Fyffe v. Massachusetts Bay Transportation Authority

As we explain in detail below, this is a case where, contrary to established law and the trial judge’s numerous cautions and rulings, plaintiff’s experienced trial counsel2 improperly argued (1) facts that were not in evidence, (2) concepts of *458liability, despite the parties’ stipulation that the only triable issues related to damages, and (3) that the jury were the conscience of the community and had a duty in this case to safeguard users of public transportation in the future. Plaintiff’s counsel also wil-fully disregarded the judge’s explicit rulings on a number of issues and, by defiantly challenging her rulings in front of the jury, undermined her attempts to remedy his misconduct. As a result of these numerous transgressions by plaintiff’s counsel, the judge was required to “conduct[ ] the trial under severe and exasperating handicaps.” Stavisky v. Slotnik, 19 Mass. App. Ct. 1028, 1030 (1985). Mindful of the deference we owe the judge’s determination on a motion for a new trial whether such errors were prejudicial, in this case our review of the record of this very brief trial (two full days of testimony) persuades us that the errors committed by plaintiff’s counsel, considered in their totality, “injuriously affected the substantial rights” of the defendants and deprived them of a fair trial. G. L. c. 231, §§ 119, 132. Accordingly, despite the judge’s commendable patience, we vacate the judgment and remand for a new trial.

Procedural background. The plaintiff, Colleen Fyffe, was injured on May 8, 2009, when the Massachusetts Bay Transportation Authority (MBTA) trolley in which she was riding struck another trolley on the MBTA’s Green Line in Boston. She filed suit in Superior Court against the MBTA and the operator of her trolley, Aiden Quinn, alleging that the defendants were liable in negligence. Before trial it was agreed that the plaintiff’s trolley crashed due to the negligence of the operator.3 The parties stipulated, and the trial judge instructed the jury, that the sole issue was the amount of money that would represent fair and reasonable compensation to the plaintiff for the injuries she suffered as a result of the defendants’ negligence. Also as agreed, the jury were instructed that punitive damages were not part of the case before *459them. The verdict slip called for the jury to provide a single figure representing the total of all compensatory damages, with no breakdown of the damages components on which they were instructed, such as medical expenses, lost earnings, and pain and suffering.

The jury returned a verdict awarding the plaintiff $1,228 million in damages. After the entry of judgment, the defendants timely filed a motion for a new trial or remittitur, asserting that the verdict was excessive and against the weight of the evidence; that as a result of deliberate and prejudicial misconduct by plaintiffs counsel the jurors were exposed to evidence not presented at trial; and that their verdict was reached under the influence of passion, sympathy, and prejudice. After a hearing, the trial judge issued a memorandum of decision and order denying the defendants’ motion. The defendants appeal from both that order and the judgment.

Evidence at trial. The plaintiff presented evidence that she was forty-six years old at the time of the crash; that when the trolleys collided her neck snapped sharply backwards (her seat faced the rear of her train4); that she sustained cervical and lumbar spine injuries; that she incurred medical bills in the amount of $20,309.66; that she could not return to her job as a gate agent for Delta Airlines (Delta) because her injuries prevented the required regular lifting of heavy suitcases; that her 2008 Delta wages were $32,781; that if she worked full-time for Delta, she could earn up to $40,000 annually plus benefits; and that in July of 2010 she began working in a restaurant where, in 2011, she worked two days per week, earning $15,479.

Although the defendants agreed with the plaintiff that the MBTA trolley operator was negligent, there were a number of issues they disputed at trial, including the severity and consequences of the plaintiff’s neck injury; whether her lower back injury, chronic headaches, and depression and anxiety were preexisting conditions not caused or aggravated by the collision; the extent to which the plaintiff was disabled from working; and the adequacy of the proof of damages attributable to lost earning capacity.

