### IN THE COURT OF APP EALS OF TENNESS EE ATJAC KSON April 22, 201 0 S es sio n TERES A LYNN STANFIEL D, ET AL 

### . v. J OHN NEB LET T, JR., M.D., ET AL 

### .

D irec t A p p ea l f

ro m th e C ircu it C o u rt fo r M a d ison C o u n ty N o. C 06- 273 R oger A . P age, Judge

N o. W 2009- 01891- C O A - R 3- C V - F i l ed June 4, 2010

T hi s i s a medi cal m alpra cti ce c as e. T he j ur yr etur ned a ve r di ct , fi ndi ng t hatt he A ppel l ee/ D oct or devi at ed fr om t he s t andar d of ca r e, butt hathi s devi at i on w as nott he l egal caus e of the i nj ur y . A ppel l antcont ends t hatt he tr i al cour t err ed i n deny i ng herm ot i on for a di r ect ed ver di ct , er r ed i n ruli n g on herobj ect i ons t o A ppel l ee’ s expert s and the i m peac h me n to f

h e re x p e r t s , t h a ts h e was p r e j u d i c e d b yt h e l a n g u a g e u s e d o n t h e v e r di ct for m , and t hat t he t r i al cour tabus ed i t s di s cr et i on i n al l ow i ng A ppel l ee t o m ake a pow erpoi nt p r e s e n t a t i o n d u r i n g o p e n i n g s t a t e me n t s a n d c l o s i n g a r g u me n t s . F i n d i n g n o e r r o r , we a f f i r m.

Tenn. R . A pp. P. 3. A ppe al as of R i ght ; Judgm ent of

t he C i rcui t C ourt A f

f i rm ed 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 H OL L Y M. K I RBY , J

. , j oi ned. M i chae l L

. W ei nm an, J acks on, T ennes s ee, and Thom as L

. L ong, C ol l i er vi l l e, T ennes s ee, for th e a p p e llan t, T e re sa L yn n S tan f ield , In d iv id u a lly , an d o n b e h a lf o f th e h e irs a t law o f

T rista J a n e G re e n e , D e c e a s e d

. D ix ie W . C o o p e r, C h ri s J

. T a rd io , N a s h v ille , T e n n e s s e e , f o r th e a p p e lle e s , J o h n N e b le tt, J r., M

. D. , a n d W e s tTe n n e s s e e Ne u r o s u r g i c a l Cl i n i c . P

. C. OP I NI ON O n A u g u st 8 , 2 0 0 6 , A p p e llan t, T e re sa L yn n S tan f ield (“ M s. S tan f

ield ” ) f iled th is act i on i ndi vi dual l yand on beha l f of the hei r s atl aw of herdaught er , T r i s t a J ane G r eene ( “M s . G r eene ”)

. M s . St anfi el d named A ppel l ees , J ohn N ebl ett , M

. D

. ( “D r . N ebl et t ”) andJ acks onMa di s onCo un ty Gen e r a l Hos pi t a l Di s tr i c t , d/b/ aJack son Madison Cou nty G eneral Hospital 1 was also n am ed a s a defend ant. Sub seque ntly Ms. Stanfield

v oluntarily

dis mis s e d the c laim

ag ainst th e hosp ital. Dr. N eblett als o as serted the d efense of the comparativ e fau lt of Ms. Greene or the perso n 2 respon sible fo r the ATV accident. Upo n the motion of Ms. S t a nf i e l d, t hi s de fense was struck by the trial co urt. Th is is n ot

an is su e on

a pp ea l. -2- W es tT ennes s ee N eur os ur gi cal C l i ni c, P. C

. as d ef en d ant s . M s . G r eene s us t ai ned hea d

1 i nj ur i es dur i ng an A T V acc i dent , w hi ch o cc u rr ed on A ugus t29, 2005. Fol l ow i ng t he acc i dent , s he w as t aken t o J acks on M adi s on C ount y H os pi t al ( t he “H os pi t al ”)

. A ft erbei ng t r eat ed and e val uat ed i n t he em er gency r oom , M s . G r eene w as admi t t ed t o t he neur ol ogi cal i n t e n s i v e c a r e u n i t a t t h e Hos p i t a l

. On Aug u s t 3 0 , 2 0 0 5 , s h e was t r a n s f er r ed t o t he i nterm ediat e neu rosur gical un i ton t he o rder s o f D r. N eblet t and ano t her doc t or t hat w as al so tr ea ti n g M s. G ree n e. A t som e p o int du ri n g h er stayat t h e h o sp it al, M s. G ree n e’s n e u ro lo g ica l sta tu s d e ter io ra ted . It i s d isp u ted w h e n th e d e ter io ra tio n b e g a n . D r . N e b lett a ss e rts th a t h e w a s n o t n o tifie d o f th e d e ter io ra tio n in M s. G re e n e ’s sta tu s u n til a p p ro x im a tely 10: 50 p. m on A ugus t30, 2005. M s . G r eene di ed o n A u g u st 3 1 , 2005, as a r es ul tof her neur ol ogi cal i nj ur i es . M s . St anfi el d as s er t ed i n hercompl ai ntt hatD r . N eb let t is gui l t yof m edi cal negl i gence forfai l i ng t o pr oper l yas s es s and t r eat herdaught er , fort r ans ferr i ng her daught eroutof t he i nt ens i ve ca r e uni t , and forfai l i ng t o t i m el ydi agnos e and tr eather daught er . A l s o i n hercompl ai nt , M s . St anfi el d as s er t ed t hat t he nurs i ng s t aff att he hos pi t al “fa i l ed t o appr eci at e [he r daught er ’ s ] changi ng neur ol ogi cal s t atus , ” w hi ch cha nges r equi r ed im m e d iate a tten tio n , an d “ f a iled to tak e th e a p p ro p ria te a c tio n .. .. a n d f a iled to im m e d iate ly n o tif yD r. N e b le tt....” D r. N eb let t and W est T en n esse e N eu rolo g ical C li n ic, P

. C

. fil ed an an sw er o n Jan u ary 8, 2007. I n hi s ans w er , D r . N ebl et tdeni ed thathe w as gui l t yof m edi cal negl i gence , s t at i ng that h e c o m p li ed w ith the st an d ard o f ca re. I n d ef en se o f th e c lai m s lod g ed ag ains t him , D r. N ebl et taverr ed the compar at i ve fa ul tof t he hos pi t al and nur s i ng s t aff

. 2

A j ur yt r i al began on February23, 2009. T he t r i al concl uded on M ar ch 3, 2009. T hat s a me d a y , t h e j u r yr e tu r n e d a v e r d i c t i n f a v o ro f Dr

. Ne b l e t t

. Ac c o r d i n g t o t h e v e r d i c tf o r m, t he j ur yfound t hatD r . N ebl et tdi d devi at e fr om t he st andar d of car e, butt hathi s devi at i on w as nott he l egal caus e of M s . G r eene ’ s death. T he tr i al cour tent er ed a j udgm entr efl ect i ng th is d e c is io n o n M a rc h 2 4 , 2 0 0 9

. O n A pri l 22 , 20 09 , M s . St a nf i e l d fi l e d a M ot i on fo r N e w Tr i a l

. I n he r mot i on , M s. S tanf iel d raised ten issu es w h ic h sh e c o n tend ed en ti tl ed h er to a n ew tr ial

. T h e tri al co u rt ent er ed an or deron Sept ember 4, 2009, deny i ng t he mot i on.-3-

M s . St anfi el d fi l ed a not i ce of appea l on Sept ember 11, 2009. She r ai s es s even i s s ues forourr evi ew , al l of w h ich w er e al s o r ai s ed i n herM ot i on forN ew T r i al as r equi r ed by T enn . R

. A pp . P

. 3(e)

. W e res t at e t hem as fol l ow s: 1. W het hert he t r i al cour terr ed i n al l ow i ng D r . N ebl et t ’ s couns el t o s how p o r t i ons of w hatw as purpor t ed t o be exc erpt s fr om t he tr i al t r ans cr i ptt o t he j ur ydur i ng cl os i ng argum ents ? 2. W het hert he t r i al cour t err ed by deny i ng M s . St anfi el d’ s M ot i on fora di r ect ed ver di ct as t o D r. N eblet t ’s com parat i ve fa ultcl ai m s? 3. W het hert he tr i al cour ter r ed by al l ow i ng D r . N ebl et t ’ s expert s t o t es t i fyas t o opi ni ons no ti den t i fi ed in t heirR ule 26 dis cl osures? 4. W het hert he l anguage r egar di ng caus at i on on t he ver di ctfor m w as m i s l ead ing a nd, t her efor e, caus ed the j ur yt o m i s under s t and the r equi r ed s how i ng? 5

. W h ethe r th e tri al co u rterred in allow ing D r. N eb let t t o im p ea ch M s. S tanf iel d ’s exp ert s t hroug h m edical t reat i ses? 6. W het herD r . N ebl et t ’ s expert s s at i s fi ed t he l ocal i t y rul e and w er e prope r l yqual i fi ed t o rende r opi nions? 7. W het hert he tr i al cour ter r ed i n al l ow i ng D r . N ebl et t ’ s couns el t o m ake a pow erpoi nt p re s e n ta ti o n , w h ic h in c lu d e d e x h ib it in g d o c u m e n ts th a t h a d n o t ye t b e e n a d m it te d in to e v i d e n c e , d u r i n g o p e n i n g a r g u me n t s ? I. Direc ted Ve rdict M s . St anfi el d conten d s that t he tr i al cour terr ed i n deny i ng herm ot i on fordi r ect ed ver di cton D r . N ebl et t ’ s compar at i ve fa ul tdefe ns e. A t r i al cour t ' s deci s i on t o gr anta mot i on fo r directed v erd ictinv o lves a q u esti o n o f l a w . U nder w ood v. H C

A Heal th Serv s . of T ennes s ee , I n c . , 8 9 2 S

. W

. 2 d 4 2 3 , 4 2 5 ( Te n n . Ct

. Ap p . 1 9 9 4 )

. On a p p e a l , we a p p l yt h e s a me s ta n d a rd u s e d b yth e tr ia l co u rt w h e n ru lin g o n th e m o tio n in itia lly. U ni ted B r ake Sys . , I

nc. v . Am . Envtl

. Pr ot . , I nc . , 963 S. W

. 2d 749, 754 ( T enn. C t

. A pp. 1997)

. A ccor di ngl y , w e do n o t w e ig h th e e v id e n c e o r e v a lu a te th e c re d ib ility o f w itn e s s e s . I

d. ( ci t i ng U

nder w ood , 892 S. W

. 2d at425)

. R ather , w e cons i deral l of t he evi dence , t aki ng t he s t r onges tl egi t i m at e vi ew o f it in th e n o n -m o v in g p a rt y ' s f a v o r. E a to n v . McL a in , 8 9 1 S

. W

. 2 d 5 8 7 , 5 9 0 (T en n . 1 9 9 4 ). T he courts houl d gr antt he mot i on, "onl yi f, aft eras s es s i n g t he evi dence acc or di ng t o t he for egoi ng s t andar ds, i tdet er m i nes t hatr eas onabl e mi nds coul d notdi ffe ras t o t he con cl usi on s t o b e draw n from t he ev i den ce. " I d. I n hi s ans w er , D r . N ebl et t as s er t ed t he defens e of t he com par at i ve faul tof t he hos pi t al and the nur s i ng s t aff

. A cc o rdi ngl y , D r . N ebl et tbear s t he bur den of pr ovi ng compar at i ve f a u lt. B anks v. E l

ks Club P r i de of

T enn. 1102 , 3 0 1 S .W .3 d 2 1 4 , 2 2 4 (T e n n . 2 0 1 0 ).-4-

A ft er r eview i ng t he record, w e fi nd t hat the tr i al cou rtd id n o t e rr in den y i ng M s. St anfi el d’ s m ot i on for a di r ect ed ver di ct

. T her e i s ampl e evi dence i n t he r ecor d upon w hi ch a j urycou ld f

in d t hat the n ursi ng st aff w as atfault

. O n d i rectexam i nati on , as M s. S tanf iel d ’s w itn ess, D r. N eb let t t esti fied that, b ase d o n the n u rse’s n o tes i n M s. G ree n e’s m edi cal r ecor ds ar ound 7: 00 p. m . on A ugus t30, 2005, t he nur s i ng s t aff s houl d have c al l ed hi m t o inf

o rm h im o f M s . G r eene ’ s s t atus . I ns t ead, acc or di ng t o D r . N ebl et t , he w as not cont act ed unt i l appr oxi m at el y10: 50 p. m . t hatday

