## Facts

- Lorraine Ann Meschino underwent surgery under general anesthesia at Lahey Clinic on October 14, 1983.
- During the operation, she suffered cardiac arrest and severe brain damage attributed to inadequate oxygenation.
- A PEEP valve manufactured by Boehringer Laboratories was inserted by a nurse anesthetist into the supply side of the ventilation circuit rather than the exhaust side.
- The anesthesia machine used was a Narkomed 2 manufactured by North American Drager and supplied to the clinic by Bay State Anesthesia.
- Plaintiffs pursued product-liability and failure-to-warn theories against the manufacturer(s) and supplier, asserting equipment design and instruction/warning defects contributed to the injury.
- Plaintiffs sought to use two *Health Devices* magazine articles as learned-treatise evidence on anesthesia machine safety; a defense expert challenged the publication’s reliability, and the trial court excluded the articles.

## Issues

1. Whether the evidence permitted liability against the corporate defendants or whether medical negligence severed causation as to the product and supplier defendants.
2. Whether the district court properly directed a verdict for Bay State Anesthesia at the close of the plaintiffs’ case.
3. Whether excluding the *Health Devices* articles under Fed. R. Evid. 803(18) was an abuse of discretion and, if erroneous, whether it was prejudicial.
4. Whether any other claimed instructional or evidentiary errors required reversal of the verdicts for North American Drager and Boehringer.

## Decision

- The First Circuit affirmed the judgments in favor of North American Drager and Boehringer entered on the jury’s special verdict.
- The court affirmed the directed verdict for Bay State Anesthesia, concluding plaintiffs’ proof did not allow a reasonable finding of independent fault by Bay State.
- The court upheld the exclusion of the *Health Devices* articles, finding insufficient foundation that they were “reliable authority” and concluding that, in any event, the exclusion did not warrant reversal given the liability findings.
- The court rejected remaining evidentiary and instructional challenges as non-prejudicial in light of the jury’s determination that the corporate defendants were not liable.

## Legal Principles

- A directed verdict is proper when, viewing the evidence most favorably to the nonmovant, only one reasonable conclusion is available to a rational jury.
- Under Fed. R. Evid. 803(18), learned-treatise material is admissible only upon an adequate foundation that the specific work is a “reliable authority”; professional publication alone does not establish authority.
- Trial courts have broad discretion in determining whether a publication qualifies as a reliable authority for Rule 803(18) purposes.
- When a jury finds a defendant not at fault on the controlling liability determinations, alleged errors in admitting or excluding evidence, or related instruction disputes, generally do not justify reversal absent a showing of prejudice affecting the liability finding.

## Conclusion

The First Circuit left intact defense judgments for the anesthesia machine and valve manufacturers and for the machine supplier, holding that plaintiffs failed to present sufficient proof to send the supplier’s liability to the jury and that the trial court acted within its discretion in excluding periodical articles offered as learned-treatise evidence without a proper showing of authoritative reliability.


Meschino v. N. Am. Drager, Inc., 841 F.2d 429 (1st Cir. 1988)