### IN THE COURT OF APP EALS OF TENNESS EE ATJAC KSON January 22, 201 0 S es sio n HARRISO N KERR

TIGRETT v. JOHN E. LINN , M . D, ET A L 

### . In ter locu tor y A p p ea l f ro m th e C ircu it C o u rt fo r S h elb y C o u n ty N o. C T - 004155- 04 K ay S. R obi l i o, Judge

N o. W 2009- 00205- C O A - R 9- C V - F i l ed M arch 31, 2010

T hi s i s a Tenn. R

. A pp. P. 9 appea l of t he deni al of a moti o n fo r sum m aryj udgm enti n a m edi cal m al pr act i ce c as e. T he t r i al cour tdeni ed A ppel l ant s / D efe ndant s ’ m ot i ons for s um m aryj ud g m en t, fin d ing that the s tatu te of rep o se, T en n . C o d e A nn. §29- 26- 116( a) ( 3) , w as t ol l ed as a r esult o f fr audul entconce al m enton t he partof A ppel l ant s / D efe ndant s . Fi ndi ng t hatt her e ar e mat er i al i s s ues of fa cti n d ispu te, w e af fi r m t he tr i al cour t ’ s deni al of A ppel l ant s ’ m ot i ons fors um m aryj udgm ent

. W e, how ever , vaca t e anydeci s i on t hat t he s ta tu te o f lim ita tio n s w a s to lle d a s a re s u lt o f f ra u d u le n t c o n c e a lm e n t. T enn. R . A pp. P . 9 - I nt erl ocut ory A ppeal by P erm i s s i on ; J u d g m e n t o f th e C irc u it

C ourt A f

f i rm ed i n P art , V acat ed i n P art and R em anded J. S TEV EN S TAFF ORD , J

. , del i ver ed t he opi ni on of t he C our t , i n w hi ch A L AN E. H I GHERS , P .J ., W

. S. , and D AV I D R. F ARMER , J

. , j oi ned. J err yE

. M i t chel l and J us t i n N

. J oy , M emphi s , T ennes s ee, for t he appe l l ant s , J ohn E

. L i nn, M

. D. a n d Vi t r e o r e t i n a l F o u n d a t i o n , P LL C. JerryO ’N ea l Po tt er a n d Jen n ifer S

. H arrison , M em p h is, T en n esse e, fo r t h e a p p ell an t, L arry M . Jo n e s. O .D ., In d iv id u a lly a n d d /b /a C e n ter f o r V isu a l In d e p e n d e n c e a n d /o r M o n ro e v ill e O p tom etri c C en ter. J. H o u sto n G o rd o n , C o v in g to n , T e n n e ss e e , fo r th e a p p e llee , H a rriso n K e rr T ig re tt.

OP I NI ON In ea rl y Jan u ary 2 0 0 0 , A p p ell ee H arrison K err T igrett(“M r. T igrett ”) sa w D r. L arryLA SIK stands for L aser- Assiste d in S itu Keratomileusis. 1 Keratoconu s is a deg enerativ e disorde r of the ey e in whic h structural chang es w ithin th e co rnea 2 cause it to th in an d ch ang e to a more c onical shape than its n orm al gradual curv e. -2- M

. Jo n es (“ D r. Jo n es” ), an o p tom etri st prac ticing in M em p h is, to inq u ir e a b o u t L A S IK corr ect i ve ey e s ur gery . O n J anuary 5, 2000, D r . J ones conduct ed a s er i es of t es t s , i ncl udi ng 1 t opogr aphi ca l s tu d i e s a n d e y e me a s u r e me n t s , a s a pr e- s cr eeni ng pr oces s t o det er m i ne w hether M r . T i gr et tw as a s ui t abl e ca ndi dat e fort he pr ocedur e. D r . J ohn E

. L i nn ( “D r . L i nn”) i s an o p h thalm o log ist , also p rac ti cing in M em p h is. A fter rev iew ing the p re-o p era ti v e tests, D r. J ones opi ned thatM r . T i gr et tw as a good candi dat e for L A SI K s ur gery , and s peci fi cal l yt hat there w as n o i ndi cat i on of K er at oconus i n t hes e pr e- oper at i ve s tudi es . D r . L i nn admi t t ed 2 i n hi s depos i t i on t hathe ac tual l yr evi ew ed the t opogr aphi cal s tudi es pr i ort o s ur gery ; and, on J a n u a ry 2 1 , 2 0 0 0 , D r. L in n p e rf o rm e d th e L A S IK p ro c e d u re o n M r. T ig re tt. F o ll o w ing rou ti n e p o st- o p era ti v e ev alua ti o n s o n Jan u ary 2 2 an d M arc h 3 , 2 0 0 0 , M r. T i gr et t ’ s s ur geryappea r ed t o be s ucce s s fu l, and hi s pos t

- oper at i ve cour s e w as unevent ful u n ti l O ctob er o r N o v em b er, 20 0 3

. A t th is t im e, M r. T igr e tt, w h o h ad n o t seen eit h er D r. J ones orD r . L i nn s i nce the M arc h 3 , 2000 appoi nt m ent , began t o exper i ence ey e pai n, b lu rre d v isio n , an d u n c o n tr o llab le e y e m o v e m e n t. O n D e c e m b e r 2 2 , 2 0 0 3 , M r. T ig re tt r etur ned t o t he cl i ni c for t r eatm ent of t hes e s y m pt om s . Fol l ow i ng eval uat i on, D r . J ones and anotherdoct ori n hi s offi ce, D r. A ly ce M i l es , i nfor m ed M r . T i gr et tt hathe “maybe devel opi ng K er at oconus , ” and a pl an of t r eatm ent w as out l i ned. M r . T i gr et t w as t ol d t hatt he s u rg e ry h a d n o h a rm f

u l e f f e c t o n h is v is io n . O n Ju ly2 0 , 2 0 0 4 , M r. T igrettfil ed a c o m p lai n t fo r m ed ical m alpra cti ce ag ains t D r. Jo n e s, in d iv id u a llya n d d /b /a C e n ter f o r V is u a l In d e p e n d e n c e a n d /o r M o n ro e v ill e O pt om etr i c C ent er , and again st D r . L i nn, i ndi vi dual l yand d/b/ a V i t r eor et i nal Foundat i on, P. L

. L

. C

. ( t ogether“A ppel l ant s ”)

. T he compl ai ntw as bas ed upon al l eged a ct s and omi s s i ons o f A p p e llan ts in th e e x a m in a tio n , ca re , su rg e ry , trea tm e n t o f , a n d /o r c o n c e a lm e n t o f f a c ts f ro m , M r. T ig re tt v is a v is t he LA SI K s ur geryper for m ed on J anuary21, 2000. O n Sept ember 8, 2004, t he A ppel l ant s fi l ed a j oi ntans w er , deny i ng anynegl i gentact or om i ssi on , w hich w ou l d h ave ca used M r. T i gret t ’s al l eged i njur i es. T he A pp el l ants al so speci fi cal l yden i ed thatt he p re- op e ra ti ve st ud i es show ed an ycl i nical K erat oco nu s. M or eover , D r . L i nn aff

i r m at i vel yaverr ed t hat “the act i on s etouti n t he C om pl ai nti s barr ed b y the .