In order to understand the significance of remarks made by plaintiff’s counsel in his closing argument, it is necessary to set *460forth something of the testimony of the two medical experts. The plaintiff’s expert, Dr. Francis Rockett, a neurosurgeon, first saw the plaintiff in December, 2010, about twenty months following the train crash.5 6 He did not review her medical records from before the May, 2009, crash. Based on a magnetic resonance imaging (MRI) study of the plaintiff done in June, 2009,® he opined that she had a herniated cervical disc. When asked, over defense objection, “what that herniated disc is doing,” he not only stated it was “pushing against the spinal cord,” but added if the “anterior spinal ligament,” which protects the spinal cord “from further extrusion of the disc,” did not remain intact, “it would render the patient quadriplegic.”7 After another objection to a follow-up question, there was a sidebar conference. Counsel for the defendants pointed out that the subject of quadriplegia had not previously surfaced in any discovery. Plaintiff’s counsel readily *461admitted that quadriplegia was “not in question.”8 The judge assumed and plaintiff’s counsel readily acknowledged that the witness was not going to testify that the plaintiff was a quadriplegic. Dr. Rockett went on to explain that in March, 2012, he noted the plaintiff had reported pain radiating down her left arm to her left hand, and that this pain was the result of the pressure of the disc against the ligaments in the spinal canal. He added that the degree of the plaintiff’s pain depended on the degree of pressure against those ligaments. He also opined that the plaintiff’s complaints of low back pain first made about nine months after the trolley crash, and of headaches (which had also been a subject of complaints dating back to 2004), were related to that event. Dr. Rockett opined that the collision permanently disabled the plaintiff from her job as a Delta gate agent due to the requirement that such workers lift heavy pieces of luggage. Dr. Rockett did not opine that the plaintiff was permanently disabled from other types of employment that did not involve heavy lifting. See note 8, supra.

The jury also heard testimony by means of a videotaped deposition of Dr. Joseph D’Alton, a board certified neurologist called by the defendants. Dr. D’Alton did not treat or examine the plaintiff, but rendered opinions based on a review of the plaintiff’s medical records. He agreed with Dr. Rockett that the June, 2009, MRI study of the plaintiff’s neck revealed a disc herniation at C4-C5 that was caused by the trolley crash, but he described the injury far differently from Dr. Rockett.9 Dr. D’Alton testified that in most such cases the extruded disc material is reabsorbed by the body and, with physical therapy, the symptoms go away within six to twelve weeks. In particular, he interpreted the *462plaintiff’s medical records, especially the notes of her 2009 physical therapy treatment, as indicating that by November, 2009, she had improved considerably, had only mild pain, and was fit to return to work with limitations on lifting for about one month before she would be ready to resume her regular employment. He also opined that there was no causal relationship between the plaintiff’s lower back problems and the train crash.

Discussion. 1. Introduction. The defendants contend that during the opening statement, throughout the presentation of the evidence, and during closing argument, plaintiff’s counsel violated established rules of practice and evidentiary standards, frequently in direct violation of a ruling sustaining a defense objection. Observations made by the trial judge in her memorandum of decision indicate that she took the same view of the conduct of plaintiff’s counsel, noting, for example, his “efforts to elicit evidence without any apparent good faith basis to believe that such evidence would be admissible.” Although the judge responded to some of these violations by sustaining objections and giving instructions to the jury, we do not believe the actions taken by the judge cured the prejudice caused by counsel’s misconduct.

2. Opening statement by plaintiff’s counsel. “The proper function of an opening is to outline in a general way the nature of the case which the counsel expects to be able to prove or support by evidence.” Posell v. Herscovitz, 237 Mass. 513, 514 (1921). “It is not an opportunity for argument.” Commonwealth v. Croken, 432 Mass. 266, 268 (2000). In his opening, plaintiff’s counsel made multiple statements about the crash and the train operator’s actions prior to and during the crash, despite the fact that the parties had stipulated that the defendants were negligent. For example, counsel told the jury that as the trolley left Government Center station and accelerated to full speed, defendant Quinn took out his cellular telephone and called his girlfriend, leaving a voice message. The judge sustained an objection and told counsel “to concentrate on the issue that is before the jury.” Plaintiff’s counsel responded by telling the jury that the operator then composed and sent a text message to his girlfriend as the train sped by yellow and red warning lights indicating a stopped train was ahead. Another objection was sustained, and again the judge instructed counsel, “[Ljet’s move on to the issue that is before the jury.” Plaintiff’s counsel then described for the jury a scene in which the operator looked up from his telephone and saw the *463crash about to occur, despite the fact that there was no basis for counsel to believe there would be admissible evidence to support his statement. Despite several admonishments, plaintiff’s counsel persisted in referring to facts that he had no reasonable basis to expect would be proved by the evidence. Finally, the judge delivered a cautionary instruction to the jury.

