Gallagher v. Firelands Regional Med. Ctr.
2017 Ohio 483
| Ohio Ct. App. | 2017Background
- Mary Gallagher (84) had carotid stenting on May 30, 2012; postoperative systolic BPs in the 80s–90s persisted through the night; she was asymptomatic for much of the day and nurses did not notify a physician.
- At 1:35 a.m. she developed left-sided weakness; stroke team was summoned, she was transferred to University Hospitals (UH), and imaging showed stroke affecting the right pons and other areas.
- Appellees (Gallagher estate) sued Firelands Regional Medical Center for medical negligence, alleging nurses’ failure to notify a physician of prolonged hypotension proximately caused the stroke; defendant contended the stroke was embolic from atrial fibrillation.
- Before trial the court granted plaintiffs’ motion in limine excluding UH records/opinions (relying on Hytha and Evid.R.803(6) concerns). During trial, testimony opened lines of questioning about what UH physicians had said; the trial court ultimately admitted the UH records (including Dr. Sundararajan’s opinion that atrial fibrillation likely caused the stroke).
- Jury found nurses breached standard of care but unanimously concluded the breach did not proximately cause the stroke; plaintiffs moved for a new trial arguing admission of UH records was improper and prejudicial. Trial court granted a new trial; defendant appealed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of UH records/opinions under Evid.R. 803(6) (business-records hearsay exception) | UH records contained inadmissible expert opinion/hearsay; trial court previously excluded them and they should not have been admitted absent the author testifying | UH records were discussed at trial, were authenticated (custodian certification), Dr. Sundararajan’s assessment was made in regular course and would be admissible if she testified; admission was proper | Court held admission was not erroneous: records were properly authenticated and admissible under the business-records framework (court followed prior local decisions like Reneau construing Hytha and Weis principles) |
| Whether plaintiffs "opened the door" to admission of UH records | Plaintiffs did not open the door; defense counsel improperly elicited and relied on UH opinion | Defense argued plaintiffs’ witness (Dr. Susan Gallagher) raised UH discussion such that cross-exam and records were fair rebuttal | Court found “opening the door” arguments legally immaterial: even if door opened, that does not convert inadmissible hearsay into admissible evidence; but here holding on admissibility rested on authentication/business-records analysis rather than door doctrine |
| Prejudicial error warranting a new trial under Civ.R. 59(A)(9) | Admission of UH records introduced an untestified expert opinion (Dr. Sundararajan) and likely influenced jury (jury referenced UH records in finding breach) | Multiple live experts testified at length for both sides and were cross-examined; UH opinion was cumulative and not outcome-determinative | Court of Appeals held any error (if one) was not prejudicial given extensive competing expert testimony; trial court erred in granting a new trial |
| Standard of review for new-trial order premised on legal error | N/A (procedural) | N/A (procedural) | Review is de novo where new-trial grant was for an error of law; appellate court reverses new-trial order if there was no error or no prejudice |
Key Cases Cited
- Hytha v. Schwendeman, 40 Ohio App.2d 478 (10th Dist. 1974) (articulates seven-factor test for admitting medical diagnoses in records)
- Weis v. Weis, 147 Ohio St. 416 (Ohio 1947) (hospital records of observable acts and diagnoses admissible where helpful and properly authenticated)
- Shumaker v. Oliver B. Cannon & Sons, Inc., 28 Ohio St.3d 367 (Ohio 1986) (medical-causation testimony must be stated as to probability/reasonable medical certainty)
- Rohde v. Farmer, 23 Ohio St.2d 82 (Ohio 1970) (de novo appellate review where new trial was granted for an error of law)
- Ferguson v. Dyer, 149 Ohio App.3d 380 (10th Dist. 2002) (discussing review standard and reversal when trial court’s new-trial order involves only a question of law)
- Sanders v. Mt. Sinai Hosp., 21 Ohio App.3d 249 (8th Dist. 1985) (appellate review rejects new-trial order if error was not prejudicial)