. . statu te o f re p o se f o u n d at T

. C

. A

. § 2 9 -26 -11 6 (a)(3).” O n F eb rua ry1 5 , 2 0 0 6 , D r. Jo n e s f iled a m o tio n f

o r su m m a ry ju d g m e n t, in w h ich h e f irst a lleg e d th a t M r. T ig re tt’s c laim w as barr ed byt he s t atut e of r epos e. O n Febru ary 24, 2006, D r . L i nn fi l ed a mot i on for su m m a ry ju d g m e n t, a d o p tin g a n d in c o rp o ra tin g D r. Jo n e s’ m e m o ra n d u m o f law f iled inO n June 12, 20 06 , Mr

. Tigre ttf il ed an amen de d op po si ti on

to th e App el lant s’ mot io n. In hi s 3 am endment, Mr. Tigrett asserted that the statute of repose is unco nstitutiona l. This court declined to grant interlocuto ry

app eal on

this issue and therefore we do not a ddress this argum ent. -3- s u p p o rt o f

h is m o tio n . M r. T i gret tfi l ed w ri t t en o pp osi t i on t o b oth m oti on s, al l eging t hat the st atute of repose w as t ol l ed byfr audul entconce al m ent

. M r . T i gr et ts ubm i t t ed thatt he tr i al cour ts houl d deny 3 t he mot i ons as t her e w er e mat er i al i s s ues of fa cti n di s put e. M r . T i gr et tas s er t ed thatD r . L i nn a n d D r. Jo n e s w e re b o th a w a re th a t h e h a d K e ra to c o n u s s o a s to re n d e r h im a n u n su itab le candi dat e forL A SI K s ur gery . H e s ubm i t t ed thatt he A ppel l ant s knew of hi s condi t i on and conce al ed i tand t he eff

ect i t had on t he s ucce s s of t he s ur gery fr om hi m bot h befor e and a ft er t he s ur gery . M r . T i gr et talso pr ovi ded the af fi davi tt es t i m onyof t w o expert s i n s uppor tof h is p o s itio n . O n Ju n e 3 0 , 2 0 0 6 D r. L in n f iled a se c o n d m e m o ra n d u m o f law in su p p o rt o f

h is m ot i on fors um m aryj udgm ent , as s er t i ng t hatM r . T i gr et t ’ s al l egat i ons of fa ctconst i tut ed sim p le ne g li g en ce , an d n o t frau d u lent co n ce alm en t, so as to toll the s tatu te of rep o se. D r. L i nn fur t herar gued t hata vi ol at i on of a phy s i ci an ’ s dut yt o di s cl os e onl ycons t i tut es f ra u d u len t co n c e a lm e n t if th e d o c to r c o n c e a ls k n o w n f a c ts. O n S e p tem b e r 1 2 , 2 0 0 8 , in r es pons e t o M r . T i gr et t ’ s opposit ion to t he mot i ons fors um m aryj udgm ent , D r . J ones a d o p ted , an d re lied u p o n , th e f a c tu a l a ss e rtio n s a n d leg a l a rg u m e n ts m a d e b y D r. L in n in h is s econd mem or andum i n s uppor tof t he mot i on. A ppel l ant s ’ m ot i ons fors um m aryj udgm entw er e hea r d byt he tr i al cour ton Sept ember 12, 2008. B yl et t erof Sept ember 19, 2008, t he tr i al cour ti nfor m ed the part i es of i t s rul i ng, deny i ng t he mot i ons fors um m aryj udgm ent

. T he courts t at ed it s rea s on fort he deni al of t he mot i ons as fol l ow s : “[T] he expe r t s for[M r . T i gr et t ] i ndi cat e [thatt he] condi t i on e x i s t e d s u c h t h a ti tc o u l d b e d i a g n o s e d a t t h a t t i me [ i

. e . , p r i o r t o t h e L AS I K p r o c e d u r e ]

. ” On N o v e m b e r 3 , 2 0 0 8 , the c o u rt e n ter e d its o rd e r, d e n y in g th e m o tio n s f o r su m m a ryju d g m e n t, w h ic h O rd e r s p e c if

ic a lly in c o rp o ra te d th e S e p te m b e r 1 9 , 2 0 0 8 le tte r. O n D ece m ber2, 2008, A ppel l ant s fi l ed m ot i ons and s uppor t i ng m emora nda foran in ter lo c u to rya p p e a l p u rsu a n t to T e n n . R . A p p . P . 9 . O n D e c e m b e r 1 1 , 2 0 0 8 , M r. T ig re tt fi l ed h i s r e s p o n s e t o App e l l a n t s ’ mot i o n f o r i n t e r l o c u t o r y a p p e a l , s t a t i n g “ t h a t an in ter lo c u to rya p p e a l co n c e rn in g w h e th e r, u n d e r th e f a c ts of th is c a se , the sta tu te o f re p o se is to lle d d u e to f

ra u d u le n t c o n c e a lm e n t p u rs u a n t to T .C .A . § 2 9

- 2 6 -1 1 6 (a )( 3 ) i s a p p ro p ri a te .” O n Jan u ary2 3 , 2 0 0 9 , the tri al co u rt g ran ted t h e m o ti o n fo r interl o cu tory ap p ea l. T h is C o u rt g ra n ted th e p a rties ’ jo in t ap p lica tio n f o r p e rm iss io n to a p p e a l o n M a rc h 1 9 , 2 0 0 8

. T h e so le issue fo r rev iew is: w h ethe r the t ri al co u rterred in d en y ing A p p ell an ts’ m o ti o n s fo r sum m ary-4-

j udgm ent , upon i t s fi ndi ng t hat A ppel l ee had al l eged fac t s s uffi ci ent t o t r i ggert he fr audul ent co n ce alm en t exc ep ti o n to the statu te of rep o se, T en n . C o d e A n n . § 2 9 -26 -11 6 (a)(3). A t r i al cour t ’ s deci s i on t o gr ant a m ot i on for s um m aryj udgm entpr es ent s a ques t i on of l aw . O urr evi ew i s t her efor e de novo w i t h no pr es um pt i on of corr ectnes s aff or ded t o t he tr ia l c o u rt ’s d e te rm in a tio n . B a in v . W e lls , 9 3 6 S .W .2 d 6 1 8 , 6 2 2 (T e n n . 1 9 9 7 ). “T h is C o u rt m us tm ake a fr es h det er m i nat i on t hatt he r equi r ement s of Tenn. R

