Opinion ID: 852280
Heading Depth: 1
Heading Rank: 1

Heading: Admission of Plaintiff's Testimony

Text: The defendant first challenges the trial court's decision in allowing the plaintiff, over defendant's objection, to recite hearsay testimony at trial about what Dr. Saquib told her about her injuries. Appellant's Br. at 16. The defendant argues that Dr. Saquib, Cave's internist, was not the one receiving medical diagnosis or treatment and that the plaintiff's testimony as to what Dr. Saquib allegedly told her about the results of diagnostic tests and the cause of her pain does not qualify as an exception to the hearsay rule under Evid. R. 803(4) since the statements at issue were made by Dr. Saquib to Cave and not by Cave to Dr. Saquib for purposes of receiving a diagnosis or treatment. Id. at 19. Indiana Evidence Rule 803(4) operates as an exception to the general rule that hearsay is inadmissible evidence at trial. The rule states: Statements for Purpose of Medical Diagnosis or Treatment. Statements made for purposes of medical diagnosis or treatment and describing medical history, or past or present symptoms, pain, or sensations, or the inception or general character of the cause or external source thereof insofar as reasonably pertinent to diagnosis or treatment. The plaintiff points to Coffey v. Coffey, 649 N.E.2d 1074 (Ind.Ct.App.1995), trans. not sought, as authority for allowing statements made by a health care provider to a patient to be admitted under the 803(4) hearsay exception. Coffey involved the distribution of marital assets in a dissolution proceeding. To show available assets, the husband attempted to admit a letter from his doctor describing his medical condition and diagnosis, arguably a relevant factor when determining property division. Id. at 1078. The trial court excluded the letter, and in his appeal, the husband argued the letter should have been admitted under 803(4). Id. The Court of Appeals agreed, reversed, and remanded, apparently concluding that the letter's information regarding physical diagnosis, treatment agenda, and resulting inability to work fell within rule 803(4)'s language, which does not explicitly state whose statements fall within the exception. We disagree with and disapprove of this holding in Coffey. The rationale for the 803(4) hearsay exception is that a declarant has a personal interest in obtaining a medical diagnosis and treatment, and this interest motivates the patient to provide truthful information. See McClain v. State, 675 N.E.2d 329, 331 (Ind.1996). Stated another way, a patient's personal interest in receiving medical treatment supplies significant indicia of reliability that the patient's statements are true, thus reducing the need for exclusion of hearsay evidence not subject to cross-examination. Declarations made by a physician or other health care provider to a patient do not share this enhanced indicia of reliability. Furthermore, because of the substantial likelihood that a typical patient may fail to fully or accurately comprehend or understand the physician's report, to admit into evidence a patient's personal perception of the physician's statement would not only foster the possibility of misreporting but also eliminate the opportunity for clarifying cross-examination of the physician. While Rule 803(4) does not expressly identify which declarants' medical statements are intended to be treated as a hearsay rule exception, we hold that the Rule is intended and should apply only to statements made by persons who are seeking medical diagnosis or treatment. For this reason, the plaintiff's testimony reporting Dr. Saquib's statements about the results of diagnostic tests and the cause of her pain does not qualify as an exception to the hearsay rule under Rule 803(4). On the other hand, errors in the admission of evidence are to be disregarded as harmless error unless they affect the substantial rights of a party. McClain, 675 N.E.2d at 331. Likewise, reversible error cannot be predicated upon the erroneous admission of evidence that is merely cumulative of other evidence that has already been properly admitted. Davis v. Garrett, 887 N.E.2d 942, 947 (Ind. Ct.App.2008), trans. denied. To determine whether the admission of evidence affected a party's substantial rights, we assess the probable impact of the evidence upon the jury. McClain, 675 N.E.2d at 331. Anticipating the application of the harmless error doctrine, the defendant argues that the objectionable evidence is not merely cumulative of other evidence and that [i]t cannot be said that the addition of the `medical testimony' from the absent Dr. Saquib could not have affected the jury's decision and hence the outcome of the trial. Appellant's Br. at 21. The defendant principally challenges the plaintiff's testimony reporting Dr. Saquib's statements to her regarding the probable degree and duration of discomfort, the frequency that similar traffic accidents result in injuries not immediately evident, that the curve of my spine was off based on like whiplash, that her MRI showed a bulging disc between L5 and S2 spine bones, and that the location of the bulging disc was in the same spot that the plaintiff initially identified in the emergency room. Appellant's Br. at 7-9. The defendant identifies the plaintiff's statement, I knew the pain in my lower back was because of the bulging disc, id. at 10, and argues that it was improperly admitted over his objection for lack of foundation, showing no medical expertise, id. at 19-20. We find that substantially all of this evidence was also presented to the jury through other exhibits, including Plaintiff's Exhibit 11, fifty-five pages of the plaintiff's medical treatment records from Priority 1 Medical, where she was under the care of Dr. Saquib, and through the testimony of the plaintiff's medical witness, Dr. Sheppard. The Priority 1 Medical records, including the plaintiff's MRI test results, were admitted without objection. Among the other evidence admitted, for example, was the written report of radiologist Ronald I. Landau, M.D., expressing his MRI impression of Annular disc bulging at L5-S1. Plaintiff's Exhibit 12, Appellee's App'x at 309-10. In addition, Dr. Sheppard testified without objection that the MRI showed that the plaintiff was suffering from a bulging disc at L5-S1, that this was consistent with her complaints of back pain, and that her injuries were the result of trauma. Considering the nature and probable impact of the plaintiff's lay testimony expressing her recollection of medical information received, the substantial medical confirmation and elaboration provided through the testimony of Dr. Sheppard, and the rather extensive medical records admitted without objection, we conclude that the erroneous admission of the plaintiff's testimony regarding what Dr. Saquib told her about the results of diagnostic testing is cumulative, did not affect the defendant's substantial rights, and thus does not require reversal. [3] The defendant also contends that the trial court erred in permitting the plaintiff to give her own opinion as to the cause of her pain. In this regard, the defendant identifies a single statement as being improperly admitted. When asked on direct examination what she believed was causing her pain, the plaintiff replied: Well I knew that the pain in my lower back was because of the bulging disc, the rest of it was just terrible muscle pain I felt like I had been rolled down stairs repeatedly. Appellant's Br. at 10, quoting Tr. at 90, Appellant's App'x at 20. The defendant's sole trial objection claimed no proper foundation. Id. The trial court overruled the objection stating, I think it's within the range of what a patient can or the plaintiff can describe. Id. On appeal, the defendant alternatively contends that the plaintiff should not have been permitted to repeat the opinion of Dr. Saquib under the guise of Rule 803(4) or that, if the plaintiff had arrived at these opinions on her own, she was not qualified to give medical opinion testimony under Indiana Evidence Rule 702 absent a proper foundation. Only the claim of improper foundation was presented at trial and is thus eligible for appellate consideration. In giving the challenged testimony, the plaintiff was not testifying as an expert. The question eliciting the plaintiff's response did not ask for her medical expertise regarding the causation of her pain; it merely asked, What did you believe was causing your pain? Tr. at 90, Appellant's App'x at 20. Her resulting answer, merely stating her own personal belief about the source of her pain, was permissible as testimony by a lay witness pursuant to Indiana Evidence Rule 701. The trial court did not err in overruling the defendant's objection.