Wednesday, March 21, 2007

Tina A. Hall v. UMMS (Ct. of Appeals)

Filed March 21, 2007 -- Opinion by Judge Robert Bell.

Issue: Whether notes contained in the hospital record of a pregnant mother were hearsay and/or not pathologically germane in a medical malpractice case brought by the child who was born of the pregnancy.

Held: The Circuit Court erred in excluding the records because they were admissible under the business records exception to the hearsay rule and because they were pathologically germane.

Facts/Court Analysis: Plaintiff "Teonna" is the minor biological daughter of Joyce Boyce. Plaintiff was born on November 12, 1992 with, among other things, cerebral palsy, mental retardation, and developmental delay. Teonna claimed that her conditions were caused by defendant's delay in performing a c-section on her mother. "The parties agreed that liability was dependent on one factor - when appellant's mother presented and was treated at the hospital." Teonna claimed that her mother had first arrived at defendant hospital at 12:30 am on November 12, 1992, complaining of abdominal pain. Defendant UMMS claimed that Teonna's mother first presented at 6:45 am.

In attempting to establish her case, plaintiff sought to introduce records from defendant hospital indicating that her mother had presented to defendant hospital at 2:00 am on November 12, 1992. These records were prepared by physicians at the end of their shift on November 12 (at approximately 4:45 pm and at approximately 5:00 pm). The recording physicians each testified at deposition that the information in their notes came from a person with personal knowledge of Teonna's history. The lower court held that the records were inadmissible as hearsay and that they were not pathologically germane.

The Court of Appeals reversed, holding that the records were admissible under the business record exception to the hearsay rule. While generally a determination of admissibility is left to sound discretion of the trial court, where it involves a legal determination, the decision will be reviewed de novo. A trial court's decision to exclude evidence based on hearsay is generally a decision of law and is to be reviewed de novo. Ordinarily, hospital records will be admitted as an exception to the hearsay rule. Notes made at the end of a doctor's shift "are within the meaning contemplated by the words in Rule 5-803(B)(6)(A) 'at or near the time.'" Any issues regarding the recording physicians personal knowledge of the facts contained in the notes goes to the weight of the evidence and not its admissibility. Finally, the discrepancy between the mother's testimony of arriving at the hospital at 12:30 am and the information in the notes that the mother arrived at 2:00 am was not so serious as to indicate a lack of trustworthiness sufficient to exclude the evidence.

The Court of Appeals also found that the information in the notes was pathologically germane. To be pathologically germane, information "'must fall within the broad range of facts which under hospital pracitice are considered relevant to the diagnosis or treatment of the patient's condition.'" "As a general proposition, we fail to understand how the medical treatment of the mother of an unborn baby within hours before delivery is not pathologically germane to the treatment of an unborn (or newborn) baby."

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