. C i v. P. 56 have be en s at i s fi ed. ” Ma th e w s P a r tn e rs, L L C v . L e m m e, N o . M2 0 0 8

- 0 1 0 3 6

- C O A

- R 3

- C V , 2 0 0 9 WL 3172134 at*3 ( ci t i ng Hun te rv . Br o wn , 9 5 5 S .W .2 d 4 9 , 5 0 -5 1 (T e n n . 1 9 7 7 ))

. W hen a mot i on fors um m ar yj udgm enti s m ade, t he m ovi ng par t yhas t he bur den of sh o w in g th a t “th e r e is n o g e n u in e iss u e a s to a n ym a ter ial f a c t an d th e m o v in g p a rtyis e n title d to ju d g m e n t as a m a tte r o f la w .” T e n n . R

. C iv

. P

. 5 6 .0 4

. T he movi ng par t ym ay acc om pl i s h t hi s byei t her : ( 1) aff i r m at i vel y negat i ng an es s ent i al el ement of t he non- m ovi ng par t y ’ s cl ai m ; or( 2) s how i ng t hatt he non- m ovi ng par t yw i l l notbe abl e t o pr ove an e s s ent i al e le m e n t a t tr ia l. Han n a n v . Al lte l Pu b l ’ gCo

. , 2 7 0 S

. W

. 3 d 1 , 8 -9 (T en n . 2 0 0 8 ). H o w ev er, “[i ] ti s notenough fort he movi ng par t yt o chall en g e the nonm ovi ng par t yt o ‘ putup or s hutup’ oreven t o cas tdoubton a part y ’ s abi l i t yt o pr ove an e l ement att r i al

. ” Id

. a t 8

. I f, and onl yi f, t he m ovi ng par t y s ucce s s ful l y demonst r at es a non-movi ng par t y ’ s i nabi l i t yt o pr ove an essenti al el em ent att ri al , do es the bu rden shi ftt o the non -m ov i ng part yt o creat e atl east a d is p u te o f

f a c t. I d . a t 7 . T h e n o n -m o v in g p a rtym a ya c c o m p lish th is b y : “( 1 ) p o in tin g to evi dence es t abl i s hi ng m at er i al fac tual d ispu tes t hatw er e over l ooked ori gnor ed byt he m ovi ng par t y ; ( 2) r ehabi l i tat ing t he evi dence at t acke d byt he movi ng par t y ; ( 3) pr oduci ng addi t i onal evi dence es t abl i s hi ng t he exi s t ence of a ge nui ne i s s ue fort he tr ial ; or( 4) s u b mi t t i ng a n af

fi d a v i te x p l a i n i n g t h e n e c e s s i t yf o rf u r t h e rd i s c o v e r yp u r s u a n tt o Te n n . R. C i v. P. , R ul e 56. 06. ” Mar tin v. N or f ol k Souther n R ailw ay. Co. , 271 S. W

. 3d 76, 84 ( T enn. 2 0 0 8 )( c ita tio n s o m itte d ). W h en rev iew ing the e v iden ce , w e m u st d eterm ine w h ethe r fa ctua l dispu tes ex ist

. In e v a lu a tin g th e trial c o u rt’s d e c isio n to g ra n t su m m a ryju d g m e n t, w e re v iew th e e v id e n c e in t he l i ghtm os tfavor abl e t o t he nonmovi ng par t yand dr aw al l r eas onabl e infer ence s i n t he n o n m o v in g p a rt y ’s f

a v o r. Stoval

l v. Clar ke , 113 S. W

. 3d 715, 721 ( T enn. 2003)

. I f w e fi nd a di s put ed fa ct , w e must“det er m i ne w hether t he facti s m at er i al t o t he cl ai m ordefe ns e upon w hi ch s um m ar yj udgm enti s pr edi cat ed and w hether t he di s put ed fac t cr eat es a genui ne i s s ue fort r i al

. ” Mathew s P artn ers , 2009 W L 3172134 at*3( ci t i ng B yrd , 847 S. W

. 2d at214)

. “A di s put ed fa cti s m at er i al i f i tm us tbe dec i ded i n or dert o r es ol ve the s ubs t ant ive cl ai m or defe ns e atw hi ch the mot i on i s di r ect ed. ” B yrd , 8 4 7 S .W .2 d a t 2 1 5 . A g e n u in e iss u e e x ists i f “a r eas onabl e j ur y coul d l egi t i m at el y r es ol ve t he fact i n favorof one s i de ort he other

. ” I d. “Sum m aryj udgm enti s onl yappr opr i at e w hen the fact s and l egal concl us i ons dr aw n fr om t he fa ct s r eas onabl yper m i tonl yone conc l us i on. ” L andry v. South C um ber land A m oco, et-5-

a l. , N o. E 2 0 0 9 -01354-CO A

- R 3- C V , 2010 W L 845930, *3 ( T enn. C t

. A pp. M ar ch 10, 2010) ( ci t i ng Car vel

l v. B ottom s , 9 0 0 S .W .2 d 2 3 (T e n n . 1 9 9 5 ). I n t he cas e befor e us , t he A ppel l ant s ar gue t hat t hey ar e ent i t l ed t o su m m ary j udgement beca us e the s t atut e of r epos e bar s M r . T i gr et t ’ s cl ai m . T enn. C ode A nn. §29- 26- 1 1 6 (a ) p ro v id e s, in p e rtin e n t p a rt:

( 3) I n no event s hal l any s uch act i on [i

. e. , m edi cal m al pr act i ce] be br ought m or e t han t hr ee ( 3) y ear s aft er t he dat e on w hi ch the n e g lig e n t ac t o r o m iss io n o c c u r re d e x c e p t w h e re th e re is fr audul ent co n ce al m enton t he partof t he def endant , i n w hi ch cas e the act i on s hal l be comm ence d w i t hi n one ( 1) y earaft er dis cov eryt hat the cau se of acti on exis t s. T hi s s t atut e of r epos e for m edi cal m al pr act i ce act i ons pr ovi des an al m os tabs ol ut e l i m i t at i on o n th e tim e a p la in tif

f h a s to f ile h is o r h e r m e d ic a l m a lp ra c tic e c la im

. Calaw ay v. Schucker , 193 S. W

. 3d 509, 515 ( T enn. 2005)

