Case Title: Stottlemyer v. Ghramm

Citation: 

Docket Number: 031613

State: virginia

Court: Virginia Supreme Court

Date: 2004-06-10T00:00:00Z

Document:
Present:  All the Justices 
 
CAROLYN STOTTLEMYER 
 
 
      OPINION BY CHIEF JUSTICE LEROY R. HASSELL, SR. 
 
v.  Record No. 031613 
 June 10, 2004 
 
JOHN W. GHRAMM, M.D., ET AL. 
 
FROM THE CIRCUIT COURT OF THE CITY OF WINCHESTER 
John J. McGrath, Jr., Judge 
 
I. 
 
 
In this appeal of a judgment entered in favor of health 
care providers who were defendants in a medical negligence 
action, we consider whether the circuit court erred by 
refusing to permit the plaintiff to cross-examine the 
defendant physician regarding his alleged prior acts of 
negligence and misconduct. 
II. 
 
Plaintiff, Carolyn Stottlemyer, filed her motion for 
judgment against John W. Ghramm, M.D., and Winchester Medical 
Center, Inc.  She alleged in her motion for judgment that both 
defendants breached the standard of care owed to her during 
the performance of an abdominal hysterectomy at a hospital 
known as the Winchester Medical Center.  Plaintiff alleged 
that the Winchester Medical Center, Inc., which operates the 
hospital, knew or should have known that Dr. Ghramm should not 
have been granted privileges to practice medicine at the 
hospital prior to the surgery and that he should not have been 
 
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permitted to perform the surgery on plaintiff.  Stottlemyer 
also alleged that Winchester Medical Center breached the 
standard of care owed to her because it failed to adequately 
supervise Dr. Ghramm. 
 
Winchester Medical Center filed a demurrer to plaintiff's 
motion for judgment.  The circuit court sustained the demurrer 
on the basis that a hospital does not have a duty to supervise 
a physician who is an independent contractor using the 
hospital's facilities.  The circuit court granted plaintiff 
leave to amend her purported cause of action for negligent 
credentialing.  Plaintiff filed an amended motion for judgment 
and alleged that Winchester Medical Center breached the 
standard of care owed to her because it was negligent in the 
credentialing process for Dr. Ghramm.  Plaintiff also alleged 
in her motion that Dr. Ghramm committed acts of negligence 
related to the performance of the procedure upon her. 
 
Prior to a jury trial, the Winchester Medical Center 
filed a motion to sever plaintiff's actions against it and Dr. 
Ghramm.  The circuit court ruled that the plaintiff's cause of 
action for medical negligence against Dr. Ghramm would be 
bifurcated from plaintiff's claim of negligent credentialing 
against the Winchester Medical Center.  The circuit court also 
ruled that plaintiff was required to present her case of 
negligence against Dr. Ghramm, and if the jury found that 
 
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Ghramm was negligent, the plaintiff would be permitted to 
present her case against the Winchester Medical Center and Dr. 
Ghramm for the alleged acts of negligent credentialing. 
 
During the trial, plaintiff contended that Dr. Ghramm 
failed to take her medical history and failed to conduct a 
physical examination of her at the hospital before the 
abdominal hysterectomy.  Dr. Ghramm had performed a different 
surgical procedure on the plaintiff a year before he performed 
the abdominal hysterectomy.  Plaintiff's expert witness 
testified that the records of the plaintiff's medical history 
that Dr. Ghramm claimed he took from plaintiff and records of 
the physical examination that Dr. Ghramm claimed that he 
performed on plaintiff related to the abdominal hysterectomy 
"seemed to match the history and physical condition" of the 
plaintiff during her prior surgery.  Plaintiff's expert 
witness also testified that the medical history that Dr. 
Ghramm claimed he took from plaintiff and the records of the 
physical examination Dr. Ghramm claimed he performed were 
inconsistent with the records recorded by the nursing staff at 
the time of the abdominal hysterectomy.  Plaintiff also 
claimed that Dr. Ghramm had not obtained her informed consent 
to perform the abdominal hysterectomy. 
Dr. Ghramm testified that he took the plaintiff's medical 
history and conducted a physical examination of her at the 
 
