ÿWPC> ÑOõ&ÔЂ®QE½a·ûKJtóR…¢þJ#Y3~Ä ÿX 1~á¾­y]°e5·¼…±Ö~RX†(ßǃ(Œ96‚ý,¨á^™é¶öÇ®¤që0Æð–ÑÔN0eôÏ&6-èMÒᇲÉ=ê˜G»¼ïòôiàÚö^‚p¥¨~?Wé %˽©4Ú§ÂðþÜÉ7²ZÞN2oÉ‘Øó|”nXZòP<‘ÿæÌ;h„ï$s•vÙu£9Ö³mÃòœ—y0×ê¥tÞ”…ÁÕ\‡ÇŽR/+ä'‰Î³ì^qvÜ#ƒe¯ãÖⲂ›´Âütú>ÜO|~ÜóaAN`F0F=ˆD%ùYHѶkfÛºÁY.Ÿbr±û1hVõŸ²Vô°‹ôB.Â¥ì!UFq4qò¸]º3gëFTœÖ Šë}™Ëš¤éû¸açÑíÕÈ^xæøíêÙpnuÞ¿O»þ½=ѵ-–ðýîŸù Ãy­SغòÕrqM‹ˆ¬‡R¹’X wl¶Ià¢'èýHT[àÈTK±µ²éN,Óˆòb.òþŸrwÅ1½6eÚ8®ƒË­hð™kK¨ >ÌdLûŠf@)„){à (¿= æŒM¿Cø–iFFáâ‰Åú¦’jb#Á\ % ^ # 0ˆ/ UN· w 4 z Ò— i x mz ‘ Æ™ Æ_ Æ% Æë ë N±N³ zµÒ//E      ! )))))))))))b111111111111111111111111111111111111 0ë9999 B$$ 0¤A D5å D- 0KGG AS’Æå 0¤« 0DO A«“˜\\IB27S11T\stats1ÈÈ,,,,ÈÈ0»Ŧr/s (`£ª$¡¡Ñ€.ÑÑ8€½­»»d»»d8ÑÑ ý ÑÓ  Ó(í€"  Z6Times New Roman Regular8AÅ.ê:i¢Ø+00 ˜C:\PROGRA~1\COREL\WORDPE~1\TEMPLATE\CUSTOM~1\REVISE~1.WPTC:\Program Files\Corel\WordPerfect Office 2000\Template\Custom WP Templates\revised standard opinion.wpt3|xÿU‹ÿÀÀÀ Level 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5˜C:\PROGRA~1\COREL\WORDPE~1\TEMPLATE\CUSTOM~1\REVISE~1.WPTC:\Program Files\Corel\WordPerfect Office 2000\Template\Custom WP Templates\revised standard opinion.wptH45678- ù-(|G2hø$¤¤Ý ƒ£ª!ÝÑ€.ÑÑ8€Iý»»dd8ÑÑ ý ÑÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  ÚóóÔ€X yX»»Ô d(|3’$££Ý ƒ£ª!ÝÑ€.ÑÑ8€Iý»»dd8ÑÑ ý ÑÓ  ÓÝ  ÝVVVV)ÿÿ!dxdx)!ÈÈÈÈdxdx( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó^_X`YEþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(|3’$¢¢Ý ƒ£ª!ÝÑ€.ÑÑ8€Iý»»dd8ÑÑ ý ÑÓ  ÓÝ  Ý($$””ò òÚ  Ú1Ú  Úó óX[Z&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ£ª!ÝÑ€.ÑÑ8€L¹»»ddÈ8ÑÑ ý ÑÓ  ÓÝ  ÝÔ_ÔÔ€¼L¹»»»ÔÑ8€5XXdì»»d8ÑÓ  ÓÔ‡X5X»¼L¹Ôà@@7 7 ìàIN€THE€SUPREME€COURT€OF€TENNESSEEÐ ° ÐSPECIAL€WORKERSðð€COMPENSATION€APPEALS€PANELÐ œì Ðà@@ƒƒìàAT€KNOXVILLEà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àà0 @ àÐ ˆØ ÐSeptember€19,€2003Ð tÄ ÐÌò òÔ_ÔTRACIÔ_Ô€L.€NOLAN€v.€COVENANT€HEALTHÐ L œ ÐÌDirect€Appeal€from€the€Chancery€Court€for€Ô_ÔLoudonÔ_Ô€CountyÐ $ t ÐNo.€9945à0 @ àà0 @ àà0 @ àà0 @ àà0 @ à€€€€€Frank€V.€Williams,€III,€ChancellorÐ  ` ÐÌFiled€November€17,€2003Ð è 8  Ð________________________Ð Ô$  ÐÌE2003„00288„Ô_ÔWCÔ_Ô„R3„CVÐ ¬ü  Ð________________________Ð ˜è  Ðó óÓ  ÓÌÌThis€workersðð€compensation€appeal€has€been€referred€to€the€Special€Workersðð€CompensationÐ \¬ ÐAppeals€panel€of€the€Supreme€Court€in€accordance€with€Tennessee€Code€Annotated€Ô#†¼L¹»XX5î#ÔÔ€X5X»¼L¹Ôðð€50„6„Ð H˜ Ð225(e)(3)€for€hearing€and€reporting€to€the€Supreme€Court€of€findings€of€fact€and€conclusions€ofÐ 4„ Ðlaw.€€The€trial€court€found€the€plaintiff€did€not€prove€that€she€contracted€Hepatitis€C€while€in€theÐ  p Ðcourse€and€scope€of€her€employment.€€We€affirm€the€judgment€of€the€trial€court.