Virginia Supreme Court Weighs Probative vs. Judicial Evidence in Medical Negligence Case

Published on: 9/28/2004

September 28, 2004

In a recent opinion, the Virginia Supreme Court again addressed long-standing principles of evidence. The Court issued the decision, styled Donna J. Gamache, M.D., et al. v. Craig Allen , Record No. 032321, on September 17, 2004.

The case involved allegations that the physician failed to timely diagnose the plaintiff's spinal disease called transverse myelitis. At a pretrial hearing, plaintiff informed the trial court that he intended to introduce evidence that would permit the jury to conclude that he attempted to commit suicide in April 2002, and that this act was proximately caused by the negligence of the health care providers. The health care providers informed the court that they intended to introduce evidence that plaintiff's attempted suicide was related to other factors, including his pregnant wife's alleged abuse of plaintiff's narcotic medication and his wife's alleged acts of self-mutilation. The plaintiff argued that this evidence should be precluded because the prejudicial effect of such evidence far outweighed its probative value. The health care providers argued the evidence was relevant to show the jury that these factors caused plaintiff to attempt suicide. The trial court ruled that the health care providers could present evidence of plaintiff's wife's depression, but they could not present evidence of her alleged abuse of narcotics or her alleged acts of self-mutilation.

At trial, plaintiff presented evidence that he incurred physical and emotional damages, including major depression, proximately caused by the physician's acts of medical negligence. Plaintiff's treating psychiatrist testified that plaintiff suffered from depression, which was caused by major "stressors," including his suffering from a neurological illness, his job, his marriage, and financial problems. Plaintiff also introduced into evidence the cost of medical treatment necessitated by the suicide attempt.

The jury returned a verdict in favor of the plaintiff against one of the two physician defendants and her employer. The physician and her employer appealed, arguing that evidence of the plaintiff's wife's use of his narcotic medication while pregnant and her alleged acts of self-mutilation should have been admitted. The Virginia Supreme Court agreed, citing long-standing principles of evidence. The court held that the trial court abused its discretion by refusing to permit the defendant physicians to elicit evidence that plaintiff's depression and attempted suicide may have been related to his wife's alleged abuse of his narcotic medication and her alleged acts of self-mutilation. The court stated that "[t]he jury was entitled to consider this evidence, which was relevant, even though this evidence may be potentially damaging to plaintiff." The court determined that the probative value of this evidence was not substantially outweighed by the danger of unfair prejudice to the plaintiff, and that the physicians were entitled to present evidence that other significant events that occurred in plaintiff's life for which [the physicians] were not responsible were the proximate cause of plaintiff's attempted suicide. "This evidence was not collateral," the court explained, "but was relevant to an element of damages that plaintiff claimed was proximately caused by the physicians' acts of negligence." The court ordered a new trial on the issue of proximate cause and damages, and specified that upon retrial, the health care providers will be permitted to present evidence of plaintiff's wife's alleged abuse of his narcotic medication while pregnant and her alleged acts of self-mutilation.

The health care providers also asserted that they should have been permitted to present evidence that two of plaintiff's treating physicians did not believe plaintiff was trustworthy, and that one of the treating physicians had discharged plaintiff as a patient because he did not believe the plaintiff was honest with him regarding his use of prescription pain medication. The Court disagreed, citing well-established precedent that "[w]hen a litigant impeaches a witness' reputation for truth and veracity, such evidence must be confined to the general reputation of the impeached witness for truth and veracity and may not include the commission of specific acts of untruthfulness or other bad conduct, even though these have bearing on veracity."