However, plaintiff’s counsel disregarded the judge’s ruling and injected facts into the case that were prejudicial, not probative of the issues, and not supported by admissible evidence. For example, despite the judge’s explicit caution during a bench conference that counsel not refer to facts that would not be supported by evidence, counsel continued, “At the crash people are thrown from their seats in the trains, against the walls and on to the floor. People are seen with contorted extremities, bleeding, necks are snapped, and —.” Defense counsel objected again at this point, but the judge did not respond except by stating, “Counsel, again, you need to confine yourself to what you have reason to expect is going to come into evidence.” Contrast Rivera v. Club Caravan, Inc., 77 Mass. App. Ct. 17, 21 (2010) Gudge struck plaintiff’s counsel’s improper statement as to driver’s blood alcohol level and instructed jury that they would not receive evidence on that subject, that the statement should not have been made, and that they should disregard it).

Unlike in A.C. Vaccaro, Inc. v. Vaccaro, 80 Mass. App. Ct. 635, 640-641 (2011), where there was one improper statement in the opening, in this case there were multiple improper statements. As in Goldstein v. Gontarz, 364 Mass. 800, 811-812 (1974), where an improper statement was the basis for ordering a new trial, here the improper statements were not probative and were made deliberately — and in contravention of the judge’s numerous directives to counsel to confine his statements to the evidence and to the issue at trial.

3. Closing argument. Prior to the closing arguments, the judge gave the jurors a comprehensive instruction explaining that closing arguments were not evidence and reminding them that they must rely on their own memory of the evidence.

In keeping with customary practice, defense counsel made the first closing argument, and suggested that the central question was what is fair and reasonable compensation for the injuries that the plaintiff suffered as a result of the trolley crash. Defense counsel attempted to draw a distinction between fair compensation to the plaintiff for her injuries and a damage award that was *464intended to punish the defendants. He discussed the plaintiff’s medical records, and argued that the jury should credit the opinion of the defense medical expert who opined that the plaintiff’s injuries due to the train collision were not as significant as she claimed and that some of her complaints were not related to the defendants’ negligence. Defense counsel also stressed that there was important evidence missing from the case — in the sense that there was no evidence of how long the plaintiff, then forty-nine years old, had planned to work — to enable the jury to accurately calculate the value of the plaintiff’s loss of earning capacity in the event the jury believed that she was no longer able to work.

Plaintiff’s counsel, in stark contrast to the approach taken by defendants’ counsel, chose not to follow established rules of conduct during his closing. He told the jurors that not only were they required to answer the question submitted by the judge, but that each juror had a duty to explain to the other jurors the reason or reasons for deciding each issue in a particular way. Defense counsel objected, but the judge deferred a ruling on the matter. Plaintiff’s counsel next not only argued that the defendants’ apologies were “h[o]llow,” but in direct violation of earlier rulings by the judge and settled principles of evidence law, he added that the defendants had failed to take corrective action to prevent such collisions from happening in the future. See Mass. G. Evid. § 407(a) (2014) (evidence of subsequent remedial measures generally inadmissible).10 A defense objection was sustained, and the judge told plaintiff’s counsel to confine himself to the issue before the jury, but plaintiff’s counsel followed immediately by telling the jurors that the defendants had forced the plaintiff to bring this lawsuit. Another objection was lodged by defense counsel and sustained by the judge, who again instructed plaintiff’s counsel to confine himself to the issue and the evidence. *465Plaintiff’s counsel responded by disagreeing with the judge’s ruling and by repeating the suggestion that the MBTA had not taken responsibility for the plaintiff’s injury. Another objection was made by defense counsel, to which the judge responded by delivering a cautionary instruction.11

