ÿWPCi( ƒ’1±£ÝYÊ¥é ¥x˜ËõiÍ ¥ÈrH>Ëlíªä4꺜wEì¹o¸øSqNŠDPËéû uäëfõsïS!ÌEö€˜·0¥Gm6ÞÓ&,cše-AUõDq£%-ñ)òÛÝé²4¶"ÓYs÷ÝÜÃg¿jÂ2.dƒ_ÁžöïâR¨Fz¢ÏäÄÄÊÕò<{¨ v7j³ŒØ w$,ƒ³WH~l+ÍLˆª\ÿÄ'$D;Æyé,•a·Ò<¦¬ÎGFà|ÃþaÛùk;úÈÇìˆtçÍFGiØÆ¬Ù±DáBþˆ†Æ—ù½DÈÖÖ£¥¿ øÁöÒØê•i“z“iÿÀÿÿdü<Ày‰'WŽ:úÌ™±?=T]œÀKËñ¾~ÖnC®ÖÁOcM—k* âú0Ùƒ®¤øÔñSŽä䤲`\elây©¢ã‹œÈwvt6y~…0N C1ã_¡f/J¦q#¨nz˜ ͹Jmv¾î{üܤ¨qÍ4ß$˜YÖʇ9mê-ƒGP¹Îƒï½q`ò&àfm8OŠÝ°Ï\cPbÄTr.¨g³ñ'î|²EŸ¨æŸ£÷Ÿf¼Ô„|ÄY¿0ɶ†FÍø@ÓE@é¿3ub %\^ b 0ˆnUNöwD4H\ zkÒå· m¹ ¹ #ÁÐ Æ‘ ÆW Æ Æã ©N±M³ 0DED¥F 1‡ë 72r 1u¤ 72 0cKL® 1‡ú 72 1‡³ 72: 1‡l 72ó 1‡% 72¬wÞSUUÿ¨¨¨·§§b^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^#^# 0ëf#f#f#f# BQ$Q$ 0¤n$ D3% D-E% 0Kr%r% AS½%Æ& 0¤Ö& 0Dz' A«¾'»xk4-s (`£ª$¡¡Ñ€.ÑÑ8€½­»»d»»d8ÑÑ ý ÑÓ  Ó(í€"  Z6Times New Roman Regularš‚,-Ȥ¤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 4050 Series PCL 6ÈÈ,,,,ÈÈ0Level 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5  CÝ ƒRñ $ÝÓ  Óà  àòòÚ  Ú2Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àDr.€Ô_ÔLeCorpsÔ_Ô€was€under€contract€with€the€Tennessee€Department€of€Correction€to€provide€orthopaedicÐ ° Ðservices€to€inmates€at€Riverbend.€€(#Ã$òòÚ  Ú0Ú  Úóó ›Ý ƒRñ $ÝÓ  Óà  àòòÚ  Ú1Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àGiven€the€scant€record€on€appeal€in€this€case,€our€summary€of€background€facts€is€taken€from€theÐ ° Ðcomplaint€filed€by€the€plaintiff,€the€answer€filed€by€the€defendant,€and€the€deposition€testimony€of€the€plaintiffððs€expertÐ tÄ Ðwitness.€(нCEKQW]cioAutoList1A.A.A.A.A.A.A.A.A.3#37=CIQYag­­1.a.i.(1)(a)(i)1)a)i)(;3£$´´Ô2#ÔÚ  Ú0Ú  Ú.Ô3  Ôà0  à BÝ ƒRñ $ÝÓ  Óà  àòòÚ  Ú3Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àThe€deposition€indicated€that€Dr.€Kennedy€was€board„certified€by€the€American€Board€of€OrthopaedicÐ ° ÐSurgery€in€1972€and€had€a€private€practice€in€orthopaedic€surgery€from€1972€to€1998€in€Johnson€City,€Tennessee.€Ð tÄ ÐAlthough€he€retired€from€practice€in€1998,€Dr.€Kennedy€worked€part„time€performing€independent€medical€examinationsÐ 8ˆ ¢ Ðand€providing€related€depositions€and€testimony.(š½CEKQW]cioAutoList2A.A.A.A.A.A.A.A.A.(ª½CEKQW]cioAutoList3A.A.A.A.A.A.A.A. A.(º½CEKQW]cioAutoList4A.A.A.A.A.A.A.A."A.(ʽCEKQW]cioAutoList5A.A.A.A.A.A.A.A.$A. mÝ ƒRñ $ÝÓ  Óà  àòòÚ  Ú7Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àThis€purpose€is€further€evident€in€the€requirements€of€Tenn.€Code€Ann.€ðð€29„26„115(b),€which€mustÐ ° Ðbe€construed€òòin€para€materia€óówith€Tenn.€Code€Ann.€ðð€29„26Ô_Ô„115(a).Ô_Ô IÝ ƒRñ $ÝÓ  Óà  àòòÚ  Ú4Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àWe€note€that€there€is€no€evidence€in€the€limited€record€on€appeal€regarding€whether€Dr.€Ô_ÔLeCorpsÔ_Ô€wasÐ ° Ðboard€certified€in€orthopaedic€surgery. õÝ ƒRñ $ÝÓ  Óà  àòòÚ  Ú5Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àRobinson€argues€that€a€national€standard€of€care€has€been€embraced€by€a€majority€of€jurisdictions€andÐ ° Ðis€particularly€appropriate€in€cases€involving€defendants€who€are€board„certified€in€a€specialized€area.€€òòóóThe€TennesseeÐ tÄ ÐMedical€Association,€Tennessee€Hospital€Association,€Hospital€Alliance€of€Tennessee,€and€Reciprocal€of€America,Ð 8ˆ Ðparticipating€in€this€case€as€òòamicus€curiaeóó,€oppose€the€adoption€of€a€national€standard€and€vigorously€dispute€RobinsonððsÐ üL Ðclaim€that€a€majority€of€jurisdictions€have€applied€such€a€standard.