Court Opinion

ID: 9636182
Source: CourtListenerOpinion
Date Created: 2023-08-22 14:18:52.062537+00
Date Added: 2024-06-11T12:06:37.743071
License: Public Domain

EDGERTON, Associate Justice
(dissenting in part).
The insurance company offered the following hospital records, with proof that *307they were made in the regular course of business:1 (1) A statement of history, etc., taken by an attending physician from the insured when he was admitted to the hospital; (2) a diagnosis of his condition at that time; (3) reports of operations which he underwent and other treatment which he received in the hospital; (4) reports of consultations in 'which he discussed his history and his depressed state of mind and gave conflicting explanations, one of them suicidal, of his taking a large dose of codeiu and aspirin; (5) reports of psychiatric examinations, one of which included a diagnosis of “psychoneurosis, hypochondriasis” ; and (6) the proceedings and findings of the Board of Officers of the hospital concerning the cause of death. The trial court rejected all of these records. The beneficiary recovered double indemnity on the theory that death was accidental.
Appellant, the insurance company, now concedes that the rejection of the sixth item was correct. That question, therefore, is not before us. Some of the disputed items are quoted in the transcript; others are merely described. In my opinion the quoted items should have been admitted. So far as the character of the others can be judged from their descriptions, I think they also should have been admitted.
The federal Shop Book Rule, an Act of Congress, provides: “In any court of the United States and in any court established by Act of Congress, any writing or record, whether in the form of an entry in a book or otherwise, made as a memorandum or record of any act, transaction, occurrence, or event, shall be admissible as evidence of said act, transaction, occurrence, or event, if it shall appear that it was made in the regular course of any business, and that it was the regular course of such business to make such memorandum or record at the time of such act, transaction, occurrence, or event or within a reasonable time thereafter. All other circumstances of the making of such writing or record, including lack of personal knowledge by the entrant or maker, may be shown lo affect its weight, but they shall not affect its admissibility. The term ‘business’ shall include business, profession, occupation, and calling of every kind.” 2
The Shop Book Rule is an exception to the hearsay rule. Its purpose is to avoid the necessity of identifying, locating and calling numerous witnesses. Its chief drawback is that it prevents the opposing party from cross-examining them. The Supreme Court has recently stated its purpose and its principle. An enterprise, the Court said in Palmer v. Hoffman, commonly “entails the keeping of numerous books and records essential to its conduct or useful in its efficient operation. Though such books and records were considered reliable and trustworthy for major decisions in the industrial and business world, their use in litigation was greatly circumscribed or hedged about by the hearsay rule — restrictions which greatly increased the time and cost of making the proof where those who made the records were numerous. * * * It was that problem which started the movement towards adoption of legislation embodying the principles of the present Act. * * * And the legislative history of the Act indicates the same purpose.” The basis of the Rule is “the probability of trustworthiness of records because they were routine reflections of the day to day operations of a business. * * * ‘Regular course’ of business must find its meaning in the inherent nature of the business in question and in the methods systematically employed for the conduct of the business as a business.” 3
The routine records of hospitals are with- ' in the literal meaning of the Rule. That they are within the intent of Congress is shown by the fact that two of the cases cited in the committee reports involve such records.4 They are also within the princi*308pie and purpose of the Rule as explained by the Supreme Court in the Palmer case. The business of hospitals is caring for patients. By its “inherent nature” this business “entails the keeping of numerous books and records essential to its conduct or useful in its efficient operation.” “The methods systematically employed” for its conduct include the making and keeping of records of histories, diagnosis and treatment. These are “routine reflections of the day to day operations” of the hospital’s business. And, as Wigmore points out, some of the reasons for the admission of records in evidence apply with special force to the records of hospitals. “The calling of all the individual attendant physicians and nurses who have cooperated to make the record even of a single patient would be a serious interference with convenience of hospital management. There is a Circumstantial Guarantee of Trustworthiness * * *; for the records are made and relied upon in affairs of life and death.” It may be added that the members of a hospital staff are persons of more than average responsibility; and that they have two strong motives, one humanitarian and the other professional, for correctness, and usually no motive for fabrication. Dean Wigmore continues: “Moreover, amidst the day-to-day details of scores of hospital cases, the physicians and nurses can ordinarily recall from actual memory few of none of the specific data entered; they themselves rely upon the record of their own action; hence, to call them to the stand would ordinarily add little or nothing to the information furnished by the record alone. The occasional errors and omissions, occurring in the routine work of a large staff, are no more an obstacle to the general trustworthiness of such records than are the errors of witnesses on the stand.” Statutes in a number of states have specifically authorized the admission of hospital records.5
