Lynn Kace, administratrix v. Ivan Liang

Summary

The Massachusetts Supreme Judicial Court reviewed a wrongful death medical malpractice judgment against an emergency physician. The court held that the plaintiff substantially complied with expert-disclosure requirements, although the expert's testimony and counsel's use of it were problematic, and that Internet materials concerning myocarditis did not qualify as learned treatises. The court nevertheless affirmed because the evidentiary errors did not cause undue prejudice to the defendant.

Holdings

1. The plaintiff satisfied the basic expert-disclosure requirements because the expert's opinion that the defendant's five-minute examination was inadequate was linked to and constituted an explanation or development of his disclosed opinions concerning the defendant's failure to recognize myocarditis symptoms and order an EKG. The disclosure should have been clearer and more complete, and counsel improperly attempted to use the opinion as an independent standard-of-care violation, but reversal was not warranted.
2. The Johns Hopkins and Mayo Clinic Internet pages did not qualify as reliable authorities under Mass. G. Evid. § 803(18)(B). The plaintiff failed to establish the reliability of the specific pages because they were directed to laypersons and did not identify an author or authors whose reliability could be established.
3. Mass. G. Evid. § 803(18)(B) did not authorize the plaintiff to use the Internet pages during redirect examination of the defendant because the defendant was testifying as a party, not as an expert witness. The testimony concerning the pages was inadmissible hearsay when offered for its truth.
4. The trial judge erred by preventing defense counsel from cross-examining the plaintiff's expert about a prior medical record that was admitted by agreement and had been used during direct examination, and by preventing counsel from referring to that record in closing argument.
5. The evidentiary errors did not require reversal because they did not materially prejudice the defendant. The Internet-page evidence was cumulative of properly admitted testimony, and the excluded prior medical record contained minimal information that would not have affected the central issue.

Questions Presented

1. Whether the plaintiff's disclosure of her medical expert's opinions satisfied Mass. R. Civ. P. 26(b)(4)(A)(i), despite the expert's trial testimony that the defendant's five-minute examination was inadequate.
2. Whether Internet pages from the Johns Hopkins University School of Medicine and Mayo Clinic qualified as reliable published treatises or periodicals admissible under Mass. G. Evid. § 803(18)(B), and whether that provision permitted their use during redirect examination of the defendant.
3. Whether the trial judge erred by restricting cross-examination of the plaintiff's expert concerning a prior medical record that had been admitted as a trial exhibit and used during direct examination.
4. Whether the expert-disclosure, Internet-material, and cross-examination errors required reversal of the judgment.

Disposition

affirmed