Plaintiff’s counsel responded to the judge’s caution with a polite “Thank you, Your Honor,” and, with his next breath, returned to his theme that the MBTA blamed the plaintiff and was not taking responsibility for her injuries: “What the MBTA has done in talking about the damages sustained by Colleen Fyffe, is to try to present to you a lack of responsibility. To try to blame Colleen Fyffe, blame other things going on in her life, and shed their responsibility and blame everything else. They’ve looked through every one of her drawers, looked into her cupboards, looked into her medical —.” Another objection was made by defense counsel, and again, the judge instructed plaintiff’s counsel to confine himself to the evidence.

A few moments later, plaintiff’s counsel returned to his theme that the MBTA sought to blame the plaintiff for her injuries, which led to another objection and another caution by the judge, who instructed plaintiff’s counsel to finish and stated she would discuss the matter with counsel at sidebar after the argument.

Plaintiff’s counsel then sailed into another theme by arguing that the jury should be aware that this was an “important coverage case,” that there may be media coverage of it, and that it would be the first verdict after the train crash.12 Following another objection, the judge gave yet another cautionary instruction tell*466ing jurors to disregard any consideration of media coverage.18

Plaintiff’s counsel moved on to discuss his client’s injuries, limitations, and ongoing impairment for the next few minutes of his closing. He told the jury that all the doctors, including the defendants’ medical expert, Dr. D’Alton, agreed that the plaintiff suffered a “severe injury.” Counsel then made an unveiled reference to Dr. Rockett’s testimony on the possibility that the plaintiff could become a quadriplegic:

“This herniated disc at C-4/5, which has left the disc space and entered into the spinal canal, impinging on our spinal cord, being held back from further damage to that spinal cord now by only a very thin fragile membrane. That thin fragile membrane being the only thing that is preventing, or presently, at this moment, holding back the further herniation of that disc into Colleen Fyffe’s spinal cord with the potential, with a risk that she lives with every day of very, very grave consequences. They don’t want to talk about that.”

Defense counsel objected and the judge sustained the objection, but plaintiff’s counsel responded by arguing with the judge, before the jury, that what he had said was “exactly what the evidence was.” The judge again told plaintiff’s counsel to confine himself to the evidence of the damages suffered by the plaintiff, and he responded, again before the jury, “[Tjhat’s exactly what I’m talking about, Your Honor.” What then followed was yet another attempt by plaintiff’s counsel, in violation of the judge’s explicit prior rulings, to use the testimony of Dr. Rockett to summon the image of his client as a person standing on the precipice of quadriplegia:

“This damage that Colleen Fyffe suffered to her spinal column, to this herniated disc is one that she lives with every day. She lives with not only the pain, not only the function or loss, not only the effects on every part of her life, but with the *467risk of the further harms that sit in the background and will sit in the background for the rest of her life. And your determination on this case will be the final determination. Your verdict will be the only verdict on this case. Your verdict will be the verdict forever. Now, Colleen Fyffe’s injury was — is not static. It is one as described by the medical evidence in the case, by Dr. Rockett, as one that changes. It changes all the time and it changes in part based upon use. The more stress, strain, use that Colleen Fyffe placed on her neck, it changes the disc. She every day walks a tightrope of whether or not there’s going to be further injury from this disc. Whether or not this membrane that is holding the disc back now from the spinal column is going to stay there. Whether it’s going to hold.”

Later, when plaintiff’s counsel finally came to the issues of causation and the various components of her damages, he injected the following: “It was the MBTA’s choice to save the money on a seat without a head restraint.” There is no evidence in the case to support this remark, which was, in any event, irrelevant to the question before the jury. Defense counsel objected, and once again the judge told plaintiff’s counsel to confine himself to the issue of damages.

After some skirmishing over whether plaintiff’s counsel should specify the amount of damages she was seeking, another remarkable exchange occurred that illustrates that plaintiff’s counsel was acting in conscious disregard of the law as well as the judge’s repeated instructions:

Plaintiff’s counsel: “On this case, you as this jury, as the jury in all cases that we do, is considered by the courts to be the conscience of the community. It is your job as the conscience of the community —”

Defense counsel: “Objection, Your Honor.”

