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▪ -•11 Cr% -t; (pm > AMT. r- •• cr) PO < IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON cD
In the Matter of the Detention of No. 75974-4-1
C.S., DIVISION ONE
Appellant. UNPUBLISHED
FILED: January 16, 2018
Cox, J. — C.S. appeals the order committing him for 14 days of
involuntary treatment. The trial court did not abuse its discretion in allowing
witnesses to testify regarding the contents of portions of the medical records that
were not admitted into evidence. This evidence falls under the business records
exception to hearsay, pursuant to RCW 5.45.020. We affirm.
On September 16, 2016, a Designated Mental Health Professional filed a
petition to place C.S. on a 72-hour involuntary treatment hold after he was
brought to Highline Medical Center. The next day, C.S. was transferred to No. 75974-4-1/2
Fairfax Hospital, which sought an additional 14 days of involuntary treatment.
The court held a two-day commitment hearing on September 21 and 22, 2016.1
After considering the evidence, the trial court determined that C.S.
suffered from a mental disorder, specifically Bipolar Disorder, Type 1, and as a
result presented as a substantial risk of harm to himself, harm to others, and as
gravely disabled.2 It entered an order committing C.S. to Fairfax for a 14-day
period.
C.S. appeals.
BUSINESS RECORDS EXCEPTION TO HEARSAY
C.S. argues that the trial court abused its discretion in permitting
witnesses to testify regarding the contents of his medical records where those
records were not admitted into evidence. We disagree.
"Hearsay is 'a statement, other than one made by the declarant while
testifying at the trial or hearing, offered in evidence to prove the truth of the
matter asserted.'"3 In general, hearsay is not admissible.4 RCW 5.45.020
provides an exception for records kept in the ordinary course of business.5
This statute provides:
A record of an act, condition or event, shall in so far as relevant, be competent evidence if the custodian or other qualified witness testifies to its identity and the mode of its preparation, and if it was made in the regular course of business, at or near the time of the
1 See RCW 71.05.240. 2 See id. 3 State v. Iverson, 126 Wn. App. 329, 336, 108 P.3d 799(2005)(quoting ER 801(c)). "Id. 5 See also ER 803(a)(6).
2 No. 75974-4-1/3
act, condition or event, and if, in the opinion of the court, the sources of information, method and time of preparation were such as to justify its admission.[8]
The provisions of RCW 5.45.020 require the proponent of evidence to lay
a foundation before that evidence may be admitted as a business record.7
We review the trial court's decision to admit business records under RCW
5.45.020 for a manifest abuse of discretion.8
Here, the State laid the foundation for admitting portions of C.S.'s medical
chart by presenting testimony from Dr. Richard Thomas and Dr. Angel Lugo-
Steidel, Ph.D. Dr. Thomas testified that he was a contract evaluator at seven
different facilities including Highline. He testified that he was authorized to
review and write notes in medical charts at Highline. He testified that: he was
familiar with the manner in which medical records were maintained at Highline,
medical records were regularly maintained in the course of business, the entries
were made into the medical charts at or near the time of the events being
described, and the notes in the medical charts were used by Highline to establish
medical diagnosis and treatment. He further testified that the medical charts
were relied upon by hospital experts to formulate their opinions.
6RCW 5.45.020. 7Id.; see State v. Ziegler, 114 Wn.2d 533, 538-40, 789 P.2d 79(1990); Iverson, 126 Wn. App. at 337-38. 8 Ziegler, 114 Wn.2d at 538; State v. Garrett, 76 Wn. App. 719, 722, 887 P.2d 488 (1995).
