Opinion ID: 2087724
Heading Depth: 2
Heading Rank: 1

Heading: Evidence of Dr. Tierney's Conduct

Text: Plaintiffs assign error to the trial court's evidentiary rulings on (A) a motion in limine and (B) a hypothetical question to an expert witness, both regarding the conduct of Dr. Tierney. Of course, the admissibility of evidence is a matter for the sound discretion of the trial court, and its decision will not be reversed on appeal unless that discretion has been clearly abused. Gill v. Foster (1993), 157 Ill.2d 304, 312-13, 193 Ill.Dec. 157, 626 N.E.2d 190.
Prior to trial, the trial court denied plaintiffs' motion in limine to bar the introduction of evidence regarding the alleged negligence of any person other than the named defendants. At trial, the court allowed defendants to question several witnesses regarding Dr. Tierney's duties and responsibilities as decedent's attending physician. The appellate court upheld the trial court's ruling. 262 Ill.App.3d at 415-16, 199 Ill.Dec. 13, 633 N.E.2d 809. Plaintiffs contend that evidence of Dr. Tierney's conduct was irrelevant and, therefore, inadmissible. Indeed, plaintiffs oppose the concept of the empty chair defense, also known as and hereafter referred to as the sole proximate cause defense. This defense seeks to defeat a plaintiff's claim of negligence by establishing proximate cause in the act of solely another not named in the suit. Hall v. Clark (Mo.1957), 298 S.W.2d 344, 348; Fabian v. Minster Machine Co. (1992), 258 N.J.Super. 261, 276-77, 609 A.2d 487, 495. In attacking the sole proximate cause defense, plaintiffs rely on the common law principle that there can be more than one proximate cause of an injury, and that a person is liable for his or her negligent conduct whether it contributed wholly or partly to the plaintiff's injury as long as it was one of the proximate causes of the injury. ( Nelson v. Union Wire Rope Corp. (1964), 31 Ill.2d 69, 88, 199 N.E.2d 769.) A person who is guilty of negligence cannot avoid responsibility merely because another person is guilty of negligence that contributed to the same injury. Where such guilt exists, it is no defense that some other person or thing contributed to the injury. Thus, evidence of another person's liability is irrelevant to the issue of defendant's guilt. See Kochan v. Owens-Corning Fiberglass Corp. (1993), 242 Ill.App.3d 781, 788-89, 182 Ill.Dec. 814, 610 N.E.2d 683, quoting Lipke v. Celotex Corp. (1987), 153 Ill.App.3d 498, 509, 106 Ill.Dec. 422, 505 N.E.2d 1213. Plaintiffs' reliance on this principle is misplaced. This principle presumes that a defendant's conduct is at least a proximate cause of the plaintiff's injury. (See Restatement (Second) of Torts § 433B, Comment g (1965).) In the present case, defendants denied that they were even partly a proximate cause of plaintiffs' injuries. Rather, the defense theory was that Dr. Tierney was the sole proximate cause of plaintiffs' injuries. Plaintiffs insist that defendants' general denial of negligence is insufficient to raise the sole proximate cause defense. Plaintiffs maintain that defendants should be required to plead sole proximate cause of a non-party as an affirmative defense. This contention is erroneous. In any negligence action, the plaintiff bears the burden of proving not only duty and breach of duty, but also that defendant proximately caused plaintiff's injury. ( Smith v. Eli Lilly & Co. (1990), 137 Ill.2d 222, 232, 148 Ill.Dec. 22, 560 N.E.2d 324; see 1 M. Polelle & B. Ottley, Illinois Tort Law § 14.23 (2d ed. 1994).) The element of proximate cause is an element of the plaintiff's case. The defendant is not required to plead lack of proximate cause as an affirmative defense. ( Korando v. Uniroyal Goodrich Tire Co. (1994), 159 Ill.2d 335, 344, 202 Ill.Dec. 284, 637 N.E.2d 1020 (products liability).) Obviously, if there is evidence that negates causation, a defendant should show it. However, in granting the defendant the privilege of going forward, also called the burden of production, the law in no way shifts to the defendant the burden of proof. See Caley v. Manicke (1961), 29 Ill.App.2d 323, 328-29, 173 N.E.2d 209, rev'd on other grounds (1962), 24 Ill.2d 390, 182 N.E.2d 206; M. Graham, Cleary & Graham's Handbook of Illinois Evidence § 301.4 (6th ed. 1994). Based on these principles, we agree with the appellate court that an answer which denies that an injury was the result of or caused by the defendant's conduct is sufficient to permit the defendant in support of his position to present evidence that the injury was the result of another cause ( Simpson v. Johnson (1977), 45 Ill.App.3d 789, 795, 4 Ill.Dec. 397, 360 N.E.2d 144), and so hold. Accord Burrows v. Jacobsen (1981), 209 Neb. 778, 782, 311 N.W.2d 880, 883-84; Clement v. Rousselle Corp. (Fla.Dist.Ct.App.1979), 372 So.2d 1156, 1158; Dickman v. Truck Transport, Inc. (Iowa 1974), 224 N.W.2d 459, 467; Birmingham v. Smith (Mo.1967), 420 S.W.2d 514, 516-17. Citing Ruesch v. Richland Memorial Hospital (1994), 260 Ill.App.3d 49, 198 Ill. Dec. 328, 632 N.E.2d 658, plaintiffs argue that the sole proximate cause defense distracts a jury's attention from the simple issue of whether a named defendant caused, wholly or partly, a plaintiff's injury. We disagree. The sole proximate cause defense merely focuses the attention of a properly instructed jury (which instruction we will discuss later) on the plaintiff's duty to prove that the defendant's conduct was a proximate cause of plaintiff's injury. (See Fabian, 258 N.J.Super. at 276-77, 609 A.2d at 495.) Decisions that contain statements to the contrary, such as in Ruesch, are overruled on this point. We cannot say that the trial court clearly abused its discretion in denying plaintiffs' motion in limine. Consequently, we find no error in defendants' questioning of witnesses concerning Dr. Tierney's duties and responsibilities.
