## Facts

- Tina K. Field arrived at Trigg County Hospital’s emergency room in Cadiz, Kentucky, after being bitten twice on her right foot by a copperhead snake.
- Dr. William B. Anderson, an on-call emergency-room physician, reviewed a reference text on snake-bite treatment and arranged for antivenin to be delivered to the hospital.
- Anderson monitored Field and provided supportive care but did not administer antivenin as her condition worsened, including progressive swelling and loss of a pulse in the right foot.
- The next evening, Anderson telephoned Vanderbilt University Medical Center and spoke with two physicians (identified only as an emergency-room doctor and a toxicologist).
- At trial, Anderson testified that the Vanderbilt physicians told him he was acting appropriately, was doing what they would do, and that they would not administer antivenin for a copperhead bite.
- Field ultimately underwent a below-the-knee amputation.
- Field and her husband sued for medical malpractice in federal court under diversity jurisdiction, alleging deviation from the standard of care, including failure to administer antivenin and failure to transfer to a better-equipped facility.
- The district court admitted Anderson’s testimony about the Vanderbilt physicians’ statements with a limiting instruction that the jury could consider the conversation as part of the circumstances of his decision-making but not as proof of the validity of the advice.
- A jury found for Anderson; the district court denied plaintiffs’ motion for a new trial challenging the admission of the consultation testimony.

## Issues

1. Whether admitting Anderson’s testimony recounting statements of two unnamed, undisclosed consulting physicians was an abuse of discretion because the statements were hearsay offered to prove conformity with the standard of care.
2. Whether any hearsay exception or non-hearsay purpose justified the testimony, including a “state of mind” rationale or expert-related rules.
3. Whether any error in admitting the testimony was harmless or required a new trial.

## Decision

- The Sixth Circuit vacated the defense verdict and remanded for a new trial.
- The court held the Vanderbilt physicians’ statements were classic hearsay offered for their truth—that Anderson’s treatment met the standard of care—and no hearsay exception applied.
- The court held the limiting instruction did not cure the prejudice because the statements functioned as substantive endorsement by specialists.
- The court concluded the evidentiary error was not harmless given the centrality and persuasive force of the anonymous specialist “approval” on the standard-of-care dispute.

## Legal Principles

- Out-of-court statements by consulting physicians, recounted to show that “other doctors agreed” the defendant’s care was appropriate, are hearsay when used to prove the standard of care and are inadmissible absent a specific exception.
- A party cannot introduce anonymous, undisclosed expert opinions through a testifying physician to avoid hearsay limits and the adversary’s opportunity for cross-examination.
- A limiting instruction may be inadequate when the substance of the statements predictably serves as proof of a contested element (here, compliance with the standard of care).
- Erroneous admission of highly persuasive hearsay on a central contested issue may warrant a new trial when it likely affected the verdict.

## Conclusion

The Sixth Circuit ordered a new trial because Anderson’s testimony relaying unnamed Vanderbilt physicians’ assurances that his care was appropriate amounted to inadmissible hearsay used to prove compliance with the standard of care, and the error was prejudicial despite a limiting instruction.


Field v. Trigg Cnty. Hosp., Inc., 386 F.3d 729 (6th Cir. 2004)