3 No. 75974-4-1/4
Based on this testimony, the trial court determined that Dr. Thomas had
properly laid the foundation for admission of portions of C.S.'s Highline medical
chart pursuant to RCW 5.45.020.9
Dr. Thomas then testified to notes in C.S.'s medical chart that described
C.S.'s actions and statements. The notes documented that, while in the
emergency room, C.S. was hostile, demanding to staff, and manic. C.S.
admitted being manic but denied needing further treatment. The next day, C.S.
presented as extremely agitated, refused to return to his room, postured with his
fists clenched, and said he would "show karate" if not given underwear. The trial
court did not allow Dr. Thomas to testify about the statements made by the
ambulance driver or by C.S.'s wife even though those statements were contained
in C.S.'s medical chart.
Dr. Angel Lugo-Steidel also testified to lay the foundation to admit entries
from C.S.'s medical record at Fairfax. Dr. Lugo-Steidel testified that he is a
licensed clinical psychologist and employed by Fairfax where he is a court
evaluator.
He testified that he was familiar with C.S.'s medical chart, and he was
authorized to write in that chart and to review the notes contained therein. He
testified that he was familiar with the manner in which the medical chart was
maintained, that it was regularly maintained by the hospital in the course of its
business, and that entries in the chart were made at or near the time of the event
9 See Iverson, 126 Wn. App. at 338-39; Garrett, 76 Wn. App. at 725.
4 No. 75974-4-1/5
being described. He further testified that the chart notes were used by Fairfax to
establish the medical diagnosis of patients, and that the charts were relied upon
by hospital experts to formulate their opinions. The trial court determined that Dr:
Lugo-Steidel laid the foundation for admission of C.S.'s Fairfax medical records
under the business records exception to the hearsay rule.1°
Dr. Lugo-Steidel read entries from C.S.'s Fairfax medical chart into the
record. Those entries stated that C.S. had claimed he was from the planet
"Alamd," and he was delusional, manic and very psychotic. He attempted to
avoid taking his medications by placing them inside his cheek instead of
swallowing. He was guarded, fidgety, hyperactive, restless, illogical,
uncooperative, and paranoid. He had poor eye contact, repeatedly asked for
discharge, threw trash, flipped tables and banged on the floor. C.S. threatened
staff and had to be given emergency medication.
Dr. Lugo-Steidel testified that in evaluating C.S., he relied on his interview
with C.S., the medical charts from Highline and Fairfax, and the testimony of
Free access — add to your briefcase to read the full text and ask questions with AI
cp • MC:3 -4= co C-. rn
▪ -•11 Cr% -t; (pm > AMT. r- •• cr) PO < IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON cD
In the Matter of the Detention of No. 75974-4-1
C.S., DIVISION ONE
Appellant. UNPUBLISHED
FILED: January 16, 2018
Cox, J. — C.S. appeals the order committing him for 14 days of
involuntary treatment. The trial court did not abuse its discretion in allowing
witnesses to testify regarding the contents of portions of the medical records that
were not admitted into evidence. This evidence falls under the business records
exception to hearsay, pursuant to RCW 5.45.020. We affirm.
On September 16, 2016, a Designated Mental Health Professional filed a
petition to place C.S. on a 72-hour involuntary treatment hold after he was
brought to Highline Medical Center. The next day, C.S. was transferred to No. 75974-4-1/2
Fairfax Hospital, which sought an additional 14 days of involuntary treatment.
The court held a two-day commitment hearing on September 21 and 22, 2016.1
After considering the evidence, the trial court determined that C.S.
suffered from a mental disorder, specifically Bipolar Disorder, Type 1, and as a
result presented as a substantial risk of harm to himself, harm to others, and as
gravely disabled.2 It entered an order committing C.S. to Fairfax for a 14-day
period.
C.S. appeals.
BUSINESS RECORDS EXCEPTION TO HEARSAY
C.S. argues that the trial court abused its discretion in permitting
witnesses to testify regarding the contents of his medical records where those
records were not admitted into evidence. We disagree.
