15 N.Y.3d 610 (2010)
Statements in medical records are admissible under the business records exception to the hearsay rule if they are relevant to diagnosis and treatment; however, statements not related to these purposes are inadmissible.
Summary
The New York Court of Appeals addressed whether certain statements in medical records were properly admitted under the business records exception to the hearsay rule. In People v. Benston, the complainant’s medical records included references to “domestic violence” and a “safety plan.” In People v. Ortega, the complainant stated he was “forced to” smoke crack cocaine. The Court held that the references to domestic violence and a safety plan were admissible as relevant to diagnosis and treatment of a domestic violence victim, while the reference to the weapon’s color was harmless error. The statement in Ortega was also admissible, as it related to the treatment of a patient who was the victim of coercion. The Court affirmed both convictions.
Facts
People v. Benston: The complainant, who allowed the defendant to live in her apartment, was assaulted and choked by him after she asked him to move out. At the hospital, she reported being strangled by an old boyfriend with a black leather belt, and was diagnosed with “domestic violence [and] asphyxiation.”
People v. Ortega: The complainant claimed the defendant forced him at gunpoint to smoke crack cocaine and withdraw money from ATMs. He was taken to the hospital, where he reported he “was forced to smoke [a] white substance from [a] pipe.” The defendant testified that the complainant voluntarily smoked crack and handed over his personal property.
Procedural History
People v. Benston: The defendant was convicted of assault and other charges. The Appellate Division affirmed. The Court of Appeals affirmed.
People v. Ortega: The defendant was convicted of criminal possession of stolen property. The Appellate Division affirmed. The Court of Appeals affirmed.
Issue(s)
1. Whether references to “domestic violence” and a “safety plan” in a victim’s medical records are admissible under the business records exception to the hearsay rule.
2. Whether a complainant’s statement that he was “forced to” smoke crack cocaine is admissible under the business records exception.
Holding
1. Yes, because with all that has been learned about the scourge of domestic violence in recent decades, we now recognize that it differs materially, both as an offense and a diagnosis, from other types of assault in its effect on the victim and in the resulting treatment.
2. Yes, because treatment of a patient who is the victim of coercion may differ from a patient who has intentionally taken drugs.
Court’s Reasoning
The Court relied on CPLR 4518(a), which allows admission of records made in the regular course of business if made at the time of the event or within a reasonable time thereafter. Hospital records are considered trustworthy because they are relied upon in matters of life and death and reflect the patient’s motivation to report accurately.
The Court distinguished Williams v. Alexander, where a statement about how an accident occurred was deemed inadmissible because it was irrelevant to diagnosis or treatment. The Court noted, however, that in some situations, how an injury occurred may be helpful to medical understanding.
In Benston, the Court found the relationship between the parties clearly one subject to classification as involving domestic violence. “In this context, it is relevant for purposes of diagnosis and treatment that complainant’s assault was at the hands of a former boyfriend.” The Court emphasized that domestic violence differs materially from other assaults, requiring consideration of psychological and trauma issues. Developing a safety plan and providing information about social services are important parts of treatment.
In Ortega, the statement that the complainant was “forced to” smoke crack was relevant, as the amount and nature of the substance ingested, and the fact that it was coerced, can impact treatment.
Judge Smith concurred, arguing that the business records exception alone is insufficient to admit the statements, as it does not address hearsay within hearsay. He proposed adopting a medical diagnosis and treatment exception to the hearsay rule, justifying it by the intrinsic reliability of statements to one’s own doctor.
Judge Pigott concurred in the result only, arguing that the content of medical records should be subject to redaction of irrelevant information. The “diagnosis” of domestic violence and references to a “safety plan” should not have been admitted because “whether complainant was strangled by a former intimate partner or by a stranger was irrelevant to the type of treatment she received for her physical injuries.”