ÿWPCü ~£áŽOàDÄy5½¡Ær\¯á亄'jš DÄy5{I¢M)_]àõ,ÜÝÞ&"¬œ7£v­¦úb«5ëŸmå„“_#˜áÌÕÿ$–è“ÅfÙÉ’aC öW@žnkÉŽt VãÞÏÒÁCCOoyÉêD ±ŒH¸ HÒžJ÷ƒ1U/t(c™†®}µX÷ç7ðøÍפRÏàyqm:î0éi —Aûðˆ@£ʧPøÒÔ·G³‚‹F–›é-./ ‰¬'ÄÃ1Õ4±‰ºÜÄÒ°g©ïص¹ÚŒ0œí`ïLœwÇñ\†Ú³¨aHør­"ÓÕ5­Tõ\@ísØe­\DumlÍÍ@H‡ñÇš8x2óe?òéÂiP¡£ØN|Cù …Íg@°R¢Ím4K DÇ!\2EÁϺ%"«v„¸òY]¾ JÔ¢w¾lÆÔÆk7 ØmS†öT™€Ïƒ01F&ÇZ|7@Ô‚HLO~G¯•ùÒœ¼nÁ½–˜nSí9Q•vœ”áî]Aûƒbû6DË`íÊ‘EïõÏ»ž„€Þo=u<„‰7û”ü K8qÄo&³ŒÃ|¡ÕÞf’Â*MÚN°cþ+)]q.¤àNôo³Y±b#É\ %% ^ + 0ˆ7 UN¿ w 4 z% ÒŸ q € m‚ 0™ ÆÉÆÆUÆ 1uáNV 72X 0cŠEííííííííííííííííííííííííbïïïïïïïïïïïïïïïïïïïïïïïïïïïïïïïïïïïï 0ë÷÷÷÷ Bââ 0¤ÿ D5£ D-Ø 0K ASPÆ£ 0¤i 0D  A«Q˜\\ib01s01\clerk1nasÈÈ,,,,ÈÈ0»ùp1 (`£ª$¡¡Ñ€.ÑÑ8€½­»»d»»d8ÑÑ ý ÑÓ  Ó(í€"  Z6Times New Roman Regular„‚–0B011C8 ˜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.wpt3|x ÿU‹ÿÀÀÀ FRALIXArmbristerCooneyHillmanBallentineT.C.A.T.R.C.P.DeGlopper S.W.McClenanhanTenn.Ct.AppGaitanRevellMcCaughanShipleyWellwoodMalletteHemphillimpleadingpertermitelicensureAyersBursack Ph.DTenn.AppDolenCeletexCatrett S.CtT.C.R.P. COA P.J. Administratrixlaminectomysubrogationtortfeasorpretermit L.EdLevel 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 53#37=CIQYag­­1.a.i.(1)(a)(i)1)a)i)(;3£$´´Ô2#ÔÚ  Ú0Ú  Ú.Ô3  Ôà0  à- ù-(|G2É0$¤¤Ý ƒ£ª!ÝÑ€.ÑÑ8€V¹»»dd8ÑÑ ý ÑÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  ÚóóÔ€ôé‘ò»»Ô d(|3ÇŒ$££Ý ƒ£ª!ÝÑ€.ÑÑ8€V¹»»dd8ÑÑ ý ÑÓ  ÓÝ  ÝVVVV)ÿÿ!dxdx)!ÈÈÈÈdxdx( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó^_X`YEþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(|3ÇŒ$¢¢Ý ƒ£ª!ÝÑ€.ÑÑ8€V¹»»dd8ÑÑ ý ÑÓ  ÓÝ  Ý($$””ò òÚ  Ú1Ú  Úó óX[Z&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ£ª!ÝÑ€.ÑÑ8€V¹»»ddÈ8ÑÑ ý ÑÓ  ÓÝ  ÝÔ_ÔÑ  ÑÔ€¼V¹»»»ÔÑ8€­XXdì»»d8ÑÑ  Ñà@ü ü ìàÔ‡îF4V¹ÔIN€THE€COURT€OF€APPEALS€OF€TENNESSEEˆÐ ° Ðà@kk$ìàAT€NASHVILLEÔ#†¼V¹»îîF4 #ԈРÖ& ÐÓ  ÓJuly€9,€2004€SessionÐ üL ÐÔ‡X­X»¼V¹ÔÌò òÔ#†¼V¹»XX­ñ#ÔESTATE€OF€JASON€JENKINSÔ‡X­X»¼V¹Ôó óÐ úJ ÐÌAppeal€from€the€Circuit€Court€for€Davidson€CountyÐ ú J Ðà@@øøìàNo.€00C„2944Ð æ 6 ÐÌÌà@@ìì*ìàßA€V) °°` d€÷E<©` AßÐ ªú  ÐÌà@@TTìàNo.€€M2003„01561„Ô_ÔCOAÔ_Ô„R3„CV€„€ò òFiled€November€16,€Ô_Ô2004ó óÔ_Ô€€€€€Ô#†¼V¹»XX­N#ÔÔ‡X­X»¼V¹ÔÐ ¥õ  ÐÌßA€V) °°` dE<€` AßÐ Ñ  ÐÌÓ  ÓThis€is€a€suit€for€personal€injuries€brought€by€the€mother€of€a€mentally€challenged€17€year€old€boyÐ |Ì  Ðoccurring€when€his€teacher€attempted€to€transfer€him€from€one€chair€to€another€and€tripped€over€aÐ h¸ Ðnearby€rocker.€€Neither€his€teacher€nor€the€Defendant€Nurse€who€immediately€attended€to€him€afterÐ T¤ Ðthe€accident€detected€the€fractured€leg.€€Young€Jason€Jenkins€died€from€causes€unrelated€to€theÐ @ Ðaccident,€and€his€suit€was€revived€against€Defendants,€Metropolitan€Government€of€Nashville,Ð ,| ÐDavidson€County,€Mary€Ann€Armbrister,€and€Lisa€Morrow.€€The€case€was€voluntarily€dismissed€asÐ h Ðto€Defendant€teacher€Ms.€Armbrister,€and€a€settlement€was€reached€between€Plaintiff€andÐ T ÐMetropolitan€Government€of€Davidson€County.€€The€trial€court€sustained€a€Motion€for€SummaryÐ ð@ ÐJudgment€on€behalf€of€Ms.€Morrow€from€which€Plaintiff€appeals.€€We€affirm€the€action€of€the€trialÐ Ü, Ðcourt.Ð È ÐÓªÓÌò òTenn.€R.€App.€P.€3€Appeal€as€of€Right;€Judgment€of€the€Circuit€CourtÐ  ð ÐAffirmed€and€Remanded€ó óÐ ŒÜ ÐÌòòÓ  ÓÔ#†¼V¹»àX­#ÔÔ‡X­X.¼V¹ÔWilliam€B.€Cain,óó€J.,€delivered€the€opinion€of€the€court,€in€which€òòóóWòòILLIAMóó€C.€KòòOCHóó,€JòòRóó.,€P.J.,€M.S.,Ð d´ Ðand€òòóóFòòRANKóó€G.€CòòLEMENTóó,€JòòRóó.,€J.,€joined.Ð P   ÐÌG.€Kline€Preston,€IV,€Nashville,€Tennessee,€for€the€appellant,€Tammie€Fralix,€Administratrix€of€theÐ ("x! ÐEstate€of€Jason€Jenkins.Ð #d" ÐÌC.€Hayes€Cooney,€Nashville,€Tennessee,€for€the€appellee,€Lisa€Morrow.Ð ì$< $ ÐÌÓ} ÓÌò òOPINIONó óÔ#†¼V¹»XX­¬ #ÔÔ‡X­X»¼V¹ÔÐ °'#' ÐÌòòóóÔ#†¼V¹»XX­ô #ÔÔ‡X­X»¼V¹ÔÓ  Óà  àJason€Jenkins€was€a€mentally€challenged€17„year„old€child€enrolled€in€Harris„HillmanÐ ˆ)Ø$) ÐSchoolððs€special€education€program.