Plaintiffs also argue that the trial court erred by refusing to strike a hypothetical question regarding Dr. Tierney's conduct. As part of their case in chief, plaintiffs called a defendant, Dr. Balasaraswathi, one of decedent's anesthesiologists. (See 735 ILCS 5/2-1102 (West 1994).) He testified as follows. On September 4, 1979, at 9:30 a.m., when decedent had cyanotic lips and was perspiring heavily, was restless, and complained of abdominal pain, the physician or nurse who was taking care of decedent should have, based on accepted medical practice, immediately administered to decedent oxygen and a blood gas test. Decedent's symptoms indicated, inter alia, a pulmonary embolism. During defendants' cross-examination, Dr. Balasaraswathi testified that Dr. Tierney was decedent's treating physician. Also, Dr. Balasaraswathi was referring in his direct examination to Dr. Tierney as someone who might have deviated from the standard of care. Defense counsel then asked Dr. Balasaraswathi: Q. Now ifand I will connect this up, your Honor. If Dr. Tierney was notified, and an obstetrical resident was there and wanted to draw a blood gas, and Dr. Tierney countermanded the order and told the obstetrical resident that she could not, it would be Tierney who was causing that blood gas not to be drawn; is that right? After a sidebar on plaintiffs' objection, defendants' cross-examination continued: THE COURT:    You may read the question back, please.       THE WITNESS: Yes, sir. [Defense Counsel:] And if the failure to have a blood gas was a deviation from the standard, then the one who prevented it from being drawn would be the one who had deviated; is that correct? A. That's right. At the close of the evidence, the trial court denied plaintiffs' motion to strike the hypothetical question. Plaintiffs view the hypothetical question as stating that at 9:30 a.m. on September 4, 1979, Dr. Tierney countermanded an order issued by a resident to obtain a blood gas sample. Plaintiffs contend that the hypothetical question was not supported by the record and, consequently, the trial court erred by refusing to strike it. Counsel has a right to ask an expert witness a hypothetical question that assumes facts that counsel perceives to be shown by the evidence. ( Coriell v. Industrial Comm'n (1980), 83 Ill.2d 105, 110, 46 Ill.Dec. 166, 413 N.E.2d 1279.) The assumptions contained in the hypothetical question must be based on direct or circumstantial evidence, or reasonable inferences therefrom. ( Smith's Transfer Corp. v. Industrial Comm'n (1979), 76 Ill.2d 338, 350, 29 Ill.Dec. 457, 392 N.E.2d 14.) The hypothetical question should incorporate only the elements favoring his or her theory, and should state facts that the interrogating party claims have been proved and for which there is support in the evidence. On cross-examination, the opposing party may substitute in the hypothetical those facts in evidence that conform with the opposing party's theory of the case. Coriell, 83 Ill.2d at 110-11, 46 Ill.Dec. 166, 413 N.E.2d 1279. It is within the sound discretion of the trial court to allow a hypothetical question, although the supporting evidence has not already been adduced, if the interrogating counsel gives assurance it will be produced and connected later. Evidence admitted upon an assurance that it will later be connected up should be excluded upon failure to establish the connection. Coriell, 83 Ill.2d at 111, 46 Ill.Dec. 166, 413 N.E.2d 1279; People v. Smith (1912), 254 Ill. 167, 173-74, 98 N.E. 281. Applying these principles to the present case, we agree with the appellate court that the hypothetical question at issue had sufficient support in the evidence. However, more evidence was required to support the hypothetical question than what the appellate court cited. As a reviewing court, we can sustain the decision of a lower court on any grounds which are called for by the record, regardless of whether the lower court relied on those grounds and regardless of whether the lower court's reasoning was correct. Bell v. Louisville & Nashville R.R. Co. (1985), 106 Ill.2d 135, 148, 88 Ill.Dec. 69, 478 N.E.2d 384; see Werner v. Botti, Marinaccio & DeSalvo (1990), 205 Ill.App.3d 673, 679, 151 Ill.Dec. 41, 563 N.E.2d 1147. The appellate court cited the testimony of plaintiffs' expert, Dr. Hau Kwaan, and of Dr. Balasaraswathi. (262 Ill.App.3d at 416, 199 Ill.Dec. 13, 633 N.E.2d 809.) Dr. Kwaan testified that Dr. Tierney, as the treating physician, was in charge of decedent and was responsible for whatever was necessary to be done. Thus, according to Dr. Kwaan, a resident was required to follow Dr. Tierney's orders. However, the appellate court misapprehended the testimony of Dr. Balasaraswathi. He testified that on