Opinion ID: 1742206
Heading Depth: 2
Heading Rank: 3

Heading: Double Hearsay Statements to Nurse McCormick

Text: [11] ¶ 34. The statements of Nurse Practitioner McCormick require a more detailed analysis, since McCormick's challenged testimony was not just the result of a personal conversation with Jeri, but was also based on third-party statements made to McCormick by Jeri's mother and Bell. Such testimony constitutes double hearsay. To be admissible, each prong of a double hearsay statement must conform with an individual exception to the hearsay rule. See Wis. Stat. § 908.05; [7] State v. Kreuser, 91 Wis. 2d 242, 249, 280 N.W.2d 270 (1979). ¶ 35. As discussed above, Jeri's statements to her mother are admissible under either the excited utterance or the residual hearsay exception. Thus, the first step of the double hearsay requirement is met. Our double hearsay inquiry then turns on whether the statements of Jeri's mother to McCormick also fit within an established hearsay exception. See Wis. Stat. § 908.05. ¶ 36. The State contends, and the court of appeals agreed, that the statements of the mother to McCormick fall within the medical diagnosis or treatment exception, Wis. Stat. § 908.03(4). [8] This presents us with a question of first impression. This court has never considered whether the medical diagnosis exception applies only to first parties speaking with their health care providers, or whether the exception may also be invoked to cover third parties making statements in the course of seeking diagnosis and medical treatment for another. ¶ 37. As a threshold matter, we note that at trial the defendant challenged the application of Wis. Stat. § 908.03(4) to McCormick's testimony by claiming McCormick was not consulted for purposes of medical diagnosis or treatment. However, McCormick explicitly testified that Jeri was referred to her office by Bell for purposes of diagnosing the extent of the abuse she had suffered and determining an appropriate course of treatment. The circuit court accepted McCormick's testimony on this issue and determined that the nurse practitioner was consulted for medical purposes. This is a discretionary credibility conclusion which binds this court. [12] ¶ 38. We are thus squarely confronted with third-party application of Wis. Stat. § 908.03(4). In considering the scope of the medical diagnosis exception, we must remain cognizant of the previously stated underlying basis for all hearsay exceptions: the presence of sufficient guarantees of trustworthiness. The primary guarantee of trustworthiness surrounding a declarant's statements offered for purposes of medical diagnosis or treatment is that, because any proposed treatment will be based in part on the exactitude and veracity of those statements, the declarant has a substantial self-interest in being truthful. See State v. Wyss, 124 Wis. 2d 681, 370 N.W.2d 745 (1985), overruled on other grounds, State v. Poellinger, 153 Wis. 2d 493, 505, 451 N.W.2d 752 (1990). [13] ¶ 39. Young children cannot independently seek out medical attention, but must rely on their caretakers to do so. A parent's interest in obtaining necessary medical care for a child demonstrates fundamental indicia of reliability. See United States v. Yazzie, 59 F.3d 807, 813 (9th Cir. 1995). Moreover, as Weinstein notes in relation to parental statements to medical professionals, [t]he relationship between declarant and patient will usually determine admissibility. In the case of a child, a court would surely presume the absence of any motive to mislead on the part of the parents. 5 Jack B. Weinstein & Margaret A. Berger, Weinstein's Federal Evidence, § 803.09[3], at 803-43 (Joseph M. McLaughlin ed., 2d ed. 1997). Accordingly, because Jeri's statements to her mother are admissible under a recognized hearsay exception, and because the mother's statements to McCormick fall within. Wis. Stat. § 908.03(4), the circuit court's discretionary decision to admit that portion of McCormick's testimony was reasonable. [9] ¶ 40. The circuit court in this case also admitted McCormick's testimony that repeated what Jeri had told Bell. The circuit court made this ruling relying on its impression that Jeri's statements to Bell were also statements made in the course of seeking medical diagnosis or treatment. We disagree. ¶ 41. While this court has not confined the scope of Wis. Stat. § 908.03(4) solely to medical doctors, we have not previously applied the exception to counselors or social workers. We have applied the exception to statements made to psychologists. See State v. Nelson, 138 Wis. 2d 418, 424, 406 N.W.2d 385 (1987). We have applied the exception to statements made to psychiatrists. See State v. Wyss, 124 Wis. 2d at 707. Our courts have also applied the exception to chiropractors. See Klingman v. Kruschke, 115 Wis. 2d 124, 126, 339 N.W.2d 603 (Ct. App. 1983). Moreover, in this case we apply the exception to statements concerning medical diagnosis or treatment that are made to a nurse practitioner on staff with a physician. ¶ 42. We decline, however, to apply the hearsay exception for statements made for medical diagnosis or treatment, Wis. Stat. § 908.03(4), to statements made to counselors or social workers. Such an expansive application of the doctrine would strain the traditional grounds for the exception. Receipt of proper medical diagnosis and treatment requires doctors to obtain basic information about a patient implicating that diagnosis and treatment. The doctor is focused on diagnosis and treatment of the individual, not on the process of providing larger social remedies aimed at detecting abuse, identifying and punishing abusers, and preventing further mistreatment, which involves skills and social intervention lying beyond the expertise of doctors. 4 Christopher B. Mueller & Laird C. Kirkpatrick, Federal Evidence § 442, at 464 (2d ed. 1994). ¶ 43. Because we decline to extent the medical diagnosis or treatment exception to counselors and social workers, the double hearsay test cannot be fulfilled. Admission of the statements based on McCormick's conversation with Bell was an erroneous exercise of discretion. However, we determine that the error was harmless because McCormick's rendition of Jeri's abuse was also based on her conversations with Jeri and Jeri's mother, who repeated essentially the same allegations. We conclude there is no reasonable probability that the error contributed to the defendant's conviction. See State v. Dyess, 124 Wis. 2d 525, 543, 370 N.W.2d 222 (1985). ¶ 44. We also note that the defendant asserted at oral argument, though not in briefs, that the circuit court's admission of Jeri's statements to her mother, sister, Officer Glau, Bell, and McCormick was piling on and was cumulative. Under Wis. Stat. § 904.03, needless presentation of cumulative evidence is one factor in the circuit court's discretionary consideration of whether evidence is more prejudicial than probative. [14] ¶ 45. There was no cumulative error in this case. It is significant that at trial the defendant's theory of the case was that the defendant did not commit the crimes alleged. Inherent in this position is an assertion that the victim had falsified her accusations. When the State pressed the court on whether the defense could attack inconsistencies in Jeri's testimony, the defense responded, [T]hat's our entire defense. The defense repeatedly proved this assertion by attacking perceived inconsistencies in Jeri's statements to each of the other witnesses. By attacking Jeri's testimony in such a manner, the defendant made the testimony of the individuals to whom Jeri had repeated her accusations material to the case. Accordingly, the circuit court's failure to find the repetitive testimony cumulative and prejudicial was not an erroneous exercise of discretion.