FIRST DIVISION
MARCH 30, 2001

No. 1-98-4451

JUSTICE TULLY delivered the opinion of the court:

This case concerns an action for medical malpractice brought by a minorplaintiff, Paige Preston, against defendants Dr. Gayle Simmons, Dr. Mary Horan,and St. Joseph Hospital, for injuries plaintiff suffered at the time of herbirth. The jury returned a verdict in plaintiff's favor and awarded damages inthe amount of $1,010,000. Defendants thereafter filed a posttrial motion,seeking a new trial or judgment notwithstanding the verdict, which the trialcourt denied. Defendants now appeal from that order, arguing a new trial is orjudgement notwithstanding the verdict is warranted because: (1) the trial courtimproperly coerced the jury into rendering a verdict when the jury wasdeadlocked; (2) the trial court allowed the use of prejudicial demonstrative evidence; (3)plaintiff's counsel violated motions in limine barring certain evidence;(4) plaintiff's counsel improperly cross-examined defendants' medical expert;(5) the trial court improperly circumscribed defendants' cross-examination ofplaintiff's witness; (6) plaintiff's counsel engaged in improper closingargument; (7) the trial court issued instructions on damages not supported byany evidence; (8) the jury awarded excessive damages and (9) the verdict wasagainst the manifest weight of the evidence. This court has jurisdictionpursuant to Supreme Court Rules 301 and 303 (155 Ill. 2d Rs. 301, 303). For thereasons set forth below, we reverse and remand for a new trial.

Background

On May 15, 1991, Patricia Preston gave birth to plaintiff at St. JosephHospital. In the course of delivery, plaintiff's shoulder became impacted underMrs. Preston's pelvic bone, a condition known as shoulder dystocia. Shoulderdystocia is a potentially emergent condition because the infant may be deprivedof oxygen until the shoulder is released and the infant is delivered.Defendants, Dr. Gayle Simmons (Dr. Simmons), a board-certified obstetrician andgynecologist, and Dr. Mary Horan (Dr. Horan), a first-year obstetrics andgynecology resident, were in attendance during Mrs. Preston's labor and utilizedseveral techniques to try to release plaintiff's shoulder. After severalattempts, plaintiff was released and delivered, but she suffered an injury tothe nerves in her left arm and shoulder, known as a brachial plexus nerveinjury, permanently depriving her of some use of her left arm. Plaintiffthereafter brought a medical malpractice action alleging Dr. Simmons failed toproperly supervise Dr. Horan, and Dr. Simmons and Dr. Horan failed to use theproper techniques when delivering plaintiff, thereby causing her injury. A jurytrial commenced on March 24, 1998.

Dr. Simmons testified at trial that she had seven years' experience in labor,delivery and performing shoulder dystocia maneuvers, had trained residents toperform these maneuvers during her tenure as St. Joseph's assistant medicaldirector, and had trained Dr. Horan in shoulder dystocia maneuvers and performed50 deliveries with Dr. Horan prior to plaintiff's delivery. Dr. Simmons statedthat when Mrs. Preston arrived at St. Joseph Hospital, she and Dr. Horanexamined her to determine her stage of labor. At 11:30 a.m., Mrs. Preston wascompletely dilated and Dr. Simmons and Dr. Horan began the delivery ofplaintiff. Mrs. Preston lay supine on a delivery bed, Dr. Simmons and Dr. Horanstood between her legs, guiding plaintiff's head down the birth canal, and ElmerPreston, plaintiff's father and Mrs. Preston's husband, stood on the right sideof Mrs. Preston. At 11:37 a.m., plaintiff's head was delivered and Dr. Simmonssuctioned plaintiff's mouth and nostrils to remove fetal stool and amnioticfluid. Dr. Horan felt for the umbilical cord and informed Dr. Simmons that itwas wound tightly around plaintiff's neck. Dr. Simmons cut the cord and placedher hands over Dr. Horan's hands to correctly position them for delivery. Dr.Horan attempted to deliver plaintiff, applying gentle downward traction, butdiscovered plaintiff's shoulder was impacted. When Dr. Horan alerted Dr. Simmonsto this fact, Dr. Simmons pushed Ms. Preston's left leg back, applied suprapubic pressure, and told Dr. Horan to attempt delivery again. Dr. Simmonsrepresented that in shoulder dystocia cases, supra pubic pressure is anappropriate procedure to dislodge an impacted shoulder, while progressively moreinvasive procedures are used if the shoulder cannot be freed. Dr. Horan triedgentle downward traction again, but plaintiff's shoulder remained impacted. Wheninformed of this, Dr. Simmons called over two nurses to help perform a McRobertsmaneuver. A McRoberts maneuver involves hyper-flexing both of the mother's legs,while applying supra pubic pressure to the mother and gentle downward tractionto the infant. The maneuver facilitates delivery by flattening the mother'sbackbone and rotating the pelvic bone, creating a larger opening for the infantto be delivered through. Two nurses held both of Mrs. Preston's legs back, whileDr. Simmons applied supra pubic pressure, and Dr. Horan applied gentle downwardtraction to plaintiff. Plaintiff was delivered easily at 11:40 a.m., but in theprocess of delivery, the nerves in her left shoulder and arm were stretched,resulting in a brachial plexus nerve injury. In Dr. Simmons opinion, plaintiff'sinjury was caused by the impaction of her shoulder under Mrs. Preston's pelvicbone, and Dr. Horan acted within the normal scope of expertise as a first-yearresident in aiding in plaintiff's delivery.

