I N THE COURT OF APPEALS FILED July 2, 1997 Cecil Crowson, Jr. Appellate C ourt Clerk REBA V. DAVI S a nd TYLER W AYNE ) ROANE CI RCUI T DAVI S b y ne xt f r i e nd, REBA V. ) C. A. NO. 03A01- 9701- CV- 0001 6 DAVI S, ) ) Pl a i nt i f f s - Appe l l a nt s ) ) ) ) ) ) vs . ) HON. RUSSELL E. SI M ONS, J R. M ) J UDGE ) ) ) ) ) HARRI M AN CI TY HOSPI TAL, THE ) CI TY OF HARRI M AN, J EAN ANGELO, ) BRENDA RUTHERFORD, BETTY ) SAM PSON, RHONDA M ARTI N, M ELI NDA ) AFFI RMED AND REMANDED LATHAM SHARON UNDERW , OOD a nd ) VI CKI E KLI NNERT, ) ) De f e nda nt s - Appe l l e e s )

DAVI D C. LEE, Le e , Le e & Le e , Knoxvi l l e , f or Appe l l a nt s .

HAROLD D. BALCOM, J R. , Ki ngs t on, f or Appe l l e e , Ci t y of Ha r r i ma n Ho s p i t a l .

GERALD LARGEN, Ki ngs t on, f o r Appe l l e e s , J e a n Ange l o, Br e n d a Ru t h e r f or d, Rhonda M r t i n, Sha r on Unde r wood, a nd Vi c ki e Kl i nne r t . a

O P I N I O N M M r a y, J . c ur

Thi s i s a me di c a l ma l pr a c t i c e c a s e . Pl a i nt i f f , Re ba V. Da vi s b r o u g h t s ui t , i ndi vi dua l l y a nd on be ha l f of he r i nf a nt s on, Tyl e r , a ga i n s t Dr . El be r t Cunni ngha m, Ha r r i ma n Ci t y Hos pi t a l a nd t he Ci t y of Ha r r i ma n f or i nj ur i e s s us t a i ne d by Tyl e r s hor t l y a f t e r hi s b i r t h. Af t e r r e a c hi ng a s e t t l e me nt wi t h Dr . Cunni ngha m, t he p h y s i c i a n who de l i ve r e d Tyl e r , M . Da vi s a me nde d he r c ompl a i nt t o s i n c l u d e a l l e ga t i ons of ne gl i ge nc e a g a i ns t t he a t t e nda nt Ha r r i ma n Ci t y Ho s pi t a l nur s e s .

The de f e nda nt s move d f or s umma r y j udgme nt . The c our t gr a n t e d s u mma r y j udgme nt on t he gr ound t ha t t he pl a i nt i f f ha d f a i l e d t o p r e s e nt pr oof , i n c ont r a ve nt i on of t ha t of f e r e d by t he de f e nda n t s , t ha t a n y a l l e ge d ne gl i ge nc e o n t h e pa r t of t he de f e nda nt s , wa s a p r o x i ma t e c a us e of Tyl e r ' s i nj ur i e s . M. s Da vi s ha s a ppe a l e d a nd c ha l l e nge s t he p r opr i e t y of t he s umma r y j udgme nt . W a f f i r m t he e j u d g me n t of t he t r i a l c our t .

The onl y i s s ue p r e s e nt e d, a s s t a t e d i n t he pl a i nt i f f ' s br i e f , i s " wh e t he r ma t e r i a l e vi de nc e e xi s t [ s ] i n t he r e c or d s uf f i c i e nt t o o v e r t u r n t he Tr i a l Cour t ' s gr a nt i ng of s umma r y j udgme nt a s t o t h e f i v e n u r s e s , a nd c ons e que nt l y t he i r e mpl oye r ? "

M . Da v i s s e t t l e d t h e c l a i ms a g a i n s t t wo o f t h e n u r s e s , Be t t y Sa mp s o n a n d s M l i n d a La t h a m, t h e r e f o r e , t h i s a p p e a l c o n c e r n s t h e r e ma i n i n g f i v e n u r s e s , J e a n e An g e l o , Br e n d a Ru t h e r f o r d , Rh o n d a M r t i n , Vi c k i e Kl i n n e r t , a n d S h a r o n Un d e r wo o d a n d a t h e i r e mp l o y e r , Ha r r i ma n Ci t y Ho s p i t a l .

