ANKENY v GRUNSTEAD
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No, 13173 I N THE SUPREME COIJRT OF THE STATE OF M N A A OTN 1976 GERALD E . ANKENY , J R . , P l a i n t i f f and Respondent, LAURIE GRUNSTEAD, ROLAND M. GRUNSTEAD and MILLIE GRUNSTFAD, Defendants and A p p e l l a n t s . Appeal from: D i s t r i c t Court of t h e T h i r t e e n t h J u d i c i a l D i s t r i c t , Honorable C. B. Sande, Judge p r e s i d i n g . Counsel o f Record: For Appellants : G a r l i n g t o n , Lohn and Robinson, Missoula, Montana Sherman V. Lohn a r g u e d , and Gary L, Graham a r g u e d , Missoula , Montana F o r Respondent: Reno and Dolve, B i l l i n g s , Montana James A. Reno a r g u e d , B i l l i n g s , Montana Roger A. Kander, Long Beach, C a l i f o r n i a March 8, 1976 Submitted: Decided : JUR 2 4 1976 Filed: rjUM 2 4 19-0 Hon. A . B . M a r t i n , D i s t r i c t Judge, s i ~ t i n g f o r Chief J u s t i c e James T . H a r r i s o n , d e l i v e r e d t h e Opinion of t h e Court: In t h i s a c t i o n t h e d i s t r i c t c o u r t , Yellowstone County, s i t t i n g without a j u r y , awarded Gerald E . Ankeny, Jr. $83,302 a s damages f o r i n j u r i e s claimed t o have been s u s t a i n e d on June 15, 1970, a s a r e s u l t of an i n t e r s e c t i o n c o l l i s i o n between a motor b i k e o p e r a t e d by Ankeny and a c a r owned by Roland M. Grunstead and M i l l i e Grunstead and d r i v e n by t h e i r d a u g h t e r L a u r i e Grunstead. Of t h e t o t a l damages t h e c o u r t awarded $409 f o r emergency h o s p i t a l expenses, $5,248 f o r medical c a r e provided b y t h e Veterans A d m i n i s t r a t i o n , and t h e b a l a n c e of $77,645 f o r g e n e r a l damages. Grunsteads do n o t , on t h i s a p p e a l , deny r e s p o n s i b i l i t y f o r the c o l l i s i o n , but claim as a defense t h a t t h e vehicular c o l l i s i o n was n o t t h e cause of t h e low back i n j u r i e s f o r which t h e c o u r t i n l a r g e p a r t awarded damages. Ankeny began e x p e r i e n c i n g low back t r o u b l e w h i l e i n t h e m i l i t a r y s e r v i c e i n 1965. From t h a t time he was plagued w i t h low back p a i n f o r which h e r e p e a t e d l y sought medical r e l i e f . H i s t r o u b l e was f i n a l l y diagnosed a s s p o n d y l o l i s t h e s i s , a c o n g e n t i a l low back d e f e c t . As a l a s t resort he underwent s u r g e r y f o r a s p i n a l f u s i o n , which was performed February 16, 1969. Following a p o s t o p e r a t i v e p e r i o d of about one y e a r , Ankeny was d i r e c t e d t o Doctor Pearlman, a r a d i o l o g i s t w i t h t h e Denver Veterans H o s p i t a l . According t o Ankeny, Doctor Pearlman examined him, t o l d him t o d i s c o n t i n u e t h e u s e of t h e back b r a c e and r e Leased him w i t h o u t p r e s c r i b i n g f u r t h e r medication o r t r e a t m e n t . Ankeny t e s t i f i e d t h a t from March 1970 t o June 15, 1970, a period o i about t h r e e and one h a l f months, he was f r e e of low back pain. The i n f e r e n c e which Ankeny would have drawn from t h e foregoing circumstances i s t h a t a s o l i d f u s i o n had been achieved b u t t h a t i t was d i s p l a c e d by t h e f o r c e of t h e i n t e r s e c t i o n c o l l i s i o n . To f o r t i f y t h i s i n f e r e n c e , Ankeny c a l l e d Doctor Hertwig as a witness. Doctor Hertwig t e s t i f i e d t h a t as Ankeny's ward p h y s i c i a n he had examined X-ray r e p o r t s prepared by Doctors Pearlman, Edwards and McCowen. I n response t o a r e q u e s t f o r ad- mission by Grunsteads, Ankeny admitted t h e s e r e p o r t s were genuine. P e r t i n e n t p o r t i o n s of Doctor pearlman's r e p o r t were put i n e v i dence by t h i s testimony: "Q. Well do you have a copy of Doctor Pearlman's l e t t e r t h e r e ? A. Yes, t h e X-rays were taken i n February of 1970 a t t h e Denver VA H o s p i t a l and I w i l l read the reports as A s seen by Doctor Pearlman, ' M r . i n February, 1969. Gerald Ankeny had a back f u s i o n X-rays of h i s back i n February of 1970 t o t h i s h o s p i t a l , And t h e n he goes show a s o l i d f u s i o n and s t a b l e back.' 