Dr. Horan testified that she was a board-certified obstetrician andgynecologist, but at the time of plaintiff's delivery, she was in the tenthmonth of her first year of a four-year residency in obstetrics and gynecology.In her first year of residency, Dr. Horan performed roughly 270 deliveries,supervised by an attending physician, was trained in shoulder dystociamaneuvers, and was present during four to five shoulder dystocia deliveries,prior to plaintiff's delivery. Dr. Horan agreed that too much traction couldcause a brachial plexus injury by stretching the nerves in an infant's neck andshoulders. Dr. Horan could not quantify in pounds the amount of force she usedin delivering plaintiff because the proper amount of traction could only bemeasured by feel. Dr. Horan stated that the amount of traction used on an infantduring delivery does not vary according to whether a delivery is normal orwhether a shoulder dystocia delivery is indicated, because gentle downwardtraction is the only appropriate force. Dr. Horan testified that she used gentledownward traction at all times when attempting to deliver plaintiff.

Elmer Preston testified on behalf of plaintiff at trial. Prior to examinationof Mr. Preston, the court granted plaintiff's motion in limine, overdefendants' objection, to bar cross-examination of Mr. Preston concerning hisestrangement from Mrs. Preston and the fact that he lived with another womanoutside Illinois, so long as the direct testimony did not invite inquiry intothese issues.

Mr. Preston testified that when plaintiff's delivery began, he stood on theright side of Mrs. Preston, while Dr. Horan and Dr. Simmons stood between Mrs.Preston's legs. When plaintiff's head was delivered, Dr. Horan stated that theumbilical cord was around plaintiff's neck, at which point the doctors cut theumbilical cord and suctioned plaintiff. After the cord was cut, Dr. Horan beganpulling on plaintiff's head, while Dr. Simmons pushed Mrs. Preston's leg back,but did not apply pressure to Mrs. Preston's abdominal or pubic area. Dr. Horancontinued to pull on plaintiff's head, harder and harder, and at one point, puther leg up on the side of the bed to gain greater leverage when pulling onplaintiff's head. Mr. Preston told the doctors to go easy, but they ignored him.Some time later, Dr. Simmons and a nurse pulled both of Mrs. Preston's legsback, and plaintiff was delivered easily. Mr. Preston testified that he had anopportunity to observe plaintiff over the years at various times, and that avideo-tape and photographs shown at trial accurately depicted plaintiff'sdisabilities and disfigurement.