. H e t es t i fi ed t hatt he s t andar d of ca r e w as t o r el yon t he nur s es t o cal l hi m . D r . M ar vi n R ozea r , one of M s . St anfi el d’ s expert s , t es t i fi ed t hatbas ed upon t he G l as gow C om a s cor e gi ven byt he nur s e at 1 : 00 p. m . on A ugus t30, 2 0 0 5 , the n u rse’s n o tes d esc ri b ing M s. G ree n e’s co n d it ion w ere inac cu rate. M o reo v er, D r. R ozea rt es t i fi ed t hathe expe ct s hi s nur s es t o cont acthi m upon a cha nge i n t he ment al s t atus of a pa t i ent , and t hat , had the nur s es cont act ed D r . N ebl et tand had he r es ponded app ropri at el y , t he o utcom e w ou l d h ave d i ffered. D r. Isa b e lle R ichm on d, al so on e of M s. St anfi el d’ s expert s , t es t i fi ed t hatt he A ugus t30, 2005, 1: 00 p

. m . nur s e’ s not es and the G as l gow C o ma Sc o r e g i v e n b yt h e n u r s e a t1 : 0 0 p . m. a r e i n c o n s i s t e n t , i mpl y i n g t h a tt he n u r s e e r r e d

. Dr

. Ri c h mo n d a l s o t e s t i f i e d t h a tt h e n u r s e d i d n o tn o t i f yDr

. Ne b l e t ta t4 : 1 5 p . m. w hen s he d o cu m en ted th at M s. G ree n w as ho lding h er he ad an d g roa n ing , an d that, h ad D r. N eb let t bee n n o ti fied an d h ad h e c o m e t o the h o sp it al, M s. G ree n w o u ld h av e su rviv ed

. D r. R i chm on d tes t i fi ed thatshe w as fam i l i ar w i t h n ursi ng prot oco l s and w hen a do ct or should be no ti fied

. D r. A r t hurD aus , anotherexpertforM s . St anfi el d, al s o t es t i fi ed thati tw as r eas onabl e forDr

. Neb l e t tt o e x p e c ta c a l l f r o m t h e n u r s e s whe n M s . Gr e e n e ’ s s t a tus ch an g ed

. D r. O w en S am u els, an e x p e rt fo r D r. N eb let t, test ifi ed that the s tand ard o f c are r equi r ed the nur s es t o comm uni cat e anychange s t o D r . N ebl et t and t hat t hey fai l ed t o cont act him at 7:00 p. m . on A ug ust 30 , 20 05 , aft er docu m enti ng dram at i c chan ges. F i nall y , t he n urse t hat w as on dut y t he ni ght of A ugus t30, 2005, and w ho actual l yt r eat ed M s . G r eene , t es t i fi ed t hats he knew t hat t he s t andar d of ca r e r equi r ed hert o cal l D r . N ebl et tupon a cha nge i n t he m ent al s t atus of a pa t i ent

. She t es t i fi ed thats he w as notent i r el ys ur e thatM s . G r eene had under gone a si gni fi cant change , but i ns t ead of cont act i ng D r . N ebl et t as s he knew s he s houl d, s he cons ul t ed w i t h ot hernur s es . Fi ndi ng s uffi ci entevi dence i n t he re cor d, w e af fi r m t he tr i al c o u rt ’s d e n ia l o f

M s . S ta n f

ie ld ’s m o tio n f

o r a d ir e c te d v e rd ic t. II. E x p er ts D eci s i ons r egar di ng t he admi s s i bi l i t y of evi dence r es tw i t hi n t he s ound di s cr et i on of th e tr ia l c o u rt

. O tis v. Cam br i dge Mut . Fir e I ns. Co. , 8 5 0 S

. W

. 2 d 4 3 9 , 4 4 2 (T en n . 1 9 9 2 ). A cco r d i n g l y , we r e v i e w t h e t r i a l c o u r t ’ s d e c i s i o n s u n d e ra n a b u s e o f d i s c r e t i o n s t a ndar d. S ta te D e p ’t o f T ra n sp . v. V

e g lio , 78 6 S

. W

. 2d 94 4, 94 8 ( T enn . C t

. A pp . 19 89 ). T he ab use of di s cr et i on s t andar d r equi r es us t o cons i der“( 1) w hethert he dec i s i on has a s uffi ci ent evi dent i aryfoundat i on, ( 2) w hethert he tr i al cour tcorr ect l yi dent i fi ed and pr oper l yappl i ed t h e appropr i at e l egal pr i nci pl es , and ( 3) w hethert he dec i s i on i s w i t hi n t he r ange ofTenne ss ee R ul e of C iv ilP ro ce dure 2 6. 02 p ro v id es in p erti ne nt p art: 3 4) Tri alP re parati on : E xp erts

. D is co v er y of f ac ts k no wn an d op in io ns h el d by exp erts, otherw ise disc ov erable unde r the prov isions of su bdiv ision (1) of thi s rul e a nd acquired or dev eloped

in anticipation

of litig ation or for trial, may be obtaine d o nly

as follow s: (A )( i) Ap arty

may thro ugh inte rr og atories r eq ui re any o th er p arty to id enti fy e ac h pe rs on

who m th e othe r party

e xp ects to c al l a s an

e xp ert witnes s at trial, to state the subject m atter on whic h the expert is expec ted to testify , and to state the substance of the facts and opin ions to which the expert is exp ected to testify and a sum mary of the ground s for each opinio n.

-5- acc ept abl e al t er nat i ves . ” State ex r el . Vaugh n v. K

aatr ude , 2 1 S .W .3 d 2 4 4 , 2 4 8 (T e n n . C t. A p p . 2 0 0 0 ). “W h ile w e w ill se t as id e a d isc re tio n a ryd e c isio n if it r e s ts o n a n in a d e q u a te evi den t i a r y f

o u n d a t i o n o r i f i t i s c o n t r a r y t o t h e g o v e r n i n g l a w, we wi l l n o t s u b s t i tu t e our j udgm ent fort hatof t he tr i al cour tm er el ybeca us e w e mi ghthave c hos en another al t ernat i ve. ” I

d . I f t hi s C our tfi nds err or , w e w i l l onl ys etas i de the fi nal j udgement upon a f in d in g th a t th e e rro r “ m o re p r o b a b lyth a n n o t af f e c ted th e ju d g m e n t o r w o u ld re su lt i n p re ju d ic e to th e ju d ic ia l p ro c e s s .” T e n n . R . A p p . P . 3 6 (b ). A . D r. N e b lett’s E

x p e rts i

. R ule 26 D i scl osures M s. S tanf

iel d su b m it s o n ap p ea l th at t h e tri al co u rterred in allo w in g D r. N eb let t’ s e x p e rts to tes tify re g a rd in g o p in io n s n o t p ro v id e d in th e ir R u le 2 6 d isc lo su re s. P u rsu a n t to 3 R u le 37

. 0 3 o f th e T en n esse e R u les o f C ivil P roc ed u re, th e tri al co u rtm ayex clud e a n ex p ert’s tes tim o n yw h e n th e o p p o sin g p a rtya ss e rts th a t th e e x p e rt d id n o t d isc lo se a n o p in io n in h is orherR ul e 26 expe r tdi s cl os ur es . “Excl us i on i s pr operonl yi f t he di s cl os ur es fai l ed t o gi ve th e o p p o sin g sid e re a so n a b le n o tice o f th e o p in io n s s u c h th a t, w ith o u t ex c lu sio n , the re w o u ld be unfai rs urpr i s e ort r i al byambush. ” W a tk in s v . A

ff ilia te d I n te r n is ts, P.C

., N o. M 2008- 01205- C O A

- R 3- C V , 2009 W L 5173716, *20 ( T enn. C t

. A pp. D ec. 29, 2009)(cit at i ons o m itted). Th e d e c i s i o n t o e x c l u d e a n e x p e r t s t e s t i mon y u n d e r Rul e 3 7

. 0 3 r e s t s wi t hi n t he s ound di s cr et i on of t he tr i al court an d w il l n otbe overtur ned abs entan abus e of that d is c re tio n . I

d . A c c o rd in g to M s. S tan f ield , th e trial co u rt e rre d in a llo w in g D r. N e b lett’s e x p e rts to t est i fyabo ut the acti on s o f t he nu rs es, speci fi cal l y t heir fai l ure to no t i fy D r. N eblet tas t hese opi ni ons w er e notpr evi ous l ydi s cl os ed. A l s o, M s . St anfi el d ar gues t hat t he t r i al cour ter r ed-6-

i n al l ow i ng D r . N ebl et t ’ s expert , D r . O w en S amuel s , t o t es t i fy as t o a new l yfor m ed opi ni on o n M s. G re e n e ’s tr an sfe r sum m ary. Pr i ort o t r i al , M s . St anfi el d fi l ed a mot i on i n l i m i ne r eques t i ng t hatt he t r i al cour t l i m i t D r . N ebl et t ’ s expert s ’ t es t i m oni es t o onl yt hos e opi ni ons pr ovi ded i n t he R ul e 26 di s cl os ur es . B yor derent er ed M ay14, 2009, t he tr i al cour tgr ant ed t he mot i on i n t hatt he “e xpert s [w o u ld] be r equi r ed byt he [tr i al ] cour tt o t es t i fycons i s t ent w i t h t hei rR ul e 26 di s cl os ur es . ” A t t he pr etr i al hear i ng, t he tr i al cour ts peci fi cal l ys t at ed that th e e x p e rts w o u ld n o t b e re q u ire d to tes tifyf ro m th e ir re p o rt. H o w e v e r, th e trial c o u rt h e ld t h a tt h e e x p e r t s wo u l d n o tb e a l l o we d t o o f f e r n e w o p i n i o n s , b u tc o u l d r e s p o n d t o c r i t i c i s ms m ade b yM s. S t anfiel d’s expert s. M s . St anfi el d, i n herbr i ef, onl ys peci fi cal l yobj ect s t o t he t es t i m onyof D r . O w en Sam uel s . A ft er r evi ew i ng D r . N ebl et t ’ s expert di s cl os ur es , t hi s C our t fi nds tha t t he t es t i m onyof t he expe r t s as t o t he act i ons of t he nur s i ng s t aff w as adequa t el y di s cl os ed. T he su p p lem e n tal d isc lo su re f o r D r. S a m u e ls sp e c if

ica lly sta tes th a t th e n u rse s w e re re q u ire d to not i fy D r . N ebl et t w hen M s . G r eene ’ s G l as gow C om a Scor e dr opped fr om a s cor e of thi r t een t o a s cor e of ni ne. A l s o, t w o ot her di s cl os ed exper t s i ndi cat ed i n t hei rR ul e 26 di s cl os ur es t h a tt h e y h a d c r i t i c i s m s o f t h e f a i l u r e o f t h e n u r s i n g s t a f

f t o n o t i f y D r . N e b l e t t

. A c c o r d i n g l y, an ytestim o n y re g ard ing the a cti o n s o f th e n u rsi n g staff w as n o t ou tsi d e the sco p e o f D r. N e b le tt’ s R u le 2 6 d is c lo s u re s . F u rt h er, after rev iew ing the reco rd, this C o u rt fin d s that the testi m o n yo f D r. N eb let t’ s exper t s , r egar di ng t he act i ons of t he nur s es and t he expec t at i ons D r . N ebl et ts houl d have of t h e n u r s e s , a n d t h e t e s t i mo n yr e g a r d i n g t h e t r a n s f e rs u mma r ywe r e r e s p o n s e s t o c r i t i c i s ms m ad e b yM s. S tanf

iel d ’s ex p erts. W h ile n o t r eq u ir ed , D r. N eb let t’ s R u le 26 d iscl o su re sp e c if ica llysta tes th a t “[ t]h e e x p e rts d isc lo se d a b o v e m a yb e c a lled u p o n to re sp o n d to s peci fi c cr i t i ci s m s l evi ed by t he expe r t s di s cl os ed by[M s . St anfi el d] ort o s peci fi c t es t i m ony e licite d f ro m o th e r w itn e ss e s a t trial.” O n d ire c t ex a m in a tio n o f D r. N e b lett, M s. S tan f

ield m a d e a n iss u e o f

th e n u rse s’ d u ty , w ith o u t s p e c if ic o rd e rs, to c o n tac t D r. N e b lett upon a chan ge in t he m ental st atus of a pati ent. F urt her, w i t h regard t o the act i on of the nu rs es, M s. S tanf iel d ’s ex p ert, D r. Isab ell a R ichm o n d , in resp o n se to a q u esti o n ask ed b yM s. S tanf iel d ’s cou nsel , t est i fi ed t hat t he nu rs e’s 1:00 p.m

