## Facts

- Dessi Williams, a pedestrian, was struck by Mervin K. Alexander’s automobile while crossing a Brooklyn street with the traffic light in his favor and sustained a fractured right leg.
- Williams was taken to Kings County Hospital for treatment.
- The parties presented conflicting accounts of causation:
  - Williams testified Alexander approached the intersection without slowing and hit him.
  - Alexander testified he stopped at the light and was rear-ended, which pushed his car into Williams.

- Williams introduced portions of the hospital record related to injuries and treatment.
- Alexander offered the remainder of the hospital record, including a physician’s notation that Williams said an automobile hit another automobile at a standstill, causing the standstill car to strike him.
- Williams denied making that statement, and the physician who recorded it did not testify.
- Over objection, the trial court admitted the notation as a business record; the jury found for Alexander.

## Issues

1. Whether a hospital-record entry reporting a patient’s narrative of how an accident occurred, offered to prove the manner of the accident, is admissible under the business-records statute when the narrative is not germane to diagnosis or treatment.
2. Whether admitting such an entry, where liability is sharply contested and the recorder does not testify, constitutes reversible error.

## Decision

- The Court of Appeals reversed the judgment for Alexander and ordered a new trial.
- The court held the challenged entry was not admissible as a business record because the accident narrative was not germane to diagnosis, prognosis, or treatment.
- The court concluded the erroneous admission was prejudicial given the sharply conflicting versions of the accident.

## Legal Principles

- The business-records exception admits only those entries made in the regular course of the enterprise’s activities and relied upon for that enterprise’s operations.
- For hospital records, admissibility as a business record is limited to entries relevant to medical care—diagnosis, prognosis, or treatment.
- Patient statements in medical records may be admissible when they concern symptoms, pain, or history that clinicians reasonably rely on for treatment decisions.
- A narrative description of how an accident happened, directed to fault or liability and not needed for treatment, is inadmissible hearsay when offered through the record alone.
- The presence of a statement in a hospital chart does not, by itself, satisfy the statutory “regular course” requirement for business records.
- Even if the recorder could have testified to the statement under another evidentiary theory (such as an admission), the record entry remains inadmissible unless it independently fits the business-records exception.

## Conclusion

The court limited hospital-record admissibility under the business-records statute to medically relevant entries and excluded accident narratives aimed at proving liability; because the improperly admitted statement likely affected the verdict, a new trial was required.


Williams v. Alexander, 309 N.Y. 283, 129 N.E.2d 417 (N.Y. 1955)