Title: Ligon v. Southside Cardiology Assoc.

State: virginia

Issuer: Virginia Supreme Court

Document:

Present:  All the Justices 
 
JANE V. LIGON, ADMINISTRATOR OF THE 
ESTATE OF PEARL V. VAUGHAN, DECEASED 
 
v.  Record No. 982467   OPINION BY JUSTICE BARBARA MILANO KEENAN 
 
 
 
September 17, 1999 
SOUTHSIDE CARDIOLOGY ASSOCIATES, 
P.C., ET AL. 
 
 
FROM THE CIRCUIT COURT OF PRINCE EDWARD COUNTY 
Richard S. Blanton, Judge 
 
 
 
In this medical negligence case, we consider whether the 
trial court erred in admitting "habit" evidence from medical 
personnel to prove that a patient did not complain of pain on a 
specific occasion, and that the defendant's treatment of the 
patient conformed to his routine practice. 
 
Jane V. Ligon, administrator of the estate of Pearl V. 
Vaughan, filed a wrongful death action in the trial court 
against Dr. Girish Purohit and his medical practice, Southside 
Cardiology Associates, P.C. (collectively, the defendant).  
Ligon alleged, among other things, that the defendant was 
negligent in failing to provide a proper diagnosis and treatment 
of Vaughan's heart disease. 
The following evidence was presented in a jury trial.  In 
May 1995, Vaughan experienced chest pains and received three 
days of treatment at the Southside Community Hospital 
(Southside) in Farmville.  Five days after her release, she 
returned to Southside's Cardiac Diagnostic Unit (CDU) as an 
outpatient to take a Persantine stress test.  In this test, the 
drug Persantine is administered to place additional stress on 
the patient's heart so that abnormalities can be detected and 
evaluated. 
 
Vaughan's daughter, Audrey Johnson, took Vaughan to the 
hospital for the Persantine stress test and remained there 
during the course of the procedure.  Under the standard protocol 
for this test, Vaughan completed a medical history form in the 
CDU and an intravenous "saline lock" was placed in her arm.  
Vaughan then went to the hospital's Nuclear Medicine Department 
where she received an injection of a radioactive medicine.  A 
medical technician took photographic images, commonly referred 
to as a "nuclear scan," of Vaughan's resting heart. 
After three hours, Vaughan returned to the CDU where 
another medical technician connected her to vital sign monitors 
and obtained various electrocardiograms (EKGs).  Dr. Purohit 
supervised the injection of the Persantine and the 
administration of the stress test.  The stress test took 14 
minutes to complete.  During the stress test, Vaughan 
experienced tightness and pain in her chest.  At Dr. Purohit's 
direction, Vaughan was given nitroglycerin, and her chest pain 
stopped.  After Vaughan completed the stress test, the heart 
monitor and EKG connections were removed and she returned to the 
 
2
Nuclear Medicine Department where a technician took a second 
nuclear scan of her heart. 
Vaughan left the hospital with Johnson and went to 
Johnson's home.  That night, Vaughan died in her sleep.  All 
three medical experts who testified at trial agreed that Vaughan 
probably died from an arrhythmia that resulted in cardiac 
arrest.  One of these three witnesses, Dr. James T. Rittelmeyer, 
a cardiologist, stated that Vaughan also had experienced a 
"heart attack" during the stress test administered by Dr. 
Purohit.  The other two medical experts disagreed with that 
conclusion. 
 
Johnson testified that as she waited in the CDU reception 
area while her mother was undergoing the stress test, she heard 
Vaughan call her name.  Johnson stated that she went to the area 
where the test was being administered and found Vaughan lying on 
a gurney, dressed in her own clothes and not connected to any 
monitors.  Johnson said that Vaughan was crying, trembling, and 
complaining that she could not breathe and that she had pain in 
her chest and arm. 
 
Johnson testified that Dr. Purohit was standing nearby, 
along with two female technicians or nurses.  Johnson stated 
that when she asked Dr. Purohit whether Vaughan's condition was 
normal, he assured her that it was and said that her mother 
would be fine once she went home and rested. 
 