. no t es w ere i nco nsi st ent and i nd i cat ed err or. M s. St anfi el d’ s expert , D r . A r t hurD aus , al s o i ndi cat ed on di r ectexami nat i on t hatt he nur s es m ay hav e err ed in t heirasses sm ent of M s. G reene at 1:00 p.m

. A s t o the t ransfersum m ary , M s. S tanf iel d ’s ex p ert, D r. M arv in R o ze ar , te sti fied that, u p o n b eing n o ti fied o f M s. G ree n e’s t r ans ferfr om t he i nt ens i ve ca r e uni tt o t he fl oor , D r . N ebl et ts houl d have a s ked aboutt he con dit i on of the pati ent. D r. R ozear t est i fi ed that , based u po n t he n otes regar ding M s. G r eene ’ s s t atus i n t he tr ans fers um m ary , D r . N ebl et ts houl d not h av e al l ow ed hert o be t r ans ferr ed. D r . R ozea rbas ed hi s bel i ef thatD r . N ebl et tw as not i fi ed of the tr ans feron t he n o ta tio n s c o n ta in e d in th e tr a n s f e r s u m m a ry.-7-

T he rul es of di s covery exi s t , i n par t , t o pr event“tr i al byambush. ” A ustin v. Cit y of Mem p h is , 6 8 4 S

. W

. 2 d 6 2 4 , 6 3 2 (T en n . C t. A p p . 1 9 8 4 ). E xper tt es t i m onys houl d onl ybe e x c l u d e d whe n t h e r e wou l d b e “ u n f a i rs u rp r i s e o rt r i a l b ya mbu s h. ” W a tkins v. A

f f ili ated I n te r n is ts, P.C

., 2 0 0 9 WL 5 1 7 3 7 1 6 a t * 2 0

. Ba s e d o n M s . S t a n f i e l d ’ s e x a mi n a t i o n o f

h e ro wn e x p e rts, it i s o b v io u s to th is C o u rt th a t sh e w a s a w a re th a t th e a c tio n s b yth e n u rse s, a s w e ll as th e tran sfe r sum m ary , w ere an issue

. C o n seq u en tl y , w e d o n o t fi n d that the tri al co u rt a b u s e d its d is c re tio n in a llo w in g D r. N e b le tt’ s e x p e rt s to te s tif yo n th e s e is s u e s . i i

. Q ual i fi cat i ons A t t ri al , t here w ere num erous obj ect i on s t o the qua l i fi cat i on s of each part y ’s exp ert s. M s . St anfi el d cont ends t hatD r . N ebl et t ’ s expert s w er e notpr oper l yqual ifi ed to t es t i fyas ex p erts. T h e d eterm ination o f th e a d m issi b il ity , q u a lif ica ti o n s, an d co m p eten cyo f e x p ert te s tim o n ylie s w ith in th e s o u n d d i s c r e t i o n o f th e tr ia l c o u rt

. T

aylorex r el

. G nei w ek v. J a c k s o n -Ma dis o n Co u n ty G e n . Ho s p . D is t., 2 3 1 S

. W

. 3 d 3 6 1 , 3 6 5 (T en n . C t. A p p . 2 0 0 6 ). A ccor di ngl y , w e r evi ew t he admi s s i bi l i t yof expe r tt es t i m onyunderan abus e of di s cr et i on s ta n d a rd

. W

il s on v. P atters on , 7 3 S

. W

. 3 d 9 5 , 1 0 2 (T en n . C t. A p p . 2 0 0 1 ). M s. S tanf

iel d firstsu b m it s tha t n eit h er D r. M an u el W eiss, D r. R icha rd M il ler, n o r D r. O w en Samuel s qual i fi ed as expert s under t he l ocal i t y r equi r ement

. T he l ocal i t yr equi r ement is fo u n d in T e n n e ss e e C o d e A n n o tate d § 2 9 -2 6 -1 1 5 (b ). B a se d o n th e lo c a lityre q u ire m e n t, t o t es t i fyas an expe r ti n a m edi cal m al pr act i ce c as e, t he expe r tm us t( 1) have be en l i cens ed t o pr act i ce i n T ennes s ee or a cont i guous bor der i ng s t at e, a pr ofes s i on w hi ch w oul d m ake the test im o n yrele v a n t an d (2) h av e a ctua ll yp rac ti ce d the p rof essio n in T en n esse e o r a cont i guous bor der i ng s t at e i n t he y ear pr ece di ng t he dat e of the al l eged i nj ur y . T enn. C ode. A n n . § 2 9 -2 6 -1 1 5 (b ). A f ter re v iew in g th e r e c o rd , w e f in d th a t all o f

D r. N e b lett’s e x p e rts m e t th e lo c a lity re q u ire m e n t. D r. S a m u e ls w a s a lice n se d a n d p ra c ticin g p h y sic ian in G e o rg ia i n 2005 and att he t i m e of t r i al , and w as boar d cert i fi ed i n neur ol ogy . D r . M i l l eri s a s ur geon w h o sp e c ializ e s in tra u m a . H e w a s th e m e d ica l d ir e c to r o f th e tra u m a u n it at V a n d e rb ilt U ni ver s i t yM edi cal C ent eri n T ennes s ee i n 2005 and att he t i m e of t r i al

. H e w as cert i fi ed underA dvance d T r auma L i fe Support ( “A T L S”) and w as l i cens ed i n T ennes s ee i n 2005 and a t th e tim e o f

th e tr ia l. D r. W e iss is a n e u ro su rg e o n w h o w a s lic e n se d a n d p ra c ticin g in T en n esse e a t th e ti m e o f tri a l and in 2 0 0 5

. C o n seq u en tl y , this C o u rtfin d s tha t al l of D r. N e b le tt’ s e x p e rt s m e t th e s ta tu to ry lo c a lity re q u ir e m e n t. Fr om M s . St anfi el d’ s br i ef i t appea r s that s he m ay be conf us i ng t he r equi r ement t hat t he expe r tbe s uffi ci ent l yfami l i arw i t h t he st andar d of car e re qui r ed of D r . N ebl et t w i t h t he l ocal i t yr equi r ement

. T he l ocal i t yr equi r ement and th e r equi r ement t hatt he expe r tbe fa m i l i ar w i t h t he s t andar d of ca r e ar e t w o s epar at e r equi r ement s . T ennes s ee C ode A nnot at ed § 29- 26- 115( a) r equi r es t hatt he expe r tbe fa m i l i arw i t h t he s t andar d of car e r equi r ed of the pr ofes s i on-8-

an d sp ec ial ity o f th e d ef en d an t i n the c o m m u n ityin w h ich th e d ef en d an t prac ti ce d o r a s im ila r c o m m u n ity. T o test ifyas a m ed ical ex p ert, “[ e]x p ert w itn e ss e s m a yn o t sim p ly as se rt th e ir fami l i ar i t y w i t h t he s t andar d of pr ofes s i onal car e i n t he defe ndant ' s comm u n it y w i t hout i ndi cat i ng t he bas i s fort hei rfami l i ar i t y . ” W illia m s v . B a

p tis t Me m o r ia l Ho s

p ., 193 S. W

. 3d 545, 553 ( T enn. 2006) ( ci t ati ons om i t t ed) . T h e b u rd e n o f d e m o n stra tin g th a t th e e x p e rt is q u a lif ie d is o n th e p a rt yp ro f

f e ri n g th e te s tim o n y . Car penterv. K

eppler , 205 S. W

. 3d 474, 783 ( T enn. C tA pp. 2006)

. “The exper tm us t pr es ent fac t s demonst r at i ng how he ors he has know l edge of

t he appl i cabl e st andar d of prof es s i onal car e ei t her i n t he com m uni t y i n w hi ch t he def endant p h y s i ci an pr act i ces ori n a s i m i l arcomm uni ty . ” K enyon v. H

andal , 122 S. W

. 3d 743, 762 ( T enn. C t. A pp. 2003)

. T hi s C our thas pr evi ous l yr ej ect ed a na t i onal s ta n d a rd o f

c a re a n d e v e n a s ta te -w id e s ta n d a rd o f c a re . I d . (cit ati o n s o m itted). A n ex p ert n e e d n o t b e a b le to re c ite a ll o f th e m e d ic a l s ta tis tic s o f a c o m m u n ity. L e d

fo rdv . Mo sk o v itz , 742 S. W

. 2d 645, 648 ( T enn. C t

. A pp. 1987)

. H ow ever , “a c om pl et e lack o f know l edge conce r ni ng a comm uni ty ’ s m edi cal r es our ces w oul d be contr aryt o know l edge of t he r equi r ed s ta n d a rd o f

c a re . Mabon v. Jacks on-Madis on C ount y G ener al

Hos pital , 968 S. W

. 2d 826, 831 ( T enn. C t

. A pp. 1997)

. “[A ] r eas onabl e bas i s for an expert s know l edge of t he medi cal comm uni t yi n ques t i on coul d cons i s tof i nfor m at i on s uch as t he s i ze, l ocat i on and pr es ence o f te a c h in g h o s p ita ls in th e c o m m u n ity. C ar penter , 205 S. W

. 3d at478 ( ci t i ng Sandlin v. U n iversit y Medical

Center , No. M 2 0 0 1

- 0 0679- C O A

- R 3- C V , 2002 W L 167716, at*6 ( T enn. C t. A pp. J ul y25, 2002) )

. W e r evi ew t he tr i al cour t ’ s deci s i on on w hethert he expert p rese n ted s u ff

ici en t fac ts t o d em o n str ate tha t he o r she is fam il iar w ith the st an d ard o f c are of the com m un i t yi n w hich t he d efen dan t pract i ces o r a si m i l ar com m un i t yun der an ab use o f d is c r e t i o n s ta n d a rd

. I

d . a t 7 5 9 . W e w ill n o t o v e rtu rn th e trial c o u rt’s d e c isio n m e re ly b e c a u s e re a s o n a b le m in d s c o u ld re a c h a d if f e re n t c o n c lu s io n . E ldr i dge v. E ldr i dge , 42 S

. W

. 3 d 8 2 , 8 5 (T en n . 2 0 0 1 ). O u r S u p rem e C o u rth as h ad sev era l op p o rtu n it ies t o rev iew an d d iscu ss a tri al co u rt ’s d ec isi o n o n w h ethe r an ex p ert h a s k n o w ledg e o f th e stan d ard o f c are in the d ef en d an t’ s comm uni t y or a s i m i l ar comm uni t y . I n Stoval l v. Clar ke , 113 S. W

. 3d 715 ( T enn. 2003) , our Supr eme C our taff

i r m ed a t r i al cour t ’ s det er m i nat i on t hatt he expe r thad know l edge of t he appr opr i at e s t andar d of ca r e. I n aff i r m i ng t he tr i al cour t , t he S to v a ll cour tnot ed thatunl i ke o ther c ase s the ex p ert at i ssu e d id n o t r elyo n a n ati o n al st an d ard o r eq u ate the stat e stan d ard t o a nat i onal one, nor di d t he exper t s i m pl ym ake a vague c oncl us or ys t at ement t hathe had k n o w le d g e o f

th e a p p ro p ri a te s ta n d a rd o f c a re . I d. at 723. I ns t ead, as di s cus s ed i n S to v a ll , th e e x p e rt tes tifie d th a t h e h a d n e v e r p ra c tice d in T e n n e ss e e , b u t h a d re v iew e d tw e n ty m edi cal chart s fr om T ennes s ee, t es t i fi ed i n t hr ee othercas es i n T ennes s ee a nd had r evi ew ed s t at i s t i cal i nfor m at i on aboutt he med ical comm uni t y , i ncl udi ng t he number of m edi cal s p e c ia lis ts a n d re s o u rc e s a v a ila b le

. I d . T he S tov a ll C o u rt d i s t i ngui s hed i t s cas e fr om-9-

R obinson v. L e Cor

ps , 8 3 S

. W

. 3 d 7 1 8 (T en n . 2 0 0 2 ), in w h ich th e c o u rth eld th at t h e e x p ert d id n o t p ro v id e su f

f icie n t su p p o rt f

o r h is a ss e rtio n th a t h e w a s f a m ili a r w ith th e a p p ro p ria te s ta n d a rd o f

c a re . I d . I n Robi nson , the cour tnot ed thatexpertm er el yt es t i fi ed thatt he s t andar d of ca r e “w oul d be expe ct ed” t o be the s ame as t he nat i onal s t and ard o f car e. R obinson , 83 S. W