€€Metropolitan€Government€of€Davidson€County€operatedÐ t*Ä%* ÐHarris„Hillman€School€for€the€disabled,€and€employed€Mary€Ann€Armbrister€as€a€teacher€at€theÐ `+°&+ Ðschool.€€Lisa€Morrow€was€a€licensed€practical€nurse€at€Harris„Hillman€and€also€an€employee€ofÐ L,œ', ÐMetropolitan€Government.€€It€is€alleged€by€Plaintiff€and€undisputed€by€Defendants€that€both€Ms.Ð 8-ˆ(-ý ÐÔ_ÔArmbrister€and€Ms.€Morrow€were€employees€of€Metropolitan€Government€and,€at€the€time€of€theÐ ° Ðincidents€involved€in€the€case,€were€acting€within€the€course€and€scope€of€their€employment.€€VenueÐ œì Ðand€jurisdiction€are€based€upon€Tennessee€Code€Annotated€section€29„20„101,€et€seq.,€the€TennesseeÐ ˆØ ÐGovernmental€Tort€Liability€Act.Ð tÄ ÐÌà  àIt€is€alleged€and€established€by€the€undisputed€proof€that,€on€November€12,€1999,€Ms.Ð L œ ÐArmbrister,€while€holding€Jason€in€her€arms,€tripped€and€fell€attempting€to€transfer€him€from€oneÐ 8 ˆ Ðchair€to€another.€€Jason€Jenkins€was€attended€at€the€scene€both€by€Ms.€Armbrister€and€by€Ms.Ð $ t ÐMorrow.€€The€existence€or€extent€of€his€injuries€was€not€immediately€discovered€by€either€Ms.Ð  ` ÐArmbrister€or€Ms.€Morrow.€€When€he€was€returned€home€by€bus€at€the€end€of€the€day,€his€motherÐ ü L  Ðimmediately€took€Jason€to€Vanderbilt€Hospital€at€which€time€his€broken€leg€was€discovered€andÐ è 8  Ðtreated.Ð Ô$  ÐÌà  àOn€October€6,€2000,€Jason€Jenkins,€by€next€friend€and€mother,€Tammy€Fralix,€filed€this€suitÐ ¬ü  Ðfor€personal€injuries€in€the€Circuit€Court€of€Davidson€County.€€While€the€suit€was€pending€onÐ ˜è  ÐJanuary€3,€2002,€Jason€Jenkins€unexpectedly€died€of€causes€not€connected€with€his€injuries,€and€thisÐ „Ô  Ðsuit€was€revived€in€the€name€of€his€estate.€€Metropolitan€Government€answered€the€ComplaintÐ pÀ Ðessentially€denying€allegations€of€proximate€negligence€and€by€way€of€affirmative€defense€assertedÐ \¬ Ðdiscretionary€function€immunity€from€liability€pursuant€to€Tennessee€Code€Annotated€section€29„20„Ð H˜ Ð205(1).€€Ms.€Armbrister€answered€essentially€denying€all€allegations€of€proximate€negligence€andÐ 4„ Ðby€way€of€affirmative€defense€asserted€that€no€action€for€personal€injuries€could€be€brought€againstÐ  p Ðher€because€she€was€personally€immune€from€such€claims€under€Tennessee€Code€Annotated€sectionÐ  \ Ð29„20„310.Ð øH ÐÌà  àMs.€Morrow€answered€the€claim€pointing€out€that€she€was€a€licensed€practical€nurse€and€notÐ Ð  Ða€registered€nurse€but€was,€at€all€times,€an€employee€of€Metropolitan€Government€acting€within€theÐ ¼  Ðscope€and€course€of€her€employment.€€She€further€asserted€the€affirmative€defense€of€comparativeÐ ¨ø Ðfault€on€the€part€of€Co„Defendants.Ð ”ä ÐÌà  àSince€Plaintiff€dismissed€her€case€against€Ms.€Armbrister,€and€settled€her€case€as€toÐ l¼ ÐDefendant€Metropolitan€Government€of€Davidson€County,€the€case€remains€before€the€court€onlyÐ X ¨ Ðas€to€Ms.€Morrow€and€only€in€her€capacity€as€a€ð ðhealth€care€practitionerðð€within€the€meaning€ofÐ D!” ÐTennessee€Code€Annotated€section€29„20„310(b).€€Except€for€such€status€she€is€immune,€just€as€theÐ 0"€  Ðteacher€Ms.€Armbrister€is€immune,€under€the€terms€of€that€same€statute.€€òòHill€v.€City€of€Germantownóó,Ð #l! Ð31€S.W.3d€234€(Tenn.€2000).Ð $X" ÐÌà  àTennessee€Code€Annotated€section€29„20„310(b)€provides:Ð à%0!$ ÐÌà8  àà ` àNo€claim€may€be€brought€against€an€employee€or€judgment€entered€againstÐ ¸'#& Ðan€employee€for€damages€for€which€the€immunity€of€the€governmental€entity€isÐ ¤(ô#' Ðremoved€by€this€chapter€unless€the€claim€is€one€for€medical€malpractice€broughtÐ )à$( Ðagainst€a€health€care€practitioner.€€No€claim€for€medical€malpractice€may€be€broughtÐ |*Ì%) Ðagainst€a€health€care€practitioner€or€judgment€entered€against€a€health€careÐ h+¸&* Ðpractitioner€for€damages€for€which€the€governmental€entity€is€liable€under€thisÐ ° Ðchapter,€unless€the€amount€of€damages€sought€or€judgment€entered€exceeds€theÐ œì Ðminimum€limits€set€out€in€ðð€29„20„403€or€the€amount€of€insurance€coverage€actuallyÐ ˆØ Ðcarried€by€the€governmental€entity,€whichever€is€greater,€and€the€governmental€entityÐ tÄ Ðis€also€made€a€party€defendant€to€the€action.