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hospital "just before" he performed the abdominal 
hysterectomy.  Dr. Ghramm stated that he had met with the 
plaintiff in his office about two months before he performed 
the abdominal hysterectomy and that she signed an informed 
consent form.  Dr. Ghramm testified about the manner in which 
he performed the surgery, and he discussed a consent form that 
"purported to be witnessed by a woman who had been an 
assistant in his office."  The woman, however, did not testify 
during the trial. 
Plaintiff attempted to cross-examine Dr. Ghramm about 
certain alleged "prior bad acts" he had committed.  Plaintiff 
sought to cross-examine Dr. Ghramm about the following:  
whether Dr. Ghramm had previously made improper alterations of 
medical records; whether the State Board of Medicine had made 
a finding that Dr. Ghramm had modified medical records; 
whether Dr. Ghramm had ever abandoned a patient; whether Dr. 
Ghramm had admitted to the State Board of Medicine that he had 
provided care beneath the standards required by a hospital; 
whether the State Board of Medicine had reprimanded Dr. Ghramm 
for improper conduct; whether a hospital had suspended Dr. 
Ghramm's medical staff privileges; whether a hospital had 
granted Dr. Ghramm medical staff privileges conditioned upon 
his submission to supervision by other physicians; whether Dr. 
Ghramm had ever lied about prior reprimands or suspensions on 
 
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his applications for hospital medical staff privileges; 
whether a psychiatrist made a finding that Dr. Ghramm was not 
fit to practice medicine in a hospital setting; whether a 
hospital had required Dr. Ghramm to receive psychiatric care 
and counseling as a condition for the continuation of his 
medical staff privileges at that hospital; and whether Dr. 
Ghramm had consented to the State Board of Medicine's findings 
of 19 prior acts of improper conduct in the hospital. 
 
Plaintiff made an evidentiary proffer in support of these 
assertions.  The circuit court refused to permit plaintiff to 
cross-examine Dr. Ghramm on these subjects and, thus, the jury 
did not consider this evidence.  At the conclusion of the 
trial, the jury returned a verdict in favor of Dr. Ghramm.  
The circuit court entered an order confirming the verdict and 
dismissed plaintiff's claims for negligent credentialing 
against Dr. Ghramm and the hospital.  Plaintiff appeals. 
III. 
 
Plaintiff argues that the right to cross-examine a 
witness is "fundamental to jurisprudence" and that she was 
deprived of this right during her trial.  Continuing, she 
contends that she was entitled to cross-examine the defendant 
about his alleged prior acts of negligence and misconduct that 
we have summarized.  Plaintiff asserts that she was entitled 
to cross-examine him about his alleged prior bad acts to 
 
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impeach his credibility.  She also claims that the circuit 
court's refusal to permit her to cross-examine Dr. Ghramm on 
these subjects denied her the right to cross-examination.  We 
disagree. 
 
In this Commonwealth, the rule is well established that a 
litigant may not cross-examine a witness about collateral 
independent facts irrelevant to the issues before the trier of 
fact.  Clark v. Commonwealth, 202 Va. 787, 789, 120 S.E.2d 
270, 272 (1961); Allen v. Commonwealth, 122 Va. 834, 841, 94 
S.E. 783, 785 (1918).  We have stated the following principles 
that are pertinent to our resolution of this appeal: 
 
"It is an elementary rule that the evidence 
must be confined to the point in issue, and hence 
evidence of collateral facts, from which no fair 
inferences can be drawn tending to throw light upon 
the fact under investigation, is excluded, the 
reason being . . . that such evidence tends to draw 
away the minds of the jurors from the point in 
issue, and to excite prejudice and mislead 
them . . . ." 
 
Jackson v. The Chesapeake & Ohio Ry. Co., 179 Va. 642, 648, 20 
S.E.2d 489, 491 (1942) (quoting Moore v. Richmond, 85 Va. 538, 
539, 8 S.E. 387, 388 (1888)).  Accord PTS Corp. v. Buckman, 
263 Va. 613, 620, 561 S.E.2d 718, 722 (2002); Spurlin v. 
Richardson, 203 Va. 984, 990, 128 S.E.2d 273, 278 (1962). 
 
