Munoz v. Lupercio

1
NOT DESIGNATED FOR PUBLICATION

No. 116,816

IN THE COURT OF APPEALS OF THE STATE OF KANSAS

ISIDRO MUNOZ,
Appellant,

v.

MARIA LUPERCIO,
Appellee.


MEMORANDUM OPINION

Appeal from Ford District Court; SIDNEY R. THOMAS, judge. Opinion filed December 8, 2017. Affirmed.

Peter J. Antosh, of Garcia & Antosh, LLP, of Dodge City, for appellant.

Terry J. Malone, of Williams-Malone, P.A., of Dodge City, for appellee.

Before SCHROEDER, P.J., MCANANY and POWELL, JJ.

PER CURIAM: In February 2008, Isidro Munoz and Maria Lupercio were involved
in a slow-speed two-car accident in which Lupercio's vehicle, traveling about five miles
per hour, struck the rear of Munoz' vehicle. Munoz apparently first sought treatment for
back complaints in May 2008. Munoz commenced his negligence action against Lupercio
for his personal injuries and damages, but that action was dismissed other than on the
merits. Munoz refiled the case in April 2012 under the provisions of K.S.A. 60-518. In
his petition, Munoz claimed he suffered bodily injury, pain and suffering, medical
expenses, and lost wages as a result of Lupercio's negligence.

2
In May 2013, Munoz deposed Dr. Paul Stein. Dr. Stein conducted an examination
of Munoz. He did not provide any treatment. He saw Munoz in May 2012, over four
years after the accident. In his deposition, Dr. Stein opined:

"Mr. Munoz was involved in an apparently mild motor vehicle accident in 2008
in which his pickup truck was struck from the rear. The referral letter from the attorney
indicates that Mr. Munoz started to notice significant back pain a few weeks after the
accident. In giving history today, the claimant reports that he had pain in the back and
some in the neck later the day of the accident and that he went to his chiropractor a few
days after the accident. The medical records from the chiropractor indicate that the first
visit after this accident was on 5/20/08, approximately three months after the incident. I
have no documented basis upon which to determine when symptomatology started and, if
it started relatively shortly after the accident, why there was no earlier medical attention.
Assuming that the pain started the day of the accident and progressed as described by Mr.
Munoz today, and assuming that there was no lower back pain prior to the accident, there
would be a causal relationship in the form of aggravation of preexisting degenerative
change."

At the court's pretrial conference in May 2014, Lupercio admitted that she was
negligent in causing the collision but denied the nature and extent of Munoz' claimed
injuries and damages and causation.

In September 2014, Lupercio moved in limine to exclude the testimony of Munoz
concerning his medical treatment and the medical expenses incurred. Lupercio argued
that the evidence lacked foundation absent the testimony of a qualified medical expert.
Munoz stated that he intended to introduce his medical bills into evidence in the
following manner:

"a. Plaintiff will first introduce previously designated deposition testimony from his
retained medical expert, Dr. Paul Stein, pertaining to an independent medical
examination previously performed on the Plaintiff.
3
"b. Next, Plaintiff will testify as to:
"i. how he felt physically prior to the accident,
"ii. how he felt physically after the accident,
"iii. where he went for medical treatment,
"iv. what he recalls the physicians and medical staff did for him at his treatment
sessions,
"v. whether he has received and reviewed medical bills in that connection, and
"vi. whether the bills introduced through him appear to him to be accurate."

Munoz acknowledged that he had no additional witnesses who would offer foundation
testimony for his medical records or expenses. The district court sustained the motion in
limine.

The case ultimately was tried to the court rather than to a jury in August 2016. The
parties stipulated that Lupercio was 100% at fault in causing the accident. Munoz
testified on his own behalf and introduced the deposition testimony of Dr. Stein.

Munoz testified that he experienced back pain the same day as the accident. He
acknowledged that he suffered a back injury eight years prior. He stated that he was no
longer receiving treatment or taking medication for his prior back injury, though Dr.
Stein noted that Munoz had "some mild residual lower back symptomatology" from this
prior injury. Munoz testified about his ongoing back complaints and the medication he
was taking since the time of the accident. He testified that he saw Dr. Stein for an
evaluation. He testified that the cost to repair his vehicle was $387.32. He did not provide
any testimony regarding his lost wage claim.

Munoz proffered that he received medical treatment that was "fully related to this
accident," for which he received bills totaling $8,111.98. He proffered that his first
treatment for his injuries was in April 2011. The bills themselves were proffered into
evidence but, consistent with the order in limine, they were excluded. Munoz informed
4
the court that "he had no other evidence to present on either causation, necessity or
reasonableness of the medical services and medical charges alleged to have been caused
by defendant's fault."