. T he t i m e of di s coveryof t he i nj ur y , ort he bas i s fort he m edi cal m al pr act i ce c l ai m , i s not r el evant beca us e the s t atut e oper at es t o baran ac t i on bas ed s ol el yupon t he dat e of the ac t or om i s s i on gi vi ng r i s e t o t he m al pr act i ce cl ai m , r egar dl es s of w h e n th e a c tio n a c c ru e d

. Id ; s e e a l s o B r aden v. Y

oder , 5 9 2 S .W .2 d 8 9 6 , 8 9 7 (T e n n . C t. A pp. 1979) ( “Thi s t hr ee- y earcei l i ng is u n rela t ed t o t he ac crual of a c aus e of a ct i on c o m m e n c in g n o t o n d isc o v e ry b u t ra th e r at th e d a te o f th e a lleg e d lyn e g lig e n t ac t.”). D e sp ite th e h a rsh re su lt th a t o f

ten e n su e s u n d e r th is s tatu te, o u r S u p re m e C o u r t h a s h e ld th a t, i n e n a c tin g T e n n . C o d e A n n . § 2 9 -2 6 -1 1 6 (a )(3 ), o u r L e g isla tu re in ten d e d “ to p lac e a n a b so lu te t hr ee- y earbarbey ond w hi ch no medi cal m al pr act i ce r i ght of act i on m ay s ur vi ve. ” Mil l s v. W ong , 1 5 5 S. W

. 3 d 9 1 6 , 9 2 0 ( Te n n . 2 0 0 5 )

. Be c a u s e o f t h e l e g i s l a t i v e i n t e n tt o p r o v i de c e r t a i n t y a s t o t h e l e n g t h o f t i m e a h e a l t h c a r e p r o v i d e r m a y b e s u b j e c tt o p o t e n t i a l l i a b i l i t y, Cr o n in v . How e , 9 0 6 S .W .2 d 9 1 0 , 9 1 3 (T e n n . 1 9 9 5 ), th e e x c e p tio n to th e stric t ti m e lim it im p o s e d b yth e s ta tu te o f re p o s e is , n e c e s s a ri ly, n a rr o w a n d s p e c if ic

. M r. T ig re tttc o n ten d s h o w e v e r, th a t h is c laim is n o t b a rre d b e c a u se th e A p p e llan ts f r a u d u l e n t l y c o n c e a l e d t h e f a c t s g i v i n g r i s e t o h i s c l a i m , b o t h b e f o r e a n d a f

t e rt h e s u r g e r y. S p e c if ica lly , M r. T ig re ttt a lleg e s tha t b o th D r. L in n a n d D r. Jo n e s k n e w , b a se d o n b o th h is pr e- oper at i ve t es t s and pos t

- oper at i ve t es t s , that h e suffe r ed fr om K er at oconus and w as th e re f o re n o t a c a n d id a te f

o r th e su rg e ry , an d f

a il e d to d isc lo se th is f

a c t, de sp ite th e ir d u ty t o do s o, ei t herbefor e oraft ert he s ur gery . Fr audul entconce al m enti s an excep ti o n t o t he th re e y e a r s ta tu te o f

re p o s e . Shadri ck v. Coker , 963 S. W

. 2d 726, 736 ( T enn. 1998)

. I n or der to u til ize th e f

ra u d u len t co n c e a lm e n t ex c e p tio n , a p lain tiff m u st p ro v e : ( 1) t he hea l t h car e pr ovi der t ook aff i r m at i ve ac t i on t o conce al-6- t he w r on gd oi ng orr e mai ne d s i l e nta nd fa i l e d t o d i s c l os e m at er i al fac t s des pi t e a dut yt o do s o, ( 2) t he pl ai nt i ff c oul d not h av e di s cover ed the w r ong des pi t e exe r ci s i ng r eas onabl e ca re and di l i gence , ( 3) t he hea l t h car e pr ovi der knew of fac t s gi vi ng r i s e t o t he ca us e of a ct i on and, ( 4) a co ncea l m ent , w hi ch may cons i s tof t he def

endantw i t hhol di ng m at er i al i nfo r m at i on, m a k in g u se o f

so m e d e v ice to m isle a d th e p lain tif f , o r sim p ly rem ainin g sil en t and fa il ing to d iscl o se m aterial fa cts w h en there w a s a d u ty to s p e a k

. Id . at 7 3 6. T ennes s ee c our t s have c l ear l yhel d t hatpr oof of act ualk n o w led g e o f f a c ts g iv in g ri s e to th e c a u s e o f a c tio n is re q u ir e d to e s ta b lis h f ra u d u le n t c o n c e a lm e n t. S e e, e .g., P er o’s Steak & SpaghettiHouse v. L ee , 9 0 S .W .3 d 6 1 4 , 6 2 5 (T e n n . 2 0 0 5 ). H o w e v e r, w h ile a tr i erof fa ctm aynots i m pl yas s um e that a p erson had actual know l edge, i tm ayi nfer k n o w le d g e f

ro m th e p ro o f

p re s e n te d

. Shadri ck , 963 S. W

. 2d at737 ( hol di ng t hatevi dence o f k n o w led g e m a yb e in f

e rre d ); s ee al

s o B enton v. Snyder , 825 S. W

. 2d 409, 414- 415 ( T enn. 1992) ( fi ndi ng s uffi ci entci r cumst ant i al evi dence t o al l ow a j ur yt o i nferfra u d u le nt c o n c e a lm e n t)

. A c c o rd in g ly , to b e e n tit led to su m m a ryju d g m e n t, th e A p p e llan ts m u st d e m o n stra te t hatM r . T i gr et tw i l l notbe abl e t o pr ove one of t he fourr equi r ed el ement s of fr audul ent conce al m ent

