Williams v. McClain
| Decision Date | 13 February 1987 |
| Citation | 520 A.2d 1374,513 Pa. 300 |
| Parties | Jean Baker WILLIAMS, Appellant, v. Edward J. McCLAIN, M.D., Appellee. |
| Court | Pennsylvania Supreme Court |
Ronald N. Heck, Patrick J. Shannon, Pittsburgh, for appellee.
Before NIX, C.J., and LARSEN, McDERMOTT, HUTCHINSON and ZAPPALA, JJ.
The plaintiff in the trial below, Jean Baker Williams, appeals by allowance an order of Superior Court, 345 Pa.Super. 633, 496 A.2d 861, affirming the Court of Common Pleas of Allegheny County, which denied plaintiff's motion for a new trial. In affirming Common Pleas, Superior Court held that the medical opinion of a social worker contained in a hospital report on Williams was admissible under the Uniform Business Records as Evidence Act, 42 Pa.C.S. § 6108 (Business Records Act). The social worker was not called to testify. The report involved out of court statements made by Williams to the social worker as well as the expression of an opinion by the social worker, an unqualified witness, based on those out of court statements. She recorded admissions by appellant concerning cause of pain and financial difficulties, and based on these admissions, the absent social worker opined in the report that appellant's problems were caused by matters which were independent of her medical treatment and pre-existed that treatment. Causation was a key issue in the case. The admission into evidence of an opinion contained in this report under the Business Records Act is inconsistent with prior decisions of this Court concerning this exception to the hearsay rule. 1 We therefore reverse Superior Court and remand for a new trial.
Jean Baker Williams was born with a congenital dislocated hip. Before meeting with Dr. Edward McClain about this problem she had seen several physicians between 1962 and 1969. During this time she underwent at least four surgical procedures. In December, 1969, Williams visited McClain about her problem, which included pain in the affected hip and a disparity in the length of her legs. An operation was performed on June 4, 1970, and a McKee-Ferrar type prosthesis 2 was implanted in place of her right hip. After the operation, Williams continued to experience pain. To alleviate this problem a second operation, which replaced the McKee-Ferrar with a Minneapolis implant, was performed on September 4, 1970. After this operation an infection developed, and several additional procedures were also needed to alleviate a bleeding problem that had developed as a result of the operation.
Williams brought a medical malpractice action against McClain on June 3, 1975. Her lawsuit was based on two distinct theories. The first was that McClain had been negligent when performing the operations. Second, Williams asserted that McClain was liable for her injuries because he did not provide a sufficient explanation of the risks involved in the procedures used, and the alternatives available. Thus, she could not give an informed consent to the operations. She contends that as a result of McClain's breach of duty the pain in her hip is far more severe than before the operations, and that her right leg no longer functions effectively. She also alleges she has become a drug addict as a result of this pain, and that addiction has led to financial difficulty. In 1981, a jury found Dr. McClain not liable. Williams filed a motion for a new trial which was denied on December 17, 1981. She then appealed to Superior Court which affirmed the decision of the trial court on April 19, 1985.
The first issue raised on appeal before this Court deals with the admissibility of a social worker's report. Williams argues that the report was erroneously admitted into evidence. The contents of the disputed report read as follows:
Avocational interests, sewing and church activities, attitude toward illness. Mrs. Williams has had severe hip problems during the years when she had no family and financial problems and, well, she now blames all of her social problems on the constant hip pain, numerous hospitalizations and surgeries which had combined to make her life miserable for too many years, she said.
Current Social Situation. Mrs. Williams revealed instability and frustration when discussing her environmental circumstances which must contribute to much aggravating stress for the patient possibly aggravating the existing physical problem. She had been married twice with both men deserting her to raise three boys by herself. The sons are now grown with two married and one in the service. Mrs. Williams is very attached to the boys and to her elderly parents who live in Greensburg. Financial worries have haunted the patient for years she said with an income limited to the Social Security disability because she has not been able to work steadily due to hip pain. With her many medical expenses and unemployment Mrs. Williams acquired two new large debts and is now faced with bankruptcy and sheriff sales of her house.
(R. 481-483) (emphasis supplied).
Superior Court justified the admission of this report under the Business Records Act. 42 Pa.C.S. § 6108. This Act states in pertinent part:
General Rule.--A record of an act, condition or event shall, insofar as relevant, be competent evidence if the custodian or other qualified witness testifies to its identity and the mode of its preparation, and if it was made in the regular course of business at or near the time of the act, condition or event, and if, in the opinion of the tribunal, the sources of information, method and time of preparation were such as to justify its admission.
