W hi l e t he case w as o n a p p eal , the A p p el l ees f i l ed a S uggest i o n of D eat h of P l ai nt i f f / A p p el l ant , and pursuant 1

t o t he O r der of

t hi s Co ur t , Ap pel l ant ’ s couns el has f i l ed a mot i on for s ubs t i t ut i on of par t i es , ci t i ng t hat t he decedent was
unm arri ed at t he t i m e o f her death, that no e st at e has b een o p ened for the d eced ent , a nd t hat s he was s urvi ved by f o ur chi l d ren, Jaco b S ho res , E ri c N el son, Leif N el son, and M i st y N el son, who are t he p rop er part i es f o r s ub st i t ut i o n, pursuant to T .C .A

. § 2 0 -5 -1 0 6

.



### IN THE COURT OF APP EALS OF TENNESS EE

AT JAC KSON A ugus t 22 , 200 5 S es sio n
PATTI Z AKOUR v . UT MEDICAL G ROUP, INC., ET AL 

### .
A Dire ct A ppeal f

romthe Circ uit Court for Tip ton County Nos. 5234, 5500 The Honorabl e Joseph H. Walk er, Judge

No. W2003-01193-C OA-R3-C V - F iled October 31, 2005

The jury returne d a ver dict for the de fenda nt doctors and medic al cl i n i c i n t h is medical malprac tice ac tion. The plaintiff ar g ues on appe al that the trial court committed reve rsible er ror at
sever al stag es of the trial, including jury selec tion, witness’ testimony and jury instructions. Further , the plaintiff ar g ues that there was insufficient evidenc e to support the jury ’s verdic t. We affirm the tr ia l c ou rt

.

Tenn. R. App . P . 3; Appeal as of Right; Judgme nt of th e Circ uit Court Aff irm ed

W. F RAN K C RAW FORD , P. J ., W

. S

. , d elivere d the opinion of the court, in which A L AN E. H I G H ERS , J . and H OL L Y M. K I RBY , J ., joined.

Daniel A. Sew ard of

Memphis, Tennesse e for Appellant, Patti Z akour

J o h n H. Do t s o n o f M em p h i s , T en n es s ee fo r A p p el l ee s , UT M ed i ca l Gr o u p , In c

. an d S co t tC ra i g, M.D.

OP IN ION

On J une 2, 1998, Patti Z akour (“Plaintiff” or “Appellant”) presente d to the Fa milyPractice 1 Center ( “the c linic”) in Covington, Te nnessee operated by the Univer sityof Tenne ssee Me dical Group (“U TMG”)

. Ms. Z akour pr esente d with a mass in her right br east e stimated by her e x amining phy sician, re sident Dr. Na ncy Rockstroh, to be 1.5 ce ntimeters in diameter . Dr. Rockstroh consulted with Dr. John Kelly , another phy sician at the c linic, and they ag ree d t o re fe r p atient for a-2-

mammogr am. The ma mmogr am was perf ormed on J une 4, 1998 at the Ba ptist Hospital in Tipton Cou nty

. Th e ma ss wa s int e rp re te d by Dr

. Soh e il Ha nn a , the e xami nin g ra dio log ist , as “pr obably benig n.” On June 5, 1998, Dr. Ke lly sent a letter

to Ms. Za

kour stating th at , b as ed o n the
ra dio log ist ’s re a din g of the ma mmo g ram, h e re c omm e nd e d a fo llo w- up ma mmo g ram in six mo nth s. Ms. Z akour r eturne d to the clinic on J uly 6, 1998, wher e Dr . Rockstroh, and he r super vising phy sician, Dr. Scott Craig examined her. Ac cording to the medical r ecor ds, Dr. Rockstroh, with Dr. Cr ai g’s co n sent, rec ommended a r epeat clinical bre ast exam in three months and a r epeat
ma mmo g ram in six mo nth s. Th e do c tor s a lle g e that th e y tol d M s. Z ako ur that sh e ha d tw o o pti on s, to either pursue a surg ical refer ral for biopsy

of the mass or c hoose a c lose clinical follow- up. The doctors stated that Ms. Z akour c hose the c lose clinical follow- up. Ms. Z akour w as told by the doctors to re turn to the clinic in three months. I n Marc h of 1999, nine months afte r the orig inal mammogr am, Ms. Z akour r eturne d to the clinic complaining that the mass had be come lar g er. B ased on the cha ng ed condition of Ms. Z akour ’s rig ht brea st, Drs. Rockstroh and Cra ig r efe rre d Ms. Z akour for a surg ical consult. F ollowing a biopsy , Ms. Z akour was diag nosed with me tastatic brea st canc er.
On Marc h 8, 2000, Ms. Z akour f iled suit ag ainst Dr. Na ncy Rockstroh, Dr. Scott Craig , Dr. John Ke l l y , U T M e d i c a l G r o u p , I n c

. a /k / a F a m i l y P r a c t i c e C e n t e r , B ap t i s tM e m o r i a l H o s p i t a lCovington, and D r. Soheil Hanna . The Complaint alleg ed that the de fenda nt Drs. Craig and Rockstroh neg lige ntly

failed to diag nose Ms. Z akour’ s canc er a nd that as a pr ox imate re sult of suc h neg lige nce, Ms. Z akour suf fer ed injuries, which would not otherwise ha ve occ urre d. On April 20, 2000, Dr. Cra ig and UTMG filed se parate answe rs to the complaint. On Nove mber 15, 2000, the court e ntere d an orde r of Volu n t ar y Di s m i s s al as to Dr. Craig. Ms. Z akour r efiled he r Complaint ag ainst Dr. Craig on November 15, 2001. On May

17, 2002, a conse n t order w as ente red consolidating the ca se ag ainst UTMG with the new case ag ainst Dr. Craig . Be cause of the va rious nonsuits and a mendments, the pleading s in this case are somewhat confusing

. Howeve r, we see no need to r elate the pleading s in de tail, but suffice it to say that at the time of trial, only defe ndants Dr. Craig and UTMG ( “De fenda nts”) re mained in the lawsuit.

The trial b egan on March 31, 2003. D uring jury selec tion, Pl aintiff Z akour’ s counsel objected to the pe remptory challeng es by

Def endants, c harg ing that the defe nse counse l was striking jurors based on rac e and g ender . Plaintiff issued a Batson Cha lle ng e a nd arg ue d that th e De fe nd a nts g ave no neutra l rea son or leg al justification for c halleng ing a ll the African-American membe rs of the jury pool. Furthe r, Plaintiff arg ued that the Defenda nts’ exclusion of women from the jury pool was pre judicial. The trial c ourt denied the Plaintiff’s objections as to per emptory challeng es of the Def endants. The Plaintiff the n moved for a mistrial, which the tria l court denie d. The re sulting jury consisted of four

fema les, and e ight male s, all of whom wer e Cauc asians.
During the trial, De fenda nts called Alisa Goe hring , UTMG Mana g er of Contract and L eg al Service s as the cor

poration' s repr esenta tive and as a witness. Ms. Goehring was disclosed by way of a me nd e d in te rr og a tory

re sp on se s o n th e fi rst mo rn ing of the tr ia l, t wo da y s b e fo re sh e wa s to testify

