People v. Ortega
15 N.Y.3d 610, 942 N.E.2d 210 (2010)
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Rule of Law:
Statements in medical records describing the cause of an injury, including the identity of a perpetrator in a domestic violence context, are admissible under the business records exception to the hearsay rule if they are germane to the patient's medical diagnosis and treatment. This concept of treatment is broad, encompassing not only physical injuries but also psychological and safety needs.
Facts:
- In People v. Benston, the complainant asked her former boyfriend and current housemate, Benston, to move out of her apartment following an argument.
- Benston became angry, threatened to kill the complainant, assaulted her, and choked her first with a scarf and then with a leather belt.
- At the hospital, the complainant told medical staff she had been strangled by an "old boyfriend" with a "black leather belt," which was recorded in her medical file along with a diagnosis of "domestic violence" and a note about a "safety plan."
- In People v. Ortega, the complainant alleged that the defendant and another man, at gunpoint, forced him to smoke crack cocaine.
- The men also allegedly forced the complainant to provide his bank card PINs and withdraw money from several ATMs.
- After escaping, the complainant was taken to a hospital where he reported to medical personnel that he "was forced to smoke [a] white substance from [a] pipe."
- The defendant in Ortega claimed the complainant voluntarily smoked crack and gave him the money and property.
Procedural Posture:
- In People v. Benston, defendant was convicted by a jury in a New York trial court on multiple charges, including assault and criminal contempt.
- Prior to trial, the court denied Benston's motion to redact all references to domestic violence and the perpetrator's identity from the complainant's medical records.
- Benston, as appellant, appealed to the Appellate Division, First Department, which affirmed the conviction.
- In People v. Ortega, defendant was convicted by a jury in a New York trial court of criminal possession of stolen property.
- Ortega, as appellant, appealed to the Appellate Division, First Department, which affirmed the conviction, finding any error in admitting the hospital records to be harmless.
- A Judge of the Court of Appeals granted leave to appeal to both Benston and Ortega (as appellants), and the cases were consolidated for review.
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Issue:
Does the business records exception to the hearsay rule permit the admission of statements in a patient's medical records that identify the perpetrator and describe the criminal nature of an assault, on the grounds that such information is relevant to the patient's medical diagnosis and treatment?
Opinions:
Majority - Chief Judge Lippman
Yes. Statements in medical records are admissible under the business records exception when they relate to diagnosis, prognosis, or treatment. In Benston, identifying the assailant as a former boyfriend and noting the context as 'domestic violence' were relevant to treatment, which includes addressing psychological trauma and developing a safety plan, not just treating physical injuries. In Ortega, the statement that the complainant was 'forced to' smoke crack was relevant because a doctor would treat a patient differently knowing they had no control over the substance or dosage. While the color of the belt in Benston was irrelevant and its admission was error, it was harmless given the overwhelming evidence.
Concurring - Judge Smith
Yes, but the majority's reasoning is incomplete. The statements are admissible not simply under the business records exception, but because they fall under a 'hearsay within hearsay' scenario that should be resolved by explicitly adopting the exception for statements made for medical diagnosis or treatment, similar to Federal Rule of Evidence 803(4). The business records exception authenticates the record itself, but a separate exception is needed to admit the patient's hearsay statement contained within it. Statements to a doctor for treatment are inherently reliable, justifying their admission, and the court should openly acknowledge it is adopting this rule.
Concurring - Judge Pigott
No, this evidence should not have been admitted, though the error in both cases was harmless. The majority interprets the business records exception too broadly. Information like 'domestic violence' or the perpetrator's identity was irrelevant to treating the complainant's immediate physical injuries in Benston. Similarly, whether the complainant was 'forced' to ingest drugs in Ortega improperly bolstered his testimony and was not shown to be medically relevant. This broad rule risks admitting unreliable or prejudicial information, such as false cover stories victims sometimes provide, and a trial judge should retain discretion to redact such conclusory and non-medical statements.
Analysis:
This decision significantly broadens the scope of the 'diagnosis and treatment' prong of New York's business records exception, particularly in domestic violence cases. It establishes that treatment is a holistic concept that includes a patient's psychological well-being and future safety, making the identity of an abuser and the context of the abuse medically relevant. The ruling makes it easier to admit victims' initial statements to medical providers, which can be critical evidence if a victim later recants or is unavailable to testify. While the majority did not explicitly adopt the federal 'statements for medical diagnosis' hearsay exception as urged by the concurrence, its reasoning functionally moves New York jurisprudence in that direction.