€€As€used€in€this€subsection,€ð ðhealth€careÐ `° Ðpractitionerðð€means€physicians€licensed€under€title€63,€chapter€6,€and€nurses€licensedÐ L œ Ðunder€title€63,€chapter€7.Ð8 ˆÐ Ð  ÐÌTenn.€Code€Ann.€ðð€29„20„310(b).Ð  ` ÐÌà  àBecause€Ms.€Morrow€is€a€licensed€practical€nurse,€she€is€subject€to€liability€for€proximateÐ è 8  Ðnegligence€under€the€provisions€of€Tennessee€Code€Annotated€section€29„26„115,€et€seq.Ð Ô$  ÐÔ#†¼V¹»XX­R #ÔÔ€X­X»¼V¹ÔÌà  àWhile€both€parties€assert€the€single€issue€on€appeal€of€whether€or€not€the€trial€court€erred€inÐ ¬ü  Ðgranting€summary€judgment€to€Ms.€Morrow,€it€appears€that€three€sub„issues€are€actually€involved:Ð ˜è  ÐÌ1.à0  àDid€the€rule€in€òòTransports,€Inc.€v.€Perryóó,€414€S.W.2d€p.€1€(Tenn.€1967)€survive€theÐ pÀ Ðimplementation€of€comparative€fault€principles€set€forth€in€òòMcIntyre€v.€Ballentineóó,€833Ð \¬ ÐS.W.2d€52€(Tenn.€1992)?ÐH˜(#(# Ð2.à0  àDid€Plaintiff€offer€any€expert€testimony€to€establish€a€disputed€question€of€material€fact€asÐ 4„ Ðto€the€standard€of€acceptable€professional€practice€and€any€deviation€therefrom€as€is€requiredÐ  p Ðin€medical€malpractice€actions€by€the€provisions€of€Tenn.€Code€Ann.€ðð€29„26„115(a)?Ð \(#(# Ð3.à0  àIn€considering€motions€for€summary€judgment€is€the€court€limited€to€considering€theÐ øH Ðrespective€statements€of€undisputed€facts€under€Tenn.€R.€Civ.€P.€56.03€rather€thanÐ ä4 Ðconsidering€the€entire€record€before€the€court€including€affidavits,€depositions,€and€otherÐ Ð  Ðmaterials€designated€in€Tenn.€R.€Civ.€P.€rule€56.06?м (#(# ÐÌà  àPrior€to€the€decision€of€the€Supreme€Court€in€òòMcIntyre€v.€Ballentineóó,€833€S.W.2d€52€(Tenn.Ð ”ä Ð1992),€Tennessee€recognized€the€well„settled€common€law€rule€that€negligence€and€contributoryÐ €Ð Ðnegligence€presented€ð ð€ðð€all€or€nothingðð€ðð€questions.€€833€S.W.2d€52€at€54.€€By€the€same€common€lawÐ l¼ Ðrule,€proximate€contributory€negligence€absolutely€barred€recovery€by€Plaintiff.€€òòTalbot€v.€Tayloróó,Ð X ¨ Ð184€Tenn.€428,€432,€201€S.W.2d€1,€3€(Tenn.€1935);€òòHudson€v.€Gaitanóó,€675€S.W.2d€699,€704€(Tenn.Ð D!” Ð1984).€€The€burden€of€proof€was€on€Plaintiff€to€establish€the€proximate€negligence€of€Defendant€byÐ 0"€  Ða€preponderance€of€the€evidence.€€òòDeGlopper€v.€Nashville€Railway€and€Light€Co.óó,€123€Tenn.€633,Ð #l! Ð134€S.W.€609€(Tenn.€1911).€€Nothing€in€the€òòMcIntyreóó€comparative€fault€system€has€changed€thisÐ $X" Ðbasic€responsibility€of€Plaintiff.€€The€rule,€as€reiterated€and€supplemented€following€òòMcClenanhanÐ ô$D # Ðv.€Cooleyóó,€806€S.W.2d€767€(Tenn.€1991),€recognizes€Plaintiffððs€burden€of€proof€as€to€both€cause€inÐ à%0!$ Ðfact€and€proximate€cause.€€òòSee€Waste€Management€v.€South€Central€Bellóó,€15€S.W.3d€425,€430Ð Ì&"% Ð(Tenn.Ct.App.€1997).€€Acting€under€the€common€law€rule€the€supreme€court€decided€òòTransports,€Inc.Ð ¸'#& Ðv.€Perryóó,€414€S.W.2d€1€(Tenn.€1967).€€In€that€case€Mrs.€Viola€Perry,€injured€while€a€passenger€in€anÐ ¤(ô#' Ðautomobile,€brought€suit€against€the€owner€and€driver€of€the€bus€involved€in€a€rear€end€collision.€Ð )à$( Ðâ âThe€evidence€before€the€jury€as€to€the€injuries€to€Mrs.€Perry€was€conflicting€particularly€as€toÐ |*Ì%) Ðwhether€or€not€surgery€subsequent€to€the€accident€had€exacerbated€her€condition.€€In€determining€theÐ ° Ðcase€the€court€held:Ð œì Ðâ âÌà8  àà ` àThere€was€some€evidence€from€which€the€jury€might€have€found€that€the€lossÐ tÄ Ðof€continence,€numbness€in€the€vagina€and€other€complaints€later€reported€by€Mrs.