Opinion ID: 2156396
Heading Depth: 2
Heading Rank: 3

Heading: Dr. Quinn's Testimony

Text: At trial, the prosecutor asked Dr. Michael Quinn, one of I.J.'s two treating physicians, to read in evidence a medical record prepared by the other physician, Dr. Fallack. That record reported a statement by I.J.'s grandmother that I.J. had told her that Jenkins had put [a] pillow over my body and put his fingers in my privates. Trial counsel objected on grounds of inadmissible hearsay. The prosecutor countered that the entire medical record (like that of Dr. Purow) was admissible for its truth under the medical diagnosis exception to the hearsay rule, citing Federal Rules of Evidence 803(4) [4] and a similar (though distinguishable) [5] factual pattern in Galindo v. United States, supra . Trial counsel replied that Galindo was inapposite because it was not a medical record case. Galindo, he pointed out, was entirely testimonial; not only the doctor but also the mother and child whose hearsay statements were at issue all testified at trial, subject to cross-examination. Galindo, 630 A.2d at 211. That distinction, he said, left no room for admission of I.J.'s recorded, uncross-examined, hearsay statement to her grandmother contained in the medical record. The prosecutor rejoined that a first-level hearsay statement made in aid of medical diagnosis (here, by the grandmother to Dr. Flack), incorporating a second-level hearsay statement by the patient (here, I.J.), will be admissible in its entirety if the first-level declarant is someone with a special relationship to the person seeking treatment. [6] According to the prosecutor, nothing in Galindo suggested that the grandmother's testimony, incorporating I.J.'s story, could not be presented exclusively  without redaction  through a medical record in lieu of live testimony. Noting that the government was seeking admission for the truth of the matter asserted not only of the grandmother's statement to Dr. Fallack but also of I.J.'s statement to the grandmother, the trial court was troubled. The court recognized that hearsay is admissible for its truth under the medical diagnosis exception  typically, the first-level hearsay statement of a patient to her doctor recorded in a medical record  because of the presumed truthfulness of a patient who seeks a doctor's help for illness or injury. Galindo, 630 A.2d at 210; Sullivan v. United States, 404 A.2d 153, 158 (D.C.1979) (quoting McCormick on Evidence § 292 (2d ed. E. Cleary 1972)). But the trial court wondered whether there was comparable trustworthiness of a child's statement to a parent or grandparent about the child's condition that would justify admission of such second-level hearsay under the special relationship rationale in every case: [U]nderneath all of that has to be some underlying assumption that the child in reporting to the parent would similarly be giving an accurate report to the parent, and I am wondering whether we don't need to have some testimony from the grandmother that is a foundation to understand the nature of that relationship, to see whether it's appropriate to apply, to permit the intermediary to serve as a surrogate for the child really, in talking to the doctor. [7] The court accordingly said, I want to think about this and took a brief recess. When court reconvened a half hour later, and before the trial judge ruled, trial counsel withdrew his objection, permitting admission of the medical record for the truth of the grandmother's and I.J.'s statements in it. Counsel explained at the § 23-110 hearing that he preferred the jury to hear these statements through the static, relatively antiseptic vehicle of a medical record, rather than through the live testimony of the grandmother, who otherwise, he believed, would surely be called as a government witness. Her hatred of appellant, he said, was palpable. In his judgment, she was likely to blurt out irrelevant, prejudicial statements that Jenkins had abused her daughter and grandchildren on previous occasions. Nor did counsel want the jury to hear I.J. testify, inevitably arousing sympathy. It appeared to counsel that the government would not call these witnesses if the medical record in full were allowed in evidence. (And, of course, if counsel predicted wrongly and the government called them to the stand anyway, subject to cross-examination, counsel had to know  as we have seen in connection with Dr. Purow's testimony  that there would have been little if any chance under Galindo of suppressing the medical record as additional evidence). The question, then, is whether this trial strategy, as Jenkins now contends, was constitutionally deficient under Strickland v. Washington, supra , on the ground that counsel could  and should  have kept I.J.'s hearsay statement away from the jury. Noting the double-hearsay nature of the medical record, Jenkins argues that even if the medical diagnosis exception would permit admission of the grandmother's statement to Dr. Fallack (on the ground that the grandmother had a special relationship with I.J.), that exception would not permit admission of the second level of hearsay: I.J.'s statement to her grandmother. That statement, he says, required an independent basis for admissibility that is altogether lacking here (citing Barrera, supra note 6, 668 A.2d at 873 n. 3 (each of the out-of-court statements must satisfy the requirements of some exception to the hearsay rule)). For this reason, he says, this court's opinion in Galindo  which did not concern second-level hearsay, see supra note 5  cannot be read to permit admission of such hearsay. Furthermore, according to Jenkins, Galindo was not a medical record case and thus for that reason, too, does not allow admission of I.J.'s second-level hearsay through a medical record alone, without any opportunity for cross-examination of one or more of the critical declarants (in this case, the grandmother and I.J.). We must agree with appellant to this extent: Galindo did not expressly deal with second-level hearsay. It also is true that, because the crucial witnesses in Galindo testified at trial, our special relationship analysis in that opinion did not come to grips with the evidentiary question presented here: whether a child's second-level hearsay description of her sexual assault contained in a medical record is admissible under the medical diagnosis exception to the hearsay rule. Although Galindo  in a stretch  might be read to permit, or at least not to bar, admission of a medical record containing such second-level hearsay, without related live testimony, a more careful reading would conclude that this court left that question open. This open question, however, is not before us in the present case. The question, rather, is whether defense counsel was constitutionally deficient in failing to force the trial court to resolve this unsettled hearsay issue by persisting with an objection to admission of Dr. Quinn's medical record. While it is not far-fetched to suggest that a trial counsel will lack resourcefulness in failing to challenge second-level hearsay in a medical record, it is difficult, in light of Galindo, to conclude that a lawyer who lacks that resourcefulness is constitutionally deficient. But even more to the point, trial counsel, in objecting initially to that hearsay, appears to have recognized the potential for that objection  a recognition that supports the trial court's conclusion that counsel made a strategic decision in withdrawing his objection, rather than a decision based on inadequate understanding of the law. We agree with the trial court that counsel finally decided, as a matter of trial strategy, to permit admission of the first- and second-level written hearsay in the medical record, even for the truth of the statements made, in lieu of risking live testimony by a hostile witness, the grandmother, and the sympathetic complainant, I.J. Some may question this strategy, but the Constitution, as interpreted by Strickland, does not permit us to substitute our judgment for that of trial counsel on these facts, especially when Jenkins faults trial counsel not for failing to pursue a sure thing  a patently correct objection  but for failing to force the trial court to rule on an issue of first impression in this jurisdiction. See Strickland, 466 U.S. at 690-91, 104 S.Ct. 2052. We conclude, accordingly, that trial counsel's performance was not constitutionally deficient. (We therefore need not reach the second, prejudice question under Strickland ).