Opinion ID: 2069963
Heading Depth: 1
Heading Rank: 2

Heading: The Refusal to Admit Perales's Medical Records

Text: Jose Perales testified for the defense and admitted that the cocaine was his alone and that before his encounter with the police, he had deposited the drugs in a trash can. When confronted on cross-examination with a statement he had previously given to the police in which he implicated defendant, Perales insisted that the statement was not true and that he had been beaten by the police and coerced into signing it. He testified that when he initially refused to sign the allegedly false statement, Det. A'Vant hit him in the back of the head six times with a flashlight. The defendant then sought to introduce into evidence as a full exhibit a four-page medical report, dated March 18, 1998, from the Rhode Island Department of Corrections (DOC) that contained the DOC physician's notation that, [f]our weeks ago [Perales] was hit with a club. Defense counsel argued that this exhibit was admissible pursuant to Rule 803(4) and (6), the medical diagnosis ortreatment exception and the business records exception to the hearsay rule. [4] The state objected on the ground that the physician's notation was highly suspect because it indicated that Perales was beaten, not with a flashlight, as Perales testified at trial, but with a club. [5] In line with the prosecution's objection, the trial justice also had serious reservations about the reliability and trustworthiness of the DOC physician's notation on March 18, 1998. He found that the report was barely legible and that the length of time between Perales's statement (February 24, 1998) and the DOC physician's notation (March 18, 1998) rendered the report untrustworthy for the purpose for which it was proffered. The trial justice concluded that Perales could have suffered the injuries at any time between February 23 and March 18 and therefore, standing alone, the statement, without any more corroboration or causality attached to it by any competent medical physician    [is] too speculative to allow it to go to the jury. The trial justice declined to permit the jury to engage in speculation about how or when the witness was injured or whether it was with a flashlight or a club. Therefore, he refused to admit the DOC report as a full exhibit. The admissibility of evidence is a question addressed to the sound discretion of the trial justice and will not be disturbed on appeal absent a clear abuse of that discretion. State v. Andreozzi, 798 A.2d 372, 374-75 (R.I.2002) (per curiam). Rule 803(4),  Statements for Purposes of Medical Diagnosis or Treatment,  allows for the admission into evidence of 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, but not including statements made to a physician consulted solely for the purposes of preparing for litigation or obtaining testimony for trial. In the context of this case, Perales's statement to DOC medical personnel that he was struck by a club a few weeks previous to the examination qualifies as a statement made for purposes of medical diagnosis or treatment pursuant to Rule 803(4). The admissibility of this evidence hinge[s] on whether what has been related by the patient will assist or is helpful in the diagnosis or treatment of [the patient's] ailment. In re Jessica C., 690 A.2d 1357, 1363 (R.I.1997) (quoting State v. Ucero, 450 A.2d 809, 815 (R.I.1982)). The test is whether the statement is reasonably pertinent to the formulation of a medical diagnosis or treatment. Id. at 1364. According to Perales, the purpose of the visit to the DOC medical facility was for examination and treatment of an alleged head injury; the statement was directly related to that physical complaint and qualifies as an exception to the hearsay rule pursuant to Rule 803(4). We are further satisfied that the DOC record is a record maintained by DOC in connection with its regularly conducted activity of providing medical diagnosis and care for its inmate population and therefore would qualify, pursuant to Rule 803(6) as a business record exception to the hearsay rule.That does not end the inquiry, however. Notwithstanding that this evidence may fall within a recognized exception to the hearsay rule and may otherwise be relevant, its admissibility is nonetheless addressed to the sound discretion of the trial justice and may be excluded if its introduction will lead to speculation and confusion of the issues. Rule 403 of the Rhode Island Rules of Evidence provides that relevant evidence may be excluded if its probative value is substantially outweighed by the danger of unfair prejudice, confusion of the issues, or misleading the jury, or by considerations of undue delay, waste of time, or needless presentation of cumulative evidence. In deciding whether to admit testimony or documentary evidence of questionable probative value trial judges are required to conduct an evidentiary balancing test and are vested with broad discretion to exclude otherwise relevant evidence that may lead to speculation or confusion. In refusing to admit the DOC medical report, the trial justice had the benefit of Perales's in-court testimony that he signed a confession that implicated defendant after being struck several times with a flashlight or a hard, cold object. The proffered exhibit, a medical report prepared several weeks later, lacked sufficient detail to avoid speculation on the part of the jury. The statement sought to be introduced did not refer to Perales's arrest, his interrogation, or the fact that he was beaten by the police; it was barely legible and described the weapon as a club, not a flashlight. Further, the record discloses that there were photographs of Brooks taken on February 23, 1998, depicting his face without any apparent facial injuries. Thus, the introduction of the medical record would have opened the door to the introduction of these photographs, remote and collateral evidence tending to confuse the jury. Therefore, the speculative nature of the report and the likelihood of additional ancillary evidence tending to distractthe fact-finder was an appropriate ground for exclusion of the medical report. We discern no error on the part of the trial justice in refusing to admit the report into evidence.