ÿWPCŽ0 _# BUNM %› 0 û¡w@œ4Üð 0?ÿ 0D> 0J‚ 0TÌ 0^ 0h~ 0ræ 0|X U<Ô 0† – 0œ 1u, 0d¡ AQÆV 0 0@3 0Ds D/· Bæ D3U>6U*tB)žDCÇ AM U*Wßi` ɬӳ‘2!´Ã"Õw%ÔL'v~ )vÓž* Bq0˜HP LaserJet 4 PlusHPPCL5MS,ð,,,,,ð0nLHÎ(ÈhH  Z 6Times New Roman RegularX(Ó*³$¡¡Ñ  ÑÒ°ÒÒ„°ÒÔ€¼$è¼XXÔÑ7€ÌüXXdðXXdð7ÑÑTR[  AØ'ÿ Legal[  AØ'ÿ Legal AØ'ÿ Legal AØ'ÿ LegalTÑ ÊUPÓ€&'V(î)À•{:$SvNN†††3|x)(ï(3–t$¤¤Ý ƒ*³!ÝÑ  ÑÒ°ÒÒ„°ÒÔ€¼„™¼XXÔÑ7€lªXXdðdð7ÑÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÝ  Ýà ` àòòÚ  Ú0Ú  Úóó(1Ã$òòÚ  Ú7Ú  Úóó2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô.èB' Z‹$Arrus BT Roman2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  ÔH2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)P ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ!"#$&Cþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5(ï3´ $¢¢Ý ƒ*³!ÝÑ  ÑÒ°ÒÒ„°ÒÔ€¼„™¼XXÔÑ7€lªXXdðdð7ÑÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÝ  Ý("ÿÿ$££Ò  ÒÒ  Ò($$””ò òÚ  Ú1Ú  Úó ó(('÷ÿ dxdüÿP Pd^^^^'ÿÿdxd< Œ 9p`(&Times New Roman< Œ 9p`(Times% Line 7 d----7Border 1dd!#.Cþÿ << Gÿÿ< Œ 9p`(Arial ÕÝ ƒ!ÝÑ  ÑÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ""ÝÝ  ÝÔ€0ÔÔ€0ÔÓ  Óò òÔ YYY ÔFILEDÔ€0XÔÌÌMarchÏ27,Ï1998ÌÌCecilÏW.ÏCrowsonÌAppellateÏCourtÏClerkÔ  Ôó ó _Ý ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔProzac€is€an€antidepressant€for€oral€administration.€€It€is€not€a€controlled€substance.€€òòAnxiety,Ïnervousness,€óóand€òòinsomniaóó€are€often€reported€by€patients€treated€with€Prozac.€€òòSignificant€weight€lossóó€mayÏoccur.€€It€may€interfere€with€òòcognitive€and€motor€functions,óó€since€any€psychoactive€drug€may€impair€judgment,Ïthinking€or€motor€skills.€Patients€are€cautioned€about€òòdriving€automobilesóó€while€taking€Prozac.€€The€mostÏcommonly€observed€adverse€events€associated€with€the€use€of€Prozac€are€òònervous€system€complaints,€anxiety,Ïnervousness,€insomnia,€drowsiness,€fatigue,€tremor,€sweating,€gastrointestinal€complaints,€anorexia,€nausea,€andÏdiarrhea,€dizziness€and€light„headedness›.€€Physiciansðð€Desk€Reference,€óóœ49th›€Ed.,€1995.Ì Ý ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔNeuropsychology€is€psychology€related€to€neurology,€It€is€concerned€with€the€relationship€betweenÏthe€nervous€system€and€behavior,€and€is€a€latter„day€discipline.Ì ¢Ý ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔThe€cortex€is€the€outer€layer€of€gray€matter€over€most€of€the€brain.Ì ©Ý ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔWhich,€according€to€the€literature,€is,€or€may€be,€a€side€effect€of€Prozac.Ì ‡Ý ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔWho€was€a€sort€of€ððclearing€house.ððÌ ªÝ ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔPossibly€an€oblique€reference€to€the€fact€that€her€daughter„in„law,€who€was€in€charge€of€workersððÏcompensation€claims€for€the€employer,€was€playing€a€role€which€may€have€involved€a€serious€conflict€ofÏinterest.€€Exacerbative€is€the€fact€that€the€daughter„in„law,€herself,€had€filed€a€claim€for€benefits€for€ð ðmentalÏstress.ððÌ ËÝ ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€+ôÔWhich,€according€to€the€literature,€are€the€side,€or€adverse,€effects€of€Prozac,€as€are€anxiety€andÏhysteria.Ì ÊÝ ƒ!ÝÑ#€d#ÑÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€d#ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ""ÝÝ  ÝÔ€0ÔÔ€0ÔÓ  Óò òÔ YYY ÔFILEDÔ€0XÔÌÌMarchÏ27,Ï1998ÌÌCecilÏW.