State v. Huston

• Decision Date: 25 January 2013
• Docket Number: No. 11–1262.,11–1262.
• Citation: 825 N.W.2d 531
• Parties: STATE of Iowa, Appellee, v. Karen Sue HUSTON, Appellant.
• Court: Iowa Supreme Court

825 N.W.2d 531

STATE of Iowa, Appellee,

v.Karen Sue HUSTON, Appellant.

No. 11–1262.

Supreme Court of Iowa.

Jan. 25, 2013.

Mark C. Smith, State Appellate Defender, Samuel S. Berbano, Student Legal Intern, and Shellie L. Knipfer, Assistant State Appellate Defender, for appellant.

Thomas J. Miller, Attorney General, Bridget A. Chambers, Assistant Attorney General, Michael P. Short, County Attorney, and Clinton R. Boddicker, Assistant County Attorney, for appellee.

WATERMAN, Justice.

Defendant, Karen Sue Huston, was one of several adult caregivers for a five-year-old girl suffering from malnutrition. This appeal presents the question whether the district court committed reversible error in Huston's criminal jury trial by allowing a caseworker for the Iowa Department of Human Services (DHS) to testify that a child abuse report against Huston was administratively determined to be “founded.” Huston objected to this testimony as irrelevant and unfairly prejudicial.

The jury found Huston guilty of child endangerment causing serious injury. The district court sentenced Huston to a term of fifteen years in prison. Huston appealed, contending the evidence was insufficient to prove a “serious injury” and that the district court erred by allowing testimony on the DHS administrative finding. The court of appeals affirmed, and we granted Huston's application for further review.

We exercise our discretion to limit our review to the evidentiary ruling on the founded child abuse report. See State v. Marin, 788 N.W.2d 833, 836 (Iowa 2010). Division III of the court of appeals decision shall stand as the final opinion in this appeal on the sufficiency of the evidence to support Huston's conviction. For the reasons explained below, we hold it was reversible error to allow testimony that DHS had determined the child abuse complaint against Huston was founded. Accordingly, we vacate Division II of the decision of the court of appeals, reverse the judgment of the district court, and remand the case for a new trial.

I. Background Facts and Proceedings.

The victim, T.H., was born in January 2005 to Brandon Holmes and Christie Polhans. Brandon is now married to Mandy Holmes, who has four children. Mandy is the daughter of Karen and Fred Huston.¹

In November 2008, T.H. began living with Brandon and his wife, Mandy, in Fort Madison, Iowa, after DHS removed T.H. from the care of her mother. Approximately one month later, Brandon, Mandy, T.H., and Mandy's four children moved into the Hustons' two-bedroom home, where they all stayed until April or May 2010. Mandy was T.H.'s primary caregiver during this time. In April of that year, shortly before Brandon and Mandy moved out, Huston returned home from serving a ten-month federal prison sentence in Texas for passing money orders in violation of 18 U.S.C. § 500.

Although Karen and Fred initially denied that T.H. lived with them, Huston admitted at trial that when Brandon and Mandy moved out T.H. remained at the Hustons' home. During this eight-month period, Karen, Fred, and Mandy were all involved in caring for T.H. Fred would occasionally make breakfast or dinner for T.H., but was otherwise gone most of the day. Mandy would come over daily and sometimes would prepare T.H.'s breakfast or lunch. Mandy was also the one who would bathe T.H.

Huston is disabled and confined to a wheelchair. She weighs 395 pounds, and her right hip socket is “broke off.” She suffers from COPD and asthma. She is unable to climb stairs and, for that reason, sleeps on a bed in the dining room. In light of her limited mobility, Huston could only prepare sandwiches and other quick meals for T.H.

Dr. Frank Artinian, T.H.'s pediatrician, first became concerned about T.H.'s weight in November 2009. T.H. had lost approximately five pounds or twelve percent of her body weight since her last doctor's visit in May. Dr. Artinian tested T.H. for various medical conditions that could be at the root of her failure to thrive, but all the tests came back negative. Dr. Artinian wished to have T.H. admitted to the hospital at that time for further testing and evaluation, but Mandy lacked authority to consent to T.H.'s hospitalization, and DHS declined to force T.H.'s hospitalization. In lieu of hospitalization, Mandy brought T.H. in for weekly weight checks for the next month. T.H.'s weight remained stable during this time period.

Dr. Artinian did not see T.H. again until ten months later when Mandy brought T.H. in at the request of DHS. DHS caseworker, Sharon Andrusyk, had received a report that T.H. was not wearing the glasses prescribed for her to correct her crossed eyes. Andrusyk contacted Mandy, and she brought T.H. into the DHS office a day later on October 20, 2010. During this meeting, Andrusyk immediately noticed that something was wrong with T.H. Andrusyk noted that T.H.'s skin was “pale and gray,” her affect was flat, and the hair on the top of her head was extremely thin. Andrusyk asked Mandy to take T.H. to see a doctor.

