Court Opinion

ID: 9684996
Source: CourtListenerOpinion
Date Created: 2023-08-24 14:20:42.142991+00
Date Added: 2024-06-11T18:18:01.621979
License: Public Domain

D. C. Riley, P.J.
Plaintiff appeals from a judgment of no cause of action entered against him in circuit court. The claim brought by plaintiff alleges professional negligence against the individual defendants for their failure to diagnose plaintiffs dislocated shoulder when he sought treatment at defendant hospital’s emergency room.
In 1972, plaintiff, a physician specializing in obstetrics and gynecology, experienced physical difficulties and discovered the existence of cardiac problems. Surgery to replace a heart valve was successfully conducted in early 1973, after which plaintiff resumed his practice. In July of 1973, plaintiff suffered a stroke but after treatment regained muscle usage and nearly complete sensation in his left arm. After the stroke, plaintiff no longer practiced medicine but acted as a surgical assistant to fellow doctors.
On February 2, 1974, plaintiff lost consciousness *220while at home and fell to the floor. He was taken to defendant hospital’s emergency room and then transferred to the cardiology floor. Plaintiff complained of pain in his left shoulder and X-rays were taken which showed no positive injury. Therefore, defendant Garcia’s tentative diagnosis was that plaintiff had probably bruised or sprained his shoulder. The shoulder pain continued after plaintiff’s discharge from the hospital and he was unable to achieve a full range of movement of the left arm. The pain and problems persisted, thus, plaintiff pursued further medical treatment from defendant Garcia who referred plaintiff to defendant Bluhm, a specialist in rheumatology. Plaintiff was forced to discontinue his work as a surgical assistant.
On April 27, 1974, plaintiff was admitted to defendant hospital for further treatment. Dr. Bluhm changed the anti-inflammatory medication and ordered X-rays. The new medication had reduced the swelling in the shoulder and, on the basis of the X-rays, Dr. Bluhm suspected a hidden posterior dislocation of the shoulder. This diagnosis was confirmed and a closed reduction procedure was conducted. The plaintiff was discharged the following day. He testified that he experienced permanent pain and restriction of movement in the shoulder.
I
Plaintiff contends that the court committed error in failing to grant him a mistrial on the basis of defense counsel’s closing argument. The comments objected to were that allegedly plaintiff’s counsel had withheld evidence from his expert and that "obviously something is going on” between plaintiff’s counsel’s firm and plaintiff’s expert. -
*221One of plaintiffs experts was unable to come to Michigan for the trial and, therefore, had to be deposed in Massachusetts. Defendant objected to the deposition and filed an application for emergency leave to appeal. This Court reached its decision against defendant late Friday, December 14, 1979. The plaintiff then sought a trial court order allowing the X-rays on exhibit to be taken to Massachusetts for the deposition. However, because of the lateness of the hour, no circuit judge was available to sign the order and defendants’ counsel refused to stipulate to taking the X-rays to the deposition. Plaintiff thus argues that, because defense counsel would not stipulate to the taking of the X-rays already introduced into evidence to Massachusetts to allow the expert to review them, defense counsel’s argument that plaintiff was withholding evidence from his own expert was incorrect and prejudicial.
This argument is difficult only in its facts and not the law. The appellate briefs must be compared with the more than 300-page trial transcript to resolve the confusion. Defense counsel’s closing argument that plaintiff did not provide the X-rays to his expert refers not only to the deposition of December 15, 1979, but to plaintiffs failure to provide the X-rays to his expert during the entire course of the expert’s preparation for the case. Furthermore, the record shows that, in his initial closing argument, plaintiffs counsel made allegations as to defendants’ part in the nonproduction of the X-rays. These allegations against defendants introduced the subject of nonproduction of the X-rays and "opened the door” to comment on the subject by defense counsel in his closing argument. Allowance of statements made by counsel in closing argument will not be an error if the state-*222merits are made in response to arguments made by opposing counsel. Haynes v Monroe Plumbing & Heating Co, 48 Mich App 707, 721; 211 NW2d 88 (1973).
The plaintiff also objects to defense counsel’s comments concerning plaintiffs experts and his counsel’s firm. The trial court denied plaintiffs motion for a mistrial based on these alleged errors. The denial of a motion for a mistrial will not be reversed unless it is shown that the denial constituted an abuse of discretion. Flinn v Sun Oil Co, 96 Mich App 59, 62; 292 NW2d 484 (1980), People v Coffman, 45 Mich App 480, 487; 206 NW2d 795 (1973).