Our s t a nda r d of r e vi e w i n c ons i de r i ng t he pr opr i e t y of s umma r y j u d g me n t i s a s f ol l ows :

The s t a nda r ds gove r ni ng a n a ppe l l a t e c our t ' s r e vi e w o f a t r i a l c our t ' s a c t i on on a mot i on f or s umma r y j u dgme nt a r e we l l s e t t l e d. Si nc e our i nqui r y i nvol ve s p u r e l y a que s t i on of l a w, no pr e s umpt i on of c or r e c t ne s s a t t a c he s t o t he t r i a l c our t ' s j udgme nt , a nd our t a s k i s c o nf i ne d t o r e vi e wi ng t he r e c or d t o de t e r mi ne whe t he r t he r e qui r e me nt s of Te nn. R. Ci v. P. 56 ha ve be e n me t . Cowde n v. So vr a n Ba nk/ Ce nt r a l Sout h , 8 16 S. W 2d 741, 744 ( Te nn. .

1 9 91) . Te nn. R. Ci v. P. 56. 03 pr ovi de s t ha t s umma r y j udgme nt i s onl y a ppr opr i a t e whe r e : ( 1) t he r e i s no ge nui ne i s s ue wi t h r e ga r d t o t he ma t e r i a l f a c t s r e l e va nt t o t he c l a i m o r d e f e ns e c ont a i ne d i n t he mot i on, Byr d v. Ha l l , 847 S. W 2 d 208, 210 ( Te nn. 1993) ; a nd ( 2) t he movi ng pa r t y i s . e n t i t l e d t o a j udgme nt a s a ma t t e r of l a w on t he undi s - put e d f a c t s . Ande r s on v . St a nda r d Re gi s t e r Co . , 8 57 S. W 2d 555, 559 ( Te nn. 1993) . . The movi ng pa r t y ha s t he b u r de n o f p r ovi ng t ha t i t s mot i on s a t i s f i e s t he s e r e qui r e me nt s . Downe n v. Al l s t a t e I ns . Co. , 8 1 1 S. W 2d .

5 2 3, 524 ( Te nn. 1991) .

The s t a nda r ds gove r ni ng t he a s s e s s me nt of e vi de nc e i n t he s umma r y j udgme nt c o nt e xt a r e a l s o we l l e s t a b- l i s he d. Cour t s mus t vi e w t he e vi de nc e i n t he l i ght mos t f a vor a bl e t o t he nonmovi ng pa r t y a nd mus t a l s o dr a w a l l r e a s ona bl e i nf e r e nc e s i n t he nonmovi ng pa r t y' s f a vor .

Byr d , 847 S. W 2d a t 210- 11. . Cour t s s houl d gr a nt a s u mma r y j udgme nt onl y whe n bot h t he f a c t s a nd t he c o nc l us i ons t o be dr a wn f r om t he f a c t s pe r mi t a r e a s on- a b l e pe r s on t o r e a c h onl y one c onc l us i on. I d.

Ca r v e l l v. Bot t oms , 900 S. W 2d 23, 26 ( Te nn. 1995) . .

Th e ma t e r i a l f a c t s a r e undi s put e d. Dr . Cunni ngha m de l i ve r e d Ty l e r b y c a e s a r i a n s e c t i on on J une 12, 1991, a t 10: 39 P. M. Tyl e r e x h i b i t e d a nor ma l a nd he a l t hy a ppe a r a nc e , a nd vi t a l s i gns we r e wi t hi n t he nor ma l r a n ge s e xc e pt f or r e l a t i ve t a c hypne a ( f a s t e r b r e a t h i ng r a t e t ha n n or ma l ) . Dr . Cunni ngha m i ns t r uc t e d t he nur s e s o n d u t y t o " f ol l ow c l os e l y" Tyl e r ' s pr ogr e s s . Dr . Cunni n g h a m r e t u r ne d t o c he c k on Tyl e r a t 10: 55 a nd 11: 15 P. M. Dr . Cunni ngh a m t e s t i f i e d t o t he f ol l owi ng r e ga r di ng Tyl e r ' s c ondi t i on a t 11 : 1 5 P. M : .