3
 
Dr. Purohit testified that he had no independent 
recollection of Vaughan's condition in the CDU.  Debora S. Hurt, 
the CDU technician who cared for Vaughan, also had no 
independent recollection of Vaughan.  However, Courtney Gates, 
the nuclear technologist who obtained the final nuclear scan of 
Vaughan's heart after the stress test, testified that she 
remembered Vaughan.  Gates stated that Vaughan complained of 
indigestion or "stomach upset" at that time, but that she never 
complained of chest pain.  At trial, all three medical experts 
testified that a violation of the standard of care would occur 
if a patient, complaining of chest and arm pain under the 
circumstances described by Johnson, were released from the 
hospital without further evaluation.  Thus, a critical factual 
issue in the trial was whether Vaughan complained of chest and 
arm pain after completing the stress test. 
 
Over Ligon's objection, the defendant was permitted to 
present evidence of the routine or "habit" of Dr. Purohit, Hurt, 
and Gates in responding to other patients who complained of 
chest pain after completing stress tests.  Dr. Purohit testified 
that he had administered one or two stress tests per day over 
the last ten years, and that at least a dozen of those patients 
had complained of chest pain after completing the test and 
changing into their own clothes.  He stated that whenever this 
occurred, he re-evaluated the patient by obtaining another EKG 
 
4
and performing a physical examination.  Dr. Purohit testified 
that he had never failed to re-evaluate a patient who complained 
of chest pain on completion of a stress test. 
 
Hurt testified that she had worked as a cardiac diagnostic 
technician for ten years.  When asked how many times she had 
observed patients develop complaints similar to those described 
by Johnson, Hurt responded that such complaints had occurred 
more than ten times.  She testified that when these complaints 
were brought to her attention, she reconnected the patients to 
an EKG monitor and had them re-evaluated by a physician. 
 
Gates testified that during the 30 years she had worked as 
a nuclear technologist, patients had complained of chest pain 
"more than ten" times.  Gates stated that she immediately 
responded to those complaints by requesting assistance from the 
cardiac unit or the emergency room. 
 
At the conclusion of the evidence, the jury returned a 
verdict in favor of the defendant.  The trial court entered 
judgment in accordance with the jury's verdict. 
 
On appeal, Ligon argues that the trial court erred in 
admitting the defendant's "habit" evidence.  Ligon asserts that 
the challenged testimony permitted the jury to speculate that 
because Dr. Purohit, Hurt, and Gates provided proper medical 
care to other patients, they provided the same care to Vaughan.  
Ligon argues that under our holding in Jackson v. Chesapeake & 
 
5
Ohio Ry. Co., 179 Va. 642, 20 S.E.2d 489 (1942), evidence of a 
defendant's habitual conduct is inadmissible to prove that the 
defendant acted in conformance with such conduct on a particular 
occasion. 
 
In response, the defendant argues that the witnesses' 
testimony concerning their responses to other patients' 
complaints of chest pain was not evidence of general habit such 
as that addressed in Jackson, but was evidence of "specific 
responses to a specific situation."  The defendant asserts that 
in a medical negligence action, when a defendant physician has 
no memory of a patient, evidence of the physician's routine or 
habit is relevant to establish his conduct with regard to that 
particular patient.  The defendant further contends that the 
challenged testimony was not offered to prove that the defendant 
was not negligent, but merely was offered to show that a 
particular event, Vaughan's complaint of chest pain, did not 
occur.  We disagree with the defendant's arguments. 
 
Our decisions do not draw a distinction between "general" 
and "specific" habit evidence.  Instead, the focus of our 
analysis has been whether the proffered evidence is relevant to 
the issues at trial.  See Cherry v. D.S. Nash Constr. Co., 252 
Va. 241, 244-45, 475 S.E.2d 794, 796-97 (1996); Spurlin v. 
Richardson, 203 Va. 984, 989-90, 128 S.E.2d 273, 277-78 (1962); 
Jackson, 179 Va. at 650, 20 S.E.2d at 492. 
 
