Court Opinion

ID: 9962332
Source: CourtListenerOpinion
Date Created: 2024-04-23 15:19:24.168984+00
Date Added: 2024-06-11T08:20:26.574200
License: Public Domain

COURT OF APPEALS OF VIRGINIA
UNPUBLISHED

              Present: Judges Beales, Friedman and Callins
              Argued at Leesburg, Virginia

              MICHAEL LYONS
                                                                           MEMORANDUM OPINION* BY
              v.     Record No. 0421-23-4                                  JUDGE RANDOLPH A. BEALES
                                                                                 APRIL 23, 2024
              MOSTAPHA EL JLAILATI

                                   FROM THE CIRCUIT COURT OF FAIRFAX COUNTY
                                              Richard E. Gardiner, Judge

                              D. Cory Bilton (Bilton Law Firm, PLLC, on briefs), for appellant.

                              Sarah E. Marks (Ramika D. Stephens & Associates, on brief), for
                              appellee.

                     Mostapha El Jlailati admitted liability for an auto accident that injured Michael Lyons.

              Lyons was awarded a total of $30,000 after a jury trial on the issue of damages. On appeal,

              Lyons argues that the trial court erred when it ruled that Lyons could only enter his medical bills

              into evidence for the purpose of showing his pain and suffering – and not for the purpose of

              proving economic damages.

                                                       I. BACKGROUND

                     El Jlailati testified that on November 22, 2017, he crashed his vehicle into the back of

              Lyons’s vehicle. Lyons testified that he went to an orthopedist about a week after the accident

              because he was experiencing neck pain. Lyons also went to physical therapy sessions, and he

              received multiple “trigger point injections” into his back and neck. In addition, he went through

              “nerve ablations” procedures to help relieve his neck pain. Lyons also acknowledged that he had

                     *
                         This opinion is not designated for publication. See Code § 17.1-413(A).
suffered from intermittent neck pain since 2010. The record before us on appeal shows that he

had gone to physical therapy for his neck pain before the accident occurred.

       After testifying about the medical treatments that he received after the accident, Lyons

attempted to introduce copies of his medical bills into evidence as an exhibit. Counsel for El

Jlailati objected, arguing a lack of foundation, and he also argued that Lyons’s medical expert

“Dr. Mo would be the one to lay the foundation for each of the medical bills, which he will not

do in his testimony that’s coming up this afternoon.” The trial court did not admit the medical

bills into evidence at that time, and it indicated that Lyons’s medical expert would first need to

lay the appropriate foundation before the bills could be admitted into evidence.

       Counsel for Lyons then played the pre-recorded video deposition of Dr. Fred Mo, an

expert witness in orthopedic surgery.1 Dr. Mo explained how he began treating Lyons for his

neck pain in 2019. Dr. Mo testified, “Before coming to see me, he [Lyons] had a -- a significant

amount of treatment, including physical therapy -- an extensive amount of visits -- as well as

pain management. He did undergo injections into his neck by pain management physicians and

tried to improve his symptoms.” Dr. Mo’s recommendation to Lyons “was to obtain a new MRI

and also was to continue maximizing conservative treatment, meaning physical therapy, pain

management further.” Later in the deposition, counsel for Lyons asked:

               And the treatment that Mr. Lyons has received since the accident --
               the treatment that you’ve talked about, doctors’ visits, physical
               therapy, pain management, getting the MRI, the follow up visits
               with you -- do you believe that all of that treatment is causally
               related to the accident in November of 2017?

       1
         The record on appeal contains only the transcript from Dr. Mo’s deposition; it does not
contain the actual video of that deposition.
                                              -2-
Dr. Mo then responded, “I do.” Counsel for Lyons then asked, “And all of the treatment that

Mr. Lyons has received since the accident, has it been fair and reasonable?” Dr. Mo responded,

“They have been.”

