Opinion ID: 195070
Heading Depth: 1
Heading Rank: 2

Heading: the admission of testimony

Text: 44 Defendant's argument on this issue is stated as follows: 45 The Trial Court Abused Its Discretion By Allowing The Plaintiffs To Ask Nurse Watkins Whether She Had Investigated The Source Of Kimberly F.'s Infection 46 A. Mrs. Watkins's Testimony About Her Investigation on Behalf of the Infections Committee Was Precluded by the Express Terms of the Statute Appellants' Brief at -i-. 47 We have scoured the record and can find no question by plaintiff's counsel on direct examination of Nurse Watkins asking whether she had investigated the source of Kimberly F.'s [plaintiff's] infection. Nor have we been able to find any testimony by Nurse Watkins about her investigation on behalf of the Infections Committee. 48 Nurse Watkins testified that plaintiff's husband spoke to her in 1986 about the source of plaintiff's infection. At that time he was employed by the Mary Hitchcock Memorial Hospital as an echocardiography technologist and knew Nurse Watkins as a co-worker. Plaintiff's husband knew that Nurse Watkins' special responsibility was infection control and transmission of infectious diseases. According to Nurse Watkins, when plaintiff's husband spoke to her he had three specific concerns: the use of ice packs, lack of cleanliness generally in the hospital, and the dirty bathtub. Nurse Watkins said she would look into it. She denied that the husband asked her to inquire into a few things. She never informed the husband about anything bearing on the source of plaintiff's infection. Nor did she tell him that she would make an investigation for the hospital. Most of the direct examination of Nurse Watkins by plaintiff's counsel focussed on the infection control procedures used at the hospital. 49 Nurse Watkins was also asked questions about entries in the plaintiff's hospital records by the doctors and nurses who treated her. 50 On cross-examination Nurse Watkins gave the following testimony: 51 Q. Given your job as [sic] the hospital, as nurse epidemiologist, what do you generally do when a, a question of a hospital-acquired infection is brought to you? 52 A. Well, it's my job to look into the circumstances of the infection, with the primary being a focus to identify practices which could be improved to decrease the risk of similar infections in the future. 53 I also had the responsibility for educating hospital personnel about infection risk and transmission again so that their practice will decrease the risk of transmission. 54 Q. Now, did you take those steps when Mr. F. came to you and suggested the problems he did? 55
56 Q. What did you conclude? 57 There was an objection by plaintiff's counsel to the last question which was upheld on the ground that it was precluded by N.H. Rev. Stat. Ann. ch. 151:13-a (1981). 58 Before we discuss the scope of the New Hampshire statute we also must point out another serious omission in the record. Defense counsel made no objection to any of the questions pertinent to this issue asked by plaintiff's counsel. This was a waiver of the issue under Fed. R. Evid. 103(a)(1). 3 Nor is this omission cured because defendants had filed a motion in limine at the start of trial. Objections to questions must be made when the questions are asked. We also point out that there was not even a general objection to the line of questioning, although we do not suggest that this would have been sufficient to preserve defendants' rights. 59 The pertinent provision of the New Hampshire statute provides: 60 II. Records of a hospital committee organized to evaluate matters relating to the care and treatment of patients or to reduce morbidity and mortality and testimony by hospital trustees, medical staff, employees, or other committee attendees relating to activities of the quality assurance committee shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding, except that in the case of a legal action brought by a quality assurance committee to revoke or restrict a physician's license or hospital staff privileges, or in a proceeding alleging repetitive malicious action and personal injury brought against a physician, a committee's records shall be discoverable. 61 N.H. Rev. Stat. Ann. ch. 151:13-a II. The New Hampshire Supreme Court carefully delineated the scope of the statute in a case that was the opening chapter to the case before us. The parties were the same; the issue concerned only the scope of the statute. Justice Souter, then an associate justice of the New Hampshire Supreme Court, wrote the opinion, In re K, 561 A.2d 1063 (N.H. 1989). In the state case the evidence was clear that Nurse Watkins made an investigation as to the source of plaintiff's infection, then made a report to the Infections Committee and prepared a written report which was kept in files in her own office. Plaintiff's lawyer requested the hospital, through Nurse Watkins, to release the results of the investigation. The hospital refused, claiming a privilege under N.H. Rev. Stat. Ann. 151:13-a. Plaintiff then brought a petition in the New Hampshire Superior Court seeking a disclosure order. The superior court held the privilege inapplicable and ordered disclosure of Nurse Watkins' written report and the relevant portion of the minutes of the meeting of the Infections Committee at which Nurse Watkins made her report. The hospital appealed. Id. at 1065. After a lengthy explanation and discussion of the legislation, the New Hampshire Supreme Court held that the minutes of the Infection Committee meeting and Nurse Watkins' written report were insulated from disclosure by the New Hampshire statute. Id. at 1065. The court also held: 62 Once, however, it is understood that the requisite committee structure and quality review function are present, our traditionally limiting approach to privilege claims must be honored by recognizing that the privilege does not go beyond the records of testimony, as such, to which the statute refers. As we observed before, a quality assurance committee's attention does not place its subject matter beyond the bounds of discovery or disclosure in the normal course; the privilege is confined to the records and testimony described in the statute. See N.H.S. Jour. 1410-14 (1981). Thus, the ordinary record of a patient's treatment remains admissible as it always has been, even though a quality assurance committee may have studied that record and issued a report based on data culled from it. And a physician may still be obligated to testify about the course of a patient's case, and to render a professional evaluation of the treatment, even though a quality assurance committee may already have elicited the same testimony on the same subject in the course of its own proceedings. 63 Id. at 1070. 64 We have no difficulty finding that the New Hampshire statute was not implicated by the direct examination of Nurse Watkins in the case at bar. It was arguably implicated by defendants' cross-examination, but that is not an issue before us. It is incredible to us that defendants would misstate in their argument the questions asked and the testimony given, fail to object at trial to questions and answers which they now claim led to a violation of the statute, deliberately implicate the statute on cross-examination, and still appeal the issue. This not only transcends the proper limit of appellate argument, it requires a good measure of chutzpa.