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ALZIRA GOIS v. JONATHAN ASARO

(AC 35285)

DiPentima, C. J., and Sheldon and Bishop, Js.

Argued January 23—officially released May 27, 2014

(Appeal from Superior Court, judicial district of

Stamford-Norwalk, Povodater, J.)
Brock T. Dubin, with whom, on the brief, was Matthew H. Geelan, for the appellant (defendant).

Tanya M. Bachand, for the appellee (plaintiff).
Opinion

BISHOP, J. The defendant, Jonathan Asaro, appeals

from the judgment of the trial court rendered after a

jury verdict in favor of the plaintiff, Alzira Gois. On

appeal, the defendant claims that the court erroneously:

(1) failed to preclude evidence at trial concerning posttraumatic stress disorder (PTSD) as well as references

to a traumatic brain injury (TBI) in the plaintiff’s medical records; and (2) denied the defendant’s motion for

remittitur.1 We affirm the judgment of the trial court.

The following facts, which the jury reasonably could

have found, and procedural history are relevant to our

resolution of the defendant’s appeal. This personal

injury case arose out of a motor vehicle accident which

occurred on the afternoon of June 11, 2007, on Interstate

95 in Darien. While the plaintiff was driving in the right

northbound lane in her Hyundai, a tractor trailer truck

owned by the defendant collided with the plaintiff’s

vehicle when the defendant attempted to merge into the

right lane. The force of the impact caused the plaintiff’s

vehicle to crash into the right shoulder barrier and flip

overinto a construction zone. The plaintifffirstreceived

medical attention at the scene of the accident, and then

was transported to Stamford Hospital for further treatment and evaluation. At the hospital, the plaintiff complained of left-sided chest pain, left-sided abdominal

pain, and a headache. Tests performed at the hospital

revealed the presence of fluid surrounding her aorta,

as well as multiple rib fractures and abrasions to her

eye, wrist, and flank. The plaintiff was discharged on

June 12, 2007, and thereafterfollowed up with Dr. Philip

Corvo, a general surgeon, on June 18, and again on

August 16, 2007, when Corvo referred her to a neurologist for additional evaluation. The plaintiff continued

to see several specialists for further treatment for an

extended period of time. During her time of treatment,

the plaintiff complained of insomnia, numbness in her

limbs, a ‘‘crawling’’ and tingling sensation on her head,

back and shoulder pain, and headaches. After the accident, the plaintiff could not return to work as a private,

full-time nanny but, instead, began doing light cleaning

for her roommate’s cleaning company in exchange

for rent.

On March 30, 2010, the plaintiff filed her amended

complaint in which she claimed that she suffered from,

inter alia, a 5 percent whole person impairment, concussion, post-concussion syndrome, headaches, PTSD,

severe anxiety, and memory loss as a result of her

collision with the defendant. The defendant filed his

operative answer on July 18, 2011, in which he generally

denied the plaintiff’s allegations but admitted that ‘‘he

failed to keep a proper lookout for other vehicles and

moving traffic lawfully traveling on [the] highway.’’

Because the defendant admitted liability for the collision, the trial was limited to the issues of causation
and damages.

The jury heard evidence over several days in September, 2012, and, on October 2, 2012, it returned a verdict

in favor of the plaintiff in the amount of $82,959.89

in economic damages and $288,000 in noneconomic

damages2

for a total award of $370,959.89. On October

9, 2012, the defendant filed a motion for remittitur and,

on October 10, 2012, the defendant also moved to set

aside the verdict. On December 6, 2012, the court denied

both motions and, thereafter, rendered judgment in

favor of the plaintiff. This appeal followed. Additional

facts will be set forth as necessary.

I

EVIDENTIARY CLAIMS

The defendant first claims that the court erred by

admitting evidence at trial concerning: (A) PTSD; and

(B) TBI.

We begin by setting forth the applicable standard of

review concerning a trial court’s evidentiary rulings. ‘‘It

is a well established principle of law that the trial court

may exercise its discretion with regard to evidentiary

rulings, and the trial court’s rulings will not be disturbed

on appellate review absent abuse of that discretion.

. . . Sound discretion, by definition, means a discretion

that is not exercised arbitrarily or wilfully, but with

regard to what is right and equitable under the circumstances and the law . . . . And [it] requires a knowledge and understanding of the material circumstances

surrounding the matter . . . . In our review of these

discretionary determinations, we make every reasonable presumption in favor of upholding the trial court’s

ruling. . . . [Our Supreme Court has] often stated that

before a party is entitled to a new trial because of an

erroneous evidentiary ruling, he or she has the burden

of demonstrating that the error was harmful. . . .

