Opinion
F084634
11-28-2023
THE PEOPLE, Plaintiff and Respondent, v. MAGGIE DAVIS, Defendant and Appellant.
Rudolph Kraft, under appointment by the Court of Appeal, for Defendant and Appellant. Rob Bonta, Attorney General, Lance E. Winters, Chief Assistant Attorney General, Michael P. Farrell, Assistant Attorney General, Darren K. Indermill and Paul E. O'Connor, Deputy Attorneys General, for Plaintiff and Respondent.
NOT TO BE PUBLISHED
APPEAL from a judgment of the Superior Court of Kern County No. FP004648. Brian M. McNamara, Judge.
Rudolph Kraft, under appointment by the Court of Appeal, for Defendant and Appellant.
Rob Bonta, Attorney General, Lance E. Winters, Chief Assistant Attorney General, Michael P. Farrell, Assistant Attorney General, Darren K. Indermill and Paul E. O'Connor, Deputy Attorneys General, for Plaintiff and Respondent.
OPINION
THE COURT [*]
INTRODUCTION
Appellant Maggie Davis contends that the trial court erred in admitting prejudicial and inadmissible hearsay at her recommitment trial. Specifically, appellant claims "large portions of the government's exhibits were not admissible under Evidence Code sections 1271 or 1280 as either business or public records." We disagree and affirm the judgment.
All further statutory references are to the Evidence Code unless otherwise indicated.
BACKGROUND
The People filed a petition to extend appellant's commitment as an offender with a mental disorder pursuant to Penal Code section 2970. A jury trial was held on the petition. Dr. David Contreras, a senior psychologist in the forensic evaluation department at Patton State Hospital, testified for the People. Contreras had evaluated appellant, which included interviewing her and reviewing her hospital records.
Contreras diagnosed appellant as suffering from schizophrenia, a psychotic spectrum disorder with symptoms including delusions, delays in speech, and flattened affect. Contreras explained that people with schizophrenia have difficulty discerning reality-distinguishing what is true from what is false-especially if they experience delusions. He observed that appellant experienced auditory hallucinations, held various delusional beliefs, a flattened affect, poverty of thought and poverty of speech.
Contreras noted appellant demonstrated ongoing symptoms of schizophrenia during the interview. Appellant's responses were delayed, she did not show emotion during the interview, and she gave short, terse answers. She also lacked insight into her illness, was unable to identify her symptoms, and said the diagnosis was the opinion of mental health professionals. Appellant stated delusional beliefs, such as being related or married to former Presidents Barack Obama and Donald Trump, that she had been kidnapped, and that members of her family had been killed. More specifically, appellant told Contreras that she had been kidnapped by a group of 12 people and these same 12 people killed her family. Appellant also denied participating in the commitment offense but said that the victim of the offense was part of the group that killed her family. As such, Contreras opined that appellant had ongoing symptoms of schizophrenia and that it was not in remission.
Contreras was concerned about appellant's lack of insight into her commitment offense. A patient should have insight into the symptoms or triggers related to the commitment offense in order to identify the same symptoms or triggers in the future. If a patient lacks insight into the symptoms or triggers, there is a risk that he or she will not recognize them in the future, increasing the risk of a repeat offense. Contreras opined that appellant continued to represent a substantial danger of physical harm to others. In support of his opinion, Contreras cited appellant's delusions, negative symptoms, thought disorganization, flat affect, poor insight into her illness, and her lack of a plan for managing that illness. The doctor believed that appellant would be unable to recognize her symptoms or seek the intervention necessary to manage her symptoms-which were not even in remission.
The jury found the petition true and the trial court extended appellant's commitment.