W l l , t he r e s pi r a t or y r a t e a t t ha t t i me wa s 56 whi c h e i s a l i t t l e hi gh but not t e r r i bl y a l a r mi ng. Te mpe r a t ur e wa s nor ma l a nd he a r t r a t e wa s , I be l i e ve , 156. So i t wa s j us t one of t he s e t hi ngs , t hi s ba by i s ha vi ng a l i t t l e b i t of t r oubl e ge t t i ng s t a r t e d, t he l ungs a r e not e x p a ndi ng, l oos e ni ng up qui t e a s r a pi dl y a s we wo u l d l i ke , b ut s t i l l s e e me d t o be oka y.

The r e c or d i ndi c a t e s t ha t not hi ng e ve nt f ul oc c ur r e d f o r t he n e x t 3 hour s , a nd t ha t Tyl e r wa s ge ne r a l l y " r e s t i ng qui e t l y" wi t h e ve n r e s pi r a t i on. At a r ound 3: 45 A. M , t he a t t e ndi ng nur s e s no t e d . t ha t r e s pi r a t i on wa s a bout 80 pe r mi nut e , we l l a bove t he nor ma l r at e, a nd t h a t Tyl e r wa s e xhi bi t i ng c ya nos i s ( bl ui s h c ol or a t i o n ) a r o u n d t he e xt r e mi t i e s a nd mout h. The nur s e s a dmi ni s t e r e d " bl o ws " o f o x y g e n, whi c h e nt a i l e d t ur ni ng on a n oxyge n t a nk c onne c t e d t o a c a t h e t e r , a nd hol di ng t he c a t he t e r i n t he ge ne r a l vi c i ni t y of t h e i nf a nt ' s nos e a nd mo u t h t o h e l p hi m b r e a t he mor e e a s i l y. Th e n u r s e s a l s o s ummone d Dr . Cunni ngha m. At 3: 55 A. M , Dr . Cunni ngh a m . o b s e r v e d t he s i t ua t i on a nd i ns t r uc t e d t he n u r s e s t o " j us t wa t c h [ t he ] i nf a nt c l os e l y. "

At 4: 00 A. M , t he nur s e s a dmi ni s t e r e d mor e oxyge n. The nur s e s ' . n o t e s i ndi c a t e t ha t a t 5: 30 A. M , Tyl e r wa s c ya not i c i n c ol or a n d . h a d " f l oppy a r ms . " M e bl ows of oxyge n we r e gi ve n, whi c h i mpr o v e d or h i s c o l or . The nur s e s ' not e s s how t ha t Dr . Cunni ngha m c he c ke d o n

Tyl e r ' s c ondi t i on a t 7: 00 A. M , a t whi c h t i me t he a t t e ndi ng nur s e s . i n f o r me d hi m t ha t Tyl e r ' s c ol or ha d be e n " dus ky. " Dr . Cunni ngh a m opi ne d a t t he t i me t ha t Tyl e r ' s c ondi t i on wa s " pr oba bl y t r a n s i - t i ona l . " Fr om a ppr oxi ma t e l y 7: 20 A. M , Tyl e r ' s c ondi t i on de t e r i o - . r a t e d , a nd he be ga n e xhi bi t i ng mor e a l a r mi ng s ympt oms of r e s pi r a - t or y di s t r e s s .

Dr . Cunni ngha m t e s t i f i e d t ha t by 8: 45 A. M , . "i t be c a me a pp a r e nt t o [ hi m] t ha t Tyl e r wa s n o t i mp r o vi ng" a nd he ma de t h e d e c i s i o n t o t r a ns f e r hi m t o Ea s t Te nne s s e e Chi l dr e n' s Hos pi t a l .

Th e c h i l dr e n' s hos pi t a l pe di a t r i c t e a m a r r i ve d a r ound 10: 15 A. M , . a nd t r a ns f e r r e d Tyl e r by a mbul a nc e a t 12: 30 P. M. Dr . Cunni ngha m' s d i s c h a r ge di a gnos i s wa s : " Ta c hypne a of ne wbor n wi t h pr ogr e s s i v e d e t e r i or a t i on of ge ne r a l c ondi t i on, a c i dos i s a nd s hoc k- l i ke s t a t e , e t i ol og y unde t e r mi ne d. Po s s i bl e s e pt i c e mi a or pos s i bl e c onge ni t a l h e a r t d e f e c t wa s e nt e r t a i ne d a s di a gnos i s whe n i t l e f t . "

As a r e s ul t of Tyl e r ' s de t e r i or a t i ng c ondi t i on a nd r e s pi r a t o r y di f f i c ul t i e s , he s u f f e r e d br a i n da ma ge a nd i s s e r i ous l y ha n d i - c a pp e d. Ne i t he r Dr . Cunni ngha m nor s ubs e que nt t r e a t i ng phys i c i a n s we r e a bl e to de f i ni t i ve l y de t e r mi ne a c a us e or or i gi n of hi s me d i c a l c ondi t i on.

