Hansen v. Heath
| Decision Date | 23 April 1993 |
| Docket Number | No. 920225,920225 |
| Citation | 852 P.2d 977 |
| Parties | Gail O. HANSEN, Plaintiff and Appellant, v. John HEATH, Personal Representative of the Estate of James Woo, Deceased, Defendant and Appellee. |
| Court | Utah Supreme Court |
John Farrell Fay, Jim Mouritsen, Mitchell R. Jensen, Salt Lake City, for plaintiff.
Roger H. Bullock, Salt Lake City, for defendant.
Plaintiff Gail Hansen appeals a jury verdict of no cause in her action to recover for injuries sustained in an automobile accident involving James Woo. 1 We affirm.
On July 15, 1988, Hansen was injured when Woo's vehicle struck her vehicle from behind. At the time of the accident, Woo, then 78 years old, was returning from a doctor appointment at the Veteran's Administration Hospital ("VA"), where he was receiving on-going treatment for shortness of breath associated with lung and heart disease. Woo's medical records revealed that on the day of the accident, his condition was improving and he was sent home with no restrictions on driving.
At the accident scene, paramedics examined Woo and later noted in their report that Woo had possibly suffered a syncopal episode. A syncopal episode occurs when a person suddenly loses consciousness without warning. It appears that Woo did not volunteer any information to the paramedics concerning any loss of consciousness. Instead, the paramedics reached that conclusion independently.
Shortly after the accident, Woo was transported to the VA, where he told his treating physician that he had suddenly lost consciousness without warning and that he remembered nothing about the accident until a woman was pulling him from his car after the collision. Woo's physician diagnosed his condition as "syncope and CHF (coronary heart failure)." Woo was admitted to the hospital for six days and received treatment for the syncopal episode.
Hansen filed a complaint on February 3, 1989, alleging that Woo negligently caused the accident that injured her. Woo responded and set forth the affirmative defense that he had suddenly and without prior warning lost consciousness at the time of the accident and was therefore not liable for Hansen's injuries. 2 Woo died six months after the complaint was filed. He was never deposed.
Prior to trial, Hansen filed a motion to strike and a motion in limine to exclude Woo's statement to his treating physician that he blacked out prior to the accident. Hansen claimed that because Woo was no longer alive, the statement was inadmissible hearsay under Utah Rule of Evidence 802 and did not qualify as an exception to the hearsay rule.
The trial court denied Hansen's motions. The court permitted Heath's expert, Dr. Freedman, to testify regarding not only the medical record that included Woo's actual statement, but several other subsequent medical records indicating the syncope diagnosis. Freedman also testified that Woo's medical records and actions were consistent with a blackout, which was most likely caused by a condition known as "ventricular tachycardia," meaning a rapid heartbeat.
The jury returned a verdict for Heath, finding that Woo had suffered a blackout that absolved him of liability for the accident. Hansen now appeals. She raises several issues, including claims that the trial court erred by (1) allowing the medical record containing Woo's statement into evidence through Freedman's testimony, and (2) permitting Freedman to testify as to Woo's other medical records indicating a syncope diagnosis.
The issues presented concern the admissibility of evidence under Utah Rules of Evidence 802 and 803. Our past cases inconsistently apply the standard of review to trial court rulings under these provisions. 3 The difficulty arises because the exceptions to the hearsay rule listed in rule 803 vary as to whether the trial court's analysis involves a factual or legal determination or some combination thereof. 4 Therefore, the appropriate standard of review of a trial court's decision admitting or excluding evidence under rules 802 and 803 depends on the particular ruling in dispute.
This case concerns rule 803(4), which allows admission of statements made for "purposes of medical diagnosis and treatment." Whether a statement was made for purposes of medical diagnosis or treatment is a mixed question of law and fact. On the one hand, it involves a factual determination that the statement was indeed made to aid medical diagnosis. This court will not overrule a trial court's factual findings unless they are clearly erroneous. 5
On the other hand, Hansen also challenges the trial court's legal determination that Woo's statement is admissible even though it is exculpatory in nature. As we have previously stated, we review legal determinations for correctness. 6
At trial, Heath presented the medical record containing Woo's statement to his treating physician following the accident. The medical record states in pertinent part, This testimony strongly supported Heath's assertion that Woo suffered a syncopal episode that absolved him of liability for the accident. The jury evidently believed that to be the case and returned a verdict for Heath. Hansen claims on appeal that the trial court erred in admitting Woo's statement and that the error was prejudicial.