€€The€òòamicióóalso€contend€that€any€change€in€the€localityÐ À Ðrule€as€set€forth€in€Tenn.€Code€Ann.€ðð€29„26„115(a)(1)€must€come€from€the€legislature€and€that€there€is€no€evidence€thatÐ „Ô Ða€national€standard€exists.€€ ­Ý ƒRñ $ÝÓ  Óà  àòòÚ  Ú6Ú  ÚóóÔ€ô¸•ò»»ÔÝ  ÝÔ_Ôà ` àIn€addition,€the€statute€provides€that€ð ðà8 @* à[n]o€person€in€a€health€care€profession€requiring€licensure€underÐ ° Ðthe€laws€of€this€state€shall€be€competent€to€testify€in€any€court€of€law€to€establish€the€facts€required€to€be€established€byÐ tÄ Ðsubsection€(a),€òòunless€the€person€was€licensed€to€practice€in€the€state€or€a€contiguous€bordering€stateóó€a€profession€orÐ 8ˆ Ðspecialty€which€would€make€the€personððs€expert€testimony€relevant€to€the€issues€in€the€case€òòand€had€practiced€thisÐ üL Ðprofession€or€specialty€in€one€(1)€of€these€states€during€the€year€preceding€the€date€that€the€alleged€injury€or€wrongfulÐ À Ðact€occurredóó.€.€.€.ðð€€(Emphasis€added)òòóó.€€Tenn.€Code€Ann.€ðð€29„26„115(b).- ù-(|G2ñ $¤¤Ý ƒ£ª!ÝÑ€.ÑÑ8€½»»dd8ÑÑ ý ÑÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  ÚóóÔ€ô¸•ò»»Ô d(|3ÿu$££Ý ƒ£ª!ÝÑ€.ÑÑ8€½»»dd8ÑÑ ý ÑÓ  ÓÝ  ÝVVVV'ÿÿdxd)!ÈÈÈÈdxdx( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó^_X`YEþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(|3ÿu$¢¢Ý ƒ£ª!ÝÑ€.ÑÑ8€½»»dd8ÑÑ ý ÑÓ  ÓÝ  Ý($$””ò òÚ  Ú1Ú  Úó óX[Z&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ£ª!ÝÑ€.ÑÑ8€½»»ddÈ8ÑÑ ý ÑÓ  ÓÝ  ÝÔ_ÔÑ  ÑÑ  ÑÔ€¼½»»»ÔÑ8€\QXXdì»»d8Ñà@™ ™ ìàÔ‡î ½ÔIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ ° Ðà@kk$ìàAT€NASHVILLEˆà0 È àÔ#†¼½»îî #ÔÐÖ&È(#È(# ÐÓ  ÓJune€5,€2002€SessionÐ üL ÐÔ‡X\QX»¼½ÔÌò òÔ#†¼½»XX\Q#ÔJACKIE€ROBINSON€v.€PATRICK€J.€Ô_ÔLeCORPSÔ_Ô,€M.D.Ô‡X\QX»¼½Ôó óÐ úJ ÐÌà@@½½ìàò òAppeal€by€Permission€from€the€Court€of€AppealsÐ ú J ЀCircuit€Court€for€Davidson€CountyÐ æ 6 Ðà@@øøìàNo.€96C„3528€€€€€€Mary€Ashley€Ô_ÔNicholsÔ_Ô,€Special€JudgeÐ Ò " ÐÌÌà@@ìì*ìàßA€V) °°` d€÷E<•` AßÐ –æ  ÐÌà@@TTìàNo.€M1999„01581„SC„R11„CV€„€Filed€September€5,€Ô_Ô2002Ô_ÔÐ ‘á  ÐÌßA€V) °°` dE<h` AßÐ i¹  Ðó óÌÓ  Óò òÌÔ#†¼½»XX\Q•#Ôó óÔ€X\QX»¼½ÔWe€granted€review€in€this€medical€malpractice€action€to€address€whether€the€trial€court€erred€byÐ P  Ðexcluding€expert€medical€testimony€offered€by€the€plaintiff€and€dismissing€the€complaint.€€The€CourtÐ <Œ Ðof€Appeals€affirmed.€€After€reviewing€the€record€and€applicable€authority,€we€conclude€(1)€that€theÐ (x Ðplaintiff€did€not€produce€expert€testimony€to€establish€the€standard€of€professional€care€in€theÐ d Ðcommunity€in€which€the€defendant€practiced€or€a€similar€community€as€required€by€Tenn.€Code€Ann.Ð P Ððð€29„26„115(a)(1)€(2000€&€Supp.€2001),€and€(2)€that€the€trial€court€did€not€abuse€its€discretion€inÐ ì< Ðexcluding€the€testimony€and€dismissing€the€complaint.€€We€therefore€affirm€the€Court€of€AppealððsÐ Ø( Ðjudgment.Ð Ä ÐÌÓÓò òTenn.€R.€App.€P.€11€Appeal€by€Permission;€Judgment€of€the€Court€of€Appeals€Affirmed€ó óÐ œì ÐÌòòÓ  ÓE.€Riley€Anderson,€J.óó,€delivered€the€opinion€of€the€court,€in€which€òòFrank€F.€Ô_ÔDrowotaÔ_Ô,€C.J.,€óóandòòÐ tÄ ÐÔ_ÔAdolphoÔ_Ô€A.€Birch,€Jr.,€Janice€M.€Holder,óó€and€òòWilliam€M.€Barker,€JJ.óó,€joined.Ð `° ÐÌMary€A.