As not e d a bove , a f t e r r e a c hi ng s e t t l e me nt wi t h Dr . Cunni ngh a m, M. s Da v i s a me nde d t he c ompl a i nt on Tyl e r ' s be ha l f to i nc l u d e

a l l e g a t i ons of ne gl i ge nc e by t he nur s e s i n a t t e nda nc e a nd M . s Br e n d a Rut he r f or d, t he hos pi t a l ' s Di r e c t or of Nur s i ng. Fi ve of t h e d e f e n d a nt s , Nur s e s J e a n Ange l o, Br e nda Rut he r f or d, Rhonda M r t i n , a Vi c k i e Kl i nne r t , a nd Sha r on Unde r wood move d f or s umma r y j udgme n t .

I n o p pos i t i on t o t he mot i on f or s umma r y j udgme nt , M. s Da v i s f i l e d t he a f f i da vi t of M . Chr i s t i ne Bus c h, a n R. N. , s l i c e ns e d i n Vi r g i ni a . I n he r a f f i da vi t , Nur s e Bus c h s t a t e d t ha t t he de f e nda nt s b r e a c he d t he s t a nda r d o f car e r e qui r e d o f nur s e s i n c ommun i t y hos pi t a l s s uc h as Ha r r i ma n on s e ve r a l oc c a s i ons , i nc l ud i n g " f a i l [ i ng] t o r e c ogni z e i n Tyl e r W yne Da vi s , s ympt oms of r e s pi r a - a t o r y d i s t r e s s s yndr ome . . . " The t r i a l c our t c or r e c t l y not e d t h a t Nur s e Bus c h' s a f f i da vi t wa s s uf f i c i e nt t o c r e a t e a ge nui ne i s s ue of ma t e r i a l f act on t he que s t i on of t he de f e nda nt s ' a l l e ge d ne g l i - g e nc e .

M . Da vi s ' s c ouns e l s t i pul a t e d, howe ve r , t ha t Nur s e Bus c h wa s n o t q u a l i f i e d t o gi ve e xpe r t t e s t i mony on me di c a l c a us a t i on, a nd t h a t s h e wa s not be i ng of f e r e d a s a c a us a t i on wi t ne s s . M . Da v i s s p r e s e n t e d t he de pos i t i on t e s t i mony of Dr . J os e ph B. Phi l i ps , I I I , f or p r o of on t he c a us a t i on i s s ue . The t r i al c our t f ound t h e f o l l o wi ng:

The Cour t f i nds t ha t t he pa r t i e s ha ve not di s put e d t he opi ni on of t he pl a i nt i f f ' s e xpe r t wi t ne s s , Dr . J os e ph B. Phi l i p s , I I I , t h a t t he c a us a t i on of t he pl a i nt i f f ' s i nj ur y wa s t he f a i l ur e t o mor e a ggr e s s i ve l y i nt e r ve ne t o

d i a gnos e a nd t r e a t t he pl a i nt i f f . He a l s o i ndi c a t e d t ha t t he me di c a l pe r s on r e s pons i bl e t o di a gnos e a nd i ns t i t ut e t r e a t me nt wa s Dr . Cun ni ngha m.

Dr . Cunni ngha m i n hi s de pos i t i on i ndi c a t e d t ha t he wa s ke pt f ul l y a wa r e of t he c ondi t i on of t he pa t i e nt by t he de f e nda nt nur s e s , a nd t ha t i t wa s hi s r e s pons i bi l i ty t o di a gnos e a nd i ns t i t ut e a ppr opr i a t e t r e a t me nt whi ch i n c l ude d t he a dmi ni s t e r i ng of oxyge n.