September 4, 1979, at 9:30 a.m., Dr. Tierney might have deviated from the standard of care by failing to immediately administer to decedent a blood gas test. The appellate court characterized Dr. Balasaraswathi as testifying that Dr. Tierney deviated from the standard of care by preventing a blood gas test from being taken. We earlier quoted the disputed hypothetical question to Dr. Balasaraswathi. As is seen, the reference to preventing the blood gas test from being taken was not Dr. Balasaraswathi's testimony; rather, it was a continuation of the hypothetical question itself. In sum, the expert testimony establishes at most that: (1) Dr. Tierney might have deviated from the standard of care by failing to immediately administer a blood gas test, and (2) a resident was required to follow Dr. Tierney's orders. This testimony, alone, does not support the hypothetical question that Dr. Tierney countermanded a resident's order to take a blood gas test. However, defendants sought to further support the hypothetical question with the additional testimony of two Loyola senior residents, Drs. John Payne and John Gianopoulos, and a Loyola resident, Dr. Marguerita Hefti. Sustaining plaintiffs' objections, the trial court ruled that the portions of their testimony that related to the hypothetical question were inadmissible hearsay. Defendants made offers of proof of the excluded testimony. Dr. Payne testified in an offer of proof as follows. On the morning of September 4, 1979, Dr. Payne was paged to come to decedent's bedside. Dr. Hefti paged Dr. Payne because she had a dispute with Dr. Tierney. Dr. Hefti wanted to test decedent's blood gases, but Dr. Tierney did not. Dr. Payne contacted the department chairman, who ordered Dr. Payne to see the patient and render the appropriate care. Dr. Gianopoulos testified in an offer of proof as follows. On the morning of September 4, he accompanied Dr. Payne to decedent's bedside. Later that morning, Dr. Hefti told Dr. Gianopoulos that at 9:30 a.m., she believed that decedent should have received a blood gas test. However, Dr. Tierney ordered her not to do anything until a Dr. Nemickas arrived. Dr. Hefti was frustrated because she had never heard of that physician. Dr. Hefti testified in an offer of proof as follows. She did not remember the exact exchange between herself and Dr. Tierney, or exactly what she said to Dr. Gianopoulos. However, she did remember speaking to Dr. Gianopoulos at decedent's bedside, and that the conversation involved both Dr. Tierney and the identity of Dr. Nemickas. Defendants assign error to the trial court's exclusion of this testimony. We agree. The principles are quite settled. An out-of-court statement that is offered as proof of the matter asserted in court is hearsay and, therefore, inadmissible. ( People v. Carpenter (1963), 28 Ill.2d 116, 121, 190 N.E.2d 738.) The distinction between admissible testimony and inadmissible hearsay is illustrated by the example of the witness A testifying that `B told me that event X occurred.' If A's testimony is offered for the purpose of establishing that B said this, it is clearly admissibleif offered to prove that event X occurred, it is clearly inadmissible. Carpenter, 28 Ill.2d at 121, 190 N.E.2d 738. The record in the present case shows that defendants did not offer the testimony of Drs. Payne, Gianopoulos, and Hefti to establish that the event, i.e., the substance of the conversation between Drs. Tierney and Hefti, occurred. Rather, defendants offered the testimony to establish what those residents did and why they acted as they did. This evidence was to be additional circumstantial evidence to support defendants' hypothetical question to Dr. Balasaraswathi. When an out-of-court statement is used not as evidence of the fact asserted, but as circumstantial evidence for another purpose, the hearsay rule does not apply. See Reynolds v. Alton & Southern Ry. Co. (1983), 115 Ill.App.3d 88, 98, 70 Ill.Dec. 929, 450 N.E.2d 402; Smith v. Solfest (1978), 65 Ill.App.3d 779, 782-83, 22 Ill.Dec. 441, 382 N.E.2d 831; Goshey v. Dunlap (1973), 16 Ill.App.3d 29, 34, 305 N.E.2d 648. True, defendants' hypothetical question to Dr. Balasaraswathi was not supported by direct evidence of the exact exchange between Drs. Hefti and Tierney. Dr. Tierney and the decedent are dead, and Dr. Hefti does not remember. However, we conclude that the hypothetical question was connected up to sufficient circumstantial evidence of record and reasonable inferences from the direct and circumstantial evidence, including the proffered testimony of the Loyola residents. After carefully reviewing the entire record, we cannot say that the trial court clearly abused its discretion in refusing to strike the hypothetical question.