Title: Jefferis v. Marzano
Citation: 298 Or. 782, 696 P.2d 1087
Docket Number: N/A
State: Oregon
Issuer: Oregon Supreme Court
Date: March 19, 1985

696 P.2d 1087 (1985)
298 Or. 782
A.L. JEFFERIS, Personal Representative of the Estate of Jo Ann Wood, Deceased, Respondent On Review,
v.
Louis A. MARZANO, Petitioner On Review, and Pathology Consultants, P.C., a Professional Corporation, Defendant.
TC 16-79-03226/CA A21703/SC S30460.

Supreme Court of Oregon, In Banc.
Argued and Submitted January 29, 1985.
Reconsideration Denied April 23, 1985.
Decided March 19, 1985.
*1088 Randall Bryson, of Bryson &amp; Bryson, Eugene, argued the cause for petitioner on review. With him on the petition was Calkins &amp; Calkins, Eugene.
J. Michael Alexander, of Brown, Burt, Swanson, Lathen &amp; Alexander, Salem, argued the cause for respondent on review.
JONES, Justice.
This is an appeal of a medical malpractice civil case against a physician and a pathology consulting corporation. The defendants were charged with negligence in the diagnosis and treatment of uterine cancer which caused the death of a 27-year-old woman. A jury found in favor of both *1089 defendants and judgment was entered accordingly.
The Court of Appeals originally affirmed the trial court judgment without opinion but, on reconsideration, reversed and remanded the case, holding that the trial judge erred in an evidentiary ruling. Jefferis v. Marzano, 64 Or. App. 855, 669 P.2d 843 (1983), rev'd and remanded on reconsideration 66 Or. App. 725, 676 P.2d 880 (1984).[1] We granted review to consider the evidentiary issue and to discuss the trial procedure which occurred when that issue arose.
The factual history of the case was accurately set forth by Judge Rossman in the Court of Appeals opinion as follows:
As a key part of the case, the plaintiff maintained that Dr. Marzano was negligent in allowing a non-medical person to evaluate and handle lab reports. The specific issue raised by the plaintiff's claim of evidentiary error, and the one on which the Court of Appeals reversed the trial court, concerned the following series of questions and answers asked Dr. Marzano by defense counsel on direct examination relating to whether the practice of having a non-medical person review lab reports was proper:
To this question plaintiff's counsel made numerous objections and, at the suggestion of the court, defense counsel reframed the question as follows:
Again plaintiff's counsel made several objections which were overruled, but before the witness could answer defense counsel asked a third question as follows:
To which plaintiff's counsel objected for the reasons stated to the previous versions of that same question. We recap the objections as follows:
The trial court overruled all these objections. We believe the ruling was correct, because the question as finally presented to the witness essentially called upon the physician to render an opinion as to whether his employe was engaged in an appropriate function[2] in handling Pap smear reports.
*1091 The defendant doctor answered the question as follows:
After an objection was overruled that the witness was not being responsive, Dr. Marzano continued:
Plaintiff's counsel then, in the presence of the jury, interjected the following objection to the doctor's testimony as follows:
The court then observed that "one of the issues is what is the community standard among specialists in this community," to which plaintiff's counsel responded:
The court further observed:
We break into the testimony and colloquy between court and counsel at this point to analyze what has occurred. The testimony of the witness adds up to the doctor stating that he allowed a non-medical person to sort out normal and abnormal Pap smear reports because this was:
We break down the legal objections of plaintiff's counsel to the answer as follows:
In discussing the basis for expert opinion, distinctions must be drawn between: (1) information and understanding that the witness has acquired as a result of his education and experience that constitute him an expert in his field; (2) information concerning the facts of the litigated case; and (3) information concerning the appropriate procedure involved in the litigated case. In this case we are concerned with the third category. Included in this third category are the expert's own experience in comparable cases, the experience of other experts communicated to him and professional principles, practices and theories that he has learned from technical literature, shop talk and the like.
It is clear that there can be no valid objection to the fact that a witness's opinion rests upon hearsay in the sense that the information he relies upon to know the appropriate medical practice is derived in part from extrajudicial statements of others. Such statements may include lectures in medical school, writings of various kinds and conversations with colleagues. It is by assimilation of hearsay of this sort that expert opinions are in fact, for the most part, made, and to demand education independent of the statement of others is to demand what does not exist and will not be forthcoming. See Weinstein, Mansfield, Abrams and Berger, Cases and Materials on Evidence 399 (7th ed 1983).
None of these objections was well taken. The appropriate medical practice is most commonly proven by learning what other specialists in the field do in the area. The appropriate medical practice in this case could have been observed by the physician at a hospital or in any other clinical setting; learned at a staff meeting at a hospital or at an educational seminar; ascertained from reading medical literature; and, finally, the appropriate medical practice could be ascertained by discussing the proper method for sorting out Pap smear reports with other doctors in the community as to what they do.
All this information is what a specialist actually uses to decide what medical practice to utilize in his or her chosen specialty. All this information is usually and properly relied upon by specialists when making their day-to-day life and death decisions in the practice of medicine. It is only incidental that this same information may be used by a physician in rendering an expert opinion in court.[3] Although OEC 703[4] was enacted by the legislature after this case arose, the legislative commentary to this rule of evidence succinctly states the reason for allowing this type of trial testimony. The commentary reads:
Although we are concerned in this case with the issue of what is the defendant doctor's opinion about appropriate medical practice as opposed to a diagnosis, both are a matter of professional opinion and the background information needed for the physician's opinion is the same. To be sure, the defendant could have subpoenaed every obstetrician/gynecologist practicing in the Springfield-Eugene area or others elsewhere and asked each specialist how Pap smear reports are handled in the specialist's office, and the sum total of that testimony would clearly demonstrate the appropriate practice. In addition, each of the specialists could be asked if they knew the appropriate practice for handling such reports. Testimony of this nature not only would be time-consuming, but of more importance, would be unnecessary. Each of these specialists in testifying about the appropriate medical practice would necessarily have to resort to the same sources of information as relied upon by the witness in this case. In effect each would testify, "I do it this way because I learned to do it this way. I learned to do it this way by talking to other doctors, attending staff meetings, observing other specialists' practices, reading literature, etc." The same objection could be raised and the solution no different.
Oregon has recognized that experts in land condemnation cases may rely upon the out-of-court discussions by others involved in sales of real property as a proper basis for forming their opinions on the value of property. See, Highway Commission v. Fisch-Or, 241 Or. 412, 399 P.2d 1011, 406 P.2d 539 (1965). Similarly, prior to the adoption of OEC 703, we have held that expert medical witnesses may base their opinions at trial upon medical charts and records not in evidence to the same extent that they would rely upon the same documents in the treatment of their patients. Lewis v. Baker, 243 Or. 317, 326, 413 P.2d 400 (1966). The facts or data which form the basis for the opinion need not be restricted to hospital charts or records, but may include any facts or data of "a type reasonably relied upon by experts in the field" in making their day-to-day professional opinions or in engaging in their day-to-day standard of practice. The objection by counsel that the doctor's answer was based on hearsay was properly overruled by the trial court.[5]
After the court overruled the hearsay objection, defense counsel asked the defendant physician the following question:
To which the witness responded:
Again, plaintiff's counsel launched into a totally inappropriate objection moving to strike the answer because, "I do not believe for a minute that it is true." The court instantly and appropriately cut off counsel's outburst by ruling that counsel's personal belief was irrelevant. However, the court's ruling did not dissuade plaintiff's counsel from continuing to inject his own alleged personal knowledge into the case. Plaintiff's counsel objected by stating:
We observe from the record that although plaintiff's counsel originally moved to strike the doctor's assertion on the stand that all the people he named "did something in a way that we have already discussed," upon inquiry from the court, counsel *1095 redefined his motion to strike the names of the particular doctors and the names of the specific institutions on the basis that he could not cross-examine them.
The fact of the matter is that counsel could cross-examine the witness as to the names of each of the doctors and about the names of the institutions. Further, by being provided specific information, plaintiff's counsel could have called any or all the physicians named as well as persons practicing at the institutions if he wished to contradict Dr. Marzano's testimony. Even giving counsel's objection the widest scope, the witness merely was pointing out to the jury the basis of his opinion. His testimony was that he became aware of the practice by ascertaining which doctors were engaged in that practice and how those doctors performed the particular function of sorting Pap smear reports. There is not one word of testimony that any specific doctor made a specific out-of-court statement, oral, written or otherwise, which statement was offered in court to prove the truth of the matter asserted.[6] The testimony was that the witness "became aware of the standard of practice" (emphasis added), without defining how this awareness was developed. But even if the witness had personally talked to each of these doctors and each of these doctors had told the witness what his practice was in handling Pap smear reports, as we said earlier in this opinion, the testimony nevertheless would still not be subject to a hearsay attack because this information was gathered to form the basis of engaging in a standard of practice and is the type of data that physicians rely upon in making their day-to-day life and death decisions. This type of data which is commonly relied upon by physicians in making professional opinions and judgments is likewise a proper basis for forming expert opinions to be rendered in court.
The trial court's ruling as to each and every one of the defendant's objections was proper.
In disposing of this case, we do not turn our backs on the challenges inherent within OEC 703. This rule has been the subject of much controversy and may well present this court with future difficulty. See Arnolds, Federal Rule of Evidence 703: The Back Door is Wide Open, 20 Forum 1 (1984). However, our decision in this case would be the same whether we were dealing with OEC 703 or its predecessor law.
The Court of Appeals is reversed and the trial court judgment in favor of defendant Marzano is reinstated.
[1]  The opinion on reconsideration reversing and remanding to the trial court was filed January 25, 1984. On February 7, 1984, defendant Pathology Consultants filed a petition for reconsideration of the opinion on reconsideration. The Court of Appeals allowed the petition and affirmed the trial court judgment as to Pathology Consultants, modifying its former opinion to reflect that the reversal of the trial court judgment applied only to defendant Marzano. Jefferis v. Marzano, 67 Or. App. 527, 678 P.2d 781 (1984). Plaintiff did not seek review of this ruling.
[2]  As we said in Creasey v. Hogan, 292 Or. 154, 166-67, 637 P.2d 114 (1981):