Plaintiff’s counsel: “— to determine —”

The judge: “I’m going to be explaining to the jury their function. The only issue before the jury is the amount of the damages. Counsel, you’ve used up your time. Let’s finish now.”

Plaintiff’s counsel: “Okay. As this jury, you are the guardians of the safety of all of the moms, all of the dads, and all *468of the children, and all of the grandparents that ride in these trains. It is your —”

Defense counsel: “Objection, Your Honor.”

Plaintiff’s counsel: “— decision —”

Defense counsel: “Objection.”

Plaintiff’s counsel: “—• that —”

Defense counsel: “Move to strike any comment that —”

The judge: “I’ll address it. Counsel, finish up, please.”

Plaintiff’s counsel: “Thank you, Your Honor. It is your decision that will make the determination as to what the responsibility is by the MBTA for the protection of these people, the paying passengers of its trains. Thank you.”

The judge: “I’ll see counsel at sidebar.”

At sidebar,14 the judge informed counsel that she would address the improprieties in the closing argument by instructing the jury (1) that their role was to fix the compensation due to the plaintiff and not to punish the defendants; (2) that a juror is not under any obligation to explain his or her thinking to the other jurors; and (3) that because liability was not an issue, they were not required to determine how the trolley had been operated, or the nature of the seat or other equipment.15 However, she did not give any *469instructions on these matters at that time, instead moving on to the final jury charge.

In her final instructions, the judge addressed in direct fashion two aspects of the numerous acts of misconduct committed by plaintiff’s trial counsel. First, she instructed the jury that “[t]he news media is entirely irrelevant to your task in this case. You should give no thought to how the news media, or anyone else, might report on your verdict or might react to you.” Second, she told the jurors, “[Y]ou don’t have any sort of obligation to explain yourself to anyone. It can be helpful in the course of deliberation if, when you express a view, you explain why you hold that view, and sometimes if you give an explanation, you persuade other jurors. But you have no obligation in the course of your deliberations or at any other time to explain your views to anyone.” However, beyond these instructions that related to specific errors by plaintiff’s trial counsel, the judge did not specifically address his other misconduct, such as (1) referring to facts about the train crash that were not in evidence; (2) stating that the MBTA had tried to save money by installing a seat without a head rest; (3) stating that the MBTA had not corrected the problems that caused the plaintiff’s injury, that the MBTA forced the plaintiff to bring the lawsuit, and that it subjected her to unfair scrutiny; (4) arguing that the medical evidence was that the plaintiff lived with the daily risk of becoming a quadriplegic; and (5) arguing that the jury “are the guardians of the safety of all of the moms, all of the dads, and all of the children, and all of the grandparents that ride in these trains.” Instead the judge relied upon standard language that compensatory damages are meant to remunerate the plaintiff, not punish the defendants; that the jurors were to decide the case based on the evidence; that the lawyers’ arguments are not evidence; and that the jury had the right to believe or disbelieve the testimony of any witness, including the medical experts.16

*4704. The conduct of plamtiff’s counsel caused prejudicial error. In her memorandum of decision on the defendants’ motion for a new trial or remittitur, the judge acknowledged that plaintiff’s counsel engaged in misconduct and that he lacked any good faith basis for his actions. The judge wrote:

“The defendants] point[ ] to improprieties in the conduct of plaintiff’s counsel, particularly during opening statement and closing argument, and suggest ] that counsel’s conduct may have led the jury to act based on passion and prejudice rather than reason. The Court agrees that plaintiff’s counsel repeatedly exceeded well-established boundaries in both opening and closing, as well as in efforts to elicit evidence without any apparent good faith basis to believe that such evidence would be admissible.”17

However, the judge ultimately concluded that the curative instructions given to the jury sufficed to cure any prejudice to the defendants.

