Opinion ID: 6985051
Heading Depth: 2
Heading Rank: 1

Heading: The ACOG Video

Text: The Costantinos argue that because videotapes are not mentioned in Rule 803(18), they can never be learned treatises. Alternatively, they maintain that even if videos can be learned treatises, reversal is still required because Judge Gleeson: (1) erred in admitting the ACOG video without proper foundation; and (2) should have excluded the video as unduly confusing and prejudicial under Rule 403. None of these contentions warrant reversal. 1
The primary question presented is whether videotapes can be admitted as learned treatises pursuant to Rule 803(18). We are the first federal Court of Appeals to address this question, though various state courts have considered it under their cognate learned treatise exceptions, and have forged no consensus. Compare Loven v. State, 831 S.W.2d 387, 396-97 (Tex.Ct.App.1992) (admissible), and Schneider v. Cessna Aircraft Co., 150 Ariz. 153, 722 P.2d 321, 327 (Ct.App.1986) (same), with Simmons v. Yurchak, 28 Mass.App.Ct. 371, 551 N.E.2d 539, 542-43 (inadmissible), review denied, 407 Mass. 1103, 554 N.E.2d 851 (1990), and Morrison v. Stallworth, 73 N.C.App. 196, 326 S.E.2d 387, 392-93 (1985) (same). We review Judge Gleeson’s legal conclusion that videos can constitute learned treatises de novo. See Borawick v. Shay, 68 F.3d 597, 601 (2d Cir.1995). In its entirety, Rule 803(18) provides: The following are not excluded by the hearsay rule, even though the declarant is available as a witness: (18) Learned treatises. To the extent called to the attention of an expert witness upon cross-examination or relied upon by the expert witness in direct 'examination, statements contained in published treatises, periodicals, or pamphlets on a subject of history, medicine, or other science or art, established as a reliable authority by the testimony or admission of the witness or by other expert testimony or by judicial notice. If admitted, the statements may be read into evidence but may not be received as exhibits. Fed.R.Evid. 803(18). The rationale for this exception is self-evident: so long as the authority of a treatise has been sufficiently established, the factfinder should have the benefit of expert learning on a subject, even though it is hearsay. See Christopher B. Mueller & Laird C. Kirkpatrick, Evidence § 8.52, at 997 (1995). Emphasizing plain language, the Costan-tinos argue that videos cannot fall within the scope of Rule 803(18) because unlike “published treatises, periodicals, or pamphlets,” they are not specifically listed in the Rule. They rely on Simmons v. Yurc-hak, 28 Mass.App.Ct. 371, 551 N.E.2d 539, revieio denied, 407 Mass. 1103, 554 N.E.2d 851 (1990), which accepted this contention, and affirmed a trial court’s refusal to recognize videotapes as learned treatises under the Massachusetts version of Rule 803(18). According to the Simmons court: “adding videotapes to the list of materials in [the Massachusetts learned treatise exception] would constitute judicial legislation.” 551 N.E.2d at 543. Uttering the dark incantation of “judicial legislation” is to substitute a slogan for an analysis. Indeed, we are exhorted in Rule 102 to interpret the Rules of Evidence to promote the “growth and development of the law ... to the end that the truth may be ascertained.” Fed.R.Evid. 102. In this endeavor a certain measure of legislative judgment is required. As Justice Holmes, in his Boston Brahmin prose conceded: “I recognize without hesitation that judges do and must legislate, but they can do so only interstitially; they are confined from molar to molecular motions.” Southern Pac. Co. v. Jensen, 244 U.S. 205, 221, 37 S.Ct. 524, 61 L.Ed. 1086 (1917) (Holmes, J., dissenting). Or as a graduate of N.Y. City College, Justice Frankfurter, put it more prosaically: “legislatures make law wholesale, judges retail.” Joseph P. Lash, From the Diaries of Felix Frankfurter 67 (1975) (quoting unidentified letter from Felix Frankfurter to Hugo Black). Because judges “cannot escape the responsibility of filling in gaps which the finitude of even the most imaginative legislation renders inevitable,” the problem is “not whether the judges make the law, but when and how much.” Id. In this case, we are compelled to “make law.” For we agree with Judge Gleeson that it is just “overly artificial” to say that information that is sufficiently trustworthy to overcome the hearsay bar when presented in a printed learned treatise loses the badge of trustworthiness when presented in a videotape. We see no reason to deprive a jury of authoritative learning simply because it is presented in a visual, rather than printed, format. In this age of visual communication a videotape may often be the most helpful way to illuminate the truth in the spirit of Rule 102. See, e.g., Schneider v. Cessna Aircraft Co., 150 Ariz. 153, 722 P.2d 321 (Ct.App.1986) (training film admissible under Arizona Rule 803(18) in action against an aircraft manufacturer arising from crash, where the film depicted a crash similar to the manufacturer’s version of what happened). In sum, we agree with the Texas Court of Appeals that “[videotapes are nothing more than a contemporary variant of a published treatise, periodical or pamphlet.” Loven v. State, 831 S.W.2d 387, 397 (Tex.Ct.App.1992). Accordingly, we hold that videotapes may be considered learned treatises under Rule 803(18).