Superior Court, citing Isaacson v. Mobil Propane Corporation, 315 Pa.Superior Ct. 42, 461 A.2d 625 (1983), applied a three part test and concluded that the social worker's report was admissible. The Isaacson court summarized this three part test:
A medical record is admissible under the business records exception to the hearsay rule if the report: (1) was made contemporaneously with the events it purports to relate, (2) at the time the report was prepared, it was impossible to anticipate reasons which might arise in the future for making a false entry in the original, and (3) the person responsible for the statements contained in the report is known.
Isaacson, supra, 315 Pa.Superior Ct. at 49, 461 A.2d at 629. See also Paxos v. Jarka Corporation, 314 Pa. 148, 171 A. 468 (1934) (applying similar test).
These three factors are helpful in determining whether a business record is admissible. A report that contains nothing but facts, and meets this three part test may be admissible under the Business Records Act. Simply meeting these three factors, however, does not guarantee the admissibility of a record under the Business Records Act.
The basic justification for the business records exception to the hearsay rule is that the purpose of keeping business records builds in a reliability which obviates the need for cross-examination. Fauceglia v. Harry, 409 Pa. 155, 185 A.2d 598 (1962) (citing 5 Wigmore, Evidence, § 1632 at 514 (3d. ed. 1940)).
Under this exception, hospital records have been admitted to show the fact of hospitalization, treatment prescribed, and symptoms found. Commonwealth v. DiGiacomo, 463 Pa. 449, 345 A.2d 605 (1975), Platt v. John Hancock Mutual Life Insurance Company, 361 Pa. 652, 66 A.2d 266 (1949). As Superior Court noted in Commonwealth v. Seville, 266 Pa.Superior Ct. 587, 405 A.2d 1262 (1979):
No such doubts as to reliability and accuracy are entertained when a record is offered merely to prove facts, such as the event of hospitalization, treatment prescribed, symptoms, given, or the existence of some readily ascertained substance or chemical within the body.
This Court, however, has consistently held that opinion evidence contained in hospital records is inadmissible. Commonwealth v. DiGiacomo, supra; Jones Appeal, 449 Pa. 543, 297 A.2d 117 (1972); see also Morris v. Moss, 290 Pa.Superior Ct. 587, 593, 435 A.2d 184, 187 (1981) (). In DiGiacomo, supra, we held that the medical diagnosis of a licensed physician was inadmissible because the unavailability of the physician for cross-examination raised doubts as to the reliability of the diagnosis contained in the report. DiGiacomo, 463 Pa. at 455-56, 345 A.2d at 608.
The social worker's report in this case contains opinion evidence. 3 It states in part, "Mrs. Williams revealed instability and frustration when discussing her environmental circumstances which must contribute to much aggravating stress for the patient, possibly aggravating the existing problem." Not only is the social worker not available for cross-examination, there is no evidence to show that she is in any way qualified to make the diagnosis she made. The social worker determined that the pain in Williams's leg may have a psychosomatic source, and that Williams was unstable and frustrated. Clearly her opinion was beyond the knowledge of the average layman. It would, therefore, have to be established that she is "one who because of the possession of knowledge not within ordinary reach is specifically qualified to speak upon the subject to which [her] attention is called." Steele v. Shepperd, 411 Pa. 481, 483-84, 192 A.2d 397, 398 (1963) (quoting Struthers v. Philadelphia and Delaware County Railroad Co., 174 Pa. 291, 298, 34 A. 443 (1896)). See also Dambacher By Dambacher v. Mallis, 336 Pa.Superior Ct. 22, 36, 485 A.2d 408, 415 (1984) McCormick on Evidence 33 ). There is no evidence in the record from which the trial court could have reasonably inferred that this social worker had sufficient expertise in the field of psychiatry or psychology for her opinion to be of any relevant...
To continue reading
Request your trial
-
Sprague v. Walter
...hospital records is inadmissible where the physician who authored those records is unavailable for cross-examination. Williams v. McClain, 513 Pa. 300, 520 A.2d 1374 (1987). The medical diagnosis of a licensed physician contained in hospital records is evidence of this type. Id. However, un......
-
Braun v. Wal–mart Stores Inc.
...for independent business purposes are not self-serving or created for litigation. As stated by the Supreme Court in Williams v. McClain, 513 Pa. 300, 520 A.2d 1374 (1987): “... the basic justification for the business records exception to the hearsay rule is that the purpose of keeping busi......
-
Braun v. Wal-Mart Stores Inc.
...for independent business purposes are not self-serving or created for litigation. As stated by the Supreme Court in Williams v. McClain, 513 Pa. 300, 520 A.2d 1374 (1987): ". . . the basic justification for the business records exception to the hearsay rule is that the purpose of keeping bu......
-
Duquesne Light Co. v. Woodland Hills School Dist.
...a report which is prepared as a business record is an exception to the hearsay rule and is generally admissible. Williams v. McClain, 513 Pa. 300, 520 A.2d 1374 (1987). In Pennsylvania, the admissibility of a business record is governed by 42 Pa.C.S. § 6108 which A record of an act, conditi......