Munoz' medical bills were not received into evidence. The district court ruled that
any damages for medical care and treatment were speculative and based upon conjecture.
The district court awarded Munoz $387.32 in property damage for the cost to repair his
vehicle.

Munoz appeals. His sole issue on appeal is his claim that the district court erred in
rejecting his testimony regarding the treatment he received for his injuries and the
medical expenses he incurred. In our review

"[f]irst, we determine the relevance of the challenged evidence, i.e., whether the evidence
is probative and material. The district court's determination that the evidence is probative
is reviewed for an abuse of discretion; the court's determination that the evidence is
material is subject to de novo review. [Citations omitted.] If the evidence is relevant, we
then determine, de novo, which rules of evidence or other legal principles govern the
admission of the evidence in question. Appellate review of the district court's application
of the pertinent legal rules and principles depends on whether the rule or principle
permits the district court to exercise its discretion or whether the rule raises questions of
law. Next, we must consider whether the district court abused its discretion in weighing
the probative value of the evidence against the potential that the evidence will unfairly
and prejudicially surprise a party who has not had reasonable opportunity to anticipate
the evidence. [Citation omitted.]" Evergreen Recycle v. Indiana Lumbermens Mut. Ins.
Co., 51 Kan. App. 2d 459, 508, 350 P.3d 1091 (2015).

The parties agree that evidence concerning Munoz' medical treatment and
expenses is relevant. "Unless prohibited by statute, constitutional provision, or court
decision, all relevant evidence is admissible. [Citations omitted.]" City of Mission Hills v.
Sexton, 284 Kan. 414, 429, 160 P.3d 812 (2007); see K.S.A. 60-407(f). Lupercio agrees
5
that the evidence is material to establishing the extent of Munoz' damages, but she asserts
it is not admissible because Munoz failed to establish a proper foundation for its
admission.

Foundation testimony refers to "'preliminary questions designed to establish that
evidence is admissible.' [Citations omitted.]" Wiles v. American Family Life Assurance
Co., 302 Kan. 66, 74, 350 P.3d 1071 (2015). Whether there was an adequate evidentiary
foundation to admit evidence is a question of fact subject to the district court's discretion.
We will not disturb the district court's ruling if substantial competent evidence supports
it. See 302 Kan. at 74-75.

A proper, competent foundation must be established before opinion evidence may
be presented. See Roberts v. J.C. Penney Co., 263 Kan. 270, 278, 949 P.2d 613 (1997).
K.S.A. 60-419 establishes that before any witness is permitted to testify regarding a
relevant or material matter, "there must be evidence that he or she has personal
knowledge thereof, or experience, training or education if such be required." See Stafford
v. Karmann, 2 Kan. App. 2d 248, 250, 577 P.2d 836 (1978). "It is axiomatic that a
foundation must be laid establishing the competency, materiality and relevancy of all
evidence prior to admission." Cansler v. Harrington, 231 Kan. 66, 69, 643 P.2d 110
(1982).

Here, Munoz' testimony was insufficient to establish that the medical expenses
were necessary and reasonable. See Rood v. Kansas City Power & Light Co., 243 Kan.
14, 16, 755 P.2d 502 (1988), disapproved of on other grounds by Dixon v. Prothro, 251
Kan. 767, 775, 840 P.2d 491 (1992). Further, he lacked sufficient experience, training, or
education to testify about the necessity and reasonableness of his medical treatment and
expenses or to testify as to causation, particularly in a case involving the interplay
between current complaints and a prior unrelated injury.

6
The familiar elements of a tort action such as this are duty, breach, causation, and
damages. See Shirley v. Glass, 297 Kan. 888, 894, 308 P.3d 1 (2013). At issue in this
case are the elements of causation and damages. Proximate cause is defined as "the cause
that in a natural and continuous sequence, unbroken by any [superseding] cause, both
produced the injury and was necessary for the injury. The injury must be the natural and
probable consequence of the wrongful act. [Citation omitted.]" Hale v. Brown, 287 Kan.
320, 322, 197 P.3d 438 (2008). The existence of a causal connection between the
breached duty and the injuries sustained is a question of fact. Wicina v. Strecker, 242
Kan. 278, 280-81, 747 P.2d 167 (1987).

