California Court of Appeal Mar 4, 2015 No. E059840Unpublished
Filed 3/4/15 P. v. L.F. CA4/2
NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
FOURTH APPELLATE DISTRICT
DIVISION TWO
THE PEOPLE,
Plaintiff and Respondent, E059840
v. (Super.Ct.No. FELSS1205147)
L.F., OPINION
Defendant and Appellant.
APPEAL from the Superior Court of San Bernardino County. Victor R. Stull,
Judge. Affirmed.
Michele Anne Cella, under appointment by the Court of Appeal, for Defendant
and Appellant.
Kamala D. Harris, Attorney General, Julie L. Garland, Assistant Attorney General,
A. Natasha Cortina and Ryan H. Peeck, Deputy Attorneys General, for Plaintiff and
Respondent.
In October 2009, defendant and appellant L.F. was sentenced to three years in
prison following a conviction for assault with a deadly weapon. (Pen. Code, § 245, subd 1
(a)(1).) In December 2010, the Board of Prison Terms (the Board) found that he met the
requirements of a mentally disordered offender (MDO) under Penal Code section 2962
and detained him at Atascadero State Hospital for continued involuntary treatment. On
October 24, 2012, defendant’s MDO commitment was continued, and he was moved to
Patton State Hospital (Patton). Defendant filed a petition challenging the Board’s
determination (Pen. Code, § 2966). On October 1, 2013, a jury affirmed the Board’s
determination.
Defendant appeals, contending the trial court prejudicially erred in admitting into
evidence Patton’s Interdisciplinary Notes written by numerous staff members. For the
reasons set forth below, we affirm.
I. FACTS AND PROCEDURAL HISTORY
Prior to trial, defendant moved to exclude testimony about the contents of the
hospital records, or Interdisciplinary Notes, upon which the prosecution expert witnesses
relied. The Interdisciplinary Notes consisted of 13 (out of 545) pages of handwritten
notations by staff members at Patton concerning defendant’s behaviors, statements, and
well-being. Outside the presence of the jury, the attorneys argued about admissibility and
whether the jury should be able to consider the Interdisciplinary Notes as evidence.
Defense counsel asserted that the prosecution had not laid and would not be able to lay
the appropriate foundation to admit the Interdisciplinary Notes, and that the
Interdisciplinary Notes alone were unreliable. When asked to identify which specific
notes were objectionable, defense counsel maintained that she was “objecting to all of
them” because the records were inadmissible hearsay lacking a foundation. In response,
2
the prosecutor argued that her experts could rely upon the Interdisciplinary Notes
regardless of whether they were admissible, but agreed that a foundation was necessary
for their admission. Nonetheless, she further asserted that the Interdisciplinary Notes
were admissible as business records pursuant to Evidence Code section 1561. The trial
court agreed that the Interdisciplinary Notes, which are routinely relied upon by
professionals in the field, are reliable, and it found them admissible under Evidence Code
section 1562.
At the MDO hearing, evidence was introduced through the testimonies of
Drs. Robert Suiter, Steven Galarza, and defendant.
A. Dr. Suiter’s Testimony
Dr. Suiter is a psychologist who evaluated defendant on October 2, 2012, to
determine whether he suffered from a severe mental disorder, whether he was in
remission or could not be kept in remission, and whether the disorder caused him to be a
danger to others. The doctor diagnosed defendant with severe schizophrenia, paranoid
type. He explained that schizophrenia is an incurable chronic condition, causing
delusions which are irrational thoughts (paranoid) or beliefs (grandiose).
Dr. Suiter opined that defendant was not in remission and could not voluntarily be
kept in remission, and that defendant presented a substantial danger of harm to others
because of his condition. The doctor explained that defendant “hears voices which
disrespect him,” and suffers from a number of different paranoid delusions. For example,
defendant has believed that members of his family attempted to kill him; he was a
prisoner of war in a concentration camp; his medication was poisoning his body and his
3
brain; and that the judge in his case, police, and the legal system colluded to hospitalize
him so that the hospital would receive funds and other people would be paid for his
commitment. During Dr. Suitor’s interview with defendant, defendant was medicated but
was nevertheless delusional.