. 3d at 724. M or eover , t he R obi ns on expertpr ovi ded no bas i s w hat s oever f o r a ss e rtio n o f

k n o w led g e o f th e sta n d a rd o f c a re o r w h yh e th o u g h t N a sh v ill e a n d h is c o m m u n ity w e re s im ila r. I d . T hi s C our thas al s o r evi ew ed a tr i al cour t ’ s deci s i on on w hether an ex p ert has know l edge of t he st andar d of ca r e i n t he def endant ’ s comm uni t yora s i m i l arcomm uni t yon num er ous occa s i ons . W e af fi r m ed the tr i al cour t ’ s deci s i on t o excl ude an e xper t ’ s t es t i m ony i n A y e rs v . R u th e r

fo r d Ho s p . I n c, 689 S. W

. 2d 1 5 5 ( T enn. C t

. A pp. 1984)

. I n A yers , t he e x p e rt a t iss u e te s tif

ie d to a n a tio n a l s ta n d a rd o f c a re . I d . a t 1 6 2 -6 3 . F u rth e r, th e e x p e rt d id no tkn ow w here M urfr eesboro- t he d efen dan t ’s com m un i t y - w as l ocated, w hetheri tw as a bi g or s m al l t ow n, any phy s i ci ans i n M ur fr ees bor o, w her e the def endant s t r ai ned ort he s i ze o f th e h o s p ita l a t is s u e . I d . at 163. I n Mabon , w e aga i n found t hatan expe r tw as notfami l i ar w ith th e a p p ro p ri a te s ta n d a rd o f c a re a n d th e re f o re c o u ld n o t te s tif

y . Ma b o n , 968 S. W

. 2d at 831. T he Mabon experti ndi cat ed i n hi s test im o n y thathe bel i eved ther e w as a nat i onal s t andar d o f car e. M or e i m por t ant l y , t he expe r tdi d notknow t he popul at i on of t he ci t yat i s s ue, t he number of hos pi t al s i n t he ci t y , w hethert here w er e anycol l eges , uni ver s i t i es or m edi cal s chool s i n t he ci t y , how m any sp ec i al i t i es w er e r epr es ent ed i n t he ci t y , how m any doct or s w her e i n t he ar ea, and thathe had nott r eat ed any one fr om t he ci t y or r evi ew ed any m e d ic a l r e c o rd s f

ro m th e c ity. I

d . I n K enyon , w e agai n found t hat t he expe r tdi d nothave th e re q u ir e d k n o w le d g e o f a n a p p ro p ri a te s ta n d a rd o f c a re . Keny on, 122 S. W

. 3d at762. T he exper t s t at ed t hat t he s t at e s t andar d of car e w as t he s ame as hi s s t at e’ s s t andar d, i ndi cat i ng th a t h e re lie d o n a s ta te w id e s ta n d a rd o f c a re . I d . A lso , th e e x p e rt p ro v id e d n o b a sis f o r h is as s er t i on t hathe w as fami l i arw i t h t he s t andar d of ca r e or hi s as s er t i on t hatt he comm uni t i es w e re s im ila r. I

d . We h a v e r e v i e we d t h e t e s t i mo n y o f e a c h o f Dr

. Ne b l e t t ’ s e x p e r t s . Af t e r o u rr e v i e w, w e fi nd t hat , bas ed on t he ca s e l aw of t hi s St at e, M s . St anfi el d has notdemonst r at ed thatt he t r i al cour tabus ed i t s di s cr et i on i n fi ndi ng t hat D r . N ebl et t ’ s expert s had s uffi ci entknow l edge o f th e s ta n d a rd o f

c a re o f D r. N e b le tt’ s c o m m u n ity o r a s im ila r c o m m u n ity. D r . Sam uel s i s a phy s i ci an l i cens ed i n G eor gi a, boar d cert i fi ed i n neur ol ogy , and at th e tim e o f

trial, h e w a s s e r v in g a s th e d ire c to r o f n e u ro lo g ica l ca re a t E m o ryU n iv e rsity School of M edi ci ne. D r . Sam uel s admi t t ed thathe does not t r eat pat i ent s i n T ennes s ee, but had spoken at V anderbi l t M edi cal School s ever al t i m es . D r . Sam uel s s t at ed thathe knew t he hos pi t al ati s s ue had abo u t s i x hundr ed beds , m aki ng i ta l ar ge hos pi t al , and thati thad m ul t i pl e s ub-s peci al i t i es , an ac t i ve neur os ur gerys er vi ce, fi ve ors i x neur os ur geons , and aCatchm ent refe rs to the are a which the h ospital beingdes cribed treats the m edical issues that arise

. 4 -10- lar g e c a tch m e n t a re a o f f iv e h u n d re d th o u sa n d p e o p le. H e tes tifie d th a t th is w a s s im ilar to 4 E m or y , t he hos pi t al he pr act i ced at

. H e expl ai ned t hat t he hos pi t al i n J acks on has a ful l s cope tr au m a se rvice

. A cc o rdin g to D r. S am u els, the lev el of tr au m a se rvice an d the i n tens ive c are u n it fo r h e a d tr a u m a a t th e Ja c k so n h o sp ital is s im ilar to E m o ry . D r. S a m u e ls c a re f u lly expl ai ned the equi pm entand s er vi ces avai l abl e att he hos pi t al i n ques t i on. H e expl ai ned that all o f th e m ed ical spe ciali ti es n e e d e d f o r th e treatm en t of

an injuryli k e M s. G ree n e’s a re a v a ilab le in Ja c k so n . H e f u rth e r e x p lain e d th a t th is is s im ilar to E m o r y. D r. S a m u e ls t es t i fi ed t hat t he hos pi t al had a neur ol ogi cal i nt ens i ve car e uni t and a ne ur ol ogyfl oor , act i ve oper at i ng r oom s capa bl e of doi n g w hat everneede d t o be done, and a “ ful l gamut ” of rad iolog ical serv ices. H e test ifi ed that thes e fa ctors m ak e the h o sp it al si m il ar to E m o ry . D r. Sam uel s expr es s ed t hat he under s t ood t he nurs i ng fl ow s heet s , m ethods of m oni t or i ng and t r eatm ent m odal i t i es us ed at t he hospi t al i n ques t i on. A ccor di ng t o D r . Sam uel s , t he nur s i ng fl ow s heet s us ed att he hos pi t al ar e s i m i l ar t o t he ones he us es at E m or y . H e t es t i fi ed thatt he m oni t or i ng of M s . G r eene , as evi dentfr om t he medi cal r ecor ds , i s s i m i l ar t o t he met hod of m o n ito rin g p ro v id e d a t E m o ry . D r. S a m u e ls te stif ied th a t th e re w e re tw o h o sp itals in J acks on, w i t h aboutt hr ee hundr ed doct or s . H e fur t hert es t i fi ed thatt he hos pi t al at i s s ue and E m oryare si m i l ar as far as t he t reatm ent of cl osed head i njur i es l i ke M s. G reene’s

. O n cross ex am ination h e a d m itted th at Jac k so n an d A tl an ta are n o t si m il ar co m m u n it ies. H o w ev er, o n re -d ir e c t e x a m in a tio n , D r. S a m u e ls te s tif ie d th a t th e m e d ic a l c o m m u n itie s a re s im ila r. A s i n S to v a ll , Dr

. Sa mue l s p r o v i d e d s u f f i c i e n ts u p p o r tf

o rh i s a s s e r t i o n t h a th e was fami l i arw i t h t he s t andar d of ca r e of a s i m i l ar m edi cal comm uni t y . H e di d nots i m pl ym ake a bar e as s er t i on w i t houtpr ovi di ng t he courtw i t h s uppor t forhi s as s er t i on. H e had de t ai l ed kno wl e d g e o f t h e h o s p i t a l s a n d me d i c a l f a c i l i t i e s i n J a c k s o n , ma k i n g h i m a war e o f t he re so u rc e s a v a ilab le in th e a re a . W e re c o g n ize th a t m e re lysp e a k in g a t a m e d ica l sc h o o l in t he s ame st at e does not al one i ndi cat e t hat an exper t i s fami l i ar w i t h t he st andar d of ca r e of t he def endant ’ s m edi ca l co m m uni t y . H ow ever , D r . Sam uel s t es t i fi ed thathe w as fami l i ar w i t h the ho s pi t a l a ti s s ue fr om r e a di ng a bo utt he medi c a l c omm un i t y . H e r e vi e w e d M s. G re e n e ’s m e d ic a l r e c o rd s a n d tes tifie d th a t th e yw e re sim ilar to th o se u se d in h is h o sp ital, i ndi cat i ng t o t hi s C our tt hathe had a s uffi ci entunder stan d ing an d exper i ence w i t h t he s t andar d of ca r e expe ct ed i n J acks on. W e r ecogni ze thatM s . St anfi el d w as notpr ovi ded the op po r tun i t y t o vo i r di r e D r . Sa muel s . H oweve r , M s . St a nf i e l d w a s a l l owed t o ful l y cross exam i ne D r. S am uels

. O t her t han a si ng l e qu est i on com pari ng Jackson and A t l anta, M s. St anfi el d di d notatt empt t o ques t i on D r . Sam uel s on hi s know l edge of t he s t andar d of ca r e. I ti s notw i t hi n t he pr ovi nce of t hi s C our tt o as s um e fa ct s aboutt he hos pi t al s orcomm uni t i es d is c u s s e d w h e n s u c h d o e s n o t ap p e a r w ith in th e re c o rd

. State D ept . O f Childr en Ser vs . v. D .W .J ., No. E2 0 0 4

- 0 2 8 6

- CO A- R3- PT, 2 0 0 5 W L 1 5 2 8 3 6 7 , a t * 4 ( J u n e 2 9 , 2 0 0 5)

. B as ed upon t he re cor d i n t hi s cas e, w e fi nd t hatt he tr i al courtdi d notabus e i t s di s cr et i on i n hol di ngDr. Miller’s testimony w as p resented

to the jury

throu gh a v ideo- taped depo sition. 5 -11- th a t D r. S a m u e ls p ro v id e d su f f icie n t f a c ts to su p p o rt h is a ss e rtio n th a t h e w a s f a m ili a r w ith th e s ta n d a rd o f

c a re in a c o m m u n ity sim ila r t o D r. N e b le tt’ s . D r. M ill e r tes tifie d th a t h e w a s th e m e d ica l d ire c to r o f th e tra u m a u n it at V a n d e rb ilt Uni v e r s i t yM e d i c a l Ce n t e ri n Nas h v i l l e . He t e s t i f i e d t h a t h e was c e r t i f

i e d t o t e a c h t h e ATLS 5 c o u rse in h is re g io n . D r. M ill e r t e stif ied th a t h e w a s f

a m ili a r w ith th e m e d ica l co m m u n ity i n J acks on and t he s t anda rd o f car e fora pat i entw i t h an i nj ur yl i ke M s . G r eene ’ s att he Ja c k so n h o sp ital in 2 0 0 5 . H is f a m ili a rityw ith Ja c k so n c o m e s in p a rt b e c a u se h e tre a ts pat i ent s r efe r r ed fr om t hat ar ea and al s o beca us e he i s act i vel yi nvol ved i n t he tr auma sy s t em fort he St at e. H e t es t i fi ed that t he C i t y of J acks on had a popul at i on of abouts i xt yt hous and and the ar ea ha d a popul at i on of aboutone- hundr ed- and- for t y t hous and. H e t es t i fi ed thathe o f ten in ter a c ts w ith p h y sic ian s in Ja c k so n w h e n d isc u ss in g w h e th e r to tr a n sf e r a p a tien t to N as hvi l l e. H e t es t i fi ed thatt her e ar e tw o hos pi t al s i n J acks on and thatt he hos pi t al ati s s ue has appr oxi m at el ys i x hundr ed beds. D r . M i l l er t es t i fi ed t hat t he hospi t al has a neur ol ogi cal i nt ens i ve ca r e uni tand al s o a s t ep-d o w n u n it o n the s ame fl oor . H e t es t i fi ed thathe w as f a m ili a r w ith th e sta n d a rd o f c a re f o r th e tre a tm e n t o f

a p a tien t li k e M s. G re e n a t V a n d e rb ilt , a n d th a t th e sta n d a rd o f c a re w a s sim ilar to th e sta n d a rd o f c a re in Ja c k so n . H e th e n d ire c tly te s tif ie d th a t h e w a s f

a m ilia r w ith th e s ta n d a rd o f c a re in J a c k s o n . D r. M ill e r a lso p ro v id e d su f f icie n t su p p o rt f

o r his a ss e rtio n th a t h e w a s f a m ili a r w ith the s tand ard o f c are in Ja ck so n an d s im ila r c o m m u n it ies. H e d id n o t si m p lym ak e a b are as s er t i on, but i ns t ead pr ovi ded t he t r i al cour t w i t h an ade quat e bas i s forhi s as s er t i on t hathe w as fami l i arw i t h t he s tand ard o f car e i n J acks on. H e t es t i fi ed thathe i s i nvol ved i n t he tra u m a sy ste m th ro u g h o u t th e S tate , w h ich in c lu d e s w o rk in g w ith p a tien ts a n d d o c to rs in J acks on. H e t eac hes t he A T L S cour s e i n t he r egi on, w hi ch i ncl udes J acks on, demonst r at i ng hi s know l edge of

