Tsuna apologizes for turning down the title of boss, but Timoteo understands him and thinks that he should be successful in life and to have more confidence in himself. Suddenly, one of the Timoteo's guardians informs Tsuna that there is a call for him from Gokudera, saying that there is an emergency. Gokudera informs Tsuna of what happened to Yamamoto.
Tsuna and Reborn immediately head to the hospital where a seriously injured Yamamoto is being operated on. Tsuna, his Guardians, and the Simon Famiglia sit together and wait. The Simon family thinks that the one who attacked Yamamoto are the same one who attacked the Giegue Famiglia. Just then, Reborn arrives and informs them that he found a clue in the locker room. Reborn asks the Simon Family to leave for a while since they are going to talk about Vongola's secret information and to be careful since they might be attacked as well. Reborn informs the Vongolas that Yamamoto left a writing in blood which he translated to sin. Reborn continues to explain about the Vongola Sin and that it must be the culprit's motive. Reborn tells them that the only time the Sin appears is during the Inheritance Ceremony. Tsuna, furious at what happened to Yamamoto, decides to go to the ceremony so he could catch the culprit.
*Note: Bold + Italicized = First Appearance