In evaluating defendant, Dr. Suiter primarily relied upon Patton’s records,
including the Interdisciplinary Notes. Within these records, Dr. Suiter found evidence
that defendant demonstrated or reported symptoms indicative of his psychotic disorder.
Specifically, Dr. Suiter recounted three incidents in August and September 2012. The
incidents involved defendant being verbally abusive to hospital staff, entering another
patient’s room and threatening him, and “mim[ing] with his hand as if he was firing a
handgun” at his treating psychiatrist, Dr. Galarza. The incidents were significant because
they confirmed that defendant was not in remission and thus posed a danger to others.
B. Dr. Galarza’s Testimony
Dr. Galarza is defendant’s psychiatrist at Patton. Defendant has been
Dr. Galarza’s patient since late 2011. In order to determine what kind of mental disorder
defendant suffers, the doctor reviewed his medical history and his legal file, discussed
defendant’s condition with his mother, and met with defendant personally. Dr. Galarza
diagnosed defendant with schizophrenia, paranoid type, and agreed that it is a chronic
disease. The doctor testified that defendant suffers from paranoid delusions, such as
delusions of conspiracy involving his belief that people want to hurt, attack and kill him.
During these periods he would become threatening, requiring emergency doses of
medication and multiple staff members to calm him down. In treating defendant,
4
Dr. Galarza explained that the “first thing” is supervision. Defendant attends group
sessions where he learns how to regulate his mood, and he is prescribed medications.
Dr. Galarza testified that during the year prior to October 2012, defendant had
trouble differentiating between what was reality and what was imagined. He suffered
from paranoid delusions, and had a “near zero understanding of his condition.” For
example, he thought he was in a concentration camp, that members of the staff were
Nazis, and that he was being “set up by the government.”
Dr. Galarza was shown the Interdisciplinary Notes, and he explained they are
Patton’s medical records. More particularly, the doctor was questioned as to why
defendant was on “30-minute checks” on October 20, 2012. Dr. Galarza explained that
during the week ending October 20, defendant was walking around the hospital unit,
mumbling to himself, and glaring at other patients and staff. He appeared “very
disturbed.” Multiple times, he told staff members that he wanted to kill the doctor.
Dr. Galarza was warned to stay away from the unit pending further investigation.
In October 2012, defendant was on medication. In fact, a few months earlier,
Patton had sought and obtained a court order that allowed staff to “pursue[] an
involuntarily medication request” because they feared defendant presented an imminent
danger to others. During that same period, if members of the staff were not conducting
30-minute checks on defendant, they were closely supervising him.1 Because defendant
1“Close supervision” is often called “one-to-one supervision” and involves a staff member, such as a nurse or psychiatric technician, “follow[ing] a patient around 24/7 [footnote continued on next page]
5
felt threatened, he started eating more and doing things to increase his weight because he
wanted to “get bigger” in order to protect himself. Other examples of defendant’s state of
mind include a July 2012 incident in which defendant became agitated because he
believed staff members wanted to steal his truck. However, defendant did not own a
truck. Also, around the same time, defendant wanted to escape Patton and threatened to
hurt the nurses because he thought he was being poisoned.
According to Dr. Galarza, defendant was not in remission; rather, he was “very
delusional.” The doctor opined that if defendant was left to his own devices, he would
stop taking his medications and would present a substantial danger of physical harm to
others because of his condition.