Mrs. Preston testified that at the time of plaintiff's delivery, Dr. Simmonsand Dr. Horan stood between her legs, while Mr. Preston stood on her right side.After the doctors told Mrs. Preston to push for the second time, plaintiff'shead was delivered. The doctors then told Mrs. Preston to stop pushing, and oneof them said that the cord was around plaintiff's neck. From her position, Mrs.Preston could not see the doctor's hands, but she could see the upper part oftheir bodies and shoulders. After the cord was cut and plaintiff was suctioned,the doctors told Mrs. Preston to push again. At some point, someone said thatplaintiff's shoulder was stuck, and the doctors again told Mrs. Preston to stoppushing. Dr. Simmons pushed Mrs. Preston's left leg back toward her chest, whileDr. Horan tried again to deliver plaintiff. Dr. Simmons did not apply pressureto Mrs. Preston's abdominal or pelvic area at any time during the delivery. Mrs.Preston asked the doctors if her husband could help, but they did not respond toher. Dr. Horan applied gentle pressure when first attempting to deliverplaintiff, but her movements became more vigorous and rapid after plaintiff'sshoulder became stuck. At one point, Mrs. Preston heard Mr. Preston say,"Easy, easy, you're hurting the baby." Eventually, one of the nursescame to Mrs. Preston's left side and joined Dr. Simmons in pressing on Mrs.Preston's left leg. Mrs. Preston was uncomfortable with one leg pushed back, soshe pulled her right leg back on her own, at which point, plaintiff deliveredeasily.

Dr. John Long, a board-certified obstetrician and gynecologist, testified onbehalf of plaintiff. Dr. Long stated that Dr. Simmons breached the standard ofcare by pushing back only one leg when attempting to release plaintiff'simpacted shoulder. Dr. Long stated that pushing back one leg compounds theproblem in a shoulder dystocia case because this action does not raise themother's pelvic bone, and instead tilts the pelvic bone, creating a kink in thebirth canal and a smaller opening for the infant to be delivered through. Dr.Long represented that although pushing one leg back does not harm an infant, ithinders the delivery process. Dr. Long testified that a proper McRobertsmaneuver, by contrast, which involves pushing both legs back to the chest andapplying supra pubic pressure, facilitates delivery by changing the angle of thebirth canal and the pelvic bone. Dr. Long stated that Simmons deviated from thestandard of care by allowing Dr. Horan, a first-year resident, to perform themost difficult part of delivery in an emergency situation, and Dr. Horan, inturn, deviated from the standard of care by applying too much traction whenattempting to deliver plaintiff. In Dr. Long's opinion, too much traction wasmost likely the cause of plaintiff's brachial plexus injury.

At the prompting of plaintiff's counsel, Dr. Long stated that he had examinedthe mechanics of a human skeletal model and that the use of that model wouldhelp him to explain his testimony. Using the skeletal model, Dr. Longdemonstrated what happens to the pelvic bone when one leg is pushed back.Defense counsel objected to the demonstration on the basis that the skeletalmodel distorted the movements of the pelvis because the model's legs wereaffixed with rubber ligaments on only one side, the spine was fixed to thepelvic region with screws, and the skeleton was of male rather than female, butthe trial court allowed the demonstration. On cross-examination, Dr. Longadmitted that the skeleton model used in his demonstration was probably of amale skeleton, because a woman's pelvis is rounder. Dr. Long also stated thatunlike the model, an actual woman would have ligaments on both legs, and herspine would move when her leg was pushed back.

Dr. Michael Hughey, a board-certified obstetrician and gynecologist,testified on behalf of defendant. Dr. Hughey stated Dr. Simmons complied withthe standard of care when delivering plaintiff because pushing one leg back andapplying supra pubic pressure was an appropriate way to treat shoulder dystocia,separate and apart from the McRoberts maneuver. Dr. Hughey stated that Dr. Horanwas qualified to participate to the extent she did in plaintiff's delivery, andthat her application of mild to moderate downward traction, as she described,also conformed to the standard of care. Dr. Hughey testified that a brachialplexus injury may occur in a shoulder dystocia delivery, in the absence of anynegligence, because maternal pushing and delivery maneuvers, even properlyperformed, may stretch the brachial plexus nerves. In Dr. Hughey's opinion,plaintiff's injury occurred while she was coming through the birth canal.

On cross-examination, plaintiff's counsel questioned Dr. Hughey concerningrepresentations he made at the time of his deposition regarding the location ofan instructional video on shoulder dystocia. The videotape itself was neverintroduced at trial and its location was not at issue. Defense counsel objectedto this cross-examination on the basis it was irrelevant, and the issue of thetape's location entirely collateral. The trial court overruled the objection,finding Dr. Hughey's deposition answers had bearing upon his candor andcredibility as a witness.