€Parker€and€Richard€D.€Ô_ÔPiliponisÔ_Ô,€Nashville,€Tennessee,€for€the€appellant,€Jackie€Robinson.Ð 8!ˆ  ÐÌC.€Hayes€Ô_ÔCooneyÔ_Ô,€Nashville,€Tennessee,€for€the€appellee,€Patrick€J.€Ô_ÔLeCorpsÔ_Ô,€M.D.Ð #`" ÐÌWilliam€B.€Ô_ÔHubbardÔ_Ô€and€Robyn€E.€Smith,€Nashville,€Tennessee,€for€Amicus€Curiae,€TennesseeÐ è$8 $ ÐHospital€Association.Ð Ô%$!% ÐÌWilliam€L.€Penny€and€Jonathan€D.€Rose,€Nashville,€Tennessee,€for€Amicus€Curiae,€Hospital€AllianceÐ ¬'ü"' Ðof€Tennessee,€Inc.Ð ˜(è#( ÐÌA.€Ô_ÔYarnellÔ_Ô€Ô_ÔBeattyÔ_Ô,€Nashville,€Tennessee,€for€Amicus€Curiae,€Tennessee€Medical€Association.Ð p*À%* ÐÌDavid€Ô_ÔKumatzÔ_Ô,€Nashville,€Tennessee,€for€Amicus€Curiae,€Reciprocal€of€America.Ð H,˜', ÐÐ 4-„(-ý ÐÔ_ÔR.€Sandler€Bailey,€Jr.,€Memphis,€Tennessee;€Randall€L.€Kinnard,€Nashville,€Tennessee;€T.€J.Ð ° ÐEmison,€Alamo,€Tennessee;€J.€D.€Lee€and€Dan€C.€Stanley,€Knoxville,€Tennessee;€and€John€A.€Day,Ð œì ÐBrentwood,€Tennessee,€for€Amicus€Curiae,€The€Tennessee€Trial€Lawyers€Association.Ð ˆØ ÐÌÓQ Óà@@OO&ìàò òOPINIONó óÐ `° ÐÌÓ  Óà@ÛÛ%ìàò òòòBackgroundóóˆÐ 8 ˆ Ðó óÌà  àThe€plaintiff,€Jackie€Robinson,€is€an€inmate€housed€in€Riverbend€Maximum€Security€InstituteÐ  ` Ðin€Nashville,€Tennessee.׃×Ý ƒ#ÃÝòòÚ  Ú1Ú  ÚóóÝ  Ý×  ×€€On€March€11,€1994,€Robinson€injured€his€left€ankle€and€was€diagnosedÐ ü L  Ðwith€an€ankle€sprain€by€a€nurse€practitioner€in€the€prison€infirmary.€€After€the€pain€and€swellingÐ è 8  Ðcontinued€for€three€days,€Robinson€was€treated€in€the€infirmary€by€Dr.€Frank€Thomas;€an€x„ray€ofÐ Ô$  ÐRobinsonððs€ankle€showed€a€fracture€of€the€left€lateral€malleolus€with€distraction€of€the€ankle€mortise.Ð À  ÐÌà  àOn€March€15,€1994,€Robinson€was€treated€by€the€defendant,€Dr.€Patrick€J.€LeCorps,׃Ü×Ý ƒ#ÃÝòòÚ  Ú2Ú  ÚóóÝ  Ý×  ×€anÐ ˜è  Ðorthopedic€surgeon€with€offices€in€Nashville,€Tennessee.€€He€set€Robinsonððs€ankle€and€applied€a€longÐ „Ô  Ðleg€cast.€€On€April€5,€1994,€Dr.€LeCorps€removed€the€long€cast€and€replaced€it€with€a€short€leg€cast.€Ð pÀ ÐAlthough€Robinson€complained€that€the€ankle€was€painful,€swollen,€and€turned€at€an€awkward€angle,Ð \¬ ÐDr.€LeCorps€replied€that€the€ankle€would€straighten€out€as€it€continued€to€heal.€€On€April19,€1994,Ð H˜ Ðfour€days€after€the€short€cast€was€removed,€Robinson€had€pain€in€his€ankle€and€a€severe€limp;€Dr.Ð 4„ ÐLeCorps€prescribed€pain€medication€and€said€that€the€injury€would€improve€in€time.€€On€€May€3,Ð  p Ð1994,€and€July€5,€1994,€Dr.€LeCorps€again€prescribed€pain€medication€and€told€Robinson€the€painÐ  \ Ðwould€decrease.€€Ð øH Ðà  àÌà  àIn€September€of€1994,€Robinson€was€treated€by€Dr.€John€Lamb.€€An€x„ray€revealed€a€pastÐ Ð  Ðfracture€of€the€left€lateral€malleolus€with€a€partial€rupture€of€the€deltoid€ligament€and€subluxation€ofÐ ¼  Ðthe€talus€laterally.€€Dr.€Lamb€prescribed€pain€medication€and€a€modified€shoe€insole.€€In€DecemberÐ ¨ø Ðof€1994,€Dr.€William€Bacon€diagnosed€post„traumatic€arthritis€in€Robinsonððs€left€ankle.€€Nearly€oneÐ ”ä Ðyear€later,€in€November€of€1995,€Dr.€Bacon€performed€ankle€fusion€on€Robinson.Ð €Ð ÐÌà  àRobinson€filed€this€medical€malpractice€action€alleging€that€Dr.€LeCorps€was€negligent€andÐ X ¨ Ðthat€the€negligence€resulted€in€permanent€injury€and€ankle€fusion€surgery.€€In€an€evidentiaryÐ D!” Ðdeposition€for€trial,€Robinsonððs€expert€witness,€Dr.