Aumand v. Dartmouth Hitchcock Medical Center

United States District Court for the District of New Hampshire · Evidence

EvidenceRule 26(a)(2)(A)Rule 37(c)(1)Rule 702Rule 701Rule 803(6)Rule 801(d)(2)(D)Rule 403

Facts

The plaintiffs alleged that Dartmouth Hitchcock negligently administered glucose through a catheter in Katherine Coffey's hand, causing extravasation, worsening hand injury, partial amputation, infection, and ultimately death. Before trial, the plaintiffs sought to exclude various defense evidence, and Dartmouth Hitchcock sought rulings limiting damages and excluding certain family-member testimony. The record included Coffey's medical records, statements by unidentified hospital personnel to family members, and late disclosure by Dartmouth Hitchcock of treating physicians it intended to use for opinion testimony. Dartmouth Hitchcock also argued that damages for medical services should be limited to amounts actually paid by Medicare and supplemental insurance rather than billed charges.

Issue

Whether the challenged evidence should be admitted or excluded at trial, especially: whether treating physicians not timely disclosed as experts may offer opinion testimony; whether third-party payments of medical bills may be used to measure or prove value of medical services; whether a treating physician's note in medical records is admissible; and whether statements by unidentified hospital employees qualify as admissions or otherwise are admissible.

Rule

A witness who will offer evidence under Rules 702, 703, or 705, including a treating physician testifying to diagnoses, prognoses, or similar medical conclusions, must be disclosed under Rule 26(a)(2)(A). If such disclosure is not timely made, Rule 37(c)(1) generally bars the opinion testimony unless the proponent shows the failure was substantially justified or harmless. Opinions and diagnoses contained in medical records admissible under Rule 803(6) are not excluded merely because the author was not separately qualified under Rule 702, absent a showing of untrustworthiness. Under Rule 801(d)(2)(D), agency and scope may be shown circumstantially even when the declarant is unidentified. Evidence of amounts paid by collateral sources toward medical bills is generally inadmissible where its probative value is substantially outweighed by the risk the jury will improperly reduce damages.

🔒

See the holding & full analysis

Create a free KwikCourt account to unlock the rest of this brief — and practice the case.

The court's holding and reasoning
Doctrine tests, pitfalls & exam hypotheticals
10 practice questions + 4 AI-graded essays on this case

Free sample · practice this case

Test yourself

One of 10 multiple-choice questions for this case. Pick an answer to see why.

In a medical malpractice suit in federal court in New Hampshire, Harbor Valley Clinic listed Dr. Nina Patel, a treating internist from Manchester, as a trial witness but never disclosed her as an expert by the scheduling-order deadline. At trial, the clinic plans to ask Dr. Patel whether the patient's post-discharge symptoms were consistent with sepsis and whether the patient's decline was likely unrelated to the clinic visit.

What is the strongest basis for ruling on this proposed testimony?

Explanation. A treating physician's diagnoses, prognoses, and similar medical conclusions are based on specialized knowledge and therefore fall within Rule 702, not Rule 701. Under the majority opinion, any witness who may present Rule 702 testimony must be disclosed under Rule 26(a)(2)(A), even if not retained. If the disclosure was not timely made, Rule 37(c)(1) generally requires exclusion unless the proponent shows substantial justification or harmlessness.