* * * The Cour t f i nds f r om t he a b o v e t ha t a ny br e a c h of t he s t a nda r d of c a r e by t he nur s e de f e nda nt s wa s not t he c a us e of a ny pe r s ona l i nj ur y t o t he pl a i nt i f f a nd t ha t t h e M i on f or Summa r y J udgme nt s houl d be s us t a i ne d. ot

T. C. A. § 29- 26- 115 r e qui r e s a c l a i ma nt t o pr ove t ha t t he d e f e n d a nt ' s ne gl i ge nc e wa s t he c a us e of hi s o r he r i nj ur i e s . It p r o v i d e s i n pe r t i ne nt pa r t a s f ol l ows :

( a ) I n a ma l pr a c t i c e a c t i on, t he c l a i ma nt s ha l l h a ve t he bur de n of pr ovi ng by e vi de nc e a s pr ovi de d by s ubs e c - t i on ( b) : * * * ( 3) a s a pr oxi ma t e r e s ul t of t he d e f e nda nt ' s n e gl i ge nt act or omi s s i on, t h e p l a i nt i f f s uf f e r e d i n j ur i e s whi c h woul d not ot he r wi s e ha ve oc c ur r e d; * * *

For s umma r y j udgme nt pur pos e s , onc e a pl a i nt i f f i s f a c e d wi t h a p r o p e r l y s uppor t e d mot i on, he or s he mus t pr e s e nt e vi de nc e a t l e a s t s u f f i c i e nt t o r a i s e a ge nui ne i s s ue of ma t e r i a l f a c t a s t o wh e t h e r t he de f e nda nt s ' a l l e ge d ne gl i ge nc e wa s t he pr oxi ma t e c a us e of he r i nj ur i e s . Ki l pa t r i c k v. Br ya nt , 868 S. W 2d 594 ( Te n n . .

1 9 9 3 ) ; W t e v. M t hodi s t Hos p. Sout h , 844 S. W 2d 642 ( Te nn. Ap p . hi e .

1992) . Thus , as M . s Da vi s ha s not e d i n he r br i e f , " t he que s t i o n he r e i n i s whe t he r Dr . Phi l i ps ' t e s t i mony c ombi ne d wi t h t ha t of Nur s e Bus c h e s t a bl i s h[ e s ] c a us a t i on a g a i ns t t he f i ve nur s e s , a nd c o n s e q u e nt l y t he i r e mpl oye r unde r t he doc t r i ne of r e s pond e a t s upe r i or . "

Dr . Phi l i ps t e s t i f i e d by de pos i t i on a s f ol l ows :

Q: At t hi s t i me , Doc t or , i f y o u woul d, woul d you go a he a d a nd s t a t e f or us your opi ni ons ? And we c a n l i s t t hos e , t h e opi ni ons you ha ve i n t hi s c a s e ba s e d u p o n y our r e vi e w of t he s e r e c or ds a nd t he n we c a n ki nd of go ba c k a n d t a k e e a c h one a nd l ook a t t he ba s i s f or t hos e opi ni ons , i f you c a n do t ha t f or us .

M W TE: Obj e c t i on.

R. AI A: W l l , my ove r a l l opi ni on i s t ha t a l l of t he i ndi vi d- e ua l s c a r i ng f or t hi s i nf a nt i gnor e d a c ol l e c t i on o f s ympt oms t ha t s houl d ha ve be e n s uf f i c i e nt t o t r i gge r e a r l i e r a nd mor e a ggr e s s i ve i nt e r ve nt i on t o di a gnos e a nd s t a bi l i z e t hi s i n f a nt a nd pr e ve nt wha t ul t i - ma t e l y ha ppe ne d.

Q: Oka y. Any ot he r opi ni ons ?

M W TE: Obj e c t i on.

R. AI A: W l l , i t ' s my opi ni on t ha t f a i l ur e t o a ppr opr i a t e l y e d i a g nos e a nd t r e a t t hi s i nf a nt e a r l i e r c a us e d t h e s e ve r e br a i n i nj ur y t ha t t he c hi l d s uf f e r e d a nd t ha t i s r e s pons i bl e f o r why t he c hi l d i s pr of oundl y i nj ur e d t oda y.

* * * Q: W n you s a y a l l i gnor e d t he c ol l e c t i on of s ympt oms , he who a r e you r e f e r r i ng t o whe n you s a y " a l l " ?

A: Thos e i ndi vi dua l s who we r e c a r i ng f o r t h e i nf a nt , t he nur s i ng s t a f f a nd Dr . Cunni ngha m.