. Plaintiff objected to Ms. Goehring being called as a witness, claiming that she had not be en pro p e r ly id e n ti f

ie d d u r in g d is c o v e r y

. Pl a in ti f f ma d e a n o r a l mo ti o n to p r e v e n t G o e h r in g from testify ing, or

in the alternative to be able to de pose her prior to te stimony , but plaintiff' s attorney was-3-

specific ally authorized to ta lk w ith Ms. Goehring be fore she testified. The Plaintiff’s motion was de nie d. Ms. Go e hring te sti fi e d th a t th e De fe nd a nt U TM G w a s a no np rof it or g a nizatio n w ho se pu rp os e wa s patie nt c are , re se arc h a ndthe tr a ini ng of do c tor s. Ms. Go e hring te sti fi e d th a t a t th e tim e Ms. Z akour w as treated at the UT Fa milyPractice Center in Coving ton, Tennesse e, UTMG ope rate d that clinic. Upon cross examination of Goehring, Plaintiff attempted to examine the witness about UT MG p h y s i c i anp r o f

i t

- s ha ri ng plans a ndre ve nu e g e ne rate d b y UT MG a ndits e mpl oy e e ph y sic ia ns

. Upon objection of D efe ndants’ counse l, the trial court would not all ow Plaintiff to cross examine Ms. Go e hring re g ard ing the fi na nc ia l st ru c tur e of UT MG , a ndthe c omp e ns a tio n o f i ts p hy sic ia ns

. Plaintiff made an offer of proof reg arding the compensation plan of UTMG based upon production and per centa g e of r evenue broug ht in by phy sicians.

At the conc lu s i o n o f p ro of, Plaintiff objecte d to the jury instruction proposed by the De fe nd a nts ’ c ou ns el re fe rring to T e nn e sse e Pa tte rn Jury I ns truc tio n 6 .1 1, Du ty

of Spe c ia lis t. Pla int if f a rg ue d th a t Dr

. Cr a ig wa s no t a sp e c ia lis t a t the tim e he tr e a te d Ms. Z ako ur , be c a us e he did not take the e x am to become board certified in f amily medicine until the month after he tre ated the P l a i n t i f f i n J u l y o f 1 9 9 8

. T h e tr i a l c o u r t o v e rru l e d t h i s o b j e c t i o n , a n d g a v e t h e i n s tru c t i o n t o t h e j u r y. Further, the Plaintiff objec ted to the trial court’s placing of non def endants Dr s. Kelly

and Rockstroh on the jury

verdic t form, and not putting Def endant UT MG on the jury verdic t form. The tria l court
ov e rr ule d th e Pla int if

f’ s o bje c tio n a s to na me d p art ie s o n th e jury ve rd ic t form. Th e ve rd ic t f or m, a s su bmi tte d to the jury , li ste d D rs . Cr a ig , K e lly , Ro c ks tr oh , a ndPla int if f Z ako ur , b ut d id n ot l ist UT MG fo r a ssi g nme nt of fa ult

. On Ap ri l 2, 20 03 , th e jury re turne d a

ve rd ic t in fa vo r o f D e fe nd a nts , finding that none of the phy sicians wer e neg lige nt, and a judg ment was entered the reon. O n May 1, 2003, the Plaintiff filed a motion for a new tria l, which was de nied by the trial court on October 7, 2003. Plaintiff filed a Notice of Appeal and raises the foll owing issues for review, as stated i n her brie f:

1. Whether the Appellee s issued pere mptory challeng es to potential Afric an-A merica n jurors base d upon their rac e in an attempt to secure an all white jury

in violation of the equal prote ction clause and Tenne ssee law ? 2. Whether the Appe llees issued pere mptory challeng es to potential fe ma le jur or s b a se d up on the ir g e nd e r i n a n a tte mpt

to s e c ur e a

ma le dominated jury

in violation of th e eq u al protec tion clause a nd Tenne ssee law ? 3. Whe the r i t w a s re ve rs ibl e e rr or to a llo w the [Ap pe lle e s’ ] wit ne ss, Alisa [Goehring ], t o testify on appellee s’ beha lf when she had not been identified as a witness prior to trial and whether the trial co urt proper ly limit ed t h e cross e x amination of Appe llant’s counsel
r e g ar d i n g h e r

t e s t i m o n y? 4. Whether the trial court committed e rror in not putting UT Medica l Group, Inc. on t h e jury

verdic t form and wa s there a lso error in the-4- trial co urt placing non defe ndants, Drs. John Kelly and Na ncy Roc ks tr oh , o n th e jury

ve rd ic t f orm? 5. Whether it was re versible e rror for the trial court to instruct the jury on T.P.I . 6.11, Duty of Specia list, when the [Appellee] was not
a sp e c ia lis t of

a ny kin d at th e tim e of

the a lle g e d n e g lig e nt a c ts? 6. Whether the testimony of App el l ee s’ expert, Dr. B irkenstock, proper ly rebutted or

ref uted the Appellant’s experts, D r. Johns on and Dr. S hull and whe ther Appe llees’ e x pert pre sented c redible e vidence on the standar d of ca

re in this case

.

This me d ic a l m a lp r a c ti c e a c ti o n is c o n tr o ll e d b y T

. C. A

. § 2 9

- 2 6

- 1 1 5 ( 2 0 0 5 Su p p

. ) , w hich pr ov ide s in pe rt ine nt p art :

29-26-115. Claim ant’s b u rd en in malprac tice action – Expert test im ony – P resum ption of negligence – Jury instructions. –(a) I n a malpra ctice a ction, the claimant shall have the burden of proving by evidenc e as pr ovided by

subsection (b): (1) The rec og nized standard of acc eptable pr ofessional pra ctice in the pr o f e s s io n a n d th e s p e c ia lt y th e r e o f, if

a n y , th a t th e d efe ndant prac tices in the community in which the def

endant pr actice s or in a simil ar c ommunityat the time the alleg ed injury or wrong ful ac tion
occur red; (2 ) Th a t the de fe nd a nt a c te d wi th le ss than or faile d to a c t with ordinary and re asonable car e in ac corda nce w ith such standard; a nd (3) As a proxi mate result of the de fenda nt’s neg lige nt act or omission, the plaintiff suff

ere d injuries which would not otherw ise have
occur red.
Where, a s here , a trial judge has approved a jury ' s verdict, our standard of

revie w is whether the re is a ny

ma te ri a l e vid e nc e to s up po rt the jury ' s v e rdict . T e nn . R. Ap p. P. 1 3( d) . A bs e nt a
reve rsible err or of law, we will se t a side a judgme nt on a jury verdic t only wher e the r ecor d contains no materia l ev i d en ce t o support the ver dict. Foster v. Bue, 749 S.W .2d 736, 741 (Tenn. 1988)

. Ho we ve r, iss ue s th a t hin g e on the pr op e r i nte rp re ta tio n o f l a w a ndits app lic a tio n to the fa c ts o f this
case are questions of law. Mem phis Pu bl'g Co. v. Cherokee Chi ldren & Fam ily Servs., Inc.
, 87 S.W. 3d67 , 7 4 ( Te nn . 2 00 2) ; Waller v. Bryan
, 16 S.W .3d 770, 773 (Tenn. Ct. App. 1999). T he trial court' s resolution of a que stion o f l aw is not entitled to Tenn. R.App. P. 13(d)' s presumption of
c or re c tne ss o n a

pp e a l; i ns te a d, thi s Co urt r e vie ws de novo issues reg arding a trial c ourt’s pr o p er app lic a tio n of the la w. Th e we ig ht, faith , an d cr e dit to b e g ive n to a ny

wi tne ss’ s te sti mon y

lie s in the first instance with the trier of fac t, t h e j u ry i n t his cause, and the cr edibilityacc orded w ill be g iven g reat weig ht by

the appe llate court. Kim v. Boucher , 55 S.W .3d 551 (Tenn. Ct. App. 2001).