Hansen asserts that Woo's statement constitutes inadmissible hearsay that does not qualify for any of the exceptions to the hearsay rule. Utah Rule of Evidence 802 forbids the admission of hearsay evidence, 7 and rules 803 and 804 provide exceptions to the hearsay rule. 8 Heath claims that Woo's statement is admissible under the hearsay exception found in rule 803(4). That rule states:
The following are not excluded by the hearsay rule, even though the declarant is available as a witness:
....
(4) Statements for purposes of medical diagnosis or treatment. Statements made for purposes of medical diagnosis or treatment and describing medical history, or past or present symptoms, pain, or sensations, or the inception or general character of the cause or external source thereof insofar as reasonably pertinent to diagnosis or treatment.
Rule 803(4) was adopted verbatim from Federal Rule of Evidence 803(4). 9 Therefore, reference to federal cases and the Advisory Committee Note to Federal Rule of Evidence 803(4) is pertinent to give meaning and effect to the Utah rule. 10
To qualify as an exception to the prohibition against the use of hearsay testimony at trial, a statement to a physician must satisfy two elements: (1) The statement must be made with an intent to facilitate medical diagnosis or treatment, and (2) the statement must in fact be reasonably pertinent to diagnosis or treatment. 11 If the statement meets both qualifications, it is admissible because of the "patient's strong motivation to be truthful" when discussing his or her medical condition with a doctor. 12 Such statements carry a "guarantee of trustworthiness" entitling them to an exception from the mandates of the hearsay rule. 13
In admitting Woo's statement contained in the medical record, the trial court relied on rule 803(4). The court reasoned:
The Court is going to permit the medical records. The Court agrees with [Heath's] view of Rule 803. There's a built-in safeguard. A patient has an interest in having their [sic] medical needs treated. And trying to mislead or make incorrect statements to a physician, I think, is not the motive that you'd expect the patient to give the doctor. So, I think there's a reasonable safeguard as to that statement.
We agree with the trial court's ruling and the reasoning supporting it. Woo made the declaration to his treating physician immediately after being transported from the accident scene to the VA. His physician transcribed the statement in her own handwriting. The statement reflected Woo's medical condition at the time of the accident, something a concerned patient would undoubtedly want to share with his or her doctor. Hence, it was made with intent to facilitate medical diagnosis and treatment. Furthermore, losing consciousness suddenly would undoubtedly prompt medical attention, and any information concerning the episode is reasonably pertinent to diagnosis and treatment. 14 We therefore find ample record evidence that the statement was made for the purpose of medical diagnosis and treatment, and we will not disturb the trial court's ruling on the matter.
Hansen also suggests that Woo's statement is inherently untrustworthy because it is self-serving and because Woo could have contrived his "story" about passing out before the accident while in the ambulance on the way to the VA. Although the declaration was ultimately exculpatory, it also expressed a past or present symptom, which is admissible under rule 803(4). A statement that qualifies for a hearsay exception should not be stricken merely because it is self-serving unless there is substantial doubt about its trustworthiness. 15
At the time of the accident, Woo was 78 years old, was ailing, and had difficulty expressing himself in English. It is doubtful that he knew that, as a matter of law, unconsciousness could absolve him of liability, much less that he had the wherewithal to fabricate a story while in the back of an ambulance. Woo's statement engenders no inherent lack of trustworthiness; on the contrary, we believe the trial court was correct in ruling that it is a reliable declaration, qualifying for exemption from the hearsay rule under section 803(4).
Hansen complains that the medical record containing Woo's initial statement and his subsequent records referring to syncope are inadmissible hearsay because Woo's treating physician was not available to lay the proper foundation for the records and again...
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