Ð `° ÐPerry€were€due€to€the€laminectomy€or€exploratory€surgery€itself,€and€plaintiffÐ L œ Ðcorrectly€insists€that€if€this€were€true,€the€defendants€would€still€be€liable€for€the€sameÐ 8 ˆ Ðif€the€surgery€itself€was€made€necessary€and€was€itself€a€direct€and€proximate€resultÐ $ t Ðof€the€injury€sustained€in€the€accident.€€There€was€material€evidence,€however,€fromÐ  ` Ðwhich€the€jury€could€have€found€that€the€surgery€performed€was€not€really€madeÐ ü L  Ðnecessary€by€any€injury€or€aggravation€thereof€sustained€in€this€accident.Ðè 8 Ð Ð  Ðà8  àà ` àThis€Court,€like€most€others,€recognizes€that€if€one€is€injured€by€theÐ Ô$  Ðnegligence€of€another,€and€these€injuries€are€aggravated€by€medical€treatment€(eitherÐ À  Ðprudent€or€negligent),€the€negligence€of€the€wrongdoer€causing€the€original€injury€isÐ ¬ü  Ðregarded€as€the€proximate€cause€of€the€damage€subsequently€flowing€from€theÐ ˜è  Ðmedical€treatment.,€òòSee€Revell€v.€McCaughanóó,€162€Tenn.€532,€538,€39€S.W.2d€269Ð „Ô  Ð(1931);€òòShipley€v.€Wellwood€Silk€Throwing€Millsóó,€164€Tenn.€281,€47€S.W.2d€561Ð pÀ Ð(1932);€òòMallette€v.€Mercury€Outboard€Supply€Co.óó,€204€Tenn.€438,€450,€321€S.W.2dÐ \¬ Ð816€(1959).€€We€do€not€understand€that€the€defendants€controvert€this€well€settledÐ H˜ Ðprinciple€of€law.€€Ð4„Ð Ð  ÐÌòòTransports,€Inc.€v.€Perryóó,€414€S.W.2d€1,€4„5€(Tenn.€1967).Ð  \ ÐÌà  àTwo€years€after€òòMcIntyreóó€this€court€first€addressed€the€question€of€whether€or€not€the€rule€inÐ ä4 ÐòòTransports,€Inc.€v.€Perryóó€survived€òòMcIntyre€v.€Ballentineóó.€€In€reaffirming€òòTransports,€Inc.€v.€Perryóó,Ð Ð  Ðthis€court€reasoned:Ð ¼  ÐÌà8  àà ` àAbolition€of€the€common€law€rule€would€effectively€shift€the€burden€ofÐ ”ä Ðproving€medical€negligence€(or€its€absence)€from€the€defendant€to€the€plaintiff.€€ToÐ €Ð Ðprotect€themselves,€plaintiffs€in€future€cases€would€feel€compelled€to€timely€nameÐ l¼ Ðmedical€providers€as€defendants€in€any€suit€where€the€negligence€of€the€originalÐ X ¨ Ðtortfeasor€led€to€the€necessity€for€medical€care,€whether€or€not€medical€negligenceÐ D!” Ðwas€actually€suspected.€€In€cases€like€the€present€one,€where€this€was€not€done,€andÐ 0"€  Ðthe€one€year€statute€of€limitations€for€filing€medical€malpractice€claims€passed,Ð #l! Ðallowing€the€defendant€to€allege€medical€negligence€as€an€affirmative€defense€wouldÐ $X" Ðunfairly€prejudice€the€plaintiffððs€right€to€a€full€recovery€for€her€injuries.Ðô$D #Ð Ð  Ðà8  àà ` àBy€retaining€the€common€law€rule,€as€other€jurisdictions€that€have€adoptedÐ à%0!$ Ðcomparative€negligence€have€apparently€done,€we€do€not€penalize€the€injuredÐ Ì&"% Ðplaintiff,€nor€do€we€eliminate€any€remedies€previously€available€to€the€defendant.€Ð ¸'#& ÐThough€he€may€not€assert€the€negligence€of€a€subsequent€medical€provider€as€anÐ ¤(ô#' Ðaffirmative€defense€to€reduce€his€liability€to€the€plaintiff,€the€defendant€may€still€fileÐ )à$( Ða€third€party€claim€or€a€separate€suit€in€subrogation€to€redeem€his€own€rights€againstÐ |*Ì%) Ðthe€negligent€practitioner.Ðh+¸&*Ð Ð  ЇòòAtkinson€v.€Hemphillóó,€1994€WL€456349,€*3€(Tenn.Ct.App.€1994)€(no€app.€to€appeal€filed)€(footnoteÐ ° Ðomitted).Ð œì ÐÌà  àIn€1998€the€Eastern€Section€of€this€court€followed€òòAtkinson€v.€Hemphillóó€in€òòTroy€v.€Herndonóó,Ð tÄ Ð1998€WL€820698€(Tenn.Ct.App.€1998)€(no€app.€to€appeal€filed).Ð `° ÐÌà  àWhile€the€case€at€bar€was€on€appeal,€the€Western€Section€of€this€court€issued€its€opinion€inÐ 8 ˆ ÐòòJackson€v.€Hamiltonóó,€W2000„01992„COA„R3„CV,€2003€WL€22718386€(Tenn.Ct.App.€May€21,Ð $ t Ð2003)€(òòperm.app.deniedóó€NFC€May€10,€2004).€€In€that€case€Plaintiffs€appealed€a€$600€verdict€and€theÐ  ` ÐCourt€of€Appeals,€relying€on€òòAtkinson€v.€Hemphillóó€and€òòTroy€v.€Herndonóó,€reversed€the€trial€court€andÐ ü L  Ðremanded€for€a€new€trial,€holding:Ð è 8  ÐÌà8  àà ` àBecause€we€uphold€the€common€law€rule€of€the€original€tortfeasorððs€liabilityÐ À  Ðfor€subsequent€medical€complications,€we€find€that€the€trial€court€committedÐ ¬ü  Ðprejudicial€error€when€it€refused€to€instruct€the€jury€on€this€rule€of€law.