The Supreme Court defined "abuse of discretion” in Spalding v Spalding, 355 Mich 382, 384-385; 94 NW2d 810 (1959), in the following manner:
"[A]n abuse of discretion involves far more than a difference in judicial opinion between the trial and appellate courts. The term discretion itself involves the idea of choice, of an exercise of the will, of a determination made between competing considerations. In order to have an 'abuse’ in reaching such determination, the result must be so palpably and grossly violative of fact and logic that it evidences not the exercise of will but perversity of will, not the exercise of judgment but defiance thereof, not the exercise of reason but rather of passion or bias.”
Having reviewed the record, we conclude that the trial court did not abuse its discretion.
II
The plaintiff alleges that the trial court commit*223ted reversible error in denying his motion for a mistrial in response to defense counsel’s reference to plaintiffs income tax returns during closing arguments.
Defense counsel had repeatedly tried to have plaintiff produce his income tax returns before trial, which plaintiff failed to do. At trial, the court denied defense counsel’s request for an instruction concerning the tax forms. Defendants were informed by the trial court that the failure to produce the tax records could be used when plaintiff made a claim of lost wages. The judge said: "You may argue to the jury the lack of proofs, as you see it, of earning capacity, but the request to instruct is refused.”
During closing argument, defense counsel began describing his attempts at obtaining plaintiffs income tax returns. This was immediately objected to on the ground that this was not in evidence. Defense counsel continued mentioning his motion to produce the records to which plaintiffs counsel also objected. Both objections were sustained. Defense counsel then stated that he had tried to get the records and that plaintiffs counsel had not shown the income tax records to the jury. Again, plaintiffs counsel objected. At this point, the trial judge excused the jury and explained that defense counsel could properly comment on the lack of plaintiffs proof with respect to income. loss but that he could not go through the details of the pretrial procedures undertaken to have the records produced. Defense counsel then stated that he would limit himself to comment consistent with the instruction. Plaintiffs counsel moved for a mistrial because he thought the remarks already made were "very prejudicial”.
*224The standard of review applied to a trial court’s denial of a motion for a mistrial has been discussed earlier in this opinion. We must determine whether the court abused its discretion. It was not the fact that defense counsel raised the subject of tax returns, which had been held proper by the court, but the manner in which he introduced the subject that is objected to. The references to which plaintiff objects all occurred during the same short span of closing arguments. We conclude that the trial court did not abuse its discretion in denying plaintiffs motion.
Ill
The plaintiff further contends that the court erred when it struck portions of his expert’s testimony when the expert used the personal pronoun "I” in describing the applicable standard of care. The plaintiffs Massachusetts expert, during his video-taped deposition, answered questions by responding with what he would have done rather than with what the standard of practice was.
A treating physician is liable for damages when it is shown that he departed from the standard of care which is known as customary medical practice. Wood v Posthuma, 108 Mich App 226, 230; 310 NW2d 341 (1981). The measuring standard of care is founded upon how other doctors in that field of medicine would act and not how any particular doctor would act. Rytkonen v Lojacono, 269 Mich 270; 257 NW 703 (1934). The expert’s use of the pronoun "I” was improper. Id. Because the stricken responses involved the expert’s own personal practices, the trial court did not err in *225striking those responses before the video-taped deposition was played to the jury.
IV
Plaintiff argues that the court erred in failing to give Standard Jury Instruction (SJI) 34.01 as requested. That instruction involves the statutory mortality table and the court initially agreed to give the instruction. After closing argument, the court refused to give the instruction because the table is for ordinarily healthy persons which the court believed was inappropriate as to the plaintiff.
The Court in Javis v Ypsilanti Board of Education, 393 Mich 689, 697; 227 NW2d 543 (1975), held that GCR 1963, 516.6(2) requires that the standard jury instructions be used whenever they are applicable, accurate and requested by a party. Standard Jury Instruction 34.01 is not applicable for a person not in an average, normal, healthy condition. Fortner v Koch, 272 Mich 273, 279; 261 NW 762 (1935).