ÏCrowsonÌAppellateÏCourtÏClerkÔ  Ôó óPtPtHHÚ(ÿáÿáùEG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑGenevaÑÑ ÑÒ  ion-F Geneva ÒÒ  ion-F Geneva Ò dÝ ƒ!ÝÔ . ÔÔ€+ÔÑ  ÑÒ  ÒÒ „ ÒÔ€+¼ÔÑ#€,,Xd#ÑÑ#€,,Xd#ÑÑ\R AØ'\ÑÝ  ÝÓÓ›Þ ÞÌà@ àò òIN€THE€SUPREME€COURT€OF€TENNESSEEÌÙ€!ÙœßR€/1.A1-j|` à. `€€@ÿRß›à@ àSPECIAL€WORKERS'€COMPENSATION€APPEALS€PANELÌà@ àAT€NASHVILLEÌÓÓÌÌÌó óBETTY€A.€PRIMM,à àà àà à)Ìà àà àà àà àà àà à)Ìà àPlaintiff/Appelleeà àà àà à)à àMARSHALL€CIRCUITÌà àà àà àà àà àà à)Ìv.à àà àà àà àà àà à)à àNO.€01S01„9705„CV„00120Ìà àà àà àà àà àà à)ÌKANTUS€CORPORATION€andà à)à àHON.€Ô% € ÔLEE€RUSSELLÌœTHE€YASUDA›€FIRE€&€MARINEà à)à àJUDGEÌINS.€CO.€OF€AMERICA,à àà à)Ìà àà àà àà àà àà à)à àREVERSED€andÌà àDefendants/Appellantsà àà à)à àDISMISSED.ÌÌÌò òòòFor€the€Appellants:à àà àà àFor€the€Appellees:ÌÌó óóóJohn€R.€Whiteà àà àà àà àCharles€G.€BlackardÌCharles€L.€Richà àà àà àà à155€Franklin€Road,€Suite€155Ì202€First€National€Bank€Bldg.à àà àBrentwood,€Tennessee€37027ÌP.€O.€Box€169ÌShelbyville,€TN€37162ÌÌÌÌÌÌÌÓ  Óò òòòM€E€M€O€R€A€N€D€U€M€€€O€P€I€N€I€O€NÌÌMembers€of€Panel:ÌÌóóó óJustice€Lyle€ReidÌSenior€Judge€William€H.€InmanÌSpecial€Judge€Joe€C.€Loser,€Jr.ÌÓ  ÓÌÌÌÌÌÌÌò òœREVERSED€andó ó›Ìò òœDISMISSED›à àà àà àà àà àœà àINMAN,›€œSenior›€JudgeÌó óÌÓÓà àThisÔ€0Ô€Ô€+Ôworkers'€compensation€appeal€has€been€referred€to€the€SpecialÏWorkers'€Compensation€Appeals€Panel€of€the€Supreme€Court€in€accordanceÏwith€€T.C.A.€ðð€50„6„225(e)(3)€for€hearing€and€reporting€to€the€SupremeÏCourt€of€findings€of€fact€and€conclusions€of€law.à àÌà àAppellate€review€requires€that€we€presume€that€the€judgment€of€the€trialÏcourt€is€correct.€òòRule€óó13(d)òò,€T.€R.€A.€P.€óóWe€indulge€no€other€presumptions,Ïbut€look€to€see€where€the€preponderance€of€the€evidence€lies.€€T.C.A.€ðð€50„6„225(e)(2).€€It€is€axiomatic€that€the€essential€elements€of€a€workersððÏcompensation€case,€like€any€other,€must€be€proved,€and€that€the€plaintiff€mustÏbear€the€burden€of€proof.€€There€are€no€presumptions€at€the€trial€level.€€òòSee,ÏTindall€v.€Waring€Park€Assððn.,óó€725€S.W.2d€935€(Tenn.€1987).€€While€we€doÏnot€substitute€our€judgment€for€that€of€the€trial€judge,€we€are€as€wellÏpositioned€to€judge€the€probative€worth€of€depositional€testimony.€€òòCooper€v.ÏINA,€óó884€S.W.2d€446€(Tenn.€1994).Ìà àThe€trial€court€found€that€the€plaintiff€sustained€a€job„related€injury€toÍher€central€nervous€system€and€psychological€injury€as€a€direct€result€ofÏexposure€to€Hexane€in€the€work€place€and€that€she€was€totally€and€permanentlyÏdisabled€as€a€result.€€We€find€that€the€evidence€preponderates€against€theÏjudgment€and€accordingly€reverse€and€dismiss.€€òòRule€óó13(d)òò,€T.€R.€A.€P.€óóÌò òà@ àIÌà àó óThe€complaint€alleged€that€in€April,€1993€the€plaintiff€ð ðdiscovered€thatÏshe€was€experiencing€health€problems€as€a€result€of€her€exposure€to€Hexane,ððÏand€that€on€ð ðOctober€1,€1993€was€released€from€work.ðð€€She€alleged€that€sheÏwas€ð ðpermanently€disabled€resulting€in€permanent€impairment.ðð€€She€made€òònoÏallegation€with€respect€to€the€nature€of€the€impairment€or€disability.Ìà àóóThe€defendants€responded€that€they€had€insufficient€information€withÏwhich€to€admit€or€deny€the€various€averments,€and€demanded€ð ðstrict€proof.ððÌò òà@ àIIÌà àó óThe€plaintiff€is€62€years€old,€a€high€school€graduate€with€two€yearsðð€Ìattendance€at€a€business€college.