Case Title: Arnold v. Wallace

Citation: 

Docket Number: 

State: virginia

Court: Virginia Supreme Court

Date: 2012-04-20T00:00:00Z

Document:
PRESENT:  All the Justices 
 
MARY ARNOLD 
 
 
 
 
  
     
 
      OPINION BY  
v. 
Record No. 110394 
 
 
    JUSTICE WILLIAM C. MIMS 
 
 
 
 
 
 
 
 
     April 20, 2012 
JONATHAN PETER WALLACE, ET AL. 
 
FROM THE CIRCUIT COURT OF FAIRFAX COUNTY 
Jan L. Brodie, Judge 
 
 
In this appeal, we consider whether the circuit court erred 
in admitting medical records under the business records 
exception and finding an expert physician qualified to testify 
when her partner previously had been retained by the opposing 
party. 
I. BACKGROUND AND PROCEEDINGS BELOW 
 
Mary Arnold was injured in an automobile collision on April 
28, 2005.  She brought a negligence action against the other 
driver, Jonathan Peter Wallace, who was uninsured.  Travelers 
Insurance Company, Arnold’s carrier, defended the suit pursuant 
to its uninsured motorist coverage.  The matter was tried to a 
jury, which awarded a verdict for Arnold in the amount of 
$9,134.61.  Arnold appealed to this Court, assigning error to 
two of the circuit court’s rulings. 
II. MEDICAL RECORDS EXHIBIT 
 
Arnold’s first assignment of error relates to the 
introduction into evidence of her medical records from her 
treating physicians.  The records contained hearsay opinions 
related to her pre-existing physical conditions. 
In her case-in-chief, Arnold called Dr. Charles Gardner, 
her treating physician following the collision.  Dr. Gardner 
testified that Arnold had been a patient of his practice group, 
Northern Virginia Family Practice Associates (“NVFP”), since 
approximately 1994.  A week after the collision, Arnold 
presented to Dr. Gardner complaining of neck and back pain, 
headaches, nausea, and vomiting.  According to Dr. Gardner, 
Arnold’s neck and back pain was caused by the collision, since 
it “started at the moment that she had had the automobile 
accident.”  He testified that an MRI revealed spinal stenosis,1 
as well as bone edema,2 which he opined was caused by the 
collision.  He also diagnosed her with post-concussion syndrome.3 
 
Wallace asked Dr. Gardner on cross-examination about a 
patient’s medical records or “chart” maintained by NVFP.  Dr. 
Gardner confirmed that each patient had a single chart and that 
when a patient had an appointment with the practice she was not 
necessarily seeing one specific physician.  The treating NVFP 
                         
1 Spinal stenosis, according to Dr. Gardner, is a condition 
somewhat like advanced arthritis, caused by the “closing down” 
of space between the bones through which the spinal nerves pass. 
2 Dr. Gardner explained that “bone edema” was “like a bone 
bruise” and “shows up when you have an acute injury to the 
bone.” 
3 Dr. Gardner defined post-concussion syndrome as a series 
of symptoms following a brain trauma, including headache, 
confusion, speech difficulties, nausea, vomiting, and ataxia. 
physician would utilize that chart for a returning patient and 
add to it following the appointment.  According to Dr. Gardner, 
“[w]hen you have an existing chart, the way our charts are set 
up, you can very quickly look and see what the patient’s medical 
problems are, what medications they are on.  And of course, if 
you want to look . . . further, you’ve got the previous records 
to refer to.” 
 
Wallace then showed Dr. Gardner an exhibit that Dr. Gardner 
identified as Mary Arnold’s medical records chart from NVFP.  
Dr. Gardner confirmed that it was regularly kept in NVFP’s 
practice.  Wallace moved to admit the exhibit into evidence.  
Arnold objected on the grounds that a proper foundation had not 
been laid that Dr. Gardner was the records custodian.  She 
further objected that Wallace “[h]asn’t laid the elements of the 
business records foundation, and I don’t want to tell him what 
it is.  That’s his job.”  Following a renewed cross-examination 
of Dr. Gardner, Wallace again offered the exhibit into evidence, 
and Arnold renewed her objection for lack of foundation.  The 
circuit court overruled the objection and admitted the exhibit. 
 