€William€E.€Kennedy,׃,×Ý ƒ#ÃÝòòÚ  Ú3Ú  ÚóóÝ  Ý×  ×€from€Johnson€City,Ð 0"€  ÐTennessee,€testified€that€he€had€reviewed€the€medical€records€and€x„rays€regarding€Robinsonððs€ankleÐ ° Ðand€that€Dr.€LeCorps€initially€acted€appropriately€in€performing€a€closed€reduction€of€the€fractureÐ œì Ðby€setting€the€ankle€and€applying€a€cast.€€Dr.€Kennedy€further€testified,€however,€that€x„rays€showedÐ ˆØ Ðwidening€of€the€ankle€mortise€on€April€5,€1994,€and€that€surgery€was€the€only€treatment€option€at€thatÐ tÄ Ðpoint.€€Ð `° ÐÌà  àWhen€Dr.€Kennedy€was€asked€about€the€standard€of€care€applicable€to€an€orthopaedicÐ 8 ˆ Ðsurgeon€in€Nashville,€Tennessee,€counsel€for€the€defendant,€Dr.€LeCorps,€objected€on€the€ground€thatÐ $ t ÐDr.€Kennedyððs€testimony€in€a€prior€discovery€deposition€had€been€ð ðbased€on€the€national€standard.ðð€Ð  ` ÐThe€following€exchange€then€occurred:€€€Ð ü L  ÐÌÓ€ $(ʽ83ÓØ! !ØÝ"‚3£"ÝÝ  Ýà  àà8 ` àÝ‚3£ÝÔ2ʽÔÚ  ÚQÚ  Ú.Ô3  Ôà0¸ ` x` xàÝ  Ý(Plaintiffððs€Counsel).€€Do€you€consider€the€national€standardÐ Ô$  Ðto€be€the€same€as€the€recognized€standard€of€acceptableÐ À  Ðprofessional€practice€as€it€would€be€in€Nashville,€Tennessee?€Ð ¬ü  Ð݃3£Ô݌Р¸ x¸ x ÐŒÝ  ÝÌà  àà ` à[Defendantððs€Counsel].€€Same€objection,€based€on€his€prior€deposition.€Ð pÀ ÐÌà  àà ` àA.€à0 ¸ àYes.€€ÐH˜¸ (#¸ (# ÐÌÓ€ (ª½88$ÓØ! !ØÝ"‚3£"ÝÝ  Ýà  àà ` àÝ‚3£Ì"ÝÔ2ª½ÔÚ  ÚQÚ  Ú.Ô3  Ôà0 ¸ àÝ  ÝWhat€do€you€base€that€on,€that€opinion?€Ýƒ3£Ì"#݌Рp¸ (#¸ (# ÐŒÝ  ÝØ! !Øà  à¹Ó€ "(º½88 Óà8  àà ` àA.à8¸ Ð Ð àNashville€is€certainly€recognized€as€a€regional€medicalÐ øH Ðcenter,€and€communication€and€training€are€such€inÐ ä4 Ðour€country€today€that€the€two€standards,€locally,€asÐ Ð  Ðheld€in€Nashville€and€for€that€matter€where€I€haveÐ ¼  Ðpracticed€in€Johnson€City,€would€be€expected€to€beÐ ¨ø Ðthe€same,€and€also€the€same€as€a€national€standard.€Ð”ä¸ ¸  ÐÌà8  àà8` Ð Ð àà0¸ ` x` xàThere€is€no€differentiation€recognized€in€our€profession€of€oneÐ l¼ Ðlocality€as€opposed€to€the€other,€certain€localities€comparableÐ X ¨ Ðwith€Nashville€and€Johnson€City,€Tennessee,€on€the€part€ofÐ D!” Ðany€of€our€national€organizations€including€the€AmericanÐ 0"€  ÐBoard€of€Orthopaedic€Surgery.€Ð#l!¸ x¸ x ÐÌà  àà8 ` àà8¸ ` x` xàAll€of€us,€whether€we€are€from€Johnson€City€or€fromÐ ô$D # ÐNashville,€would€stand€the€same€test€and€would€beÐ à%0!$ Ðexpected€to€have€the€same€knowledge€and€to€practiceÐ Ì&"% Ðin€very€similar€fashions€by€the€American€Board€ofÐ ¸'#& ÐOrthopaedic€Surgery.€€Ð¤(ô#'¸ ¸  Їà  àà ` à[Defendantððs€Counsel].à0 À àSame€objection.€€€€à È à€à  à€€Ð°À(#À(# ÐÌÌà  àThe€trial€court€granted€the€defendantððs€motion€to€exclude€the€expert€testimony€after€findingÐ tÄ Ðthat€it€was€based€on€a€national€standard€and€did€not€establish€the€standard€of€care€for€the€communityÐ `° Ðin€which€Dr.€LeCorps€practiced€medicine,€òòi.e.óó,€Nashville,€or€a€similar€community€as€required€in€aÐ L œ Ðmalpractice€action€under€Tenn.€Code€Ann.€ðð€29„26„115(a)(1)€(2000€&€Supp.€2001).׃'×Ý ƒ#ÃÝòòÚ  Ú4Ú  ÚóóÝ  Ý×  ×€€The€trial€courtÐ 8 ˆ Ðalso€refused€to€allow€the€plaintiff€to€introduce€the€testimony€of€Dr.€Kennedy€at€trial€and€dismissedÐ $ t Ðthe€complaint.€€The€Court€of€Appeals€affirmed€the€trial€courtððs€judgment.