People v. Rippberger
| Decision Date | 05 July 1991 |
| Docket Number | No. A047810,A047810 |
| Citation | 231 Cal.App.3d 1667,283 Cal.Rptr. 111 |
| Court | California Court of Appeals Court of Appeals |
| Parties | The PEOPLE of the State of California, Plaintiff and Respondent, v. Mark Lynn RIPPBERGER et al., Defendants and Appellants. |
David E. Mackenroth, Robert A. Cutbirth, Mackenroth, Seley & Anwyl, Sacramento, for defendants and appellants.
John K. Van de Kamp, Atty. Gen., Richard B. Iglehart, Chief Asst. Atty. Gen., John H. Sugiyama, Sr. Asst. Atty. Gen., Herbert F. Wilkinson, Supervising Deputy Atty. Gen., Clifford K. Thompson, Jr., Deputy Atty. Gen., San Francisco, for plaintiff and respondent.
Mark Lynn Rippberger and his wife Susan Edna Middleton appeal from a conviction of felony child endangerment. The conviction was based on the death of appellants' 8-month-old daughter, caused by bacterial meningitis after a 15-day illness during which appellants withheld medical attention and treatment on the basis of their beliefs as Christian Scientists. We affirm the judgment of conviction.
Eight-month-old Natalie Middleton-Rippberger died on December 9, 1984. Subsequently, on the basis of an autopsy, her death was determined to have been caused by acute purulent meningitis. Appellants Rippberger and Middleton were charged by information with involuntary manslaughter (Pen.Code, § 192, subd. (b)) and felony child endangerment (Pen.Code, § 273a, subd. (1)). After the trial court's overruling of appellants' demurrer and denial of their motion to dismiss, and this court's denial of appellants' petition for a writ of prohibition and stay of trial, the Supreme Court stayed the trial and granted review. After the filing of its opinion in Walker v. Superior Court (1988) 47 Cal.3d 112, 253 Cal.Rptr. 1, 763 P.2d 852 (hereafter Walker), the Supreme Court dismissed appellants' petition, vacated the stay and remanded the matter to this court. We then returned the case to the trial court.
At trial before a jury, the prosecution offered the testimony of three witnesses to prove that appellants wrongfully endangered the life and health of their daughter by willfully withholding medical care from her: Therese Miller, a Christian Science visiting nurse; A. Jay Chapman, M.D., a forensic pathologist, and Michael W. Witwer, M.D., an expert in infectious diseases. It was stipulated that Natalie was appellants' child, and that she died at their home on December 9, 1984.
Miller testified that at all times relevant to this case, she was a Christian Science graduate visiting nurse, who had completed a three-year course of training at a Christian Science accredited facility and worked full-time making house calls at the homes of Christian Scientists. On December 2, 1984, she was summoned to appellants' home in the vicinity of Healdsburg either by appellants or by "the Christian Science Practitioner on the case." As a visiting Christian Science nurse, she could not have been called onto the case unless there was an attending Christian Science practitioner involved.
When Miller arrived at appellants' home on December 2, she found both of them with Natalie, along with their other children. Miller found that Natalie "was very warm to the touch"; that she was "somewhat responsive"; that "her eyes tended to roll back in her head"; and that "she cried when her position was changed." Miller testified that she did not use a thermometer to ascertain the child's temperature, because "as Christian Science nurses we do not take temperatures." Appellants told Miller that Natalie had already been sick for seven days.
After staying with the child for an hour, Miller "just advised [appellants] to keep the baby warm and to keep trying to give [her] nourishment." She also recommended that appellants notify the Christian Science Church Committee on Publications because Natalie's case did not appear to be responding to prayerful treatment as quickly as it should be. Miller described the Committee on Publications as a Church organization that oversees the "legal aspects of things" and that stays "in touch with cases that maybe aren't yielding as quickly to the prayerful treatment as they should be." Miller also reported her findings to appellants' Christian Science practitioner.