Ð  \ ÐÌÌò òTenn.€Code€Ann.€ðð€50„6„225(e)(1999)€Appeal€as€of€Right;€Judgment€of€the€Chancery€Court€€Ð Ð  Ѐ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€is€AffirmedÐ ¼  ÐÌó óòòJohn€K.€Byers,€Sr.€Jóó.,€delivered€the€opinion€of€the€court,€in€which€òòÔ_ÔE.RileyÔ_Ô€Andersonóó,€J.,€andÐ ”ä ÐòòRoger€E.€Thayeróó,€Sòòpóó.€J.,€joined.Ð €Ð ÐÌJoseph€M.€Ford,€Ô_ÔLoudonÔ_Ô,€Tennessee,€for€the€appellant,€Ô_ÔTraciÔ_Ô€L.€Nolan.Ð X ¨ ÐÌF.€Michael€Ô_ÔFitzpatrickÔ_Ô,€Knoxville,€Tennessee,€for€the€appellee,€Covenant€Health.Ð 0"€  ÐÌÌÓ  Óò òMEMORANDUM€OPINIONÐ ô$D # ÐÌó óÓ  Óà  àReview€of€the€findings€of€fact€made€by€the€trial€court€is€òòde€novoóó€upon€the€record€of€theÐ Ì&"% Ðtrial€court,€accompanied€by€a€presumption€of€the€correctness€of€the€findings,€unless€theÐ ¸'#& Ðpreponderance€of€the€evidence€is€otherwise.€€òòTenn.€Code€Ann.óó€ðð€50„6„225(e)(2);€òòStone€v.€City€ofÐ ¤(ô#' ÐÔ_ÔMcMinnvilleÔ_Ô,€óó896€S.W.2d€548,€550€(Tenn.€1995).€€The€application€of€this€standard€requires€thisÐ )à$( ÐCourt€to€weigh€in€more€depth€the€factual€findings€and€conclusions€of€the€trial€court€in€workersððÐ |*Ì%) Ðcompensation€cases.€€òòSee€Corcoran€v.€Foster€Auto€Ô_ÔGMCÔ_Ô,€Inc.,óó€746€S.W.2d€452,€456€(Tenn.Ð h+¸&* Ð1988).Ð T,¤'+ Ðà  àThe€trial€court€found€that€the€plaintiff€did€not€establish€that€she€contracted€Hepatitis€CÐ @-(,ý ÐÔ_Ôwhile€in€the€course€and€scope€of€employment,€and€dismissed€her€claim.€€The€plaintiff€argues€thatÐ ° Ðshe€did€in€fact€satisfy€her€burden€of€proof€as€to€causation€by€eliminating€all€possible€causes€forÐ œì Ðcontracting€the€disease€other€than€an€incident€she€was€involved€in€while€treating€a€patient€atÐ ˆØ Ðwork.€Ð tÄ ÐÌò òÓ  ÓFactsÐ L œ ÐÌÓ  Óó óà  àThe€plaintiff,€Traci€Nolan€is€a€39€year„old€female€who€was€employed€by€defendant,Ð $ t ÐCovenant€Health,€from€September€of€1997€until€August€of€2000.€€The€plaintiff€is€a€registeredÐ  ` Ðnurse€and€regularly€worked€from€8:00€to€5:00€seeing€about€8€to€10€patients€per€day,€and€was€alsoÐ ü L  Ðon„call€a€great€deal€of€time,€averaging€around€50€hours€per€week.€€The€plaintiff€contends€that€sheÐ è 8  Ðcontracted€Hepatitis€C€from€exposure€while€in€the€course€and€scope€of€her€employment€with€theÐ Ô$  Ðemployer.€Ð À  ÐÌà  àOn€February€18,€1999,€the€plaintiff€was€attending€to€a€patient,€Ms.€Bishop.€€The€plaintiffÐ ˜è  Ðwas€leaning€over€Ms.€Bishop€tending€to€a€wound€on€Ms.€Bishopððs€left€breast€when€a€boil€on€Ms.Ð „Ô  ÐBishopððs€face€burst,€spewing€a€blood€and€pus€mixture€onto€the€plaintiffððs€body€and€clothes.€€TheÐ pÀ Ðplaintiff€testified€at€trial€that€the€patientððs€body€fluids€contacted€her€eyes€(although€the€plaintiffÐ \¬ Ðwas€wearing€glasses),€mouth,€nose,€and€psoriatic€skin€on€her€arm.