We w ill no w c on sid e r the iss ue s.I t i s no t d i scernabl e f rom t he reco rd preci sel y whi ch p rosp ect i ve jurors were A f ri can- A m eri can. H o wever, 2

t he reco rd al l o ws t he co urt t o de t erm i ne t hat t he D efend ant s used seven p erem p t o ry chal l enges i n t he fo l l o wi ng m anner: G end er: s i x f

em al es, one m al e; R ace: t hree A f ri can- A m eri cans, fo ur E urop ean- A m eri cans. T he P l ai nt i f f us ed fo ur p ere m p t o ry cha l l en ge s, all fo ur E uro p ea n-A m erica n m ales.
-5- 1. Whether t he Appellees i ssued peremptory challeng es t o potential Afric an-A merica n jurors based upon the ir rac e in an attempt to secure an all white jury

in violation of the equal prote ction clause and Tenne ssee law ?
Rely ing on Batson v. Kentucky, 476 U.S. 79, 106 S.C t. 1712, 90 L .Ed.2d 69 (1986), Appellant ar g ues that the e x clusion of the only Afric an-A merica n members of the venire from the jury vio la te d h e r c on sti tut ion a l r ig ht t o equ al pro te c tio n u nd e r the la w. Th is i ssu e re qu ir e s u s to determine whether

the trial court failed to follow the thre e-step pr ocess of Batson , when it denied the Ap p ell ant’s objec tion of the use of D efe ndant’s per emptory challeng es for

all the AfricanAm e ri c a n me mbe rs of the jury po ol. We re vie w f or c le ar e rr or

a tr ia l c ou rt ’s de c isi on on the ult imate question of discriminatory intent under Ba tso n. Hernandez v. New York, 500 U.S. 352, 364, 111 S.Ct . 1859, 114 L .Ed.2d 395 (1991). We may reve rse that f

inding of fac t only wher e we find clea

r err or. Id. at 369, 111 S.Ct. 1859. See also Woodson v. Porter B r o w n L i m es t o ne Co., Inc., 916 S.W. 2d89 6, 90 6 ( Te nn . 1 99 6) ; Sta te v . Ca rro ll, 34 S.W .3d 317, 319-20 (Te nn. Crim. App. 2000).

I n Tenne ssee, the right to ex erc ise a peremptory challeng e is provided by statute. Acc ording to T.C.A. § 22-3-105 (1994) , “either party to a civil action may

challenge four ( 4) jurors without
a ssi g nin g a ny c a us e .” T. C.A . § 22 -3 -1 05 (a ). As in the pr e se nt ca se , if the re is “m or e than one pa rt y defe ndant in a civil ac tion, four (4) a dditional challeng es shall be a llowed.” T.C.A. § 22- 3-105 (b)

. The trial c ourt fo l l o we d t he statute, whic h entitled Plaintiff to four per emptory challeng es and
e nti tle d th e De fe nd a nts to e ig ht.

The re cord e stablishes that at the beg inning of voir dire, two prospec tive jurors we re e x cused b ec au s e t h ey could not serve for the f ull ex tent of the trial. F ive other pr ospective juror s were excused for c ause because, either they or t heir family members, were patients of t he De fenda nt, Dr. Craig

. On t he first round of challeng es, five prospec tive jurors were c halleng ed, four fema les and one male, at least one of the fema les being an Af rica n-American. The second round of pe remptory 2 challeng es included two pr ospective juror s, one male a nd one Af rica n-American f

emale. Plaintiff’ s counsel issued a Batson challeng e, objec ting to the De fenda nts’ pere mptor y ch alleng es as impermissiblybased on race , citing the exclusion by the def ense of the only two Afric an-A merica ns of the ve nir e

. Th e c ou rt did no t a dd re ss the Pla int if f’ s Batson challeng e at that time. Following the third round of c halleng es, and a fter the Def endants’ e x clusion of a third an d t he only rema ining Afric an-A meric an from the venire , the Plaintiff reque sted that the court addre ss her Batson
c ha lle ng e . A t th e be nc h, the Pla int if f as ke d tha t the De fe nd a nts state a ra c e -n e utr a l ba sis fo r the irFrom t he reco rd, i t ap p ears t hat M s. Frazi er and M s. Snee d are Afr i can- A m eri cans. I t i s uncl ear whet her t he 3

re m a inin g A fric a n -A m e ric a n in the ju ry p o o l wa s M s. M c In to sh , M s. C ra ig, o r M s. B rya n t.
-6- exclusion of all the African-American membe rs of the venire

. The following exchang e took place
a tt h e b e n c h i n t h e p r e s e n c e o f t h e j u r y, b u to u t s i d e t h e h e ar i n g o f t h e j u r y: De fens e Co unse l: As far

as Ms. Fr azier wa s conce rned, I believe she was the one that had the diff iculty reme mbering about what kind of

– what she d e c id e d o n a

p r e v io u s ju r y

c a s e in a c iv il a c ti o n

. T hat
c a us e s me so me c on c e rn , p lus the fa c t th a t sh e had so me famil y history with canc er. * * * As fa r a s Ms . Sn e e d, Yo ur H on or, sh e wa s o ne of the pe op le that I noticed wa s nodding he r hea d all throug hout the portion of Mr. Sewar d ’ s (Plaintiff’s counse l) examination. I ’ve g ot other people like Ms. McI ntosh nodding he ad. Ms. C ra i g, als o Ms. Bry ant nodding h e a d

. Y o u r

H o n o r , t h a t ’ s t h e r e a s o n w h y. 3

P lai nt iff’s Co unse l: I

would say

out of the t hree Afric an-A merica n fema les that have been se ated on t h i s jury , this defenda nt has sy st em at i ca l l y

ex cl u d ed Af

ri ca n -A m er i ca n females from the jury pool of a jury pool that consisted of a ma x imum of 11 Afric an-A merica ns to begi n wi t h

. He sy stematically excluded or struck e ach A fricanAm e ri c a n in the jury , or po te nti a l jur or s, wi th n o r a c e -n e utr a l ba sis , a ndit’ s b a sic a lly

no thi ng mor e than a n att e mpt to se le c t an a ll- wh ite jury to try this case. De fens e Co unse l: F ir st o f a ll, Yo ur Ho no r, I take pe rsona l off

e ns e abo ut the a lle g a tio n o f sy ste ma tic e lim inatio n o f A fric a n- Am e ri c a ns

. I ’ve ne ver be en ac cused of that ever befor e in my

profe ssional car eer

. But to g et to the meat of the matter, I ’ve had justification f or eac h and
every one of my

strikes. I f Your H onor, in order

to c lear the rec ord, wants us to withdraw our ob je c tio n as to Ms. Sne e d, I ’m ha pp y to do that sinc e that’ s p ri mari ly b as ed on the head nodding , which I have, just fr ankly , struck
every body that did that. The Court: The court will a cce pt that a s a ra ce- neutra l rea son. I f y ou still want to use that strike, y ou can. De fens e Co unse l: My

c o- c ou ns e l say s st a y

wi th i t.-7- P lai nt iff’s Co unse l: Your Honor , I respe ctfully

object just for the
rec ord , at this point and ask the Court to note my exception to the
ru l i n g , r e s p e c t f

u l l y.