€€She€has€held€various€jobs,€and€began€herÏemployment€with€Kantus€Corporation€in€1989,€ððtrimming€knee€boostersðð€forÏcar€dashboards.€€In€1990,€she€was€assigned€to€œð ð100%›€final€audit,ðð€the€lastÏinspection€before€the€product€was€delivered€œto€›Nissan,€which€required€that€theÏpads€be€cleaned€with€a€solvent€containing€Hexane.€€She€performed€this€jobÏwearing€gloves,€and€in€an€open€room€with€80€fellow€employees.Ìà àOn€some€unspecified€date,€she€testified€that€ð ðI€would€be€dizzy,€numb.€€IÍcouldnððt€work,€I€would€have€to€hold€onto€the€walls€to€get€out€of€theÏdepartment€to€go€to€lunch€or€go€to€my€car€to€go€home.€€I€had€headaches,€andÏthe€pain€was€so€unreal€.€.€.€all€over€the€body.€€I€had€a€specific€pain€complaintÏabout€my€arms,€hand€and€shoulder€œ.€.›€œ.ð𛀜€›€She€testified€to€a€loss€of€memory,Ïand€about€the€difficulties€she€encountered€in€performing€household€chores.Ìà àOn€cross„examination,€she€said€that€some€of€the€pain€went€away€whenÏshe€saw€Dr.€Arney€[a€psychiatrist],€who€prescribed€Prozac,€which€she€has€beenÏtaking€three€(3)€times€a€day€for€a€year,€as€of€the€date€of€trial.œ× ƒ2 ××  ×›Ìà àThe€plaintiff€reported€her€health€problems€to€the€workersððÏcompensation€department€of€her€employer,€which€was€apparently€supervisedÏby€her€daughter„in„law,€Denise€Primm,€who€had,€at€trial€time,€a€suit€pendingÏfor€workersðð€compensation€benefits€for€mental€stress.Ìà àThe€plaintiff€has€seen€a€veritable€litany€of€experts.€€The€record€isÏsomewhat€unclear€as€to€the€number,€but€they€include€Drs.€Cook,€Gaw,ÏSimmons,€Lisella,€Bluhm,€Gray,€Arney€and€Hollister,€among€others.€€TheÏrecord€is€œreplete›€with€depositions€of€these€experts,€whose€testimony€will€beÏconsidered€in€course.€€The€defendants€concede€that€exposure€to€chemicalsÍduring€the€course€of€employment€which€œresults›€in€injury€is€œcompensable›€underÏthe€workersðð€compensation€law.€€The€dispositive€issue€is€whether€theÏpreponderant,€probative€evidence€establishes€a€causal€connection€between€theÏphysical€and€mental€complaints€and€the€workplace.Ìò òòòà@ àDr.€Jerry€Simmonsóóó óÌò òòòà àó óóóDr.€Simmons€is€the€Director€of€the€Division€of€Occupational€andÏEnvironmental€Medicine€at€Meharry€Medical€College,€from€which€he€wasÏgraduated€in€1979.€€He€is€not€board„certified.€€He€initially€saw€the€plaintiff€onÏDecember€3,€œ1992,›€at€the€request€of€her€daughter.Ìà àThe€plaintiff€was€complaining€of€headaches,€and€numbness€in€her€rightÏhand.€€The€examination€was€normal,€but€he€thought€a€neurologicalÏexamination€was€indicated,€ð ðsince€I€couldnððt€find€anything€concrete,ðð€andÏreferred€her€to€a€neurologist,€Dr.€Lisella,€who€reported€òòthat€there€were€noÏabnormal€nerves€or€other€damage€to€the€nerves.Ìóóà àDr.€Simmons€saw€her€again€on€December€17,€1992,€and€recommendedÏthat€she€not€work€with€Hexane€for€six€months,€because,€as€he€understood,ÏHexane€is€a€neurological€solvent€that€has€been€associated€with€nerve€disordersÏand€cognitive€dysfunctions.€€In€February€1993,€Dr.€Simmons€saw€the€plaintiffÏfor€the€third€time.€€Her€chief€complaint€at€that€time€was€muscle€pain€in€theÏarea€of€the€right€collar€bone.€€He€prescribed€no€medication€and€imposed€noÏwork€restrictions.€€He€saw€her€the€fourth€time€on€February€18,€1993,€when€heÍdiscussed€the€results€of€her€lab€work.€€He€also€did€a€chest€x„ray.