The Costantinos argue that even assuming that the ACOG video may be a learned treatise, Judge Gleeson erred in admitting it without a proper foundation. We disagree. Rule 803(18) explicitly requires trial judges to act as gatekeepers, ensuring that any treatise admitted is “authoritative.” Schneider v. Revici, 817 F.2d 987, 991 (2d Cir.1987). Thus, trial judges must first determine that the proffered treatise is “trustworth[y] ... as viewed by professionals in [the relevant] field.” Id.; see Fed.R.Evid. 803(18) Advisory Committee Note. In making this evaluation, trial judges need not be draconian. “Since the object of [Rule 803(18) ] is to make valuable information available to the trier of fact, trial judges should not insist on a quantum of proof ... that the proponent cannot meet.” See Weinstein’s Federal Evidence § 803.23[4] (2d ed.1997) (citation omitted). Judge Gleeson’s finding that the authoritativeness of the ACOG video had been sufficiently established is reviewed for abuse of discretion and will not be disturbed absent “manifest error.” See Starter Corp. v. Converse, Inc., 170 F.3d 286, 292 (2d Cir.1999) (quoting Proteus Books Ltd. v. Cherry Lane Music Co., 873 F.2d 502, 514 (2d Cir.1989)). The Costantinos invite us to apply the reasoning of Meschino v. North American Drager, Inc., 841 F.2d 429 (1st Cir.1988). There, the First Circuit ruled that it was not enough that the trade magazine in which an article appeared was reputable; the author of the particular article must also to be shown to be an authority before the article could be used - as a learned treatise pursuant to Rule 803(18). See id. at 433-34; see also Twin City Fire Ins. Co. v. Country Mut. Ins. Co., 23 F.3d 1175, 1184 (7th Cir.1994) (same). The Court reasoned that “[i]n these days of quantified research, and pressure to publish, an article does not reach the dignity of a ‘reliable authority’ merely because some editor, even a most reputable one, sees fit to circulate it.” Meschino, 841 F.2d at 434. The Costantinos argue that Meschino requires reversal because Judge Gleeson’s sole basis for accepting the video as authoritative was its sponsorship by ACOG. They claim that no testimony was offered that the video itself had received acceptance in the medical profession, or that its narrator, Dr. Young, was considered an authority in the field. And these omissions were particularly devastating, the Costantinos maintain, because as the Simmons■ court noted, it is unclear that the “careful, professional criticism” which ensures the reliability of printed treatises, also attends the production and dissemination of videotapes. 551 N.E.2d at 543. These arguments are unavailing. Even assuming that the potential authoritativeness of videotapes ■ is somehow more suspect than that of materials like “pamphlet[s]” explicitly listed by the Rule, we cannot fault the district court’s performance as a gatekeeper in this case. We, of course, agree with the Meschino court that the contents of a periodical cannot be automatically qualified “wholesale” under Rule 803(18) merely by showing that the periodical itself is highly regarded. 841 F.2d at 434. We do not, however, read Meschino to say that the reputation of the periodical containing the proffered article is irrelevant to the authoritativeness inquiry. Publication practices vary widely, and an article’s publication by an esteemed periodical which subjects its contents to close scrutiny and peer review, obviously reflects well on the authority of the article itself. Indeed, because the authoritativeness inquiry is governed by a “liberal” standard, good sense would seem to compel recognizing some periodicals — -provided there is a basis for doing so — as sufficiently esteemed to justify a presumption in favor of admitting the articles accepted for publication therein. See generally Weinstein’s