. I n t hei r r es pect i ve m ot i ons , t he A ppel l ant s bot h as s er t t hat M r . T i gr et tw i l l not b e a b le to sh o w th a t th e yh a d a c tu a l k n o w led g e o f h is c o n d iti o n . D r. L in n a n d D r. Jo n e s b o th as s er tt hatt heydi d notknow t hatM r . T i gr et t t h ad K er at oconus unt i l D ece m ber2003. A s s um i ng ar

guendo th a t th e se sta tem e n ts d e m o n stra te th a t M r. T ig r e tt w ill n o t b e a b le to p rov e a ctua l kn o w ledg e, an esse n ti al elem en t of fra u d u lent co n ce alm en t, an d that there fo re t he b u r d e n s h i f

t s t o M r . Ti g r e t t , we wi l l r e v i e w t h e r e c o r d t o d e t e r mi n e i f M r . T i gr et t has cre ated a d ispu te of

fa ct. It is n o t i n cu m b en t on M r. T igrettto sh o w , at t h is po int, that D r. L i nn and/ orD r . J ones had ac tual know l edge. H e nee d onl ys how t hatt her e i s a di s put e of f a c t a s to th e ira c tu a l k n o w le d g e . I n r es pons e t o t he A ppel l ant s ’ m ot i ons fors um m aryj udgm ent , M r . T i gr et ts ubm i t t ed aff i davi t s fr om t w o expert s , D r . R ol ando Toy os ( “D r . T oy os ”) and D r . Paul J ames H ar t on ( “D r . H ar t on”)

. D r . T oy os opi ned t hat M r . T i gr et t ’ s pr e- oper at i ve re por t s s how t hathe had a p ree x ist ing co n d it ion o f K era toco n u s an d sh o u ld n o t h a v e h ad the s u rge ry . F u rt h er, D r. T o y o s o p ined that D r. L inn an d D r. Jo n es ha d a d u tyto d iscl o se th is t o M r. T igrettan d fa il u re to d o s o w o u ld b e a b re a c h o f th e s ta n d a rd o f

c a re . A s to D r. Jo n es, D r. T o y o s o p ined that D r. Jo n es f ail ed to p rop erlyd etec t and rec o rd t hatM r . T i gr et tw as nota ca ndi dat e fort he s ur gery , and w as negl i genti n notdi s cl os i ng t he-7-

m edi cal condi t i on and t hathe w as nota candi dat e for t he s ur geryt o M r . T i gr et t

. D r . T oy os opi ned t hat ei t her D r . J ones fai l ed t o ( 1) pr oper l yr ead the t es tr es ul t s , ( 2) i nfor m t he pat i ent o f th e te s t r e s u lts , (3 ) t e s t f u rt h e r, ( 4 ) g e t s o m e o n e q u a lif ie d to p e rf

o rm a n d re a d th e te s ts , or (5) req u est fu rt h er t esti n g . F u rt h er, D r. T o y o s o p ined that D r. Jo n es v iolated th e stan d ard of ca r e bynotdi s cl os i ng t he condi t i on t o M r . T i gr et t ei t her befor e or aft er t he s ur gery , and bym i s l eadi ng M r . T i gr et tbyt el l i ng hi m t he s ur gery had no har m ful eff ecton hi s vi s i on as th e s u re g e ry w a s a s u b s ta n tia l c a u s e o f h is a c c e le ra te d a n d e x a c e rb a te d c o n d itio n . A s t o D r. L i nn, D r . T oy os opi ned thatei t herhe di d notr evi ew t he pr e- oper at i ve r epor t s o rn e g l i g e n t l yd i d s o . Dr

. To y o s n o t e d t h a tt h e p r e - o p e r a t i v e r e p o r t s c l e a r l ys how K er at oconus and t hatD r . L i nn admi t t ed r evi ew i ng t he re por t s . D r . T oy os al s o opi ned that D r . L i nn w as negl i genti n notdi s cl os i ng the co n d i t i on t o M r . T i gr et tw hen i tw as obvi ous fr om t he r epor t s , and t hat D r . L i nn vi ol at ed the s t andar d of ca r e i n notdi s cl os i ng “the t rue fac t s ” af t ert he sur gery and fur t her t es t i ng, and i n not di s cl os i ng t hatt he condi t i on w oul d be m u c h w o rse a s a re su lt o f in a p p ro p ria te su rg e ry . D r. H a rto n o p in e d sim ilarly in h is a f f id a v it. A f ter re v iew in g th e re c o rd , w e f in d th a t M r. T ig re tt su b m itt e d su f f icie n t ev id e n c e to cr eat e an i s s ue of f

actas t o t he know l edge of bot h t he A ppel l ant s . T w o expert s have opi ned t hatt he pr e- oper at i ve r epor t s cl ear l ys how t hat M r. T i gr et thad K er at oconus and thatany d o ctor co m pl y i ng w i t h t he s t andar d of ca r e s houl d have know n of hi s condi t i on. T he A ppe l l a n t s b o t h a d mi t r e a d i n g t h e p r e - o p e r a t i v e r e p o r t s , a n d e a c h c o n t e n d s t h a t he w as compl y i ng w i t h t he appl i cabl e st andar d of car e. Y et , eac h one s ubm i t s t hathe di d notknow t hatM r . T i gr et t had K er at oconus . I tappea r s obvi ous t o t hi s C our tt hatt her e i s a ques t i on of f a c ta s t o t h e k n o w l e d g e e a c h d o c t o r p o s s e s s e d o f M r . T i g r e t t ’ s c o n d i t i o n p r i o rt o s u r g e r y. T o a llo w a d o c to r to m e re lyc laim , “ I did n o t k n o w ,” a n d b e e n tit led to su m m a ryju d g m e n t, des pi t e t es t i m onyfr om ot herexpert s t hatt he condi t i on w as cl earand obvi ous i n t he medi cal r e c or ds , w ou l d e ff

e c t i ve l y ba r a l l c l a i ms of fr a ud ul e nt c on c e a l ment

. Thi s i s e s pecial l y so w hen th e d ef

en dantdoct orcont ends t hathe w as act i ng i n acc or dance w i t h t he s t andar d of car e, and t he opposi ng expert opi nes t hat , i f t he doct or w as compl y i ng w i t h t he s t andar d of c a re , h e w o u ld h a v e k n o w n . A p p e llan ts a rg u e th a t th e e x p e rt a f f id a v it s d o n o t cr e a te a q u e stio n o f f a c t. Speci fi cal l y , t heyci t e t o t he por t i ons of t he af fi davi t s w hi ch s t at e thatt heynegl i gent l yfai l ed t o det ectand pr oper l yr ecor d t hatM r . T i gr et t w as notan appr opr i at e ca ndi dat e fort he s ur gery . W e agr ee thatt hi s s t at ement onl yi ndi cat es negl i gence and w oul d n o t ri se to the l evel of ac tual know l edge a nd fr audul ent co n ce al m ent