"Hearsay is 'a statement, other than one made by the declarant while
testifying at the trial or hearing, offered in evidence to prove the truth of the
matter asserted.'"3 In general, hearsay is not admissible.4 RCW 5.45.020
provides an exception for records kept in the ordinary course of business.5
This statute provides:
A record of an act, condition or event, shall in so far as relevant, be competent evidence if the custodian or other qualified witness testifies to its identity and the mode of its preparation, and if it was made in the regular course of business, at or near the time of the
1 See RCW 71.05.240. 2 See id. 3 State v. Iverson, 126 Wn. App. 329, 336, 108 P.3d 799(2005)(quoting ER 801(c)). "Id. 5 See also ER 803(a)(6).
2 No. 75974-4-1/3
act, condition or event, and if, in the opinion of the court, the sources of information, method and time of preparation were such as to justify its admission.[8]
The provisions of RCW 5.45.020 require the proponent of evidence to lay
a foundation before that evidence may be admitted as a business record.7
We review the trial court's decision to admit business records under RCW
5.45.020 for a manifest abuse of discretion.8
Here, the State laid the foundation for admitting portions of C.S.'s medical
chart by presenting testimony from Dr. Richard Thomas and Dr. Angel Lugo-
Steidel, Ph.D. Dr. Thomas testified that he was a contract evaluator at seven
different facilities including Highline. He testified that he was authorized to
review and write notes in medical charts at Highline. He testified that: he was
familiar with the manner in which medical records were maintained at Highline,
medical records were regularly maintained in the course of business, the entries
were made into the medical charts at or near the time of the events being
described, and the notes in the medical charts were used by Highline to establish
medical diagnosis and treatment. He further testified that the medical charts
were relied upon by hospital experts to formulate their opinions.
6RCW 5.45.020. 7Id.; see State v. Ziegler, 114 Wn.2d 533, 538-40, 789 P.2d 79(1990); Iverson, 126 Wn. App. at 337-38. 8 Ziegler, 114 Wn.2d at 538; State v. Garrett, 76 Wn. App. 719, 722, 887 P.2d 488 (1995).
3 No. 75974-4-1/4
Based on this testimony, the trial court determined that Dr. Thomas had
properly laid the foundation for admission of portions of C.S.'s Highline medical
chart pursuant to RCW 5.45.020.9
Dr. Thomas then testified to notes in C.S.'s medical chart that described
C.S.'s actions and statements. The notes documented that, while in the
emergency room, C.S. was hostile, demanding to staff, and manic. C.S.
admitted being manic but denied needing further treatment. The next day, C.S.
presented as extremely agitated, refused to return to his room, postured with his
fists clenched, and said he would "show karate" if not given underwear. The trial
court did not allow Dr. Thomas to testify about the statements made by the
ambulance driver or by C.S.'s wife even though those statements were contained
in C.S.'s medical chart.
Dr. Angel Lugo-Steidel also testified to lay the foundation to admit entries
from C.S.'s medical record at Fairfax. Dr. Lugo-Steidel testified that he is a
licensed clinical psychologist and employed by Fairfax where he is a court
evaluator.
He testified that he was familiar with C.S.'s medical chart, and he was
authorized to write in that chart and to review the notes contained therein. He
testified that he was familiar with the manner in which the medical chart was
maintained, that it was regularly maintained by the hospital in the course of its
business, and that entries in the chart were made at or near the time of the event
9 See Iverson, 126 Wn. App. at 338-39; Garrett, 76 Wn. App. at 725.
4 No. 75974-4-1/5
being described. He further testified that the chart notes were used by Fairfax to
establish the medical diagnosis of patients, and that the charts were relied upon
by hospital experts to formulate their opinions. The trial court determined that Dr:
Lugo-Steidel laid the foundation for admission of C.S.'s Fairfax medical records
under the business records exception to the hearsay rule.1°
Dr. Lugo-Steidel read entries from C.S.'s Fairfax medical chart into the
record. Those entries stated that C.S. had claimed he was from the planet
"Alamd," and he was delusional, manic and very psychotic. He attempted to
avoid taking his medications by placing them inside his cheek instead of
swallowing. He was guarded, fidgety, hyperactive, restless, illogical,
uncooperative, and paranoid. He had poor eye contact, repeatedly asked for
discharge, threw trash, flipped tables and banged on the floor. C.S. threatened
staff and had to be given emergency medication.
