà àà àà àà àà àDon€T.€McMurray,€JudgeÌÌ̛̜Ì___________________________________ÌHouston€M.€Goddard,€Presiding€JudgeÌà àà àà àà àà àÌÌÌ___________________________________ÌHerschel€P.€Franks,€Judgeà àœÌÌÇÑ  ÑÑ7€ûaXXd×XXd×7Ñà@ àIN€THE€COURT€OF€APPEALSÌÌÌÌÌÌÌÌREBA€V.€DAVIS€and€TYLER€WAYNE€€€)à àROANE€CIRCUITÌDAVIS€by€next€friend,€REBA€V.€€€)à àC.A.€NO.€03A01„9701„CV„00016ÌDAVIS,€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€Plaintiffs„Appellants€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ìvs.€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)à àHON.€RUSSELL€E.€SIMMONS,€JR.Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)à àJUDGEÌ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)ÌHARRIMAN€CITY€HOSPITAL,€THE€€€€€)ÌCITY€OF€HARRIMAN,€JEAN€ANGELO,€€)ÌBRENDA€RUTHERFORD,€BETTY€€€€€€€€)ÌSAMPSON,€RHONDA€MARTIN,€MELINDA€)à àAFFIRMED€AND€REMANDEDÌLATHAM,€SHARON€UNDERWOOD€and€€€€)ÌVICKIE€KLINNERT,€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€)Ì€€€€€€€€€€Defendants„Appellees€€)ÌÌÌ€Ìà@ àò òòòJUDGMENTóóó óÌÌÌÓÓà àThis€appeal€came€on€to€be€heard€upon€the€record€from€theÏCircuit€Court€of€Roane€County,€briefs€and€argument€of€counsel.€ÍUpon€consideration€thereof,€this€Court€is€of€the€opinion€thatÏthere€was€no€reversible€error€in€the€trial€court.Ìà àThe€trial€court's€judgment€is€affirmed€and€the€case€remandedÏfor€such€other€and€further€action€as€may€be€necessary.€€Costs€onÏappeal€are€taxed€and€assessed€to€the€appellant.ÌÌ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€PER€CURIAM