Opinion ID: 4469365
Heading Depth: 3
Heading Rank: 4

Heading: Testimony of Dr. Polk

Text: Dr. Norman Polk (“Dr. Polk”) served as minor son’s diagnostic radiologist at Wahiawa General Hospital. Dr. Polk had begun practicing medicine in Hawaiʻi during his residency at Tripler in 1975, where he worked for about four years. Dr. Polk was on duty as a radiologist at Wahiawa General Hospital on September 22, 2014. His involvement in minor son’s care consisted of viewing radiographs taken of minor son and speaking with Dr. Doerrige regarding his findings. He opined that minor son had a left femur mid-shaft fracture that was slightly angulated anteriorly. Dr. Polk also testified there was soft tissue swelling, but the babygram did not reveal any prior fractures. After being stabilized at Wahiawa General Hospital, minor son had been taken to Tripler for treatment. The deputy prosecuting attorney then began asking Dr. Polk whether he previously had the opportunity to view several x-ray images apparently taken at Tripler before coming to court that day. Dr. Polk responded that he had seen “the post-treated injury when [minor son] was at Tripler.” The deputy prosecuting attorney then asked Dr. Polk whether in his past experience, he had viewed x-ray images from Tripler. Dr. Polk then responded 14  FOR PUBLICATION IN WEST’S HAWAIʻI REPORTS AND PACIFIC REPORTER  in the affirmative to this question as well as another question regarding whether he relied on images from other hospitals. The deputy prosecuting attorney then handed State’s Exhibit 3 for identification to Dr. Polk and asked him to verify that the name, date of birth, and date of the image was “in line” with the x-rays he had previously reviewed regarding minor son. Dr. Polk agreed that “[t]hey appear[ed] to correlate.” Dr. Polk then began testifying as to what State’s Exhibit 3 for identification showed even before it was received in evidence. In summary, he described State’s Exhibit 3 as showing a left femur after it had been realigned. Although Dr. Polk did not testify that the image was of minor son’s left femur, he stated it “look[ed] [like a] fair and accurate” depiction of minor son’s fracture. The deputy prosecuting attorney then began asking about another Tripler x-ray, a lateral view x-ray of a left femur that had been realigned, marked as State’s Exhibit 4. The deputy public defender then objected that Dr. Polk had been testifying regarding exhibits yet to be received in evidence, and also asserted that no proper foundation had been laid for the admission of the x-rays. The family court disagreed and admitted State’s Exhibit 3 into evidence. The deputy public 15  FOR PUBLICATION IN WEST’S HAWAIʻI REPORTS AND PACIFIC REPORTER  defender raised a running objection to the State’s other exhibits. Dr. Polk then further explained what was depicted in State’s Exhibit 3: For the sake of discussion, this is the femur, or thigh bone is what people know it as. And this is the fracture here, the mid-portion. And these two pieces of bone have been separated. And if there’s no fracture the white line would be contiguous all the way through. The knee doesn’t have any obvious fracture. The tibia and fibula, which are the lower leg bones, don’t show any obvious fracture. This is the hip. There’s no displacement or fracture up here. Basically the fracture involves the midshaft. And now it looks like it’s well aligned for orthopedic purposes on this film. The white lines out here are the plaster cast. And the swelling is -- it’s basically adjacent to the area of the fractures. You don’t see the same sort of swelling down below. After foundational questions were asked similar to those asked of State’s Exhibit 3, State’s Exhibit 4 was also admitted into evidence. Dr. Polk then also opined that minor son’s injury would be consistent with jumping and falling off of a bed only “[i]f the bed was on a second story of a building.” He explained as follows: Children’s bones are unlike old people[’s bones] . . . . Children[’s] . . . bones tend to bend. . . . So it takes a lot of force to take a young kid’s leg -- and the femur is . . . one of the largest and strongest bones in the body -- to take it and actually break it in two pieces, snap it in two and to displace it, . . . that’s a lot of force. He also testified that a broken femur in a two-year-old is a “really unusual” injury, and is often related to non-accidental 16  FOR PUBLICATION IN WEST’S HAWAIʻI REPORTS AND PACIFIC REPORTER  trauma, such as an automobile accident, falling down the stairs, or blunt force trauma.