€€When€asked,Ïð ðDid€you€discover€any€abnormalities€in€the€musculoskeletal€system€that€wouldÏattribute€to€the€symptoms€she€was€displaying?ðð€he€replied€that€he€did€not.Ìà àDr.€Simmons€saw€the€plaintiff€for€the€fifth€time€on€August€12,€œ1993,›Ïwhen€she€reported€that€her€muscular€aches€and€pains€ð ðare€just€about€gone.ððÌà àShe€then€related€to€Dr.€Simmons€that€she€had€suffered€another€chemicalÏexposure,€the€nature€of€which€he€was€uncertain.Ìà àBecause€the€plaintiff€was€ð ðstill€complaining€of€symptoms,ðð€Dr.€SimmonsÏreferred€her€to€a€neuropsychologist,€notwithstanding€that€she€had€beenÏevaluated,€at€Dr.€œSimmonsðð€request,€by€a€neurologist,€Dr.€Lisella,€who,€asÏpreviously€stated,€found€no€basis€for€the€plaintiffððs€complaints.€€TheÏneuropsychologist,× ƒ3 ××  ×€Dr.€Gray,€saw€her€on€March€31,€1994,€but€in€theÏmeantime,€on€March€3,€1994,€Dr.€Simmons€saw€her€for€the€sixth€time.€€HeÏthen€had€the€benefit€of€Dr.€Lisellaððs€studies,€which€revealed€no€nerveÏproblems,€but€he€wanted€to€know€if€there€were€any€cortical€dysfunctionsÏinvolved.× ƒ4 ××  ×€€Dr.€Simmons€had€keyed€on€Hezane€as€the€possible€cause€of€theÏplaintiffððs€problems,€and€he€ð ðwas€trying€to€rule€out€the€occupational€causes.ððÌà àDr.€Simmons€next€saw€the€plaintiff€for€the€seventh€and€last€time,€onÍApril€28,€1994,€following€the€receipt€of€the€report€from€Dr.€Gray,€whoÏopined€that€the€plaintiff€had€ð ðhigher€cortical€residuals€which€were€associatedÏwith€individuals€who€were€exposed€to€various€solvents,€particularly€Hexane.€ÏHe€said€that€one€of€the€symptoms€of€exposure€was€loss€of€memory,€òòbut€thatÏmicrovasculr€problems€produce€the€same€symptoms.óó€€To€rule€outÏmicrovascular€problems,€an€MRI€or€a€CAT€scan€is€indicated,€he€said,€and€aÏCAT€scan€was€performed,€which€was€negative€for€microvascular€changes.Ìà àHe€then€testified€that€ð ðit€is€my€opinion€that€Hexane€played€a€part€inÏproducing€the€symptoms€that€sheððs€experiencing€right€now.ððÌà àAt€this€juncture,€counsel€for€the€defendant€objected€on€the€ground€thatÏDr.€Simmons€had€not€been€qualified€as€an€expert€in€the€field.Ìà àDr.€Simmons€continued€his€testimony€„€perhaps€reacting€to€the€objectionÏ„€thusly:Ìà àð ð€.€.€.€I€òòthink€itððs€possible€that€Hexane€may€have€played€a€part€.€.€.ððÌà àóóDr.€Simmons€was€not€qualified€as€an€expert€in€toxicity€and€the€objectionÏto€his€opinion€should€have€been€sustained.Ìò òòòà@ àDr.€Casey€Arneyóóó ó€Ìà àDr.€Arney€is€a€psychiatrist,€to€whom€the€plaintiff€was€referred€by€Dr.ÏSimmons€for€evaluation€of€her€symptoms€of€depression.€€She€had€markedÏsymptoms,€according€to€Dr.€Arney,€who€described€ð ða€great€deal€of€conflictÏbetween€she€[sic:€her]€and€her€employer€regarding€[exposure€to€a€solvent]€andÍthat€her€symptoms€came€up€during€this€exposure€and€conflict.ðð€€She€relatedÏher€alleged€exposure€to€Hexane€to€Dr.€Arney.€€Thereafter,€her€depressionÏimproved,€but€because€she€evinced€some€signs€of€chronicity,€he€prescribedÏProzac.€€He€last€saw€her€on€January€2,€1996.€€She€continued€to€have€problemsÏwith€concentration,€memory,€and€anxiety.× ƒ5 ××  ×€€He€expresed€no€opinion€about€herÏmemory€problems,€and€relied€on€the€report€of€Dr.€Gray,€and€testified:ÌÓ  ÓÓÓà0 àQ:à8 àð ðWith€a€degree€of€medical€certainty€can€you€ascertainÏwhether€or€not€the€conditions€that€Mrs.€Primm€isÏdisplaying€to€you€can€be€related€to€chemical€toxication?