DISCUSSION
I. The Trial Court Did Not Abuse its Discretion in Admitting the Hospital Records under Sections 1271 and 1280.
Appellant contends the trial court abused its discretion admitting the hospital records under sections 1271 and 1280. Appellant's objections at trial were that the documents contained opinions that were not admissible and described events that did not occur at or near the time the documents were created. The People contend the court did not abuse its discretion in admitting the hospital records because the relevant statements within the records were "covered by a hearsay exception with sufficient foundation." The People also contend any error in admitting the records was harmless, arguing "there was ample independent evidence supporting the recommitment." We agree with the People and deny appellant's claim.
A. Relevant Factual and Procedural Background
Before trial, the People filed a motion in limine seeking to admit appellant's hospital records, which were her mental health records. Appellant filed motions in limine opposing the full admission of her mental health records, arguing they included hearsay and had to be admitted through a hearsay exception or through an appropriate witness.
In the pretrial hearing, the trial court considered appellant's claim that portions of the prosecutor's exhibits were not admissible as either business or public records under sections 1271 or 1280. Appellant's objections to the documents were that they contained opinions that were not admissible and they described events that did not occur at or near the time the documents were created. The People explained the documents fell under the public records and business records exceptions and they provided an affidavit from the hospital testifying that the records were "accurate and authentic mental records." The records were limited to those that the expert relied upon and cited to in rendering his opinion. The People argued the documents were "required to be admitted into evidence in order for the doctor to give his opinion, and the failure to introduce [them would be] reversible error."
The trial court pointed out that appellant's arguments were "outside of ... the original intent of what the legislature intended." The court explained that "these are documents that are generated in the ordinary course of business. They are generated in the ordinary course of [a] public institution." It found that the hospital was "transcribing events of meetings and incidences at or near the time that those meetings or incidences or reviews happened, and as such, that does meet the definition of [the] business records and public-public records exception." Appellant again argued that none of the records met the business records or public records exception. The court took the matter under submission.
Appellant provided the trial court with her proposed redacted versions of the exhibits. The court ruled that the hospital records were admissible as public records under section 1280, finding they were trustworthy based on public employees doing their job under section 664. Subsequently, the court addressed each of the specific portions of the documents highlighted by appellant and allowed both sides to comment and make any objections. Appellant objected to the notes stating appellant's thought content contained "delusions of grandeur" and to comments that her insight was poor and her judgment was fair, arguing they were opinion. The court allowed the evidence to remain. Appellant objected to the diagnosis section, and the court allowed the schizophrenia diagnosis to remain, finding it was relevant to the proceedings and because the expert testifying was going to independently diagnose her with schizophrenia. The court also noted that in one part of the report appellant admitted her diagnosis was schizophrenia and so it came in as a party admission. Appellant's argument that portions of the record described past contacts and were not acts, conditions, or events was rejected by the court and such evidence was allowed to remain. Appellant pointed to other comments in the report arguing they were opinion. The court allowed some in and excluded other portions.
Although the record actually states section 654, we agree with the People's presumption the court meant section 664, which is the section regarding the presumption that an official duty was regularly performed, as relevant here.
At trial, Contreras testified he evaluated appellant. For the evaluation, Contreras reviewed and considered appellant's medical records. The medical records were received into evidence at trial over appellant's objections for lack of foundation, hearsay, cumulativeness and under People v. Sanchez (2016) 63 Cal.4th 665 (Sanchez). Contreras formed the opinion that appellant's condition was reflective of schizophrenia and that her condition could not be kept in remission without treatment.