I n Batson, the Un ite d St ate s Sup re me Cou rt ma de it c le ar that a

pe re mpt ory

c ha lle ng e to strike a juror

may not be exercised on the basis of ra ce. Bat so n, 476 U. S

. at 89, 96-98. The proce dure for i nvoking a Batson challeng e wa s discussed in State v. Carroll , 34 S.W .3d 317 (Tenn. Cr im. Ap p. 20 00 ) a s f

oll ow s:

B a ts on p ro vides a thre e-step pr ocess f or the e valuation of ra cial discrimination claims in jury selec tion. First the def

endant must make
a pr im a fa c ie showing that the prosec utor has exerc ised pere mptory challeng es on the ba sis of rac e. P u c k e t t v . E l e m, 514 U.S. 765, 767, 11 5 S. Ct. 17 69 , 1 77 0- 71 , 1 31 L .E d. 2d83 4 ( 19 95 ); Bat so n, 47 6 U .S.
a t 96 -9 8, 10 6 S. Ct. 17 12 , 1 72 2- 24 . I f the de fe nd a nt s a tis fi e s th is initial burden, the burde n then shifts to the prosec utor to articulate a rac e-ne utral explanati o nf o r e xc luding the venire member in que stion. Puc ke tt, 51 4 U.S. a t 767, 11 5 S. Ct. 17 70 -7 1; Bat so n, 476 U.S. at 94, 106 S.Ct . 1712, 1721. Third, t he trial court must determine whether the def endant ha s met his burden of pr oving pur poseful discrimination. Bat

so n, 476 U.S. at 97-98, 106 S.Ct . 1712, 1723-24; Hernandez v. New York, 500 U.S. 352, 358-59, 111 S

. C t

. 1 8 59, 1865

- 6 6 , 1 1 4 L

. E d

. 2 d 3 9 5 ( 1 9 9 1 )

. I n ma k in g it s d e te r mi n a tion of whether use of a pere mptory ch all eng e wa s discriminatory , the trial
c ou rt mus t a rt ic ulate sp e c if

ic re a so ns for eac h o f i ts f ind ing s. Woodson [ v. Porter Brown Lim estone Co. ], 916 S.W .2d [896,] 906 [Te nn .1 99 6]. Th e tr ia l c ou rt ' s fi nd ing s are imp e rativ e fo r r are ly wi ll
a tr ia l re c or d a lon e pr ov ide a le g iti ma te ba sis fr om wh ic h to s ub sti tut e an appe llate court's opinion for that of the trial c ourt. Thus, on appea l, the trial court' s finding th at t he State excused a venire
me mbe r f

or ra c e -n e utr a l reason s w ill no t be re ve rs e d u nle ss i t is clea rly err oneous. Se e Wo od

so n, 916 S.W .2d at 906.

Car ro ll, 34 S.W .3d at 319-20. As in Car ro ll, the trial court i n t he pre sent ca se did not make a specific finding that Plaintiff had made a pr im a fa c ie showing of discrimination. S ee i d. at 392. Nonethele ss, the trial court would not ha ve require d the Def endant to pr ovide a race -neutra l explanation for the cha lleng e had the trial court de termined that a pr im a fa c ie showing had not been made. Id .; se e als o W

oo ds on, 916 S.W .2d at 905. " Thus, we a ssume that the court impli citly found that [Defenda nt] had satisfied the first prong of the Batson tes t. " Car ro ll, 34 S.W .3d at 320. As the United States Supreme Court obse rved in He rn an de z, "[o]nce a pr osecutor ha s offe red a rac e-ne utral explanation for the per emptory challeng es [without prompt ing] and the tria l court has r uled on the-8-

ultimate question of intentional discrimination, the prelimi nary issue of whether the defenda nt had made a pr im a fa c ie showing become s moot." He rna nde z, 500 U.S. at 359, 111 S.Ct . at 1866.

The trial c ourt' s finding s are sparse reg arding the Def endants’ rac e-ne utral explanation for the cha lleng e. The rec ord is sufficie nt, however , to undertake our re view. The issue in the second step of the Batson pro cess res ts up on th e faci al val id it y of th e Defen dan ts ’ exp lan ati on ." Id. at 360, 111 S.Ct

. at 1866. "A neutra l e x planation

. . . means an explanation based on something other than th e race o f t he j uro r." Id. Unless a discriminatory intent is inhere nt in the Defenda nts’ explanation,

“ the re a so n of

fe re d wi ll be de e me d ra c e -n e utr a l." Id. I n t h e second pha se of the inquiry , the Defen dan ts ’ ex pl anat io n i s n otrequ ir ed t o b e "pers uas iv e or e ven pl aus ib le. " Puc ke tt, 514 U.S. at 768, 115 S.Ct . at 1771.

I n th e pr e se nt ca se , the De fe nd a nts of fe re d sev e ra l expla natio ns fo r the ir c ha lle ng e s. F ir st, the Def endants stated that Ms. Fra zier’s had difficulty reme mbering what she de cided on a previous jury case in a civil action, and that she had some fam i l y h i s t o ry wi t h canc er. A s to the other two Af ri c a n- Am e ri c a ns e xclu de d b y the De fe nd a nts , M s. Sne e d a nda no the r p art y , th e De fe nd a nts challeng ed them bec ause the y wer e nodding their hea ds “all t h ro u ghout the portion of [P laintiff’s counsel] examination.” Defe ndants’ counsel stated that he had excluded other individuals who ar e not African-Americans, for the same “ head nodding ” re ason.

“The centr al func tion of the rig ht of pere mptory challeng e is to enable a litiga nt to remove
a ce rtain num b er o f potential jurors who a re not c halleng eable for c ause, but in whom the litiga nt pe rc e ive s bia s or host il it y ." S ta te v . Sp ra tt , 31 S.W .3d 587, 598 (Tenn. Crim. App. 2000) . The determination of a discriminatory intent on the part of the challeng er " larg ely will turn on evaluation of cr edi bi li ty ." Bas ton, 476 U.S. at 98 n.21, 106 S.Ct . at 1724 n.2 1

. "I n the typical per emptory challeng e inquiry , the dec isive question will b e whether c ounsel' s rac e-ne utral explanation for a pere mptory

challeng e should be believed. There will se ldom be much evidenc e bea ring on that issue, and the be st evidence often will be the d em eanor of the attorney

who exercises the challeng e." He rna nde

z, 500 U.S. at 3 6 5 , 1 1 1 S.Ct . at 1869. The D efe ndants observe d the three prospec tive jurors expressing a bias towa rd De fenda nts, a nd the trial court acc epted this rac ial-neutra l rea son for exercising a per emptory

challeng e. Plaintiff has not shown that the trial court e rre d in acc rediting the De fe nd a nts ’ r a c ia lly

ne utr a l e xpla na tio n f

or e xcu sin g the

p r o s p e c t i v ew i t n e s s e s

. T h eD e f e n d ants ’ basis for the use of a pere mptory challeng e ag ainst the three Afric an-A merica ns from the jury pool
was s u ff i ci en t ly rac e-ne utral to withstand a Batson challeng e. Ac cording ly , we hold that the tria l court c orre ctly

applied Batson in r

uling there had not be en a violation, a nd Plaintiff is not entit led to relief on this issue.