"* * * The competency of the expert to express an opinion is not established by knowledge of the legal standard of care but by knowledge of what is proper conduct by practitioners in the community or a similar community under circumstances similar to those which confronted the defendant. * * *"
[3]  On hearsay and expert testimony in general, see Maguire and Hahesy, Requisite Proof of Basis for Expert Opinion, 5 Vand.L.Rev. 432 (1952), Selected Writings on Evidence and Trial 503 (1957); Rheingold, The Basis of Medical Testimony, 15 Vand.L.Rev. 473 (1962).
[4]  OEC 703 provides:

"The facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to the expert at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence."
[5]  We note that the objection was not restricted to hearsay but included an unsworn statement by counsel: "I don't know whether [everybody could be disobeying the law]. I never heard of a doctor who did what they did in my life." (Emphasis added.) Defense counsel objected that the plaintiff's lawyer's statement was inappropriate to be made before the jury. We certainly agree. No counsel should express personal opinions on the facts of a case or give unsworn testimony about an essential aspect of a case at any time and especially before the jury. DR 7-106(C)(3) provides:

"In appearing in the lawyer's professional capacity before a tribunal, a lawyer shall not:
* * * * * *
(3) Assert his personal knowledge of the facts in issue, except when testifying as a witness."
Trial courts must restrict counsel's objections to a statement of the antiseptic legal grounds without argument and without comment. After hearing counsel's objection, ordinarily the court should rule on the objection and if either party is aggrieved by the ruling the aggrieved party should ask to be heard on the objection outside the presence of the jury. There should be no occasion for discussion of legal matters before the jury.
[6]  OEC 801(3) defines hearsay as "a statement, other than one made by the declarant while testifying at the trial or hearing, offered in evidence to prove the truth of the matter asserted." OEC 801 adopts the essence of pre-code definitions of hearsay. See, Sheedy v. Stall, 255 Or. 594, 468 P.2d 529 (1970).