Field v. Trigg County Hospital, Inc.

386 F.3d 729 (6th Cir. 2004)

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Nature of the Case

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Facts

P sought treatment at the Trigg emergency room after being bitten twice on her right foot by a copperhead snake. D was the physician on call. D is a family practitioner with a solo practice, but he also works shifts at Trigg. D reviewed the emergency room textbook concerning the treatment of snake bites and called a hospital in Murray, Kentucky, to have antivenin delivered. The antivenin arrived shortly after P checked into the emergency room. D had experience with only one venomous snake bite prior to treating Tina Field's injury, and he had no experience administering antivenin. P felt sick to her stomach, faint, dizzy, and numb, and D noted significant swelling in her right foot and that the foot was warm. D determined that Field had a 'wet' bite, which meant that there had been envenomation. The plan was to monitor her, administer intravenous fluids and a tetanus shot, and look for any progression of the bite's severity. D checked on P periodically during the night but did not give her any antivenin. At 9:00 a.m. on September 2, P had swelling above her right knee, and her right foot was becoming cold and had a bluish color to it. At 5:00 p.m. on September 2, P complained of pain in her right big toe and coldness in her right foot. There was no pulse. The nurse called Dr. Anderson. At 8:10 p.m., D made his first call for assistance. He phoned an attending emergency room physician at the Vanderbilt University Medical Center, who then referred him to a Vanderbilt toxicologist. The Vanderbilt physicians were never deposed and they never testified at trial. Their identities, names, and credentials remain completely unknown. D testified at trial that he telephoned these individuals and asked for a consult. P objected-as to what the Vanderbilt physicians said over the telephone. The Vanderbilt emergency room physician and toxicologist told him that he was 'doing everything appropriately,' that 'they would be doing the same thing;' and that the main treatment is to elevate and monitor the leg. P remained under the care of D, through September 6. D believed the snake bite was improving. P was discharged and instructed to keep her right leg elevated and to return for an appointment two days later. On September 8 the foot was still cool and there was still no pulse. P’s sought treatment at the Blanchfield Army Hospital emergency room in Fort Campbell, Kentucky. P's right foot was surgically amputated on October 1, 1998. P then underwent a below-the-knee leg amputation. She subsequently required two additional surgeries to modify the stump in order to accommodate a prosthetic device. The judge ruled that the testimony was admissible under the hearsay exception in Fed. R. Evid. 803(4), which permits statements made for purposes of medical diagnosis or treatment to be admitted for the truth of the matter asserted. The judge instructed the jury that the statements were not to be considered for their truth. P objected on the grounds that the testimony was classic hearsay, that it did not fall under the Fed. R. Evid. 803(4) exception, and that the Vanderbilt physicians' statements constituted expert opinions. D got the verdict and p appealed.