Thereafter, Miller visited appellants every day for several days. During her second visit on December 3, 1984, Miller observed no change in Natalie's condition. However, the next day, December 4, Miller observed that the infant's eyes were "rolling or jerking"; her tongue "tended to roll up a little bit"; her legs were "very rigid"; and she was unable to bend her legs at the knees. Appellant Susan Middleton told Miller that Natalie had lost some weight and was "sweating a lot." Miller had never seen a baby with this particular set of symptoms before in her experience as a Christian Science nurse. The next day, December 5, Miller noted that there was "nothing new" in Natalie's condition. Up to this point, Miller had spent an hour at appellants' house on each of her visits.
December 6, 1984, was the twelfth day of Natalie's illness. When Miller visited appellants' home that day, the child's condition had deteriorated. Natalie was having "what appeared to be heavy convulsions." Miller testified that "[s]he was very rigid, the eyes were really rolling back, and she appeared not responsive." Miller discussed Natalie's condition with appellants, and told them that "the situation was serious." However, she did not suggest that they obtain any medical care for Natalie. Miller changed the baby's diaper and sheets, bathed her, and then "gave silent reading, which is also something Christian Science nurses do." This consisted of silently reading from the Bible and Christian Science scriptures, as well as praying. After Natalie fell into a "restless sleep" around 6:40 p.m., Miller left.
She returned at 8:30 p.m., at appellants' request. Natalie "had awakened to heavy convulsions and she felt very hot to touch." Miller spent that night at appellants' home, alternately sleeping, praying, reading scriptures, and "voicing the truth to the baby." Although Natalie's condition was obviously worse, Miller testified that she never called for a medical doctor to come and assist because Early the next morning, after Miller had fed her some milk and water, Natalie again went into convulsions. Miller called the Christian Science practitioner and prayed. After changing the infant's sweat-soaked clothing and bedding, and giving her a sponge bath, Miller left appellants' house. At that time, approximately 7 a.m. on December 7, 1984, Natalie was "resting."
During the remainder of December 7 and all the next day, Miller was busy with other cases. Her Christian Science relief nurse visited Natalie on December 8. When Miller next saw Natalie at 9:30 a.m. on December 9, the infant was dead. Miller informed appellants of this fact and told them that they needed to call the coroner.
Under cross-examination by appellants' attorney, Miller testified that as a Christian Science nurse, she never administered medications; her role was "to provide the practical care to those relying on Christian Science for their healing." Her name was published worldwide in Christian Science publications as an accredited Christian Science nurse. Miller further testified that at that time she was a Christian Scientist herself, that she understood that appellants "were using Christian Science care," and that appellants had consulted a Christian Science practitioner about Natalie's case. She did not relay all of her observations and evaluations of Natalie's symptoms to appellants because in Christian Science "they try to look away from the disease and turn to the higher power," and she was trying to assist appellants "to not see the reality ... of the physical symptoms but ... to see the reality of the child being healed and well through the prayers...." Miller further testified that part of her job as a Christian Science nurse was to "evaluate if the parents seemed sincere in applying Christian Science to the situation"; and that appellants' care for Natalie was "consistent with the practices and principles of the Christian Science Religion."
Dr. A. Jay Chapman, an expert in the field of forensic pathology, performed the autopsy on Natalie's body on December 10, 1984, for the County of Sonoma. He determined the cause of death to have been acute purulent meningitis of the brain and spinal cord, brought on by hemophilus influenza bacteria. Dr. Chapman testified that this form of meningitis is susceptible to treatment and cure with penicillin drugs. He estimated that the infection had existed in the infant's body for a week and a half to two weeks, during which time the baby's brain became swollen and softened by the bacterial infection. Dr. Chapman also testified that meningitis is a very painful disease.
The prosecution's third and final witness to testify before the jury was Dr. Michael W. Witwer, a specialist in infectious diseases and an associate clinical professor on the faculty of the University of California San Francisco Medical School. Dr. Witwer had extensive experience in teaching about meningitis, and in treating patients of all ages with the disease. Bacterial meningitis is an extremely serious, life-threatening disease; Dr. Witwer testified that it is the most serious infectious disease known. 1 In young children the symptoms of meningitis are fever, lethargy, irritability, disinterest in feeding, lack of responsiveness and interaction with parents, and then convulsions, seizures, rigidity, arching of the back, rolling of the eyes, and curling, "flopping" or jerking of the tongue. Dr. Witwer testified that the presence of fever and lethargy in an eight-month-old infant were serious symptoms of...
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