Thereafter, Wallace asked Dr. Gardner about hearsay entries 
in Arnold’s chart.  Five of the entries, made by practitioners 
other than Dr. Gardner, contained medical observations 
indicating that Arnold suffered from a variety of physical 
ailments that preceded the collision, including a deteriorating 
cervical disc, extreme stress, dizziness, migraine headaches, 
blurred vision, and pain and numbness in her limbs.  Arnold made 
no objection during this testimony. 
 
On appeal, Arnold assigns error to the circuit court’s 
overruling of her objection to the exhibit and its admission 
into evidence.  She argues that Wallace failed to establish the 
elements of the business records exception to the hearsay rule.  
According to Arnold, those elements include a showing that the 
medical records were factual in nature and not medical opinions.  
Wallace responds that he established an adequate foundation and 
that Arnold failed to apprise the circuit court that she 
objected to any medical opinions contained in the chart. 
A hearsay objection lies against the admission of written 
statements which were made out of court and are offered for the 
truth of what they say.  See Virginia Rules of Evidence 2:801 
and 2:802 (enacted by 2012 Acts chs. 688, 708).  Business 
records, including medical records, are admissible as an 
exception to the hearsay rule, “provided there is a 
circumstantial guarantee of trustworthiness.”  Smith v. 
Commonwealth, 280 Va. 178, 183, 694 S.E.2d 578, 580 (2010) 
(quoting McDowell v. Commonwealth, 273 Va. 431, 434, 641 S.E.2d 
507, 509 (2007)). 
The requisite trustworthiness or reliability of the hearsay 
statements in the documents, we have explained, is guaranteed by 
a showing of: 
“the regularity of [the documents’] preparation 
and the fact that the records are relied upon in 
the transaction of business by the person or 
entities for which they are kept and they are 
kept in the ordinary course of business made 
contemporaneously with the event by persons 
having the duty to keep a true record.  The final 
test is whether the documents sought to be 
introduced are the type of records which are 
relied upon by those who prepare them or for whom 
they are prepared.” 
 
Smith, 280 Va. at 183-84, 694 S.E.2d at 580 (quoting McDowell, 
273 Va. at 434-35, 641 S.E.2d at 509). 
 
Arnold asserts that in response to her foundation objection 
Wallace was required to show that the chart was factual in 
nature and not opinion.  Arnold relies on Neely v. Johnson, 215 
Va. 565, 571, 211 S.E.2d 100, 106 (1975), where we held that the 
business records exception does not “include opinions and 
conclusions of physicians or others recorded in hospital 
records.”  Arnold argues that pursuant to Neely, the factual 
nature of medical records is an element of the foundation and 
therefore must be established prior to their admission in 
response to a “foundation” objection.  She concludes that 
Wallace failed to make such a showing and therefore failed to 
lay an adequate foundation, and that the circuit court thus 
erred in admitting the medical records.  Wallace responds that, 
pursuant to Neely, the presence of opinion in a proffered 
business record constitutes an independent ground for objection 
which Arnold failed to assert at trial.  We agree with Wallace. 
Our cases do not require that the party offering a document 
for admission under the business records exception establish 
that all of the entries therein are factual in nature and 
contain no opinions.  An objection to the foundation of an 
entire chart does not encompass an objection to specific 
opinions in individual documents.  Rather, it is incumbent upon 
the objecting party to identify the passages within a business 
record offered into evidence that contain inadmissible opinions.  
We therefore hold that Arnold’s objection to “foundation” did 
not apprise the circuit court of additional specific objections 
to opinions in the chart.  Thus the objection was waived.  Rule 
5:25.  Compare Booker v. Commonwealth, 276 Va. 37, 41, 661 
S.E.2d 461, 463 (2008) (objection sufficient when it “informed 
[the circuit court] with reasonable certainty of [the 
litigant’s] concern”) with Jones v. Ford Motor Co., 263 Va. 237, 
259, 559 S.E.2d 592, 603-04 (2002) (objection to foundation not 
sufficient to encompass arguments made on appeal). 
We conclude that Wallace established a sufficient 
foundation for the admission of Arnold’s chart pursuant to the 
business records exception to the hearsay rule.  See Smith, 280 
Va. at 183-84, 694 S.E.2d at 580.  Dr. Gardner identified the 
proposed exhibit as Arnold’s chart.  He testified as to the 
regular preparation of the chart as part of NVFP’s practice and 
that it was kept in the ordinary course of NVFP’s business.  
Finally, he testified regarding the treating physicians’ 
reliance on the chart to assess a patient and form a diagnosis. 
III. TESTIMONY OF DR. HARTMAN 
 