In this case, there was ample evidence to support the position that plaintiff was not a normal, healthy, 50-year-old male at the time of trial. He underwent heart surgery in 1973, and suffered a stroke later that year and suffered from seizures and recurring cardiac problems. He stated that he did not expect to live much longer than ten years. Plaintiff’s counsel repeated this expectation in closing argument and noted that plaintiff might live longer because "he is a man that does not quit”. The court’s determination that the instruction should not be given is not reversible error.
*226V
Plaintiffs final allegation is that the court erred in excluding as hearsay the clinical impressions of an emergency room physician who worked at the defendant hospital and treated plaintiff when he was admitted. The statement at issue appeared under a box on the medical chart labeled "Clinical Impressions”. The emergency doctor wrote "Impression: Frozen shoulder, secondary to old trauma”.
Both parties agree that the statement is actually an admission by an agent of defendant hospital. Therefore, the admission is not hearsay at all according to MRE 801(d)(2)(D). Plaintiff contends that because the statement is an admission, the impression should have been admitted. However, the impression is contained in a writing which must qualify on its own for admission. The Court stated in Lovend v Beaumont Hospital, 78 Mich App 686, 688; 261 NW2d 37 (1977): "Unquestionably, the admissibility of party admissions is well-established. However, the party admission was contained in a business record and, therefore, involves a second level of hearsay that must also come within the business records exception to be admissible.”
The plaintiff argues in the alternative to the business record exception that the statement was "made for purposes of medical treatment or medical diagnosis in connection with treatment” and, thus, it qualifies as a hearsay exception under MRE 803(4).
This exception is not applicable here as it permits statements by the patient of his physical *227condition, symptoms, or medical history. The rule in MRE 803(4) does not apply to statements by the doctor regarding the patient’s physical condition. Gallaway v Chrysler Corp, 105 Mich App 1, 9; 306 NW2d 368 (1981).1
The admission contained in the report can only then be admitted if MRE 803(6) is applicable. That rule provides that the records of a regularly conducted activity are an exception to the hearsay rule. This rule is commonly known as the business records exception. The rule states:
"(6) Records of regularly conducted activity. A memorandum, report, record, or data compilation, in any form, of acts, transactions, occurrences, or events, made at or near the time by, or from information transmitted by, a person with knowledge, if kept in the course of a regularly conducted business activity, and if it was the regular practice of that business activity to make the memorandum, report, record, or data compilation, all as shown by the testimony of the custodian or other qualified witness, unless the source of information or the method or circumstances of preparation indicate lack of trustworthiness. The term 'business’ as used in this paragraph includes business, institution, association, profession, occupation, and calling of every kind, whether or not conducted for profit.” (Emphasis added.)
The rule in MRE 803(6) has béen subject to minimal appellate review since 1978, when the Michigan evidence rules were adopted. The precursor to the present rule was MCL 600.2146 (Stat Ann 1962 Rev §27A.2146): "Under this statute it has been held that hospital records are admissible as business entries to the extent they record *228events and acts, such as admissions, discharges, and ministrations in the hospital, although they are not ordinarily admissible as a means of introducing medical history or diagnosis.” Bond v Greenwood, 34 Mich App 41, 43; 190 NW2d 731 (1971). The Court went on to say that a general description of a physicál condition, as distinguished from a diagnosis, was admissible under the business records statute. Id. Plaintiff makes an attempt to classify the clinical impression in this case as a mere statement of a physical condition, rather than a diagnosis and, thus, bring this case under the holding in Bond. We have determined, as did the trial court, that the statement at issue is a diagnosis and not a mere statement of physical condition.
The language of MRE 803(6) varies from that of the Federal Rule 803(6) in a way that is determinative to this case. The Michigan rule applies to "acts, transactions, occurrences, or events”; the federal rule applies to "acts, events, conditions, opinions, or diagnoses”. (Emphasis added.) The Michigan rule is narrower in scope than its federal counterpart. Michigan apparently has chosen to exclude medical diagnosis from the business record exception, MRE 803(6). Therefore, the trial court did not err in excluding the clinical impression offered by plaintiff.
Affirmed. Costs to appellees.
Cynar, J., concurred.

 Unfortunately, certain language in Echols v Rule, 105 Mich App 405, 411; 306 NW2d 530 (1981), regarding MRE 803(4), which was approved by the writer, would suggest otherwise; to the extent that it does, I now disavow the same.