€€In€light€of€theÐ ˜è  Ðdisposition€of€this€issue,€the€only€other€issue€this€Court€needs€to€address€is€issueÐ „Ô  Ðseven€above.ÐpÀÐ Ð  Ðò òÓ  ÓAmending€Defendantððs€Answeró óÐ \¬ ÐÓPCÓà8  àà ` àDefendants€assert€that,€if€this€Court€should€remand€this€appeal€for€a€new€trial,Ð H˜ ÐDefendants€should€be€permitted€to€amend€their€answer€to€include€the€affirmativeÐ 4„ Ðdefense€of€the€comparative€fault€of€Dr.€Robinson,€the€Plaintiffððs€chiropractor.€€WeÐ  p Ðfind,€as€the€òòAtkinsonóó€and€òòTroyóó€courts€did,€that€such€an€amendment€would€beÐ  \ Ðinconsistent€with€the€common€law€rule€of€holding€the€original€tortfeasor€liable€forÐ øH Ðsubsequent€medical€treatment.€€Though,€at€first€glance,€this€may€seem€a€harsh€resultÐ ä4 Ðfor€a€defendant,€as€the€Court€in€òòAtkinson€óónoted,€such€defendant€could€have€theÐ Ð  Ðalternatives€of€impleading€a€third€party€to€the€original€suit€or€suing€the€medicalÐ ¼  Ðprovider€under€a€theory€of€subrogation.€€òòId.€óóat€*5.€€Therefore,€we€deny€DefendantsÐ ¨ø Ðrelief€to€amend€their€answer.ДäÐ Ð  ÐÌ2003€WL€22718386,€at€*6.Ð l¼ ÐÌà  àOn€December€31,€2003,€Defendant€filed€its€application€to€appeal€òòJackson€v.€Hamiltonóó€to€theÐ D!” ÐSupreme€Court€and,€on€May€10,€2004,€the€Supreme€Court€denied€the€application€but€designated€theÐ 0"€  Ðopinion€ð ðnot€to€be€citedðð€pursuant€to€Supreme€Court€Rule€4.€€Section€(F)(1)€of€that€rule€provides:€Ð #l! Ðð ðIf€an€application€for€permission€to€appeal€is€hereafter€denied€by€this€court€with€a€ððNot€for€CitationððÐ $X" Ðdesignation,€the€opinion€of€the€intermediate€appellate€court€has€no€precedential€value.ðð€€SinceÐ ô$D # ÐòòJackson€v.€Hamiltonóó€was€predicated€entirely€on€the€survival€of€the€common€law€rule€in€òòTransport,Ð à%0!$ ÐInc.€v.€Perry,óó€as€that€rule€was€reiterated€by€this€court€in€òòAtkinsonóó€and€òòHerndonóó,€we€must€concludeÐ Ì&"% Ðthat€the€Supreme€Court€has€serious€questions€about€the€survival€of€the€common€law€rule€iterated€inÐ ¸'#& ÐòòTransport,€Inc.€v.€Perryóó.€€Since€we€have€an€ample€basis€for€deciding€this€case€on€grounds€other€thanÐ ¤(ô#' Ðthe€survival€or€non„survival€of€the€common€law€rule€in€òòPerryóó,€we€pretermit€the€issue.Ð )à$( Ðâ âÐ |*Ì%) Ðà  àIn€a€suit€for€malpractice€against€a€ð ðhealthcare€practitionerðð€employed€by€a€local€governmentÐ ° Ðâ âentity€and€exempted€from€the€protection€offered€to€other€local€government€employees€underÐ œì ÐTennessee€Code€Annotated€section€29„20„310(b),€Plaintiff€faces€the€ordinary€burdens€in€aÐ ˆØ Ðmalpractice€action€which€are€imposed€by€Tennessee€Code€Annotated€section€29„26„115.€€PlaintiffÐ tÄ Ðmust€prove:Ð `° ÐÌà8  àà ` à(1)€The€recognized€standard€of€acceptable€professional€practice€in€theÐ 8 ˆ Ðprofession€and€the€specialty€thereof,€if€any,€that€the€defendant€practices€in€theÐ $ t Ðcommunity€in€which€the€defendant€practices€or€in€a€similar€community€at€the€timeÐ  ` Ðthe€alleged€injury€or€wrongful€action€occurred;Ðü L Ð Ð  Ðà8  àà ` à(2)€That€the€defendant€acted€with€less€than€or€failed€to€act€with€ordinary€andÐ è 8  Ðreasonable€care€in€accordance€with€such€standard;€andÐÔ$ Ð Ð  Ðà8  àà ` à(3)€As€a€proximate€result€of€the€defendantððs€negligent€act€or€omission,€theÐ À  Ðplaintiff€suffered€injuries€which€would€not€otherwise€have€occurred.Ьü Ð Ð  ÐÌTenn.€Code€Ann.€ðð€29„26„115(a).Ð „Ô  ÐÌà  àð ðIn€Tennessee,€expert€testimony€is€required€to€establish€negligence€and€proximate€cause€inÐ \¬ Ðmalpractice€actions€unless€the€alleged€malpractice€is€within€the€common€knowledge€of€laymen.ðð€Ð H˜ ÐòòAyers€v.€Rutherford€Hospital,€Inc.óó,€689€S.W.2d€155,€160€(Tenn.Ct.App.€1984);€òòBursack€v.€Wilsonóó,Ð 4„ Ð982€S.W.2d€341,€343€(Tenn.Ct.App.€1998).Ð  p ÐÌà  àPlaintiff€attempts€to€establish€her€malpractice€claim€by€the€affidavit€of€Karen€S.