Opinion ID: 2441011
Heading Depth: 2
Heading Rank: 1

Heading: Dr. Spiridigliozzi's Testimony

Text: Skillicorn asserts that the trial court erred in excluding the testimony of Dr. John Spiridigliozzi offered during the penalty phase. Spiridigliozzi carried a file pertaining to Skillicorn with him to the stand. The state sought to review the file, claiming that the evidence was discoverable and had not been disclosed in response to a proper request made pursuant to Rule 25.05(A)(1). Skillicorn's counsel claimed the attorney-client privilege, the physician-patient privilege, and that the file was work product. The court ordered Skillicorn's attorney to turn over the file so that the prosecutor could review the documents briefly before testimony of Dr. Spiridigliozzi was received in open court. Skillicorn's attorney refused, attempting to physically block the passage of the file from Spiridigliozzi to the prosecutor. The court issued an ultimatum to Skillicorn's attorney: surrender the file, or have Dr. Spiridigliozzi's testimony excluded. Skillicorn's attorney was recalcitrant, continuing to refuse to hand over the file. The court dismissed Dr. Spiridigliozzi as a witness after the defense made its offer of proof. [5] Regardless of whether the file should have been turned over prior to trial pursuant to the state's discovery request, once Dr. Spiridigliozzi sought to testify concerning Skillicorn's mental condition, it was appropriate for the trial court to order the file to be turned over. Placing Skillicorn's mental condition in issue waived the privilege accorded by Section 491.060, RSMo. That section provides: The following persons shall be incompetent to testify:       (5) A physician licensed under chapter 334, RSMo, a licensed psychologist or a dentist licensed under chapter 332, RSMo, concerning any information which he may have acquired from any patient while attending him in a professional character, and which information was necessary to enable him to prescribe and provide treatment for such patient as a physician, psychologist or dentist. The physician-patient privilege has no constitutional underpinning and is statutory in origin. State v. Ward, 745 S.W.2d 666 (Mo. banc 1988). The physician-patient privilege and the attorney-client privilege are to be used for preserving legitimate confidential communications, not for suppressing the truth after the privileged one lets the bars down. State v. Carter, 641 S.W.2d 54, 59 (Mo. banc 1982), cert. denied, 461 U.S. 932, 103 S.Ct. 2096, 77 L.Ed.2d 305 (1983). It is well settled that when a party once places the question of his mental condition in issue he thereby waives the physician-patient privilege to exclude testimony of any doctors who have examined him for that purpose. Id. at 57. This waiver, sometimes called the `patient-litigant' waiver, has been recognized in many jurisdictions. Brandt v. Medical Defense Associates, 856 S.W.2d 667, 671 (Mo. banc 1993). Such a waiver is a full waiver. There are at least two reasons for this guiding principle that a waiver is a full waiver. First, the medical privilege only covers matters that are confidential. Once there is a disclosure of the information in any form, it is no longer confidential and therefore no longer privileged. Second, and even more important, the Missouri courts have made it abidingly clear that a patient should not be allowed to use the medical privilege strategically to exclude unfavorable evidence while at the same time admitting favorable evidence. We have referred to this prohibited practice as permitting the plaintiff to use the privilege both as `a shield and a dagger at one and the same time' (which we do not believe the legislature intended).... Id. at 672 (citations omitted). Once Dr. Spiridigliozzi sought to testify concerning his examination of the defendant, any information compiled by Dr. Spiridigliozzi pertaining to his examination of Skillicorn was no longer privileged. Nor could the work product doctrine insulate Dr. Spiridigliozzi's notes from disclosure and use at trial. Work product consists of `opinions, theories or conclusions of defendant's attorney ... [and] communications between defendant and his attorney.' Carter, 641 S.W.2d at 59 (citations omitted). Dr. Spiridigliozzi's notes were not an opinion, theory or conclusion of defendant's counsel or a communication by defendant to his attorney, and therefore were not the work product of the attorney. Hired on a one-time basis to give defendant a psychiatric examination and prepare an objective report on defendant's mental condition, Dr. Spiridigliozzi acted in the capacity of an independent contractor, not as an agent of defense counsel in any real sense of the word, and not as a member of defense counsel's legal or investigative staff. Regardless of what took place before the trial, the court properly found that the file held by Dr. Spiridigliozzi was discoverable because no privilege existed as to those materials. Thus, the court properly ordered the defense to permit the prosecutor to examine the file. Defense counsel's refusal to hand over the file was a [w]ilful violation by counsel of ... an order issued pursuant to an applicable discovery rule, and the court was well within its discretion to exclude testimony evidence relating to the file. Rule 25.16. Point Two is denied.