Ð  ` ÐÌà  àWe€granted€this€appeal.€€€Ð è 8  ÐÌà@‚‚&ìàò òAnalysisó óˆà p àòòÐ À  ÐóóÌà@HH"ìàòòStandard€of€CareóóˆÐ ˜è  ÐÌà  àThe€plaintiff,€Jackie€Robinson,€contends€that€the€trial€court€erred€in€finding€that€he€did€notÐ pÀ Ðintroduce€expert€testimony€to€establish€the€recognized€standard€of€professional€care€in€theÐ \¬ Ðcommunity€in€which€the€defendant€practiced€or€in€a€similar€community€as€required€by€Tenn.€CodeÐ H˜ ÐAnn.ðð€29„26„115(a)(1).€€Moreover,€Robinson€argues€that€this€Court€should€enlarge€the€scope€of€theÐ 4„ Ðð ðlocality€ruleðð€as€expressed€in€the€statute€by€adopting€a€national€standard€of€care€that€would€reflectÐ  p Ðthe€modern€changes€and€improvements€in€the€practice€of€medicine,€medical€technology,€andÐ  \ Ðcommunication.׃)×Ý ƒ#ÃÝòòÚ  Ú5Ú  ÚóóÝ  Ý×  ×€òòóó€Ð øH ÐÌà  àThe€defendant,€Dr.€LeCorps,€maintains€that€the€trial€court€applied€the€ð ðlocality€ruleðð€asÐ Ð  Ðrequired€by€the€statute€and€properly€found€that€Robinson€failed€to€meet€his€required€burden.€ò òó óÐ ¼  ÐÌà  àOur€review€of€the€trial€courtððs€action€requires€an€examination€of€the€medical€malpracticeÐ ”ä Ðstatute,€Tenn.€Code€Ann.€ðð€29„26„115,€and€we€will€begin€by€summarizing€familiar€principles€ofÐ €Ð Ðstatutory€construction.€€The€purpose€of€statutory€construction€is€ð ðto€ascertain€and€give€effect€to€theÐ l¼ Ðlegislative€intent€without€unduly€restricting€or€expanding€a€statuteððs€coverage€beyond€its€intendedÐ X ¨ Ðscope.ðð€€òòOwens€v.€Stateóó,€908€S.W.2d€923,€926€(Tenn.€1995)€(citation€omitted)òòóó.€€Courts€must€restrictÐ D!” Ðtheir€review€ð ðto€the€natural€and€ordinary€meaning€of€the€language€used€by€the€legislature€in€theÐ 0"€  Ðstatute,€unless€an€ambiguity€requires€resort€elsewhere€to€ascertain€legislative€intent.ðð€€òòBrowder€v.Ð ° ÐMorrisóó,€975€S.W.2d€308,€311€(Tenn.€1998)€(citing€òòAustin€v.€Memphis€Pub.€Co.óó,€655€S.W.2d€146,Ð œì Ð148€(Tenn.€1983)).€€The€construction€of€a€statute€is€a€question€of€law€subject€to€òòde€novoóóreviewÐ ˆØ Ðwithout€a€presumption€of€correctness.€€òòIvey€v.€Trans€Global€Gas€&€Oilóó,€3€S.W.3d€441,€446€(Tenn.Ð tÄ Ð1999).Ð `° ÐÌà  àWith€these€principles€in€mind,€we€turn€to€the€statutory€provisions€under€review€in€this€case:€Ð 8 ˆ ÐÌà8  àà8` Ð Ð à(a)à0¸ ` x` xàIn€a€malpractice€action,€the€claimant€shall€have€the€burden€ofÐ  ` Ðproving€.€.€.€:€Ðü L ¸ x¸ x ÐÌà8  àà8` Ð Ð à(1)à0¸ ` x` xàThe€recognized€standard€of€acceptable€professional€practiceÐ Ô$  Ðin€the€profession€and€the€specialty€thereof,€if€any,€that€theÐ À  Ðdefendant€practices€òòin€the€community€in€which€the€defendantÐ ¬ü  Ðpractices€or€in€a€similar€communityóó€at€the€time€the€allegedÐ ˜è  Ðinjury€or€wrongful€action€occurred.€€Ð„Ô ¸ x¸ x ÐÌTenn.€Code€Ann.€ðð€29„26„115(a)(1)€(emphasis€added).׃,×Ý ƒ#ÃÝòòÚ  Ú6Ú  ÚóóÝ  Ý×  ×òòóóÐ \¬ ÐÌà  àThe€plain€and€ordinary€language€in€ðð€115(a)(1)€embraces€the€so„called€ð ðlocality€rule,ðð€whichÐ 4„ Ðrequires€that€the€standard€of€professional€care€must€be€based€upon€ð ðthe€community€in€which€theÐ  p Ðdefendant€practices€or€in€a€similar€community.ðð€As€this€Court€has€said:€€€Ð  \ ÐÌà8  àà8` Ð Ð àThis€geographic€component€to€the€relevant€standard€of€care€evolvedÐ ä4 Ðout€of€a€recognition€that€medical€customs€or€practices€variedÐ Ð  Ðdepending€on€the€particular€area€in€which€the€physician€practiced....