€Ward,€aÐ øH Ðclearly€qualified€registered€nurse€holding€a€Ph.D€from€Cornell€University€and€a€Masterððs€Degree€inÐ ä4 Ðpsychiatric€nursing€from€Vanderbilt.€€She€opines:Ð Ð  ÐÌà8  àà ` àThe€acceptable€standard€of€practical€nursing€practice€on€November€12,€1999,Ð ¨ø Ðdid€òònotóó€permit€Mrs.€Morrow,€a€licensed€practical€nurse,€to€conduct€an€assessment€ofÐ ”ä ÐMr.€Jenkins.€€Under€the€acceptable€standard€of€practical€nursing€practice,€Mrs.Ð €Ð ÐMorrow€had€a€duty€to€refer€Mr.€Jenkins€to€an€appropriate€healthcare€provider€forÐ l¼ Ðappropriate€assessment.€€The€failure€to€do€so€constitutes€a€breach€of€the€acceptableÐ X ¨ Ðstandard€of€practical€nursing€practice.ÐD!”Ð Ð  Ðà8  àà ` àClear€„€or€unclear€„€verbalization€of€pain€in€a€specific€site€should€not€haveÐ 0"€  Ðdetermined€one€way€or€the€other€how€to€conduct€the€assessment.€€Mr.€JenkinsððÐ #l! Ðlimitations€on€communication€mandated€a€complete€and€thorough€assessment.€€ThisÐ $X" Ðincluded€removal€of€his€clothing€to€examine€his€lower€extremities€in€their€entirety.€Ð ô$D # ÐThe€failure€to€do€so€constitutes€a€breach€of€the€acceptable€standard€of€practicalÐ à%0!$ Ðnursing€practice.ÐÌ&"%Ð Ð  Ðà8  àà ` àGiven€the€nature€and€extent€of€the€fracture,€it€is€clear€that€this€injury€wouldÐ ¸'#& Ðhave€been€discovered€if€a€proper€assessment€had€been€performed€by€a€competentÐ ¤(ô#' Ðâ âhealthcare€provider.Ð)à$(Ð Ð  Ðà8  àà ` àAs€a€direct€and€proximate€result€of€Mrs.€Morrowððs€breach€of€the€acceptableÐ ° Ðstandard€of€professional€nursing€practice,€Mr.€Jenkinsðð€treatment€for€this€significantÐ œì Ðfracture€was€unnecessarily€delayed€for€several€hours.ЈØÐ Ð  Ðâ âÌà  àThe€record€on€appeal€also€contains€the€deposition€testimony€of€Dr.€Neil€E.€Green,€AssociateÐ `° ÐProfessor€of€Pediatrics€at€Vanderbilt€University€Medical€Center,€who€testified:Ð L œ ÐÌà8  àà ` àQ.à ¸ àOkay.€€Can€you€tell€from€the€records€that€youððve€reviewed€whether€orÐ $ t Ðnot€Jason€Jenkins€has€suffered€any€permanent€injury€as€a€result€of€this€fracture?Ð `Ð Ð  Ðà  àà ` àA.à0 ¸ àHe€has€suffered€no€permanent€injury.Ðü L ¸ (#¸ (# Ðà8  àà ` àQ.à ¸ àOkay.€€And€can€„€„€can€you€tell€us€whether€or€not€in€your€opinion€hisÐ è 8  Ðtreatment€was€„€„€the€delay€of€treatment,€if€injury€did€occur€earlier€in€the€day,€wasÐ Ô$  Ðworse€„€„€worsened€his€injuries€in€any€way€or€retarded€his€healing€in€any€way?ÐÀ Ð Ð  Ðà  àà ` àA.à0 ¸ àNo,€it€did€not.Ьü ¸ (#¸ (# Ðà  àÌà  àPlaintiff€argues€that€since€Dr.€Greenððs€testimony€is€not€included€in€the€Statement€ofÐ „Ô  ÐUndisputed€Facts€filed€by€Defendant€pursuant€to€Tenn.€R.€Civ.€P.€56.03,€the€court€is€barred€fromÐ pÀ Ðconsidering€Dr.€Greenððs€testimony€in€ruling€on€the€Motion€for€Summary€Judgment.€€This€positionÐ \¬ Ðis€without€merit.€€The€specification€of€material€facts€under€Tenn.€R.€Civ.€P.€56.03€is€designed€ð ðtoÐ H˜ Ðassist€the€court€in€ascertaining€whether€there€are€any€material€facts€in€dispute.ðð€€T.R.C.P.€56.03.€€TheÐ 4„ Ðstatement€required€under€the€rule€is€auxiliary€to€the€motion€in€order€to€assist€the€court€in€renderingÐ  p Ðjudgment€on€the€motion€ð ðforthwith€if€the€pleadings,€depositions,€answers€to€interrogatories,€andÐ  \ Ðadmissions€on€file,€together€with€the€affidavits,€if€any,€show€that€there€is€no€genuine€issue€as€to€anyÐ øH Ðmaterial€fact€and€that€the€moving€party€is€entitled€to€judgment€as€a€matter€of€law.ðð€€Tenn.€R.€Civ.€P.Ð ä4 Ð56.04.Ð Ð  ÐÌà  àIn€òòByrd€v.€Hallóó,€847€S.W.2d€208€(Tenn.€1993)€the€Supreme€Court€of€Tennessee€specificallyÐ ¨ø Ðendorsed€the€reasoning€of€the€United€States€Supreme€Court€in€òòCelotex€Corp.€v.€Catrettóó,€477€U.S.Ð ”ä Ð317,€106€S.Ct.€2548,€91€L.Ed.2d€265€(1986).€€Justice€Brennan€pointed€out€in€òòCelotexóó€the€mechanicsÐ €Ð Ðby€which€a€moving€party€carries€his€burden€under€rule€56.Ð l¼ ÐÌà8  àà ` àRather,€as€the€Court€confirms,€a€party€who€moves€for€summary€judgment€onÐ D!” Ðthe€ground€that€the€nonmoving€party€has€no€evidence€must€affirmatively€show€theÐ 0"€  Ðabsence€of€evidence€in€the€record.