Federal Evidence § 803.23[4] (2d ed.1997); Allen v. Safeco Insurance Co., 782 F.2d 1517, 1519-20 (11th Cir.), vacated on other grounds, 793 F.2d 1195 (1986); McCarty v. Sisters of Mercy Health Corp., 176 Mich.App. 593, 440 N.W.2d 417, 419-21 (1989). Turning to the instant case, there is no small irony in plaintiffs’ complaint that ACOG sponsorship was insufficient to establish the video as an authority. After all, while plaintiffs’ own expert Dr. Na-thanson refused to concede the authoritativeness of the video itself, he nevertheless: (1) touted himself as a member of ACOG; (2) praised ACOG as an organization that “publishes a great deal of material which serve[s] to contribute to setting a standard of care for obstetricians and gy-neeologists;” and (3) testified in a prior action that he generally accepted “the standards promulgated by ACOG” within the field of obstetrics as “authoritative.” Moreover, Dr. Nathanson relied in part on ACOG publications in reaching his opinion that Dr. Herzog had committed malpractice. In any event, other factors — quite apart from ACOG’s status as a reputable organization — established the authoritativeness of the video. In particular, Dr. Nathanson recalled seeing a version of the ACOG video at a staff conference, “inferentially conceding]” that it was exactly what the defense said it was: a training resource for the continuing medical education of obstetricians and gynecologists. Dawson v. Chrysler Corp., 630 F.2d 950, 960-61 (3d Cir.1980). And the video’s use as a training resource — “written primarily and impartially for professionals, subject to scrutiny and exposure for inaccuracy, with the reputation [of its producers and sponsors] at stake” — is clearly an important index of its authoritativeness under Rule 803(18). Fed.R.Evid. 803(18) Advisory Committee Note. Moreover, Judge Gleeson himself took the additional precaution of reviewing the ACOG video in camera. Through that review, Judge Gleeson knew that the tape’s narrator, Dr. Young, was a physician at Dartmouth College’s Hitchcock Medical Center, and that the video itself had won an ACOG award, credentials which compared favorably with those of any expert who testified at trial. And after the same review, Judge Gleeson found that the video was what the defense represented it to be: a training resource— with recommendations culled from the “available literature” — used to show doctors “how they should go about dealing with this problem [of shoulder dystocia].” Having viewed the videotape ourselves, and having observed its clinical format, as well as its calm and instructional tone, we cannot say this finding amounts to “manifest error.” Starter Corp., 170 F.3d at 297 (internal quotation marks omitted); see Loven, 831 S.W.2d at 397 (affirming trial court’s finding of authoritativeness after viewing challenged video). In sum, we conclude that Judge Gleeson’s determination that the ACOG video was sufficiently authoritative to deserve admission rested on an appropriate foundation. This was not a case in which there was “no basis” for finding the proffered treatise trustworthy. Schneider, 817 F.2d at 991. And while some of the indicia of the video’s reliability came to light through Judge Gleeson’s independent in camera review, rather than through testimony, the authoritativeness inquiry is a freewheeling one and may be conducted by “any means.” Fed.R.Evid. 803(18) Advisory Committee Note; see also Weinstein’s Federal Evidence § 803.23[4] (2d ed.1997) (“trial judge[s] should be liberal in allowing other proof of ... authoritativeness, so long as it indicates that the [treatise] is recognized by the medical profession”) (citing Ward v. United States, 838 F.2d 182, 187 (6th Cir.1988)). Judge Gleeson did not abuse his discretion in finding that the ACOG video was sufficiently authoritative to be presented to the jury.
