Opinion ID: 853547
Heading Depth: 2
Heading Rank: 5

Heading: Alteration of Medical Records

Text: After arguments from both parties concerning the admissibility of evidence that Kohne altered Cummings' medical records, the trial court determined that evidence of spoliation was admissible against Kohne on the issue of proximate causation. According to the trial court, because Dr. Kohne was a medical doctor with knowledge of the stages of cancer and the increased risks to the patient when cancer is not timely diagnosed and treated. A reasonable inference is that Dr. Kohne was conscious that he increased the risk of harm to Mr. Cummings giving rise to falsification of his testimony and his records. The Court of Appeals concluded that the spoliation rule, as it exists in Indiana, does not apply where the evidence has not been destroyed and no jury instruction is required to cure its unavailability. See Cahoon, 715 N.E.2d at 16. Under normal relevancy restrictions, the court further concluded, the trial court had abused its discretion in admitting this evidence because, once Kohne had conceded breach of duty, this evidence was no longer relevant. See id. at 16-17. Spoliation consists of [t]he intentional destruction, mutilation, alteration, or concealment of evidence, usually a document. If proved, spoliation may be used to establish that the evidence was unfavorable to the party responsible. Black's Law Dictionary 1409 (7th ed.1999). In Indiana, the exclusive possession of facts or evidence by a party, coupled with the suppression of the facts or evidence by that party, may result in an inference that the production of the evidence would be against the interest of the party which suppresses it. Porter v. Irvin's Interstate Brick & Block Co., 691 N.E.2d 1363, 1364-65 (Ind.Ct.App.1998); see also Great Am. Tea Co. v. Van Buren, 218 Ind. 462, 467, 33 N.E.2d 580, 581 (1941) (While this rule will not be carried to the extent of relieving a party of the burden of proving the case, it may be considered as a circumstance in drawing reasonable inferences from the facts established.). Spoliation evidence arises more commonly in the criminal context, but is also relevant in civil cases. 12 Robert Lowell Miller, Jr., Indiana Practice § 401.112 (2d ed.1995). Spoliation evidence is ordinarily admissible not as to a single issue only, but rather bears on the strength of the case in general and the defendant's consciousness of guilt. See 2 John Henry Wigmore, Evidence in Trials at Common Law § 278 (1979), revised by James H. Chadbourn. The primary alteration alleged here is the addition of the words Cline scope to Cummings' December 1991 x-ray report. Kohne originally maintained that he had recommended to Cummings that he have an endoscopy, but that Cummings had not done so. Cline was a doctor to whom Kohne would have referred Cummings had Kohne recommended an endoscopy. The endoscopy, in turn, would have likely revealed esophageal cancer. Copies of medical records sent to plaintiff's counsel before litigation was commenced did not bear this notation. [7] Although it is true that the few Indiana cases on point have involved situations in which evidence has been destroyed or is made unavailable, see, e.g., Porter, 691 N.E.2d at 1363, we see no reason to restrict the application of this rule to that context. Spoliation, according to its dictionary definition, includes the alteration of documentary evidence as well as its destruction. Thus, we hold that the evidence of the addition of Cline scope to Cummings' x-ray report qualifies under the spoliation rule in Indiana. The trial court did not abuse its discretion in admitting the evidence as probative of Kohne's belief on the issue of proximate causation. As we have already noted, spoliation evidence is admissible to show the defendant's consciousness of guilt and the strength of his or her case generally. Here, Kohne conceded that he breached his duty to Cummings. By trial, the only remaining issue for the jury to resolve was causation. Therefore, the trial court concluded that this evidence was admissible as to the only remaining issueproximate causation. The Court of Appeals concluded that instructing the jury regarding the defendant's perspective on causation had the effect of converting Kohne into an expert witness. The instruction read: [I]f you find that there are unexplained or intentional alterations of medical records by Dr. Kohne, you can presume that the evidence would have been unfavorable to Dr. Kohne on the issue of proximate causation. Allowing evidence to be presented as to Kohne's perspective regarding proximate cause was proper to demonstrate that Kohne himself believed his inaction to have been significant in the treatment of Cummings. A jury could easily find this evidence significant as to both duty and proximate cause, necessary elements of a tort claim. Thus, it was not error to instruct the jury that they could infer from the alteration of Cummings' records that Kohne believed he had caused harm to Cummings. [8]