On appeal from Superior Court, Appellate Division, whose opinion is reported at 270 N.J. Super. 373 (1994).
The opinion of the Court was delivered by Pollock, J. Chief Justice Wilentz and Justices Handler, O'Hern, Garibaldi, Stein, and Coleman join in this opinion.
The opinion of the court was delivered by: Pollock
(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized).
JESSICA STIGLIANO, ET AL. V. CONNAUGHT LABORATORIES, INC., ET AL. (A-55-94)
Argued January 4, 1995 -- Decided May 31, 1995
POLLOCK, J., writing for a unanimous Court.
The issue before the Court is whether defendants may introduce videotape Dispositions of plaintiffs' treating physicians in which they describe the cause of Jessica Stigliano's chronic-seizure disorder.
On March 17, 1987, three-month-old Jessica Stigliano was immunized by Dr. Nihal Nagahawatte against diphtheria, pertussis, and tetanus (a DPT shot). Connaught Laboratories, Inc. (Connaught) had manufactured the vaccine. Approximately six-and-one-half hours after the DPT shot was administered by Dr. Nagahawatte, Jessica suffered a series of convulsive seizures. Jessica and her parents (plaintiffs) claim that the DPT shot caused "DPT encephalopathy," which resulted in Jessica's chronic seizure disorder.
Jessica's parents consulted three pediatric neurologists, Dr. Jeffrey Buchalter, Dr. A.M. Chutorian, and Dr. Joseph Schneider ("the treating doctors"), for diagnosis and treatment of Jessica's seizures. None of the treating doctors found any evidence that the DPT shot had caused the seizures. Moreover, they disputed the existence of DPT encephalopathy, opining that Jessica would have experienced the seizures without the DPT shot.
The Stiglianos, individually and on behalf of Jessica, sued Dr. Nagahawatte and Connaught, alleging that Dr. Nagahawatte deviated from accepted standards of medical practice by administering the DPT vaccine without first adequately examine Jessica for the existence of fever caused by an infection. Plaintiffs also claim that Connaught is liable because the DPT vaccine is a dangerous and defective product.
Because Drs. Buchalter and Chutorian reside out-of-state and because of their anticipated unavailability at trial, defendants preserved their testimony in videotape depositions. At the depositions, both doctors testified that the DPT shot had not caused Jessica's seizures.
On plaintiffs' motion, the trial court entered an order precluding defendants from referring at trial to the treating physicians' opinions on the cause of Jessica's seizure disorder. Defendants were also directed to eliminate all causation testimony from the depositions of Drs. Buchalter and Chutorian. The court reasoned that the treating doctors were not experts and, therefore, should not be able to render opinions harmful to plaintiffs' case. Moreover, the trial court found that plaintiffs would be unduly prejudiced by causation testimony from Jessica's own treating doctors.
The Appellate Division granted defendants' motion for leave to appeal and reversed the order of the trial court. The court found that there was no general rule that a treating physician cannot render opinions that are potentially harmful to a patients' case; that the treating doctors' opinions regarding causation were related to Jessica's treatment, diagnosis and prognosis; and that although the testimony might be harmful to plaintiffs, it would not be unfairly so.
The Supreme Court granted plaintiffs' motion for leave to appeal.
HELD: Because the cause of a patient's illness is an essential part of diagnosis and treatment, a treating physician may testify about the cause of the patient's disease or injury.
1. Only after a patient puts his or her injury or disease in issue may a treating doctor testify about the diagnosis and treatment of that injury or disease. By bringing suit against Dr. Nagahawatte and Connaught, plaintiffs have waived the physician-patient privilege. Jessica's seizure disorder is the subject of this litigation; her treating doctors must testify regarding her treatment and diagnosis; and the waiver of the physician-patient privilege extends to all of the physician's knowledge regarding the physical condition at issue. To bar the treating doctors' testimony regarding causation would deprive the jury of relevant information on the crucial issue in the case, whether the DPT shot caused Jessica's disorder. (pp. 6-9)
2. The treating doctors did not examine Jessica in anticipation of litigation or in preparation for trial and they gained no confidential information about plaintiffs' trial strategy. The treating doctors are essentially fact witnesses whose testimony relates to their diagnosis and treatment of Jessica. In order to properly treat a patient, the treating doctor must determine the cause of the disease, whether that determination is characterized as fact or opinion. The treating doctors' testimony concerning potential causes of Jessica's seizure disorder is factual information, albeit on the form of an opinion. (pp. 9-12)
3. The treating doctors needed to determine the cause of Jessica's problem so that the could properly treat her. Accordingly, Piller and Serrano do not prevent the treating doctors from offering their opinions on the cause of Jessica's seizure disorder. Courts in other states also have allowed treating physicians to render opinions ...