"[T]he well-established test for determining whether expert testimony is required
is whether the subject matter is too complex to fall within the common knowledge of the
jury and is 'beyond the capability of a lay person to decide.' [Citations omitted.]"
Williamson v. Amrani, 283 Kan. 227, 245, 152 P.3d 60 (2007), superseded by statute on
other grounds as stated in Kelly v. VinZant, 287 Kan. 509, 520-22, 197 P.3d 803 (2008).
Here, whether Munoz' complaints were caused by the collision with Lupercio or his prior
injury was "too complex to fit within the common knowledge exception and . . . beyond
the capability of a lay person to decide." See Hare v. Wendler, 263 Kan. 434, 445, 949
P.2d 1141 (1997). Thus, evidence of a causal connection between Munoz' accident and
his postaccident complaints had to come from an expert witness. See Nunez v. Wilson,
211 Kan. 443, 447, 507 P.2d 329 (1973) (testimony regarding whether there is a causal
connection between accident and resulting injury is not within the competency of a
layman and expert testimony may be required).

While Dr. Stein, the only expert to testify, acknowledged that a low-speed impact
such as here could potentially cause some of Munoz' symptoms, he effectively was
unable to establish a causal link between the accident and Munoz' current complaints. He
stated that if Munoz did not have any back pain before the accident (which contradicts
Dr. Stein's earlier finding of residual back pain), and "if there is a temporal relationship
7
between the accident and the onset of symptoms, that is, within 24 or 48 hours or
thereabouts, then both of those things coming together would suggest that the accident
was the cause of the current symptoms." But with respect to the temporal connection
between the accident and the onset of symptoms, Dr. Stein concluded that he had "no
documented basis upon which to determine when symptomology started and, if it started
relatively shortly after the accident, why there was no earlier medical attention." Thus, to
find causation would require Dr. Stein to assume the truth of assertions that he found to
be contradicted by his examination of Munoz and by Munoz' own medical records.

Munoz failed to present evidence to satisfy the essential causation element of his
cause of action. Just as importantly, Dr. Stein did not opine on the reasonableness and
necessity of the medical bills Munoz sought to introduce at trial. Without expert
testimony on this issue, Munoz was unable to prove that his medical treatments were
necessary and that the bills for those treatments were reasonable.

Evidence regarding a plaintiff's medical treatment and records has been admitted
through plaintiff's testimony when coupled with medical testimony as to the
reasonableness, necessity, and causation of medical treatment and injuries. See Rood, 243
Kan. at 16-17 (finding sufficient foundation to show reasonableness and necessity of
medical bills when plaintiff testified as to medical treatment received and a physician
testified that such treatment was standard for plaintiff's injury); Cansler, 231 Kan. at 69
(medical bills properly admitted where plaintiff testified about her bills for medical
treatment of injuries resulting from accident and two physicians testified that plaintiff's
treatment was needed); Lewark v. Parkinson, 73 Kan. 553, 555-56, 85 P. 601 (1906)
(damages awarded for reasonable and necessary services). But here, Munoz lacked the
predicate expert medical testimony to establish a causal link between his current
complaints and Lupercio's negligent conduct, or to establish the reasonableness and
necessity of the care and treatment for which Munoz claims pecuniary loss.

8
Munoz relies on the holding in Francis v. Pennington, No. 64,022, unpublished
opinion filed October 19, 1990. But Munoz failed to attach a copy of the Francis opinion
to his appellate brief as required by Supreme Court Rule 7.04(g)(2)(C) (2017 Kan. S. Ct.
R. 45). Accordingly, we decline to consider the unpublished opinion in Francis which
has not been provided to us. See State v. Adams, No. 106,935, 2013 WL 4046396, at *6
(Kan. App. 2013) (unpublished opinion).

In Hards v. Renteria, No. 84,734, unpublished opinion filed September 1, 2000,
the court found that the plaintiff was not competent to testify as to the reasonableness and
necessity of her medical expenses, and "no medical doctors testified as to the
reasonableness and/or necessity of Hards' nonchiropractic treatment and medical
expenses." Slip op. at 4. Thus, the district court did not abuse its discretion in striking her
testimony. Slip op. at 6.

Munoz' final argument is a public policy argument. He asserts that the cost of
procuring the medical testimony to establish foundation prohibits plaintiffs from pursuing
small to mid-sized personal injury lawsuits. He provides no support for his position that
the cost of a lawsuit is a basis for the courts to change a rule of evidence and waive the
requirements of establishing a foundation for the admission of evidence. Further, he
would have us ignore legislative enactments and case precedents and substitute a
different version of what he believes the law should be. This we will not do.

We find no error in excluding Munoz' medical bills for lack of a proper
foundation.

Affirmed.