. H ow ever , ot hers t at ement s i n t he aff i davi t s i ndi cat e that t he doct or s had actual know l edge a nd w i t hhel d fac t s t hatt heyhad a dut yt o di s cl os e. For exampl e, D r . T oy os opi ned thatD r . J ones ei t herfai l ed t o pr oper l yr ead t he t est show i ng t hat M r. T ig re tt h a d kerat oco nu s orf a iled to in f

o rm M r. T ig re tt o f

th is c o n d iti o n . T h e f

irst a lleg a tio n o n lya m o u n ts to n e g lig e n c e , h o w e v e r , th e late r is c lea rly-8-

fr audul entconce al m ent

. Fur t her , D r . T oy os opi ned thatD r . J ones fai l ed t o di s cl os e the condi t i on aft ert he s ur gery , and mi s l ed the pat i ent as t o t he s ucce s s of t he s ur geryand the eff ect s i tw oul d l i kel yhave on hi s vi s i on. A s t o D r . L i nn, D r . T oy os ’ opi ni ons i ndi cat e t hat he mayonl yb e gui l t yof negl i gence pr i ort o s ur gery , butt hathe fa i l ed t o di s cl os e the true fac t s aft ert he s ur gery . W e r ecogni ze t hat t hes e af fi davi t s ar e notar t ful l ydr aft ed, how ever forpurpos es of s um m ar yj udgm entw e r evi ew t he evi dence i n t he l i ght m os tfavor abl e t o t he n o n m o v in g p a rt ya n d d ra w a ll r e a s o n a b le in f e re n c e s in th e n o n m o v in g p a rt y ’s f a v o r. S to v a ll v. Clar ke , 113 S. W

. 3d 715, 721 ( T enn. 2003)

. A ft erdoi ng s o, i tappea r s t o t hi s C our tt hat t he expe r t aff

i davi t s s ubm i t t ed by M r . T i gr et t cr eat e a que s t i on of fa ctas t o t he know l edge o f th e A p p e lla n ts

. E ven as s um i ng ar

guendo that D r. L inn an d D r. Jo n es did n o t k n o w o f M r. T igrett ’s condi t i on pr i ort o s ur gery , t her e i s atl eas ta qu esti o n of fa ctas t o t hei rknow l edge a nd pos s i bl e fr audul entconce al m ent aft er t he s ur gery . D r . T oy os opi ned thatD r . J ones m i s l ed M r . T i gr et t i n i nfor m i ng hi m t hatt he s ur geryw as s ucce s s ful , and fur t herm i s l ed hi m i n 2003 byt el l i ng hi m t hatt he sur gery had no har m ful eff ecton hi s vi s i on. Fur t her , D r . T oy os opi ned t hatD r . J ones vi ol at ed hi s dut yt o di s cl os e t o t he pat i ent , aft er s ur gery , t he negl i gentact s t hat had occu rr ed p ri or t o s urgery . A s t o D r. L i nn , D r. T oy os op i ned t hat he fai l ed to di scl ose aft er t he sur gery , t he t rue fact s of M r . T i gr et t ’ s condi t i on, and the l i kel i hood t hathi s vi s i on w o u ld w o rsen . F rom D r. T o y o s’ af fid av it , itap p ea rs th at h e is of the o p inion that b o th D r. J ones and D r . L i nn knew of M r . T i gr et t ’ s condi t i on aft er t he s ur gery and the l i kel i hood t hat t he s ur geryw oul d caus e hi s vi s i on t o w or s en; y et , i n vi ol at i on of t he s t andar d of ca r e, t hey di d notdi s cl os e thes e fa cts t o M r . T i gr et t

. A s s um i ng t hatD r . L i nn and D r . J ones di d not k n o w o f t h e co n d it ion p ri o r t o the s u rge ry , u p o n learn ing o f th e c o n d it ion af ter th e su rge ry they w o u ld h av e a d u ty to d iscl o se th e c o n d it ion an d it s ef fe cts o n the s u cc ess o f th e su rge ry t o M r . T i gr et t

. B ynotdoi ng s o, t heyw oul d h av e co n ce al ed fa ct s gi vi ng r i s e t o a ca us e of a c tio n , o f

w h ic h th e yw e re a w a re . D r. L in n f

u rth e r c o n ten d s th a t th e re is n o in d ica tio n th a t h e h a d a n o p p o rtu n ityto g a in know l edge of

M r . T i gr et t ’ s condi t i on aft ert he s ur gery . A ft err evi ew i ng t he r ecor d, w e fi nd that there is a d ispu te of fa ct as to th is co n tention

. F ir st, M r. T igrett asse rt s tha t he s aw D r. L i nn aft ert he s ur gery , and t he medi cal r ecor ds befor e and a ft ert he s ur gery , acc or di ng t o t he ex p erts , i ndi cat e M r . T i gr et thad K er at oconus . A l s o, D r . T oy os ’ aff i davi tcontr adi ct s D r. L in n ’s a ss e rtio n . D r. L in n f u rth e r a ss e rts th a t th e m e d ica l re c o rd s d o n o t sh o w a d iag n o sis b efor e the s ur gery . H ow ever , ourSupr eme C our thas pr evi ous l yhel d t hatt he abs ence of document at i on m ayactual l yal l ow a j ur y t o i nfer , w hen com bi ned w i t h ot herfac t s , fr audul ent c o n c e a lm e n t. B enton v. Synder , 8 2 5 S .W .2 d 4 0 9 , 4 1 5 (T e n n . 1 9 9 2 ). A ddi t i o nal l y , D r . L i nn and D r . J ones at t empt t o di s t i ngui s h t hi s cas e fr om ot her m e d ic a l m a lp ra c tic e a n d f ra u d u le n t c o n c e a lm e n t c a s e s . ( C i t i ng Shadri ck v. Coker , 963-9-

S

. W

. 2 d 7 2 6 (T en n . 1 9 9 8 ); B enton v. Snyder , 8 2 5 S

. W

. 2 d 4 0 9 , 4 1 1 (T en n . 1 9 9 2 ); G r een v. S acks , 5 6 S .W .3 d 5 1 3 (T e n n . C t. A p p . 2 0 0 1 ); Me rlo v . Max w e ll , N o . 0 1 A 0 1

- 9 8 1 1

- CV

0 0 6 1 0 , 19 99 W L 82 07 28 (Ten n. C t

. A pp . Jul y14 , 19 99 ))

. S pecifi cal l yt heyasser tt hat these cas es i nvol ve fr audul ent conce al m ent of know n fac t s aboutm edi cal t r eatm enti n t he cont ext of i nfor m ed cons ent

. H ow ever , fr audul ent conce al m ent of know n fac t s and l ack of i nfor m ed c o n se n t is e x a c tlyw h a t M r. T ig re tt h a s alle g e d