C. Defendant’s Testimony
Defendant acknowledged that he suffers from “schizophrenia and bipolar and
delusions.” He experienced symptoms of schizophrenia and paranoia while serving time
in prison for his 2009 conviction. These symptoms necessitated his being kept in the
prison’s special facility for people with mental health conditions.2 He was transferred to
Atascadero State Hospital, which he believed was a concentration camp, and he saw
himself as a prisoner of war. He further believed that the doctors were part of a Nazi
[footnote continued from previous page]
during the daytime, during the nighttime, just to be able to either redirect him or if [he is] gonna attack someone to attempt to stop it, sound the alarms.”
2 Defendant’s conviction resulted from his assault and battery on his roommate, whom defendant believed was the Unabomber.
6
group because they interrogated him; however, he no longer holds that belief. Defendant
maintained that the facility is run like a concentration camp. When asked whether he
remembered complaining about the insulin he was being given, he said that it was the
medication that was too much and that it was poisoning his body.
Defendant believed that he was transferred to Patton in retaliation for his lawsuit
against the manufacturer of a drug “Zyprexa,” which he stated caused him to become
diabetic.3 Regarding the incidents that Dr. Suiter referenced, defendant denied
threatening other patients at Patton. He claimed they tried to fight with him and he acted
in self-defense. He admitted that he had pointed his finger (mimicking a gun) at
Dr. Galarza, but he claimed that it was in jest. It was his belief that he was sent to Patton
to be protected from drug dealers. He further believed his doctors were giving him drugs
to “kill his genes” in order to prevent him from having children. When asked if he really
believed that to be true, he replied, “What would be the other alternative [reason for
administering the drugs]?”
Regarding his view of members of the legal system, defendant believed that
“Judge McComber” and the district attorney “blackmailed” him and “framed him” for
seven failures to appear in court. Specifically, he claimed that the “D.A. was
deliberately, automatically framing [him] in the courtroom and giving false accusations,
saying that [he] was doing something and [he] wasn’t . . . .” Defendant opined that the
3 Defendant stated the lawsuit was filed on his behalf by California Department of Corrections and resulted in a settlement.
7
court system was after him and there was a “sting operation” at Patton with the patients
acting like detectives who interrogate him.
In defendant’s opinion, his medications were not helpful, because they increased
his paranoia and caused damaging side effects, including double vision, obesity, high
blood pressure, fatigue and chest pains, necessitating a trip to the emergency room.
Regarding obesity, defendant admitted that when he first arrived at Patton he weighed
375 pounds; however, now he weighs 295.
II. DISCUSSION
In three separate but related arguments, defendant contends: (1) the trial court
erred in admitting the Interdisciplinary Notes because they contained inadmissible
hearsay for which there was no exception (hearsay evidence argument); (2) the admission
of the Interdisciplinary Notes violated his due process right to a fair trial (due process
argument); and (3) absent the admission of the Interdisciplinary Notes, the jury’s finding
that defendant met the criteria for recommitment as an MDO does not stand (harmless
error argument).
A. Hearsay Evidence Argument
As a preliminary matter, we note that defendant agreed the experts could rely on
the Interdisciplinary Notes for their testimony, even if they were not admitted into
evidence. However, defendant argued at the trial level, and maintains on appeal, that the
experts could not testify about the content of the Interdisciplinary Notes because the
content was inadmissible hearsay.
8
The extent to which a document is admissible as a properly authenticated writing
made in the regular course of business was discussed in People v. Nelson (2012) 209
Cal.App.4th 698, 707-714 (Nelson). In that case, this same issue was raised on appeal by
another patient at Patton. (Id. at p. 707.) “The People sought [and were permitted] to
introduce ‘Interdisciplinary Notes’ made by Patton staff members recording three
incidents of Nelson’s aggression against other persons during the preceding year.” (Id. at
pp. 703-705.) Nelson challenged the admission of the Interdisciplinary Notes,
contending, “because they contain hearsay and multiple hearsay, the trial court erred by
allowing the experts to discuss them in detail, providing the jury with them during
deliberations, and refusing her request for a limiting instruction.” (Id. at p. 707.)
