Opinion ID: 2583948
Heading Depth: 1
Heading Rank: 10

Heading: Did the district court err in precluding evidence of appellee Hrabal's prior malpractice claims, the suspension of Hrabal's hospital privileges, and other matters affecting her credibility?

Text: [¶ 40] The appellants' complaint in this case alleged that Dr. Hrabal was negligent in her care of Armstrong. During discovery, the appellants learned of a previous lawsuit against Dr. Hrabal, with similar allegations of negligence. The appellants moved for leave to amend their complaint to add an allegation of negligent misrepresentation based upon Dr. Hrabal's failure to disclose this prior lawsuit to her employer, EMP, and to UMC. The appellees resisted this motion and moved in limine to preclude the admission of any evidence of the prior claim. [¶ 41] In the memorandum written in support of their motion in limine, the appellees argued first that the gist of a medical malpractice case is proof of the standard of care and proof that the defendant doctor violated that standard on a particular occasion. Proof that the defendant has been sued before, even under similar circumstances, does not tend to make the existence of these necessary elements any more probable, so the evidence is irrelevant. Second, the appellees argued that, even if such evidence is marginally relevant, it should be excluded under W.R.E. 403 because its probative value is substantially outweighed by the danger of unfair prejudice, because its introduction would tend to mislead and confuse the jury, and because the trial would be unduly lengthened by the need for Dr. Hrabal to defend herself against the earlier accusations. [4] Specifically, the appellees contended that introduction of evidence about the prior lawsuit undoubtedly would lead the jury to impermissible conclusionsthat Dr. Hrabal was a bad doctor because she had been sued before, that Dr. Hrabal violated the standard of care once, so she probably did so again in this case, and that the standard of care established by the expert witnesses in the first case was the standard of care in this case, even though those experts were not witnesses in this case. [¶ 42] The appellants' response to the motion in limine emphasized two points: first, that the appellees' experts were not aware of this information when they formulated their opinions that Dr. Hrabal was qualified to work in the emergency department, and second, that Dr. Hrabal's withholding of the information was relevant to her credibility and was therefore admissible under W.R.E. 608(b). [5] In a separate further response, the appellants contended that, if the appellees' expert, Dr. Rosen, was aware of the prior lawsuit when he rendered his opinion that Dr. Hrabal was qualified to serve in the emergency room, then the evidence of the prior lawsuit should be admissible during his cross-examination because the expert who testified against Dr. Hrabal in the prior case was Roger L. Barkin, M.D., who happens to be Dr. Rosen's primary professional collaborator. [¶ 43] The motion for leave to amend the complaint was heard on July 2, 2002, and was denied by an order filed August 8, 2002. The order does not indicate whether counsel also argued the motion in limine at that time, and no transcript of the hearing appears in the record. The motion in limine was later mentioned during the final pretrial conference, at which time the district court indicated that it had already ruled on the motion. The order granting the motion in limine, which order was filed on the first day of trial, gave no reasons for it having been granted. [¶ 44] In their appellate brief, the appellants broaden their attack upon the district court's liminal order to include complaints that the district court also prevented them from cross-examining Dr. Hrabal or otherwise presenting evidence that Dr. Hrabal's privileges were suspended at a hospital in Georgia and that she was also sued in New Mexico. As at trial, they contend that the order prevented them from effectively cross-examining Dr. Hrabal as to her credibility, and prevented them from effectively cross-examining Dr. Hrabal's expert witnesses as to the bases of their opinions, particularly as to what they knew about her fund of knowledge regarding infectious disease. The appellants rely heavily on Dysthe, 2003 WY 20, ¶¶ 19-20, 63 P.3d at 883-84 and Chrysler Corp. v. Todorovich, 580 P.2d 1123, 1133 (Wyo. 1978), for the proposition that wide latitude should be allowed in the cross-examination of experts to determine the basis of an opinion. They also cite several cases from other jurisdictions where cross-examination of experts about prior specific instances of conduct was allowed. [6] [¶ 45] In their appellate brief, the appellees support the district court's grant of their motion in limine with several arguments. After reminding this Court that the standard