2. Whether t he Appellees i ssued peremptory challeng es t o potential fe ma le jur or s ba se d u po n th e ir g e nd e r i n a n a tte mpt

to s e c ur e a

ma le dominated jury

in v i o l at i o n of the e qual protec tion clause a nd Tenne ssee law ?-9-

F oll ow ing the c ou rt ’s re so lut ion of the Pla int if

f’ s Batson challeng es based on r ace , and af ter the fourth r ound of per emptory challeng es wa s complete, the Plai n t i ff m ad e a se cond B atson challeng e base d on the Def endants’ use of six of their se ven per emptory challeng es to exclude fema les from t h e j u ry pool. During a benc h confe renc e, which w as held on the r ecor d in the prese nce of

the jury but out of the hea

ring of the jury , the following exchang e took place :

P lai nt iff ’s C ouns e l: Yo ur Ho no r, a t th is p oin t I

wo uldre ne w m y mot ion a s to my

pr e vio us Batson c ha lle ng e a s to the vo ir dir e of thi s jury selec tion process by

the def endant. I would say to the Court . . . of t he seven [challeng es used by Def endant] either a ll but one were fema les that they

challeng ed during the per emptory challenges , and I would say

on that basis th er e h as b ee n as a r esult a proc ess of
e lim inatin g fe ma le s f

ro m the jury sy ste ma tic a lly by thede fe nd a nts in thi s c a se

. No t ne c e ssa

ri ly Af ri c a n[- Am e ri c a n] f

e ma le s. I n r e tr os pe c t,
a ll fe ma le s. So I

wo uldsa y

the re c or d s pe aks fo r i tse lf . I wo uldstate to the Court out of the, I believe the n u m b er i s seven tha t were challeng ed. I

believe the o n l y m al e they informed me of

was Mr. Smit h, who was a

male.

*** The Court: I

g ue ss f or the re c or d I

sh ou ld s a y

that th e re are c ur

re ntl y four f emales a nd seven ma les empane led. Does the defe ndant have any response ? De fend ant s’ Co unse l: Well, I ’m g lad, Your H onor, that the Batson challeng e has be en I g uess removed as far as rac e, and we did strike at least one male that I

have note s on. W e ce rtainly wer e not – that
was n ’t t he dete rmining f actor . I f the Court wa nts me to go ba ck throug h eac h and every challeng e, I think I can ref er to my notes and come up with that. B ut we do have four fema le jurors on this jury

. A n d w e w e n t th r o u g h th e s a me p r o c e s s M r

. Se w ar d [P laintiff ’s
c ou ns e l] di d. An d I

do n’ t g o b a c k a nd take a loo k at his c ha lle ng e s, if they wer e all men or

not. But we h ad a fair r epre sentation of the community

here , and ther e was no sy stematic for rac e or sex factor, just all based on experienc e and body mecha nics. Th e C o ur t: I gu ess for the rec ord the plaintiff e x erc ised all four challeng es, and the y

wer e all male. P lai nt iff’s Co unse l: Thank y ou, Your Honor

. The Court: Okay . I s there any thing e lse? P lai nt iff’s Co unse l: No, Your H onor.-10-

I n J.E.B. v. Alabam a, ex rel. T. B., 511 U.S. 127, 114 S.Ct

. 1419, 128 L .Ed.2d 89 (1994), the Un ite d St a te s Su pr e me Cou rt he ld that pe re mpt ory

strike s ma de so le ly

on the ba sis of

g e nd e r a lso violate the dictates of the equal protec tion clause. The Supreme Court of Te nnessee has addr essed this issue in holding that a defe ndant could not use pe remptory strikes to remove a ll females f rom the jury venire

. Sta te v . T

urne r, 879 S.W .2d 819, 823 (Tenn.1994) . The procedur e and burdens for invoking the pr otection of Batson based on g ender are the s ame as a cha lleng e base d on rac e. Sta te
v . Sp ra tt, 31 S.W .3d 587, 596 (Tenn. Crim. App. 2000)

.

I n this case, Plaintiff’s objec tion to the state' s use of six out of seve n of its pere mptory challeng es to r emove women from the jury pool suf fice d to r aise an infere nce that the g ender of the jurors involved wa s a fa ctor in the de cision to strike. That infer ence established, we tu rn t o the
e xpla natio n g ive n b y

the De fe nd a nts fo r i ts c ha lle ng e d s tr ike s. Th e De fe nd a nts e xpla ine d th a t th e ir
c ha lle ng e s w e re ba se d o n b od y me c ha nic s o f the pr os pe c tiv e jur or s a nd the ir ow n pa st e xpe ri e nc e s. Additionally , the Def

endants pointed out that one of their cha lleng ed jurors w as a ma le. Ag ain, the trial court' s findings a

re spa rse r eg arding the State' s g end er -n eu tral explanation for the c halleng e. Howeve r, the Court obviously acc epted this explanation as g ender -neutra l and st ated for the re cord that the plaintiff exerc ised all four of her c halleng es on males.

I n J.E.B. , the U.S

. Supreme Court states t hat “when an e x planation is require d, it need not ri se to the le ve l of

a “ fo r c a us e ” c ha lle ng e ; rathe r, it m e re ly mus t be ba se d o n a

jur or c ha ra c te ri sti c other than g ender , and the pr offe red e x planation may not be pre text ual. J.E.B., 511 U.S. at 1 44. Furthermore , “ [w]hat Batson me a ns by a le g iti ma te re a so n i s not a re a so n th a t ma

ke s se ns e , b ut a
rea son that does not deny equal pr otection.” Purkett v. Elem

. 514 U.S. at 767. With the se c on sid e ratio ns , w e c on c lud e that th e ba sis fo r the De fe nd a nts ’ use of pe re mpt ory c ha lle ng e s a g a ins t six fema le jurors was sufficie ntly g ender -neutra l to dispel a ny indicia of purpose ful discrimination. Acc o rd i n gl y , we hold that the tria l court cor rec tly applied Ba tso n in ruling the re ha d not been a violation, and Plaintiff is not entit led to relief on this iss ue.

3. Whe the r i t wa s re ve rs ibl e e rr or to al low the [Ap pe lle e s’ ] wit ne ss, Alisa [Goehring ], t o testify on appellee s’ behalf when she had not been ide ntified as a w itness prio r t o trial and whe ther the tria l court proper ly limit ed the c ross ex am ination of Appellant’s c ounsel
r e g ar d i n g h e r

t e s t i m o n y?