Rejecting Nelson’s contentions, the appellate court held that hospital records such
as the Interdisciplinary Notes fall within the business record exception (Nelson, supra,
209 Cal.App.4th at p. 710; Evid. Code, § 12714) and “may also qualify as public records
under [Evidence Code] section 1280[5] if properly authenticated. [Citation.]” (Nelson,
4 “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.” (Evid. Code, § 1271.)
5 “Evidence of a writing made as a record of an act, condition, or event is not made inadmissible by the hearsay rule when offered in any civil or criminal proceeding to prove the act, condition, or event if all of the following applies: [¶] (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. [¶] (c) The source of information [footnote continued on next page]
9
supra, at p. 710; see also Evid. Code, § 1280.) Nonetheless, Nelson argued that Evidence
Code sections 1271 and 1280 required the People to call a witness to lay a proper
foundation. (Nelson, supra, at p. 710.) The appellate court disagreed, stating:
“‘“Although similar to the business records exception [Evid. Code section 1271], the
official records exception differs in one important respect. . . . [Evidence Code section]
1271 ‘requires a witness to testify as to the identity of the record and its mode of
preparation in every instance. In contrast, . . . [s]ection 1280 . . . permits the court to
admit an official record or report without necessarily requiring a witness to testify as to
its identity and mode of preparation if the court takes judicial notice or if sufficient
independent evidence shows that the record or report was prepared in such a manner as
to assure its trustworthiness.’”’ [Citation.]” (Ibid., original italics.) The Nelson court
further held that the Interdisciplinary Notes “are not testimonial in nature, and thus the
due process right of confrontation does not arise. The notes were recorded by hospital
staff members for purposes of discipline and the safety of other patients and staff, and the
treatment of Nelson required by her conduct. The notes do not suggest staff was
concerned with possible future litigation.” (Id. at p. 713.)
We conclude the Nelson court’s analysis and conclusion are applicable to the case
before this court. Here, the trial court admitted the Interdisciplinary Notes under
Evidence Code section 1562. That section provides: “If the original records would be
[footnote continued from previous page]
and method and time of preparation were such as to indicate its trustworthiness.” (Evid. Code, § 1280.)
10
admissible in evidence if the custodian or other qualified witness had been present and
testified to the matters stated in the affidavit, and if the requirements of [Evidence Code]
[s]ection 1271 have been met, the copy of the records is admissible in evidence. The
affidavit is admissible as evidence of the matters stated therein pursuant to [Evidence
Code] [s]ection 1561 and the matters so stated are presumed true. When more than one
person has knowledge of the facts, more than one affidavit may be made. The
presumption established by this section is a presumption affecting the burden of
producing evidence.” (Evid. Code, § 1562.) “Although hospital and medical records are
hearsay, they can be admitted under the business records exception to the hearsay rule”
when properly authenticated. (Garibay v. Hemmat (2008) 161 Cal.App.4th 735, 742;
Evid. Code. § 1271.) A trial court has wide discretion to determine whether a sufficient
foundation was laid to qualify a document as a business record, and we will not reverse
the trial court’s ruling absent an abuse of discretion. (People v. Hovarter (2008) 44
Cal.4th 983, 1011.) To demonstrate an abuse of discretion, the defendant must show
“‘“no reasonable basis”’” for admitting the evidence. (People v. Dean (2009) 174
Cal.App.4th 186, 193 [Fourth Dist., Div. Two].)
The requirements of Evidence Code section 1271 were met. According to Exhibit
1, Stephanie Perez, Director of Health Information Management at Patton, certified that
“the accompanying documents are true copies from the Patton State Hospital
DESIGNATED RECORD SET (DRS), and that I am the duly authorized custodian
thereof and have the authority to certify such records, that such records are prepared by
the personnel of the hospital in the ordinary course of hospital business at or near the time
11
of the act, condition or event. [¶] Documents containing handwritten entries are
prepared by the professional staff signing the entry.” (Exh. 1, original boldface.)