t he s t andar d of ca r e expe ct ed of doc t or s t r eat i ng t r auma pat i ent s s uch as M s. G re e n e in Ja c k so n . H e h a s a lso tre a te d p a ti e n ts re f e rre d f ro m Ja c k so n , ind ica tin g h is know l edge of

w hatt o expec tfr om doct or s i n t hatar ea. Fur t her , unl i ke the expe r t s i n A yers and Mabon , h e h a d d e taile d k n o w led g e o f Ja c k so n a n d th e m e d ica l re so u rc e s a v a ilab le in J acks on, i ndicati n g k now l edge of t he l evel of ca r e w hi ch coul d be expe ct ed i n t hat comm uni t y . Fur t her , M s . St anfi el d di d notcr os s exami ne D r . M i l l eron hi s as s er t i on t hathe w as fami l i arw i t h t he s t andar d of car e i n J acks on. B as ed upon t he re cor d i n t hi s cas e, w e fi nd th a t th e trial c o u rt d id n o t ab u se its d isc re tio n h o ld in g th a t D r. M ill e r p ro v id e d su f f icie n t f a c ts t o s uppor thi s as s er t i on t hathe w as fami l i arw i t h t he s t andar d of ca r e i n J acks on. D r. W e iss tes tifie d th a t h e w a s a n e u ro su rg e o n c u rre n tlyp ra c ticin g a t se v e ra l h o sp itals in N a sh v ill e , T e n n e ss e e . D r W e iss tes tifie d th a t h e w a s f a m ili a r w ith th e sta n d a rd o f c a re in J a c k s o n . He s a i d t h a t h e h a d t r e a t e d p a t i e n t s r e f e r r e d f r o m c o mm u n i t i e s l i k e J a c k s o n . He-12-

e x p r e s s e d k n o w l e d g e o f n u m e r o u s d e t a i l s a b o u tt h e h o s p i t a l a ti s s u e i n J a c k s o n ; s p e c i f i c a l l y, t hati thad s i x ors even hundr ed beds , had a c at chment of aboutfi ve hun d red t hous and p ati en ts, h ad six p rac ti cing n eu rosu rge o n s, h ad b o th a n eu rolo g ical f loo r a n d inten sive ca re un i t , had abo ut tw entyop erat i ng room s, and C T scans w ere r eadil yavail able. D r. W ei ss al so tes tifie d a b o u t th e tre a tm e n t m o d a lit ies a n d n u rsin g f lo w s h e e ts u se d b yth e h o sp ital in J a c k s o n . He f

u r t h e r t e s t i f

i e d t h a t t h e h o s p i t a l i n J a c k s o n p r a c t i c e d d i f f e r e n t i a l d i a g n o s i s . He t es t i fi ed t hat he knew J acks on had a popul at i on of about s i xt y or s eventy t hous and peopl e and t hat t h e r e wer e t wo h o s p i t a l s i n J a c k s o n . Dr

. W e i s s t e s t i f i e d t h a t h e was f

a mi l i a r w i t h t he s t andar d of ca r e thatw oul d appl yt o a neur os ur geon l i ke D r . N ebl et ti n t he ca r e of a pa t i ent l i ke M s . G r eene i n 2005. Fi nal l y , w e fi nd t hat D r . W ei s s al s o pr ovi ded s uffi ci ents uppor tforhi s as s er t i on t hat he w as fami l i arw i t h t he s t andar d of ca r e i n J acks on. L i ke the ot herexpert s , he al s o di d not sim p lym a k e a b a re a ss e rtio n o f f a m ili a rityw ith o u t p ro v id in g th e c o u rt w ith a b a sis f o r h is as s er t i on. L i ke D r . M i l l er , D r . W ei s s has t r eat ed pat i ent s r efe r r ed fr om J acks on, i ndi cat i ng his kn ow l edg e of th e sta nd ard of care t o b e exp ect ed from ph y si ci ans i n Jackso n. H e al so demonst r at ed a de t ai l ed know l edge of Jac ks on and the medi cal fac i l i t i es and r es our ces avail able i n thatcom m un i t y , w hich w ou l d aff ect t he st and ard of care t o b e exp ect ed. H e al so t est i fie d a b o u t t he resources avai l able, t he tr eat m ent m od al i t i es and m et ho d o f diagno si s, i ndi cat i ng an under s t andi ng and expe ri en ce w i t h t he l evel of ca r e pr ovi ded i n J acks on. Fur t her , M s . St anfi el d di d notcr os s exami ne D r . W ei s s on hi s as s er t i on t hathe w as fami l i ar w i t h t he s t andar d of ca r e i n J acks on. B as ed upon the r ecor d i n t hi s cas e, w e fi nd t hatt he tr i al c o u rt d id n o t ab u se its d is c r e tio n in h o ld in g th a t D r. W e iss p ro v id e d su f f icie n t f a c ts to s u p p o rt h is a s s e rt io n th a t h e w a s f a m ilia r w ith th e s ta n d a rd o f c a re in J a c k s o n . M s. S tan f

ield a lso c o n ten d s th a t n e ith e r D r. M ill e r n o r D r. S a m u e ls w e re q u a lifie d to t es t i fyaboutt he s tand ard o f ca r e of a neur os ur geon. T ennes s ee Code A nnot at ed §29- 26- 115( b) r equi r es t hatt he expe r tbe l i cens ed i n a pr ofes s i on ors peci al t yw hi ch makes t he t e s t i mo n yr e l e va nt

. Th e r e i s n o r e q u i r e me n tt h a tt h e e x p e r tb e l i c e n s e d i n t h e s a me p ro f e s s io n o r s p e c ia lity a s th e d e f e n d a n t. See B r avo v. Sum nerR eg’l Heal th Sys. , I nc. , 148 S. W

. 3d 357, 365 ( T enn. C t

. A pp. 2003) ( ci ti n g T enn. C ode. A nn. § 29- 26- 115( b) ; and L e d fo rdv . Mo sk o w itz, 7 4 2 S .W .2 d 6 4 5 , 6 4 7 (T e n n . C t. A p p . 1 9 8 7 ))

. A tt he t i m e of t r i al , D r . Sam uel s w as boar d cert i fi ed i n neur ol ogy , and w as s er vi ng as th e d ire c to r o f

n e u ro lo g ica l ca re a t E m o ryU n iv e rsityS c h o o l o f M e d icin e . H e tes tifie d th a t, a s p a rt o f

h is p o sitio n , h e tra in s n e u ro lo g ists a n d n e u ro su rg e o n s in th e c a re o f a c u te b ra in i n j u r i e s . A l s o , a s p a r t o f h i s p o s i t i o n , h e i s i n c h a r g e o f t h e i n t e n s i v e c a r e u n i t a t E m o r y, over s eei ng t he nur s i ng s t aff and ot her doct or s . H e t es t i fi ed thathe tr eat s pat i ent s i n t he ar ea o f n e u ro c ritica l ca re , w h ich in c lu d e s n e u ro lo g ya n d n e u ro su rg e r y. C le a rly , D r. S a m u e ls t es t i m onyi s r el evantt o D r . N ebl et t ’ s car e of M s . G r eene and D r . N ebl et t ’ s expec t at i ons of-13-

th e n u rs in g s ta f

f

. D r . M i l l er , att he t i m e of tr i al , w as the m edi cal di r ect orof t he tr auma uni tat V anderbi l tU ni ver s i t yM edi cal C ent er . H e w as boar d cert i fi ed i n bot h gener al s ur ger yand s ur gi cal cr i t i ca l ca re. H e t eac hes t he A T L S cour s e dea l i ng w i t h the tr eatm entof cr i t i cal p a tien ts. I n h is p ra c tice , h e is re sp o n sib le w ith th e o v e ra ll ca re o f a p a tien t an d c o n su lts d a ily w i t h t he neur os ur geons . H e i s oft en i nvol ved i n t he deci s i on t o t r ans fer a pat i ent , w i t h a hea d i nj u r y s i mi l a r t o M s . Gr e e n e ’ s , f r o m th e i n t e n s i v e c a r e u n i t t o t h e f l o o r . Hi s j o b i nvol ves r e a d i n g a n d i n t e rp r e t i n g a p a t i e n t ’ s C T s c a n s , a n d d e v e l o p i n g a c o u r s e o f t r e a t m e n t

. C l e a r l y, D r . M i l l er ’ s t es t i m onyi s r el evantt o t he i s s ues i n t hi s cas e; s peci fi cal l y , t he all egat i ons by M s . St anfi el d t hat D r . N ebl et t devi at ed fr om t he s t andar d of ca r e i n t r ans ferr i ng M s . G r eene o u t o f th e in te n s iv e c a re u n it a n d th a t h e d id n o t p ro p e rl yre a d th e C T s c a n s . i i i

. H ar m l es s E r r or E ven i f w e as s um e ar

guendo t hat t he t r i al cour terr ed ei t heri n i t s deci s i on al l ow i ng the e x p erts to t esti fy in l igh t of their R u le 26 d iscl o su res o r i n fin d ing that the e x p erts w ere q u a lifie d to tes tify , b a se d u p o n th e f in d in g s o f th e ju ry , an ye rro r w o u ld b e h a rm les s. T h is cour tw i l l onl ys etas i de a f i nal j udgm ent upon fi ndi ng t hatt he err or“more pr obabl yt han not a ff e c t e d the j ud gmen torw ou l d r e s ul ti n pr e j ud i c e t o t he j ud i c i a l pr oc e s s . ” Ten n. R. A pp . P. 3 6 (b). T h e jury fo u n d that D r. N eb let t d ev iat ed fro m the st an d ard o f ca re. H o w ev er, th e jury al s o found t hat D r . N ebl et t ’ s devi at i on w as nott he l egal caus e of M s . G r eene ’ s death. E ven if w e w e re to e x c lu d e th e tes tim o n y o f D r. S a m u e ls, D r. M ill e r a n d D r. W e iss , the re is a m p le evi dence i n t he r ecor d fr om w hi ch t he j ur ycoul d concl ude thatD r . N ebl et t ’ s devi at i on w as nott he l egal caus e of M s . G r eene ’ s death. D r . N ebl et t hi m s el f t es t i fi ed t hatt he nur s i ng s t aff sh o u ld h a v e c o n tac ted h im e a rlier , an d th a t t h is w a s a v io latio n o f th e ir d u ty . D r. M a rv in R o ze ar, M s. S tanf

iel d ’s ex p ert t esti fied as to the in ac cu rac ies i n the n u rse’s n o tes. M o reo v er, D r. R ozear t est i fi ed thatt he n urses had a du t yt o co ntactD r. N eblet t , and had t hey do ne so t he o utcom e w ou l d h ave b een d i fferent

. D r. Is abell e R i chm on d, ano t her e xp ertfor M s. S t anfiel d, test i fi ed thatt he n urses err ed in m aking no t es i n M s. G reene’s m edical recor ds. She fur t hert es t i fi ed thatt he nur s i ng s t aff s houl d have cont act ed D r . N ebl et tear l i erand had t heydone s o, M s . G r eene w oul d have s ur vi ved. Fi nal l y , t he nur s e tr eat i ng M s . G r eene t he n igh t of h er d ea th testi fied that sh e k n ew that the s tand ard o f c are req u ir ed h er to c o n tact D r. N eb let t, an d sh e did no t d o so . B ase d u p o n this test im o n y , the j u ry co u ld con clud e th at D r. N ebl et t ’ s devi at i on fr om t he st andar d of car e w as not t he l egal caus e of M s . G r eene ’ s death. M o reo v er, the on ly su b stan ti v e diff ere n ce b etw ee n the t esti m o n y o f M s. S tanf iel d ’s e x p e rts a n d th e tes tim o n yo f D r. N e b lett’s e x p e rts w a s o n th e iss u e o f w h e th e r D r. N e b lett d e v iate d f

ro m th e sta n d a rd o f

c a re . D r. N e b lett’s e x p e rts te stif ied th a t h e d id n o t d e v iate w h il e M s. S tanf

iel d ’s ex p erts t esti fied th a t h e d id d ev iat e. A s p rev iou slystat ed , the ju ry-14-

found t hat D r . N ebl et t di d devi at e fr om t he s t andar d of ca r e. T he j ur y , how ever , found t hat h is de v iat ion w as n o t th e leg al ca u se of M s. G ree n e’s de ath, as testi fied to b yM s. S tanf iel d ’s o w n e x p e rts, a n d th e tre a tin g n u rse . C o n se q u e n tly , an yerr or in a llo w in g D r. N e b lett’s e x p e rts t o tes t i fyw ou l d b e harm l ess. B . M s. S ta n field ’s Ex

p e rts M s. S tan f

ield su b m its th a t th e trial c o u rt e rre d in a llo w in g D r. N e b lett’ s c o u n se l to im p e a c h h e r e x p e rts th ro u g h th e u se o f c e rta in m e d ica l tre a tise s. S p e c if ica lly , M s. S tan f

ield cont ends t hatD r . N ebl et ts houl d not have been al l ow ed t o ques t i on D r . R i chmond re gar di ng t he eight h ed i t i on of the A T L S G uidel i nes, as t hat edi t i on w as not i n eff ectatt he ti m e of M s. G re e n e ’s d e a th a n d D r. R ich m o n d h a d ju st re c e iv e d th a t ed iti o n . A lso , M s. S tan f ield cont ends t hatD r . N ebl et ts houl d nothave be en al l ow ed to ques t i on D r . R ozea rr egar di ng m e d ic a l lite ra tu re th a t h a d n o t b e e n p ro p e rl ya u th e n tic a te d