6
 
The reasoning we articulated in Jackson is persuasive in 
resolving the issue before us.  There, a plaintiff brought a 
negligence action for personal injuries he sustained when the 
truck in which he was a passenger collided with a train.  The 
engineer in charge of the train's engine testified that on the 
day of the accident, as well as on the 6th, 7th, 8th, 9th, 22nd, 
23rd, and 24th day of every month, he rang the crossing bell and 
gave other crossing signals prior to the train's traversing the 
crossing.  The plaintiff attempted to impeach this testimony 
with proffered testimony from a witness who would have testified 
that on the same days in a month other than that in which the 
accident occurred, the crossing bell was not rung before the 
train crossed the tracks.  179 Va. at 645-46, 20 S.E.2d at 490. 
 
We held that the trial court did not err in refusing to 
allow the proffered testimony.  We stated that evidence of a 
person's general habits is not admissible for the purpose of 
showing the nature of his conduct on a specific occasion.  Id. 
at 649, 20 S.E.2d at 492.  Such evidence of habitual conduct is 
inadmissible because it consists only of collateral facts, from 
which no fair inferences can be drawn, and tends to mislead the 
jury and to divert its attention from the issues before the 
court.  See id. at 648, 20 S.E.2d at 491; Cherry, 252 Va. at 
244-45, 475 S.E.2d at 796; Spurlin, 203 Va. at 990, 128 S.E.2d 
at 278. 
 
7
 
The reasoning we employed in Jackson was a departure from 
our prior decisions in Alexandria & F.R.R. Co. v. Herndon, 87 
Va. 193, 12 S.E. 289 (1890) and Washington, A. and Mt. V. Ry. Co 
v. Trimyer, 110 Va. 856, 67 S.E. 531 (1910), in which we 
approved the admission of evidence that a defendant had acted in 
an habitually negligent manner prior to the accident at issue.  
In Herndon, we held that evidence of the habitual stopping place 
of a train at a location where its rear car had no landing place 
for exiting passengers was admissible to prove that the train 
was stopped, rather than in motion, at this location when the 
plaintiff left the rear car and was injured.  87 Va. at 199, 12 
S.E. at 291.  In Trimyer, we approved the trial court's 
admission of evidence that the defendant railroad company, in 
violation of its alleged duty, previously had failed to stop its 
train at the same intersection where the plaintiff allegedly was 
injured by the defendant's moving train.  110 Va. at 858-59, 67 
S.E. at 532. 
 
After Trimyer, however, we repeatedly have stated that 
evidence of prior negligent habit is inadmissible to prove the 
acts of negligence alleged at trial.  See Cherry, 252 Va. at 
244-45, 475 S.E.2d at 796-97; Jackson, 179 Va. at 649, 20 S.E.2d 
at 492; Southern Ry. Co. v. Rice's Adm'x, 115 Va. 235, 248-49, 
78 S.E. 592, 595 (1913).  Moreover, in these negligence cases, 
we have rejected the admission of habit evidence offered to 
 
8
prove the issues at trial for the primary reason that such 
evidence is collateral to the proof of those issues.*  See id.
 
In a negligence action, evidence of habitual conduct is 
inadmissible to prove conduct at the time of the incident 
complained of because such evidence is collateral to the issues 
at trial.  Thus, the evidence in question before us was 
inadmissible because it was collateral to the issues whether 
this decedent complained of chest pains after her stress test, 
whether the defendant was negligent in treating this patient at 
the time of the incident complained of, and whether the alleged 
acts of negligence were a proximate cause of the decedent's 
death.  See Cherry, 252 Va. at 244, 475 S.E.2d at 796; Jackson, 
179 Va. at 648, 20 S.E.2d at 492. 
 