Additionally, Dr. Galarza testified that the Interdisciplinary Notes were created as
part of the regular course of business at Patton and they reflect defendant’s interactions
during the course of his treatment. The doctor added that the contents of the
Interdisciplinary Notes are governed by medical standards and they are written by
“members of the clinical team and people that work on the unit,” such as nurses,
therapists and the doctor. He verified the contents of the Interdisciplinary Notes by
speaking with the people who wrote them and, in the case of defendant’s threat against
the doctor’s life, by personally speaking with defendant. Moreover, Dr. Galarza testified
that he personally observed some of the conduct described in the Interdisciplinary Notes
and discussed that conduct, and other issues, with defendant. The Interdisciplinary Notes
are reliable and fall within the umbrella of the business records exception. (Fuller v.
White (1948) 33 Cal.2d 236, 242; Loper v. Morrison (1944) 23 Cal.2d 600, 608 [“There
is no reason to believe that a hospital record is not as truthful as a record kept by a
commercial firm. It is a record upon which treatment of the patient is based, and
experience has shown it to be reliable and trustworthy.”]; People v. Dean, supra, 174
Cal.App.4th at p. 197, fn. 5.) “Hospital records may also qualify as public records under
alternatives, etc. . . . [patient] delusional about ‘The Feds-R-doing things 2 not make me
make it . . .’ Goin’ on & on [with] delusions. Redirected but . . . .”; and an October 16
Interdisciplinary Note (07:20 hours), which states: “It was explained to Mr. Freund that
we can call the HPO’s but . . . .” Regarding the October 16 Interdisciplinary Note (07:20
hours), defendant complains that the use of passive tense makes it impossible to
7 Defendant incorrectly identifies the date as being October 18 and that it is Exhibit 1B; however, the Interdisciplinary Note quoted is from October 17 (no time identified) and is found in Exhibit 1C.
8 Although there is no indication of the time, the writing suggests that it is a continuation of the note identified at 11:22 hours.
14
determine who did the explaining. However, the note later states that defendant cursed
and “kicked at this writer . . . .”
Next, defendant references a note from 07:00 hours on October 17, identified as
“(Late entry) for 10-16-12 0720,” and states: “Mr. Freund approached nurses station to
speak [with] shift lead regarding medication and requested to speak to HPO. Shift lead
stated ‘we can call HPO but due to court order you will still need to receive injection.
Mr. Freund rapidly escalated with anger and kicked at shift lead stating, ‘Fuck you’ he
was yelling and cursing imposing imminent danger. Placed in 5 point restraint [with] 1:1
observation.” Defendant complains that this entry fails to meet the foundational
requirement because it was not written at or near the time of the event and describes
something that happened to a third party, with no indication whether the author actually
witnessed it or was told about it. Again, Dr. Galarza’s testimony supports a finding that
the author, at a minimum, witnessed the incident. In any event, the contents of this note
were confirmed by the October 16 (07:20 hours) note written by the direct victim of
defendant’s kick, contemporaneously with the event, and discloses the same facts.
Finally, defendant labels Exhibit 1M as the “worst offender.” This page is a
typewritten historical record setting forth defendant’s personal history. As the People
point out, the certification that accompanies Exhibit 1 explains that typewritten notes are
“generated as a result of professional staff requesting that certain information be keyed
into the computer to generate date in a specific format, such as . . . demographic
information or schedules, and is abstracted from handwritten or typed documents . . .”
15
Thus, the original source of the information in Exhibit 1M was obtained in the “ordinary
course of hospital business.”
Given the above, we conclude the trial court did not abuse its discretion in finding
a sufficient foundation to admit Exhibit 1 as a business record. (People v. Hovarter,
supra, 44 Cal.4th at p. 1011; People v. Dean, supra, 174 Cal.App.4th at p. 193.)