Mandy took T.H. in to see Dr. Artinian. Dr. Artinian determined T.H. was failing to thrive. Failure to thrive is not a diagnosis but, rather, “a description of what's going on with a child.” There are numerous potential causes for failure to thrive. Dr. Artinian described T.H.'s failure to thrive as “very serious” and noted that he “was actually worried about her life at that point in time” because T.H. had not gained any weight in nearly a year. Dr. Artinian was unable to identify an illness or disease that could account for T.H.'s condition.

After examining T.H., Dr. Artinian wrote Andrusyk a letter expressing his concerns regarding T.H.'s condition. Dr. Artinian wrote: “[T.H.] had not grown or gained any weight in 10 months. Her hair is thinning, she is emaciated and has a wasted appearance. [T.H.]'s skin is dry and loose. Her affect is flat.” Dr. Artiniantold Mandy that he was “profoundly concerned about [T.H.]'s medical and psychological health.” Nevertheless, Mandy remained unconcerned. Dr. Artinian, therefore, urged DHS to compel T.H.'s hospitalization. He noted: “As a pediatrician, I have grave concerns regarding the physical and mental health of [T.H.]. I am very concerned that she is undergoing abuse/neglect in her home. DHS absolutely needs to take action to help this child.”

After receiving Dr. Artinian's letter, Andrusyk obtained authorization to remove T.H. from the Hustons' home, to admit her to the hospital, and to place her in foster care thereafter. On November 2, Andrusyk went to Brandon and Mandy's home to remove T.H., but she was not there. Brandon told Andrusyk that T.H. was with Mandy at an appointment, but refused to tell Andrusyk where they were. Eventually, Andrusyk found Mandy, but T.H. was not with her. Mandy took Andrusyk to the Hustons' home and went inside the home and removed T.H. Andrusyk noted the following about T.H.'s condition that day:

She was very dirty. Her clothing was dirty. Her hair was matted. She, again, would not make eye contact, would not talk, except to repeat some things. She did state she was hungry. Her skin was very gray and loose appearing, again, very flat affect. She just didn't talk hardly.

Andrusyk took T.H. to the hospital, where she was admitted by Dr. Christopher Youngman. T.H. stayed in the hospital for five days. Andrusyk returned to the hospital the day after T.H. was admitted and took photographs of T.H., including some bruising that appeared after she was rehydrated. Andrusyk noted T.H.'s skin tone and affect had improved markedly since her admission to the hospital the previous day.

During T.H.'s hospitalization, Dr. Artinian and Dr. Youngman ruled out a number of medical causes for T.H.'s failure to thrive. While in the hospital, T.H. ate everything presented to her and sometimes asked for more to eat. On the last day of her hospitalization, T.H. ate a lot of food and vomited. By the time T.H. was released from the hospital, she had gained nine pounds.

Dr. Artinian testified it was his opinion, to a reasonable degree of medical certainty, that

the reason why [T.H.] was failing to grow properly and gain weight over time was that she was not receiving an adequate amount of calories, meaning she was not getting enough food. This was—this was determined by ruling out the other problems that could cause it, but more than that, by hospitalizing her for five days, we were able to control her environment and control her caloric intake, and when given calories, she gained weight. We did no other intervention for her. We gave her no other medicine or therapies that would cause weight gain, and during that five days, [T.H.] came into the hospital at 34 pounds and was discharged at 43 pounds, which is a nine pound weight gain in five days, which is—just speaks to the fact that when given calories, she was able to grow.

Dr. Youngman similarly concluded, to a reasonable degree of medical certainty, that the cause of T.H.'s failure to thrive was “inadequate caloric intake ... she just was not receiving enough calories to grow.” Dr. Youngman also noted that if left untreated, “people can die of malnutrition,” and even short of death, they can suffer “[n]eurological consequences ... and other organ damage as well.”

After T.H.'s release from the hospital, she was placed in foster care. Apart from another episode of vomiting, T.H. has thrived in her new environment. T.H. has continued to gain weight since her release from the hospital and, as of her last appointment, was between the 50 and 75 percentiles on the growth chart for weight. In addition to these improvements, the hair on the top of T.H.'s head has filled in, and she has grown two inches.

Leslie Boyer, a caseworker with DHS, was assigned to investigate the allegations brought against Karen and Fred regarding T.H.'s care. Boyer interviewed Karen and Fred at their home as part of this investigation. During both interviews, Karen and Fred denied that T.H. was living with them at...