Acceptance of the contrary position urged by the defendant 
would result in the admission of irrelevant evidence in a 
variety of actions.  For example, a defendant in an automobile 
                     
 
*We also note that Graham v. Commonwealth, 127 Va. 808, 103 
S.E. 565 (1920), cited by the defendant, is inapposite to the 
present case.  There, we held that since the defendant on trial 
for murder had asserted a self-defense claim, alleging that the 
deceased had used violent, profane language and advanced toward 
him with a gun, the Commonwealth was entitled to introduce 
rebuttal evidence that the deceased did not have a habit of 
swearing.  127 Va. at 824, 103 S.E. at 570.  We stated that this 
evidence was admissible under the same principle that allows the 
admission of character evidence.  Id.  Thus, our holding in 
Graham was limited to the use of a narrow category of rebuttal 
testimony to a claim of self-defense in a criminal prosecution, 
and is unrelated to the present issue of the admissibility of 
habit evidence in a negligence action. 
 
9
negligence action would be permitted to prove that he obeyed a 
certain traffic signal at an accident scene by testifying that 
he complies with that signal on a daily basis when driving at 
that location.  We decline to adopt such a rule because the 
relevant inquiry in a negligence action is not whether a 
defendant has a habit of compliance with the type of duty at 
issue, but whether the defendant breached a specific duty owed 
to the plaintiff at a particular time. 
 
By our holding in this case, we also decline the 
defendant's request that we follow the decisions of other 
jurisdictions that permit evidence of the habitual conduct of 
medical personnel for the purpose of proving that the 
defendant's conduct on a specific occasion conformed to their 
routine practice.  See, e.g., Bloskas v. Murray, 646 P.2d 907, 
911 (Colo. 1982); Crawford v. Fayez, 435 S.E.2d 545, 549-50 
(N.C.App. 1993).  Those decisions represent a departure from our 
jurisprudence, and we perceive no benefit from the admission of 
such evidence to warrant a reversal or curtailment of the basic 
principles articulated in Jackson. 
 
We also disagree with the defendant's contention that 
admission of this type of evidence is necessary to counter a 
plaintiff's expert testimony on the applicable standard of care, 
which is based partly on actions taken by other health care 
providers under the same circumstances.  Both factual and expert 
 
10
testimony in a medical negligence action must be relevant to the 
incident at issue.  The testimony of fact witnesses is relevant 
to show what actually happened on a particular occasion.  The 
testimony of expert witnesses relates to the same specific 
incident by establishing a standard of care applicable to the 
defendant's actions on that particular occasion and by assessing 
whether those actions conformed to the established standard of 
care.  In contrast, the evidence improperly admitted by the 
trial court was relevant only to prove events that occurred on 
other occasions. 
 
For these reasons, we will reverse the trial court's 
judgment and remand the case for a new trial in accordance with 
the principles expressed in this opinion. 
Reversed and remanded.
 
JUSTICE KINSER, concurring. 
 
 
I concur in the result reached by the majority but for 
different reasons.  In prior cases, this Court has not clearly 
articulated a distinction between “general” and “specific” habit 
evidence, or discussed whether different rules apply when 
determining the admissibility of each type of habit evidence.  
However, we have, on occasions, upheld the admissibility of 
“specific” habit evidence.  See Washington, A. and Mt. V. Ry. 
 
11
Co. v. Trimyer, 110 Va. 856, 67 S.E. 531 (1910); Alexandria & 
F.R. Co. v. Herndon, 87 Va. 193, 12 S.E. 289 (1890). 
The majority states that this Court’s reasoning in Jackson 
v. Chesapeake & Ohio Ry. Co., 179 Va. 642, 20 S.E.2d 489 (1942), 
represented a departure from the decisions in Trimyer and 
Herndon.  But in Jackson, we concluded that the facts of that 
case did “not bring it within any of the exceptions to the 
general rule” that evidence of an individual’s general habits is 
not admissible for the purpose of establishing that individual’s 
conduct on a specific occasion.  Id. at 649, 20 S.E.2d at 492.  
I believe this Court’s decisions in Trimyer, Herndon, Norfolk & 
W. Ry. Co. v. Thomas, 110 Va. 622, 66 S.E. 817 (1910), and 
Kimball v. Borden, 95 Va. 203, 28 S.E. 207 (1897), all of which 
were discussed in Jackson, represent the “exceptions to the 
general rule.”  Jackson, 179 Va. at 649, 20 S.E.2d at 492.  
Thus, I do not agree that the decision in Jackson signified a 
shift from the Court’s earlier rulings.  Rather, Jackson re-
stated the rule regarding “general” habit evidence.  Id.  It did 
not overrule Trimyer or Herndon, nor does the majority decision 
today do so. 
Additionally, the more recent case of Cherry v. D.S. Nash 
Constr. Co., 252 Va. 241, 475 S.E.2d 794 (1996), involved only 
“general” habit evidence although the Court did not classify the 
challenged evidence as “general” or “specific.”  Instead, the 
 