ÌÌà0 àA:à8 àI€can€say€that€what€she€presented€to€me€[is]€that€the€stressesÏthat€have€brought€on€her€depression€are€related€to€theÏevents€and€conflict€with€her€employer€regarding€the€use€ofÏsolvents€at€her€job.ððÌÌÓ  ÓÓÓà àHe€conceded€that€he€knew€nothing€of€toxicology€and€that€his€opinionÏwas€based€on€what€the€plaintiff€related€to€him€about€working€with€solvents.Ìò òòòà@ àDr.€Edward€M.€Karlóóó óÌà àDr.€Karl€is€a€pathologist,€not€board„certified.€€He€was€asked€byÏplaintiffððs€counsel€to€research€Hexane.€€Dr.€Karl€read€certain€literature,€whichÏrevealed€ð ðthat€most€of€the€studies€are€done€on€animals.ðð€€He€knew€nothing€ofÏthe€toxicity€of€Hexane€[ððlast€time€I€saw€Hexane€was€probably€organicÏchemistry€in€collegeðð],€and€conceded€that€by€any€standard€he€did€not€considerÏhimself€an€expert€on€Hexane€effects€on€human€beings.Ìò òòòà@ àDr.€Maurice€Knucklesóóó óÌà àDr.€Knuckles€is€an€ð ðEnvironmental€Toxicologist€by€training,€anÏIndustrial€Hygienist€by€training,€and€Environmental€Health€Scientist€byÏtraining,ðð€employed€by€Meharry€Medical€College.€€He€holds€a€BachelorððsÏDegree€in€Environmental€Health,€a€Master€of€Science€in€Public€Health,€aÏMaster€of€Science€in€Industrial€Hygiene,€and€a€Ph.D.€in€Toxicology.€€HeÏpursued€post„doctoral€studies€at€the€University€of€Alabama€in€Toxicology,Ïparticularly€the€effects€of€Hexane.€€Later,€he€taught€ð ðToxicology€of€VariousÏSolventsðð€at€Illinois€State€University.€€At€Meharry,€he€is€a€ð ðresearcher€firstÏand€foremost.ððÌà àDr.€Knuckles€described€Hexane€as€a€colorless,€volatile€liquid€that€isÏaliphatic,€commonly€used€as€a€solvent€or€glue.€€Acute€exposure€is€normallyÏaccompanied€by€high€concentrations€which€result€in€asphyxia€leading€toÏcardiac€arrest€or€brain€damage.€€He€described€less€acute€exposures€resulting€inÏnausea,€dizziness,€etc.€€He€said€that€the€principal€neurological€effects€associatedÏwith€Hexane€are€peripheral€neuropathies,€meaning€that€the€chemical€tends€toÏreact€to€or€affect€the€myelin€sheath€of€the€long€axons,€by€causing€it€to€ð ðdieÏback,ðð€resulting€in€muscle€weakness€and€impaired€gait.€Under€moderateÏconditions€all€of€these€symptoms€will€resolve.Ìà àHe€testified€that€ð ðHexane€in€and€of€itself€is€not€though€to€be€the€primryÏitem€that€causes€peripheral€neuropathy.ðð€€He€further€testified:ÌÓ  ÓÓÓà0 àQ:à8 àð ðIs€there€any€evidence€that€exposure€to€n„Hexane€producesÏany€pulmonary€damage€after€inhalation€by€human€beings?ÌÌà0 àA:à8 àThat€has€not€been€the€case€in€the€literature.ÌÌà0 àQ:à8 àIs€there€any€evidence€that€exposure€to€n„Hexane€producesÏany€behavioral€or€psychological€effects€in€humans?ÌÌà0 àA:à8 àòòI€have€searched€the€literature€thoroughly€in€this€matter€andÏI€hve€not€found€anything€to€suggest€that€that€is€the€case.ððÌÌóóò òòòà@ àDr.€M.€Robert€Weissóóó óòò€óóÌÌÓ  ÓÓÓà àDr.€Weiss€is€board„certified€as€a€neurological€surgeon.€€he€initially€sawÏthe€plaintiff€on€July€19,€1996€for€purposes€of€evaluation.€€He€testified€that€sheÏhad€a€normal€neurologic€examination,€as€did€Dr.€Richard€Belden,€a€radiologistÏat€St.€Thomas€Hospital.€€he€knows€nothing€of€the€chemical€toxicology€ofÏHexane,€but€said€the€plaintiff€had€no€signs€or€evidence€of€ð ðneurosurgical€[sic:Ïneurological]€disease.€€He€emphasized€that€Mrs.€Primm€ð ðhas€a€normalÏneurological€examination,€no€objective€physical€findings€and€certainly€noÏneurological€problems.