€€In€March€of€2000,€the€plaintiffÐ H˜ Ðwas€pricked€by€a€needle€and€was€tested€for€exposure.€€Her€results€came€back€positive€forÐ 4„ ÐHepatitis€C,€but€because€of€the€incubation€period,€the€Hepatitis€C€could€not€be€the€result€of€theÐ  p Ðneedle€prick€in€March€of€2000.€€Ð  \ ÐÌà  àThe€only€exposure€known€to€the€plaintiff€was€that€of€the€incident€with€Ms.€Bishop,€so€theÐ ä4 Ðplaintiff€filled€out€a€report€with€the€employer.€€The€plaintiff€also€ruled€out€her€sexual€partners€forÐ Ð  Ð9€years€prior€to€the€incident,€as€none€of€them€tested€Hepatitis€C€positive.€€However,€the€employerÐ ¼  Ðemphasizes€that€the€plaintiff€was€a€cocaine€user€in€the€1980's,€has€been€married€5€times,€one€ofÐ ¨ø Ðher€ex„husbands€is€a€ð ðstreet€person,ðð€and€one€of€her€past€sexual€partners€was€an€IV€drug€user.€Ð ”ä ÐThe€employer€also€emphasizes€that€no€known€cases€of€Hepatitis€C€can€be€traced€to€exposure€ofÐ €Ð Ðfluids€to€the€skin,€and€that€the€plaintiffððs€symptoms€of€fatigue€and€abdominal€pain€began€prior€toÐ l¼ Ðthe€incident€with€Ms.€Bishop.€€The€plaintiff€currently€works€for€House€Call€Home€Health,€andÐ X ¨ Ðtestified€that€she€is€able€to€perform€this€job€because€it€is€fewer€hours€and€less€stress.Ð D!” ÐÌò òÓ  ÓMedical€EvidenceÐ #l! ÐÌÓ  Óó óà  àThe€medical€evidence€came€from€three€doctors,€Drs.€Anderson,€Rose,€and€Mixon.€€TheÐ ô$D # Ðplaintiff€went€to€see€Dr.€Mark€Anderson€on€June€30,€2000.€€Dr.€Anderson€practices€in€the€area€ofÐ à%0!$ Ðclinical€trials€for€ribavirin€and€interferon€treatments€for€Hepatitis€C.€€The€plaintiff€testified€thatÐ Ì&"% ÐDr.€Anderson€told€her€that€she€had€contracted€Hepatitis€C€sometime€in€the€three€years€prior€to€herÐ ¸'#& Ðseeing€him.Ð ¤(ô#' ЀÌà  àDr.€Richard€Rose,€III€is€an€infectious€disease€specialist€who€has€prior€experience€at€theÐ |*Ì%) ÐCenter€for€Disease€Control€(ð ðCDCðð).€€Dr.€Rose€testified€that€it€would€be€ð ðpossibleðð€for€theÐ h+¸&* Ðplaintiff€to€have€contracted€the€Hepatitis€C€by€contact€with€a€patientððs€bodily€fluid€to€a€psoriasisÐ ° Ðsore€or€scab,€and€that€it€was€ð ðpossibleðð€to€contract€the€disease€through€contact€with€the€eye€orÐ œì Ðmouth,€but€also€stated€that€ð ðanything€is€possible.ðð€€Dr.€Rose€also€stated€that€this€was€onlyÐ ˆØ Ðspeculative.€€Dr.€Rose€stated€that€the€plaintiff€probably€contracted€the€disease€in€the€last€ten€yearsÐ tÄ Ðbased€on€the€level€of€inflammation€from€the€plaintiffððs€liver€biopsy.€€Dr.€Rose€also€stated€thatÐ `° Ðthere€was€a€50%€chance€that€the€plaintiff€had€contracted€the€disease€in€the€last€5€years.€€Dr.