Arnold next assigns error to the circuit court’s decision 
to allow Dr. Elizabeth M. Hartman to testify as an expert 
witness for Wallace.  During discovery, Wallace filed his expert 
witness designation, which included Dr. Charles M. Citrin.  
Arnold had previously retained Dr. Citrin.  After the filing of 
the designation, she alerted Wallace of this fact.  Wallace 
disputed any potential conflict, but filed a supplement to his 
designation naming Dr. Hartman, a member of the same practice 
group, as an alternate to Dr. Citrin. 
 
Arnold then moved to exclude the testimony of Dr. Citrin.  
The circuit court granted the motion.  In its order, the court 
found that Arnold’s counsel had a reasonable expectation that a 
confidential relationship existed with Dr. Citrin.4  The circuit 
court ruled that Wallace could substitute Dr. Hartman’s 
designation for Dr. Citrin’s designation.  Arnold noted her 
objection.  Arnold later filed objections to Wallace’s list of 
                         
4 The order did not address whether Arnold’s counsel 
actually disclosed any confidential or privileged information to 
Dr. Citrin. 
witnesses and exhibits, including an objection to Dr. Hartman.  
Arnold explained that Dr. Hartman was the partner of Dr. Citrin 
and that his disqualification should be imputed to Dr. Hartman. 
 
At trial, Wallace called Dr. Hartman to testify.  During 
voir dire examination by Arnold, Dr. Hartman testified that Dr. 
Citrin did not share any confidential information with her.  
Rather, she stated that “he wanted [Dr. Hartman] to take over 
the case.  He didn’t want to do the case anymore.”  She 
testified that Dr. Citrin provided her with Arnold’s medical 
records and a copy of his designation prepared for Wallace.  
Some of the pages of the medical records given to Dr. Hartman 
contained handwritten notes.  Dr. Hartman did not know whose 
notes they were, and some of the notes were indecipherable.  
There was no showing during the voir dire that the notes 
contained any confidential information that Arnold had shared 
with Dr. Citrin. 
 
Following the voir dire, Arnold argued that Dr. Hartman 
should be disqualified because of the notes.  The circuit court 
denied the motion.  Arnold assigns error to the circuit court’s 
ruling that Dr. Hartman was not disqualified from testifying due 
to a conflict of interest.  Arnold argues that “if Dr. Citrin 
communicated substantive confidential information to his partner 
Dr. Hartman, the affiliated expert disqualification rule applies 
to disqualify her.” (Emphasis added.) 
We review the circuit court’s decision to allow Dr. Hartman 
to testify for an abuse of discretion.  See Landrum v. 
Chippenham & Johnston-Willis Hosps., Inc., 282 Va. 346, 349, 717 
S.E.2d 134, 135 (2011).  Arnold, as the party seeking 
disqualification, bore the burden of offering sufficient 
evidence that Dr. Citrin revealed confidential information to 
Dr. Hartman.  See Wright v. Kaye, 267 Va. 510, 526, 593 S.E.2d 
307, 316 (2004) (adopting majority rule requiring moving party 
to show transfer of confidential information).  Cf. Turner v. 
Thiel, 262 Va. 597, 601-02, 553 S.E.2d 765, 768 (2001) 
(requiring party moving for disqualification of side-switching 
expert to show actual disclosure of confidential information).  
There is no evidence in the record that Arnold shared any 
confidential information with Dr. Citrin, or that Dr. Citrin in 
turn shared any confidential information with Dr. Hartman.  Dr. 
Hartman testified that Dr. Citrin told her only that he “didn’t 
want to do the case anymore” and provided Arnold’s medical 
records to her.  Arnold failed to establish that the handwritten 
notes, many of which were indecipherable, contained any 
confidential or privileged information.  Consequently, we 
conclude that the circuit court did not abuse its discretion in 
allowing Dr. Hartman to testify. 
 
 
IV. CONCLUSION 
 
For the reasons stated, we will affirm the judgment of the 
circuit court. 
Affirmed.