## Facts

- Philip Filippelli III suffered a serious left-leg injury while playing basketball in March 2005 and was taken to St. Mary’s Hospital’s emergency department.
- He was treated and released with directions to obtain orthopedic follow-up.
- The next morning, Filippelli returned to the emergency department complaining of severe leg pain and other symptoms.
- Dennis M. Rodin, M.D., an orthopedic surgeon, became involved in Filippelli’s care and admitted him for observation.
- Later that day, Rodin diagnosed acute compartment syndrome and performed a four-compartment fasciotomy.
- Filippelli claimed the diagnosis and surgical treatment occurred too late and that the delay caused additional, avoidable and permanent injury.
- Filippelli sued Rodin, St. Mary’s Hospital, and related providers for medical malpractice, alleging a failure to timely diagnose and treat compartment syndrome.
- At trial, both sides presented medical witnesses on the standard of care for recognizing compartment syndrome and on causation.
- Filippelli sought to use a medical-journal article to support his standard-of-care theory; the trial court limited its use and excluded it as substantive evidence on hearsay grounds.
- Filippelli also attempted to cross-examine a defense medical witness about prior work as an expert witness for Rodin to show possible bias; the trial court limited that questioning and did not allow the plaintiff to pursue it further through a document and extended offer of proof.
- The jury returned a verdict for the defendants, and the court rendered judgment on the verdict.
- Filippelli appealed, challenging the trial court’s evidentiary rulings.

## Issues

1. Did the trial court abuse its discretion by excluding or restricting the plaintiff’s use of a medical-journal article on compartment syndrome as inadmissible hearsay, including as a “learned treatise” and for impeachment?
2. Did the trial court abuse its discretion by limiting cross-examination of a defense medical witness about prior service as an expert witness for the defendant physician, and by restricting the related offer of proof and marking of a document for identification?

## Decision

- The Connecticut Appellate Court affirmed the judgment for the defendants.
- The court held that the trial court acted within its discretion in restricting the plaintiff’s use of the medical-journal article and in preventing the article from being used as a substitute for live medical testimony.
- The court also held that the trial court acted within its discretion in limiting the attempted bias cross-examination of the defense medical witness concerning prior work for the defendant physician and in controlling the related proof.
- Because the evidentiary rulings were not an abuse of discretion, the defense verdict remained in place.

## Legal Principles

- Trial courts have broad authority over evidentiary matters, and appellate review of such rulings is for abuse of discretion.
- Medical malpractice claims generally require medical testimony to establish the standard of care and causation; medical literature is not a stand-alone replacement for that testimony.
- A medical article offered for the truth of its assertions is hearsay unless a recognized rule allows its use; even when a learned-treatise rule applies, the court may limit how the publication is presented to the jury to avoid undue emphasis, repetition, or confusion.
- The trial court has discretion to control the scope and form of cross-examination, including impeachment for bias, and may limit collateral inquiry when the jury has enough information to assess credibility.
- To obtain reversal based on an evidentiary ruling, an appellant must show both error and resulting harm; where the challenged evidence would have been cumulative or of limited added value, a claim of harm is harder to establish.

## Conclusion

Filippelli challenged a defense verdict in a compartment-syndrome malpractice trial by arguing that the trial court wrongly restricted his use of a medical-journal article and curtailed his attempt to show bias in a defense medical witness. The Appellate Court affirmed, holding that the trial judge acted within the permissible range of discretion in controlling learned-treatise use, excluding hearsay offered as substantive proof, and limiting collateral bias cross-examination, leaving the jury’s verdict for the defendants intact.


Filippelli v. St. Mary's Hospital, 61 A.3d 1198 (2013)