Field v. Trigg County Hospital, Inc.
2004 WL 2309964, 386 F.3d 729 (2004)
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Rule of Law:
Statements made by consulting physicians to a treating physician are not admissible under the hearsay exception for statements made for purposes of medical diagnosis or treatment, Federal Rule of Evidence 803(4). This exception applies only to statements made by the person seeking treatment or by someone with a special relationship to that person.
Facts:
- On September 1, 1998, Tina Field was bitten twice by a copperhead snake and sought treatment at Trigg County Hospital from Dr. William B. Anderson.
- Dr. Anderson, who had limited experience treating venomous snake bites, monitored Field but did not administer antivenin.
- By the next day, Field's condition worsened significantly, exhibiting swelling above her knee, a bluish color in her foot, and eventually, a total loss of pulse in that foot.
- After Field lost the pulse in her foot, Dr. Anderson telephoned an emergency room physician and a toxicologist at Vanderbilt University Medical Center for a consultation.
- Dr. Anderson continued to treat Field for several more days before discharging her from the hospital.
- Field's condition did not improve, and after seeking further treatment at other hospitals, she underwent a below-the-knee amputation of her right leg on October 6, 1998.
Procedural Posture:
- Tina and Norman Field filed a medical malpractice suit against Dr. Anderson and Trigg County Hospital in federal district court.
- Trigg County Hospital settled with the Fields prior to trial and was dismissed as a defendant.
- The case against Dr. Anderson proceeded to a jury trial.
- Over the Fields' objection, the trial court permitted Dr. Anderson to testify about statements made to him by two unnamed Vanderbilt physicians.
- The jury returned a verdict in favor of Dr. Anderson.
- The Fields moved for a new trial, which the district court denied.
- The Fields (Appellants) appealed the district court's denial of their motion for a new trial to the U.S. Court of Appeals for the Sixth Circuit.
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Issue:
Does a physician's testimony relaying the opinions of two non-testifying, consulting physicians constitute inadmissible hearsay that is not subject to the medical diagnosis or treatment exception under Federal Rule of Evidence 803(4)?
Opinions:
Majority - Cole, J.
Yes, a physician's testimony relaying the opinions of non-testifying consulting physicians constitutes inadmissible hearsay. The statements were classic hearsay because they were offered for the truth of the matter asserted—that Dr. Anderson's treatment was appropriate. They do not fall within the Federal Rule of Evidence 803(4) exception for statements made for medical diagnosis or treatment, as that exception is limited to statements made by the patient seeking care, not by a consulting doctor to a treating doctor. The rationale for the exception—that a patient has a strong motive to be truthful to receive proper care—does not apply to statements between physicians. The admission of these statements was highly prejudicial, not harmless error, because it allowed Dr. Anderson to introduce opinions from two anonymous, un-cross-examined 'experts' who seemingly validated his conduct at the time it was occurring. The trial court's confusing limiting instruction was insufficient to cure this prejudice.
Dissenting - Siler, J.
Yes, the statements were hearsay, but their admission was harmless error. While the substance of the conversation was improperly admitted, the trial court gave an immediate admonition to the jury instructing them not to consider the statements as proof of the validity of the advice. Juries are presumed to follow court instructions. The plaintiffs' counsel did not object to the wording of the admonition or request a clearer instruction, suggesting they were satisfied at the time. This single error, in the context of a trial with multiple testifying experts on both sides, did not affect the substantial rights of the party and therefore does not warrant a new trial.
Analysis:
This decision significantly clarifies the scope of the Federal Rule of Evidence 803(4) hearsay exception in the Sixth Circuit. It establishes that the exception is a 'one-way street,' applying to statements from a patient to a medical provider, but not from one provider to another. This prevents litigants from using a treating physician's testimony to 'backdoor' expert opinions from non-testifying consultants, thereby shielding those opinions from cross-examination. The ruling reinforces the principle that expert testimony must be presented by witnesses who can be identified, qualified, and challenged in court, ensuring the integrity of the trial process.