ððÌà àHe€testified€that€an€MRI€revealed€small€multiple€lacunes,€representingÏmicroinfarcts€from€small€vessel€disease,€but€knew€of€no€evidence€that€theseÏwould€be€related€to€Hexane€exposure.€€He€said€that€a€microinfarct€was€ð ðaÏsmall,€tiny€stroke,ðð€and€that€the€infarcts€are€small€areas€of€the€brain€that€haveÏdied€as€a€result€of€small€vessel€disease.€€Significantly,€Dr.€Weiss€testified€thatÌÓ  ÓÓÓà8 àòòð ðI€thought€this€woman€was€exceedingly€specific€in€events,€noÏobvious€evidence€of€difficulties€either€with€her€speech€orÍconversation€with€me€or€even€relating€details€of€her€currentÏlawsuit€over€the€last€couple€of€years€.€.€.€She€was€prettyÏconversant,€and€I€detected€no€obvious€memory€or€lucidityÏproblems.ððÌÌóóò òòòà@ àDr.€Renata€BluhmÌÌÓ  ÓÓÓó óóóà àDr.€Bluhm€holds€a€Doctor€of€Medicine€degree€and€a€Ph.D.€inÏPharmacology€and€Toxicology.€€She€is€board„certified€in€Internal€Medicine.€ÏOn€March€25,€1993,€she€interviewed€and€examined€the€plaintiff€at€the€requestÏof€Dr.€Simmons.× ƒ6 ××  ×Ìà àShe€received€the€plaintiffððs€history€of€complaints,€and€testified€that€ð ðitÏmay€be€beneficial€to€evaluate€her€for€the€possibility€of€musculoskeletal€diseaseÏof€the€cervical€and/or€lumbar€spine,ðð€and€thatÌÓ  ÓÓÓà8 àð ðòòShe€would€benefit€from€reassurance€that€she€has€not€developed€aÏdegenerative€disease€from€Hexane€exposure.ððóó× ƒ7 ××  ×à àÌà àÌÓ  ÓÓÓò òòòà àó óóóThe€report€of€Dr.€Bluhm€was€forwarded€to€Dr.€Simmons,€who€shared€itÏwith€the€plaintiff,€apparently€displeasing€her,€because€she€called€òòDr.€BluhmÏand€demanded€that€the€report€be€suppressed.óó€€Parenthetically,€Dr.€Simmons,Ïwho€referred€the€plaintiff€to€Dr.€Bluhm,€apparently€did€not€like€her€report,Ïsince€he€apparently€acquiesced€in€the€suppression€of€it.€€Dr.€Bluhm€thereuponÍrequested€instructions€from€Tennesseeððs€Department€of€Labor,€who€suggestedÏthat€she€forward€her€report€„€and€the€demand€that€it€be€suppressed€„€to€theÏPresident€of€the€Company.Ìà àDr.Bluhm€has€considerable€experience€with€Hexane.€€She€testified€thatÏperipheral€neuropathies€are€a€ð ðfairly€common€symptom€of€Hexane€exposure,ððÏand€that€a€peripheral€neuropathy€is€a€disease€where€basically€the€sensoryÏmuscles€in€the€hands€and€feet€atrophy€because€the€nerve€becomes€sick.€€Ìà àòòShe€testified€unequivocally€that€Mrs.€Primm€had€none€of€theseÏsymptomsóó€and€that€there€is€òòno€evidence€that€exposure€to€Hexane€produces€anyÏpulmonary€damage€after€inhalation.Ìà àóóParenthetically,€we€have€most€carefully€read€the€testimony€of€Dr.ÏBluhm€and€find€no€evidence€to€justify€the€criticism€directed€to€her€statements.Ìò òòòà@ àDr.€Jeffrey€W.€Grayóóó óÌà àDr.€Gray€is€a€neuropsychologist.€€He€holds€no€medical€or€scienceÏdegrees.€€He€practices€in€Evansville,€Indiana€and€Owensboro,€Kentucky.€ÏThere€are€no€accrediting€Boards€for€his€field.€He€described€his€function€as€aÏneuropsychologist,€ð ðto€examine€and€determine€how€different€parts€of€the€brainÏare€functioning.ððÌà àThe€plaintiff€was€referred€to€him€by€Dr.€Simmons,€from€whom€heÏreceived€ð ðsome€medical€records.ððÌà àDr.€Gray€essentially€assumed€tht€the€plaintiff€had€been€exposed€toÍHexane.€€He€testified,€ð ðDr.€Simmons€was€asking€me€to€evaluate€the€patient€toÏprovide€my€opinion€on€whether€or€not€her€symptoms€were€òòpossibly€associatedóóÏwith€her€exposure€to€Hexane.ððÌà àHe€had€no€experience€with€Hexane,€and€had€never€seen€a€patient€whoÏhad€been€exposed€to€Hexane.