. In h is co m p lain t, M r. T ig re tt a lleg e s th a t h is c o n d iti o n w a s k n o w n a n d a t n o tim e w a s h e in f o rm e d o f h is c o n d iti o n p rio r to su rg e ryo r its pos s i bl e ef

fec t s on t he out come of hi s s ur gery . T he othercas es do di ffe rs l i ght l y fr om t he cas e bef or e us i n t hatt heyi nvo lved fra u d u l entconce al m entof fa ctual as pect s of t he p ro c e d u re , i.e . w h a t typ e o f im p la n ts w o u ld b e u s e d , Me r lo , 1999 W L 820728, at* 1; w hat typ e o f p ro c e d u re w o u ld b e p e rf o rm e d , B enton , 8 2 5 S .W .2 d a t 4 1 1 ; a n d w h e th e r th e im p lan ts w e re p e rm a n e n t, Shadri ck , 963 S. W

. 2d at736. H ow ever , t hi s cas e i nvol ves al l egat i ons of fr audul entconce al m entof t he pat i ent ’ s t rue condi t i on. T hes e di ffe r ence s ar e i m m at er i al as th e e lem e n ts a n d a n a ly sis o f f ra u d u len t co n c e a lm e n t re m a in th e sa m e . M o re o v e r, M r. T ig re tt m ade a ddi t i onal al l egat i on s i n h i s compl ai ntbes i des t he al l egat i on of fr audul entconce al m ent a s it re late s to in f

o rm e d c o n se n t p rio r to h is s u rg e ry . H e a lleg e s th a t th e d e f e n d a n ts w ith h e ld in f o rm a tio n a b o u t h is c o n d itio n a f te r t h e s u rg e ry. G r een v. Sacks , 56 S. W

. 3d 513 ( T enn. C t

. A pp. 2001) , w hi ch the A ppel l ant s at t empt t o di s t i ngui s h, i s actual l y compar abl e t o t he ca s e bef or e us . I n G r e e n t he defenda ntdoct or p e rf o rm e d a s to m a c h s u rg e ry o n th e p la in tif f

. I d . at516. D ur i ng t hi s s ur gery , he w as for ced t o ch ang e his plan of p rocedu re s l i gh t l y du e t o the cond i t i on of t he p l ai nti ff’s s t om ach as a re s u lt o f a p re v io u s s u rg e ry. I

d. T he def

endantdoct ordi d notknow of t he condi t i on pr i or to s u rg e ry, b u t w a s a w a re p o s t s u rg e ry. I d. H o w ev er, the de fe n d an t d o ctor d id n o t i n fo rm th e p a tien t o f

th e c o n d iti o n , the c h a n g e s to th e p ro c e d u re , o r th e p o ss ib le e f f e c ts it w o u ld h a v e o n h e r i n th e f

u tu re . I d. Fol l ow i ng compl i cat i ons , t he pl ai nt i ff fi l ed s ui tagai ns tt he d o c t o ra p p r o x i m a t e l y f

i v e ye a r s a f

t e rt h e s u r g e r y. I

d. T he def

endantdoct orfi l ed a mot i on fors um m aryj udgement as s ert ing tha tt he s t atut e of r epos e barr ed the ac t i on, and the tr i al c o u rt g ra n te d h is m o tio n . I d. at 517. O n appea l , t hi s C our tr ever s ed the tr i al cour t , fi ndi ng th a t th e re w a s a q u e stio n o f f a c t f o r th e ju ry a s to w h e th e r th e d e f e n d a n t d o c to r’s f

a ilu re to in f o rm th e p la in tif

f a m o u n te d to f

ra u d u le n t c o n c e a lm e n t. I d . at522. I n m aki ng t hat deci s i on, t hi s C our tnot ed thatt he pl ai nt i ff had pr ovi ded an af fi davi tfr om an expe r ts t at i ng t hat t he defe nd ant do ct or h ad a du t y t o i nfo rm t he pati ent of t he chan ges and by no tdo i ng so h e v io la t e d h i s s ta n d a rd o f c a re . I d. at 52 1

. F u rt h er, th is C o u rtn o ted th at “[ f]o r a phy s i ci an’ s fai l ur e t o d is cl os e i nfor m at i on t o cons t i tut e fr audul entconce al m entfort he purpos es of t ol l i ng t he s t atut e of r epos e, t he fai l ur e t o di s cl os e s houl d al s o be,

. . . bel ow t he ‘re c o g n ize d sta n d a rd o f a c c e p tab le p ro f

e ss io n a l p ra c tice in th e p ro f e ss io n a n d sp e c ialty t her eof’ ” I

d . a t 5 2 0 (c itin g T e n n . C o d e A n n . § 2 9 -2 6 -1 1 5 (a )( 1 ))

. A s i n G r een , w e ha v e be fo re us tw o d o ctors w h o m ay h av e kn o w n o f a p a tien t’ s-10-

c o n d iti o n a f

ter su rg e rya n d y e t f

a iled to in f

o rm th e p a tien t o f

th is c o n d iti o n a n d th e e f f e c ts i t w oul d have on t he succ es s of t he sur gery . A l s o, as i n G ree n , w e have t he af fi davi t s fr om exper t s s t at i n g t hatt he doct orhad a dutyt o i nfor m t he pat i entof t hi s condi t i on, and the pos s i bl e e f

f e c t s o f t h e s u r g e r ya n d b yn o ti n f o r mi n g t h e p a t i e n t , t h e d o c t o rv i o l a t e d t he s t a n d a r d o f c a r e . Th e o n l y d i f f e r e n c e b e t wee n t h i s cas e and G r een i s t he el ement of know l edge. I n G r een , i tw as admi t t ed thatt he doct or w as not aw ar e of t he condi t i on pr i or to su rge ry , b u t i t w as a d m itted th at h e ha d k n o w ledg e af ter the su rge ry . In t h e c ase b ef o re us , i ti s s t i l l di s put ed w hen t he A ppel l ant s had kno w ledg e o f M r . T i gr et t ’ s condi t i on. H o w ev er, M r. T igretth as su b m itted s u ff ici en t pro o f to o v erc o m e a m o ti o n fo r sum m ary j udgm enton t he i s s ue of know l edge. H e nee d not , for purpos es of s um m aryj udgm ent , pr ove actual know l edge, butm us tonl ycr eat e a ques t i on of fa ctas t o t he ac tual know l edge of t he d o c to rs . H e h a s m e t th is b u rd e n . Mar tin v. N or f ol k Souther n R ailw ay. Co. , 271 S. W