The Courts of Appeals of both the Second and Third Circuits have held that hospital records are admissible under the federal Shop Book Rule.6 In the Seventh Circuit, and in this jurisdiction, they have been admitted without objection.7 Moreover, the Rule was copied almost verbatim from a so-called model act,8 and states which have adopted that act have repeatedly applied it to hospital records.9
The Rule covers records of an “act, transaction, occurrence, or event.” Any development in, and any manifestation of, the patient’s mental or physical condition is an occurrence or event. Observation, diagnosis, and treatment also are acts, occurrences, or events. Accordingly records of condition, diagnosis and treatment, made in the regular course of business, when the regular course requires them to be made within a reasonable time after the event, are admissible under the Rule so far as they are relevant. Usually, and in the present case, diagnosis involves opinion. But even before the Shop Book Rule was enacted this court had held that records of the “opinions” as well as the “observations” of medical officers were admissible.10 More recently, hospital records of diagnosis have been admitted without objection.11 The *309opinion of a physician or other expert may be given on the witness stand when it is helpful to a jury’s understanding of technical facts. I think the Shop Book Rule makes a physician’s recorded diagnosis similarly admissible. The broad language of the Rule requires this result; so does the convenience of hospitals and of litigants; and the fact that recorded diagnoses are “systematically employed for the conduct of the business” 12 and “relied upon in affairs of life and death” establishes their relative trustworthiness. Relative truthworthiness is as much as the Rule contemplates or any human testimony possesses. Most of the cases which we have cited involved, diagnosis; some of them involved psychiatric diagnosis.13
It is of course true that psychiatric diagnosis is subject to error, that cross-examination is an invaluable aid in exposing error, and that the Shop Book Rule avoids cross-examination. But the argument that records of psychiatric diagnosis should therefore be excluded from the operation of the Rule proves too much. For records of the simplest observations of the most objective facts, which are conceded to be admissible under the Rule, are also subject to errors which cross-examination, if it were available, might expose. The alleged observer may have had no opportunity, or no adequate opportunity, to observe, or he may have made no effort to observe, or he may have made only a casual and ineffective effort. He may have been either permanently or temporarily incapable of accurate observation. He may have observed one thing and either carelessly or intentionally recorded a different thing. None of these circumstances is likely to appear upon the record. Any of them might be disclosed by cross-examination. The Shop Book Rule, by denying opportunity for cross-examination, imposes no greater disadvantage on the litigant who is adversely affected by a record ora psychiatric diagnosis than upon a litigant who is adversely affected by a record of the contents of a freight car. Rather, the disadvantage is likely to be less, for counsel are commonly less competent to attack expert testimony than lay testimony, and the expert witness is commonly more competent than the layman to defend himself.
When the Rule admits in evidence the record of an “act, transaction, occurrence, or event” it does not do so for every purpose. It admits the record “as evidence of said act, transaction, occurrence, or event.” Since the making of a statement is an act or event, a record that the patient made a certain statement is admissible as proof that he did so if his doing so is relevant, if the record is made in regular course, and if the regular course requires the record to be made within a reasonable time. The mere making of any statement which tends to indicate a depressed frame of mind is relevant to the issue of suicide. Whether a record of a patient’s statements may be used not only as proof that he made them but also as proof that they are true 14 is a complex question. The Rule permits proof of an event, etc., by its record only when the regular course of business requires the record to be made within a reasonable time after the event. It may be the regular course of the hospital’s business to record certain types of statements within a reasonable time after