(i) Standard of review. The first question we must address is the standard of review. The plaintiff argues that our review on appeal from the denial of a motion for a new trial is limited to determining whether the judge abused her discretion. See Commonwealth v. Johnson Insulation, 425 Mass. 650, 668 (1997), citing Bartley v. Phillips, 317 Mass. 35, 41-43 (1944). We show great *471deference to the view taken by the trial judge in denying a new trial motion when the argument on appeal is based on the weight of the evidence, whether the damages awarded are excessive, or the impact of newly discovered evidence. See, e.g., Mirageas v. Massachusetts Bay Transp. Authy., 391 Mass. 815, 822 (1984); Robertson v. Gaston Snow & Ely Bartlett, 404 Mass. 515, 520, cert, denied, 493 U.S. 894 (1989); VanAlstyne v. Whalen, 15 Mass. App. Ct. 340, 349-350 (1983). However, this case is also before us on direct appeal from the judgment. Therefore, the deferential standard applicable to review of the new trial motion does not relieve us of the duty to examine the record to determine whether instructions that were given or not given by the judge when a matter was properly brought to her attention amounted to an error of law, and to assess whether the error was prejudicial.18 See Elart v. Morris & Co., 259 Mass. 211, 214-215 (1927). Whether remedial instructions given during the trial in response to an objection that is sustained or at the conclusion of the trial during the judge’s final charge are adequately curative presents a question of law. See Goldstein v. Gontarz, 364 Mass, at 811.

*472(ii) Determining whether there was prejudicial error. To properly assess the errors committed by plaintiff’s trial counsel in this civil case, it is instructive to consider the framework that is used to evaluate allegations of misconduct by counsel in criminal cases, notwithstanding obvious differences in the review that takes place in criminal appeals. We consider “(1) whether the defendant seasonably objected; (2) whether the error was limited to collateral issues or went to the heart of the case; (3) what specific or general instructions the judge gave to the jury which may have mitigated the mistake; and (4) whether the error, in the circumstances, possibly made a difference in the jury’s conclusion.” Commonwealth v. Lewis, 465 Mass. 119, 130-131 (2013), quoting from Commonwealth v. Kater, 432 Mass. 404, 422-423 (2000). See Commonwealth v. Kozec, 399 Mass. 514, 518 (1987). The record here indicates that the defendants seasonably and repeatedly objected; that the misconduct by plaintiff’s counsel related to the central issues in dispute; that although the judge responded to many of counsel’s improper statements, the corrective measures taken were not sufficient to negate the prejudice; and that the cumulative effect of counsel’s misconduct deprived the defendants of a fair trial. In particular, on several occasions during his closing argument, plaintiff’s trial counsel challenged the judge in front of the jury as she instructed him to confine himself to the evidence. We also attach significance to the fact that during his closing argument to the jury, plaintiff’s trial counsel was permitted to state that in assessing fair compensation for her injuries, the jury should consider the possibility that at any time in the future, without warning, the plaintiff would become a quadriplegic because “a very thin fragile membrane,” which was all that protected her spinal column from a herniated disc, could fail to hold the disc back from her spinal cord. This was not within the realm of a reasonable inference from the medical evidence, and invited the jury to speculate about the central issue in the case — fair compensation for the injury suffered by the plaintiff.

An isolated remark, even several remarks in a closing argument that make reference to matters that are not in evidence, when followed by an objection and a curative instruction directing jurors to disregard the remark, will not support an argument on appeal that there was prejudicial error requiring a new trial. See, e.g., Haddad v. Wal-Mart Stores, Inc. (No. 1), 455 Mass. 91, 112 (2009). While much is left to the discretion of the trial judge in *473assessing the impact of errors in a closing argument, see Gath v. M/A-Com, Inc., 440 Mass. 482, 495 (2003), this case stands apart from most cases in which errors in a closing argument are alleged to require a new trial. In this case, in which the evidence unfolded over the course of only two days, the improper remarks permeated the opening and closing arguments, with plaintiff’s experienced counsel deliberately disregarding the judge’s directives and pretrial rulings, openly arguing with her, and defiantly, forcefully, and repeatedly making irrelevant and prejudicial statements.19 We do not believe the judge’s final charge was sufficient to counter the damage. See Goldstein v. Gontarz, 364 Mass, at 811. Defense counsel’s numerous objections at trial, especially during plaintiff’s counsel’s closing argument, were sufficient to call the misconduct of opposing counsel to the judge’s attention and to impose on her a duty to take corrective action. See Harlow v. Chin, 405 Mass. 697, 703 n.5 (1989). See also note 14, supra. While the trial judge was unfailingly patient and issued numerous cautions to plaintiff’s trial counsel, the steps that were taken were not sufficient.