Th e re c or d s ho ws that th e Pla int if f s e rv e d the D e fe nd a nts wi th i nte rr og a torie s a ndre qu e st for pr oduction of docume nts on Dece mber 13, 2002. The Plaintiff’s interrog atory question number
on e su bmi tte d to the De fe nd a nts wa s:I t i s n ot de t er mi n abl e f r om t h e r ec or d w h en t he D ef end ant s’ i n i t i al r es pon s e t o t h e Pl ai n t i f f ’ s f i r s t s et of 4
i n t er r og at or i es w as s u bmi t t ed.
-11-

1. State the name, a ddress a nd telephone numbe r of e ach and eve ry person who ha s an y

knowledg e of the alleg ations and/or circ umstances r eleva nt to the claim of Patti Za kour in this lawsuit, not
on ly of th e eve nts of

the oc c ur

re nc e its e lf, b ut a lso the e ve nts immediately

prec eding and subseque nt thereto.

The De fenda nts submit ted re sponses to the Plaintiff’s first set of inter rog atories, and

4 inc lud e d in its a ns we r t o q ue sti on nu mbe r on e a UT MG re pr e se ntativ e . H ow e ve r, the De fe nd a nts did not lis t by

name a specific UTMG represe ntative. The Defendants amended the ir response s on Marc h 31, 2003, the first day of the trial, to include the name of Alisa Goehring as the name of the UT MG re pr e se ntativ e . T e nn e sse e Rul e of Civ il Pr oc e du re 26 .0 5 ( 1) (A ) r e qu ir e s th a t a partyis under a duty to supplement a re sponse to a re quest for discove ry under limited circ umstances. The Rul e re a ds , in pe rt ine nt p art :

A p art y wh o h a s re sp on de d to a

re qu e st f or dis c ov e ry

wi th a re sp on se that was c omplete when ma de is under no duty to s u p p lement the response to include information ther eaf ter acquired, e x cept a s follows: (1) A pa

rty is under a duty s ea s o n ab l y to supplement the party ’s re sponse with respe ct to any question directly

addre ssed to ( A) the ide nti ty

a ndloc a tio no f

p e r s o n s h a vin g kn ow le dg e of dis c ov e ra ble matters . . .

T. R. C. P . 2 6. 05 (1 )( A) . T hu s, the De fe nd a nts we re ob lig a te d u nd e r the ru le s to a me ndthe ir int e rr og a tory

re sp on se s to inc lud e Al is a Goehring be c aus e the De fe nd a nts int e nd e d to c a ll h e r t o te sti fy a s to ma tte rs re g ard ing the e mpl oyme nt s ta tus of t he de fe nd a nt p hy sic ia ns . Prior to M s. Goehring’ s testimony , Plaintiff’s counsel made an oral motion to exclude her t es t i m o n y

. The f o l l o w i n g p r o c e e d i n g s w e r e h a d o u to f t h e p r e s e n c e o f

t h e j u r y:

P lai nt iff’s Co unse l: I ’m g oin g to make a n or a l mot ion a t th is t ime to
e xclu de the te sti mon y

of Ms. Go e hring . Sh e wa sn ’t dis c los e d to m e . . . h er individually , specific ally , until Monday morning ; is that
c or re c t? De fend ant ’s Co unse l: Her name. Be fore that we had told y ou that the parties - - y ou asked for people with knowledg e, and w e said the parties ha ve kn o wl edg e. The understanding was that the pa rty that
was a UTMG represe ntative would be coming to trial, and y ou never-12- asked f or 30(b) (6). That’s all she is. She has fa cts about UTMG a s an instituti on. And I

did identify

her to y ou Monday

by name. P lai nt iff’s Co unse l: I

a g re e , y ou did . B ut i n Inte rr og a tory I a sk e d to state the name, addre ss, te lephone number of eac h and eve ry person wh o ha s kn ow le dg e of the c ir c ums ta nc e s re la tiv e to the c la im o f P a tti Z akour in this lawsuit, not onlythe eve nts of the occ urre nce itself, also of proc eeding s subsequent - - T h e C ourt: We ’ r e g o in g to ta k e a b r e ak

. I f y o u w a n t to ta lk to her fo r a min ute be fo re sh e is c a lle d, I wi ll a llo w that.

After further discussion, the J udg e denied the Plaintiff’s motion to ex clude Ms. Goe hring as a witness.

I n Tenne ssee a dmissibi lityof evide nce is within the sound discretion of the trial judge . When
arriving at a determination to admit or exclude even that evidence which is consider ed re levant trial courts ar e g ener ally

acc orded a

wide deg ree of latitude and w ill onlybe overturned on a ppeal whe re there is a showing of abuse of discre tion. See Otis v. Cam bridge Mut. F ire Ins. Co., 850 S.W .2d 43 9, 44 2 - 44 3 ( Te nn ., 19 92 ); Da v is v . Ha ll, 920 S.W .2d 213, 217 (Tenn. Ct. App. 1995). While we wi ll se t asi de a dis c re tio na ry de c isi on if it doe s not re st on an a de qu a te e vid e nti ary fo un datio n or i f it is contrary

to the g overning law, we will not subst itute our judg ment for that of the t ri al court
mere ly beca use we might have chosen a nother a lternative.

The trial c ourt found that the De fe n d an t s listed a repr esenta tive of UTMG in their initial
re sp on se to the Pla int if

f’ s int e rr og a torie s, the re fo re pr ov idi ng the Pla int if f an o pp ortun ity

to d e po se a UT MG c orp orat e re pr e se ntativ e prior to t ri a l. A s r e qu ir e d u nd e r R ule 26 .0 5, the De fe nd a nts amende d their re sponses to include the name of the specific UTMG repr esenta tive, two day s prior to c a lli ng Ms. Go e hring a s a wi tne ss. Th e tr ia l c ou rt g a ve the Pla int if f a n o pp ortun ity

to s pe ak to Ms. Go e hring prior

to h e r t akin g the st and . B a se d o n th e se fa c ts, we fi ndthat th e tr ia l c ou rt pr op e rl y applied the leg al principles in allowing the witness, Alisa Goehring, to te stify

. Acc ording ly , we f ind
n o erro r b y

t h e t ri al co u rt i n al l o wi n g t h e t es t i m o n y o f M s

. Go eh ri n g.
Plaintiff next questions whether reve rsible er

ror wa s committed when the trial court limited the c ro ss exa min a tio n of Ms. Go e hring by the Pla int if f’ s cou ns e l. Pla int if

f as se rt s tha t sh e sh ou ld have be en allowe d to cross examine Ms. Goehring , t h e UTMG Mana g er of Contract and L eg al Service s, reg arding the financial structure of UTMG, and the compensa tion of its phy sicians. I n a bench c onfer ence prior to Ms. Goehring’ s testimony , Plaintiff’s counsel stated that if Ms. Goehring
wa s al l o wed to testify

that UTMG wa s a non-pr ofit corpor ation and its missi on was pa tient car e, re se ar c h a n d t h e tr a i n i n g o f d o c t o r s , t h e P l a i n t i f

f s h o u l d b e ab l e t o c o u n t e r t h a tt e s t i m o n y

wi th information re g arding the compensation of UTMG’s phy sicians and the U TMG phy sician ince ntive pro grams . P lai nt if

f m ade an off

er of pro of in th e for m of an Adv is oryOpi ni on wri tt en b y th e P W BA Offic e of Reg ulation and I nterpre tations in ref ere nce to a proposed UTMG Ke y Employ ee Incentive-13-

Plan. The off

er of proof g ave information about a proposed plan that UTMG consider ed esta blishing to motivate its phy sicians and to inc rea se re venues a nd rete ntion of phy sicians by UTMG. Plaintiff stated that if Ms. Goehring was a llowed to testify as to the “g ood will” of the De fenda nt UTMG that sh e sh ou ld be “ e nti tle d to sh ow that the re ’s mor e than r e se arc h a ndtr a ini ng g oin g on ; th e re ’s pr of it involved.” The trial court r esponded to Plaintiff’s re quest as to the scope o f Ms . Goehring’ s t es t i m o n y an d cr o s s ex am i n at i o n b y s t at i n g:

Th e Cou rt

wo uldno t c on sid e r i t r e le va nt .