Ð ¼  ÐTraditionally,€the€relevant€geographic€area€was€strictly€defined.€€TheÐ ¨ø Ðplaintiff€was€required€to€introduce€evidence€concerning€the€standardÐ ”ä Ðof€care€in€the€strict€locality€where€the€defendant€worked.€€Ð€Ð` x` x ÐòòÌSutphin€v.€Plattóó,€720€S.W.2d€455,€457€(Tenn.€1986)€(citation€omitted).€€Although€the€òòSutphinóó€CourtÐ X ¨ Ðalso€observed€that€the€phrase€ð ðor€in€a€similar€community,ðð€may€reflect€a€ð ðmodern€trend€towards€theÐ D!” Ðnational€standardization€of€medical€practices,ððòòóó€òòid.óó,€it€nonetheless€clarified€the€legislative€intent€andÐ 0"€  Ðpurpose€as€follows:Ð #l! ÐÌà8  àà8` Ð Ð àThere€is€an€undeniable€legitimate€state€interest€in€assuring€thatÐ ô$D # Ðdoctors€charged€with€negligence€in€this€State€receive€a€fair€assessmentÐ à%0!$ Ðof€their€conduct€in€relation€to€community€standards€similar€to€the€oneÐ ° Ðin€which€they€practice.Мì` x` x ÐÌòòId.óóat€458;€òòseeóó€òòalsoóó€òòCardwell€v.€Bechtolóó,€724€S.W.2d€739,€754€(Tenn.€1987).Ð tÄ ÐÌà  àDespite€the€clear€statutory€language€and€evidence€of€legislative€intent,€òòóóRobinson€asserts€thatÐ L œ Ðthe€locality€rule€in€Tenn.€Code€Ann.€ðð€29„26„115(a)(1)€should€be€enlarged€or€broadened€by€adoptingÐ 8 ˆ Ða€national€standard€of€professional€care€for€all€malpractice€actions,€malpractice€actions€involvingÐ $ t Ðphysicians€who€are€board„certified€in€a€particular€area,€or€malpractice€actions€involving€a€specificÐ  ` Ðtreatment€issue€or€area€of€medicine.€€There€is€no€statutory€language€or€other€evidence€of€legislativeÐ ü L  Ðintent,€however,€that€would€support€such€an€interpretation.€€Ð è 8  ÐÌà  àThe€legislature,€which€is€presumed€to€know€of€its€enactments€and€the€state€of€the€law,€hasÐ À  Ðnot€amended€or€supplemented€the€statutory€language€in€any€way€that€would€broaden€the€locality€ruleÐ ¬ü  Ðor€support€such€a€sweeping€change€in€the€standard€of€care€in€malpractice€actions.€€Moreover,€in€theÐ ˜è  Ðabsence€of€applicable€statutory€language,€we€decline€to€adopt€the€plaintiffððs€interpretation€basedÐ „Ô  Ðeither€on€policy€arguments€or€alleged€evidence€of€the€existence€of€a€national€standard€of€care€in€theÐ pÀ Ðmedical€community€that€are€better€addressed€to€the€legislature.€€Ð \¬ ÐÌà  àThis€Court€is€mindful,€however,€that€in€many€instances€the€national€standard€would€indeedÐ 4„ Ðbe€representative€of€the€local€standard,€especially€for€board€certified€specialists.€€Although€suchÐ  p Ðissues€are€properly€left€to€the€discretion€of€the€legislature,€we€encourage€the€General€Assembly€toÐ  \ Ðreconsider€the€current€statutory€framework€of€the€locality€rule.€€However,€until€such€legislativeÐ øH Ðaction,€we€believe€that€the€legislative€intent€and€purpose€of€Tenn.€Code€Ann.€ðð€29„26„115(a)(1),€asÐ ä4 Ðpresently€derived€from€the€statutory€language,€continues€to€be€that€the€conduct€of€doctors€in€this€StateÐ Ð  Ðis€assessed€in€accordance€with€the€standard€of€professional€care€in€the€community€in€which€theyÐ ¼  Ðpractice€or€one€similar€to€it.׃&×Ý ƒ#ÃÝòòÚ  Ú7Ú  ÚóóÝ  Ý×  ×Ð ¨ø ÐÌà  àA€plaintiff€in€a€malpractice€action,€therefore,€must€produce€expert€medical€€evidence€toÐ €Ð Ðestablish€the€standard€of€professional€care€in€the€community€in€which€a€defendant€practices€or€in€aÐ l¼ Ðsimilar€community.