'There i s no d i s a b i l i t y i n , and he i s on t o s t a t e a b l e t o work, performing any a c t i v i t i e s t h a t h e wishes. ' , and i t i s signed by N . Pearlman, M.D." *** *** *** D r . Hertwig a l s o t e s t i f i e d from a h o s p i t a l d i s c h a r g e summary d i c t a t e d by a D r . Edwards f o r a h o s p i t a l i z a t i o n p e r i o d running from August 13 through September 21, 1969. D r . Hertwig summarized t h i s r e p o r t : *** t h e r e p o r t a t t h a t time was t h a t M r . Ankeny "A. complained of no r a d i a t i o n of p a i n down e i t h e r l e g , and s t r a i g h t l e g r a i s i n g and n e u r o l o g i c examinations were e s s e n t i a l l y n e g a t i v e . His f u s i o n was s t a t e d t o be moderately s t a b l e , and found t h i s p a t i e n t t o be remarka b l y normal p h y s i c a l l y . X-ray of t h e lumbar a r e a was e s s e n t i a l l y normal and showed . t h e a r e a of p r e v i o u s f u s i o n . " Dr. Hertwig a f t e r being shown an X-ray taken August 18, 1969, was asked: Nw o anything indicate there is "Q. with reference t o t h a t negative, i s there t h e r e t h a t i n d i c a t e s any f i n d i n g s t h a t would t o you t h a t t h e r e i s n o t a s o l i d f u s i o n ? A. No, not *.I' ** D r . Hertwig n e x t made a comparison of two X-rays, one taken i n August 1969, b e f o r e t h e a c c i d e n t , and one taken i n August 1970, about two months a f t e r t h e a c c i d e n t . The d o c t o r ' s comparison e l i c i t e d t h e testimony t h a t t h e 1970 X-ray showed "some i n c r e a s e d s u b l u x a t i o n , s l i p p i n g forward of t h i s v e r t e b r a , and I t h i n k you can s e e t h a t d i s t a n c e t h e r e , a d i s t a n c e of about one centimeter ." Preliminary t o posing a h y p o t h e t i c a l q u e s t i o n counsel s t a t e d , "Now from t h e f a c t s t h a t you have r e c i t e d s o f a r , i t would appear t h e r e was a f u s i o n and t h a t following t h e f u s i o n something happened which caused t h e X-rays taken i n 1970 t o show s u b l u x a t i o n ** *.I! Because t h e " f a c t s r e c i t e d " had r e f e r e n c e t o t h e r e p o r t s r e a d by D r . Hertwig, Grunsteads o b j e c t e d t h a t t h e f a c t s r e l i e d on i n t h e h y p o t h e t i c a l q u e s t i o n should n o t be given p r o b a t i v e weight. While counsel d i d n o t a t t h i s time c l e a r l y s t a t e t h a t he was o b j e c t i n g on t h e ground of h e a r s a y , subsequent o b j e c t i o n s t o t h e u s e of t h e r e p o r t s l e a v e no doubt t h a t hearsay was t h e b a s i s of t h e o b j e c t i o n . D r . Hertwig responded t o t h e h y p o t h e t i c a l q u e s t i o n by conc l u d i n g t h a t t h e r e was "considerable p o s s i b i l i t y " t h a t t h e body blow r e c e i v e d i n t h e a c c i d e n t would have a " l i k e l y *** e f f e c t " on Ankeny ' s f u s i o n . A t conclusion of D r . Hertwig's testimony on d i r e c t examina- t i o n , counsel f o r defendants moved: JONES: P r i o r t o c r o s s examination of t h e d o c t o r , counsel f o r t h e defendants moves t o s t r i k e any testimony and any opinions rendered by t h i s w i t n e s s which a r e pred i c a t e d upon a l l e g e d f a c t u a l r e p o r t s by t h i r d p a r t i e s , n o t p r e s e n t i n t h e courtroom and n o t s u b j e c t t o c r o s s examinat i o n , and moves t o s t r i k e any testimony based upon h i s own knowledge, based upon h i s own e x p e r t i s e . 