Opinion ID: 1059566
Heading Depth: 1
Heading Rank: 2

Heading: Evidence Outside the Record

Text: 10 The Commissioner's determination that a liver transplant facility at Sentara might reduce the quality of transplants at other facilities because a new facility would reduce the number of such procedures at those facilities was based on his conclusion that the numbers of available organs may be reaching a plateau. The Court of Appeals concluded that the evidence on trends in organ donation rates was, at best, inconclusive and that the proposition was faulty because the number of liver transplants performed in Virginia increased in 1995 and 1996. Based on this rationale, the Court of Appeals held, as a matter of law that the evidence contained in the record is insufficient to support the Commissioner's finding that organ donation rates have reached a plateau, 30 Va. App. at 279, 516 S.E.2d at 696, and, therefore, that the Commissioner must have relied upon evidence outside the record in making his decision. Because such evidence outside the record constituted neither institutional knowledge nor a public statistic, the Commissioner's reliance on it was improper. Id. at 280, 516 S.E.2d at 696. Reliance on this improper evidence was reversible error, according to the Court of Appeals, because the record did not otherwise support the concerns of the Commissioner and, therefore, Sentara was prejudiced by the Commissioner's consideration of evidence outside the record regarding organ donation rates. Id. at 11 282, 516 S.E.2d at 697. We disagree with the Court of Appeals' analysis and conclusion. In considering whether the record evidence is sufficient to support a factual finding made by an agency, we apply the substantial evidence standard of review. Virginia Real Estate Comm'n v. Bias, 226 Va. 264, 268-69, 308 S.E.2d 123, 125 (1983). Under that standard, substantial evidence is  'such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'  Id. at 269, 308 S.E.2d at 125 (citations omitted). An agency's factual findings should only be rejected if,  'considering the record as a whole, a reasonable mind would necessarily come to a different conclusion.'  Id. As the Court of Appeals and trial court acknowledged, the record in this case contains testimonial and documentary evidence suppporting the proposition that the number of livers available for transplantation has reached a plateau. Examples of this evidence include a chart prepared by MCVH showing a decline in liver donations in Virginia, testimony that MCVH must import livers from out of state for its transplant program, and various letters from members of the medical community involved in liver transplantation programs. These letters state that there remains throughout the world, a scarcity of donor solid organs for transplantation; that 12 [t]here has been an increase in the numbers of liver transplants in the state with addition of programs at UVA (1988) and Fairfax (1992); however, over the past three years . . . this number has reached a state-steady plateau, indicating the driving force is now only the numbers of available donor organs; that the number of livers donated in our procurement region is inadequate to support the existing capacity of the region to perform liver transplantations; that [a]t the present time, the availability of liver transplants is limited primarily by the availability of transplantable livers. A second transplant program . . . will do nothing to change the one limiting factor. In addition, it may diminish the overall quality and effectiveness of this procedure in our area; and [t]he most dramatic improvements in access to liver transplantation for the residents of Virginia can be accomplished through initiatives directed at improving the rate of organ donations. (Emphasis omitted.) Applying the substantial evidence standard of review, we conclude that the character of this evidence would not require a reasonable person to reject it as untrustworthy or incredible and that a reasonable mind might accept it to support the conclusion that the availability of livers may have reached a plateau. And, in light of this evidence, we 13 cannot say that a reasonable person would necessarily come to a different conclusion. For these reasons, we hold that the Court of Appeals erred in finding that the Commissioner relied on evidence outside the record in making a factual finding regarding organ donation rates. Because the Commissioner did not improperly base his finding on evidence outside the record, questions of prejudice to Sentara do not arise.