Opinion
The principal issue in this appeal is whether a nonparty witness’ invocation of the privilege against self-incrimination pursuant to the fifth amendment to the United States constitution 1 constitutes *733 admissible evidence in a civil case. The defendants, Roberto Milla and Rutila Enamorado, appeal 2 from the judgment of the trial court in a personal injury action rendered after a jury trial in favor of the plaintiff, Sharlynn Rhode. 3 On appeal, the defendants claim that the trial court improperly: (1) admitted into evidence bills from Richard Fogel, the plaintiffs chiropractor, pursuant to General Statutes § 52-174 (b); 4 and (2) precluded the defendants from introducing Fogel’s invocation of the fifth amendment privilege at trial through either his deposition transcript or live testimony in the presence of the jury. We affirm the judgment of the trial court.
The record reveals the following facts, which the jury reasonably could have found, and procedural history. *734 At approximately 6 p.m. on April 22, 2002, the plaintiff was driving her Volvo on Interstate 95 in Darien when her vehicle was struck from behind by a Honda operated by Milla and owned by Enamorado, damaging the rear bumper of the plaintiffs car. Subsequent to the accident, the plaintiff began to experience head, neck and back pain, and several days later sought medical attention at the emergency room of Norwalk Hospital as her symptoms worsened. Because she continued to experience pain, the plaintiff then went to Fogel for further medical treatment, including electrical stimulation of her neck and alignments of her spine. She visited Fogel’s office for treatment several times per week from April, 2002 through March, 2003, although her neck and back pain and pain radiating down her right arm continued to persist during that time. Subsequent to her treatment by Fogel, the plaintiff also obtained treatment for her lower back and sprained left shoulder from Nicholas Polifroni, an orthopedic surgeon, and from Physical Therapy Associates, as well as at Advanced Health Professionals from Maria Passaro-Henry, a physician, and Richard Mullin, a chiropractor.
The plaintiff brought this action against the defendants for economic and noneconomic damages, alleging that her injuries were the result of Milla’s negligent operation of the vehicle, which was imputed to Enamorado pursuant to General Statutes §§ 52-182 and 52-183. Prior to trial in this case, Fogel became the subject of a federal criminal investigation into his patient treatment and billing practices. On the advice of counsel, Fogel asserted his fifth amendment privilege in response to all questions posed to him at his deposition taken by the defendants in this case. The defendants then filed a motion in limine to preclude the admission into evidence of Fogel’s bills and records. The defendants argued that the bills and records were inadmissible under § 52-174 (b) because there is no indicia of *735 their reliability since Fogel’s invocation of the privilege meant that he could not be qualified as an expert witness and the defendants did not have the opportunity to cross-examine him. 5 The plaintiff argued in response that Fogel’s invocation of the privilege is inadmissible because it would serve no purpose other than to prejudice her, and that the defendants’ chiropractic expert, Keith Overland, would have the opportunity to testify about the propriety of Fogel’s treatment of the plaintiff as reflected in Fogel’s records. 6 The plaintiff emphasized that precluding Fogel’s bills would deny her the right to have her damages redressed by the jury, and that the records were admissible as business records. Thereafter, outside the presence of the jury, Fogel was called to the witness stand and invoked the privilege.
The trial court determined that precluding the admission of Fogel’s records and bills would be “[un] fair . . . to either side” and that the plaintiff could testify about her treatment by Fogel, with more detail to be provided by the parties’ experts. The trial court also precluded the defendants from calling Fogel solely to exercise his fifth amendment privilege in front of the juiy, and from admitting into evidence his deposition transcript indicating the same. 7 Finally, the trial court rejected the defendants’ request for an adverse inference charge on the basis of Fogel’s failure to testify under his claim of privilege.
*736 Thereafter, the jury returned a verdict for the plaintiff in the amount of $8224.50 in economic damages and $1775.50 in noneconomic damages, for a total verdict of $10,000. The trial court denied the defendants’ motions for remittitur and to set aside the verdict, but reduced the verdict by a collateral source offset of $2986.30. Accordingly, the trial court rendered judgment for the plaintiff in the amount of $7013.70. This appeal followed.
On appeal, the defendants claim that the trial court improperly: (1) admitted evidence of the plaintiffs treatment by Fogel, and specifically the plaintiffs bills from him pursuant to § 52-174 (b); and (2) precluded the defendants from introducing into evidence Fogel’s invocation of the fifth amendment privilege. At the outset, we note that the defendants properly preserved these issues before the trial court. We address each claim in turn.
I
We begin with what we view as the principal issue in this appeal, namely, the admissibility of Fogel’s invocation of the fifth amendment privilege against self-incrimination, either through live testimony or the introduction of his deposition. The defendants rely on, inter alia, this court’s decision in
Olin Corp.
v.