* * * Q: Al l r i ght . Le t ' s go ba c k a nd s e e i f we c a n now i n t e r ms of wha t y ou' ve s e e n i n t h e c ha r t t ha t e vi - de nc e d s i gns of r e s pi r a t or y di s t r e s s a nd you' ve i ndi c a t e d whe n t he r e c or ds s how e a c h pa r t i c ul a r s i gn wa s c ha r t e d whi c h you c ons i de r t o be c l i ni c a l l y s i gni f i c a nt .

Le t ' s t a ke t ha t i nf or ma t i on a nd ge t your opi ni on a s t o whe n t he s e c ons t e l l a t i on or a c c umul a t i on of s i gns we r e c l i ni c a l l y s i gni f i c a nt e nough t o whe r e you be l i e ve Dr . Cun ni ngha m s houl d ha ve i nt e r ve n e d a nd t he n we c a n t a l k a bout t he i nt e r ve nt i on a f t e r we d o t ha t .

A: W l l , I be l i e ve t ha t by f our A. M on t he mor ni ng e . f ol l owi ng bi r t h, whi c h i s a bout f i ve a nd a ha l f hour s of a g e , t h e i nf a nt wa s be i ng gi ve n bl ows of oxyge n i n or de r t o r e l i e ve c ya nos i s a nd ha d ha d s ome s i g n s of r e s pi r a t or y di s t r e s s i n a ddi t i on t o t ha t a nd i n a ddi t i on h a d t he e l e va t e d t e mpe r a t ur e s . By t ha t t i me , by f our A. M , s ome t hi ng mor e t ha n or de r - . i ng a bl ood s uga r s houl d ha ve be e n done .

Q: Now, i s i t c or r e c t t o s a y t ha t you b e l i e ve t ha t by f our o' c l oc k i n t he mor ni ng t he r e c or d r e f l e c t s t ha t t he r e we r e e nough s i gns a nd s ympt oms of r e s pi r a t or y di s t r e s s t ha t Dr . Cunni ngha m s houl d ha ve t a ke n s ome a c t i on? I s t ha t c or r e c t ?

A: Ye s .

* * *

Q: W t t r e a t me nt woul d y o u b e l i e ve s houl d ha ve be e n ha i ns t i t ut e d a t t ha t poi nt ?

A: The pr i nc i pa l t r e a t me nt pr oba bl y woul d ha ve be e n t he a dmi ni s t r a t i on of s uppl e me nt a l oxyge n.

Q: Oka y. How a bout f l ui ds ?

A: As we l l a s t he pl a c e me nt of a n i nt r a ve nous l i ne a nd a dmi ni s t r a t i on of i nt r a ve nous a nt i bi ot i c s .

Q: Ha d t ha t oc c ur r e d a t or a bout 5: 30 A. M , do you ha ve . a n opi ni on ba s e d upon r e a s ona bl e me di c a l pr oba bi l i t y t ha t t hi s i nf a nt woul d not ha ve s uf f e r e d pe r ma ne nt ne ur ol ogi c a l i nj ur y ?

A: I t hi nk t ha t i s c or r e c t .

( Al l e mpha s i s a dde d) .

The r e c or d r e ve a l s t ha t a l t hough t he s t a f f nur s e s we r e a l l owe d t o a d mi ni s t e r b l ows of oxy ge n on a n e me r ge nc y ba s i s , t he y we r e n o t a u t h o r i z e d, a bs e nt a phys i c i a n' s or de r , t o pe r f or m t he " a dmi ni s t r a - t i on o f s uppl e me nt a l oxyge n" a s Dr . Phi l i ps opi ne d s houl d ha ve b e e n done . Dr . Phi l i ps ' t e s t i mony s uppor t s t he de f e nda nt nur s e s ' a r g u me n t t ha t i t wa s Dr . Cunni ngha m, a nd not t he nur s i ng s t a f f , wh o wa s r e s pons i bl e f or t he di a gnos i s a nd t r e a t me nt whi c h Dr . Phi l i p s s a y s s h oul d ha ve oc c ur r e d a nd t ha t t he ne gl i ge nc e of t he nur s e s o r t he i r d e vi a t i on f r om t he s t a nda r d of c a r e wa s not t he c a us e of h a r m t o Ty l e r . Dr . Phi l i ps f ur t he r de pos e d a s f ol l ows :

Q: W t h r e ga r d t o your opi ni on t ha t t he r e wa s a f a i l - i ur e t o di a gnos e a nd t r e a t Tyl e r Da vi s whi c h c a us e d t he s e r i ous ne ur ol ogi c a l i nj ur y, i s i t a c or r e c t s t a t e me nt t ha t Dr . Cunni ngha m wa s t he me di c a l pe r s on who wa s c ha r ge d wi t h t he r e s pons i bi l i t y t o di a gnos e a ny c ondi t i ons a nd i ns t i t ut e t r e a t me nt ?