. 3d 76, 8 4 (T e n n . 2 0 0 8 )( c ita tio n s o m itte d ). T h e A p p ell an ts assert t h at th is c a s e is o n e o f im p rop er o r m is- d iagn o sis. T h eyare c o rre c t in th e ir a ss e rtio n th a t f o r p u rp o se s o f

to lli n g th e sta tu te o f

re p o se , “th e f

a ilu re to corr ect l ydiagnose an ai l m ent canno tbe the basi s for a fr aud ulentcon ceal m ent cl ai m un l ess t he def endanthad know l edge of t he corr ectdi agnos i s . ” Mu r p hy v . L a k e s ide Me d

. Ctr., I n c ., N o. E 2006- 01721- C O A

- R 3- C V , 2007 W L 906760 ( T enn. C t

. A pp. M ar ch 26, 2007)

. O ne c a n n o t c o n c e a l w h a t o n e d o e s n o t k n o w . May e rs v . Mil le rMe d. G r oup , N o. 01- A

- 01- 9802- C V -00101, 19 98 W L 8 48 09 5, a t *4 ( Ten n. Ct

. A pp . D e c e mber 8, 19 98 )

. “ [A] n hon est m i s t ake made by a phy s i ci an i n di agnos i ng t he ca us e of a pat i ent ’ s i nfi r m i t ys t andi ng al one, i s not evi dence of fr audul entconce al m ent

. ” R ay v. Sch eibert , 4 8 4 S .W .2 d 6 3 , 7 2 (T e n n . C t. A pp. 1972)

. I n R ay , t hi s cour taff i r m ed the t r i al cour t ’ s deci s i on t o gr anta di r ect ed ver di ct t o t he def

endantdoct or , after f

ind ing t hatno evi dence w as pr es ent ed a t tria l t hatt he d e f e n d a n t’ s a c tio n w e re a n y th in g b u t a n h o n e s t m is ta k e . I d . ( emphasi s added)

. I n t hi s cas e, how ever , t her e i s s uffi ci entevi dence for purpos es of s um m aryj udgm entt o cr eat e a que s t i on of fa ctas t o w hatt he A ppel l ant s knew and w hen t hey knew i t

. T he ques t i on as t o w hether ei t herof t he A ppel l ant s knew of M r . T i gr et t ’ s condi t i on ei t herbefor e or aft er t he s ur ger y , or w h ethe r t h e A p p ell an ts si m p lym is- d iagn o sed , ev en if n eg li g en tl y , re m a in s . A t tri al, M r. T i g r e t twi l l b e a rt h e b u r d e n o f p r o v i n g t h a tDr

. J o n e s a n d Dr

. Li n n e a c h h a d a c tu al k n o w le d g e o f h is c o n d itio n a n d e a c h a c te d to c o n c e a l it. Shadri ck v. Coker , 963 S. W

. 2d at 736. For purpos es of s um m ar y j udgm ent , how ever , M r . T i gr et tneed onl ycr eat e a que s t i on o f f a c t. T he A ppel l ant s ar gue t hat t o al l ow M r . T i gr et t t o pr ocee d w i t houtconcr et e evi dence of t he ac tual kno w ledg e o f D r. L i nn and D r . J ones w oul d under m i ne the l egi s l at i ve i nt ent behi nd t he s t atut e of r epos e. W e fi nd t hi s ar gum entt o be w i t houtm er i t

. T her e ar e numer ous cas es i n t hi s s t at e w her ei n t hi s C our tand ourSupr eme C our tal l ow ed a pl ai nt i ff t o pr ocee d t o t r i al des pi t e t he pos s i bi l i t yt hatt he act i on w oul d be barr ed byt he s t atut e of r epos e i f t he-11-

p la in tif f d id n o t p ro v e f

ra u d u le n t c o n c e a lm e n t a t tr ia l. S e e , e .g ., Shadri ck v. Coker , 963 S .W .2 d 7 2 6 , 7 3 6 -3 7 ( T e n n . 1 9 9 8 )(f in d in g th a t m a ter ial iss u e s o f f a c t re m a in e d a s to fr a u d u l e n tc o n c e a l me n ta n d a j u r yc o u l d f i n d t h a tt h e r e h a d b e e n f r a u d u l e n tc o n cea l m ent w h ich w o u ld to ll th e sta tu te o f re p o se ); B enton v. Snyder , 825 S. W

. 2d 40 9 , 4 1 4 ( T enn. 1992) ( fi ndi ng m at er i al evi dence s uffi ci entt o cr eat e a j ur yi s s ue on the el ement s of kn ow l edg e and con ceal m e n t); G reen v. Sacks , 5 6 S

. W

. 3 d 5 1 3 (T en n . C t. A p p . 2 0 0 1 ). A d d iti o n a lly , to b a r th e p lain tiff ’s c laim a t th is j u n c tu re d u e to th e sta tu te o f re p o se , d e sp ite t he ques t i ons of fact w hi ch re m ai n, w oul d i n eff ect under m i ne the fr audul entconce al m ent exce pt i on pr ovi ded byt he l egi s l atur e. W e fi nd t hatM r . T i gr et thas cr eat ed i s s ues of fa ctas t o t he know l edge of t he A ppel l ant s . T her efor e w e af fi r m t he tr ial co ur t ’ s deni al of t he A ppel l ant s ’ m ot i ons for s um m aryj udgm ent

. T hi s hol di ng, how ever , i s l i m i t ed and does notaff i r m anyfi ndi ng t he trial c o u rt m a yh a v e m a d e th a t D r. L in n a n d D r. J o n e s d id a c tu a llyf ra u d u len tlyc o n c e a l f

a c ts gi vi ng r i s e t o a caus e of a ct i on, and anys uch dec i s i on i s vaca t ed. Fur t her , w e r ei t er at e, t hat M r . T i gr et tm us tpr ove a ct ual k n o w l edge of t he condi t i on i n or dert o pr ocee d under fra u d u le n t c o n ce alm en t and itis no t eno u g h fo r M r. T igrettto sh o w that D r. L inn o r D r. Jo n e s s h o u ld h a v e k n o w n . H o w e v e r, th is ac tu a l k n o w led g e m a yb e in f e rre d f ro m th e f a c ts a n d c ir c u m s ta n c e s o f

th is c a s e . Shadri ck , 963 S. W

. 2d at737. C os t s of t hi s appea l ar e t axed agai ns tt he A ppel l ant s , L arr yM

. J ones , i ndi vi dual l yand d /b/ a C ent erforV i s ual I ndepende nce a nd/ or V i s ual I ndepende nce and/ or M onr oevi l l e O pt om etr i c C ent erand J ohn E . L in n in d iv id u a lly a n d d /b /a V itr e o re tin a l F o u n d a tio n , P L L C a n d th e irs u re tie s .

_________________________________ J

. S T E VE N S T AF F OR D, J UDGE