12
Court merely concluded that “Nash Construction’s overall 
performance record, as well as the fact that it had not been 
cited . . . for safety violations on the job, had no probative 
value regarding” what action Nash Construction took or should 
have taken on the day of the accident.  Id. at 245, 475 S.E.2d 
at 797. 
 
Regardless of the status of the Commonwealth’s 
jurisprudence regarding “specific” and “general” habit evidence 
and the import of the decision in Jackson, I believe that the 
trial court erred by admitting the evidence at issue in this 
appeal because the defendants did not establish a proper 
foundation.  According to the testimony of Dr. Girish Purohit, 
Debora S. Hurt, and Courtney Gates, they occasionally had 
patients who experienced chest pain after completing all the 
cardiac tests and changing into their own clothes.  However, Dr. 
Purohit, Hurt, and Gates admitted that such occurrences were 
infrequent.  In other words, episodes, like the one allegedly 
experienced by Pearl V. Vaughan, were not numerous or regular 
events.  Thus, I conclude that the defendants failed to prove a 
routine practice or procedure regularly utilized in response to 
a repeated specific situation from which an inference of 
habitual conduct could be drawn. 
 
For these reasons, I respectfully concur. 
 
 
13
JUSTICE LACY, dissenting. 
Until today, Virginia, like virtually all other 
jurisdictions, recognized a distinction between evidence of 
one's general habits and evidence of one's specific habits and 
considered specific habit evidence relevant and admissible under 
certain conditions.  1 McCormick on Evidence § 195 (John William 
Strong ed., 4th ed. 1992); 1A Wigmore, Evidence § 93 (Tillers 
rev. 1983).  Compare Cherry v. D.S. Nash Construction Co., 252 
Va. 241, 475 S.E.2d 794 (1996), with Jackson v. Chesapeake & 
Ohio Ry. Co., 179 Va. 642, 20 S.E.2d 489 (1942), Graham v. 
Commonwealth, 127 Va. 808, 103 S.E. 965 (1920), Washington, A. 
and Mt. V. Ry. Co. v. Trimyer, 110 Va. 856, 67 S.E. 531 (1910), 
and Alexandria & F.R.R. Co. v. Herndon, 87 Va. 193, 12 S.E. 289 
(1890). 
Following existing Virginia precedent, the trial court in 
this case determined that the evidence at issue was specific 
habit evidence and considered its admissibility on that basis.  
In reversing the trial court, the majority recites the rule 
applicable to general habit evidence, and applies it to the 
facts of this case.  Because I believe the trial court analyzed 
the evidence correctly and in accordance with our prior cases in 
ruling on its admissibility, I respectfully dissent. 
Evidence of general habits, such as evidence that a person 
generally is a careful driver offered to show that he did not 
 
14
act negligently at the time in question, regardless of any 
probative value it may have, has been held inadmissible per se.  
Thus, in Jackson, we said: 
[A]ccording to the weight of authority, evidence 
of the general habits of a person is not 
admissible for the purpose of showing the nature 
of his conduct upon a specific occasion.  
Accordingly, in actions for negligence the courts 
generally deny the admissibility of evidence of 
the reputation of the defendant for negligence, 
his habits of negligence, his habitual negligent 
conduct, etc., upon the issue of his negligence 
at the time of the injury complained of. 
 