We held in Allen, 122 Va. at 842, 94 S.E. at 786, that:  
"The test as to whether a matter is material or collateral, in 
the matter of impeachment of a witness, is whether . . . the 
 
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cross-examining party would be entitled to prove it in support 
of his case."  We have also stated that "[a] fact is wholly 
collateral to the main issue if the fact cannot be used in 
evidence for any purpose other than for contradiction."  
Seilheimer v. Melville, 224 Va. 323, 327, 295 S.E.2d 896, 898 
(1982). 
 
Applying the aforementioned principles, we hold that the 
circuit court did not err by denying plaintiff's attempts to 
cross-examine Dr. Ghramm about his alleged prior acts of 
misconduct and negligence relating to his former patients.  
The subjects of testimony upon which the plaintiff sought to 
cross-examine Dr. Ghramm were collateral, and such testimony 
would have certainly injected non-probative prejudicial 
evidence before the jury.  This collateral evidence would have 
distracted the jurors from the issues of Dr. Ghramm's alleged 
negligence, and such evidence would have excited prejudice and 
misled the jurors.  Even though a plaintiff has a right to 
cross-examine a defendant on relevant subjects of inquiry, 
that right does not permit the plaintiff to cross-examine that 
defendant on collateral matters. 
 
Plaintiff also argues that the circuit court erred 
because it denied her an opportunity to cross-examine Dr. 
Ghramm and demonstrate "his pattern and history of substandard 
care."  Plaintiff contends that she should have been entitled 
 
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to cross-examine Dr. Ghramm about the State Board of 
Medicine's findings of "his poor performance in a hospital 
setting" and the Board's reprimand.  Plaintiff asserts that 
Ghramm's alleged "prior bad acts" were relevant to the proof 
of allegations in plaintiff's cause of action and, therefore, 
such evidence should have been admitted at trial.  We 
disagree. 
 
Generally, specific acts of bad conduct or prior acts of 
negligence are not relevant or admissible to show that a 
defendant was negligent and that such negligence was a 
proximate cause of a plaintiff's injuries.  Evidence that a 
defendant was negligent on a prior occasion simply has no 
relevance or bearing upon whether the defendant was negligent 
during the occasion that is the subject of the litigation.  
Cherry v. D.S. Nash Construction Co., 252 Va. 241, 244, 475 
S.E.2d 794, 796 (1996). 
In this case, the issues before the jury were whether Dr. 
Ghramm performed an abdominal hysterectomy upon the plaintiff 
in accordance with the applicable standards of care and 
whether Dr. Ghramm obtained her informed consent for that 
procedure.  Dr. Ghramm's alleged prior bad acts and his 
alleged prior acts of negligence related to other patients 
simply had no relevance to the issues that were before the 
jury for its consideration.  Therefore, we hold that the 
 
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circuit court properly refused to permit the plaintiff to 
cross-examine Dr. Ghramm about these alleged bad acts.  
Additionally, we note that Dr. Ghramm's alleged prior bad acts 
do not constitute evidence of habit or routine practice within 
the intendment of Code § 8.01-397.1. 
IV. 
In summation, we hold that the circuit court properly 
limited the scope of plaintiff's cross-examination of Dr. 
Ghramm because plaintiff did not have a right to cross-examine 
a witness on collateral matters.  The circuit court also 
properly refused to permit plaintiff to cross-examine Dr. 
Ghramm about his alleged prior bad acts and alleged acts of 
negligence against other patients because such testimony was 
neither relevant nor probative to the issues properly before 
the jury.  In view of our holdings that evidence plaintiff 
sought to elicit during her cross-examination of Dr. Ghramm 
was not admissible, we conclude that the circuit court did not 
abuse its discretion when it bifurcated the trial.  We need 
not consider whether plaintiff had causes of action against 
Winchester Medical Center for negligent supervision or 
negligent credentialing because the jury found that Dr. Ghramm 
was not negligent and, therefore, those issues are moot.  
Accordingly, we will affirm the judgment of the circuit court. 
Affirmed.