Ìà àÌÑ  Ñà àHe€said€that€Hexane€is€a€neurotoxin,€one€of€many€ð ðthat€people€areÏexposed€to€on€a€daily€basis,ðð€such€as€gasoline,€or€glue,€or€paint€or€alcohol.Ìà àDr.€Gray€testified€that€the€referring€physician,€Dr.€Simmons,€told€himÏthat€Mrs.€Primm€developed€frequent€headaches€and€upper€body€discomfort,Ïpoor€sleep€habits,€and€a€weight€loss.× ƒ8 ××  ×€€He€opined€that€these€symptoms€wereÏcompatible€with€neurotoxic€exposure,€and€that€ð ðshe€appeared€to€have€ratherÏsignificant€higher€cortical€residuals.ðð€€He€testified€that€the€symptoms€displayedÏby€Mrs.€Primm€after€18€monthsðð€duration€could€be€considered€permanent,€andÏthat€ð ðthe€doctor€suggestedðð€that€she€has€a€significant€ð ðneuropsychologicalÏimpairment.ðð€€He€further€testified€that€she€had€a€moderate€degree€ofÏdepression,€anxiety€and€ððsome€hysteria.ðð€€He€described€Mrs.€Primm€as€ððbrain„damaged,ðð€and€òòwithin€a€reasonable€degree€of€medical€certaintyóó€that€she€wasÏinjured€and€such€injury€resulted€in€memory€loss.€€Counsel€objected€to€theseÍquestions€and€responses,€which€should€have€been€sustained,€since€Dr.€Gray€is€aÏpsychologist,€and€not€a€medical€or€scientific€practitioner.€€He€was€not€qualifiedÏto€state€an€opinion€which€required€medical€expertise.Ìà àFinally,€Dr.€Gray€likened€Mrs.€Primmððs€condition€to€Alzheimerððs.Ìò òòòà@ àThe€Rule€59€Motionóóó óÌà àThe€trial€judge€found,€òòinter€aliaóó,€that€the€plaintiff€had€been€ð ðexposed€toÏHexane€in€unlawful€quantities€in€the€workplace€for€an€extended€period€of€timeÏis€undisputed€and€indisputable,ðð€apparently€because€the€Occupational€SafetyÏand€Health€Division€of€the€Department€of€Labor€ððhad€cited€the€employer€forÏexposing€the€dashboard€area€to€92.8€parts€per€million€of€Hexane€when€theÏpermissible€level€is€50€parts€per€million,ðð€and€ð ðthat€there€is€no€evidence€toÏrebut€this€.€.€.€ð ðÌà àThe€defendants€thereupon€filed€a€59.04€Motion€advising€that€theÏDepartment€had€dismissed€the€citation,€but€through€oversight€this€significantÏevidence€was€not€adduced.€€The€plaintiff,€vigorously€resisted€the€Rule€59.04ÏMotion.€€A€hearing€was€held,€and€the€motion€was€denied€on€the€basis€that€ð ðòòthisÏCourtððs€prior€ruling€is€upheld,€as€there€was€evidence€to€support€the€finding€ofÏthe€Court.ððÌà àóóThe€evidence€offered€at€the€Rule€59€hearing€was€(1)€that€the€StateÏchemists€admittedly€analyzed€the€wrong€chemical,€and€(2)€that€the€employerÍwas€in€compliance€with€all€standards€respecting€Hexane,€òòwith€the€highest€levelsÏof€exposure€more€than€50€percent€below€the€permissible€standard.Ìò òòòóóà@ àConclusionóóó óÌ(1)€òòDr.€Simmonsððóó€opinion€respecting€causation€is€not€of€probative€value,€givenÏhis€admitted€lack€of€expertise,€and€his€equivocation.€[€ð ðI€think€itððs€possible€thatÏHexane€may€have€played€a€part.ðð]Ì(2)€òòDr.€Lisellaóó€found€no€nerve€damage,€and€thus€is€in€stark€contrast€to€Dr.ÏGray,€the€neuropsychologist.€€Since€Dr.€Lisella€is€a€scientist,€with€a€medicalÏeducation,€we€think€his€opinion€obviously€bears€greater€weight.Ì(3)€òòDr.€Arneyóó€is€a€psychiatrist,€who€conceded€his€lack€of€knowledge€ofÏneurotoxins.Ì(4)€òòDr.€Karlóó€knew€nothing€of€the€toxicity€of€Hexane.Ì(5)€òòDr.€Knucklesóó€is€remarkably€qualified€as€an€expert€in€toxicology,€byÏeducation,€training,€experience,€and€practice.€€He€testified€that€exposure€toÏHexane€did€not€cause€the€plaintiffððs€problems.ÌÑ  Ñ(6)€òòDr.€Weiss,€óóa€neurological€surgeon,€testified€that€Mrs.