When determining that issue in a civil case, the standard

to be used is whether the erroneous ruling would likely

affect the result.’’ (Citation omitted; internal quotation

marks omitted.) Washington v. Christie, 58 Conn. App.

96, 99–100, 752 A.2d 1127, cert. denied, 254 Conn. 906,

755 A.2d 884 (2000).

A

The defendant’s first claim involves several references to PTSD made by neurologists Dr. Daryl Story

and Dr. Louis Cuzzone in the plaintiff’s medical records

as well as in Story’s deposition. The medical records

and the Story deposition were admitted into evidence

at trial. Specifically, the defendant claims that neither

Story nor Cuzzone was qualified to offer an opinion

concerning PTSD because they are neurologists and

not psychiatrists and therefore, any opinion by either

of them that the plaintiff suffered from PTSD should

not have been allowed in evidence. In support of his

argument, the defendant points to Story’s deposition
testimony that because he and Cuzzone were neurologists, neither of them could properly diagnose the plaintiff as suffering from PTSD. The defendant also argues

that, as a result, it was not established with reasonable

medical probability that the plaintiff actually suffered

from PTSD, and, accordingly, any reference to PTSD

by either Story or Cuzzone should have been precluded.

We are not persuaded.

The following additional facts are relevant to the

resolution of this claim. After the collision, the plaintiff

began treatment with Cuzzone in September, 2007, at

Neurology Associates of Norwalk. In the plaintiff’s medical records admitted at trial, there is a report of Cuzzone’s visit with the plaintiff, in which Cuzzone noted:

‘‘It is my feeling that she is suffering from [PTSD] and

that many of her physical symptoms are related to the

effects of these panic episodes on her body. She has

some insight into this and I told her that referral back

to her psychiatrist might be helpful in the short term

to manage these symptoms.’’ The plaintiff also was

treated by Story at the same office in November and

December, 2007. Story’s report of his visits with the

plaintiff notes: ‘‘I agree with Dr. Cuzzone’s consideration of [PTSD]. She is seeing a psychiatrist and is

taking Xanax.’’ In her disclosure of expert witnesses

pursuant to Practice Book § 13-4,3

the plaintiff listed,

among others, physicians from Neurology Associates

of Norwalk to testify regarding her injuries including,

but not limited to, PTSD. On September 10, 2012, the

defendant filed a motion in limine to preclude the plaintiff from introducing into evidence medical records and

deposition testimony from Cuzzone and Story that made

reference to PTSD. The court denied the defendant’s

motion on September 14, 2012. At trial, Story’s deposition was read into evidence. In his deposition, Story

was questioned on notes in his medical records indicating that the plaintiff was suffering from PTSD. Specifically, Story stated that he did not consider himself

adequately trained to make such a diagnosis. When

questioned about Cuzzone’s notes on PTSD in the plaintiff’s medical records, Story stated that: ‘‘Looking at

what [Cuzzone] wrote precisely I don’t think that he

would have intended to make a formal diagnosis of

[PTSD] because we don’t make that diagnosis as neurologists. . . . I believe we can suspect it and I think that’s

what he was writing in the note but would not have—

would not have made a formal diagnosis on his own.’’

On May 15, 2013, the court issued an articulation

in response to the defendant’s motion for articulation

regarding the denial of the defendant’s motions in

limine. The court stated that: ‘‘Again, there are two

aspects to the ruling. First, regardless of specialty,

defendant never presented a basis for the court to conclude that a doctor, even acting outside his/her specialty, presumptively was not a sufficient expert to

diagnose PTSD. (The doctor was a neurologist, such
that his specialty was not as remote as it might be with

a dermatologist.) Secondly, defendant did not present

any authority for what the court considered to be a

novel proposition, to the effect that the opinion of

[Story] that an area was outside of the specialty and

expertise of [Cuzzone] was a valid basis on which the

court could conclude that the opinion of [Cuzzone]

should be precluded.’’

