Diaz v. Eli Lilly & Co.

Massachusetts Appeals Court · Torts

TortsEvidenceHospital recordsExpert testimonyG. L. c. 233 § 79hospital records exceptionhearsaydiagnosis

Facts

The main factual dispute at trial was whether Parnon caused the plaintiff's bilateral optic atrophy and resulting blindness. The plaintiff had sprayed roses with Parnon while working for a commercial rose grower and claimed toxic agents in the product caused his condition. The plaintiff's hospital records included diagnoses describing his eye condition as toxic in origin and attributing the toxic agent to Parnon or to an 'insecticide.' The judge instructed the jury that those hospital-record opinions could be considered only to the extent testifying experts relied on them, and not as independent evidence of causation.

Issue

Whether the trial judge erred in instructing the jury that opinions and diagnoses in the plaintiff's hospital records could not be treated as independent substantive evidence that a toxic agent caused the plaintiff's blindness. More specifically, the question was whether such diagnoses were admissible for all purposes as a matter of law under G. L. c. 233, § 79.

Rule

Under G. L. c. 233, § 79, hospital records are admissible only insofar as they relate to treatment and medical history and possess the characteristics that justify a presumption of reliability. Not all material in hospital records is admissible for its substantive content. When a diagnosis is not routine, is judgmental or controversial, involves serious difficulty of interpretation, or constitutes a conclusion on the ultimate issue of causation or liability, the trial judge may in his discretion require that the jury consider only the opinions of experts who testify in court and are subject to cross-examination.

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

In a products-liability trial in Massachusetts, Nora Kim claims that fumes from solvent sold by Harbor Crest Coatings in Worcester caused her rare nerve disorder. Her hospital record from Springfield includes a neurologist’s note stating, "neuropathy likely caused by Harbor Crest solvent exposure," but trial testimony shows the condition has many possible causes and is often diagnosed only by ruling others out.

How should the trial judge most likely rule on the use of that hospital-record diagnosis?

Explanation. Under the majority rule, not everything in a hospital record is admissible for its truth merely because it relates to treatment. A judge may limit a diagnosis to a non-substantive use when the diagnosis is not routine, is judgmental or controversial, involves serious interpretive difficulty, and bears on the ultimate issue of causation. Here, the rare disorder and diagnosis-by-exclusion support a finding that cross-examination is important and the diagnosis lacks the ordinary presumption of reliability. (Derived from Diaz v. Eli Lilly & Co. (n.d.).)