the patient makes them but, with the exception of events which occur after he enters the hospital, it can hardly be the regular course of business to record the facts which he states within a reasonable time after they occur. Thus it may be the regular course to ask a disabled man what caused his disability, and to record his answer, at the earliest opportunity, but the time of the recording depends upon the time of the statement and not upon the time of the injury. That may be recent or it may be very remote. It follows that the Rule does not, by itself, permit use of the record of the patient’s statement of what occurred before he entered the hospital to prove the facts which he stated. But the Rule does permit use of the record to prove *310that he made a statement; and the statement should be accepted for what it may be worth in'proof of relevant facts stated if either (1) they occurred after he entered the hospital, or (2) by virtue of some independent exception to the hearsay rule, such as statements of family history or of mental or physical condition,15 oral testimony that the patient made the same statement would be admissible in proof of the same facts.16 With respect to his pre-hospital history the Rule alone does no more, but also no less, than make the authenticated record an acceptable form of testimony that the patient’s statement was made.
Before any writing is admitted in evidence under the Shop Book Rule there are three preliminary questions of fact to be decided. (1) Was the writing “made as a memorandum or record of any act, transaction, occurrence or event”? (2) Was it “made in the regular course of any business”? (3) Was it the regular course to make the record “within a reasonable time”? Like other preliminary questions of fact upon which the admissibility of evidence depends, these are questions for the judge. In interpreting and deciding them he has a considerable power to prevent abuse of the Rule. The recent case of Palmer v. Hoffman illustrates this. There the Supreme Court found that the Rule did not admit a railroad engineer’s reports of accidents, because such reports “are not for the systematic conduct of the enterprise as a railroad business. * * * Their primary utility is in litigating, not in railroading.” 17 Since they are primarily intended for external and defensive use, they are less trustworthy than reports which are primarily intended to be relied upon as the basis of action in the internal business of the enterprise. Possibly something of the same sort might be said of the records of the Board of Officers, which are not in issue, in the present case. But nothing of the sort could be said of the records of history, diagnosis and treatment, the admissibility, of which is the only question before us. These records were not made for external or defensive use. They were made to be relied upon in the treatment of a patient.
It is true that in declining, in the Palmer case, to admit a report which was made for defensive purposes the Supreme Court said : “Such a major change which opens wide the door to avoidance of cross-examination should not be left to implication.” 18 But that language is irrelevant here, both because the records here in dispute were not made for defensive purposes and because the admission of these records does not depend on implication. They are (1) within the express language of the Shop Book Rule since they were made in the regular course of the hospital’s business, in the strictest sense, and it was the regular course to make them within a reasonable time.19 They are (2) within the Rule as interpreted in the Palmer case, since they are routine records of day to day operations and made to be relied upon in the internal conduct of the enterprise. They are to the business of a hospital what “bills of lading and the like” 20 are to the business of a railroad. They are (3) within the principle and purpose of the Rule since they are trustworthy and since their admission avoids the necessity of calling many witnesses. They are (4) within the established judicial interpretation of the Rule and of the model act on which it is based. We need not concern ourselves with hypothetical records which might meet some of these tests but would fail to meet others. We need not consider whether Congress had any intention of admitting the records which are made by newspaper men, credit men, or investigators for the ultimate purpose of selling news or views to persons outside the business organizations to which the men belong.21 It might well be contended that the Rule admits only writings which are incidental to the internal operation of a business and does not admit writings which are the very subject-matter of a business. In the light of the Palmer case, particularly, it might well be contended that *311the Rule excludes practically all records which are ultimately intended for external use. But records which meet all possible tests are not to be excluded, in the teeth of the statute, in order to preserve intact the right of cross-examination as it existed at common law. To preserve that right intact would repeal the statute; for any application of the Shop Book Rule, as of any other exception to the hearsay rule, by admitting hearsay necessarily avoids cross-examination.