11 "MR. * *-* I n c o n t r a d i s t i n c t i o n t o Ankeny's medical evidence, Gruns t e a d s c a l l e d two e x p e r t w i t n e s s e s , D r . McDonald and D r . D r o u i l l a r d , s p e c i a l i s t s r e s p e c t i v e l y i n o r t h o p e d i c s u r g e r y and r a d i o l o g y . Both examined X-rays taken b e f o r e and a f t e r t h e a c c i d e n t and each t e s t i f i e d t h a t e s s e n t i a l l y t h e same degree of f u s i o n f a i l u r e e x i s t e d before the accident, a s a f t e r the accident. I t was D r . McDonald's c o n c l u s i o n t h a t t h e a c c i d e n t d i d n o t c a u s e t h e f u s i o n b r e a k down, and t h a t w h i l e i t "may have aggravated t h e s i t u a t i o n *** t h e aggra- v a t i o n was minimal compared t o t h e e x i s t i n g problem." The c r u x of Grunsteads' a p p e a l i s t h a t u n l e s s t h e X-ray r e p o r t s of D r . Pearlman and Edwards a r e g i v e n p r o b a t i v e weight t h e r e i s no s u b s t a n t i a l evidence t o s u p p o r t t h e c o n c l u s i o n t h e c o l l i s i o n was t h e c a u s e of t h e f u s i o n f a i l u r e , p a r t i c u l a r l y s o i n t h e l i g h t of t h e c o n t r a r y testimony by Grunsteads' medical e x p e r t s . We, t h e r e f o r e , t u r n t o t h e q u e s t i o n of what weight and c o n s i d e r a t i o n , i f any, should be g i v e n t o t h e medical r e p o r t s o b j e c t e d t o by Grunsteads. W f i n d no d i f f i c u l t y i n h o l d i n g t h e r e p o r t s a r e p e r s e e hearsay. Ankeny l i k e w i s e does n o t q u e s t i o n t h i s f a c e t of d e f e n d a n t s ' objection t o the reports. I n s t e a d , Ankeny a s s e r t s t h e r e a r e o t h e r grounds j u s t i f y i n g t h e r e c e p t i o n and c o n s i d e r a t i o n of t h e r e p o r t s by t h e t r i a l c o u r t , n o t w i t h s t a n d i n g t h e i r h e a r s a y n a t u r e . One of t h e s e grounds i s p r e d i c a t e d on Grunsteads' r e q u e s t f o r an admission by Ankeny t h a t t h e r e p o r t s i n q u e s t i o n were genuine. Ankeny i n s u b s t a n c e c l a i m s t h e r e q u e s t f o r admission of genuineness i s tantamount t o Grunsteads i n t r o d u c i n g t h e c o n t e n t s of t h e r e p o r t i n t o e v i d e n c e , and having done s o , t h e y waive any o b j e c t i o n t o Ankeny's u s e of t h e r e p o r t s . This c l a i m i s h a r d l y worthy of n o t e . Grunsteads r e p e a t e d l y p o i n t e d o u t t h a t by a s k i n g f o r an admission of genuineness of t h e r e p o r t s they were n o t conceding t h a t t h e i n f o r m a t i o n c o n t a i n e d t h e r e i n was t r u e . Ankeny n e x t s u g g e s t s t h a t D r . H e r t w i g ' s r e l i a n c e on t h e r e p o r t s gave t h e r e p o r t s p r o b a t i v e v a l u e f o r t h e purpose of d e t e r mining t h e c a u s e of t h e f u s i o n break. W d i s a g r e e and h o l d t h e e p r o b a t i v e v a l u e of t h e r e p o r t s i s l i m i t e d t o t h e use t h a t D r . Hertwig made of them. I n making prognosis o r recommending t r e a t m e n t , d o c t o r s f r e q u e n t l y r e l y upon medical d i a g n o s i s made by o t h e r s who a r e experts i n a given s p e c i a l t y . 277, 485 P.2d 54. Klaus v . H i l l b e r r y , 157 Mont. D r . Hertwig's testimony c l e a r l y shows t h a t h i s use of t h e r e p o r t s was l i m i t e d t o a d v i s i n g Ankeny a s t o h i s condit i o n and f u t u r e c a r e . For t h i s l i m i t e d purpose t h e r e p o r t s were n o t o b j e c t i o n a b l e on t h e ground of h e a r s a y . Wallace v. Wallace, 85 Mont. 492, 279 P. 374. During t h e c o u r s e of t r i a l , Ankeny sought t o have D r . Hertwig express opinions r e l a t i v e t o t h e fusion break. of any e x p e r t opinion by The r e c o r d i s b a r r e n D r . Hertwig on t h e c r i t i c a l i s s u e of whether t h e f u s i o n was s o l i d o r broken p r i o r t o t h e a c c i d e n t . absence of such an o p i n i o n i s u n d e r s t a n d a b l e . The A t one p o i n t D r . k . t w i g f r a n k l y admitted t h a t he was n o t q u a l i f i e d t o i n t e r p r e t X-rays. When q u e s t i o n e d on c r o s s examination r e l a t i v e t o t h e c r i t i