of review is abuse of discretion, they contend (1) that the proscribed evidence was not relevant; (2) that its foundation was unreliable; (3) that it was an attempt to impeach with extrinsic evidence in violation of W.R.E. 608(b); (4) that it was unfairly prejudicial, confusing, and misleading in violation of W.R.E. 403; (5) that the appellants failed to preserve the issue for review because they did not make an appropriate offer of proof; and (6) that the cases relied upon by the appellants are inapposite because, unlike the expert witnesses in those cases, Dr. Hrabal did not offer expert testimony related to causation and the standard of care. [¶ 46] The appellees' focal position is that Dr. Hrabal's fund of knowledgeher training and past experiencewas irrelevant because the issue was not whether she was qualified to treat Armstrong, the question was whether, at a particular point in time, she met the applicable standard of care. The appellees point to Beavis ex rel. Beavis, 2001 WY 32, ¶¶ 11-16, 20 P.3d at 512-14, where we affirmed the district court's preclusion of qualification evidence. [7] [¶ 47] This Court is at a considerable disadvantage in attempting to review the district court's grant of the appellees' motion in limine because we do not know the district court's precise reasoning. The record contains neither a transcript of the July 2, 2002, hearing during which the matter apparently was decided nor a decision letter. The order, itself, is devoid of explanation. The best we can do is to glean from the trial transcript a hint as to the basis for the district court's decision. During the cross-examination of Dr. Hrabal, the following exchange occurred: Q. Have you failed to diagnosis sepsis in 14-year-old boys with meningococcemia? A. No, sir. Q. Do you know who Roger Barkin is? A. Yes, sir. Q. Is he co-author of the Rosen book? A. Correct. Q. Has he ever been critical of you for not diagnosing meningococcemia in a 14-year-old boy? A. No, sir. Q. Have you ever read a written affidavit of his where he was critical of you for not diagnosing meningococcemia in a 14-year-old boy? A. No, sir. MR. RUTLEDGE: Your Honor, I would object on the grounds of relevance to this line of questioning. We're not talking about a 14-year-old boy. We don't have Dr. Barkin here to testify. THE COURT: Sustained, sustained, Mr. Pickering. . . . MR. PICKERING: Your Honor, I think this is important for two reasons and relevant. One is, she was served with a copy of the affidavit of Dr. Barkin; and he was critical of her care. So it directly goes to whether she's an honest and credible witness. THE COURT: Okay. Thank you. MR. BAILEY: It also goes to her clinical  MR. PICKERING: Her fund of knowledge and theories. The reasons why I think it ought to be allowed  THE COURT: I'm at the verge right now, Mr. Pickering, of declaring a mistrial if this thing continues, you know. You don't open the door by putting an adverse witness on the stand and asking all of these questions. I've given you quite a bit of leeway, but with the understanding that you're not going to violate my order in limine. You're the one that is forcing the issue on this doctor. I don't believe that this is the way doors are opened in my opinion. Even if it is opened, Rule 403 prevents you from doing this. If you were going to do this, from day one then we would have to have this other case tried, this other issue of this youngster tried in this case. It's a complete surprise in a sense. Now, do you want to have it this way, or do you want me to declare a mistrial? I will declare a mistrial. (Emphasis added.) [¶ 48] From the entire record, we can assume that the district court sustained the appellees' relevance objection on the ground that Dr. Hrabal's prior experience and qualifications were not relevant to the question of whether she met the standard of care in regard to Armstrong. In context, the district court's reference to W.R.E. 403 suggests an additional concern with either the danger of confusing the issues or the danger of undue delay, or both. [8] We cannot say that the district court abused its discretion in reaching these conclusions, and we note that the relevancy consideration is consistent with Beavis ex rel. Beavis, 2001 WY 32, ¶¶ 11-16, 20 P.3d at 512-14. Evidentiary decisions of this nature are left to the sound discretion of the trial court and will not be overturned where the record reveals a legitimate basis for the ruling. Dysthe, 2003 WY 20, ¶ 16, 63 P.3d at 883 ( quoting Lancaster, 2002 WY 45, ¶ 11, 43 P.3d at 87). Here, the district court reasonably could have concluded that any probative value of the earlier alleged incident was outweighed by the spectre of a trial within a trial as the appellants tried to prove Dr. Hrabal's negligence in that incident. We affirm the district court's rulings on the motion in limine and the objection.