179 Va. at 649, 20 S.E.2d at 492; see also Cherry, 252 Va. at 
244, 475 S.E.2d at 796. 
However, this blanket rejection of general habit evidence 
has not been extended to evidence of specific habitual conduct, 
that is, evidence that a person regularly reacts to a specific 
set of circumstances in the same manner.  We concluded long ago 
that such specific habit evidence is probative of, and thus 
relevant to, such person's actions on a particular occasion 
under similar circumstances.  "Of the probative value of a 
present habit, or custom, as showing the doing on a specific 
occasion of the act which is the subject of the habit or custom, 
there can be no doubt."  Graham, 127 Va. at 823, 103 S.E. at 570 
(emphasis added).  Such evidence is not automatically admissible 
under the prior cases decided by this Court, but neither is it 
automatically inadmissible under those cases or under the rule 
 
15
recited in Jackson.  Rather, as Jackson pointedly observed, 
"[t]he admissibility, as well as the probative value, of this 
class of [specific habit] evidence depends in a large measure 
upon the circumstances in which it is offered."  Jackson, 179 
Va. at 647, 20 S.E. at 491. 
Thus, this Court has affirmed the admission of evidence 
showing that the railroad company's trains had habitually 
stopped at a particular place on arriving at the station because 
such evidence "did tend to prove" whether the train was stopped 
or in motion at the place plaintiff was injured.  Herndon, 87 
Va. at 199, 12 S.E. at 290.  Likewise, testimony that a train 
did not stop at an intersection on other prior occasions tended 
to prove that it did not do so on the day of the accident in 
issue, and was thus properly admitted.  Trimyer, 110 Va. at 858-
59, 67 S.E. at 532-33. 
 
The evidence at issue in this case was the habit of 
recording complaints of chest pains in a patient's record and 
re-evaluating the patient in response to the patient's complaint 
of chest pains following the completion of a stress test.  The 
appellee argued that the evidence was not evidence of general 
habits and was not offered to show a general disposition toward 
non-negligent acts.  According to the appellee, "[w]hile the 
challenged evidence admittedly has a bearing on the question 
whether Dr. Purohit was negligent, the primary purpose for which 
 
16
it was offered was to prove that the event (the alleged 
complaints of chest pain after the Persantine Stress Test had 
ended) upon which the plaintiff relies as giving rise to the 
duty to re-evaluate and hospitalize Mrs. Vaughan did not occur, 
. . . ." 
 
The trial court agreed with the appellee, stating that the 
evidence was not general habit evidence offered for the purpose 
of showing that the defendants "conducted themselves in a safe 
and careful manner," but evidence "of a specific response to a 
particular factual situation."  Before admitting the evidence, 
the trial court further required that the evidence offered meet 
the test of regularity, that is, in the words of the trial 
court, that the actions were "numerous enough to base an 
inference of systematic conduct or . . . regular response to a 
repeated specific situation." 
The admissibility of evidence is within the discretion of 
the trial court.  Roll 'R' Way Rinks, Inc. v. Smith, 218 Va. 
321, 326, 237 S.E.2d 157, 161 (1977).  The evidence in this case 
was specific, not general, habit evidence; it was relevant to 
and probative of a fact in issue — whether the patient 
complained of chest pains following the stress test; there was 
no assertion that admission of the evidence would unduly 
lengthen the trial or confuse the jury.  There is nothing in 
this record to support a finding by this Court that the trial 
 
17
court abused its discretion in admitting this evidence in this 
case.  Accordingly, I find no basis to reverse the judgment of 
the trial court. 
 