Castells,
Although the defendants posit that this decision by the trial court is an evidentiary ruling, which is subject to review only for abuse of discretion, in our view, the broader question of whether a nonparty witness’ invocation of the fifth amendment privilege constitutes admissible evidence is a question of law over which our review is plenary. See
LiButti
v.
United States,
Although this is an issue of first impression in Connecticut,
8
it is settled law in other jurisdictions that a nonparty’s invocation of the fifth amendment privilege against self-incrimination is admissible evidence so long as it does not unduly prejudice a party to the case. See, e.g.,
Federal Deposit Ins. Corp.
v.
Fidelity & Deposit Co. of Maryland,
supra,
*739
In making this determination, factors that courts should consider include: (1) “the [njature of the [relevant [relationships . . . [as] invariably . . . the most significant circumstance,” “examined . . . from the perspective of a non-party witness’ loyalty to the plaintiff or defendant, as the case may be”; (2) “the [d]egree of [c]ontrol of the [p]arty [o]ver the [n]on-[p]arty [witness,” such as whether the assertion of the privilege may be viewed as a vicarious admission; (3) “the [compatibility of the [interests of the [p]arty and [n]on-[p]arty [witness in the [o]utcome of the [litigation,” namely, whether the “non-party witness is pragmatically a noncaptioned party in interest and whether the assertion of the privilege advances the interests of both the non-party witness and the affected party in the outcome of the litigation”; and (4) “the [r]ole of the [n]on-[p]arty [w]itness in the [l]itigation,” such as “[w]hether the non-party witness was a key figure in the litigation and played a controlling role in respect to any of its underlying aspects . . . .”
LiButti
v.
United States,
supra,
Thus, we agree with the defendants that Fogel’s invocation of the fifth amendment privilege was not per se inadmissible. We conclude, however, that a review of the factors enumerated in
LiButti
demonstrates that the trial court did not abuse its discretion in refusing to admit into evidence Fogel’s invocation of the privilege. With respect to the first, and “most significant” factor, namely, the “the [n]ature of the [Relevant [Relationships”;
LiButti
v.
United States,
supra,
*742 II
The defendants also claim that the trial court improperly admitted “evidence of the plaintiffs treatment by Fogel,” specifically the medical bills pursuant to § 52-174 (b), because his invocation of the fifth amendment privilege at his deposition denied the defendants their right to cross-examine him. Whether the trial court improperly admitted evidence under § 52-174 (b) is an evidentiary question, and our review is for abuse of discretion. See
Eisenbach
v.
Downey,
Our analysis necessarily must begin with
Struckman
v.
Burns,
*744 Guided by Struckman, we conclude that the defendants did not have an adequate opportunity to cross-examine Fogel in a meaningful manner about his bills either at his deposition or at trial because of his invocation of the fifth amendment privilege. We also acknowledge that the trial court’s otherwise proper ruling refusing to admit Fogel’s invocation of the privilege into evidence; see part I of this opinion; further deprived the defendants of an opportunity to discredit him at trial. Thus, we conclude that the trial court improperly admitted the bills into evidence pursuant to § 52-174(b).
“This conclusion does not, however, end our inquiry, because [e]ven when a trial court’s evidentiary ruling is deemed to be improper, we must determine whether that ruling was so harmful as to require a new trial. ... In other words, an evidentiary ruling will result in a new trial only if the ruling was both wrong and harmful. . . . Finally, the standard in a civil case for determining whether an improper ruling was harmful is whether the . . . ruling [likely] would [have] affectfed] the result. . . . Moreover, an evidentiary impropriety in a civil case is harmless only if we have a fair assurance that it did not affect the jury’s verdict.” (Citations omitted; internal quotation marks omitted.)
Hayes
v.
Camel,
supra,
Moreover, “[a] determination of harm requires us to evaluate the effect of the evidentiary impropriety in the context of the totality of the evidence adduced at trial. . . . Thus, our analysis includes a review of: (1) the relationship of the improper evidence to the central issues in the case, particularly as highlighted by the parties’ summations; (2) whether the trial court took any measures, such as corrective instructions, that might mitigate the effect of the evidentiary impropriety; and (3) whether the improperly admitted evidence is merely cumulative of other validly admitted testimony. . . . The overriding question is whether the trial court’s *745 improper ruling affected the jury’s perception of the remaining evidence.” (Citations omitted; internal quotation marks omitted.) Id., 489-90.
Having reviewed the entire record in this case, we have a “ ‘fair assurance’ ” that this evidentiary impropriety likely did not affect the jury’s verdict. Id., 489. The bills were admitted when the plaintiff testified about her injuries, and “we have upheld the admission of doctors’ bills, even though the doctor has not appeared and testified, where the plaintiffs testify that the bills have been incurred as a result of the injuries received.”
Bruneau
v. Quick,
The judgment is affirmed.
In this opinion the other justices concurred.