€RoseÐ L œ Ðstated€that€the€appropriate€impairment€rating€for€the€plaintiff€would€be€in€the€upper€range€of€14%.€Ð 8 ˆ ÐDr.€Rose€testified€that€the€most€probable€way€of€contracting€the€disease€is€from€a€direct€needleÐ $ t Ðstick,€and€that€even€a€direct€needle€stick€only€yields€a€1.8%€chance€of€contracting€the€disease.€Ð  ` ÐDr.€Rose€also€testified€that€the€best€studies€from€the€CDC€show€that€no€transmission€has€everÐ ü L  Ðbeen€documented€from€contact€between€bodily€fluid€and€intact€or€non„intact€skin.ò òÐ è 8  ÐÌà  àó óDr.€William€Mixon€is€the€plaintiffððs€treating€physician,€and€saw€the€plaintiff€on€FebruaryÐ À  Ð9,€1999,€nine€days€before€the€incident€of€exposure€with€Ms.€Bishop.€€In€his€report,€Dr.€MixonÐ ¬ü  Ðstates€that€the€plaintiff€is€feeling€poorly.€€He€also€states€that€she€is€ð ðhaving€continuousÐ ˜è  Ðfatigue...night€sweats...and€simply€doesnððt€feel€good.ðð€€Dr.€Rose€testified€that€these€symptomsÐ „Ô  Ðwere€compatible€with€the€Hepatitis€C€disease,€and€that€they€were€most€likely€caused€by€theÐ pÀ Ðdisease.€€The€evidence€also€showed€that€the€plaintiff€was€complaining€of€migratory€abdominalÐ \¬ Ðpains€in€the€right€upper€quadrant,€which€is€the€location€of€the€liver,€in€February€of€1998.€€Dr.Ð H˜ ÐRose€also€testified€that€this€was€indicative€of€Hepatitis€C.€ò òÐ 4„ ÐÌÓ  ÓDiscussionÐ  \ ÐÌÓ  Óó óà  àThe€trial€judge€in€this€case€relied€heavily€on€the€testimony€of€Dr.€Rose,€and€found€thatÐ ä4 Ðthere€was€no€competent€testimony€to€refute€Dr.€Rose.€€We€may,€of€course,€make€an€independentÐ Ð  Ðassessment€of€the€depositions€because€we€are€in€as€good€a€position€as€the€trial€judge€to€determineÐ ¼  Ðthe€credibility€of€the€testimony.€€òòCooper€v.€INA,€óó884€S.W.2d€446€(Tenn.€1994).€€However,€unlessÐ ¨ø Ðthere€is€something€inherent€in€the€depositions€which€undermines€their€reliability,€we€do€not€reachÐ ”ä Ða€conclusion€different€from€the€trial€judge€merely€because€we€may€do€so.€€Ð €Ð ÐÌà  àThe€finding€of€the€trial€judge€is€influenced€by€the€testimony€of€Dr.€Rose€that€he€can€onlyÐ X ¨ Ðspeculate€that€Ms.€Nolan€contracted€the€disease€from€the€exposure€to€the€patient.€€AlthoughÐ D!” Ðabsolute€certainty€is€not€required€to€prove€causation,€in€all€but€the€most€obvious€cases,€such€asÐ 0"€  Ðthe€loss€of€a€member,€expert€testimony€is€required€to€establish€causation.€€òòThomas€v.€Aetna€LifeÐ #l! Ð&€Casualty€Co.,óó€812€S.W.2d€278€(Tenn.€1991).€€Although€the€trial€judge€notes€that€the€workersððÐ $X" Ðcompensation€laws€are€generally€designed€to€construe€the€evidence€in€the€favorable€light€towardÐ ô$D # Ðthe€plaintiff,€the€trial€judge€found€that€the€testimony€was€so€uncertain€and€so€tenuous€with€regardÐ à%0!