€€A€medical€expert€relied€upon€by€a€plaintiff€must€have€knowledge€of€the€standardÐ X ¨ Ðof€professional€care€in€the€defendantððs€applicable€community€or€knowledge€of€the€standard€ofÐ D!” Ðprofessional€care€in€a€community€òòthat€is€shown€to€be€similaróó€to€the€defendantððs€community.€€WhileÐ 0"€  Ðan€expertððs€discussion€of€the€applicability€of€a€national€standard€does€not€require€exclusion€of€theÐ #l! Ðtestimony,€such€evidence€may€not€substitute€for€evidence€that€first€establishes€the€requirements€ofÐ $X" ÐTenn.€Code€Ann.€ðð€29„26„115(a)(1).€€Ð ô$D # ÐÌà  àOur€interpretation€of€the€statute€is€consistent€with€prior€Court€of€Appealsðð€decisions,Ð Ì&"% Ðincluding€òòMabon€v.€Jackson„Madison€County€Gen.€Hosp.óó,€968€S.W.2d€826€(Tenn.€Ct.€App.€1997).€Ð ¸'#& Ðò òó óThere,€the€plaintiffððs€expert€stated€òòóóby€affidavit€that€he€was€ð ðfamiliar€with€the€recognized€standard€ofÐ ¤(ô#' Ðacceptable€medical€practice€.€.€.€in€an€area€such€as€Jackson,€Tennessee.€.€.,€and€that€the€standard€ofÐ ° Ðcare€in€Jackson€.€.€.€would€be€comparable€to€the€cities€and€facilities€at€which€he€had€practicedÐ œì Ðmedicine.ðð€€The€expert€later€elaborated€by€testifying€that€ð ðthere€is€a€national€standard€of€care€forÐ ˆØ Ðphysicians€.€.€.€.ðð€€òòId.óó€€The€Court€of€Appeals€concluded€that€the€plaintiff€failed€to€meet€the€burdenÐ tÄ Ðunder€Tenn.€Code€Ann.€ðð€29„26„115(a)(1):€€òòóó€Ð `° ÐÌà8  àà8` Ð Ð à[W]e€cannot€accept€Dr.€Shaneððs€bare€assertion€that€the€standard€ofÐ 8 ˆ Ðcare€in€Jackson€is€the€same€nationwide€and€that€the€level€of€care€withÐ $ t Ðwhich€Dr.€Shane€is€familiar€òòshouldóó€have€been€available€inÐ  ` ÐJackson....€Dr.€Shane€simply€failed€to€establish€that€he€hadÐ ü L  Ðknowledge€of€the€requisite€standard€of€care€in€Jackson,€Tennessee€orÐ è 8  Ðin€a€similar€community.€€òòÐÔ$ ` x` x ÐÌId.óó€at€831.Ð ¬ü  ÐÌà  àAccordingly,€in€applying€Tenn.€Code€Ann.€ðð€29„26„115(a)(1)€to€the€scant€evidence€in€thisÐ „Ô  Ðcase,€it€is€clear€that€Dr.€Kennedyððs€testimony€did€not€establish€the€standard€of€professional€care€inÐ pÀ ÐNashville,€Tennessee,€or€in€a€similar€community.€€Although€Dr.€Kennedy€was€licensed€in€Tennessee,Ð \¬ Ðpracticed€in€Johnson€City,€Tennessee,€and€was€board€certified€in€orthopaedic€surgery,€he€testifiedÐ H˜ Ðonly€that€the€applicable€standard€of€care€in€this€case€ð ðwould€be€expectedðð€to€be€the€same€as€theÐ 4„ Ðnational€standard€of€care€and€that€ð ð[t]here€is€no€differentiation€recognized€in€.€.€.€one€locality€asÐ  p Ðopposed€to€the€other,€certain€localities€comparable€with€Nashville€.€.€.€.ðð€€Dr.€Kennedy€also€stated€thatÐ  \ Ðorthopaedic€surgeons€ð ðwould€stand€the€same€test€and€would€be€expected€to€have€the€same€knowledgeÐ øH Ðand€to€practice€in€very€similar€fashions€by€the€American€Board€of€Orthopaedic€Surgeons.ðð€€He€didÐ ä4 Ðnot,€however,€relate€the€basis€for€his€knowledge€of€the€standard€of€care€in€Nashville€or€indicate€whyÐ Ð  Ðthe€Nashville€medical€community€was€similar€to,€and€thus€had€the€same€standard€of€professional€careÐ ¼  Ðas,€the€community€with€which€Dr.€Kennedy€was€familiar.Ð ¨ø ÐÌà  àWe€therefore€agree€with€the€Court€of€Appealsðð€conclusion€that€the€trial€court€did€not€abuseÐ €Ð Ðits€discretion€by€excluding€the€deposition€testimony.