. . that is , th e g ro ss i nc ome of UT Me dical Gr oup. . . . I don’t think that would be rele vant for the issues that the jury

has to dec ide. Even with a nonpr ofit company , one would expect t h at the doctors that participate there do draw a salary and do make m o n ey

. The churc h I a tt e n d is v e r y n o n p r o f it , b u t w e s ti ll p a y th e p a s to r , and I thi nkthe j u r o r s ar e a w ar e o f t h a t

. I n a n y e v e n t , n o n e o f t h i s is rele vant to the issues that the jury has to dec ide. Ag ain, it’s been a lleg ed in [the] Complaint, admit ted in [t he] Answer, that th e va

riou s d oc tor s w e re e mpl oy e e s o f U T M e dic a l G ro up , s o there ’s re ally

nothing with reg ard to the age ncy for the jury

to decide.

Ms. Go e hring te sti fi e d a ndthe c ou rt su stai ned th e obje c tio ns on bo th d ir e c t a ndc ro ss examination when counsel a sked questions ref erring t o th ec o mp ensation of UT MG phy sicians. The trial court wa s evenha nded in its ruling s, prohibiting either party from addr essing financ ial matters of UTMG or

its phy sicians. As stated a bove, admissibilityof evide nce r ests within the sound discretio n o f

th e tr ia l c o u r t, a n d w il l n o t b e d is tu r b e d o n ap p e a l i n th e ab s e n c e o f a n ab u s e o f

tha t discretion. From our examination of this re cord, w e find that the tria l court had pr operly applied the leg al principles in prohibiting Ms. Goehring from testi fy ing to fac ts rela ting to the compensation of UTMG phy sicians or re venues of the corporation. According ly , we find that the t rial court did not abuse its discre tio n in limi ting the sc ope of c ross examination of Ms. Goehring by Plaintiff’s
c ou ns e l.

4. Whether the trial court committed e rror in not putting UT Medica l

Group, Inc. on the j u ry

verdic t form and wa s there a lso error in the trial court plac ing no n d efe ndants, Drs. John Kelly and Na ncy Roc ks tr oh , o n th e jury

ve rd ic t f orm?

Th e Pla int if

f a rg ue s th a t th e abs e nc e of

the na me d p art y , UTM G, on the jury ve rd ic t f or m, a ndthe in clu si on of

no n d e fe nd a nts Dr . Ro c ks tr oh a ndDr . K e lly , c on fu se d th e jury re su lti ng in
reve rsible er

ror on the pa

rt of the trial court. Prior to c losing arg uments, the following discussion was ha d betwee n the parties’ counsel and the Court, outside the prese nce of the jury , reg arding the pa rt ie s to be na me d o n th e jury ve rd ic t f orm:-14- P lai nt iff’s Co unse l: Could I put U T Medica l Group by eac h doctor’s name? “ U T M G , I n c

. , a n d D r

. Ro c k s tr o h ; U T M G , I n c

. , a nd Dr. Craig ”?
The Court: I

do n’ t th ink

that w ou ld b e a

pr op e r v e rd ic t. P lai nt iff’s Co unse l: The only fea r that I had, Your

Honor, wa s that the jury is going to see nothing but three doctor’s names on there , and if they g ive a ve rdict, they ’re g oing to f eel they ’re not g iving a ny thing
a g a ins t U TM G i n f

ina l f orm. The Court: That’s not their c oncern. P lai nt iff’s Co unse l: Yes, sir. That was my conce rn. The Court: I m e a n , i t ’ s n o tt h e i r c o n c e r n a s t o w h o h a s t o p a y a judgme nt. I

mean, that’ s like wanting , in a ca r wr ec k ca s e, to have the i nsuranc e company listed on the verdict form, because that’s who would pay

the v er d ict in a ca

r wre ck ca se, and that’s not the jury ’s
conce rn. The jury ’s conc ern is to determine who is at fault, not who pay s the judg ment. P l a i n t i ff ’ s C o u n s e l: Yes, sir. I understand that. And I ’ve he ard statements th at if there is a verdic t ag ainst the three , it is also a judgme nt ag ainst UTMG, so I will sit down on that, Your H onor.

Furthermore , in the instructions give n by the court to the jury

prior to their de liberations, the court clarified the relationship betwe en the Def endants for members of the jury

. The instructions g iven by the court, in pertinent part, state :

The fact that a corporation is a party must not i nfluenc e y ou in y our deliberations or in y our verdic t. Corporations and persons a re e qual in the ey es of the law. B oth are entitled to the same fair and impartial tr e a tme nt andto j us tic e by the sa me le g a l st a nd ard s. There are some leg al terms that ar e re fer red to as “princ ipal” and “ag ent.” A principal can be held responsible for acts or omissi ons of the pri ncip a l’ s a g e nts ; th a t is , a c or po ratio n c a n b e he ld r e sp on sib le for their employ ees. Employ ees a re the ag ents of the c ompany they work for

. A per son who is authorized to act for another person or i n p l ac e of another person is an ag ent of that person. A per son may be an a g ent wh e the r o r n ot p a y me nt i s r e c e ive d f or se rv ic e s. F or

pu rp os e s o f this case the term “ ag ent” include s an employ ee. T he per son whoW e h av e n ot be en a bl e t o f i n d i n t h e r ec or d an y al l eg at i on on t h e pa r t of t h e de fen dan t s t h at f au l t s h ou l d be 5

a p p o rtio n e d to the tw o re sid e n t p h ysic ia n s, R o c k stro h a n d K e lly. T h e p la intiff ’s c o m p la int a g a ins t t h o se two ind ivid u a ls was nonsui t ed

. H o wever, the t ri al c o urt ins t ruct ed the j ury s p eci f i cal l y t hat t he “ d o ct o rs ” are agent s and t hat i f t he agent i s at f aul t , t he p ri nci p al , U T M G , i s at f aul t

. U nd er t hese ci rcum st ances, any err o r would b e harmles s and , i n f act , t he

e rr o r w o u ld w o rk in fa v o r o f t h e p la intiff

.

-15-

a uth orize s the a g e nt to ac t is c a lle d a pri nc ipa l. F or pu rp os e s o f this
case the term “ principal” includes an e mploy er. The de fenda nts are sue d as both principal a nd ag ent. I t ’s been established that the defe ndant UT Medic al Group is the principal and the do c tor s a

re the a g e nts ; th e re fo re , th e princ ipa l and a g e nt s ho uld be conside red a s one in assig ning f ault. I f y ou fin d a n a g e n t i s a t f a u lt , y o u ’ v e f

o u n d th e p r in c ip a l t o b e at fault. Howeve r, if y ou find the ag ent is not at fault, then [y ou have] found the princ ipal is not at fault. (Emphasis supplied).

