Opinion ID: 2326611
Heading Depth: 1
Heading Rank: 8

Heading: Doctor McCue's Testimony

Text: The defendant next asserts that the hearsay testimony of Dr. Bridget McCue, an ob-gyn resident physician at Women & Infants Hospital, was improperly admitted by the Superior Court under Rule 803(4) as a statement for purposes of medical diagnosis or treatment. On September 24, 1996, the same day that Mary first spoke to the school psychologist, Dr. McCue of Women & Infants Hospital examined Mary. First, a thorough history of the patient was taken, as per hospital procedure, to document what transpired before the hospital visit, and then a physical exam was conducted. Mary complained to Dr. McCue of pain down there and pain in her bottom, referring to her vaginal/rectal area. At trial, the state asked Dr. McCue whether Mary indicate[d] to her what acts had happened to her which caused her that pain? Defense counsel objected to the admission of Mary's hearsay declaration to Dr. McCue. The state then conducted an in limine voir dire of Dr. McCue, in which defense counsel asserted that Dr. McCue's testimony about Mary's statement to her should not be admitted unless there's an exception as medical purposes or [if] she was treating her for medical purposes. The trial justice concluded that Dr. McCue's subsequent treatment of Mary with antibiotics as prophylaxis against a sexually transmitted disease was sufficient foundation to allow Dr. McCue to present hearsay testimony of Mary's description of what caused her pain, under the Rule 803(4) medical exception. At trial, Dr. McCue read to the jury from the history she had taken from Mary at the time of the exam, including in pertinent part: On Saturday, he put his penis in the front and the back. Monday, he put his penis in the front and the back. He hurt me because he put it all the way in. Doctor McCue additionally explained that at this point in the oral history, Mary could not find words for what happened next, but Dr. McCue opined that Mary was describing ejaculation. The defendant asserts that Dr. McCue's testimony merely assigned fault by explicitly describing a sexual action, and had nothing to do with her antibiotic treatment of sexually transmitted diseases. The defendant asserts that precedent of this Court precludes the admission of this testimony, and cites to State v. Pina, 455 A.2d 313, 315 (R.I.1983), which provides in pertinent part: [I]n positing the standard as to the admissibility of such statements    the test is not determining merely whether or not the statements are part of a case history. Rather, `admission or rejection will hinge on whether what has been related by the patient will assist or is helpful in the diagnosis or treatment of his ailments. ' State v. Contreras, 105 R.I. [523,] 534-35, 253 A.2d [612,] 619 [(R.I.1969)]. If such statements narrate details not connected with either diagnosis or treatment, they will be inadmissible unless they fall within another hearsay exception. Id. When statements as to causation enter the realm of fixing fault, it is unlikely that the patient or the physician consider them related to diagnosis or treatment. Sullivan v. United States, 404 A.2d 153, 159 n. 11 (D.C.App.1979). In the circumstances where fault is an issue, statements of causation do not hold the same reliability of truthfulness and are properly excluded. (Emphasis added.) The defendant asserts that investigating the transmission of a sexually transmitted disease is designed to assign fault and is not for the purposes of treatment. We first reiterate our standard of review discussed above that the admissibility of a statement under the medical diagnosis hearsay exception is within the sound discretion of the trial justice and shall not be overturned unless clearly erroneous. We also note the similarities in circumstances surrounding the statements Mary made to Dr. McCue and those she made to the school psychologist. As with the psychologist, Mary did not seek out Dr. McCue for the purposes of medical diagnosis or treatment. Rather, she was accompanied by Det. Lori-Ann Molloy of the Warwick Police Department to Women & Infants Hospital for the express purpose of a forensic examination. Doctor McCue testified that she was asked to perform an assault, or rape (examination) kit that she described as a physical exam after a physical assault. There is, however, a vast difference between a conversation with a school psychologist in the school office and a physical examination by a doctor in a hospital. Mary's complaints of pain down there, in the latter situation, do evince a strong motivation to be truthful that provides the rational underpinning of Rule 803(4). There also was evidence that Mary had made a similar complaint to the police detective before she was taken to the hospital. Clearly, the fact that Mary recently had both vaginal and anal sex multiple times was pertinent in the diagnosis of the cause of her pain in the pelvic area. On direct examination, Dr. McCue did not testify about the identity of the person Mary had sex with, only to the fact that she recently had sexual intercourse. [6] It is similar to a situation in which a victim of a car accident is treated by a physician: the fact that injuries were suffered in a car accident is pertinent for diagnostic purposes, when other non-diagnostic facts such as the color of the car or a description of the driver may not be. In the case at hand, it was reasonable for the trial justice to conclude that Mary would not lie to the doctor about the source or potential cause of her pain, and that the statement aided Dr. McCue in her diagnosis. Moreover, Dr. McCue did, in fact, treat Mary by prescribing antibiotics. We thus conclude that the trial justice did not abuse his discretion by admitting this hearsay testimony under Rule 804(3).