Notes
The fifth amendment to the United States constitution provides: “No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offense to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.” (Emphasis added.)
The defendants appealed from the judgment of the trial court to the Appellate Court, and we transferred the appeal to this court pursuant to General Statutes § 51-199 (c) and Practice Book § 65-1.
The plaintiff did not file a brief in this court or appear at oral argument, and failed to comply with our order pursuant to Practice Book § 67-3 requiring her to file a brief by August 29, 2007. We, therefore, considered this case on the record and the defendants’ brief and oral argument only. See
Walsh v. Jodoin,
General Statutes § 52-174 (b) provides: “In all actions for the recovery of damages for personal injuries or death, pending on October 1, 1977, or brought thereafter, and in all court proceedings in family relations matters, as defined in section 46b-1, or in the Family Support Magistrate Division, pending on October 1, 1998, or brought thereafter, and in all other civil actions pending on October 1,2001, or brought thereafter, any party offering in evidence a signed report and bill for treatment of any treating physician, dentist, chiropractor, natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist may have the report and bill admitted into evidence as a business entry and it shall be presumed that the signature on the report is that of the treating physician, dentist, chiropractor, natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist and that the report and bill were made in the ordinary course of business. The use of any such report or bill in lieu of the testimony of such treating physician, dentist, chiropractor, natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist shall not give rise to any adverse inference concerning the testimony or lack of testimony of such treating physician, dentist, chiropractor, natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist.”
The defendants had argued before the trial court that precluding them from examining Fogel about his bills would leave them exposed to approximately $4500 in economic damages that might not be “reasonable and necessary.”
For her part, the plaintiff moved in limine seeking an order precluding Overland from making “improper comments about [Fogel’s] character and credibility” during his testimony, on the ground that such comments are inadmissible hearsay and irrelevant.
After the close of evidence, the trial court denied the defendants’ motion to strike the admission into evidence of Fogel’s bills and the plaintiff’s testimony about her treatment with him. The trial court also denied the defendants’ motion for a mistrial on that same ground.
See
Desrosiers
v.
Henne,
“[Although relevant, evidence may be excluded by the trial court if the court determines that the prejudicial effect of the evidence outweighs its probative value. . . . [T]he trial court’s discretionary determination that the probative value of evidence is . . . outweighed by its prejudicial effect will not be disturbed on appeal unless a clear abuse of discretion is shown. . . . [B]ecause of the difficulties inherent in this balancing process . . . every reasonable presumption should be given in favor of the trial court’s ruling. ... Of course, [a]ll adverse evidence is damaging to one’s case, but it is inadmissible only if it creates undue prejudice so that it threatens an injustice were it to be admitted. . . . [Accordingly] [t]he test for determining whether evidence is unduly prejudicial is not whether it is damaging to the
*739
[party against whom the evidence is offered] but whether it will improperly arouse the emotions of the jur[ors]. . . .
State
v.
Skakel,
At trial, the defendants took an exception to the trial court’s refusal to charge the jury that it could draw an adverse inference against the plaintiff on the basis of Fogel’s invocation of the fifth amendment privilege. See
Rad Services, Inc.
v.
Aetna Casualty & Surety
Co., supra,
In
Gordon
v.
Indusco Management Corp.,
supra,
The court stated that “the legislature undoubtedly considered the prevailing evidentiary treatment of hospital records”;
Struckman
v.
Burns,
supra,
The court further rejected the defendant’s concerns “with the costs associated with deposing an out-of-state witness. If the plaintiff had chosen to depose the nonresident medical practitioners rather than introduce their reports at trial, the defendant could hardly have objected on the ground that he would be obliged to incur additional expenses for travel in order to exercise his right of cross-examination.”
Struckman
v.
Burns,
supra,
Specifically, Overland testified, on the basis of his twenty-five years of experience in practicing chiropractic medicine, that Fogel had “provided approximately thirty-six chiropractic treatments from April 30th through October 10, 2002, and it was my opinion that at some point earlier than those full scope of visits, [the plaintiff] had reached maximum improvement under his particular type of care. And it was my opinion that should have been approximately three months and maybe twenty-four visits or so.” Overland further noted the plaintiffs lack of progress and testified that Fogel should have pursued an alternate course of treatment for her, based on Overland’s review of the records, which were “below standard” in his opinion. Overland noted that there were “similar findings on every single of the thirty-six visits when it comes to the treatment and the assessment *746 and the objective findings. And so, basically it seemed to me that at a certain point, those records did not justify continued treatments, so that’s what I really pulled out of this—the review of the notes is that there was really no justification for ongoing treatment beyond a certain point.” He testified that if treatment was not successful after three or four weeks, he would look for alternative methods of treatment, and that the fact that identical treatments were used for such a long time without change in condition indicates that Fogel had departed from the standard of care.