€€This€may€require€the€moving€party€to€depose€theÐ #l! Ðnonmoving€partyððs€witnesses€or€to€establish€the€inadequacy€of€documentary€evidence.€Ð $X" ÐIf€there€is€literally€no€evidence€in€the€record,€the€moving€party€may€demonstrate€thisÐ ô$D # Ðby€reviewing€for€the€court€the€admissions,€interrogatories,€and€other€exchangesÐ à%0!$ Ðbetween€the€parties€that€are€in€the€record.€€Either€way,€however,€the€moving€partyÐ Ì&"% Ðmust€affirmatively€demonstrate€that€there€is€no€evidence€in€the€record€to€support€aÐ ¸'#& Ðjudgment€for€the€nonmoving€party.€€Ð¤(ô#'Ð Ð  ÐòòÌCelotex€v.€Catrettóó,€91€L.Ed.2d€265,€279.Ð |*Ì%) ÐÐ h+¸&* Ðà  àAt€the€time€the€Tennessee€Supreme€Court€decided€òòByrd€v.€Hallóó,€Tennessee€Rules€of€CivilÐ ° ÐProcedure,€Rule€56.03€provided€òòóóthe€parameters€of€the€trial€courtððs€consideration:Ð œì ÐÌà8  àà ` àThe€motion€shall€be€served€at€least€thirty€(30)€days€before€the€time€fixed€forÐ tÄ Ðthe€hearing.€€The€adverse€party€prior€to€the€day€of€hearing€may€serve€opposingÐ `° Ðaffidavits.€€The€judgment€sought€shall€be€rendered€forthwith€if€the€pleadings,Ð L œ Ðdepositions,€answers€to€interrogatories,€and€admissions€on€file,€together€with€theÐ 8 ˆ Ðaffidavits,€if€any,€show€that€there€is€no€genuine€issue€as€to€any€material€fact€and€thatÐ $ t Ðthe€moving€party€is€entitled€to€a€judgment€as€a€matter€of€law.€€A€summary€judgment,Ð  ` Ðinterlocutory€in€character,€may€be€rendered€on€the€issue€of€liability€alone€althoughÐ ü L  Ðthere€is€a€genuine€issue€as€to€the€amount€of€damages.Ðè 8 Ð Ð  ÐÌTenn.€R.€Civ.€P.€56.03€(1993).Ð À  ÐÌà  àThis€is€the€Rule€56.03€that€was€construed€by€the€Tennessee€Supreme€Court€in€òòByrd€v.€Hallóó,Ð ˜è  Ð847€S.W.2d€208€(Tenn.€1993).€€Tennessee€first€adopted€the€ð ðspecifying€material€factsðð€procedureÐ „Ô  Ðnow€embodied€in€Rule€56.03€in€1997.€€The€advisory€commission€at€that€time€stated€ð ðnew€rule€56.03Ð pÀ Ðtracks€the€language€of€a€local€federal€rule€in€the€Middle€District€of€Tennessee.€€The€commissionÐ \¬ Ðbelieves€it€will€not€only€assist€the€court€in€focusing€on€the€crucial€portions€of€the€record,€but€it€willÐ H˜ Ðcause€lawyers€to€ascertain€whether€there€is€ðða€genuine€issue€as€to€any€material€fact.ðð€ððÐ 4„ ÐÌà  àThe€ð ðconcise€statements€of€material€fact,ðð€required€since€the€1997€amendment€to€Tenn.€R.Ð  \ ÐCiv.€P.€56.03,€are€significant€features€of€the€summary€judgment€procedure.€€These€statements€assistÐ øH Ðwith€docket€control€and€enable€the€courts€to€decide€summary€judgments€motions€efficiently€andÐ ä4 Ðeffectively.€€òòSee€Jackson€v.€Finnegan,€Henderson,€Farabow,€Garrett,€and€Dunneróó,€101€F.3d€145,€151Ð Ð  Ð(D.C.Cir.€1996).€€They€serve€as€ð ðroad€mapsðð€and€trial€courts€should€not€be€required€to€proceedÐ ¼  Ðfurther€if€they€are€not€provided.€€òòOwens€v.€Bristol€Motor€Speedway,€Inc.óó,€77€S.W.3d€771,€774Ð ¨ø Ð(Tenn.Ct.App.€2001).€€Thus,€requiring€compliance€by€both€parties€with€Tenn.€R.€Civ.€P.€56.03€isÐ ”ä Ðjustified.€€òòSee€Gardels€v.€Central€Intelligence€Agencyóó,€637€F.2d€770,€773€(D.C.Cir.€1980).Ð €Ð Ðà  àà ` àà ¸ àÌà  àHowever,€a€decision€to€grant€a€summary€judgment€must€ultimately€be€based€on€theÐ X ¨ Ðð ðpleadings,€depositions,€answers€to€interrogatories,€and€admissions€on€file,€together€with€theÐ D!” Ðaffidavits,€if€any.ðð€€òòSeeóó€Tenn.€R.€Civ.€P.€56.04.€€Thus,€while€the€Tenn.€R.€Civ.€P.€56.03€conciseÐ 0"€  Ðstatement€points€the€court€to€the€portions€of€the€record€that€are€particularly€relevant€to€the€summaryÐ #l! Ðjudgment€motion,€it€does€not€replace€the€evidentiary€materials€on€which€it€is€based.Ð $X" ÐÌà  àMs.€Morrowððs€Tenn.€R.€Civ.€P.€56.03€concise€statement€was€filed€on€November€28,€2001.€Ð à%0!$ ÐIt€did€not€refer€to€Dr.€Greenððs€opinion€that€her€conduct€had€not€caused€any€additional€injury€becauseÐ Ì&"% ÐDr.€Green€had€not€yet€been€deposed.