Title: Budd v. Punyanitya

State: virginia

Issuer: Virginia Supreme Court

Document:

Present:  All the Justices 
 
WILLIAM T. BUDD 
 
OPINION BY 
v.  Record No. 061138 
JUSTICE LAWRENCE L. KOONTZ, JR. 
 
April 20, 2007 
VISEPONG PUNYANITYA, M.D. 
 
FROM THE CIRCUIT COURT OF ALBEMARLE COUNTY 
Paul M. Peatross, Jr., Judge 
 
In this appeal of a judgment entered in a medical 
malpractice case, we consider whether the trial court correctly 
ruled that Code § 8.01-401.1 barred a party from introducing 
certain statements contained in published medical literature 
because copies of the statements had not been provided to the 
opposing party thirty days prior to trial.  At issue is whether 
a party may avoid this notice requirement of the statute by 
having its own expert, upon direct examination, establish the 
publications in which the statements appear as reliable 
authorities in order to subsequently use the statements in 
cross-examination of the opposing party’s expert. 
BACKGROUND 
Because this appeal is limited to a discrete issue of the 
notice requirements of Code § 8.01-401.1, we need recite only 
those facts necessary to our resolution of the appeal.  See, 
e.g., Molchon v. Tyler, 262 Va. 175, 180, 546 S.E.2d 691, 695 
(2001). 
 
 
2
On December 27, 2004, William T. Budd filed an amended 
motion for judgment in the Circuit Court of Albemarle County 
against Visepong Punyanitya, M.D. alleging that Dr. Punyanitya 
had been negligent in providing medical care to Budd for 
recurring back and leg pain.*  Budd alleged in the amended motion 
for judgment that Dr. Punyanitya had performed multiple spinal 
surgeries on Budd between October 2000 and February 2002.  
Following these surgeries, Budd was diagnosed as having “severe 
compartment syndrome” and “chronic cellulitis in the left lower 
extremity” causing him constant pain and requiring him to walk 
with a cane. 
Budd contended that prior to beginning treatment, Dr. 
Punyanitya failed to assess the risk of Budd developing 
compartment syndrome as a result of the surgeries and to timely 
diagnose that condition when it developed.  Budd sought damages 
of $1,600,000. 
On January 10, 2006, approximately one month prior to 
trial, Budd filed in the trial court a “Plaintiff’s Designation 
of Authoritative Literature” stating that “the following 
literature contain[s] statements that may be used in direct 
                     
*Martha Jefferson Hospital was also named as a defendant in 
the amended motion for judgment.  The hospital was subsequently 
dismissed from the case and is not a party to this appeal. 
 
 
 
3
examination by plaintiff’s experts as reliable authorities in 
medicine on compartment syndrome.”  Among the publications 
listed in the designation were Benjamin Gulli and David 
Templeman, “Compartment Syndrome of the Lower Extremity,” 25 
Orthopedic Traumatology: Complex Fractures and Associated 
Injuries 677, 677-84 (1994) (the Gulli/Templeman article) and 
Jeff Anglen and James Banovetz, “Compartment Syndrome in the 
Well Leg Resulting from Fracture-Table Positioning,” 1994 
Clinical Orthopaedics and Related Research 239, 239-42 (the 
Anglen/Banovetz article).  A copy of the designation was mailed 
to Dr. Punyanitya’s counsel. 
Although the designation avers that “[t]he articles 
attached will contain statements demarked by underlining unless 
the entire article is designated,” apparently no copies of the 
actual articles, demarked or otherwise, were attached to it.  In 
any event, Budd concedes that he did not provide counsel for Dr. 
Punyanitya with copies of the designated articles or otherwise 
indicate the statements within those articles upon which he 
intended to rely at least thirty days prior to trial. 
At trial, Budd called Dr. Daniel E. Gelb, an orthopedic 
surgeon, as an expert witness.  During direct examination of Dr. 
Gelb, Budd’s counsel stated that he had “one little 
administrative thing I want to do.”  Budd’s counsel then asked 
 
