Title: May v. Caruso
Citation: N/A
Docket Number: 012560
State: Virginia
Issuer: Virginia Supreme Court
Date: September 13, 2002

Present:  All the Justices 
 
ROBERT A. MAY, EXECUTOR OF THE ESTATE 
 OF VIRGIL R. MAY, M.D., DECEASED 
 
OPINION BY 
v.  Record No. 012560 
JUSTICE LAWRENCE L. KOONTZ, JR. 
 
September 13, 2002 
ANTHONY C. CARUSO, M.D., ET AL. 
 
 
FROM THE CIRCUIT COURT OF THE CITY OF RICHMOND 
Randall G. Johnson, Judge 
 
In this appeal, we consider whether the trial court erred 
in excluding certain evidence proffered by the plaintiff in a 
medical malpractice action.  The trial court ruled that the 
plaintiff had not satisfied the requirements of the hearsay 
exception for statements published in authoritative treatises 
and articles contained in Code § 8.01-401.1 and, thus, 
prohibited the introduction into evidence of statements 
contained in certain published medical literature relied upon by 
the plaintiff’s expert witness.  The trial court also excluded 
certain medical treatment records proffered by the plaintiff, 
ruling that this evidence was cumulative of prior testimony.  
Following a jury verdict for the defendant, plaintiff appealed, 
assigning error to these two actions of the trial court.  We 
will address each issue seriatim, stating within our discussion 
the relevant facts. 
On September 29, 2000, Robert A. May, executor of the 
estate of Virgil R. May, M.D., filed a motion for judgment 
alleging that Dr. May’s death was the result of medical 
malpractice.  Anthony C. Caruso, M.D. and his incorporated 
medical group, Cardiovascular Associates of Virginia, P.C., 
(collectively “Dr. Caruso”) were named as defendants to the 
action.  For purposes of our analysis of the issues presented in 
this appeal, the principal allegation of the motion for judgment 
was that Dr. May suffered a severe stroke and ultimately died as 
a result of Dr. Caruso’s breach of the standard of care by 
failing to provide anticoagulant therapy to Dr. May as part of 
his course of treatment related to the implantation of a 
temporary pacemaker. 
Prior to trial, the executor provided Dr. Caruso with 
copies of nine medical journal articles and three abstracts of 
medical articles totaling fifty-one pages of text that the 
executor had identified in his designation of medical literature 
relied upon by his expert witness, Dr. Albert Waldo.  Dr. Caruso 
filed a motion in limine to exclude the introduction of any 
statements contained in this literature.  In that motion, he 
asserted that the executor had failed to identify, as required 
by Code § 8.01-401.1, the specific statements Dr. Waldo had 
relied upon to reach his expert opinion that Dr. Caruso had 
breached the applicable standard of care.  The executor 
contended, and continues to contend on appeal, that the 
requirements of Code § 8.01-401.1 are satisfied by providing 
 
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copies of the published literature containing the statements 
relied upon by an expert witness, and that identification of 
discrete, specific statements is not required.  The trial court 
disagreed with the executor and sustained the motion in limine. 
The executor’s first two assignments of error address the 
trial court’s interpretation and application of Code § 8.01-
401.1.  In previously construing Code § 8.01-401.1, we held that 
although this statute authorizes the admission into evidence of 
an expert’s opinion that may be based in whole or in part on 
inadmissible hearsay, it did not authorize the admission of any 
hearsay opinion on which the expert’s opinion was based.  McMunn 
v. Tatum, 237 Va. 558, 566, 379 S.E.2d 908, 912 (1989); accord 
Todd v. Williams, 242 Va. 178, 181, 409 S.E.2d 450, 452 (1991).  
In 1994, the General Assembly amended Code § 8.01-401.1.  In 
relevant part, this amendment to Code § 8.01-401.1 provides: 
To the extent . . . 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. 
 
 
In Weinberg v. Given, 252 Va. 221, 225, 476 S.E.2d 502, 504 
(1996), we held that the 1994 amendment to Code § 8.01-401.1 “is 
 
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clear and unambiguous.”  We further held that this amendment 
made a substantive change in Code § 8.01-401.1 to permit, in 
certain limited circumstances, the hearsay content of certain 
statements contained in published and authoritative literature 
to be read into the record as substantive evidence, provided no 
other evidentiary rule prohibits such admission.  Id. at 226, 
476 S.E.2d at 504.  In Weinberg, however, we were not called 
upon to address any distinction the amendment makes between the 
admissible statements and the “treatises, periodicals or 
pamphlets” in which the statements are contained.  The present 
appeal requires that we do so. 
 