On cross-examination, plaintiff's counsel also asked Dr. Hughey if he hadever been represented by defense counsel's law firm, to which Dr. Hughey repliedhe had not. Plaintiff's counsel produced a notice of filing from a 1988 case,Caftori v. Hughey, showing that defense counsel's law firm filed an appearanceon behalf of Dr. Hughey. When asked by plaintiff's counsel if the notice offiling was false, Dr. Hughey responded he had no knowledge of having beenrepresented by defense counsel's firm in the past. In a sidebar conference,defense counsel objected to this line of questioning on the basis that neitherDr. Hughey nor defense counsel had any knowledge of the prior representation inthe Caftori lawsuit, and plaintiff's counsel had failed to properly disclosethis as a basis for impeachment prior to trial. After further investigation, thecourt determined that the Dr. Hughey's insurance carrier had retained defensecounsel's firm to file an appearance on behalf of Dr. Hughey, but it did notappear that Dr. Hughey ever had any contact with the firm, because the matterwas settled and dismissed. The trial court ultimately overruled defensecounsel's objection to the impeachment, but instructed the jury not to inferanything negative about defense counsel's firm from the evidence.

Dr. Alan Free, plaintiff's pediatrician, testified concerning the extent ofplaintiff's injury. Dr. Free stated that after diagnosing plaintiff's brachialplexus injury, he advised that she be enrolled in physical therapy. In the firstsix to nine months of therapy, plaintiff experienced good improvement, butreached a permanent plateau thereafter. Plaintiff had regained good strength inher lower arm, such that from her elbow down she was essentially normal.However, plaintiff still could not fully extend her arm from the elbow, herupper arm and shoulder continued to display marked weakness, and there was somedisproportion between her left arm and her right arm because of the lack ofmuscle development in the left. Dr. Free believed that occupational therapywould be appropriate for plaintiff in the future.

Dr. Norris Carroll, a pediatric orthopedic physician, estimated thatplaintiff had recovered roughly 75% from her original brachial plexus injury.Dr. Norris stated that although plaintiff's left arm would never be normal, itwould serve as a good assist limb in daily living. Dr. Norris stated thatplaintiff remained unable to lift her left arm over her head, could move herleft arm away from her side to a 30 degree angle, and her left arm was shorterthan her right arm, a discrepancy that would become more apparent as she aged.Dr. Carroll stated that although plaintiff would experience continuingfunctional impairment, she would be able to hold employment, with someoccupational limitations. In Dr. Carroll's opinion, surgery was not appropriateto treat plaintiff's condition.

Dr. Robert Eilers, a board-certified physical rehabilitation physician,testified that plaintiff's nerve damage was a static, permanent injury. Dr.Eilers agreed with Dr. Carroll's rough estimate of a 75 % recovery, and thatsurgery, while an option, was not recommended in plaintiff's case. Dr. Eilersstated that plaintiff would remain unable to bear weight with her left arm,could experience lower back strain in the future, and would always exhibitasymmetry between her left and right shoulders. Dr. Eilers stated thatplaintiff's fine motor coordination was normal, and she would be able to drive,use a keyboard or play piano with adaptations, although sports and activitiesinvolving balance or throwing overhead would be challenging. Dr. Eilersrepresented that plaintiff would have to continue to develop compensationtechniques to deal with her left arm's deficits, and additional physical therapywould be appropriate in the future.

On Friday, April 3, 1998, jury instructions were tendered to the jury. Overdefense counsel's objection, the trial court instructed the jury that it couldaward plaintiff damages for "the present cash value of earnings reasonablycertain to be lost in the future." At 2:08 the jury began deliberations,which lasted until 8:15 p.m. that day. On Monday, April 6, at 10:15 a.m., thejury reconvened for deliberations. At 12:15 p.m., the jury foreman informed thetrial judge that the jury could not reach an agreement. The trial judge informedcounsel for both parties of the deadlock and stated his intention to issueIllinois Pattern Jury Instructions, Civil, No. 1.05 (3d ed. 1995) (hereinafterIPI Civil 3d No. 1.05 ) as a deadlock jury instruction, as well as additionalcomments concerning the repercussions of a deadlock. Defense counsel objected toany instructions or comments beyond IPI Civil 3d No. 1.05 because the case wasclose. Over objection, the trial judge issued the following remarks to the jury:

"I have this instruction that I'm going to give you and then I'm going to require that you return to the jury room and continue your deliberations. And before I give that instruction I'm going to tell you that in roughly 14 years that I have sat as a judge presiding over jury trials I have had one other occasion in which a jury was not capable of reaching a unanimous verdict, that's referred to as a hung jury. The result of that is of course that you start all over again, pick a new jury and present all of your evidence once again. That is a very expensive undertaking to both sides [in] a contested lawsuit. It involves taking up the jury time of 12 other citizens and the Court's time instead of hearing another case that has not yet had its opportunity to be here.