       Shortly after Dr. Mo’s video deposition concluded, counsel for Lyons told the trial court,

“I intend to try and get the medical bills into evidence through my client.” Counsel for El Jlailati

then objected and explained, “Dr. Mo didn’t see all the bills; he just said that treatment was

related. I don’t know what he’s actually relating.” After taking a brief recess, the trial judge

stated, “I can’t see any basis on which I can let the Plaintiff [Lyons] testify concerning the bills

and to get them into evidence absent a medical expert -- qualified medical expert -- testifying

about the bills, showing that they are -- show medical necessity and/or causal relationship.” The

trial court then found that Dr. Mo “hasn’t gone through the bills” and that “Dr. Mo did not testify

one word about the bills.” The trial court then sustained El Jlailati’s objection to the introduction

of the medical bills based on Dr. Mo’s testimony. Lyons then briefly testified about his medical

expenses, and the trial court admitted Lyons’s medical bills into evidence “for a very narrow

purpose, and that’s to show that the Plaintiff [Lyons] has pain and suffering damages that he’s

claiming -- not for the specific amounts on the bills.”2

       El Jlailati called Dr. John Bruno, an expert witness in general medicine and orthopedic

surgery, to testify about Lyons’s medical expenses. Dr. Bruno admitted that it was appropriate

for Lyons to receive an MRI and then go to physical therapy for his neck pain following the

accident. However, Dr. Bruno testified that the other medical treatments (such as the pain

management treatment) were simply “treating the Degenerative Disc Disease that was present

       2
         The trial court also gave Jury Instruction P, which reads in pertinent part, “The
following medical bills were entered into evidence to assist you in determining pain and
suffering, if you determine Plaintiff’s pain and suffering at that time was causally related to this
accident . . . Do not consider these medical bills in your determination of past medical bills.”
Jury Instruction P lists specific medical bills that Lyons entered into evidence.
                                                  -3-
before this accident.” After closing arguments, the jury found that Lyons was entitled to $30,000

in damages. Lyons now appeals to this Court.

                                           II. ANALYSIS

       On appeal, Lyons argues that the trial court erred when it only allowed him to enter his

medical bills into evidence to show pain and suffering, and not to show economic damages. “We

will not overturn a trial court’s exercise of its discretion in determining whether to admit or

exclude evidence on appeal unless the evidence shows that the trial court abused its discretion.”

Riverside Hosp. Inc. v. Johnson, 272 Va. 518, 529 (2006). “Of course, an error of law, ‘by

definition,’ constitutes an abuse of discretion.” Carolino v. Commonwealth, 79 Va. App. 170,

183 (2023) (en banc) (quoting Bennett v. Commonwealth, 69 Va. App. 475, 485 (2018)).

       The Supreme Court has limited a plaintiff’s ability to enter medical bills into evidence to

prove damages. In McMunn v. Tatum, 237 Va. 558, 568 (1989), the Supreme Court stated,

“Proof of medical expenses by the introduction of bills through the sole testimony of the plaintiff

requires consideration of four major components: (1) authenticity, (2) reasonableness in amount,

(3) medical necessity, and (4) causal relationship.” 237 Va. 558, 568 (1989). The Supreme

Court then explained:

               We now hold that where the defendant objects to the introduction
               of medical bills, indicating that the defendant’s evidence will raise
               a substantial contest as to either the question of medical necessity
               or the question of causal relationship, the court may admit the
               challenged medical bills only with foundation expert testimony
               tending to establish medical necessity or causal relationship, or
               both, as appropriate.

Id. at 569 (emphasis added).

       In a subsequent case, Parker v. Elco Elevator Corp., 250 Va. 278, 280 (1995), the

Supreme Court explained that when a plaintiff “does not seek recovery for the amount of the

medical bills,” but only “seeks recovery for the pain and suffering associated with the injuries he

                                                -4-
sustained,” then the plaintiff is “not required to identify the medical bills as elements of financial

damage when those bills were to be used for this limited purpose.” Consequently, under Parker,

a plaintiff may rely solely on his own testimony as the required foundation (without any expert

testimony) to enter his medical bills into evidence as proof that he suffered and that he was in

pain because of his injuries. However, if a plaintiff intends to enter medical bills into evidence

to recover the specific amount of money reflected in those bills and the defendant challenges the

admission of those bills, then the plaintiff must have a medical expert testify about the

reasonableness and causal connection of those medical bills to the plaintiff’s injury – as required

by the Supreme Court’s decision in McMunn.

