William H. Newkirk


Past medical expenses in a medical-malpractice case — should you introduce them?


The collateral source rule does not apply and jurors may question your actual medical damages


While recent Court of Appeals deci-


sions relating to the nature and amount of medical expense to be introduced at trial in Hanif, Howell, King, Cabrera, Olsen and Nishihama generally predominate in damage discussions in the ordinary tort claim, the statutory directives of MICRA entirely redirect the strategic focus of introducing evidence of medical expense incurred by the Plaintiff in a medical- malpractice action. Instead of the ques- tion being “what amounts of medical expenses can be introduced,” the ques- tion in a health-care negligence action


14— The Advocate Magazine JULY 2011


may be “whether or not to introduce past medical expense evidence at all.” That is so because Civil Code section


3333.1, applicable to claims against a health-care provider, abrogates the “collat- eral source rule” in a claim against a health-care provider, and statutorily gives the defendant the option of introducing evidence of the fact of certain collateral source payments of medical expenses, as well as the amounts paid by those collater- al sources specified by statute. When deciding whether to introduce


medical expenses paid by a collateral source,


practical considerations of the impact on the jury prevail. When the vast percentage of past medical expenses have been paid by insurance, juries may question the motive for the lawsuit, and may balk at a finding on liability for the plaintiff. If the plaintiff does not introduce evidence of medical expenses, the option is taken away from the defen- dant, since collateral evidence is then both irrelevant and prejudicial. By the same token, if the plaintiff does not introduce evidence of medical expenses incurred in some instances, the jury may never get an appreciation of how severe the injury is.


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