. T enn essee R ule of E vidence 6 18 provides: Im peach m ent of exp ertbyl earned tr eat i ses. T o t he ext ent cal l ed t o t he at t ent i on of an expert w it n ess upon cr os s - exami nat i o n orr el i ed upon byt he w i t nes s i n di r ect exam i nati on , st at em ents con t ai ned i n p ub l i shed tr eat i ses, p e r i o d i c a l s , o r p a mph l e t s o n a s u b j e c t o f h i s t o r y , me d i ci ne, or ot hers ci ence orar t , es t abl i s hed as a r el i abl e author i t ybyt he test im o n y o r ad m issi o n o f th e w itn ess, by o ther e x p ert t esti m o n y , orbyj udi ci al not i ce, m aybe us ed t o i m peac h t he exper t w i t nes s ' s cr edi bi l i t ybutm aynotbe r ece i ved as s ubs t ant i ve evi dence

. O n cr os s exami nat i on, couns el forD r. N eb let t que s t i oned D r . R i chmond about t he G l as gow C om a Score s as des cr i bed i n t he A T L S gui del i nes . D r . R i chmond t es t i fi ed that A T L S w as a r el i abl e s our ce and t hats he us es t he A T L S gui del i nes fori ns t ruct i ng phy s i ci ans on how t o t r e a tc a s e s l i k e M s . Gr e e n e ’ s . Th e r e f o r e , t h e r e q u i r e me n tt h a tt h e t r e a t i s e s be e sta b lish e d a s r e li a b le w a s m e t. A lso , R u le 6 1 8 d o e s n o t co n tain a tem p o ra l re q u ire m e n t; m o re o v e r, w e h a v e n e ith e r b e e n p ro v id e d w ith , n o r f o u n d a n ya u th o rity r equi r i ng t hatt he p u bl i cat i on be i n eff

ect at t he t i m e of t he cas e. E ven i f t her e w as s uch a r equi rem en t, D r. Ri c h mon d a d mi t t e d i n h e rt r i a l t e s t i mon yt h a t , whi l e t h e s e v e n t h e d i t i o n o f t h e ATLS gui del i nes w as us ed att he t i m e of M s . G r eene ’ s death, t her e w as veryl i t t l e cha nge betw een t he s eventh and ei ght h edi t i ons . A tt r i al , D r . R i chmond ass er ted that s he had noty et r evi ew ed the ei ght h edi t i on, buts he t es ti fied at herdepos i t i on t hatt her e w er e no mat er i alMannitol is a prescriptio n d rugwhich m ay

be used to treat head inj uries. 6 -15- c h a n g e s b e tw e e n th e tw o e d iti o n s. C o n se q u e n tly , w e c a n n o t f in d th a t th e trial c o u rt e rre d in a llo w in g D r. R ic h m o n d to b e q u e s tio n e d o n th e e ig h th e d itio n o f th e A T L S g u id e lin e s . M or eover , anyerr or , i f any , w as har m l es s . T he l i ne of que s t i oni ng inv o l vi ng t he A T L S G ui del ines conce r ned t he ques t i on of w hethera G l as gow C om a Scor e of thi r t een ind icated a m ino r he ad injury , as stated in the eigh th ed it ion , o r a m o d era te he ad injury

. D r. R i chmond adm i t t ed t hat , even i f a s cor e of thi rt ee n i ndi cat ed a moder at e hea d i nj ur y , as o p p o s e d to a m in o r i n

ju ry, t h e r e w a s a n in e ty p e rc e n t c h a n c e o f re c o v e ry. B as ed on the j ury ’s fi nd i ng t hat D r. N eblet t ’s dev i at i on from t he st and ard of care w as not the legal cause of M s . G r eene ’ s death, w e ca nnots ay t hat t hi s ques t i oni ng “more pr obabl yt han notaff ect ed the ju d g m en t or w o u ld resu ltin p reju d ic e to the ju d ici al pro ce ss.” T en n . R

. A p p . P

. 3 6 (b). T herefore, anyerr or byt he tr i al cou rti n all ow i ng t his t ype o f qu est i on i ng w as harm l ess. M s . St anfi el d al so su b m it s t hatt he tr i al cour terr ed i n al l ow i ng D r . R ozea rt o be qu est i on ed o n m edical l i t erature t hat had n ot pr op erl ybeen est abli shed as rel i able. In cr oss exami ni ng D r . R ozea r , couns el forD r . N ebl ett asked hi m aboutl i t er atur e on the us e of M anni t ol and s t er oi ds t o t r eatpat i ent s . C ouns el di d notr efe rt o s peci fi c l i t er atur e orat t empt

6 t o r ead a nyl i t er atur e. C ouns el s i m ply ask ed ab o utt he exi s t ence of l i t er atur e t hat co n tr ad ict ed D r. R o ze ar’s o p inion s that M an n it o l o r stero ids sh o u ld h av e b ee n o rde red

. D r. R ozear adm i t t ed, up on qu est i on i ng , t hat there w as l i t erature i n ex i st ence o pp osi ng t he u se o f s te ro id s a n d M a n n ito l. A s p re v io u slysta ted b yth is C o u rt: [O ] nce a n experthas gi ven an opi ni on, he ors he maybe vi gor ous l y cr os s - exami ned t o under m i ne the evi dent i aryw ei ght o f th e o p in i o n . B r ow n v. Cr ow n E qui p. Co. , 181 S. W

. 3d 268, 2 7 5 ( T e n n . 2 0 0 5 ); Johnson v. John Hancock Funds , 217 S. W

. 3 d 4 1 4 , 4 2 6 ( Te n n . Ct

. App

. 2 0 0 6 )

. Opp o s i n g c o u n s el s h o u ld b e g iv e n b ro a d la titu d e in th e irc ro s s -e x a m in a tio n . S ta te v. Far ner , 6 6 S .W .3 d 1 8 8 , 2 0 8 (T e n n . 2 0 0 1 ); McD anie l v . CSX Tr ans p. , I nc . , 95 5 S. W

. 2d 25 7, 26 5 (T enn . 19 97 ). T hu s, cross exami n a t i o n ma yb e u s e d t o r e q u i r e a n e x p e r tt o d i s c l o s e a nd expl ai n t he fa ct s ordat a upon w hi ch hi s orheropi ni on i s bas ed. T e n n . R . E v id . 7 0 5 ; State v. T hacker , 164 S

. W

. 3 d 208, 228 ( T enn. 2005)

. J us tas an exper tm aybe cr os s - exami ned r egar di ng t he fact s or dat a he or s he consi der ed, an expe r tm ay be al s o cr os s - exami ned r egar di ng t he fa ct s or dat a t hathe ors he-16- d id n o t co n sid e r a n d th e re a so n s f o r n o t co n sid e rin g th e se f a c ts ordat a. D u r a n v . H

y u n da i Mo to rA m ., I

n c ., 2 7 1 S .W .3 d 1 7 8 , 1 9 7 -1 9 8 (T e n n . C t. A p p . 2 0 0 8 ). In th is cas e, couns el w as notat t empt i ng t o us e a medi cal t r eat i s e t o i m peac h D r . R ozea r as al l ow ed by T enn. R

. E vi d. 618 and sugges t ed by M s . St anfi el d. I ns t ead, couns el w as cr os s - exami ni ng D r . R ozea rr egar di ng heropi ni on t hatD r . N ebl et ts hould h av e pr es cr i bed M anni t ol or st eroi ds t o tr eatM s. G reene. A ccordi n g ly , it w a s en t i rel yapp ropri at e for cou nsel t o ask aboutt he exi s t ence of, and D r . R o ze ar ’ s know l edge of , l i t er atur e s uppor t i ng opi ni ons c o n tra ryto th o se o f

D r. R o z e a r. T h e re f

o re , w e f

in d th a t th e trial c o u rt d id n o t ab u se its d is c re tio n in a llo w in g th is lin e o f q u e s tio n in g . M s . St anfi el d al s o cont ends t hat t he t r i al cour t err ed i n al l ow i ng couns el t o ques t i on anotherexperton t he A T L S G ui del i nes and t o di s pl ay , dur i ng ques t i oni ng, a por t i on of t he gu i deli ne s t o the j uryon a pr oj e c t i on s c r e e n. W hi l e c r os s e xa mi ni ng D r . A r t hu rD a us, cou nsel for D r. N eblet tplaced a pag e from t he A T L S G uidel i nes on an p roj ect i on scr een so that th e ju ry c o u ld rea d it

. D r. D au s is certi fied in A T L S an d ad m itted, alon g w ith D r. R ichm o n d , that the A T L S G u idelines w ere reli ab le. N o co p y o f the p ag e d isplay ed ap p ea rs i n t he r ecor d fort hi s C our tt o exami ne. F rom the t r ans cr i pt , i tappea r s t hatt he page di s pl ay ed w as fr om t he ei ght h edi t i on of t he A T L S G ui del i nes . A s di s cus s ed above, i tw as noterr ort o al l ow ques t i oni ng bas ed on t he ei ght h edi t i on. Fur t her , t hi s C our tfi nds t hatt he t r i al cour tdi d not abus e i t s di s cr et i on i n al l ow i ng t he page t o be di s pl ay ed t o t he j ur y . T he page w as neveractual l y r ead t o t he j ur y , nor w as i tadmi t t ed i nt o evi dence

. I t s di s pl ayw as m er el yan ai d us ed bycouns el i n ques t i oni ng D r . D aus . W e have nei t herbeen pr ovi ded w i t h, n o rh a v e w e f

o u n d , a n y a u t h o r i t y t o i n d i c a t e t h a t s u c h d i s p l a y w a s i m p r o p e r . A c c o r d i n g l y, this C o u rtca n n o t fi n d that the tri al co u rtab u sed it s d iscreti o n in allow ing D r. N eb let t’ s cou nsel t o d i spl ayt ext of t he A T L S G uidel i nes, w hich w as est abli shed as rel i able byatl east tw o w itn e s s e s . I I I . V erdi ct F orm

M s . St anfi el d al s o cont ends t hatl anguage us ed i n t he V er di ctFor m w as m i s l eadi ng and ca us ed the j ur yt o m i s under s t and herr equi r ed s how i ng. T he quest ion at is s ue on t he V e rd ict F o rm p ro v id e d :

2. I f y ou fi nd t hatD r . N ebl ett d ev ia t ed fr om t he r ecogni zed s t andar d of pr ofes s i onal pr act i ce r eq u ir ed of a neur os ur geon pr act i ci ng i n J acks on, Te n nes s ee ora s i m i l arcomm uni t yi n 2005 i n his t reatm ent of M s. G reene, w as t hat devi at i on a l egal cause-17- of M s . G r eene ’ s death w hi ch w ou ld notot herw i s e have o cc u rred ? (T h e P lai n ti ff h as th e b u rde n o f p roo f o n this i ssu e). A t tr ia l, M s . S ta n f

ie ld re q u e s te d th a t th e tr ia l c o u rt u s e th e p h ra s e “ c a u s e o r c o n tr ib u te d to ,” and obj ect ed t o t he use of “l egal caus e. ” A ccor di ng t o M s . St anfi el d, t he t er m “l egal caus e” i m pl i ed t o t he j ur yt hatD r . N ebl et thad t o be the s ol e ca us e of M s . G r eene ’ s death. R ul e 49. 01 o f t he Tennes s ee Rul es of C i vi l Pr ocedur e af for ds t he tr i al cour tw i de l at i tude t o us e a s peci al ver di ctfor m as i tdeems ap p rop r i at e. T hi s C our tr evi ew s a tr i al co u rt ’s ve rdict fo rm u n d er the sam e stan d ard u p o n w h ich w e re v iew the tri al co u rt ’s j u ry in s tr u c tio n s . Jo r da n v . CSX Tr ans p. , I nc , No