€€òòSeeóó€òòMcDaniel€v.€CSX€Transp.,€Inc.óó,€955Ð l¼ ÐS.W.2d€257,€263€(Tenn.€1997)€(holding€that€the€trial€court€has€broad€discretion€in€determining€theÐ X ¨ Ðadmissibility,€qualifications,€relevancy€and€competency€of€expert€testimony).Ð D!” ÐÌà@  ìàò òòòDismissal€of€Complaintóóó óˆÐ #l! ÐÌà  àòòóóRobinson€next€argues€that€he€should€have€been€permitted€to€present€the€in„court€testimonyÐ ô$D # Ðof€Dr.€Kennedy€to€expound€upon€his€deposition€testimony€with€regard€to€the€standard€of€care€andÐ à%0!$ Ðthat€the€trial€court€erred€in€dismissing€the€action.€€The€defendant€argues€that€the€trial€court€did€notÐ Ì&"% Ðabuse€its€discretion€in€refusing€to€hear€additional€proof€under€the€circumstances€of€this€case.Ð ¸'#& ÐÌà  àThis€Court€has€stated€that€it€is€ð ðwithin€the€discretion€of€the€trial€judge€to€decide€whether€toÐ )à$( Ðreopen€the€proof€for€further€evidence,€and€the€decision€of€the€trial€judge€.€.€.€will€not€be€set€asideÐ |*Ì%) Ðunless€there€is€a€showing€that€an€injustice€has€been€done.ðð€€òòSimpson€v.€Frontier€Community€CreditÐ h+¸&* ÐUnionóó,€€810€S.W.2d€147,€149€(Tenn.€1991)€(quoting€òòHiggins€v.€Steideóó,€335€S.W.2d€533€(1959)).€Ð ° ÐWith€these€standards€in€mind€we€will€review€the€facts€and€circumstances€of€this€case.Ð œì ÐÌà  àAs€noted€by€the€Court€of€Appeals€in€the€present€case,€Robinson€was€aware€of€the€requiredÐ tÄ Ðelements€of€a€malpractice€action€under€Tenn.€Code€Ann.€ðð€29„26„115(a)€and€(b)€and€also€knew€thatÐ `° Ðthe€defendant€objected€to€the€testimony€of€Dr.€Kennedy€with€regard€to€the€standard€of€professionalÐ L œ Ðcare€in€a€discovery€deposition.€€Moreover,€counsel€for€Dr.€LeCorps€objected€and€cited€this€specificÐ 8 ˆ Ðground€on€two€occasions€during€the€evidentiary€deposition€of€Dr.€Kennedy.€€Despite€these€specificÐ $ t Ðobjections,€Robinson€did€not€ask€Dr.€Kennedy€to€clarify€his€testimony€with€respect€to€the€applicableÐ  ` Ðstandard€of€care€and€did€not€present€any€other€expert€witnesses€to€establish€an€appropriate€standard.€Ð ü L  ÐIn€addition,€Robinson€made€no€showing€of€how€Dr.€Kennedyððs€new€testimony€would€differ€or€clarifyÐ è 8  Ðthe€standard€of€professional€care€in€accordance€with€the€statutory€requirements.€€We€therefore€agreeÐ Ô$  Ðwith€the€Court€of€Appealsðð€conclusion€that€the€trial€court€did€not€err€in€refusing€to€allow€Dr.€KennedyÐ À  Ðto€testify€and€in€dismissing€the€action.€€€€Ð ¬ü  ÐÌò òà@  %ìàòòConclusionó óóóˆÐ „Ô  ÐÌà  àAfter€reviewing€the€record€and€applicable€authority,€we€conclude€that€the€plaintiff€did€notÐ \¬ Ðproduce€expert€testimony€to€establish€the€standard€of€professional€care€in€the€community€in€whichÐ H˜ Ðthe€defendant€practiced€or€in€a€similar€community€as€required€by€the€ð ðlocality€ruleðð€in€Tenn.€CodeÐ 4„ ÐAnn.€ðð€29„26„115,€and€that€the€trial€court€did€not€abuse€its€discretion€in€excluding€the€testimony€andÐ  p Ðdismissing€the€complaint.€€We€therefore€affirm€the€judgment€of€the€Court€of€Appeals.€€Costs€of€theÐ  \ Ðappeal€are€taxed€to€the€plaintiff,€Jackie€Robinson,€for€which€execution€shall€issue.Ð øH ÐÌÌÌà  àà0 ` àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà0À(#À(#à____________________________________Шø(#(# Ðà  àà ` àà ¸ àà  àà h àà À àà  àE.€RILEY€ANDERSON,€JUSTICEÐ ”ä ÐÌ