€Primm€ð ðòòhad€no€Ìobjective€physical€findings€and€certainly€no€neurological€problems,ððóó€and€thatÏhe€detected€no€ð ðmemory€or€ludicity€problems.ððÌ(7)€òòDr.€Bluhmóó€appears€remarkably€qualified€to€testify€in€a€chemical€exposureÏcase.€€She€holds€doctorates€in€both€Medicine€and€Pharmacology€andÏToxicology.€€She€was€apparently€somewhat€testy,€but€(a)€given€the€fact€thatÍDr.€Simmons€was€referring€Mrs.€Primm€to€experts€òòad€infinitum€óó[apparentlyÏuntil€he€found€one€whose€opinion€was€consonant€with€his]€and€(b)€given€theÏfact€that€Dr.€Bluhm€disliked€the€ethical€posture€of€this€case,€we€see€no€reasonÏwhatever€to€dilute€the€probative€force€of€her€testimony,€which€we€find€mostÏpersuasive.€€The€record€as€a€whole€tends€to€support€her€advice€to€Mrs.€Primm.€ÏShe€firmly€testified€that€Mrs.€Primm€had€no€symptomatology€attributable€toÏexposure€to€Hexane.Ì(8)€òòDr.€Grayóó€is€a€neuropsychologist,€not€a€medical€expert,€or€a€toxicologist,€orÏa€chemist.€€His€expertise€is€weak€to€non„existent€and€cannot€be€favorablyÏcompared€to€that€of€Dr.€Lisella,€Dr.€Knuckles,€or€Dr.€Bluhm.€€He€is€the€òòonlyóóÏexpert€who€testified€as€to€impairment.Ìà àFrom€all€of€which€we€find€the€expert€evidence€preponderates€against€theÏjudgment,€and€preponderates€in€favor€of€a€finding€that€the€plaintiff€failed€toÏcarry€her€burden€of€proof.€€Moreover,€we€find€that€the€Rule€59€Motion€wasÏwell„taken,€and€should€have€been€allowed.€€The€proof€adduced€clarified€anÏerroneous,€official€report,€one€of€the€offices€of€Rule€59.€€There€is€no€evidenceÏin€the€record€that€the€levels€of€Hexane€were€higher€than€permitted€by€law.Ìà àÌà àÌà àThe€judgment€is€reversed€and€the€case€is€dismiseed€at€the€costs€of€theÏappellee.ÓÓÌà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà àà à___________________________Ìà àà àà àà àà àà àà àWilliam€H.€Inman,€Senior€JudgeÌà àà àà àà àà àà àà àÌCONCUR:ÌÌÌÌ____________________________ÌJoe€C.€Loser,€Jr.,€Special€JudgeÌÌÌÌ____________________________ÌLyle€Reid,€Justice€€ÇÒ € ÒÒ À ÒÔ€ÔßJ€/9;+'b|P¦` à. `€@ÿJßÔ€XÔà@ àIN€THE€SUPREME€COURT€OF€TENNESSEEÌà@ àAT€NASHVILLEÌÌÌBETTY€A.€PRIMM,à àà àà à)à àMARSHALL€CIRCUITÌà àà àà àà àà àà à)à àNo.€€12410€BelowÌà àAppellee,à àà àà àà à)Ìà àà àà àà àà àà à)à àHon.€€Lee€Russell,Ìv.à àà àà àà àà àà à)à àJudge.Ìà àà àà àà àà àà à)Ìà àà àà àà àà àà à)€à àNo.€€01S01„9705„CV„00120ÌKANTUS€CORP.€&€THE€YASUDAà à)ÌFIRE€&€MARINE€INS.€CO.€OFà àà à)ÌAMERICA,à àà àà àà àà à)Ìà àà àà àà àà àà à)Ìà àAppellants.à àà àà àà à)à àReversed€and€Dismissed.ÌÌÌà@ àòòJUDGMENT€ORDERóóÌÌÓÓà àà àThis€case€is€before€the€Court€upon€motion€for€review€pursuantÏto€Tenn.€Code€Ann.€ðð€50„6„225(e)(5)(B),€the€entire€record,€including€theÏorder€of€referral€to€the€Special€Workers'€Compensation€Appeals€Panel,€andÏthe€Panel's€Memorandum€Opinion€setting€forth€its€findings€of€fact€andÏconclusions€of€law,€which€are€incorporated€herein€by€reference;Ìà àà àWhereupon,€it€appears€to€the€Court€that€the€motion€for€reviewÏis€not€well„taken€and€should€be€denied;€andÌà àà àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€fact€andÏconclusions€of€law€are€adopted€and€affirmed,€and€the€decision€of€the€Panel€isÍmade€the€judgment€of€the€Court.€€ò òÌó óà àà àCosts€on€appeal€are€assessed€to€the€appellee.Ìà àà àIT€IS€SO€ORDERED€this€27th€day€of€March,€1998.Ìà àà àà àà àà àà àà àPER€CURIAMÌÌÔ€¼ÔReid,€J.€€„€Not€participating.Ô€+Ô