$ Ðto€causation€that€he€could€not€find€for€the€plaintiff,€and€we€agree.Ð Ì&"% ÐÌà  àThe€finding€of€the€trial€judge€is€also€influenced€by€the€fact€that€Ms.€Nolan€was€havingÐ ¤(ô#' Ðsymptoms€that€can€occur€with€Hepatitis€C€prior€to€her€exposure€to€the€patient.€€The€trial€judgeÐ )à$( Ðstated:Ð |*Ì%) Ðà0  àIn€other€words,€I€take€the€doctor€to€be€saying€that€these€symptoms€that€he€has€hadÐ h+¸&* Ðdescribed€to€him€from€Dr.€Mixonððs€report€back€in€early€February€of€1999,€that€heððs€sayingÐ ° Ðthat€they€could€be€symptoms€of€Hepatitis€C€and€givenð!ðhe€goes€on€to€say€that€given€whereÐ œì Ðshe€is€today€that€he€suspects€that€they€were€in€fact,€that€they€are€in€fact€due€to€that,€due€toÐ ˆØ Ðthe€fact€that€she€was€infected€with€Hepatitis€C.ò òÐtÄ(#(# ÐÌó óBecause€of€the€foregoing€reasons,€the€trial€judge€was€unwilling€to€find€in€favor€of€the€plaintiff.Ð L œ ÐFrom€the€record€we€find€the€trial€judge€did€not€abuse€his€discretion€in€making€this€ruling,€andÐ 8 ˆ Ðagree€with€his€ruling.ò òÐ $ t ÐÌó óThe€costs€of€this€appeal€are€taxed€to€the€Appellant.ò òÐ ü L  ÐÌÌÌà  àà ` àà ¸ àà  àà h àà À àà  à____________________________________Ð ¬ü  Ðà  àà ` àà ¸ àà  àà h àà À àà  àó óJOHN€K.€BYERS,€SENIOR€JUDGEò òÐ ˜è  ÐÌó óà0  àò òÐ (#(# Ðó óà0  àò òÐ (#(# ÐÌó óà0  à€€€€ò òÐ4„(#(# ÐÌó ó€€€€Ð   \ ÐÔ‡¼L¹»XX5Ôà@7 7 ìàÔ#†X5X»¼L¹I2#ÔÔ‡¼L¹»XX5ÔIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ ° Ðà@° ° ìàAT€KNOXVILLE,€TENNESSEE€Ô#†X5X»¼L¹2#ԈР ÐÌÌÌò òÔ‡¼L¹»XX5ÔÓ  ÓTRACI€L.€NOLAN€V.€COVENANT€HEALTHÔ#†X5X»¼L¹\3#ÔÔ‡¼L¹»XX5ÔÐ ˜ è ÐLoudon€County€Chancery€CourtÔ#†X5X»¼L¹Ë3#Ôó óÐ ¬ ü ÐÓ{3Óà@xx&ìàò òÔ% ‡ ÔÔ%†{4ÔÔ% ‡ ÔÔ%† ™4ÔÔ% ‡! ÔÔ%†!·4ÔÔ% ‡" ÔÔ%†"Õ4ÔNo.€9945ˆÐ À  ÐÌà@»»"ìàNovember€17,€2003ˆÐ ˜ è  ÐÌßA€V) °°` d€÷E<o` AßÐ pÀ  ÐÌà@èèìàNo.€Ô% ‡# ÔE2003„€00288„WC„R3„CVÔ%†#¹5ԈРk»  ÐÌßA€V) °°` dE<B` AßÐ C“  Ðó óÌà@±±&ìàò òJUDGMENTó óˆÐ >Ž ÐÌòòóó€€€€€€€€€€€€€€€€€€€€€€€€€€€€This€case€is€before€the€Court€upon€the€entire€record,€including€the€order€ofÐ f Ðreferral€to€the€Special€Workers'€Compensation€Appeals€Panel,€and€the€Panel's€memorandumÐ R ÐOpinion€setting€forth€its€findings€of€fact€and€conclusions€of€law,€which€are€incorporated€herein€byÐ î> Ðreference;Ð Ú* ÐÌà  àà ` àWhereupon,€it€appears€to€the€Court€that€the€memorandum€Opinion€of€the€PanelÐ ² Ðshould€be€accepted€and€approved;€andÐ žî ÐÌà  àà ` àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€facts€and€conclusions€of€lawÐ vÆ Ðare€adopted€and€affirmed€and€the€decision€of€the€Panel€is€made€the€Judgment€of€the€Court.Ð b² ÐÌà  àà ` àThe€costs€on€appeal€are€taxed€to€the€appellant,€Traci€L.€Nolan,€for€whichÐ :Š Ðexecution€may€issue€if€necessary.€Ð & v ÐÌ€ÌÔ% € ÔÌà  àà ` àÌ