 
4
Dr. Gelb to confirm that counsel had previously requested Dr. 
Gelb “to look at some medical literature on [compartment 
syndrome]” and “form opinions whether they’re reliable 
authorities.”  Dr. Punyanitya’s counsel interposed an objection, 
stating that “[t]hese documents were not presented to us 30 days 
before trial, as required by [Code § 8.01-401.1].” 
Budd’s counsel responded that he only wished to “lay[] a 
foundation for cross-examination” of Dr. Punyanitya’s expert 
witnesses.  Budd’s counsel contended that Code § 8.01-401.1 
permits a party to establish that a medical publication 
regarding a particular medical issue is a reliable authority by 
the testimony of the party’s expert witness without first 
providing the opposing party with copies of the publication 
thirty days prior to trial.  This notice requirement of the 
statute, Budd’s counsel contended, applies only if the party’s 
expert witness would be asked to read statements from the 
publication into the record on direct examination.  Counsel 
assured the court that Dr. Gelb would not be asked to read any 
statements from the publications in question. 
The trial court sustained Dr. Punyanitya’s objection and 
Budd was not permitted to have Dr. Gelb state an opinion as to 
whether any publication was a reliable authority regarding 
compartment syndrome.  At that time, Budd did not identify the 
 
 
5
publications that he intended to have Dr. Gelb establish as 
reliable authority regarding compartment syndrome, nor did he 
proffer any statements in those publications to the trial court 
for inclusion in the record.  During cross-examination of Dr. 
Punyanitya’s expert witnesses, Budd did not seek to introduce 
any literature regarding compartment syndrome or otherwise 
attempt to question the experts on any statements in the 
literature he had previously identified in the designation of 
authoritative literature filed on January 10, 2006. 
At the conclusion of all the evidence, the jury returned 
its verdict in favor of Dr. Punyanitya.  Prior to the entry of a 
final order on the jury’s verdict, Budd filed a motion 
requesting the trial court to reconsider its ruling barring him 
from having his expert witness, Dr. Gelb, establish the 
designated literature as reliable authority for use in cross-
examining Dr. Punyanitya’s expert witnesses. 
For the first time before the trial court, Budd in the 
motion to reconsider expressly identified and proffered 
statements from the Gulli/Templeman article and Anglen/Banovetz 
article that he would have relied upon in his cross-examination 
of Dr. Punyanitya’s expert witnesses.  Budd contended that when 
he deposed those experts prior to trial, neither had indicated 
familiarity with “any article as a reliable source on the 
 
 
6
subject of compartment syndrome.”  Accordingly, Budd asserted 
that where an opposing party’s “experts would not agree that an 
authority is reliable, in order to establish its reliability and 
thus the basis for its admission into evidence, [a party] must 
lay that foundation through other means,” namely by having the 
party’s own expert do so upon direct examination.  In such 
circumstances, Budd contended that the requirement of Code 
§ 8.01-401.1 to provide the opposing party with copies of the 
statements contained in the publications thirty days before 
trial did not apply because the statements were not “intended to 
be used during direct examination.”  (Emphasis in original.) 
Dr. Punyanitya filed a brief opposing Budd’s motion for 
reconsideration, contending that Budd had attempted to introduce 
the statements contained in the publications through direct 
examination by having Dr. Gelb establish them as reliable 
authority.  Thus, Dr. Punyanitya contended that the trial court 
correctly ruled that the thirty day notice requirement of Code 
§ 8.01-401.1 was triggered even if Dr. Gelb was not going to 
read into the record, or otherwise rely on, any statements 
contained in the publications.  Dr. Punyanitya further contended 
that Budd had waived any objection to the trial court’s ruling 
because he failed to attempt to have the publications introduced 
through the testimony of Dr. Punyanitya’s expert witnesses. 
 
 
7
Following oral argument on the motion for reconsideration, 
the trial court entered separate orders dated March 14, 2006 
denying the motion for reconsideration and confirming the jury’s 
verdict in favor of Dr. Punyanitya.  We awarded Budd an appeal 
on the following assignment of error: 
 
The trial court erred in refusing to allow 
Plaintiff’s counsel to establish certain medical 
articles not previously provided as authoritative 
literature pursuant to Virginia Code Section 8.01-
401.1 during direct examination of his own standard of 
care expert in order to lay the foundation for the use 
of statements from those articles during cross-
examination of defense experts, when the articles were 
not required to be provided to opposing counsel thirty 
days prior to trial unless introduced during direct 
examination. 
 
