Using Medical Records Effectively in the Courtroom


A.                 Getting the Records into Evidence

1.                   The statute governing this is a hearsay exception under Wis. Stat. § 908.03, set forth here in full:

(6m) Health care provider records.  (a) Definition.  In this subsection, “health care provider” means a massage therapist or bodyworker issued a certificate under ch. 460, a chiropractor licensed under ch. 446, a dentist licensed under ch. 447, a physician assistant licensed under ch. 448, or a health care provider as defined in s. 655.001(8).

(b) Authentication witness unnecessary.  A custodian or other qualified witness required by sub. (6) is unnecessary if the party who intends to offer health care provider records into evidence at a trial or hearing does one of the following at least 40 days before the trial or hearing:

1. Serves upon all appearing parties an accurate, legible and complete duplicate of the health care provider records for a stated period certified by the record custodian.

2. Notifies all appearing parties that an accurate, legible and complete duplicate of the health care provider records for a stated period certified by the record custodian is available for inspection and copying during reasonable business hours at a specified location within the county in which the trial or hearing will be held.

(c) Subpoena limitations.  Health care provider records are subject to subpoena only if one of the following conditions exists:

1. The health care provider is a party to the action.

2. The subpoena is authorized by an ex parte order of a judge for cause shown and upon terms.

3. If upon a properly authorized request of an attorney, the health care provider refuses, fails or neglects to supply within 2 business days a legible certified duplicate of its records for the fees established under par. (d).

(d) Fees.  After December 31, 2002, the department of health and family services shall, by rule, prescribe uniform fees that are based on an approximation of actual costs. The fees, plus applicable tax, are the maximum amount that a health care provider may charge for certified duplicate patient health care records.  The rule shall also allow the health care provider to charge for actual postage or other actual delivery costs.  For duplicate patient health care records and duplicate X-ray reports or the referral of X-rays to another health care provider that are requested before commencement of an action, s. 146.83(1)(b) and (c) and (3m)applies.

2.                  Follow the statute and be sure to give plenty of notice.

                                                              i.      Calendar this deadline when the scheduling order is calendared.

                                                           ii.      Important to have the timeline completed by this point so that you know which records are important, which are not, and most critical, which ones are harmful.

3.                  Some “traps” for the unwary:

                                                              i.      Note the requirement of service of a copy.

                                                           ii.      Note that the records must be made available in the county in which the trial is venued.  

1.       Most lawyers will agree to use a different county – when, for example, both lawyers in the same county and it is not where the matter is venued.

2.      It is highly recommended that this agreement be documented in writing.

                                                         iii.      Note the strict limitations on subpoena power – the purpose of this statute was to avoid health care providers being inconvenienced by having to go to court.

4.                  See attached sample.

B.                 Powerful Presentation of Records at Trial

1.                   Mark entire record as an exhibit.

2.                  Mark individual pages in some corresponding fashion.

                                                              i.      If Dr. Smith’s entire chart is Exhibit 101, then a particular page from that chart is Exhibit 101A

                                                           ii.      If a transparency is made of Exhibit 101A, some courts don’t require it to be marked and some do.  

1.       One easy solution is to add a “T” to the Exhibit number, so that the transparency of Exhibit 101A is Exhibit 101A-T

2.      It is very complicated to have totally separate numbers that do not relate to the marked exhibit.

                                                         iii.      Of course, if a witness marks on the transparency, then it must be marked as its own exhibit.

3.                  Transparency vs. Blow-up vs. Elmo

                                                              i.      Elmo: top notch, very convenient, reduces need to plan ahead.

                                                           ii.      Blow-ups: impressive, very visible, expensive, must plan far ahead.

                                                         iii.      Transparencies: inexpensive (practically free), can make many extras, and can make them on a moment’s notice on almost any photocopier.

C.                 Compelling Arguments Using Medical Records

1.                   Medical records are compelling when they tell a story.

2.                  They can be used in sequence to build suspense or to paint a picture.

3.                  They can be shown in such a way to demonstrate the sheer number of, for example, physical therapy appointments, or debridements.

4.                  Records can demonstrate pain by showing the amount of narcotic drugs administered.

 CYNTHIA SANCHEZ andWILLIAM SANCHEZ, her husband                         Plaintiffs, UNITED HEALTHCARE OF WISCONSIN, INC.,andBLUE CROSS BLUE SHIELD OFALABAMA                         Involuntary Plaintiffs,v. CARSON PIRIE SCOTT d/b/a BostonStore;FINLAY FINE JEWELRY CORPORATION;                         Defendants.    Case No.:     02-CV-10617 Case Code:  30101
                        Personal                                          Injury/Auto
 The Honorable Mel FlanaganBranch 4


            Pamela M. Schmidt, Esq.            Whyte, Hirschboeck, Dudek , S.C.            555 East Wells Street            Suite 1900            Milwaukee , WI 53202-3819 Geri A. Wilkinson, Esq.Sharps & Associates5445 South Westridge DriveNew Berlin , WI   53151-8100 
            Thomas H. Koch, Esq.            3466 South 13th Street            Milwaukee , WI   53215 

PLEASE TAKE NOTICE that Plaintiffs Cynthia Sanchez and William Sanchez and by their attorneys, Stadler & Centofanti, S.C., intend to use the following certified medical records at trial and have on this date, pursuant to the provisions of §908.03(6m), Wis. Stats., made available at the offices of Stadler & Centofanti, S.C., for inspection and copying during reasonable business hours by all counsel certified copies of the health care records of the plaintiff Cynthia Sanchez as follows:

            Provider                                                                                Treatment Dates

Southside Primary Care Clinic                                                     12/20/99-09/07/01

Milwaukee , WI

St. Luke’s Medical Center                                                              2/24/00-03/08/00

Milwaukee , WI

Commonwealth Rehabilitation Group                                       05/30/02

Milwaukee , WI

St. Francis Hospital                                                                          01/13/00-06/25/02

Milwaukee , WI

Orthopedic & Reconstructive Surgeons                                      02/24/00-08/15/02

Milwaukee , WI

Dated this 9th day of February, 2004.

                                                            STADLER & CENTOFANTI , S.C.

                                                            Attorneys for Plaintiffs Cynthia and

                                                            William Sanchez


                                                                                    Kelly L. Centofanti

                                                                                    State Bar No. 1001274


1025 Glen Oaks Lane

Suite 108

Mequon , WI 53092

Telephone:  (262) 241-1900

Facsimile:  (262) 241-1910