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Adams v. City and County of San Francisco11/8/2002
medical community does not fully understand the precise physiological mechanism by which a CM-I condition becomes symptomatic after trauma. However, the critical issue in causation is whether an accident in fact caused a plaintiff's injuries. (Mitchell v. Gonzales (1991) 54 Cal.3d 1041, 1049.) Here, Dr. Rubenstein testified repeatedly that the accident in fact caused Adams's CM-I condition to become symptomatic. This testimony was adequate.
Anticipating we would reach this conclusion, CCSF contends Adams was not only obligated to prove that the accident caused her CM-I condition to become symptomatic, but also "how accident changed her underlying condition such that it produced different symptoms from before." CCSF has not cited any authority that holds such proof is required, and we decline to adopt that standard. As Adams argues persuasively in her brief, "medical science may not understand the physiological mechanism by which Agent Orange or other toxic agents cause a host of symptoms, including genetic damage, but the causative relationship can be demonstrated to a reasonable medical probability. Much of medical science is based on correlations between event and symptoms that are statistically very reliable, without understanding the mechanism of the cause. To require probable scientific understanding of the physiological mechanism would render recovery impossible for many plaintiffs, when proximate causation can otherwise be clearly demonstrated . . . ."
We conclude the evidence of causation was adequate. While Rubenstein's testimony may have contained contradictions, Adams's evidence on this issue is not insubstantial. The trial court correctly denied CCSF's motion for a partial JNOV.
B. Evidentiary Rulings
Dr. Rubenstein testified, on direct and cross-examination, that one of the factors he considered when determining whether the accident caused Adams's CM-I condition to become symptomatic was the article by Dr. Milhorat. Near the conclusion of Dr. Rubenstein's testimony, the court asked the parties whether they intended to admit the article into evidence. When Adams offered the article, CCSF objected. The court said it would admit the article. Faced with that ruling, CCSF asked the court to admit Dr. Mampalam's article into evidence. The court agreed. According to CCSF, the Milhorat article was subsequently provided to the jury.
CCSF now contends the trial court erred in two respects. First, it contends the court should not have admitted Dr. Milhorat's article into evidence because it was hearsay. We need not address the argument directly because CCSF never raised a hearsay objection in the court below. It simply objected without stating any specific grounds. "In order to preserve an objection on appeal, a party must state it in a timely fashion, and it must be accompanied by a reasonably definite statement of the grounds. . . . These requirements are designed to avoid unfair surprise to opposing parties and to prevent error by the trial court. The trial judge is given a concrete legal proposition to consider and the opposing counsel is sufficiently advised of the alleged defect to reframe the question, lay an additional foundation, or take other steps to minimize the likelihood of reversal." (Simons on Cal. Evidence (2001) Relevant Evidence, ยง 1:20, p. 18, internal citations omitted.)
Alternately, CCSF contends the trial court violated Evidence Code section 721 when it allowed the jurors to take the Milhorat article with them into the jury room. Again, we reject this argument on procedural grounds. We find no place in the record where CCSF raised this issue in the trial court, or even raised a general objection to the jurors taki
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