Court Opinion

ID: 9753230
Source: CourtListenerOpinion
Date Created: 2023-08-28 19:04:29.113413+00
Date Added: 2024-06-11T07:27:32.519458
License: Public Domain

Dissenting Opinion by
Mr. Justice O’Brien :
I disagree with the view of the majority and, therefore, dissent.
*346Initially, I do not believe that the contested autopsy report should have been admitted in evidence, and I do not agree that its admission was "at most harmless error”. The Uniform Business Records as Evidence Act, Act of May 4, 1939, P. L. 42, §2, 28 P.S. §91b, under which the autopsy report was admitted as an exception to the hearsay rule, provides as follows: "A record of an act, condition or event shall, insofar as relevant, be competent evidence if the custodian or other qualified witness testifies to its identity and the mode of its preparation, and if it was made in the regular , course of business at or near the time of the act, condition or event, and if, in the opinion of the court, the sources of information, method and time of preparation were such as to justify its admission.”
To fall within this definition, hospital and business records must satisfy three requirements: “(1) they must be made contemporaneously with the acts to which they purport to relate; (2) there must have been present at the time no contemplative motive for falsification; (3) they must have been made by a person having knowledge of the facts set forth, or one competent to predicate a medical and scientific opinion on the facts.” Freedman v. Mut. Life Ins. Co. of N. Y., 342 Pa. 404, 21 A. 2d 81 (1941); Paxos v. Jarka Corporation, 314 Pa. 148, 153, 171 Atl. 468 (1934).
The autopsy report in'question does not meet these requirements. Hospital records are admitted because they are made during a course of treatment for the benefit of the medical personnel whose duty it is to care for the patient. There is, for this reason, no contemplative motive for falsification.
An autopsy report, especially one prepared four months after the patient’s death, at a time when a conference among the decedent’s mother, Dr. Snyder and a member of the hospital staff, had already put the ap*347pellees on notice that a malpractice suit was contemplated, is entirely different. Under such circumstances, the report is no longer a routine medical record to ascertain information useful in treating future patients, and it should not have been admissible under the business records exception to the hearsay rule. The Oklahoma Supreme Court reached the same conclusion in Horn v. Sturm, 408 P. 2d 541 (1965).
Norwood v. Great American Indemnity Co., 146 F. 2d 797 (C.C.A. 3rd Cir. 1944), upon which the appellees rely, is easily distinguishable from the instant case. There, the hospital was not a party to the litigation, and the autopsy report was prepared soon after death as a routine part of the hospital’s business.
The fact that Dr. Fisher testified and was subjected to vigorous cross-examination, in my view, has no bearing on the issue of the admissibility of the report. While it is clear that Dr. Fisher’s testimony alone, if believed, could have led the jury to the factual conclusion for which appellees contend, the presence of the autopsy report prejudicially strengthened the likelihood of that conclusion. Appellees were obviously not content to rely solely upon Dr. Fisher’s testimony, for if they were so satisfied, they would not have sought to buttress it by admission of the autopsy report. A report of this kind is surrounded by an “official document” aura and must surely weigh heavily in the minds of lay jurors.
Moreover, I believe that the cross-examination of appellant’s expert witness was unfair and that permitting that cross-examination constituted an abuse of discretion by the trial court. On direct examination, appellant’s expert testified that in his opinion the failure to measure up to the usual medical standards of care in the examination and treatment of the patient in the hospital emergency room was the proximate and substantial cause of the decedent’s death, and furthermore, *348that if the cause of death were pneumonia, evidence of such disease would have been present in the patient thirty-eight hours prior to her death.
On cross-examination, counsel for appellees devoted much effort to developing his case for the reliability of the final autopsy report as opposed to the original death certificate. After numerous questions, to which appellant’s counsel objected, the court finally interceded, stating: “I have a feeling that you are right. The whole bit of pathology may be something that comes up on your side of the case, but there is no evidence that this witness relied on an autopsy. If you want to prove the value of the pathology report, I think that is the burden on your side of the case.”
This comment by the court was absolutely correct. However, it is elementary that cross-examination of a witness, unless he is one of the litigants, should be confined to matters relating to his testimony on direct examination. The defendant may not introduce his defense by way of cross-examination. Woodland v. Phila. Transp. Co., 428 Pa. 379, 238 A. 2d 593 (1968); Okotkewicz v. Pittsburgh Rwys. Co., 397 Pa. 303, 155 A. 2d 192 (1959); Kline v. Kachmar, 360 Pa. 396, 61 A. 2d 825 (1948). Here, the expert did not testify as to the cause of death, only as to the negligence exhibited by the type of examination conducted and that, if pneumonia were the cause of death, as indicated on the death certificate, it could have been diagnosed by a competent examination. Appellees should not have been permitted cross-examination as to the value of their autopsy report, and the trial court allowed such impermissible questioning to continue for far too long a period.
I also find error in the court’s charge quoted in the opinion of the majority, and do not believe that the quoted modifications cured the error. The charge was *349an inaccurate oversimplification of the issues involved. If the jury found that the examination conducted by Dr. Snyder and the St. Luke’s Hospital emergency room staff was negligently conducted, and they found that, as appellant alleges, the decedent had pneumonia on December 27, 1966, which would have been disclosed by a competent medical examination, then, even if they found that the decedent died of myocarditis, they could not excuse the appellees, unless they also found that the myocarditis was in no way related to the pneumonia. For only if the myocarditis was unrelated to the pneumonia would a negligently-conducted examination not be the proximate cause of decedent’s death. The modification, in my view, compounded the error contained in the charge. Although the modification of Point for Charge No. 18 attempted to make a correction, the modification of Point For Charge No. 23 recreated the error contained in the original charge. By reiterating “that the theory of the plaintiff was that death occurred from pneumonia and it is the theory of the defense that death occurred by virtue of myocarditis,” the court once again made it appear to the jury that the two possible causes of death were mutually exclusive and that a finding of death caused by myocarditis eliminated the possibility of liability.
Nor do I believe that the general exception to the charge precludes our review in these circumstances. As pointed out by the majority, the modified instructions were occasioned by appellant’s specific objections, and I do not believe that it requires much of a stretch to incorporate those objections in the general exception to the charge.
I would reverse the judgment and grant a new trial.