Toward a Presumptive Admission of Medical Records Under Federal Rule of Evidence 803(4)

Despite the centrality of medical records to many of the civil cases that reach trial, the rules governing their admission into evidence are a confusing morass of hearsay exceptions and exceptions to exceptions. Some rules follow ill-conceived, common-law justifications for admitting hearsay to their increasingly illogical conclusions. Others limit the application of common-law hearsay exceptions without an apparent logical basis for doing so.

There must be a better way. The recent revisions to Federal Rules of Evidence 803(6) and 807 provide a model for such a pathway. This Article examines the current state of hearsay law as applied to medical records, critiques the peculiarities of Rules 803(4) and 803(6) with respect to those records, and assesses the concern that medical records are too inaccurate to be presumptively true. Additionally, this Article proposes that courts presumptively admit into evidence medical records prepared for an actual medical purpose, subject to specific objections to identified records. It further proposes that records made in preparation of litigation be presumptively inadmissible when offered by the declarant. Finally, this Article concludes that no amendment to the Rules of Evidence is necessary to accomplish this goal. All courts need to do is discard the yoke of common-law doctrine that has developed and return to Rule 803(4)’s plain text. This reading would invert the current interpretation of the Rule in critical ways, but would better serve courts, litigants, and the administration of justice.