B. Applicable Law and Standard of Review
Hearsay, which is defined as an out-of-court statement by someone other than the testifying witness offered to prove the truth of the matter stated, is generally inadmissible unless it falls under an exception. (§ 1200, subds. (a), (b); Sanchez, supra, 63 Cal.4th at p. 674; People v. Zamudio (2008) 43 Cal.4th 327, 350.) Documents such as reports, criminal records, hospital records, and memoranda-prepared outside the courtroom and offered for the truth of the information they contain-are usually themselves hearsay and may contain multiple levels of hearsay, each of which is inadmissible unless covered by an exception. (Sanchez, at pp. 674-675; see also People v. Anderson (2018) 5 Cal.5th 372, 403 (double hearsay admissible if each level of hearsay falls within an exception); People v. Zapien (1993) 4 Cal.4th 929, 951-952.) Section 1271 provides: "Evidence of a writing made as a record of an act, condition, or event is not made inadmissible by the hearsay rule when offered to prove the act, condition, or event if: [¶] (a) The writing was made in the regular course of a business; [¶] (b) The writing was made at or near the time of the act, condition, or event; [¶] (c) The custodian or other qualified witness testifies to its identity and the mode of its preparation; and [¶] (d) The sources of information and method and time of preparation were such as to indicate its trustworthiness." (People v. Dorsey (1974) 43 Cal.App.3d 953, 960, fn. 1; Cooley v. Superior Court (2006) 140 Cal.App.4th 1039, 1045, fn. 3.)
Section 1280 provides: "Evidence of a writing made as a record of an act, condition, or event is not made inadmissible by the hearsay rule when offered ... to prove the act, condition, or event if . . .: [¶] (a) The writing was made by and within the scope of duty of a public employee[;] [¶] (b) The writing was made at or near the time of the act, condition, or event[; and] [¶] (c) The sources of information and method and time of preparation were such as to indicate its trustworthiness." (See People v. Dunlap (1993) 18 Cal.App.4th 1468, 1476.)
Under California law, "[a] trial court's exercise of discretion in admitting or excluding evidence is reviewable for abuse (People v. Alvarez (1996) 14 Cal.4th 155, 201) and will not be disturbed except on a showing the trial court exercised its discretion in an arbitrary, capricious, or patently absurd manner that resulted in a manifest miscarriage of justice (People v. Jones (1998) 17 Cal.4th 279, 304)." (People v. Rodriguez (1999) 20 Cal.4th 1, 9-10.) "A trial judge has broad discretion in admitting business records under . . . section 1271, and it has been held that the foundation requirements may be inferred from the circumstances. Indeed, it is presumed in the preparation of the records not only that the regular course of business is followed but that the books and papers of the business truly reflect the facts set forth in the records brought to court." (People v. Dorsey, supra, 43 Cal.App.3d at p. 961; see People v. Fowzer (1954) 127 Cal.App.2d 742, 747-748.) Additionally, "[a] trial court has broad discretion in determining whether a party has established [the] foundational requirements [of section 1280]." (People v. Martinez (2000) 22 Cal.4th 106, 120 (Martinez).) "A reviewing court may overturn the trial court's exercise of discretion '" 'only upon a clear showing of abuse.'" '" (Ibid.)
C. Analysis
Appellant contends that under sections 1271 and 1280, "it is not enough to correctly assert that the documents were prepared by a public official in the course of his or her duties or by a business during the normal court of business" but that additional requirements need to be met. First, appellant objects to the opinions that are contained in the exhibits, which she argues are not "acts, conditions, or events" as used in sections 1271 and 1280. Second, appellant contends that some information included in the exhibits was inadmissible because "it was not shown to have occurred at or near the time the record was created." The People respond that the trial court did not abuse its discretion in admitting the hospital records into evidence, arguing "[e]ach relevant statement within the records was covered by a hearsay exception with sufficient foundation."
"A trial court has broad discretion in determining whether a sufficient foundation has been laid to qualify evidence as a business record. On appeal, we will reverse a trial court's ruling on such a foundational question only if the court clearly abused its discretion." (People v. Hovarter (2008) 44 Cal.4th 983, 1011; Martinez, supra, 22 Cal.4th at p. 120 ["' "only upon a clear showing of abuse"' "].) The record shows that during pre-trial hearings, the court addressed and considered each section of the hospital records objected to by appellant, making decisions whether to admit or exclude the information one section at a time. Upon review, we cannot conclude the court abused its discretion by acting in "an arbitrary, capricious, or patently absurd manner ._" (See People v. Rodriguez, supra, 20 Cal.4th at pp. 9-10; Jones, supra, 17 Cal.4th at p. 304.)