c a l i s s u e , he s t a t e d h e would have t o d e f e r t o t h e o p i n i o n of a s p e c i a l i s t i n r a d i o l o g y and o r t h o p e d i c s u r g e r y . I n summary, t h e l i m i t i n g circumstances of D r . H e r t w i g ' s u s e of t h e r e p o r t s denied Gruns t e a d s any o p p o r t u n i t y t o t e s t t h e t r u t h of t h e r e p o r t s by c r o s s examination. The r e p o r t s a r e t h e r e f o r e c l e a r l y h e a r s a y and inadmis- s i b l e f o r t h e purpose of showing t h a t t h e a c c i d e n t was t h e c a u s e of t h e fusion break. S h i l l i n g s t a d v. Nelson, 141 Mont. 412, 378 P.2d 393; P i c k e t t v. Kyger, 151 Mont. 87, 439 P.2d 57. - 6 - With t h e X-ray r e p o r t s removed from c o n s i d e r a t i o n , t h e n e x t i s s u e r a i s e d i s whether t h e r e i s s u f f i c i e n t evidence t o support t h e t r i a l c o u r t ' s judgment a s t o t h e cause of t h e back defect. W keep i n mind t h e r u l e t h a t a t r i a l c o u r t ' s f i n d i n g s e w i l l n o t be d i s t u r b e d on appeal where t h e r e i s s u b s t a n t i a l evidence t o s u p p o r t them. Olsen v. Sundling, 128 Mont. 596, 281 P.2d 499. I n Sands v. S u p e r i o r Bldg. Co., 136 Mont. 531, 349 P.2d 314, t h e Court e x p l a i n s s u b s t a n t i a l evidence: " S u b s t a n t i a l evidence has been d e f i n e d by t h i s c o u r t a s such evidence ' a s w i l l convince reasona b l e men and on which such men may n o t reasonably d i f f e r a s t o whether it e s t a b l i s h e s t h e p l a i n t i f f s 1 c a s e , and, i f a l l reasonable men must conclude t h a t t h e evidence does n o t e s t a b l i s h such c a s e , then i t i s n o t s u b s t a n t i a l evidence. I " I n t h i s c a s e , t h e d e t e r m i n a t i o n of whether t h e f u s i o n was s o l i d p r i o r t o t h e a c c i d e n t must n e c e s s a r i l y be made by medical s p e c i a l i s t s s u f f i c i e n t l y competent t o a s s e s s t h e i n j u r y . be l e f t t o s p e c u l a t i o n , c o n j e c t u r e , i n f e r e n c e o r guess. v. Rolandson, 150 Mont. 270, 435 P.2d 263. It cannot Graham A s s a i d i n Bearman v. P r u d e n t i a l I n s . Co. of America, 186 F.2d 662, 665, (10th Cir.1951), "only a medical e x p e r t w i t h t r a i n i n g , s k i l l , and experience could form a considered judgment and express an i n t e l l i g e n t opinion." With r e s p e c t t o c a u s a t i o n t h e g e n e r a l r u l e a s t o proof r e q u i r e d was s e t f o r t h by Judge Jameson i n Wilson v. Northland Greyhound Lines, 166 F.Supp. 667, 675 (D.Mont. 1958): ' P l a i n t i f f must prove by l e g a l l y s u f f i c i e n t evidence t h a t a l l t h e i n j u r i e s f o r which he claims damages a r e p r o p e r l y a t t r i b u t a b l e , i n a medical s e n s e , t o t h e a c c i d e n t . While p l a i n t i f f need n o t e s t a b l i s h such c a u s a l connection w i t h c e r t a i n t y , he must do s o w i t h reasonable c e r t a i n t y o r by a preponderance of t h e evidence. There can be no recovery f o r an i n j u r y o r c o n d i t i o n which t h e evidence shows might have r e s u l t e d from two o r more c a u s e s , f o r only one of which defendant i s r e s p o n s i b l e . So, t o o , i t i s n o t s u f f i c i e n t f o r one seeking damages f o r " *** a condition claimed t o have r e s u l t e d from an a c c i dent o r i n j u r y t o show t h a t such accident o r i n j u r y might o r could have caused t h e condition; o t h e r causes should be excluded. "I With t h e hearsay r e p o r t s of Doctors Pearlman and Edwards excluded, and with D r . Hertwig eliminated a s an e x p e r t , t h e only l e g a l l y s u f f i c i e n t testimony r e l a t i v e t o t h e condition of t h e fusion before and a f t e r t h e accident i s t h a t of D r . McDonald and D r . Drouillard which c l e a r l y r e f u t e s t h e contention t h e a c c i d e n t caused t h e fusion t o f a i l . W t h e r e f o