And in that one instance, let me tell you that the second jury reached a verdict and I did not perceive any variance in the evidence that was presented the second time from that which was presented the first time. And I asked myself what was the difference, and the only difference that I could understand because I was not part of the deliberations was that the second jury was able to take the same facts, filter it and make a determination of how the case should be decided.

I'm very pleased with the composition of this jury. I believe that each one of you is an intelligent, fair-minded, honest human being who chooses to do the right thing. I'm not saying this to you so that you feel badly or that you question your own integrity or honesty nor am I attempting to influence your determination because if in fact you cannot reach a verdict then that is the law and that's what we'll live with and another jury will hear the case. If these cases were easy, we wouldn't need you."

After issuing these remarks, the trial judge issued IPI Civil 3d No. 1.05, asfollows:

"This is an instruction which the Court gives to you which you are to consider together with all the other instructions that the Court previously has provided to you.

The verdict must represent the considered judgment of each juror. In order to return a verdict, it is necessary that each juror agree to it and your verdict must be unanimous. It is your duty as jurors to consult with one another and deliberate with a view to reaching an agreement, if you can do so without violence to individual judgment. Each of you must decide the case for yourself but do so only after an impartial consideration of the evidence with your fellow jurors. In the course of your deliberations do not hesitate to reexamine your own views and change your opinion if convinced it is erroneous, but do not surrender your honest conviction as to the weight or affect of evidence solely because of the opinion of your fellow jurors or for the mere purpose of returning a verdict. You are not partisans, you are judges, judges of the facts, and your sole interest is to ascertain the truth from the evidence in the case. Bless all of you. I ask that you now please return to the jury room and continue your deliberations."

After the deadlock instructions were given, the jury deliberated for threemore hours. At 3:05 p.m., the jury returned a verdict in favor of plaintiff.Defendants thereafter filed a posttrial motion, attaching the affidavits of sixjurors, who represented that they felt coerced into returning a verdict by thejudge's comments. The trial court struck the affidavits as an improper means ofimpeaching the verdict and denied the posttrial motion. This appeal followed.

Discussion

Defendants first contend that the trial court's instructions on the issue ofdeadlock were coercive and prejudicial. In conjunction, defendants maintain thetrial court erred in failing to consider the affidavits of the jurors concerningthe coercive impact the instructions had on the process of reaching a verdict.

As a preliminary issue, we find no error in the trial court's determinationto strike the jurors' affidavits impeaching the verdict. The affidavits ofjurors cannot be used to show that the jury misunderstood the instructions orthe law. Chalmers v. City of Chicago, 88 Ill. 2d 532, 539 (1982).Accordingly, we grant no consideration to these affidavits in resolving thisissue and look solely to the language of the instruction itself and surroundingcircumstances to determine if there was error.

When a jury communicates to the court its inability to reach a unanimousverdict, the court may, in its discretion, proffer some guidance, including thegiving of a supplemental instruction. People v. Lee, 303 Ill. App. 3d356, 363 (1999). In People v. Prim, 53 Ill. 2d 62 (1972), the IllinoisSupreme Court set forth language to be used when instructing a deadlocked jury,and IPI Civil 3d No. 1.05 directly adopts the language endorsed by the courtthere. Defendants' claim of error is not directed to the giving of IPI Civil 3dNo. 1.05, however, but to the court's supplemental, non-IPI deadlockinstructions. Nevertheless, we must examine the court's supplementalinstructions together with IPI Civil 3d No. 1.05, to determine if theinstructions as a whole resulted in prejudice. Paz v. Commonwealth Edison,314 Ill. App. 3d 591, 601(2000) (jury instructions must be considered as wholeto determine if prejudice resulted to the complaining party).