We first consider appellant's complaint that sections within the hospital records should have been excluded as inadmissible opinion. Appellant relies heavily on People v. Reyes (1974) 12 Cal.3d 486 (Reyes) to argue that under California law, psychiatrists' opinions are not "an act, condition or event within the meaning of" sections 1271 or 1280. (Id. at p. 503.) However, we agree with the appellate court in People v. Nelson (2012) 209 Cal.App.4th 698 noting that Reyes applied to a narrow set of facts in that it upheld the court's decision to exclude an opinion made by a psychiatrist 20 years earlier that the victim in the murder case suffered from" 'sexual psychopathy.'" (Nelson, at p. 710, fn. 7; Reyes, at p. 502.) Reyes is distinguishable from the facts here where the hospital records in question were recent and relevant to the People's petition for recommitment.
Whether a report by a medical provider is "a record of an act, condition, or event" within the meaning of the business records exception depends whether the doctor is "reporting a patient's symptoms and the medical diagnosis ... based upon the doctor's firsthand observations of the patient." (Wegner et al., Cal. Practice Guide: Civil Trials and Evidence (The Rutter Group 2019) ¶ 8:1621, p. 8D-163 (italics omitted), citing Phillips v. G. L. Truman Excavation Co. (1961) 55 Cal.2d 801, 809-810; see Conservatorship of S.A. (2018) 25 Cal.App.5th 438, 448 [reports by psychiatric technicians of their observations of patient were within business records hearsay exception].) "Matters within the note maker's personal knowledge and the note maker's impressions come within the public records exception or business records exception." (People v. Orey (2021) 63 Cal.App.5th 529, 555.) And some "opinions" may be admitted as observations, which is allowed under the business records exception. (See Conservatorship of S.A., at p. 448 [observed conduct such as "threatening" is permissible under the business records exception]; see, e.g., People v. Blacksher (2011) 52 Cal.4th 769, 785-786 [clinician believed individual suffering from "psychotic reaction" but not diagnosed as schizophrenic]; In re M.L. (2012) 210 Cal.App.4th 1457, 1465 [individuals were described as" 'acutely psychotic'" but not necessarily diagnosed as such].) Reyes acknowledged that some diagnoses can be a statement of a fact or condition-for example, a diagnosis that a person has suffered a fracture is a record of what the person making the diagnosis has seen or observed. (Reyes, supra, 12 Cal.3d at p. 503.)
There are several portions of the record that appellant claims should have been excluded as inadmissible opinion evidence. First are appellant's challenges to references in the report that appellant's thought content "contains delusions of grandeur" were inadmissible opinion. For example, this includes appellant's reported belief that she was related to various former presidents and married to former Presidents Barack Obama and Donald Trump, which was obviously false and delusional. That appellant was delusional was an observation and falls within the public records or business records exception. (See Conservatorship of S.A., supra, 25 Cal.App.5th at p. 448; People v. Orey, supra, 63 Cal.App.5th at p. 555.)
Next, the following challenged comments admitted by the trial court are also considered to be observations rather than opinions: notes that appellant was having problems talking with her team and that she lacked insight into her mental illness, that appellant required prompting to follow her treatment plan, that appellant was "unable to discuss the name, dosage or purpose of her medication," "ha[d] poor insight into her mental illness and [was] unable to discuss its impact on her life," and that appellant had a blunted affect and euthymic mood. We reject appellant's challenges to the mental status exam portion of the report, which included permissible observations of appellant's attitude and cooperation, general appearance, and motor activity, including responses to specific questions about her mood and thought process. Appellant's argument that the court should have excluded comments regarding appellant's symptoms fails since symptoms are observable conditions and not a diagnosis or opinion. (See Reyes, supra, 12 Cal.3d at p. 503 [statement of fact or condition includes what the person has seen or observed].) As such, these portions of the record fall within the public records or business records exception.
