Supreme Judicial Court, June 26, 2012

Hospital medical records, ordinarily admitted through G.L. c. 233, § 79, are not admissible as business records through G.L. c. 233, § 78.

After being robbed at knifepoint by a passenger, a Lawrence taxicab driver fired his pistol and shot the robber in his back. Police located the defendant near to the scene, where he was suffering from an apparent gunshot wound to his back.  The defendant was seen at a local hospital and transferred to Brigham and Women’s Hospital for surgery. Two days after examining the defendant, a treating physician at Brigham and Women’s drafted a one-page report and noted “The patient states that he was minding his own business while he was in a taxicab when he got shot."  

At trial, the Commonwealth sought to introduce the medical records including this statement.  The trial judge ruled that if the documents were offered under § 79, the statement would be redacted because it did not bear a relationship to the defendant’s treatment or medical history.  The Commonwealth then sought to introduce the medical records as business records under G.L. c. 233, § 78.  The defendant objected to the admission of these records as business records and the Judge overruled his objection.  A Superior Court jury convicted the defendant of armed robbery, G.L. c. 265, § 17.

On appeal, the defendant asserted that the statement in his medical records (that he was in the taxicab when he was shot) was inadmissible as hearsay and a violation of his Sixth Amendment right to confrontation.   The Supreme Judicial Court transferred the case.

For the first time, the Court looked at whether documents admissible as hospital records can also be offered as business records.  In its analysis, the Court reasoned that the Legislature drafted specific limitations into § 79 and the Legislature could not have intended that those limitations be circumvented merely by invoking § 78 as a basis for admissibility.  “The Commonwealth's assertion that § 78 provides an alternative avenue for the introduction of hospital medical records would undermine these limitations and nullify our long-standing interpretation of § 79.” The Court looked to the provisions for medical records and found “[i]t is apparent that the Legislature, through its enactment of §§ 79 and 79G, intended that medical records be treated differently from the records of other businesses.”  The Court held it was an error for the trial judge to admit the medical records as business records.

Since the statement was not admissible under either hearsay exception, the Court did not need to reach the constitutional issue of confrontation. However, it decided to briefly discuss the relationship between medical records and the confrontation clause. It held “where statements contained in hospital medical records demonstrate, on their face, that they were included for the purpose of medical treatment, that evident purpose renders the statements both nontestimonial as to the author of the record, and as falling within the scope of § 79.”

While it was an error to admit the medical records under § 78, the Court concluded there was no prejudicial error from the erroneous admission and affirmed the conviction.