Our analysis of the defendant’s claim regarding the

admission of PTSD evidence is guided by certain governing principles. First, a ‘‘trial court has wide discretion in ruling on the qualification of expert witnesses

and the admissibility of their opinions. . . . The court’s

decision is not to be disturbed unless [its] discretion

has been abused, or the error is clear and involves a

misconception of the law.’’ (Internal quotation marks

omitted.) State v. Robles, 103 Conn. App. 383, 401, 930

A.2d 27, cert. denied, 284 Conn. 928, 934 A.2d 244

(2007).

With respect to medical experts, specifically, we have

also held that: ‘‘For medical testimony to have any probative value, it must at least advise the jury that the

inference drawn by the doctor is more probably correct

than incorrect.’’ (Internal quotation marks omitted.)

Vickers v. Jessup, 32 Conn. App. 360, 363, 629 A.2d 457,

cert. granted, 227 Conn. 922, 632 A.2d 701 (1993)(appeal

withdrawn March 18, 1994). ‘‘If the probabilities are

in balance, the matteris left to speculation.’’(Emphasis

in original; internal quotation marks omitted.) Healy v.

White, 173 Conn. 438, 444, 378 A.2d 540 (1977). Notably,

‘‘[t]he term reasonable medical certainty is another

name for the reasonable medical probability standard.

We have stated that: Expert opinions must be based

upon reasonable probabilities ratherthan mere speculation or conjecture if they are to be admissible in establishing causation. . . . To be reasonably probable, a

conclusion must be more likely than not. . . . Whether

an expert’s testimony is expressed in terms of a reasonable probability that an event has occurred does not

depend upon the semantics of the expert or his use of

any particular term or phrase, but rather, is determined

by looking at the entire substance of the expert’s testimony. . . . We do not require that certain magic words

be used, and therefore, [w]e reject the proposition that

certain formulaic words are essential when an expert

renders an opinion. . . . As long as it is clear that the

opinion of the expert is expressed in terms of probabilities, the opinion should be submitted into evidence

for a jury’s consideration. . . . [A]n expert witness is

competent to express an opinion, even though he or

she may be unwilling to state a conclusion with absolute

certainty, so long as the expert’s opinion, if not stated

in terms of the certain, is at least stated in terms of

the probable, and not merely the possible.’’ (Citations

omitted; internal quotation marks omitted.) State v.

Nunes, 260 Conn. 649, 672–73, 800 A.2d 1160 (2002).
Finally, as to expert testimony generally, ‘‘if a proponent

of testimony establishes reasonable expert qualifications for a witness, further objections to that expert’s

testimony go to its weight, not its admissibility.’’ (Internal quotation marks omitted.) Chebro v. Audette, 138

Conn. App. 278, 288, 50 A.3d 978 (2012).

With these guidelines in mind, we turn to the defendant’s claims. The defendant claims that because Story

and Cuzzone were neurologists, they were not qualified

to give their opinions as to PTSD, and thus that the

court erred in admitting their testimony on this subject.

Additionally, the defendant claims that since neither

expressed an opinion to a reasonable degree of medical

probability, any opinion expressed by either physician

should have been excluded. The defendant highlights

the fact that in his deposition testimony, Story stated

that he did not consider himself qualified to make such

a diagnosis and that generally, neurologists do not make

such diagnoses. As we have previously noted, a trial

court has wide discretion to determine the admissibility

of expert evidence, which we will not disturb on appeal

absent evidence of abuse of such discretion. Story’s

contention that, as a neurologist, he was not qualified

to diagnose PTSD does not automatically preclude his

testimony or the admission of medical records in which

Cuzzone stated his belief that the plaintiff had PTSD.

See Wood v. Club, LLC, 134 Conn. App. 768, 773–76, 41

A.3d 684 (2012) (court allowed witness to testify as

expert even though witness claimed he was not expert

because court determined he satisfied criteria for testifying as expert), appeal dismissed, 310 Conn. 373, 77

A.3d 747 (2013). The fact that both Story and Cuzzone

are neurologists and not mental health specialists does

not, in and of itself, demonstrate that the court abused

its discretion in admitting their testimony regarding

PTSD. In response to the defendant’s second motion

for articulation, the court stated that: ‘‘Other than in

the context of medical malpractice where there is a

statutory requirement that an expert witness be a ‘similar health care provider’; General Statutes § 52-184c

(d); the court is unaware of any proscription against a

generalist (e.g. family doctor or internist), or a dissimilar specialist, giving an expert opinion concerning a

condition that falls within the ambit of some other specialty—the doctor is nonetheless likely to possess

knowledge beyond the ken of the average juror that

would be of assistance in the fact-finding function.’’ We

agree with the court.