In reversing the trial court, the majority relies heavily 
on the Jackson case, a negligence action against a railroad 
company for injuries suffered when a train hit a vehicle 
occupied by the plaintiff at a railroad crossing.  The decision 
in Jackson was not based on a finding that the proffered 
evidence was inadmissible habit evidence, but rather that the 
evidence was inadmissible impeachment evidence, the ground 
asserted by the plaintiff in his objection to the trial court's 
ruling.  179 Va. at 650-51, 20 S.E.2d at 492-93.  As such, the 
Court's discussion of habit evidence in Jackson, which the 
majority finds so persuasive, is merely dicta.  Nevertheless, 
because I believe the majority misinterprets the dicta in 
Jackson, a full discussion of the case is warranted. 
An issue described by the Court in Jackson as "vital" to 
establishing the railroad's negligence in that case was whether 
the railroad crossing signals required by statute were given on 
the day of the accident.  The statutory signal requirements were 
"two sharp sounds of the whistle and a continuous ringing of the 
bell, or the whistle sounded continuously or alternatively with 
the bell from a point at least 300 yards, and not more than 600 
yards, from the crossing."  Id. at 645, 20 S.E.2d at 490.  The 
 
18
failure to give a proper signal constituted negligence per se.  
Thirty-four eyewitnesses testified on this issue, the majority 
of which testified that the crossing signals were given.  Id.
The evidence in dispute was offered by the plaintiff and 
consisted of notations made by a person stationed at a nearby 
business regarding the crossing signals given on seven days 
seven months after the accident.  The notations were that 
"different crossing signals were given;" "the whistle was blown 
on each day mentioned" but that "the number of blasts varied," 
and that the bell was not rung on any of the days.  Id. at 646, 
20 S.E.2d at 489.  The trial court refused to admit this 
evidence. 
On appeal, the Court in Jackson, as noted above, 
acknowledged the rule against the admission of general habit 
evidence but also acknowledged that the rule did not apply to 
all habit evidence, citing other Virginia cases in which habit 
evidence was admitted.  Id. at 647, 20 S.E.2d at 491.  The Court 
in Jackson, like the majority here, did not specifically 
classify the proffered evidence as evidence of general or 
specific habit.  However, the Jackson Court did not reject the 
proffered specific evidence under the rule that evidence of 
general habits is inadmissible per se as the majority states.  
This much is clear from the fact that the court engaged in a 
lengthy analysis of the reliability, relevancy, and prejudicial 
 
19
effect of the proffered evidence, which analysis would have been 
unnecessary for application of a per se rule against 
admissibility. 
Recognizing that proffered specific habit evidence "may not 
in fact have sufficient regularity to make it probable that it 
would be carried out in every instance . . . ," and that 
"[w]hether or not such sufficient regularity exists must depend 
largely on the circumstances of each case," 179 Va. at 650, 20 
S.E.2d at 492 (emphasis added)(citing Wigmore), the Court in 
Jackson affirmed the trial court's refusal to admit the 
plaintiff's proffered evidence, reasoning that the evidence 
offered involved incidents "too remote in time and too 
indefinite in substance to be relevant to the question, . . . ."  
Id.  
The Court's conclusion in Jackson that the proffered habit 
evidence in that case did not qualify as admissible specific 
habit evidence did not represent a departure from previous 
cases.  The proffered evidence in Jackson differed significantly 
in quality from the specific habit evidence admitted in previous 
cases.  See Trimyer, 110 Va. 856, 67 S.E. 531; Herndon, 87 Va. 
193, 12 S.E. 289.  The purportedly habitual act at issue in 
Jackson — giving the signal crossings in the manner required by 
statute — was not a simple, single act.  It included alternative 
formulas for sounding the signals which had to be performed at 
 
20
certain distances.  The proffered evidence only established that 
different crossing signals were given, some of which may have 
been in compliance with the statutory requirements, such as the 
continuing blast of the signal.  Also in contrast to prior 
cases, the evidence offered pertained solely to actions after 
the accident, rather than prior to the accident, and consisted 
of only seven occasions.  Under these circumstances, it is not 
surprising that the proffered evidence of a specific habit was 
determined to be inadmissible.  The reasons stated by the Court 
in Jackson for rejecting the evidence at issue in that case 
reflected the analysis which must be applied by a trial court 
each time a party seeks to introduce evidence of a specific 
habit. 
As indicated above, the trial court in the instant case 
engaged in just such an analysis and concluded that the evidence 
was relevant and admissible and unlikely to cause prejudice or 
undue delay.  The majority concludes that this evidence offered 
and admitted by the trial court was inadmissible because it was 
evidence of "collateral" matters.  This conclusion rests on a 
legal principle announced by the majority that, "evidence of 
habitual conduct is inadmissible because it consists only of 
collateral facts, from which no fair inferences can be drawn, 
and tends to mislead the jury and to divert its attention from 
the issues before the court." 
 