Generally, amplification or clarification of IPI instructions is permitted,but only in limited circumstances, where an IPI instruction is inadequate and anadditional instruction is appropriate. Podoba v. Pyramid Electric, Inc.,281 Ill. App. 3d 545, 552 (1996), citing Lay v. Knapp, 93 Ill. App. 3d855, 857-58 (1981). Where an IPI instruction is adequate to charge the jury, theuse of a non-IPI instruction is considered improper. Hilst v. General MotorsCorp., 305 Ill. App. 3d 792, 797 (1999). If a court determines an IPIinstruction is inadequate, Illinois Supreme Court Rule 239(a) (177 Ill. 2d R.239(a)) dictates that the instruction fashioned by the court be "simple,brief, impartial, and free from argument." Similarly, if a court determinesto fashion an instruction specifically to instruct a deadlocked jury, theinstruction must be "simple, neutral and not coercive." People v.Gregory, 184 Ill. App. 3d 676, 681 (1989). In reviewing the propriety of asupplemental deadlock instruction, the test is whether, under the totality ofcircumstances, the language used actually coerced or interfered with thedeliberations of the jury to the prejudice of the defendant. People v. Branch,123 Ill. App. 3d at 245, 250-51 (1984).

In this case, we agree it was improper for the trial court to issue thesupplemental deadlock instructions. IPI Civil 3d No. 1.05 by itself was adequateto charge the jury with the importance of pursuing an agreement, and no furtherinstructions were necessary or appropriate. Considering the deadlockinstructions as a whole in the context of this case, we believe the instructionsalso had the effect of impermissibly pressuring the jury to return a verdict.Although the jurors were instructed not to surrender their honest convictions,pursuant to IPI Civil 3d No. 1.05, and although trial judge pointedly advisedthe jurors he was not attempting to influence them and would "livewith" their failure to reach a verdict, other comments made by the judgesent a very different message. To begin, we find the judge's emphasis on thetime and expense invested by the parties and the judiciary laid undue stress oneconomic factors and the importance of returning a verdict. In addition, thejudge's intimation that a failure to reach a verdict would deprive another caseof the "opportunity" to be heard may well have led the jurors tobelieve it was their duty to return a verdict. The judge additionally commentedthat in his 14 years as a judge, he had only experienced one hung jury, and inhis opinion, the only difference between the first trial and the second was thatthe second jury was able to "take the same facts, filter it and make adetermination." Following this, the judge praised the jurors, stating hebelieved each of them to be an " intelligent, fair-minded, honest humanbeing who chooses to do the right thing." The problem with these commentsis that the jurors may have been left with the impression that a failure toreturn a verdict would prove the judge's appraisal of their intelligence andintegrity wrong. In addition, the judge's disclosure regarding the rarity ofhung juries, in his experience, may have impressed upon the jurors that a hungjury represented an aberration of the justice system. Considered collectively,we find the instructions worked to the prejudice of defendants and constitutereversible error.

In reaching this determination, we are cognizant that after the deadlockinstructions were issued, the jury deliberated three more hours, a notinsubstantial amount of time. However, although the length of time it took ajury to return its verdict after a supplemental instruction was given is afactor to be considered (Palanti v. Dillon Enterprises, Ltd., 303 Ill.App. 3d 58, 61 (1999)), this factor alone is not determinative of whethercoercion occurred. Gregory, 184 Ill. App. 3d at 682 . Because it isextremely difficult for a reviewing court to determine a jury's subjectivethoughts, the test of whether instructions are prejudicial ultimately must turnon whether the instruction imposed such confusion or pressure on the jury toreach a verdict that the accuracy of its verdict becomes uncertain. Gregory,184 Ill. App. 3d at 681-82; People v. Pankey, 58 Ill. App. 3d 924, 927(1978). In cases, like the present one, however, where the question of liabilityis sufficiently close that a jury might reasonably return a verdict for eitherparty, it is of even greater import that the trial be conducted in such a manneras not to improperly influence the jury. Boasiako v. Checker Taxi Co.,140 Ill. App. 3d 210, 214 (1986). Here, the deadlock instructions, at best,served to confuse the jurors and interfere with their deliberations; at worst,they served to pressure the jurors to yield their individual convictions for thesake of a verdict. Under either scenario, the integrity of the verdict isnecessarily impugned, such that a new trial is warranted.

Because we are reversing this matter and remanding for a new trial, we willaddress only the issues remaining which are likely to reoccur in a new trial.