. M1 9 9 9

- 0 1 4 1 5

- C O A

- R 3

- C V , 2 0 0 1 WL 378555, *9 ( T enn. C t

. A pp. A pr i l 17, 2001)

. “The det er m i nat i on of w hetherj ur yi ns t ruct i ons w e re prop er i s a quest i on of law and t herefore, ou r s t and ard of revi ew i s d e n o vo w i t h no p r e s u mpt i o n o f c o r r e c t n e s s . ” O w e n s v . Me th o dis t He a lth Ca r e S y s ., N o. 02A 019704C V 00089, 1999 W L 360562, *2 ( T enn. C t

. A pp. J une 7, 1999) ( ci t i ng Solom on v . Fi rs t Am . N at 'l Bank , 7 7 4 S

. W

. 2 d 9 3 5 , 9 4 0 (T en n . A p p . 1 9 8 9 )). W e re v iew the ju ry c h a rg e in its e n tir e ty to d e te rm in e w h e th e r t h e tr ia l c o u rt e rr e d

. Cit y of J o h n s on Cit

y v. O u tdo orW

e s t , I nc . , 94 7 S

. W

. 2d 85 5, 85 7 (T enn . C t

. A pp . 19 96 )( ci t at i on s om i t t ed). T his cour tw i l l noti nval i dat e t he tr i al cour t ’ s j ur yi ns t ruct i ons as l ong as t he l egal i s s ues i nvol ved a re f a ir ly d e f in e d a n d th e y d o n o t m is le a d th e ju ry. Hunterv. B urke , 958 S. W

. 2d 751, 756 ( T enn. C t

. A pp. 1997)

. I ncons i s t enci es betw een t he ver di ctfor m and the i ns t ruct i ons m ay b e m is le a d in g to th e ju ry. Jor dan , 2 0 0 1 W L 3 7 8 5 5 5 a t * 9 (c ita tio n s o m itte d ). I n i ns t ruct i ng t he j ur y , t he tr i al cour ts t at ed:

A per s on or ent i t y i s at faul ti f y ou fi nd t hatt he per s on or ent i t yw as negl i gentand t hat t he negl i gence w as a ca us e i n fac t a n d leg a l ca u se o f th e in ju ryo r d a m a g e f

o r w h ich a c laim is m a d e . F a u lt h a s tw o p a rt s : n e g lig e n c e a n d c a u s a tio n . * * * T h e s e c o n d p a rt o f

f a u lt is c a u s a tio n . C aus at i on has t w o component s : ( A ) caus at i on i n fac tand (b ) l e g a l c a u s e .

* * *-18- T w o req u ir em en ts m u st be m et t o d eterm ine w h ethe r a person or enti t y ’s neg l i gen t act s or om i ssi on s w ere a l egal cause of t he i nj ur yordamage. 1. T he conduc tm us t have be en a s ubs t ant i al fac t ori n br i ngi ng aboutt he harm bei ng compl ai ned of; and 2 . T h e h a rm g iv in g rise to th e a c tio n c o u ld h a v e b e e n re a so n a b ly for es een or ant i ci pat ed bya per s on of or di naryi nt el l i gence and p ru d e n c e . T o be a lega l c aus e of a n i nj ur yt her e i s no r equi r ement t hat the cau se be t he o nlycause, t he l ast act , or the on e nearest t o t he i nj ur y , s o l ong as i ti s a s ubs t ant i al fac t ori n pr oduci ng t he in ju ry o r d a m a g e .

* * * A s i ngl e i nj ur ycan be caus ed b y the negl i gentact s or om i ssi on s of on e or m ore persons or ent i t i es. I f y ou fi nd t hata per s on orent i t y w as negl i gentand that t he negl i gence w as a caus e i n fac tand al s o a l egal caus e of the i nj ur yordamages forw hi ch a c l ai m w as m ade, y ou have f ound t hatper s on or ent i t y t o be at faul t

. T he pl ai nt i ff ha s t he bur den t o pr ove t h e fa u lt o f D r . N ebl et t

. I f t he pl ai nt i ff f ai l s t o do s o, y o u sh o u ld f

in d n o f a u lt o n th e p a rt o f

D r. N e b lett. D r. N e b lett has t he bur den of pr ovi ng t hatJ acks on- M adi s on Cou n tyG ener al H os pi t al w as atfaul t

. I f he f ai l s t o do s o, y o u sh o ul d fi nd no f a u lt o n th e p a rt o f Ja c k so n -M a d iso n C o u n tyG e n e ra l H o sp ital. I f y ou fi nd m or e than one pe r s on or e n ti t yt o be atfaul t , y ou m us tt hen det er m i ne the per cent age of faul tchar geabl e t o eac h o f th e m . Fr om t hes e i ns t ruct i ons and t he ver di ct for m , w e cannot fi nd t hatt he tr i al cour ter r ed. T h e leg al i ss u e s a re fa ir lyd ef ined

. T h ere are n o inco n sist en cies b etw ee n the v erd ictfo rm and the i ns t ruct i ons . T he t r i al cour tcl ear l y defi ned l egal caus e and i ns t ruct ed the j ur yt hat m o re tha n o n e p erso n o r en ti tym ay b e th e cau se of the in juryo r da m ag es. T h e v erd ictfo rm asks w hetherD r. N eblet t ’s dev i at i on from t he st and ard of care w a s “ a le g a l c a u s e .” (em p has i s added)

. I t does not i ndi cat e, es peci al l y i n l i ght of t he j ur y i ns t ruct i ons , that D r. N e b lett h a d to b e th e so le c a u se . A c c o rd in g ly , w e d o n o t f in d th a t th e trial c o u rt e rre d in its-19-

u s e o f th e te rm “ le g a l c a u s e ” o n th e v e rd ic t f o rm . I V . Pow e r poi nt Pre s e nt at i ons F inally , M s. S tanf

iel d co n tend s tha t th e tri al co u rt e rr e d in allow ing D r. N eb let t’ s couns el t o us e a pow erpoi nt pr es ent at i on dur i ng openi ng and cl os i ng s t at ement s . A s t o t he o p en ing stat em en t, M s. S tanf ie ld arg u es th at sh e w as p rejud iced b ec au se D r. N eb let t’ s co u n sel w as a ll o w ed to d isplayev iden ce , n o t y et ad m itted, du ri n g o p en ing stat em en ts. In reg ard to the clos ing arg u m en ts, M s. S tanf iel d arg u es that the tr ial co u rt erred in all o w ing D r. N ebl et t ’ s couns el t o di s pl aypor t i ons of a purpor t ed tr i al t r ans cr i ptt o t he j ur yw hi l e maki ng c lo s in g a rg u m e n ts . W e w ill a d d re s s e a c h o f th e s e is s u e s s e p a ra te ly. O peni ng s t at ement s “ar e i nt ended mer ely to inf or m t he tr i al j udge and j ur y , i n a gener al w ay , of t he nat ur e of the ca s e and t o out l i ne, gener al l y , t he fa ct s eac h par t yi nt ends t o pr ove. ” H

a r r is v . B a

p tis t Me m o r ia l Ho s

p ita l , 574 S. W

. 2d 730, 732 ( T enn. 1978)

. “Tri al cour t s have w i de di s cr eti o n i n contr ol l i ng ar gum ent s of couns el , i ncl udi ng openi ng s t at ement s . . . . ” State v. Johnson , N o. W 2004- 00464- C C A

- R 3- C D , 2005 W L 645165, *14 ( Te n n . Cr i m. App

. M a r c h 1 5 , 2 0 0 5 ) ( ci t i ng S ta te v . S u tto n , 562 S. W

. 2d 820, 823 ( T enn. 1978)). A ccor di ngl y , t hi s C our tr evi ew s t he tr i al cour t ’ s deci s i ons on ar gum ent s underan a b u s e o f d is c re tio n s ta n d a rd

. I

d . “ A trial c o u rt sh o u ld p ro v id e b o th p a rties th e o p p o rtu n ity to p rese n t the ir ca se an d the fa cts u p o n w h ich th eyinten d to rely , so lon g as th o se f ac ts are d e e m e d lik e ly to b e s u p p o rt e d b ya d m is s ib le e v id e n c e . I d . ( ci t i ng State v . Stout

, 46 S. W

. 3d 6 8 9 , 7 1 3 (T e n n . 2 0 0 1 ))

. M s . St anfi el d ar gues , i n part, tha ts he w as pr ej udi ced be caus e the tr i al cour thad p r e v io u slyru led th a t th e p a rties w o u ld n o t b e a llo w e d to u se a p o w e rp o in t p re se n tatio n in openi ng ar gum ent s . W e have r evi ew ed the tr ans cr i ptof t he pr etr i al confe r ence and di s agr ee. Fi r s t , t her e i s not hi ng in the o r derfr om t he pr etr i al hear i ng w hi ch addr es s es t he i s s ue of pow erpoi ntpr es ent at i ons . D ur i ng t he conf er ence , couns el forM s . St anfi el d as ked aboutt he us e of pow erpoi nt , expl ai ni ng t hat a n o ther t r i al j udge had notal l ow ed hi m t o us e a pow erpoi nt pr es ent at i on unl es s every t hi ng s how n had al r eadybeen a dm i t t ed i nt o evi dence

. A ft erhear i ng t hi s , t he t ri al cour ts t at ed thathe agr eed w i t h t he otherj udge and w oul d not al l ow i tunl es s t he par t i es agr eed t o i t

. I n r es pons e t o a quest i on fr om t he tr i al cour t , couns el forD r . N ebl et ts t at ed t hat s he i nt ended t o us e a pow erpoi ntpr es ent at i on dur i ng heropeni ng, butw oul d notputon anyevi dence t hats he w oul d notus e i n t he ca s e. T he tr i al cour tas ked th e p a rties to e x c h a n g e in f o rm a tio n a n d sta ted th a t, if th e re w a s n o t an a g re e m e n t, he w o u ld cons i dert he i s s ue pr i ort o t he tr i al begi nni ng. T he t r i al cour t i n no w ayhel d t hatpow erpoi nt pr es ent at i ons w oul d notbe al l ow ed. I ns t ead the tr i al c o u r ts i m pl yhel d t hatt he us e of evi dence notal r eadyadmi t t ed i nt o evi dence w oul d need t o be agr eed upon by t he par t i es or p re-ap p rov ed b y th e c o u rt

. M o reo v er, ba sed u p o n co u n sel’s st atem en ts, M s. S tanf iel d ’s-20-

couns el s houl d have been ful l y aw ar e thatD r . N ebl et t ’ s couns el pl anned t o us e a pow erpoi nt p rese n tat ion d u ri n g o p en ing stat em en ts. F u rt h e r, prior to o p en ing arg u m en ts, the re co rd in d ica tes th a t c o u n se l f o r M s. S tan f

ield w a s p ro v id e d w ith a n a p p ro x im a te tw e n ty m in u te r ece s s t o r evi ew t he s l i des

. N o s peci fi c obj ect i on w as m ade as t o anyof t he mat er i al cont ai ned i n t he pr es ent at i on. M s . St anfi el d al s o cont ends t hats he w as pr ej udi ced be caus e the pow erpoi nt pr es ent at i on cont ai ned document s not admi t t ed i nt o evi dence