Pertinent to the procedural context in which the issue 
arose in this case, the clear and unambiguous language of the 
statute limits the hearsay exception applicable to statements to 
be introduced through an expert on direct examination to those 
instances in which “copies of the statements” are provided to 
opposing parties thirty days prior to trial or as ordered by the 
trial court.  Unquestionably, the statements the executor 
intended to have Dr. Waldo read into the record were contained 
within the copies of the complete medical articles and abstracts 
provided to Dr. Caruso by the executor.  As such, the provision 
of these copies technically complied with the requirements of 
Code § 8.01-401.1.   
 
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The statute is equally clear, however, that mere technical 
compliance with its requirements does not mandate admission of 
the statements into evidence by the trial court.  The statute 
expressly refers to statements contained in the published 
literature rather than the content of that literature in its 
entirety.  Moreover, the statute expressly provides that such 
statements “[i]f admitted . . . may be read into evidence but 
may not be received as exhibits.”  (Emphasis added).  The 
General Assembly’s use of this conditional language clearly 
indicates its intent that the decision whether to admit such 
evidence is committed to the sound discretion of the trial 
court.  Such discretion is particularly appropriate in light of 
the apparent purpose of limiting the hearsay exception to ensure 
notice to the opposing party and thereby safeguard the opposing 
party’s right to meaningful cross-examination of the expert 
witness.  See McMunn, 237 Va. at 566, 379 S.E.2d at 912. 
A trial court’s exercise of its discretion in determining 
whether to admit or exclude evidence will not be overturned on 
appeal absent evidence that the trial court abused that 
discretion.  John v. Im, 263 Va. 315, 320, 559 S.E.2d 694, 696 
(2002).  Here, we cannot say that the trial court abused its 
discretion in determining that the executor failed to adequately 
identify the statements he would seek to introduce into evidence 
through Dr. Waldo’s testimony.  Accordingly, we hold that the 
 
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trial court did not err in prohibiting the introduction of any 
of the statements contained in the literature provided by the 
executor to Dr. Caruso. 
During trial, the executor proffered as an exhibit over 300 
pages of medical records detailing Dr. May’s treatment and test 
results.  The trial court refused to admit the exhibit into 
evidence, ruling that it was cumulative of prior testimony.  On 
appeal, the executor contends in his third assignment of error 
that the trial court abused its discretion in refusing to admit 
this exhibit because “[i]t was vital for the jury to have this 
. . . exhibit to assess Dr. Caruso’s credibility.”  We disagree. 
Assuming, without deciding, that the entire content of the 
exhibit was relevant to some contested issue before the jury, 
the exclusion by the trial court of relevant evidence does not 
constitute reversible error if that evidence is merely 
cumulative.  Pace v. Richmond, 231 Va. 216, 227, 343 S.E.2d 59, 
65 (1986); Eason v. Eason, 203 Va. 246, 254, 123 S.E.2d 361, 367 
(1962).  “It is well settled in this jurisdiction that the 
exclusion of evidence favorable to a party in a civil action on 
the ground that it is repetitious and cumulative is a matter 
within the sound discretion of the trial court and that its 
ruling is entitled on review to a presumption of correctness.”  
Harrison v. Commonwealth, 244 Va. 576, 585, 423 S.E.2d 160, 165 
 
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(1992); accord Philip Morris Incorporated v. Emerson, 235 Va. 
380, 410, 368 S.E.2d 268, 284 (1988). 
Applying that standard, we cannot say that the trial court 
abused its discretion in excluding the medical record evidence 
proffered by the executor.  In light of the testimony of Dr. 
May’s initial treating physician, Dr. Alston Blount, and the 
executor’s other witnesses, the medical records would not have 
substantially assisted the jury in weighing the credibility of 
Dr. Caruso or otherwise to resolve any disputed issue of fact.  
Moreover, the sheer volume of the exhibit potentially could have 
overwhelmed and confused the jury.  Accordingly, we hold that 
the trial court did not err in refusing to admit the medical 
records into evidence as an exhibit. 
For these reasons, we will affirm the judgment of the trial 
court. 
Affirmed. 
 
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