‘‘Expert testimony should be admitted when . . .

the testimony would be helpful to the . . . jury in considering the issues.’’(Internal quotation marks omitted.)

Marchell v. Whelchel, 66 Conn. App. 574, 585, 785 A.2d

253 (2001). Story’s and Cuzzone’s testimony as licensed

physicians concerning the plaintiff’s likely PTSD was

helpful to the jury in considering the issues and the

weight to be accorded to their testimony. Moreover,
the lack of a formal diagnosis by either of them was for

the jury to determine. Based on the entirety of Story’s

deposition testimony and the plaintiff’s treatment with

both Story and Cuzzone, as noted in the plaintiff’s medical records, it is clear that it was their shared professional opinion that the symptoms experienced by the

plaintiff were consistent with PTSD, and thus, that she

likely suffered from that disorder. On the basis of the

foregoing, the admission of evidence from the two physicians regarding PTSD was not an abuse of discretion.

B

The defendant’s second evidentiary claim concerns

the court’s admission of neurosurgeon Dr. Roger Kaye’s

medical report, which referenced a TBI. Specifically,

the defendant argues that because the plaintiff never

claimed that she had a TBI, evidence of such an injury

was not relevant and may have confused the jury

because they ‘‘may not have properly appreciated that

TBI was not a claimed injury.’’ The defendant also

asserts that because it was not established with reasonable medical probability that the plaintiff suffered from

a TBI, any reference to such an injury should have been

redacted from Kaye’s records and not made available

to the jury.

The following additional facts are relevant to the

resolution of this claim. On September 10, 2012, the

defendant filed a motion in limine to redact any references to a TBI from Kaye’s medical report concerning

his treatment of the plaintiff. Specifically, Kaye’s unredacted report included notes from the plaintiff’s August

31, 2007 visit, which stated that: ‘‘It is clear that [the

plaintiff] has a traumatic injury to the greater occipital

nerve. This is a partial injury and I would expect gradual

improvement over the coming months. . . . It is not

clear whether she has a TBI or not.’’ After the plaintiff’s

second visit with Kaye on November 11, 2009, Kaye

noted in the plaintiff’s record that there was a ‘‘resolving

TBI.’’ The defendant argued that because Kaye, who

had been disclosed as an expert witness on behalf of

the plaintiff, formally had not diagnosed the plaintiff

as having suffered a TBI, any such reference should be

redacted to avoid confusing the jury. After arguments,

the court denied the defendant’s motion in limine on

September 17, 2012. At trial, Kaye was not called to

testify, but the plaintiff offered his medical report into

evidence pursuant to General Statutes § 52-174 (b).4

Notwithstanding reference to a TBI in her medical

records, plaintiff’s counsel confirmed several times that

she was not claiming or requesting damages for a TBI.

On March 19, 2013, several months after the verdict,

the defendant filed a motion seeking articulation as to

the reasons for the court’s denial of the defendant’s

motion in limine to redact any references to TBI in

Kaye’s reports. In its articulation, the court stated that

it denied the defendant’s motion regarding TBI for two
reasons. First, Kaye’s reference to a TBI was not a

diagnosis or medical opinion that the plaintiff had such

a condition but, rather, was simply a note identifying

a condition that she might have had. Second, the court

pointed out that the Centers for Disease Control and

Prevention website indicated that the term TBI is an

umbrella term, which encompasses concussions.

Because the plaintiff was claiming a concussion as well

as post-concussion syndrome, and because the defendant did not argue that there was no evidence of a

concussion, the defendant’s objection to Kaye’s reference to TBI was nothing more than ‘‘a nomenclature

issue—analogous to someone with leukemia also referring to the condition as cancer.’’ With this procedural

background in place, we turn to the legal principles

relevant to this claim.

‘‘The law defining the relevance of evidence is well

settled. Relevant evidence is evidence that has a logical

tendency to aid the trier in the determination of an

issue. . . . The trial court has wide discretion to determine the relevancy of evidence . . . . Every reasonable presumption should be made in favor of the

correctness of the court’s ruling in determining whether

there has been an abuse of discretion.’’ (Internal quotation marks omitted.) Hayes v. Camel, 283 Conn. 475,

483, 927 A.2d 880 (2007). However, ‘‘[e]ven when a trial

court’s evidentiary ruling is deemed to be improper, we

must determine whether that ruling was so harmful as

to require a new trial. . . . In other words, an evidentiary ruling willresult in a new trial only if the ruling was

both wrong and harmful. . . . Finally, the standard in

a civil case for determining whether an improper ruling

was harmful is whether the . . . ruling [likely] would

[have] affect[ed] the result.’’ (Internal quotation marks

omitted.) Daley v. McClintock, 267 Conn. 399, 403, 838

A.2d 972 (2004).

