Ricciardi v. Children's Hospital Medical Center

United States Court of Appeals for the First Circuit · 1987 · Evidence

811 F.2d 18 (1st Cir. 1987)

Updated August 22, 2026

EvidenceHearsayBusiness recordsRecorded recollectionResidual exceptionAdoptive admissionExpert basis testimonyFed. R. Evid. 803(6)

Facts

Ricciardi underwent aortic valve replacement surgery at Children's Hospital and later suffered neurological difficulties. His only proof of negligence was a note entered into his medical chart two days later by Dr. Nirmel, stating that during surgery an aortic cannula accidentally came out for 40 to 60 seconds. Dr. Nirmel did not witness the surgery, had no personal knowledge of the event, and could not recall who supplied the information, saying only that he assumed it came from 'professional people.' The note was central because the pretrial issues were whether the cannula came out and, if so, whether that caused Ricciardi's injuries.

Issue

Whether a hospital-chart note describing a surgical event is admissible when the physician who recorded it lacked personal knowledge and could not identify the source of the information. Also, whether an expert may rely on that note under Rule 703, and whether the note could be treated as an adoptive admission by a defendant physician.

Rule

A hospital record entry is not admissible under Massachusetts hospital-records law or Federal Rule 803(6) unless it is based on the entrant's personal knowledge or information transmitted by a person with knowledge whose source is sufficiently reliable; an unknown source indicates lack of trustworthiness. A record also fails under Rule 803(5) if the witness never had personal knowledge of the matter, and it fails under Rule 803(24) without equivalent guarantees of trustworthiness. Silence or inaction does not establish an adoptive admission without circumstances showing the party manifested adoption or belief in the statement's truth. Under Rule 703, an expert may rely on inadmissible material only if it is of a type reasonably relied upon by experts in the field, and a bizarre, unattributed chart note does not qualify absent such a showing.

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

At a medical malpractice trial in federal court in Boston, Lena Ortiz offers a hospital chart entry made the day after her surgery at Harbor View Medical Pavilion. The entry states, "sterile line briefly disconnected in OR," but the physician who wrote it testifies that he did not witness the surgery and cannot remember who told him about the event.

Is the chart entry admissible to prove the disconnection occurred?

Explanation. The majority held that a hospital record entry is inadmissible under Rule 803(6) and the analogous hospital-record approach when the entrant lacked personal knowledge and could not identify the source. The critical defect is the unknown source, which defeats the 'person with knowledge' requirement and undermines trustworthiness.