Defendants also contend it was improper to allow the use of the skeletalmodel, in conjunction with Dr. Long's testimony, to demonstrate the effect ofpushing one leg back on the rotation of the pelvic bone. Defendants maintainthat certain of the model's characteristics, specifically, the model's malegender, the absence of rubber ligaments on one of the model's legs, and theattachment of the model's pelvic area to its spine by screws, rendered it sogrossly distorted and inaccurate that its use as demonstrative evidence was perse error.

It is within the trial court's discretion to determine whether a party maypresent demonstrative evidence to clarify an expert's testimony, and a reviewingcourt will not disturb that determination absent a clear abuse of discretion. Schulerv. Mid-Central Cardiology, 313 Ill. App. 3d 326, 337 (2000). Althoughdemonstrative evidence has no probative value in itself, court's look favorableupon its use because it can help the jury to comprehend the verbal testimony ofwitnesses and understand the issues raised at trial. Schuler, 313 Ill.App. 3d at 337. The primary considerations in determining whether demonstrativeevidence should be allowed are relevancy and fairness. Hernandez v. Schittek,305 Ill. App. 3d 925, 931 (1999). Only where demonstrative evidence isinaccurate or tends to mislead the jury will its admission constitute an abuseof discretion. Hernandez, 305 Ill. App. 3d at 932.

Having reviewed Dr. Long's testimony in relation to the skeletal model, wefind the trial court did not abuse its discretion in allowing the model to beused for demonstrative purposes. Despite the differences pointed out bydefendants between the skeletal model and an actual skeleton, the model does notappear to have been so substantially different in relevant characteristics torender its use per se error. Any distinctions between the model and anactual skeleton arguably impacted upon the weight of demonstration, not itsadmissibility. Moreover, defendants were free to explore the significance of anydistinctions during the cross-examination of Dr. Long.

However, although we find no error in permitting the use of this model indemonstration, we agree with defendants that a clearer foundation should havebeen laid before the model was introduced. For a party to introducedemonstrative evidence, a foundation must be laid by a person having personalknowledge of the object that the object is an accurate portrayal of what itpurports to show. Webb v. Angell, 155 Ill. App. 3d 848, 861 (1987). Here,Dr. Long testified that he had examined the skeletal model and believed it wouldbe useful to explain his testimony, but he omitted to testify as to the accuracyof the model's depiction of the movements of a human pelvis or, specifically, afemale pelvis. Should the skeletal model be introduced in a new trial, thisdiscrepancy in the foundation testimony should be rectified.

Defendants also maintain the trial court erred in allowing plaintiff tocross-examine Dr. Hughey concerning representations he made at his depositionregarding the whereabouts of an instructional videotape.

The record indicates that, at the time of his deposition, Dr. Hughey wasasked by plaintiff's counsel if he had with him a copy of an instructionalvideotape on shoulder dystocia, which tape was at issue at that point indiscovery but was no longer at issue at the trial. Dr. Hughey responded that hedid not have the tape with him, although he apparently had given a copy of thetape to defense counsel at the deposition. At trial, plaintiff's counselattempted to cross- examine Dr. Hughey on his failure to respond fully to theinquiry into the tape's location at his deposition. Defense counsel objected tothe cross-examination on the basis that the tape's whereabouts was irrelevantand collateral. The trial court overruled the objection, however, finding Dr.Hughey's failure to give a complete and forthcoming answer to the depositionquestion reflected on his candor as a witness.

The scope of cross-examination rests within the broad discretion of the trialcourt. Tsoukas v. Lapid, 315 Ill. App. 3d 372, 380 (2000). One of thepurposes of cross-examination is to test the credibility of the witness. McDonnellv. McPartlin, 192 Ill. 2d 505, 533 (2000). Subject to the trial court'sdiscretion in determining the relative value for such purpose, it is proper toallow inquiry into collateral matters revealing the past conduct of a witnesswhich tend to impeach the witness' credibility. See Poole v. University ofChicago, 186 Ill. App. 3d 554, 561 (1989). Thus, matters tending to show aninterest, bias or motive to testify falsely of a witness may be brought out oncross-examination, even if those matters were not brought out on directexamination. Batteast v. Wyeth Laboratories, Inc., 172 Ill. App. 3d 114,136 (1988). However, for deposition testimony to be admissible for impeachment,that testimony must contradict an in-court statement of the witness on amaterial matter. Iser v. Copley Memorial Hospital., 288 Ill. App. 3d 408,413 (1997).