        Here, Lyons initially tried to enter his medical bills into evidence as proof of economic

damages relying solely on his own testimony as the layman patient. However, the trial court

sustained El Jlailati’s objection to the introduction of the bills, and the trial court required

Lyons’s medical expert, Dr. Mo, to lay an appropriate foundation for the medical bills before

those bills could be admitted to prove economic damages. Given that El Jlailati challenged the

medical necessity and causal connection of Lyons’s medical bills, the trial court could admit the

medical bills as evidence of medical expenses only if an expert testified about the necessity of

the treatment and the causal connection of those bills to Lyons’s injuries. See McMunn, 237 Va.

at 569. Therefore, the trial court did not err when it did not admit Lyons’s medical bills as

evidence of his economic damages based solely on the testimony of Lyons.

        Later during trial, Lyons tried to enter the bills into evidence again after he played the

pre-recorded deposition of his medical expert, Dr. Mo. After watching Dr. Mo’s testimony, the

trial court made the specific findings that Dr. Mo “hasn’t gone through the bills” and that

“Dr. Mo did not testify one word about the bills.” While Dr. Mo generally referenced the

treatments that Lyons received, Dr. Mo did not state anywhere in his testimony that he reviewed

                                                  -5-
Lyons’s medical bills. Consequently, given that Dr. Mo did not reference the medical bills

during his testimony at all, Dr. Mo also did not testify that the bills were medically necessary or

causally connected to the accident – as required by the Supreme Court’s holding in McMunn.

See 237 Va. at 569 (where the Supreme Court emphasized, “The mere receipt of bills regular on

their face by a plaintiff furnishes no evidence of medical necessity or causal relationship.”).

Therefore, we cannot say that the trial court abused its discretion by refusing to allow Lyons to

also use the medical bills as proof of his economic damages by simply showing the specific

amount of those medical bills. Indeed, the trial court correctly determined that it could only

admit Lyons’s medical bills into evidence for the purpose of showing pain and suffering. While

Lyons did not put on expert testimony laying the foundation for the bills to be used for “recovery

for the amount of the medical bills,” Lyons could still seek “recovery for the pain and suffering

associated with the injuries he sustained” by showing that he sought medical treatment after the

accident occurred. Parker, 250 Va. at 280.

       Consequently, given that Lyons only provided his own testimony as a layman about his

medical bills, we cannot say that the trial court abused its discretion when it admitted the medical

bills into evidence only for the limited purpose of demonstrating Lyons’s pain and suffering from

the accident – and not for proving his economic damages.

                                          III. CONCLUSION

       In short, Lyons failed to lay the proper foundation by expert testimony that is required to

admit medical bills into evidence for the purpose of recovering the specific amount of damages

reflected in those medical bills. Lyons’s medical expert, Dr. Mo, did not testify about the medical

bills at all, and, therefore, Dr. Mo’s testimony did not explain how those bills were medically

necessary or causally related to the accident. Therefore, Lyons failed to lay a proper foundation that

would allow the trial court to admit the medical bills to show Lyons’s economic damages.

                                                 -6-
Consequently, the trial court did not abuse its discretion when it refused to admit the medical bills

into evidence for the purpose of recovering the amount of Lyons’s economic damages based on

those bills. Nor did the trial court err when it allowed Lyons to admit those medical bills into

evidence only for the limited purpose of showing his pain and suffering from the accident.

       For the foregoing reasons, we do not disturb the decision of the trial court.

                                                                                              Affirmed.

                                                 -7-