Even though the ACOG video qualified as a learned treatise under Rule 803(18), Judge Gleeson retained the discretion to exclude it if its “probative value [was] substantially outweighed by the danger of unfair prejudice [or] confusion” under Rule 403. See Li v. Canarozzi, 142 F.3d 83, 88 (2d Cir.1998); Schneider, 817 F.2d at 991. The Costantinos argue that the video should have been excluded under Rule 403. We find no basis for reversal. Because the trial judge is in the best position to evaluate the evidence and its effect on the jury, his Rule 403 rulings are entitled to considerable deference and will not be overturned absent a clear abuse of discretion. See Li, 142 F.3d at 88; United States v. Smith, 727 F.2d 214, 220 (2d Cir.1984). Moreover, the improper admission of evidence is grounds for reversal only where it affects “a substantial right” of one of the parties. Fed.R.Evid. 103(a); see 28 U.S.C. § 2111; Fed.R.Civ.P. 61. “We will not conclude that a substantial right was affected unless it is likely that in some material respect the factfinder’s judgment was ‘swayed by the error.’ ” Perry v. Ethan Allen, Inc., 115 F.3d 143, 150 (2d Cir.1997) (quoting Phoenix Associates III v. Stone, 60 F.3d 95, 104-05 (2d Cir.1995)). There can be no doubt that much of the ACOG videotape represented highly probative evidence. To prove that Dr. Herzog committed malpractice under governing New York lay?, plaintiffs had to show that he deviated from the accepted obstetrical practices of the medical profession. See Pellegrino v. Cunanan, 227 A.D.2d 950, 643 N.Y.S.2d 844, 844 (4th Dep’t.1996); Walsh v. Staten Island Obstetrics & Gynecology Assocs. P.C., 193 A.D.2d 672, 598 N.Y.S.2d 17, 18 (2d Dep’t.1993). As Judge Gleeson explained in ruling that the video was admissible, one “dimension” of plaintiffs’ malpractice claim was that “the standard of care ... prohibits a doctor from engaging in any traction” to remedy shoulder dystocia. Measured against this claim, those portions of the video portraying application of “a limited” or “appropriate” amount of traction to the baby’s head were directly probative of whether such a technique is an accepted obstetrical practice. And those portions of the video portraying application of the Woods, McRoberts and Posterior Arm Sweep maneuvers were probative of whether Dr. Herzog properly used those maneuvers in delivering Amanda. We reject the plaintiffs’ claim that the ACOG video should have been excluded because of the danger of undue confusion. The Costantinos maintain that the ACOG video must have caused the jurors to confuse what they saw on the tape with what was being orally reconstructed for them throughout the - trial — i.e., the birth of Amanda. They argue that because the video shows appropriate amounts of traction being applied to babies’ heads, the jurors must have unfairly concluded that Dr. Herzog’s management of Amanda’s delivery was appropriate. This argument is pure speculation. It was obvious that Amanda’s birth was not what was depicted in the video. Even if it were not obvious to the jury, any ephemeral danger of confusion was more than outweighed by the highly probative value of the video. Plaintiffs’ second Rule 403 contention is similarly unavailing. The Costantinos point out that in addition to portraying the Woods, McRoberts and Posterior Arm Sweep maneuvers (as well as the application of traction to babies’ heads), the ACOG video portrays the two rarely performed procedures of: (1) placing the mother on all fours to facilitate delivery; and (2) pushing the baby back into the uterus to facilitate a Caesarian section. The Costantinos assert that these portrayals were not probative of anything at trial, and were highly prejudicial because “the only inference the jury could have drawn from those parts of the tape ... is that shoulder dystocia can be a complicated problem, requiring seemingly drastic measures to deliver children.” It is true that Dr. Herzog never testified that he even contemplated performing these maneuvers during the birth of Amanda. However, to the extent that these portrayals prejudiced the Costanti-nos by emphasizing the inherent dangers of shoulder dystocia, such prejudice did not warrant exclusion. Because virtually all evidence is prejudicial to one party or another, to justify exclusion under Rule 403 the prejudice must be unfair. See Weinstein’s Federal Evidence § 403.04[l][a] (2d ed.1997) (citing cases). The unfairness contemplated involves some adverse effect beyond tending to prove a fact or issue that justi-fíes admission. See Perry, 115 F.3d at 151. We fail to see how plaintiffs were unfairly prejudiced by the portrayal of the challenged procedures here. The testimony at trial established that shoulder dysto-cia is indeed a “complicated problem, requiring seemingly drastic” responses by the treating obstetrician. To cite but one example, plaintiffs’ own expert Dr. Na-thanson testified that shoulder dystocia can be a life-threatening “emergency” to both mother and child, and that it is necessary to perform an episiotomy (a vaginal incision), “as deeply and widely as possible,” frequently “extending the incision] right into the rectum, so that the entire vagina is laid open.” In light of this and similar testimony, any prejudice arising from the video’s portrayal of the challenged procedures was not unfair within the meaning of Rule 403. To the contrary, that portrayal was probative of whether Amanda Costantino’s shoulder dystocia presented an “emergency” and whether Dr. Herzog responded appropriately in attempting to remedy it.