 There was no contrary testimony. No question was raised regarding the time within which the regular course of business required the entries to be made. In view of the custom of hospitals, the standing of Walter Reed Hospital, and the absence of any suggestion to the contrary, we may infer that the regular course required the entries to be made within a reasonable time.

 49 Stat. 1561, 28 U.S.C.A. § 695.

 Palmer v. Hoffman, 318 U.S. 109, 111 — 115, 63 S.Ct. 477, 479, 87 L.Ed. 645, 144 A.L.R. 719.

 74th Cong., 2nd session, S. R. No. 1965; 74th Cong., 2nd session, H. R. No. 2357. The eases referred to are Grossman v. Delaware Electric Power Co., 4 W.W. Harr. 521., 34 Del. 521, 155 A. 806, and St. Louis v. Boston & Maine R. R. 83 N. H. 538, 145 A. 263.

 Wigmpre on Evidence, 3d ed., § 1707. Cf. §§ 1520, 1530, 1530a, 1639. The Maryland statute e. g., provides that, in civil cases, transcripts of the records of the-Maryland Tuberculosis Sanitarium or any of its branches “shall be competent evidence of the medical history of any individual who heretofore has been, or here.after may be, a patient therein.” Ann. Code Md., 1939, art. 35, § 13.

 Ulm v. Moore-McCormack Lines, Inc., 2 Cir., 115 F.2d 492; Id., 2 Cir., 117 F. 2d 222 (“clinical records” etc.); Reed v. Order of United Commercial Travelers of America, 2 Cir., 123 F.2d 252, 253 (“well under influence of alcohol”); Pollack v. Metropolitan Life Ins. Co., 3 Cir., 138 F. 2d 123 (patient’s statement of age); Estate of William Buckminster v. Com’r of Internal Revenue, 2 Cir., 147 F.2d 331 (“cerebral hemorrhage”); Norwood v. Great American Indemnity Co., 3 Cir., 146 F.2d 797 (“conflicting”' autopsy reports).

 Becker v. United States, 7 Cir., 145 F. 2d 171 (“Psychoneurosis Hysteria”); Prudential Insurance Co. v. Saxe, 77 U.S.App. D.C. 144, 134 F.2d 16.

 5 Wigmore on Evidence, § 1520.

 Borucki v. MacKenzie Bros., 125 Conn. 92, 3 A.2d 224 (“treatment, * * * condition” etc.); Wickman v. Bohle, 173 Md. 694, 196 A. 326, 329 (“fractured right clavicle”); Gile v. Hudnutt, 279 Mich. 358, 272 N.W. 706; People v. Kohlmeyer, 284 N.Y. 366, 31 N.E.2d 490, 491 (“included diagnoses of manic depressive insanity”) ; Conlon v. John Hancock Mutual Life Ins., 56 R.I. 88, 183 A. 850, 851, (“moderately advanced tuberculosis”).

 United States v. Balance, 61 App.D.C. 226, 59 F.2d 1040, 1042.

 Prudential Insurance Co. v. Saxe, 77 U.S.App.D.C.144, 134 F.2d 16.

 Palmer v. Hoffman, 318 U.S. 109, 115, 63 S.Ct. 477, 481, 87 L.Ed. 645, 144 A.L. R. 719.

 Notes 6, 7. and 9 supra. Contra, Lykes Bros. S. S. Co. v. Grnbaugh, 5 Cir., 128 F.2d 387.
I think this court is in error in citing Wigmore, § 1522, as supporting its view that the Shop Rook Rule admits only “observations which do not depend on opinion * *

 Pollack v. Metropolitan Life Ins. Co., 3 Cir., 138 F.2d 123, 128; Wickman v. Bohle, 173 Md. 694, 196 A. 326. Of. Hunter v. Derby Foods, Inc., 2 Cir., 110 F.2d 870, 133 A.L.R. 255; Contra, Sadjak v. Parker-Wolverine Co., 281 Midi. 84, 274 N.W. 719; Harrison v. Lorenz, 303 Mich. 382, 6 N.W.2Ü 554; Geroeami v. Fancy Fruit & Produce Co., 249 App.Div. 221, 291 N.Y.S. 837.

 Cf. Meaney v. United States, 2 Cir., 112 F.2d 538, 130 A.L.R. 973; Wigmore, Evidence, 3d ed., § 1714.

 Cf. Magruder, J., concurring in Pollack v. Metropolitan Life Ins. Co., supra; Hale, Hospital Records as Evidence, 14 So.Cal.L.R. 99, 106.

 318 U.S. 109, 114, 63 S.Ct. 477, 481, 87 L.Ed. 045, 144 A.L.R. 719.

 318 U.S. 109, 114, 63 S.Ct. 477, 481, 87 L.Ed. 645, 144 A.L.R. 719.

 Note 1 supra.

 Palmer v. Hoffman, 318 U.S. 109,114, 63 S.Ct. 477, 481, 87 L.Ed. 645, 144 A. L.R. 719.

 The reports of tire committees of Congress cite no cases of any such character.