M W TE: Obj e c t i on.

R. AI THE W TNESS: I wa nt t o he a r t ha t a ga i n, pl e a s e .

I ( Re que s t e d por t i on of r e c or d r e a d) .

A: He wa s t he me di c a l pe r s on, ye s .

* * * Q: Ca n you s e t your own pa r a me t e r s a s t o how you woul d f e e l c omf or t a bl e a ns we r i ng t ha t que s t i on?

A: Now, l e t me ma ke s ur e I know wha t you' r e a s ki ng me .

You' r e a s ki ng me c a n nur s e s r e nde r d i a gnos e s a nd pr e s c r i be t r e a t me nt s .

Q: Ri ght .

A: I n ne wbor n i nt e ns i ve c a r e or i n ne wbor ns .

Q: Ri ght .

A: Some c a n, t h os e wi t h s pe c i a l t r a i ni ng.

Q: Oka y.

A: M t f l oor nur s e s , s hi f t nur s e s a r e not . os

M. s Da vi s pr e s e nt e d no e vi de nc e s ugge s t i ng t ha t a ny of t h e d e f e n d a nt nur s e s ha d " s pe c i a l t r a i ni ng" or a ut hor i z a t i on t o r e n d e r d i a gn o s e s o r p r e s c r i be t r e a t me nt s .

Si gni f i c a nt l y, t he r e c or d s hows t ha t Dr . Cunni ngha m wa s p r e s e nt a nd obs e r vi ng Tyl e r ' s me di c a l s i t ua t i on a t 3: 55 AM. Hi s o n l y or de r t o t he nur s e s a t t ha t t i me wa s t o " j us t wa t c h i nf a n t c l os e l y. " Dr . Cunni ngha m t e s t i f i e d t ha t t he nur s i ng s t a f f ha d i n f o r me d hi m t ha t t he y ha d a dmi ni s t e r e d bl ows of oxyge n i nt e r mi t - t e n t l y, a nd t ha t he wa s not i f i e d e ve r y t i me Tyl e r wa s gi ve n oxyg e n .

The f o l l owi ng por t i ons of Dr . Cunni ngha m' s de pos i t i on t e s t i mony a r e s i g n i f i c a nt wi t h r e ga r d t o t he c ommuni c a t i on be t we e n hi ms e l f a n d t h e d e f e nda nt nur s e s :

Q: And d ur i ng t hi s e nt i r e t i me f r a me f r om t h e t i me of e l e ve n o' c l o c k — r c a n we a c t ua l l y s t a r t i t , I o gue s s , 10: 55 whe n you f i r s t s a w t he c hi l d; ba s e d on t hi s l a t e e nt r y i n your t e s t i mony, ha d t he nur s e s c ommuni c a t e d i n your opi ni on t he i nf or ma t i on t o you t ha t wa s n e c e s s a r y f or you t o ma ke a pr ope r di a gno- s i s of wha t wa s oc c ur r i ng wi t h Tyl e r Da vi s ?

A: Ye s .

* * * A: I wa s ke pt a c ut e l y a wa r e of t he ba by' s c ondi t i on- - Q: Oka y.

A: — y t he nur s e s . The nur s e s we r e a l l ve r y a t t e nt i ve b a nd ve r y c onc e r ne d t he whol e t i me .

* * * Q: Oka y. W r e you a dvi s e d a t 5: 45 t ha t t he r e s pi r a - e t i ons of t he c hi l d we r e t ha t hi gh?

A: I don' t know, but I wa s a dvi s e d mul t i pl e t i me s dur i ng t ha t ni ght t ha t t he r e s pi r a t i ons we r e c ha ng- i ng up a nd down f r om t i me t o t i me .

