Berry v. Cardiology Consultants, P.A.
909 A.2d 611, 2006 Del. Super. LEXIS 448, 2006 WL 3210002 (2006)
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Rule of Law:
A medical algorithm or similar document that might otherwise be considered a learned treatise under Evidence Rule 803(18) may be admitted as a physical exhibit if it was authored by the testifying expert witness and serves as a demonstrative tool to help the jury understand complex testimony.
Facts:
- Howard Scott Berry Sr., a long-time patient of cardiologist Dr. Andrew Doorey, had a history of heart attacks and other cardiac conditions.
- In November 2002, following heart bypass surgery, Mr. Berry developed atrial fibrillation.
- Dr. Doorey treated the atrial fibrillation with the drug Amiodarone, both in the hospital and via a prescription upon discharge.
- Approximately two months later, in February 2003, Mr. Berry was hospitalized with pulmonary complaints, and another doctor suspected an "early Amiodarone effect," directing him to stop taking the drug.
- After further hospitalizations, Mr. Berry died in March 2003.
- The certificate of death listed the immediate cause of death as Acute Pneumonitis and Amiodarone Toxicity.
Procedural Posture:
- The family of Howard Scott Berry Sr. (plaintiffs) sued Dr. Andrew Doorey and his employer, Cardiology Consultants, P.A. (defendants), for medical negligence in the Superior Court of Delaware (a trial court).
- The case was tried before a jury.
- The jury returned a verdict in favor of the defendants.
- The plaintiffs filed a post-trial motion for a new trial, arguing the court made a legal error by admitting a defense exhibit and that the verdict was against the weight of the evidence.
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Issue:
Does Delaware Rule of Evidence 803(18), which restricts learned treatises from being received as exhibits, prohibit a court from admitting a medical algorithm into evidence as a physical exhibit when the testifying expert witness is also the author of the algorithm?
Opinions:
Majority - Del Pesco, J.
No. The rule against admitting learned treatises as physical exhibits does not prohibit the admission of a medical algorithm authored by the testifying expert. The court reasoned that this situation is unique because the witness authored the document in question. The algorithm served as a useful demonstrative tool, akin to a chart the expert could have drawn in court to explain his decision-making process to the jury. Admitting the algorithm helped the jury understand complex medical testimony and was a matter of fairness, as the plaintiffs had already admitted their own competing algorithm into evidence. The court distinguished this from cases involving inadmissible statistical data, finding the algorithm was directly relevant to the standard of care.
Analysis:
This case carves out a significant, practical exception to the typical application of the learned treatise rule. By focusing on the expert's authorship, the court allows such a document to be re-characterized as a demonstrative aid, bypassing the rule's prohibition against admission as a physical exhibit. This gives trial judges more discretion to admit helpful explanatory materials in complex litigation, particularly medical malpractice cases where visual aids can be crucial for jury comprehension. The decision suggests that the primary concern of the learned treatise rule—preventing juries from being improperly influenced by unexamined hearsay—is mitigated when the author is present, testifying, and subject to cross-examination about the document's contents.