€€In€fact,€he€was€deposed€the€same€day€that€Ms.€Morrow€filedÐ ¸'#& Ðher€Tenn.€R.€Civ.€P.€56.03€statement.€€The€plaintiffððs€attorney€participated€in€this€deposition€andÐ ¤(ô#' Ðcross„examined€Dr.€Green.€€Dr.€Green€was€actually€Metroððs€witness.€€Following€Dr.€GreenððsÐ )à$( Ðâ âdeposition,€Metro€moved€for€summary€judgment.€€Its€accompanying€Tenn.€R.€Civ.€P.€56.03€statementÐ |*Ì%) Ðreferred€to€Dr.€Greenððs€opinion€that€ð ð[t]he€delay€in€treatment€did€not€worsen€Plaintiffððs€injury€in€anyÐ ° Ðway€or€retard€his€healing€in€any€way.ðð€€[TR.€113,€ðð€22].Ð œì Ðâ âÌà  àAfter€the€plaintiff€dismissed€its€case€against€Metro,€it€would€have€been€better€practice€for€MsÐ tÄ ÐMorrow€to€amend€her€Tenn.€R.€Civ.€P.€56.03€concise€statement€to€include€Dr.€Greenððs€opinion.€Ð `° ÐHowever,€the€plaintiff€knew€about€Dr.€Greenððs€causation€opinion€and€was€aware€that€at€least€one€ofÐ L œ Ðthe€defendants€intended€to€use€this€opinion€to€challenge€the€plaintiffððs€ability€to€prove€causation.€€TheÐ 8 ˆ Ðplaintiff€made€no€effort€to€shore€up€its€evidence€of€causation€during€the€sixteen€months€betweenÐ $ t ÐMetroððs€motion€for€summary€judgment€and€the€entry€of€the€order€granting€Ms.€Morrowððs€summaryÐ  ` Ðjudgment€motion.€€Under€these€facts,€the€plaintiff€was€not€prejudiced€by€the€fact€that€Ms.€MorrowððsÐ ü L  ÐTenn.€R.€Civ.€P.€56.03€concise€statement€did€not€refer€to€Dr.€Greenððs€causation€opinion.Ð è 8  ÐÌà  àThe€evidence€considered€in€the€light€most€favorable€to€Plaintiff€reveals€that€the€conduct€ofÐ À  ÐMs.€Morrow€played€no€part€in€causing€the€fracture€to€young€Jasonððs€leg.€€She€was€not€present€at€theÐ ¬ü  Ðtime€Ms.€Armbrister€fell€and€Jason€suffered€his€injuries.€€She€came€upon€the€scene€afterwards€andÐ ˜è  Ðexamined€him€for€injuries€and€did€not€discover€the€fracture.€€Even€if€one€concedes€that€the€failureÐ „Ô  Ðto€diagnose€the€fracture€was€negligent,€the€critical€question€under€the€statute€is€whether€PlaintiffÐ pÀ Ðð ðsuffered€injuries€which€would€not€otherwise€have€occurred.ðð€€Tenn.€Code€Ann.€ðð€29„26„115(a)(3).€Ð \¬ ÐThe€affidavit€of€Karen€S.€Ward€establishes€only€that€the€negligence€of€Ms.€Morrow€was€responsibleÐ H˜ Ðfor€the€fact€that€ð ðtreatment€for€this€significant€fracture€was€unnecessarily€delayed€for€several€hours.ððÐ 4„ ÐÌà  àIt€is€clear€that€the€fracture€of€the€leg€occurred€before€Ms.€Morrow€came€upon€the€scene.€€NoÐ  \ Ðproof€is€offered€that€the€delay€in€treatment€of€the€fractured€leg€caused€any€exacerbation€of€the€injuryÐ øH Ðor€additional€pain€that€otherwise€would€not€have€occurred.€€The€affidavit€of€Ms.€Ward€does€not€refuteÐ ä4 Ðthe€testimony€of€Dr.€Green€that€Jason€Jenkins€suffered€no€permanent€injury€as€a€result€of€the€accidentÐ Ð  Ðor€as€a€result€of€the€treatment€by€Ms.€Morrow.€€Further€critical€is€the€undisputed€statement€of€Dr.Ð ¼  ÐGreen€that€the€failure€to€discover€the€fracture€did€not€ð ðworsen(ed)€his€injuries?ððÐ ¨ø ÐÌà  àSo€it€is€that€matters€which€must€be€established€by€expert€testimony€under€the€TennesseeÐ €Ð ÐMedical€Malpractice€Act€are€simply€not€established€in€this€record,€and€summary€judgment€wasÐ l¼ Ðproperly€granted€by€the€trial€court.€€òòSee€Estate€of€Henderson€v.€Mireóó,€955€S.W.2d€56,€59€(Tenn.App.Ð X ¨ Ð1997);€òòRoddy€v.€Volunteer€Medical€Clinic,€Inc.óó,€926€S.W.2d€572,€577€(Tenn.Ct.App.€1996);€òòParkerÐ D!” Ðv.€Vanderbilt€Universityóó,€767€S.W.2d€412,€420€(Tenn.Ct.App.€1988);€òòDolen€v.€Cunninghamóó,€648Ð 0"€  ÐS.W.2d€652,€654€(Tenn.Ct.App.€1982);€Tenn.€Code€Ann.€ðð€29„26„115.Ð #l! ÐÌà  àThe€judgment€of€the€trial€court€is€affirmed€with€costs€of€the€cause€assessed€to€Appellant.€€TheÐ ô$D # Ðcase€is€remanded€to€the€trial€court€for€collection€of€costs€and€any€further€proceedings€necessary.Ð à%0!$ Ðà  àÌà  àÌÌà  àà ` àà ¸ àà  àà h àà À àà  à___________________________________€Ð )à$( Ðà  àà ` àà ¸ àà  àà h àà À àà  àWILLIAM€B.€CAIN,€JUDGE