21
 
The majority cites three cases for support of this 
principle:  Jackson, Cherry, 252 Va. at 244-45, 475 S.E.2d at 
796; and Spurlin v. Richardson, 203 Va. 984, 990, 128 S.E.2d 
273, 278 (1962).  However, of these cases only Jackson involves 
any discussion of specific habit evidence, and the referenced 
passage in each case is nothing more than a recitation of the 
unremarkable proposition that irrelevant, collateral evidence is 
inadmissible.  In fact, all three cases refer to Moore v. City 
of Richmond, 85 Va. 538, 539, 8 S.E. 387, 388 (1888), as the 
source of the statement.  "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 may 
be drawn tending to throw light upon the fact under 
investigation, is excluded."  Id.  Moore did not involve habit 
evidence at all, but rather involved evidence offered by the 
plaintiff "for the purpose of proving the defective condition of 
the sidewalk at the place where the accident occurred" that 
another person "on the same night, fell into the same hole" as 
plaintiff.  Id.  Therefore, I believe the majority has 
misinterpreted Jackson, as well as Cherry and Spurlin, as 
support for a legal principle that all habit evidence is 
evidence of collateral facts.  While the legal principle 
enunciated by the majority may arguably be valid with regard to 
 
22
general habit evidence, its applicability to evidence of 
specific habits must be determined on a case by case basis. 
 
Of equal concern to me is the majority's statement that the 
disputed evidence in this case was "collateral to the issue of 
[the defendants'] conduct and the decedent's condition at the 
time of the incident in question" and, therefore, was not 
relevant to "the issues at trial, namely, whether this decedent 
complained of chest pains after her stress test."  This 
conclusion ignores a crucial factual issue in this case — 
whether the plaintiff complained of chest pains following the 
stress test. 
 
The evidence of the defendant's habit of recording chest 
pain complaints and re-evaluating the patient whenever a patient 
complains of chest pain tends to show that they would have done 
the same had decedent complained of chest pain at the time in 
question.  This evidence, combined with the fact that decedent's 
records reveal no chest-pain complaints or re-evaluation, tends 
to prove that decedent did not, in fact, complain of chest pain.  
The disputed evidence is thus demonstrably probative of a 
crucial factual issue in the trial; it simply is not collateral 
to "the issues at trial."  See Herndon, 87 Va. at 199, 12 S.E. 
at 291 ("It is a settled rule of evidence that, whatever tends 
to prove the issue, or constitutes a link in the chain of proof, 
is relevant and admissible.") 
 
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Finally, the majority's conclusion that the evidence at 
issue is inadmissible is not supported by any discussion of why 
no reasonable inferences can be drawn from the evidence, why the 
evidence misleads and diverts the attention of the jury in this 
case, or how this evidence differs from the specific habit 
evidence directly addressed and held admissible in Trimyer and 
Herndon, cases which have not been overruled and which were 
specifically acknowledged by this Court in Jackson. 
 
I recognize the majority's valid concern that this type of 
evidence poses the danger of confusing the jury and causing 
mini-trials.  However, that danger is greater in some cases than 
in others and is non-existent in still other cases.  Thus, the 
trial court must consider this danger, in relation to the 
probative value of the proffered evidence, in determining 
whether to admit specific habit evidence in any particular case 
— the type of determination made daily by trial courts in ruling 
on the admission of evidence.  Because I believe the trial court 
made this determination correctly in this case, I would affirm. 
 
 
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