Q: Oka y.

A: And t he , quot e , nor ma l pa r a me t e r s of r e s pi r a t i ons va r y b e t we e n 65 a nd 30 a nd t he n 10 pe r c e nt e i t he r a bove or be yond t ha t i s not r e a l l y t e r r i bl y e xc i t - i ng a t t ha t t i me .

Q: Al l r i ght .

A: But I wa s a wa r e of t he c ondi t i on of t he ba by a l mos t mi nut e by mi nut e .

Dr . Cunni ngha m' s t e s t i mony t ha t t he nur s e s pr ovi de d hi m wi t h al l t h e e s s e nt i a l i nf or ma t i on he ne e de d t o ma ke a n a ppr opr i a t e d i a g n o s i s i s undi s put e d. Fur t he r , he t e s t i f i e d t ha t " I ne ve r l e f t t he h o s p i t a l . . . I wa s a l wa ys i m di a t e l y a va i l a bl e . " me

Fr om t he f or e goi ng t e s t i mony, a n d our r e vi e w of t he e nt i r e r e c or d i n t hi s c a s e , we f i nd t ha t , t a ki ng i nt o c ons i de r a t i on a l l t he e v i de nc e i n t he l i gh t mos t f a vor a bl e t o t he pl a i nt i f f a nd d r a wi n g a l l r e a s ona bl e i nf e r e nc e s i n he r f a vor , we c onc ur wi t h t h e j u d g me n t of t he t r i a l c our t t ha t t he i nj ur i e s s us t a i ne d by Tyl e r

we r e p r oxi ma t e l y c a us e d b y Dr . Cunni ngha m' s de vi a t i on f r om t h e a c c e pt e d s t a nda r d of c a r e a nd not by a ny ne gl i ge nc e on t he pa r t o f t h e d e f e nda nt nur s e s . The pl a i nt i f f ha s f a i l e d t o me e t t he bur d e n p l a c e d upon he r by T. C. A. § 29- 26- 115( a ) ( 3) .

Ac c or di ngl y, t he t r i a l c our t ' s j udgme nt i s a f f i r me d a nd t h e c a s e r e ma nde d f o r s uc h ot he r a nd f ur t he r a c t i on a s ma y be ne c e s - s a r y. Cos t s o n a ppe a l a r e t a xe d a nd a s s e s s e d t o t he a ppe l l a nt .

___________________________ Don T. M M r a y, J udge c ur

_ _ _ _ _ _ _ ____________________________ Ho u s t o n M Godda r d, Pr e s i d i ng J udge .

_ _ _ _ _ _ _ ____________________________ He r s c h e l P. Fr a nks , J udge

I N THE COURT OF APPEALS

REBA V. DAVI S a nd TYLER W AYNE ) ROANE CI RCUI T DAVI S b y ne xt f r i e nd, REBA V. ) C. A. NO. 03A01- 9701- CV- 0001 6 DAVI S, ) ) Pl a i nt i f f s - Appe l l a nt s ) ) ) ) ) ) vs . ) HON. RUSSELL E. SI M ONS, J R. M ) J UDGE ) ) ) ) ) HARRI M AN CI TY HOSPI TAL, THE ) CI TY OF HARRI M AN, J EAN ANGELO, ) BRENDA RUTHERFORD, BETTY ) SAM PSON, RHONDA M ARTI N, M ELI NDA ) AFFI RMED AND REMANDED LATHAM SHARON UNDERW , OOD a nd ) VI CKI E KLI NNERT, ) ) De f e nda nt s - Appe l l e e s )

JUDGMENT

Thi s a ppe a l c a me on t o be he a r d upo n t h e r e c or d f r om t h e Ci r c u i t Cour t of Roa ne Count y, br i e f s a nd a r gume nt of c ouns e l .

Up o n c o n s i de r a t i on t he r e of , t hi s Cour t i s of t he opi ni on t ha t t he r e wa s n o r e ve r s i bl e e r r or i n t he t r i a l c our t .

Th e t r i a l c our t ' s j ud gme nt i s a f f i r me d a nd t he c a s e r e ma nd e d f or s u c h ot he r a nd f ur t he r a c t i on a s ma y be ne c e s s a r y. Cos t s o n a pp e a l a r e t a xe d a nd a s s e s s e d t o t he a ppe l l a nt .

PER CURI AM