RedactedNarrative: On May 31, 2020, the party were in around Edgar Evins boat ramp pulling a tube.  Victim 1 was on the tube around 16:30 when she fell off the tube. She did not notice any immediate injuries, but approximately 10 minutes later she complained of a headache.  Minutes later she was unconscious.  The operator, Operator 1, took her to Edgar Evins and called for help.  State Park Rangers arrived to assist.  Victim 1 was airlighted to Vanderbilt University Hospital.  She had substantial swelling of the brain, to the degree they performed surgery to remove a portion of the skull to relieve pressure.  She stayed a few days in the hospital until injuries healed.  TWRA was not notified until hours later of the incident.  All parties were already away from the scene when the agency was aware of the events.  I made contact with parties involved and to family of Victim 1.