r e hold t h e r e i s no substane t i a l c r e d i b l e evidence f o r t h e t r i a l c o u r t ' s conclusion t h e accident was t h e cause of t h e fusion f a i l u r e . Ankeny next proposes t h a t i f t h e evidence i s not s u f f i c i e n t t o show t h e fusion f a i l u r e was caused by t h e a c c i d e n t , then t h e evidence i s s u f f i c i e n t f o r t h e purpose of proving aggravation of t h e p r e e x i s t i n g condition of h i s back. The c a s e was n o t presented t o t h e d i s t r i c t c o u r t on t h i s theory, but t h e r e i s evidence t o supp o r t some degree of aggravation. A s we understand Ankeny's reasoning, t h e general damages awarded by t h e c o u r t was primarily f o r t h e pain and a n t i c i p a t e d continuing discomfort of t h e low back i n j u r y . He argues it i s unimportant whether t h e pain i s from t h e break of t h e f u s i o n i n t h e a c c i d e n t , o r from t h e aggravation of a p r e e x i s t i n g fusion f a i l u r e , because i n e i t h e r i n s t a n c e t h e pain and discomfort w i l l be t h e same. From t h i s he deduces t h e damages should be t h e same. However c l e v e r t h i s argument may be, i t does n o t take i n t o account t h e f u l l scope of D r . McDonald's uncontradicted testimony. While t h e d o c t o r ' s testimony gives medical support t o Ankeny's theory of aggravation, t h e doctor minimizes t h e aggravation by comparing i t with t h e condition of Ankeny's back p r i o r t o t h e accident. The flaw in Ankeny's contention is ,pointed out by the doctor. The preexisting condition of the back was much more serious injurywise than the aggravation of that condition. We therefore cannot accept Ankeny's proposition the damages would be the same under either theory. We recognize Ankeny is entitled to some special and general damages, but a proper assessment of these damages would require a new trial. If Ankeny can prove no more than minimal aggravation, any recovery on a new trial might not justify the delay and expense involved. As a means of providing Ankeny an alternative to a new trial, the district court's judgment is modified to award damages in the total amount of $15,000. In fixing damages in this amount, the $409 for special damages allowed by the district court is not included for the reason there is no legally sufficient evidence of such damage. We also exclude all but $500 of the medical bill submitted by the Veterans Administration for the reason that the medical treatment furnished by the Veterans Administration was primarily for physical and mental conditions not shown to be caused by the accident. If Ankeny should elect not to accept the judgment as modified, the judgment of the district court is reversed and the cause is remanded for a new trial on the issue of damages for aggravation of the injury. Judge, sitting for Chief Justice James T. Harrison. W Concur: e M r . J u s t i c e Frank I. Haswell, concurring i n p a r t and d i s s e n t i n g in part: I concur i n t h e m a j o r i t y holding t h a t t h e r e i s no subs t a n t i a l c r e d i b l e evidence t h a t t h e a c c i d e n t caused p l a i n t i f f ' s fusion f a i l u r e . I a l s o concur w i t h t h e m a j o r i t y i n f i n d i n g e v i - dence t o support some degree of aggravation of a p r e e x i s t i n g back injury. I cannot a g r e e t h a t we, a s an a p p e l l a t e c o u r t , can s e p a r a t e and determine t h e amount of damages a t t r i b u t a b l e t o a g g r a v a t i o n of t h e p r e e x i s t i n g back i n j u r y from t h o s e a t t r i b u t a b l e t o t h e f u s i o n f a i l u r e , reduce t h e judgment a c c o r d i n g l y , and g i v e t h e p l a i n t i f f t h e o p t i o n of a c c e p t i n g t h e reduced award o r s e c u r i n g a new t r i a l . The t r i a l judge must make t h i s f a c t u a l determination and f i x t h e damages accordingly. I would award a new t r i a l on t h e amount of such damages. Justice. ' . -
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