Appellant's challenge to the report that her personal goal, listed as "[t]he substance abuse workbook," "does not appear to be a record of a statement actually made by appellant" is speculative and insufficient to conclude the trial court abused its discretion in allowing that into evidence.
Appellant misstates the following challenged portion of the report in her opening brief: that "appellant continues to meet the 'offender with a disorder' criteria.'" The report actually says, "If [appellant] continues to meet the Offender with Mental Disorder (OMD) criteria ._" (Italics added.) As such, this statement is not a diagnosis as suggested by appellant.
We reject several of appellant's objections as vague and unspecified. We cannot address claims such as "[t]his page is full of opinions" or "[t]his page contains numerous opinions," and "portions of these summaries were inadmissible."
We further reject appellant's claim that some of the information in the records "[w]as not admissible because it was not shown to have occurred at or near the time the record was created." First, we note the hospital records were submitted with an affidavit clearly attesting that "[t]he records were prepared by the personnel of the business in the ordinary course of business at or near the time of the act, condition, or event." (§ 1561, subd. (a)(3).) Moreover, appellant's claims are assumptive and speculative, at times stating the report purports or "suggests that none of the acts, conditions, or events occurred at or about the time" the record was created. Appellant's suggestions do not demonstrate the requisite "clear showing of abuse" as is required to reverse the trial court's exercise of discretion. (See Martinez, supra, 22 Cal.4th at p. 120 ["A reviewing court may overturn the trial court's exercise of discretion '" 'only upon a clear showing of abuse.'"' "].)
Appellant challenges the admission of the report's treatment plans and future goals. Appellant specifically challenges the following: events that would be beneficial to appellant, current barriers to discharge, which included "understanding of the need to remain adherent to medications in the community, [and] insight into mental health," the hospital's therapeutic plan to further assist appellant, future goals, and statements that "[t]here [were] no significant changes during this 30-[day] review" and "appellant ... required prompting to follow her treatment plan." However, these portions of the report are admissible as part of the hospital record generated in the ordinary course of business.
Last, appellant contends that the schizophrenia diagnosis should not have been admitted under the business records or public records exception, arguing that under Reyes, "opinions are not acts, conditions, or events." (See Reyes, supra, 12 Cal.3d at p. 503 ["[t]he psychiatrist's opinion that the victim suffered from a sexual psychopathy was merely an opinion, not an act, condition or event within the meaning of" section 1271].) We note, as the trial court did, that the report showed appellant admitted her diagnosis was schizophrenia. Therefore, the schizophrenia diagnosis was admissible under the party admission exception. (§ 1220.)
Regardless, even considering the court erred in admitting the schizophrenia diagnosis, any error was harmless. The People presented expert testimony from Contreras, who established that appellant was diagnosed with schizophrenia and her schizophrenia was not in remission. Contreras observed that appellant displayed ongoing symptoms of schizophrenia such as delusional beliefs, a flattened affect, poverty of thought and poverty of speech, with little to no emotion. Because the jury was made aware of the schizophrenia diagnosis of the doctor, any error in admitting the diagnosis in the hospital report was harmless. (People v. Young (1987) 189 Cal.App.3d 891, 913; People v. Watson (1956) 46 Cal.2d 818, 836-837.)
Consequently, we note that since the hospital records were admissible under the business records and public records exceptions, appellant's additional argument that Contreras's use of the information in the reports violated Sanchez, supra, 63 Cal.4th at p. 686 ["an expert cannot relate as true case-specific facts asserted in hearsay statements unless they are independently proven by competent evidence or are covered by a hearsay exception"] also fails.
DISPOSITION
We affirm the judgment.
[*] Before Hill, P. J., Smith, J. and Snauffer, J.