. W e fi nd t hi s ar gum entt o be d isin g e n u o u s. W h ile w e d o n o t h a v e a c o p y o f th e p re se n tatio n m a d e , w h ich w o u ld c e rta in ly be hel pful , i tappea r s from the re cor d t hatt he onl yexhi bi t s pr es ent ed dur i ng t he openi ng s t at ement s w er e the medi cal r ecor ds of M s . G r eene and pos s i b ly D r . N ebl et t ’ s curr i cul um vi t ae. D ur i ng t he pr etr i al confe r ence , couns el for M s . St anfi el d hi m s el f as ked foran agr eed o rd e r stip u latin g to th e m e d ica l re c o rd s so th a t th e p a rties c o u ld w o rk f ro m th e sa m e e x h ib it. C ouns el forD r . N ebl et tagr eed t o t hi s s t i pul at i on. M or eover , t he fi r s tact i on bycouns el for M s . St anfi el d, upon begi nni ng t he pr es ent at i on of t he evi dence , w as t o intr o d uce the stip u late d re c o rd s in to e v id e n c e , sta tin g th a t itw a s b yth e a g re e m e n t o f th e p a rties . W h ile att he t i m e of ope ni ng s t at ement s , t he r ecor ds had notbeen f or m al l yadmi t t ed i nt o evi dence , th e yh a d a lre a d yb e e n stip u late d to o n th e re c o rd a t th e re q u e st of M s. S tan f ield ’s c o u n se l. A tno poi ntdur i ng t he pr ocee di ngs w as t he admi s s i bi l i t y of t he medi cal r ecor ds ques t i oned. D r. N e b lett’s c u r r ic u lu m v itae a p p e a rs in th e re c o rd a s a n e x h ib it an d h e tes tifie d a s to h is backgr ound and t r ai ni ng. M s . St anfi el d has nei t herci t ed t o, norhave w e found, anypl ace i n t h e r e c o r d w h e r e M s . S t a n f i e l d o bj e c t e d t o t h i s e x h i b i to rD r . N e b l e t t ’ s t e s t i m o n y. C o n seq u en tl y , w e d o n o t fi n d th a t th e tr ial co u rtab u sed it s d iscreti o n in allow ing D r. N ebl et t ’ s couns el t o us e a pow erpoi nt pr es ent at i on, as pr evi ous l y di s cl o sed , to pr es ent s tip u la te d a n d p ro p e rl ya d m is s ib le e v id e n c e to th e ju ry d u ri n g h e r o p e n in g s ta te m e n t. A s t o cl os i ng ar gum ent s , M s . St anfi el d cont ends t hatt he tr i al cour terr ed i n al l ow i ng D r . N ebl et t ’ s cou ns el t o pr es entpor t i ons of t he tr i al t r ans cr i ptt o t he j ur yon a pr oj ect i on sc re e n d u rin g c lo sin g a rg u m e n ts. D u rin g c lo sin g a rg u m e n ts, c o u n se l f o r D r . N e b lett pr es ent ed por t i ons of t he tr i al tr an script , as pr epar ed byt he courtr epor t erbutnoty et c e rtifie d , o n a sc re e n a s p a rt o f h e r a rg u m e n t. C o u n se l f o r M s. S tan f

ield o b jec ted to th is pr i ort o t he us e of the tr ans cr i pt

. T he t r i al cour toverrul ed the obj ect i on and al l ow ed couns el f o r D r. N e b le tt to p ro c e e d

. “C l os i ng ar gum enti s a cruci al component of anyj ur yt r i al

. ” Mc Cro ry v . T rib b le , N o. W 2 0 0 9 -00 7 9 2 -C O A -R 3 -C V , 2 0 1 0 W L 1 6 1 0 8 5 7 , * 6 (T en n . C t. A p p . A p ri l 22 , 2 0 1 0 ). C l os i ng ar gum ent s al l ow couns el t o pr es ent t hei rt heoryof t he ca s e and t o poi ntouts t r engths and w eakne s s es i n t he evi dence

. “[C]ouns el i s gener al l ygi ven w i de l at i tude dur i ng cl os i ng a rg u m e n t, a n d th e tr ia l c o u rt is g ra n te d w id e d is c re tio n in c o n tr o llin g c l o s i n g a rg u m e n ts .” A n de rs o n v . S ta te , N o. E 2008- 00439- C C A

- R 3- PC , 2009 W L 2474673, * 6 ( Te n n . Cr i m A pp.-21-

A p ri l 13 , 2 0 0 9 ). A s w ith all o ther argu m en ts b y co u n sel, this C o u rt rev iew s the tr ial co u rt ’s d e c is io n s o n c lo s in g a rg u m e n ts u n d e r a n a b u s e o f d is c re tio n s ta n d a rd

. P erkins v. Sadler , 826 S

. W

. 2 d 4 3 9 , 4 4 2 (T en n . C t. A p p . 1 9 9 1 ). M s . St anfi el d cont ends t hatcouns el s houl d notbe al l ow ed t o di s pl ayunauthent i cat ed p o rtio n s o f

th e trial tra n sc rip t to th e ju ry d u rin g c lo sin g a rg u m e n ts. S h e h a s n o t p ro v id e d th is C our t , nor have w e found, any author i t y t o s uppor therpos i t i on. M s . St anfi el d ar gues t hat a p a rtyis pr o h ib ited f

ro m u sin g o th e rw ise in a d m iss ib le e v id e n c e d u rin g a c lo sin g a rg u m e n t. She i s corr ect

. H ow ever , t her e i s no i ndi cat i on i n t he r ecor d t hat t he t es t i m onypr es ent ed by D r . N ebl et t ’ s couns el w as i nadmi s s i bl e t es t i m ony . M s. S tanf iel d al s o r el i es on G odbee v. D im ic k, 213 S. W

. 3d 865, 875 ( T enn. C t

. A pp. 2006) , w her e t hi s C our t hel d t hat i t w oul d be im p ro p e r to a llo w w ritten tra n sc rip ts to b e tak e n in to th e ju ryro o m . W e a g re e th a t itw o u ld be i m pr operfort he j ur yt o t ake the tr i al t r ans cr i pti nt o t he j ur yr oom . H ow ever , t her e i s no in d ic a tio n th a t w a s d o n e in th is c a s e . I ti s w el l es t abl i s hed t hatt her e i s not hi ng w r ong w i t h r emi ndi n g the j ur yof t he te s tim o n y o f v a ri o u s w itn e s s e s in c lo s in g a rg u m e n t. P erkins v. Sadler , 826 S. W

. 2d at442. “[C]e r t ai nl yi n cl os i ng ar gum entone ca n pr oper l yut i l i ze a s um m at i on of t r i al t es t i m ony , and i ts houl d notbe i m pr operfort hi s t o be done i n a ques t i on ans w erfor m . ” I d . T h is i s e x a c tly w hat couns el for D r . N ebl et t w as at t empt i ng t o acc om pl i s h. She di s pl ay ed por t i ons of t he t r i al t r ans cr i ptt o the j ur yi n or dert o r emi nd t hem of t he t es t i m onygi ven. She chos e por t i ons of t he t es t i m onyt o emphasi ze t h e str en g ths of D r . N ebl et t ’ s t heoryof t he ca s e, and t he w ea k n esse s o f M s. S tanf iel d ’s th eo ry . C o u n sel fo r M s. S tanf iel d sim il arlyrem ind ed the ju ry o f c e r t a i n p o r t i o n s o f t h e t e s t i mo n y g i v e n i n h i s c l o s i n g a r g u me n ta n d r e b u t t a l f o rt h e s a me purpos e. H e, how ever , chos e not t o di s pl ayt he por t i ons of t he t es t i m onyt hathe vi ew ed as i m por t antt o his c ase an d ar gum ent

. W e have found no author i t yt o i ndi cat e thatcouns el shou l d n ot be abl e t o d i spl aypo rt i on s of t he tr anscri pt t o the j ury du ri ng cl osi ng argum ents

. In f a c t, T e n n e ss e e C o d e A n n o tate d § 2 0 -9 -3 0 3 p ro v id e s:

I n t he tr i al of anyci vi l s ui t , couns el forei t herpar t ys hal l be per m i t t ed t o us e a bl ackboa r d, m odel ors i m i l ardevi ce, al s o any pi ctur e, pl atorexhi bi ti nt r oduced i n evi d ence, i n connec t i on w i t h co u ns el ’ s ar gum entt o t he j ur yfort he purpos es of i l l us t r at i ng t he couns el ’ s cont ent i ons w i t h r es pect t o t he i s s ues th a t ar e to b e d e c id e d b yth e ju ry , p ro v id e d , th a t co u n se l sh a ll n o t, i n w riting , p re se n t a n y a rg u m e n t th a t c o u ld n o t b e p ro p e rly m a d e o r a l l y. C ouns el fo r D r. N ebl et tw as act i ng w i t hi n t he pr ovi s i ons of t hi s s t atut e. She di s pl ay ed por t i ons of t he tr i al t r ans cr i pti n or dert o m ak e the s ame ar gum ent s s he w oul d have be en-22-

al l ow ed t o m ake or al l y . C ons equent l y , w e do not fi nd t hat t he t r i al cour terr ed i n al l ow i ng c o u n s e l to d is p la yp o rt io n s o f th e tr ia l tr a n s c ri p t d u ri n g c lo s in g a rg u m e n ts

. A l s o i n r egar d t o cl os i ng ar gum ent s , M s . St anfi el d ar gues t hatt her e i s no w ayt o know w hethert he t r an scri pts how n w as acc ur at e as t he tr ans cr i pthad noty etbeen a ut hent i cat ed orcert i fi ed byt he courtr epor t er . W e not e thatthe r ecor d does notcont ai n a copyof w hat w as di s pl ay ed t o t he j ur y . W e have onl y t he t r ans cr i pt of t he cl os i ng ar gum ent s . Fr om our r evi ew of t he tr ans cr i pt, w e ca n n otdet er m i ne w hatw as di s pl ay ed as oppos ed t o w hatw as s i m pl ys t at ed byD r . N ebl et t ’ s couns el

. B ot h s i des conce de that w h at w as d is pl ay ed w as obt ai ned di r ect l y fr om t he cour t r epor t er . M or eover , couns el for M s . St anfi el d w as pr es ent w hen por t i ons of t he t r ans cr i ptw er e di s pl ay ed t o t he j ur y . A t no poi ntdi d he obj ectt o w hat w as bei ng di s pl ay ed ori ndi cat e on the re cor d t hathe bel i eved the tr ans cr i ptw as i nacc ur at e. Fur t her , R ul e 6 of the C our tof A ppeal s r equi r es M s. St anfi el d t o pr ovi de ci t at i ons t o t he r ecor d as t o w her e an a l l eged pr ej udi ce i s r ecor ded. M s . St anfi el d’ s br i ef pr ovi des no s uch ci t at i ons t o s uppor therar gum enttha tt he tr ans cr i pts how n w as i nacc ur at e ort hats he w as pr ej udi ced be caus e the t r ans cr i pt had not y et been cert i fi ed. A ccor di ngl y , w e ca nnotfi nd t hat sh e w as p rejud iced b y D r. N eb let t’ s u se o f p o rt ion s o f th e tran script du ri n g h is co u n sel’s c lo s in g a rg u m e n t. A lso in re g a rd to th e d isp lay of th e tr a n sc rip t, i t ap p e a rs th a t M s. S tan f ield o b jec ts beca us e the t es t i m onydi s pl ay ed w as t aken out o f co n text

. A s s t at ed above , cl os i ng arg u m en ts are a to o l u sed b y co u n sel to su m m arize their th eo ry o f the c ase , to rem ind the ju ry of t he evi dence s uppor t i n g their t heory , and al s o t o poi ntoutw eakne s s es i n t he oppos i ng couns el ’ s ar gum ent

. O ft en w hen doi ng s o, couns el w i l l r emi nd t he j ur yof a por t i on of a w i t nes s ’ t es t i m onyt hatfavor s t hei rcas e and not poi ntoutt es t i m onyt hatfavor s t he oppos i ng p a r ty . O p p o sin g c o u n se l h a s th e o p p o rtu n ityin h is o r h e r c lo sin g a rg u m e n t o r re b u ttal to poi ntoutt es t i m onyt hatw as notm ent i oned and make hi s or her ar gum entacc or di ngl y . T he fac tt hatt he t es t i m onyw as di s pl ay ed i ns t ead of m er el yr ead orpar aphr as ed does notchange w hatcouns el i s al l ow ed t o s t at e i n cl os i ng ar g u m en ts. A s not ed byt he tr i al cour t , any ar gum entt hatt he t es t i m onyw as bei n g ta ken outof cont extcoul d have pr oper l ybeen addr es s ed b y co u n s el i n r ebut t al

. T hi s i s the s ame m anneri n w hi ch couns el coul d have addr es s ed D r . N ebl et t ’ s ar gum ent , had hi s ar gum ent n o t b ee n di s pl ay ed, buti ns t ead made c o m p lete ly o ral l y . T herefore, w e do no tfi nd that the tr i al cou rtabu sed i t s di scr et i on in all o w ing co u n sel to d isplay p o rt ion s o f the tr ial tr an script, as p rep are d b ythe c o u rtrep o rt er, to th e ju ry d u ri n g c lo s in g a rg u m e n ts

. V . C onc l us i on F o r th e f o re g o in g re a so n s, w e a f f irm a ll a sp e c ts of th e trial c o u rt’s ju d g m e n t. C o sts o f th is a p p e a l a re ta x e d a g a in s t th e A p p e lla n t, T e re s a L yn n S ta n f ie ld , a n d h e r s u re ty.-23- ___________________________________ J. STEVEN ST AFF ORD, J.