DISCUSSION 
The parties’ arguments in this appeal with respect to the 
issue raised in Budd’s assignment of error are, in all material 
respects, identical to the arguments presented in the trial 
court.  However, before reaching the merits of those arguments, 
we will first briefly address two procedural issues raised by 
Dr. Punyanitya. 
Dr. Punyanitya initially contends that Budd waived his 
right to challenge the trial court’s ruling that Dr. Gelb would 
not be allowed to identify as reliable and authoritative any 
publications regarding compartment syndrome that had not been 
provided to Dr. Punyanitya’s counsel thirty days prior to trial 
 
 
8
because Budd did not make a contemporaneous proffer of those 
publications when the objection was sustained, but did so only 
in his motion for reconsideration.  We disagree. 
Dr. Punyanitya is correct that when a trial court rules 
that specific evidence will not be admitted because, for 
example, the evidence lacks relevance, the evidence ought to be 
proffered to the trial court at the time of the ruling, or as 
near in time thereafter as is practicable, so that the trial 
court can, if necessary, reconsider its ruling.  See, e.g., Rose 
v. Jaques, 268 Va. 137, 154, 597 S.E.2d 64, 74 (2004); Whittaker 
v. Commonwealth, 217 Va. 966, 968-69, 234 S.E.3d 79, 81 (1977).  
However, in this case the trial court, based upon its 
interpretation of Code § 8.01-401.1, ruled as a matter of law 
that Budd would not be permitted to introduce through direct 
examination of Dr. Gelb any medical literature copies of which 
had not been provided to opposing counsel thirty days prior to 
trial.  A contemporaneous proffer of specific literature would 
not have aided the trial court in reconsidering its ruling 
because the proffer would not have altered the underlying fact 
that copies of the literature had not been provided to Dr. 
Punyanitya’s counsel thirty days prior to trial. 
Next, Dr. Punyanitya reasserts his contention, made in the 
trial court, that Budd has waived his objection to the trial 
 
 
9
court’s ruling that Dr. Gelb would not be allowed to identify as 
reliable authority any medical publications that had not been 
provided to Dr. Punyanitya’s counsel thirty days prior to trial 
because Budd failed to cross-examine either of Dr. Punyanitya’s 
expert witnesses regarding those publications.  This is so, Dr. 
Punyanitya maintains, because in the absence of any effort by 
Budd to have the defense experts acknowledge the publications as 
reliable authorities regarding compartment syndrome, this Court 
would be left to speculate whether Budd might not have had the 
publications introduced through their testimony.  Again, we 
disagree. 
The issue before this Court is not whether a specific 
medical publication could and should have been admitted into 
evidence.  Rather, as we have already indicated, the sole issue 
is whether the trial court erred in ruling that Code 
§ 8.01-401.1 requires a party to provide to an opposing party 
thirty days prior to trial copies of publications which the 
party will establish as reliable authority through direct 
examination of its own expert solely for the purpose of having 
those publications available for use in the subsequent cross-
examination of the opposing party’s expert witnesses.  In the 
context of that issue, we are not required to speculate whether 
Dr. Punyanitya’s experts would have acknowledged the medical 
 
 
10
publications as reliable authorities so that Budd could use them 
in cross-examination of these experts.  Moreover, Budd’s 
apparent election not to attempt to establish the publications 
as reliable authority by cross-examination of the defense 
experts does not establish a waiver of the issue whether Budd 
should have been permitted to establish the publications as 
reliable authority through the direct testimony of Dr. Gelb. 
We now turn to the issue raised by Budd’s sole assignment 
of error.  Because the trial court ruled as a matter of law that 
Code § 8.01-401.1 required Budd to provide Dr. Punyanitya with 
copies of the statements contained in the publications in 
question thirty days prior to trial, the issue before this Court 
is one of statutory interpretation.  Under well-established 
principles, an issue of statutory interpretation is a pure 
question of law which we review de novo.  Crawford v. Haddock, 
270 Va. 524, 528, 621 S.E.2d 127, 129 (2005); Ainslie v. Inman, 
265 Va. 347, 352, 577 S.E.2d 246, 248 (2003).  When the language 
of a statute is unambiguous, we are bound by the plain meaning 
of that language.  Campbell v. Harmon, 271 Va. 590, 597-98, 628 
S.E.2d 308, 311-12 (2006); Virginia Polytechnic Inst. & State 
Univ. v. Interactive Return Serv., 271 Va. 304, 309, 626 S.E.2d 
436, 438 (2006).  Furthermore, we must give effect to the 
legislature’s intention as expressed by the language used in the 
 
