Opinion ID: 2039219
Heading Depth: 1
Heading Rank: 3

Heading: Was testimony of the State's medical witness admissible?

Text: Trial court overruled defendant's objections to questions designed to elicit an examining doctor's opinion the victim had sexual relations, which opinion was based partially on laboratory tests conducted by others not under his supervision. On the night of the rape, the victim was examined by the doctor at Iowa Lutheran Hospital. He conducted a pelvic examination and found her to be tender on movement of the uterus and cervix. He obtained specimens for gonorrhea and syphilis tests, a sperm and acid phosphatase test, and a pregnancy test. These specimens were turned over to a laboratory technician. The results were disclosed on hospital reports, State's exhibits two and three, which formed much of the foundation for the doctor's opinion the victim had recently engaged in sexual intercourse. The doctor testified that in his ordinary practice of medicine in the hospital he regularly relied upon reports from its laboratory. Defendant objected to the doctor's testimony as being hearsay and without proper foundation. Exhibits two and three were objected to on foundational and chain-of-custody grounds. Uncontroverted evidence disclosed these records were kept in the ordinary and regular course of business of the hospital, made at or about the time of the events recorded. They were offered in connection with the examining doctor's testimony relating to his opinion. In the circumstances disclosed by this record, we hold there was no reversible error in admitting the doctor's opinion and the related hospital records. The rationale articulated in Birdsell v. United States, 346 F.2d 775, 779-80 (5th Cir.), cert. denied, 382 U.S. 963, 86 S.Ct. 449, 15 L.Ed.2d 366 (1965), is applicable here: With the increased division of labor in modern medicine, the physician making a diagnosis must necessarily rely on many observations and tests performed by others and recorded by them; records sufficient for diagnosis in the hospital ought [to] be enough for opinion testimony in the courtroom. This portion of the Birdsell opinion was quoted with approval in State v. Salter, 162 N.W.2d 427, 430 (Iowa 1968). In Miller v. McCoy Truck Lines, 243 Iowa 483, 488, 52 N.W.2d 62, 65 (1952), a doctor was permitted to testify to a diagnosis based in part upon x-rays taken by unidentified persons. We held this was not reversible error, stating: [W]e think the sensible and correct approach to it is well expressed in Sundquist v. Madison R. Co., 197 Wis. 83, 221 N.W. 392, 393. There the doctor treating the patient, in making his diagnosis, relied in part on the records of regular hospital examinations made by hospital technicians who were not called as witnesses. In permitting the testimony, the court said: In order to say that a physician, who has actually used the result of those tests in a diagnosis and in the treatment of the plaintiff, may not testify what that diagnosis was, the court must deliberately shut its eyes to a source of information which is relied on by mankind generally in matters that involve the health and may involve the life of their families and of themselvesa source of information that is essential that the court should possess in order that it may do justice between these parties litigant. In making a diagnosis for treatment, physicians must of necessity consider many things that do not appear in sworn proof on the trial of a lawsuitthings that mean much to the trained eye and touch of a skilled medical practitioner. This court has held it will not close the doors of the courts to the light which is given by a diagnosis which all the rest of the world accepts and acts upon, even if the diagnosis is in part based upon facts which are not established by the sworn testimony in the case to be true. (emphasis added in Miller ) See Ver Steegh v. Flaugh, 251 Iowa 1011, 1017-18, 103 N.W.2d 718, 722-23 (1960); McCormick, Law of Evidence § 15 & nn.2, 3 & 4 (2d ed. 1972); Annot., 55 A.L.R.3d 551 (1974); cf., Fed.R.Evid. 703 (The facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to him at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence.). Defendant's reliance on Lessenhop v. Norton, 261 Iowa 44, 153 N.W.2d 107 (Iowa 1967), to support his foundation objections to the hospital's laboratory tests is misplaced. We have limited the Lessenhop standards to those cases, both civil and criminal, arising under Iowa Code chapter 321B circumstances. Brooks v. Engel, 207 N.W.2d 110, 114 (Iowa 1973). Nor does this appeal involve the usual controversy relating to the chain of custody of physical, or real, evidence. Even in those cases, we have held a trial judge's decision to admit evidence over a chain-of-custody objection will not be overturned unless it constitutes a clear abuse of discretion. State v. Bakker, 262 N.W.2d 538, 543 (Iowa 1978); State v. Lunsford, 204 N.W.2d 613, 616-17 (Iowa 1973). In the case before us, the specimens to be tested were delivered immediately to a laboratory technician who was present. Results of tests have been admitted into evidence even though the material tested has been lost or discarded. State v. Rush, 242 N.W.2d 313, 316-17 (Iowa 1976); Ver Steegh v. Flaugh, 251 Iowa at 1019, 103 N.W.2d at 723. Where, as here, we hold no reversible error occurred in permitting an examining doctor to express an opinion based in part on hospital tests of specimens secured in his examination, we see no error in permitting the hospital test records to be introduced into evidence, ancillary to his testimony. We find no grounds for reversal on these claims.