At the outset, we do not conclude that the court

abused its discretion in admitting this evidence.

Although the plaintiff did not claim that she suffered

from a TBI, Kaye’s description of her injury—what it

was and what it probably was not—was relevant, even

if marginally, to gaining a complete understanding of

her claims of impairment. Furthermore, Kaye did not

diagnose the plaintiff as suffering from a TBI but,

importantly, stated that it was not clear whether she

had such an injury. Instead, Kaye’s notes concerning

TBI merely demonstrated that such an injury was part

of his thought process in attempting to determine the

plaintiff’s injuries.

We also conclude that even if the court erroneously

allowed the reference to TBI in Kaye’s reports into

evidence, the defendant has not shown that he suffered

any resulting harm. First, the reference to a TBI in

Kaye’s records was for the purpose of ruling out such

an injury as a potential diagnosis. Also, the plaintiff did
not claim that she suffered from a TBI in her complaint

or at any point during the course of trial. As noted, the

plaintiff confirmed several times, on the record, that

she was not claiming or seeking damages for a TBI.

Accordingly, the defendant’s argument that the reference to a TBI in Kaye’s records may have influenced

the jury is unavailing. Because the defendant has failed

to demonstrate that he suffered any harm by the reference to TBI at trial, his second claim must also fail.

II

REMITTITUR

The defendant next claims that the court erroneously

denied his motion for remittitur. Specifically, the defendant argues that the plaintiff’s award of $263,000 for

past noneconomic damages was not supported by the

evidence. We disagree with the defendant.

The following facts are relevant to the defendant’s

final claim. The defendant filed a motion for remittitur

on October 9, 2012. In his supporting memorandum of

law, the defendant argued that: ‘‘Unfortunately, since

the jury was permitted to consider records speculating

that plaintiff suffered from [PTSD] . . . and [TBI] . . .

despite motions in limine requesting the preclusion of

said records, the verdict is largely inflated due to the

inappropriate and inadmissible speculation of plaintiff’s

physicians and not based upon relevant evidence.’’ The

court denied the defendant’s motion on December 6,

2012. On January 31, 2013, the defendant filed a motion

for articulation, in which he requested that the court

set forth, inter alia, its reasoning for the denial of his

motion for remittitur. In its articulation, the court highlighted how ‘‘remarkably conscientious, attentive and

detail-oriented’’ the jury was in this case. The court

continued that ‘‘the jury could have accepted defendant’s characterization of plaintiff’s injuries as minor

and limited in duration (with primary focus on physical

injuries and less emphasis on psychological and mental

consequences of the accident), which likely would have

resulted in a significantly smaller verdict; but the jury

was not compelled to adopt such a view of the evidence.’’ (Emphasis in original.)

Our analysis of the defendant’s claim is guided by

certain governing principles. ‘‘First, the amount of an

award [of damages] is a matter peculiarly within the

province of the trier of facts. . . . Second, the court

should not interfere with the jury’s determination

except when the verdict is plainly excessive or exorbitant. . . . The ultimate test which must be applied to

the verdict by the trial court is whether the jury’s award

falls somewhere within the necessarily uncertain limits

of just damages or whether the size of the verdict so

shocks the sense of justice as to compel the conclusion

that the jury [was] influenced by partiality, prejudice,

mistake or corruption. . . . Third, the ruling of the trial
court on the motion to set aside the verdict as excessive

is entitled to great weight and every reasonable presumption should be given in favor of its correctness.

. . . The court’s broad power to order a remittitur

should be exercised only when it is manifest that the

jury [has] included items of damage which are contrary

to law, not supported by proof, or contrary to the court’s

explicit and unchallenged instructions. . . . The relevantinquiry is whetherthe verdictfalls within the necessarily uncertain limits of fair and reasonable

compensation or whether it so shocks the conscience

as to compel the conclusion that it was due to partiality,

prejudice or mistake. . . . Furthermore, [t]he decision

whether to reduce a jury verdict because it is excessive

as a matter of law [within the meaning of General Statutes § 52-216a] rests solely within the discretion of the

trial court. . . . [Consequently], the proper standard

of review of a trial court’s decision to grant or deny a

motion to set aside a verdict as excessive as a matter

of law is that of an abuse of discretion. . . .