 
11
statute unless a literal interpretation of the language would 
result in a manifest absurdity.  Boynton v. Kilgore, 271 Va. 
220, 227, 623 S.E.2d 922, 925-26 (2006); Williams v. 
Commonwealth, 265 Va. 268, 271, 576 S.E.2d 468, 470 (2003); 
Woods v. Mendez, 265 Va. 68, 74-75, 574 S.E.2d 263, 266 (2003). 
Code § 8.01-401.1, which as a whole addresses the role of 
expert witnesses and provides an exception to the hearsay rule 
in civil cases generally, in relevant part provides: 
To the extent called to the attention of an 
expert witness upon cross-examination or relied upon 
by the expert witness in direct examination, 
statements contained in published treatises, 
periodicals or pamphlets on a subject of history, 
medicine or other science or art, established as a 
reliable authority by testimony or by stipulation 
shall not be excluded as hearsay.  If admitted, the 
statements may be read into evidence but may not be 
received as exhibits.  If the statements are to be 
introduced through an expert witness upon direct 
examination, copies of the statements shall be 
provided to opposing parties thirty days prior to 
trial unless otherwise ordered by the court. 
 
(Emphasis added.) 
We previously addressed the operation of this language, 
which was added to Code § 8.01-401.1 by amendment in 1994, in 
Weinberg v. Given, 252 Va. 221, 226, 476 S.E.2d 502, 504 (1996).  
In that case, we explained that the effect of the 1994 amendment 
was to “permit[] the hearsay content of such articles to be read 
into the record as substantive evidence, provided no other 
evidentiary rule prohibits such admission.”  Cf. Todd v. 
 
 
12
Williams, 242 Va. 178, 182-83, 409 S.E.2d 450, 452-53 
(1991)(holding, prior to the amendment of Code § 8.01-401.1, 
that it was error to permit an expert witness to refer to 
authoritative literature during testimony).  Subsequently, in 
May v. Caruso, 264 Va. 358, 362-63, 568 S.E.2d 690, 692 (2002), 
we held that the trial court did not abuse its discretion in 
refusing to permit a party to have its expert introduce 
statements from voluminous authoritative literature because, in 
providing copies of that literature to opposing counsel under 
the thirty day notice requirement of Code § 8.01-401.1, the 
party failed to identify for opposing counsel the specific 
statements that would be relied upon.  We are now called on to 
consider further the specific circumstances that will trigger 
that notice requirement pursuant to the emphasized language of 
the statute indicated above. 
The plain language of the statute makes clear that the 
thirty day notice requirement applies only to “statements [that] 
are to be introduced through an expert witness upon direct 
examination.”  Budd reads the additional language of the statute 
to permit an expert witness upon direct examination merely to 
“establish[] as a reliable authority” the published literature 
in question without introducing into evidence through that 
expert specific statements therein so that the statements can 
 
 
13
later be “called to the attention of an expert witness upon 
cross-examination,” at which time they would be “introduced” in 
evidence.  Budd contends that this is a proper reading of the 
statute because the 1994 amendment effectively overruled our 
prior holding in Hopkins v. Gromovsky, 198 Va. 389, 395, 94 
S.E.2d 190, 194 (1956), that a litigant may cross-examine an 
expert witness in order to test the expert’s knowledge and 
accuracy by reading excerpts from authoritative literature, but 
only if the expert agrees that the literature is reliable and 
authoritative.  See also Griffett v. Ryan, 247 Va. 465, 473, 443 
S.E.2d 149, 154 (1994); Todd, 242 Va. at 182-83, 409 S.E.2d at 
452-53.  The thrust of Budd’s contention then is that the 
statute now permits a party through the cross-examination of an 
opposing party’s expert witness to introduce as substantive 
evidence statements from medical literature which have been 
established previously as reliable authority through the direct 
testimony of a party’s own expert witness without triggering the 
statute’s thirty day notice requirement.  We disagree. 
As we made clear in Weinberg, the effect of the 1994 
amendment to Code § 8.01-401.1 was to create an exception to the 
hearsay rule in order to permit the introduction of 
authoritative literature as substantive evidence.  And, as 
amended, the statute unquestionably permits statements in 
 
 
14
authoritative literature to be “called to the attention of an 
expert witness upon cross-examination.”  However, as we said in 
Hopkins: 
“There is a distinction between the use of medical or 
other scientific books for the purpose of cross-
examination merely and to test the knowledge and 
reading and accuracy of the witness who is on the 
stand and the use of such books by reading them 
directly or indirectly to the jury on cross-
examination, not for the purpose of testing the 
learning, reading, or accuracy of the witness, but in 
order to get their contents and the opinions of their 
authors before the jury.” 
 