In this case, Dr. Hughey never referred to the instructional videotape in hisdirect testimony, and the videotape itself, its location, contents, andexistence were never at issue, as the tape was not in evidence. Althoughplaintiff contends Dr. Hughey's responses had bearing upon his interest, biasand motive to testify falsely, we fail to see this relationship. Even assumingDr. Hughey's deposition responses concerning the tape's location had somebearing upon his credibility, the probative value of this evidence wasoutweighed by its potential for confusing and proliferating the issues. Underthe circumstances presented, Dr. Hughey's deposition testimony was notadmissible for impeachment.

Defendants also maintain the trial court erred in prohibitingcross-examination of Mr. Preston concerning his marital relations with Mrs.Preston and the fact that Mr. Preston lived with another woman in another state,rather than with plaintiff and Mrs. Preston. Defendants contend that inquiryinto this matter was permissible and invited by Mr. Preston's testimony that hehad the opportunity to observe plaintiff over the years, and a videotape andphotographs of plaintiff accurately depicted plaintiff's disfigurement anddisabilities, and Mr. Preston's intimations that he and Mrs. Preston enjoyed atraditional marital relationship.

Although the court may allow a broad scope for cross-examination, the scopecannot be so broad as to overcome the fundamental principle that only that whichis relevant is admissible. Glassman v. St. Joseph Hospital., 259 Ill.App. 3d 730, 756 (1994). Here, Mr. and Mrs. Preston's marital relationship hadno relevance to the issues in the case, and the trial court did not error inprohibiting this cross-examination. As the trial court succinctly noted, thecase revolved around injury to a minor plaintiff, not the marital relations ofher parents. Although defendants allege inquiry into these matters was invitedby Mr. Preston's direct testimony, we find no indication of this under therecord presented. Instead, it appears the trial court cautioned plaintiff'scounsel that any testimony elicited on direct tending to misrepresent Mr.Preston's marital relationship would open the door to further inquiry, andplaintiff's counsel confined his examination accordingly.

Defendants also contend that the trial court erred in allowing plaintiff'scounsel to impeach Dr. Hughey with evidence that defense counsel's firm filed anappearance on his behalf in 1988 in the case, Caftori v. Hughey. Defendantsmaintain that allowing the impeachment was improper because, among other things,the lawsuit was over ten years old and neither Dr. Hughey nor defense counselhad any knowledge of a past attorney client relationship between them.

The record indicates that although the trial court initially allowedimpeachment on this matter, the court later concluded, at the posttrial hearing,that this determination was in error because the Caftori action was settled byDr. Hughey's insurance company ten years earlier and Dr. Hughey apparently hadno knowledge of having been represented by defense counsel's firm. Under thesecircumstances, it is unnecessary to address defendants' argument in depth. Wenote only that we agree with the trial court's posttrial assessment that thisevidence was too remote and attenuated to reliably serve as impeachment.

Finally, defendants contend that the trial court erred in allowing the juryto be instructed on damages for the loss of future earnings because the evidencewas insufficient to support an instruction on this issue.

The question of what issues have been raised by the evidence is within thediscretion of the trial court. LaFever v. Kemlite Co., 185 Ill. 2d 380,406 (1998). To be entitled to an instruction on future damages, a plaintiff needonly cite to some evidence in the record to justify the theory of theinstruction. Mikus v. Norfolk & Western Ry.Co., 312 Ill. App. 3d 11,33 (2000). However, where evidence is adduced of some permanent injury to aminor child, the trier of fact may infer a future loss of earnings from thenature of an injury, and an instruction to that effect may be issued. Alvisv. Henderson Obstetrics, S.C., 227 Ill. App. 3d 1012, 1021 (1992), citing, Hartseilv. Calligan, 40 Ill. App. 3d 1067, 1069 (1976).

Here, the uncontradicted testimony established that plaintiff's injury to herleft arm was permanent. The testimony also set forth the range of plaintiff'sfunctional impairment, including a permanent inability to fully extend,manipulate or bear weight with her left arm. On this record, we find the jurycould properly a infer a loss of future earnings from the nature of the injury,as revealed in the testimony. Accordingly, we find the giving of an instructionon the loss of future earnings was not error.

For the foregoing reasons, the trial court's judgment is reversed and thiscause is remanded for a new trial.

Reversed and Remanded.

McNULTY, P.J., and O'MARA FROSSARD, J., concur.