‘‘[A]lthough the trial court has a broad legal discretion

in this area, it is not without its limits. . . . Litigants

have a constitutional right to have factual issues

resolved by the jury. . . . This right embraces the

determination of damages when there is room for a

reasonable difference of opinion among fair-minded

persons as to the amount that should be awarded. . . .

The award of damages for pain and suffering is peculiarly within the province of the trier [of fact]. . . . The

fact that it is difficult to measure pain and suffering in

terms of money does not prevent a recovery . . . as

long as there is a reasonable basis in the record for

that recovery. . . . Furthermore, [t]he size of the verdict alone does not determine whether it is excessive. . . .

‘‘Thus, [i]n ruling on the motion for remittitur, the

trial court was obliged to view the evidence in the light

most favorable to the plaintiff in determining whether

the verdict returned was reasonably supported thereby.

. . . A conclusion that the jury exercised merely poor

judgment is an insufficient basis for ordering a remittitur. . . . Proper compensation for noneconomic damages cannot be computed by a mathematical formula,

and there is no precise rule for the assessment of damages. . . . The plaintiff need not prove damages with

mathematical exactitude; rather, the plaintiff must provide sufficient evidence for the trier to make a fair and

reasonable estimate. . . . A generous award of noneconomic damages should be sustained if it does not

shock the sense of justice. . . .

‘‘The fact that the jury returns a verdict in excess of

what the trial judge would have awarded does not alone

establish that the verdict was excessive. . . . [T]he

court should not act as the seventh juror with absolute

veto power. Whether the court would have reached a
different [result] is not in itself decisive. . . . The

court’s proper function is to determine whether the

evidence, reviewed in a light most favorable to the prevailing party, reasonably supports the jury’s verdict.

. . . In determining whether the court abused its discretion, therefore, we must examine the evidential basis

of the verdict itself . . . . [T]he court’s action cannot

be reviewed in a vacuum. The evidential underpinnings

of the verdict itself must be examined.’’ (Citations omitted; internal quotation marks omitted.) Saleh v. Ribeiro

Trucking, LLC, 117 Conn. App. 821, 825–28, 982 A.2d

178 (2009), aff’d, 303 Conn. 276, 32 A.3d 318 (2011).

Based upon ourreview of the record, there was ample

evidence concerning the operative facts of the collision

and the plaintiff’s resulting injuries to warrant the jury’s

verdict of $263,000. The verdict was not excessive; it

does not shock the sense of justice. Accordingly, the

defendant’s remittitur claim must also fail.

The judgment is affirmed.

In this opinion the other judges concurred.

1 The defendant also claims, in his statement of issues, that the court

erroneously denied his motion to set aside the verdict, but does not address

this argument in his brief. We therefore treat this claim, to the extent it

may be distinguished from the briefed claims, as abandoned. See Nowacki

v. Nowacki, 129 Conn. App. 157, 163–64, 20 A.3d 702 (2011).

2 The jury awarded $263,000 for past noneconomic damages and $25,000

for future noneconomic damages.

3 Practice Book § 13-4 (a) provides in relevant part: ‘‘A party shall disclose

each person who may be called by that party to testify as an expert witness

at trial, and all documents that may be offered in evidence in lieu of such

expert testimony, in accordance with this section. . . .’’

4 General Statutes § 52-174 (b) provides in relevant part: ‘‘In all actions

for the recovery of damages for personal injuries or death, pending on

October 1, 1977, or brought thereafter . . . any party offering in evidence

a signed report and bill for treatment of any treating physician or physician

assistant licensed under chapter 370 . . . may have the report and bill

admitted into evidence as a business entry and it shall be presumed that

the signature on the report is that of such treating physician . . . and that

the report and bill were made in the ordinary course of business. The use

of any such report or bill in lieu of the testimony of such treating physician

. . . shall not give rise to any adverse inference concerning the testimony

or lack of testimony of such treating physician . . . . In any action to which

this subsection applies, the total amount of any bill generated by such

physician . . . shall be admissible in evidence on the issue of the cost of

reasonable and necessary medical care. . . .’’