198 Va. at 395, 94 S.E.2d at 194 (quoting 32 C.J.S., Evidence, 
§ 574, p. 429) 
Thus, prior to the amendment of the statute, the rule from 
Hopkins permitted a party, without violating the hearsay rule, 
to cross-examine an opposing party’s expert witness through the 
use of statements in authoritative literature.  Nothing in the 
language of Code § 8.01-401.1 remotely suggests that the 
legislature intended to overrule Hopkins and its progeny, and 
those cases remain effective law.  So long as the statements 
from authoritative literature are used solely for the purpose of 
testing an expert’s knowledge, reading and accuracy in a field 
of expertise, and are not read directly or indirectly to the 
jury as substantive evidence regarding the contents of the 
literature or the opinions of its author, neither the hearsay 
 
 
15
rule nor the exception thereto found in Code § 8.01-401.1 is 
implicated. 
Budd concedes that he intended to have statements from the 
medical publications in question introduced as substantive 
evidence in support of his claims against Dr. Punyanitya.  
Having failed to supply opposing counsel with copies of the 
statements thirty days prior to trial, he also concedes that he 
could not introduce the publications through his own expert’s 
testimony upon direct examination.  Thus, anticipating that Dr. 
Punyanitya’s experts would not, or could not, acknowledge that 
the publications containing the statements Budd intended to rely 
upon were reliable authorities, he sought to “lay a foundation” 
for their introduction by having his own expert do so as an 
“administrative” matter. 
It is readily apparent from the express language of the 
statute that the purpose of the thirty day notice requirement 
contained in Code § 8.01-401.1 is to limit the hearsay exception 
the statute otherwise provides so as to safeguard the opposing 
party’s right to meaningful cross-examination of the expert 
witness.  May, 264 Va. at 362, 568 S.E.2d at 692.  The concept 
of a meaningful cross-examination is not satisfied when a party 
is denied the prior opportunity to review and formulate a 
response to the published statements introduced into evidence as 
 
 
16
reliable authority during the direct testimony of the opposing 
party’s expert witness. 
The crux of the issue presented in this case is then 
whether the language of the statute contemplates, as Budd 
maintains, a distinction between merely “laying a foundation” to 
establish published literature as reliable authority for the 
subsequent introduction of that literature as substantive 
evidence and the introduction of published literature in 
evidence during the direct examination of the proponent’s expert 
witness.  The language of the statute makes no such distinction.  
The fact that statements from the literature established as 
reliable authority upon the direct testimony of the proponent’s 
expert witness will not be read into the record, if at all, 
until a subsequent cross-examination of an opposing expert 
witness does not alter the conclusion that in the context of the 
language of Code § 8.01-401.1 the statements upon which the 
proponent intends to rely have been “introduced through an 
expert witness upon direct examination.” 
Moreover, if we were to adopt Budd’s construction of the 
statute, a party could successfully circumvent the statute’s 
thirty day notice requirement, and the hearsay rule, by having 
its expert essentially vouch for the reliability and authority 
of any number of publications which his opponent has never seen 
 
 
17
and has not had a fair opportunity to have his own expert review 
and prepare a response.  Such a result would not provide the 
limited and balanced exception to the hearsay rule which the 
legislature clearly intended.  To bifurcate the meaning of the 
statute’s language so as to permit a party’s expert witness to 
merely establish a publication as a reliable authority on direct 
examination without “introducing” it is inconsistent with the 
purpose of the statute and, indeed, with traditional notions of 
fair play in the adversarial process.  
Accordingly, we hold that when a party intends to introduce 
into evidence statements from published literature during the 
cross-examination of an opposing expert, but wishes to avoid the 
possibility that the opposing expert will not acknowledge that 
literature as a reliable authority on a particular matter at 
issue by having the party’s own expert establish the literature 
as a reliable authority on direct examination, the party must 
provide opposing counsel with copies of the statements in the 
literature thirty days before trial pursuant to Code § 8.01-
401.1. 
CONCLUSION 
For these reasons, the judgment of the trial court in favor 
of Dr. Punyanitya will be affirmed. 
Affirmed.