Dr. Lugo-Steidel testified that in evaluating C.S., he relied on his interview
with C.S., the medical charts from Highline and Fairfax, and the testimony of
Deputy Graeme Glasgow, the police officer who had referred C.S. for an
involuntary treatment hold. Dr. Lugo-Steidel stated that C.S. held a diagnosis of
Bipolar! Disorder, with manic, severe or psychotic, and opined that C.S.
presented a substantial risk of physical harm to himself, to others, and that he
presented as gravely disabled.
10 See Garrett, 76 Wn. App. at 725.
5 No. 75974-4-1/6
C.S. argues that the trial court erred in admitting the testimony of Dr.
Lugo-Steidel and Dr. Thomas regarding material contained in his medical records
because the medical records themselves were not admitted into evidence. He
does not contest the relevancy of the evidence, only whether it was otherwise
admissible.
Once Dr. Thomas and Dr. Lugo-Steidel laid the proper foundation for
admission of C.S.'s medical records, they could testify regarding statements and
acts attributed to C.S. even though the witnesses who entered that information
into his medical chart did not testify.11
C.S. relies on this court's decision in State v. Hamilton as support for his
argument that the trial court erred in allowing testimony about the content of his
medical chart because the State never offered the medical records as an
exhibit.12 Such reliance is misplaced.
In Hamilton, Jimi Hamilton introduced expert opinion testimony from Dr.
Stuart Grassian in support of his diminished capacity defense to a charge of
second degree assault.13 Dr. Grassian testified that Hamilton was not able to
form the requisite intent to commit assault.14 Dr. Grassian based his opinion on
his interviews with Hamilton and others.15 Although he reviewed Hamilton's
voluminous medical records, Dr. Grassian testified that he did not rely on them
11See Iverson, 126 Wn. App. at 338-39; Garrett, 76 Wn. App. at 725. 12 196 Wn. App. 461, 383 P.3d 1062(2016), review denied, 187 Wn.2d 1026 (2017). 13 Id. at 464-65. 14 Id. at 467. 15 Id. at 466.
6 No. 75974-4-1/7
when forming his opinion.18 The State then sought to impeach Dr. Grassian
using Hamilton's medical records and the opinions of four other medical doctors
contained therein.17
This court held that the State could not impeach Dr. Grassian using
records and opinions that he never claimed to have relied upon in formulating his
expert opinions.18 This court also rejected the State's argument that the opinions
contained in Hamilton's medical records were admissible as business records,
because RCW 5.45.020 "does not create an exception for the foundational
requirements of identification and authentication."18 Because the State "never
called the witnesses necessary to identify and authenticate the various medical
records" as required by RCW 5.45.020, those records, and the opinions
contained therein, were inadmissible.20
Here, unlike in Hamilton, the State laid the proper foundation for
admission of portions of C.S.'s medical records through the testimony of Dr.
Thomas and Dr. Lugo-Steidel. In addition, unlike in Hamilton, here the State
presented Dr. Lugo-Steidel's testimony that he actually relied on the evidence in
the medical charts when formulating his opinion.
16 Id. at 466-67. 17 Id. at 468-73. 18 Id. 19 Id. at 483(quoting State v. DeVries, 149 Wn.2d 842, 847, 72 P.3d 748 (2003)). 20 Id.
7 No. 75974-4-1/8
C.S. cites no other authority as support for his contention that all of his
medical chart must be admitted before witnesses could read entries from that
chart into the record.21 We assume there is none.
We affirm the order of commitment.
WE CONCUR:
21Darkenwald v. Emp't Sec. Dep't, 183 Wn.2d 237, 248, 350 P.3d 647 (2015); RAP 10.3(a)(6); King Aircraft Sales, Inc. v. Lane, 68 Wn. App. 706, 717, 846 P.2d 550 (1993).