B. Due Process Argument
Defendant contends the admission of the Interdisciplinary Notes violated his due
process right to a fair trial because he was denied his right to confrontation. Not so.
It is important to note we are not presented with evidence admitted in a criminal
prosecution, wherein a defendant has a Sixth Amendment right of confrontation. The
confrontation clause of the Sixth Amendment prevails over a state’s rules of evidence
insofar as testimonial hearsay is concerned. (Crawford v. Washington (2004) 541 U.S.
36, 51.) In a noncriminal matter, any right of confrontation is brought to bear not by the
Sixth Amendment, but by the due process clause of the Fourteenth Amendment. (People
v. Otto (2001) 26 Cal.4th 200, 214.) A key difference between testimonial hearsay
considered under the Sixth Amendment and the same evidence considered under a due
process analysis is that while such evidence is inadmissible under the Sixth Amendment
in a criminal prosecution regardless of the reliability of the evidence (Crawford v.
Washington, supra, at pp. 61-64), reliable testimonial hearsay admitted pursuant to the
Evidence Code is not categorically inadmissible under due process. (People v. Angulo
Needless to say, an individual facing an involuntary civil commitment is entitled
to due process. (People v. Otto, supra, 26 Cal.4th at p. 209.) However, the risk of an
erroneous deprivation of an alleged MDO’s compelling interest in remaining free from an
involuntary civil commitment posed by admission of evidence pursuant to Evidence
Code section 1271 is not substantial. (See People v. Castillo (2010) 49 Cal.4th 145, 165-
166.) Here, the hearing provided defendant was fundamentally fair, the touchstone of
due process. (Cf. People v. Superior Court (Howard) (1999) 70 Cal.App.4th 136, 154-
155.) In addition to meeting the Evidence Code section 1271’s requirements for
admission as business records, the court found the documents reliable. Defendant was
able to cross-examine the experts who relied on the records in forming their opinions, had
access to discovery procedures—civil and criminal (Pen. Code, § 2972, subd. (a))9—and
was free to subpoena as witnesses and examine those individuals who prepared the
records.10 Nothing prevented defendant from presenting his “‘side of the story before a
responsible government official.’” (In re Parker (1998) 60 Cal.App.4th 1453, 1462-
1463.)
9As the civil discovery act applies to MDO proceedings (Pen. Code, § 2972, subd. (a)), defendant could have taken the depositions of the individuals who made the entries into his medical chart. (People v. Angulo, supra, 129 Cal.App.4th at p. 1368.) When defense counsel was asked whether there were “any outstanding discovery issues,” she replied, “No.”
10 The fact that entries in defendant’s medical chart are written in the third person does not mean the facts set forth therein were not observed by the staff members who made the entries.
17
For the above reasons, we conclude the admission of the Interdisciplinary Notes
did not violate defendant’s due process rights.
C. Harmless Error Argument
Having concluded that defendant’s due process rights were not violated, his
prejudicial error contention is moot.
III. DISPOSITION
The judgment is affirmed.
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
HOLLENHORST J. We concur:
RAMIREZ P.J.
MCKINSTER J.
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AI Brief
AI-generated · verify before citing
Holding. The trial court did not abuse its discretion in admitting hospital Interdisciplinary Notes as business records, and their admission did not violate the defendant's due process rights in his mentally disordered offender (MDO) recommitment proceeding.
Issues
Whether the trial court erred in admitting hospital Interdisciplinary Notes as business records under Evidence Code section 1271.
Whether the admission of the Interdisciplinary Notes violated the defendant's due process right to a fair trial and confrontation.
Disposition. Affirmed
Quotations verified verbatim against the opinion
“The Interdisciplinary Notes are reliable and fall within the umbrella of the business records exception.”
“The notes were recorded by hospital staff members for purposes of discipline and the safety of other patients and staff, and the treatment of Nelson required by her conduct.”
“The trial court did not abuse its discretion in finding a sufficient foundation to admit Exhibit 1 as a business record.”