Our conclusion as to unremedied prejudice finds support in the amount of the damages awarded by the jury. In denying the defendants’ motion for a new trial or remittitur the judge reasoned in part that relief was unwarranted because the $1,228 million damages award was not disproportionate to the evidence. Although we are not prepared to say that the judge abused her discretion in denying remittitur,20 we take the view that because the amount awarded seems to lie in the upper range of what may be borne by the evidence, it suggests a significant risk that the jury’s assessment of damages was affected by the numerous *474improprieties of plaintiff’s counsel.21 Perhaps chief among these is the argument by counsel that the plaintiff would live every remaining day of her life with the real possibility of becoming a quadriplegic, where there was no record evidence to support such speculation.

The judge reasoned in part that “the consequences of counsel’s fault should not be visited on his client.” However, that is not the question before us. Ultimately, the question before us is whether there was an unacceptable risk that plaintiff’s counsel’s misconduct had a material effect on the jury’s decision. Application of the prejudicial error standard under G. L. c. 231, §§ 119, 132, requires us to undertake a case-by-case analysis. The substantial rights of a party are adversely affected when, “viewing the record in a commonsense way,” the misconduct of a party or counsel “could have made a material difference” in the outcome. DeJesus v. Yogel, 404 Mass. 44,48 (1989). Here, the jury were asked only to determine the cause, nature, and extent of the plaintiff’s injuries and to assign to those attributable to the negligence of the defendants a dollar value that would represent fair compensation to the plaintiff. We think that plaintiff’s trial counsel’s numerous *475inflammatory remarks and efforts to inject facts beyond the record into the trial, especially unfounded statements about the plaintiff’s risk of future harm and the defendant MBTA’s indifference to rider safety, could have influenced the jury’s decision-making process, and thus deprived the defendants of a fair trial. The sheer number of counsel’s acts of misconduct cannot be minimized or overlooked. See Williams v. Drake, 146 F.3d 44,49 (1st Cir. 1998) (“[individual miscues, while insufficient in themselves to warrant a new trial, [may] have an aggregate effect that impugns the fairness of the proceedings and thus undermines the trustworthiness of the verdict”). See also Leone v. Doran, 363 Mass. 1, 6, S.C., 363 Mass. 886 (1973). Although the judge sustained numerous objections, told the jury that argument by the lawyers was not evidence, and gave jurors cautionary instructions about some of counsel’s improper statements, the rubric that jurors are presumed to follow the judge’s instructions does not mean that a curative or cautionary instruction always suffices to remove the stain of what otherwise would be prejudicial error. See Allen v. Boston Elev. Ry., 212 Mass. 191, 194 (1912).

Conclusion. It is instructive to consider the observation made by the United States Court of Appeals for the First Circuit in Polonsky v. CNA Ins. Co., 852 F.2d 626, 632 (1st Cir. 1988):

“[W]e do not view favorably any attempt ‘to play fast and loose’ with our judicial system. Too often a lawyer loses sight of his primary responsibility as an officer of the court. While he must provide ‘zealous advocacy’ for his client’s cause, we encourage this only as a means of achieving the court’s ultimate goal, which is finding the truth. Deceptions, misrepresentations, or falsities can only frustrate that goal and will not be tolerated within our judicial system.” (Citations and footnote omitted.)

Ultimately, we conclude that the judge’s efforts to address the numerous and repeated violations of the law by plaintiff’s trial counsel fell short. We cannot say “with substantial confidence” that the errors committed by plaintiff’s counsel did not make a material difference in the outcome. DeJesus v. Yogel, 404 Mass, at 49. Accordingly, we vacate the judgment and remand the case for a new trial.22

So ordered.