There is no issue of fac t as to respondeat superior. A wr i t ten copy of the full jury instructions was submitted to the jury prior to their de liberations. The j u ry v er d i ct form, couple d wi th the jury

ins truc tio ns pr e pa

re d b y the tr ia l c ou rt , ma de it c le ar t o membe rs of the jury that sh ou ld any of the three phy sicians listed on the verdic t form be f ound neg lige nt, that UTMG would also be found neg lige nt. Although the verdic t form shoul d not have included t hose i ndividuals not alleg ed at fault, their inclusion is, at most , harmless e rror

. 5

5. Whether it was re versi b le er ror f or the trial c ourt to instruct the jury on T.P.I . 6.11, Duty

of Specia list, when the [Appellee] was not
a sp e c ia lis t of

a ny kin d at th e tim e of

the a lle g e d n e g lig e nt a c ts?

The Plaintiff a

rg ues that the trial court’s use of T.P.I

. 6.11confuse d the jury as to the standard of c are that D r. Cr a ig wa s to be he ld t o a ndre su lte d in re ve rs ibl e e rr or on the pa rt of the tr ia l c ou rt

. T. P.I . 3 - C ivi l 6. 11 , D uty of Spe c ia lis t r e a ds :
The skil l, knowledg e and car e required of a phy sician who pra ctices a particular specia lty is the same a s that of other r eputable phy sicians who spec ialize in the same field and pr actice in the s ame or a similar community

and under

simil ar c ircumstance s.
The standa

rd for an appe llate court's r eview of a trial judg e' s jury

char g e wa s stated in City of Johnson City v. Outdoor West, In c., 94 7 S. W.2 d 8 55 (T e nn . Ct . A pp . 1 99 6) :

We review the jury

char g e in its entirety t o d et er mine whether the trial judg e committed re versible e rror

. Ot is v. Cambr

idg e Mut. Fire Ins. C o. , 85 0 S. W.2 d 4 39 , 4 46 (T e nn .1 99 2) ; I n re E s t a te o f E l a m,-16- 738 S

. W .2d 169, 174 (Tenn. 1987) ; and Grissom v. Metropolitan Gov't of Nashville, 817 S.W .2d 679, 685 (Tenn. Ct. App. 1991) . The
c h ar g e w il l n o t b e in v a li d a te d if it " f a irly d e f in e s th e le g a l issues in vo lv ed in th e case and do es no t m is lea d t he j ury ." Ot is, 850 S.W .2d
a t 44 6; G

ri s s o m, 817 S.W .2d at 685. Furthermore , a particular instruct i o n must be considere d in the context of the entire c harg e. E l a m, 738 S.W .2d at 174. City of Johns on Ci ty v. Outdoor West, Inc. 94 7 S. W.2 d 855 , 858 (T e nn . Ct. A pp .1 99 6) . We a ssu me from the Plaintiff’s a

rg ument, althoug h she did not spe cifica lly state it, that it would be the Plainti ff’ s pref ere nce that the trial co u rt u se T.P.I . 6.10, Duty of Phy sician. Howe ver, T.P.I . 6.11, Duty of Specialist, is a highe r standar d than that re quired unde r T.P.I . 6.10 for a g ener al pra ctitioner. I f there was any err o r

o n th e p ar t o f

th e tria l c o u r t, it

w a s in h o ld in g th e d e f

e n d a n t d o c to r s to a

h ig her sta n d ar d th a n th a t o f a g e n e r a l p r a c ti ti o n e r , w h ic h th e Pl a in ti f f c laim s th e y w e r e a t the time the alleg ed neg lige nce oc curr ed. Thus, even if the j udg e’s use of t he challeng ed jury instruction was in error , in the context of the entire jury char g e, it has to be c onsidered ha rmless.
6. Whether the testimony of Appe llees’ ex p er t, Dr. B irkenstock, proper ly rebutted or ref

uted t he Appellant’s experts, Dr. Johns on and Dr. S hull and whe ther Appe llees’ e x pert pre sented c redible e vidence on the standar d of ca

re in this case

.

Whether the De fenda nts’ expert rebutted the Plaintiff’ s experts was a que stion for the jury to d e c i d e

. T h e j u r y i n t h i s c a s e l i s t e n e d t o D r

. B i rk e n s t o c k ’ s t e s t i m o n y a n d c o ns ide re d h is
c re de nti a ls, qu a lif

ic a tio n a nde xpe ri e nc e , a ndth e i r v e r d i c t i n d i c ate s th a t th e y

a c c e pte d h is c re de nti a ls and testimony

. I n a jury trial, if there is any materia l evidence to support the verdic t, the judgme nt
mus t be af

fi rm e d. Te nn .R. Ap p. P. 1 3( d) ; Barnes v

. Goodye ar Tire and Ru bber Co., 48 S.W .3d 698, 704 (Tenn

. 2 0 0 0 )

. Wh e n a d d r e s s in g w h e th e r th e r e is mate r ia l e v id e n c e to s u p p o r t a v e r d ic t, a n app e llate c ou rt

sh a ll: (1 ) t ake the str on g e st l e g iti ma te vie w o f a ll the e vid e nc e in f a vo r o f the ve rd ic t; (2 ) a ssu me the truthof a ll e vid e nc e that su pp orts the ve rd ic t; (3 ) a llo w a ll r e a so na ble inf e re nc e s to sustain the verdic t; and (4) discard all [countervailing ] evidence. Cra btr e e Ma so nry Co. v . C & R Const r., Inc. , 57 5 S. W.2 d 4 , 5 (T e nn . 1 97 8) ; Bla c k v . Q uinn, 64 6 S.W. 2d 43 7, 43 9- 40 (T e nn . Ct

. App.1982). Appe llate courts shall neither re weig h t h e evidence nor e valuate the cre dibilit y of witnesses. Whit

e v . V and e rb ilt Uni v e rsi ty , 21 S.W .3d 315 (Tenn. Ct. App. 1999). I f the re cord
c on ta ins " a ny

ma te ri a l e vid e nc e to s up po rt the ve rd ic t, [the jury ' s f

in di ng s] mu st b e a ff

ir me d; i f i t
were o th erwi se, th e part ies wou ld be dep ri ved of th eir con st it ut io nal ri ght to tr ial byju ry ." Crabtree Masonry Co. , 575 S.W .2d at 5. I n this c ase the jury has re solved the question of c redibility in the Def endants fa vor. Taking all of the rule s into consideration, there is substantial material evidenc e t o s u p p o r tt h e v e r d i c to f

t h e j u r y.-17-

For the fore g oing r easons, we aff irm the judg ment of the trial c o urt and re mand for suc h further proce eding s as may

be nece ssary

. Costs of the appea l a re assessed to the A ppellants, J acob S h o r e s , E r i c N e l s o n , L e i f N e l s o n , a n d M i s t y N e l s o n , a n d t h e i r s u r e t y.

____________________________________ W. F RANK

CRAWF ORD, P RESIDING JU DG E, W .S.