Ward v. State, 031119 MDSCA, 2135-2017

Docket Nº:2135-2017
Opinion Judge:BEACHLEY, J.
Judge Panel:Fader, C.J., Beachley, Thieme, Raymond G., (Senior Judge, Specially Assigned), JJ.
Case Date:March 11, 2019
Court:Court of Special Appeals of Maryland




No. 2135-2017

Court of Special Appeals of Maryland

March 11, 2019

Circuit Court for Calvert County Case No. 04-K-16-000226

Fader, C.J., Beachley, Thieme, Raymond G., (Senior Judge, Specially Assigned), JJ.



After a jury trial in the Circuit Court for Calvert County, Diandra Noel Ward, appellant, was found guilty of first and second-degree child abuse. She was sentenced to twenty-five years' imprisonment, with all but twenty years suspended, for first-degree child abuse. The remaining conviction was merged for sentencing purposes. This timely appeal followed.


Appellant presents three questions for our consideration, which we have rephrased slightly, as follows: 1. Did the trial court abuse its discretion in granting the State's motion in limine to redact statements from medical records, thereby impairing appellant's constitutional right to present a defense?

2. Did the trial court abuse its discretion in allowing the State to introduce records from the Office of Child Care?

3. Did the trial court err or abuse its discretion in admitting into evidence text messages sent by appellant?

For the reasons set forth below, we shall affirm.


This case arises out of allegations that appellant committed child abuse against an infant, J.M., who was born in December 2015. J.M. lived with his mother, V.B., his father, D.M., V.B.'s son from a prior relationship, P.G., and D.M.'s daughter from a prior relationship, S.M. At all times relevant to this case, P.G. was approximately eight years old and S.M. was approximately eleven years old. P.G. and S.M. were allowed to hold J.M. if they were sitting on a couch and their mother or father were present, but they were not permitted to watch him by themselves. With the exception of a respiratory infection and nasal congestion, J.M. was a healthy baby and his parents had no concerns about his development.

On February 1, 2016, J.M. entered First Steps, a licensed daycare center appellant operated in her home in Calvert County. There were six children, including J.M., in appellant's care at First Steps.1 Appellant used a cellular phone "app" and text messages to keep V.B. apprised of J.M.'s activities throughout the day, including his eating and sleeping habits. Prior to April 15, 2016, J.M. did not have any notable injuries, difficulty breathing, or problems opening or tracking with his eyes. He was able to hold his head up and hold items in his hands.

On the evening of April 14, 2016, J.M. ate normally and slept through the night. The following morning, V.B. took J.M. to appellant's daycare facility. Typically, she would take J.M. out of his car seat, sign in, hug and kiss him, and then hand him over to appellant. When saying goodbye, V.B. would put J.M. "in [her] face and love on him and kiss him." She described holding him in the air and giving him "a shimmy." On April 15, 2016, V.B. received updates from appellant throughout the day, informing her that J.M. had, among other things, consumed baby formula, napped, and had dirty diapers.

At 3:03 p.m., V.B. received a telephone call from appellant asking how fast she could get to the daycare because J.M. was not waking up. When V.B. arrived about fifteen minutes later, she saw an ambulance outside the house. Inside the house, she saw J.M. lying on a couch in his diaper making a "screaming," "screeching" noise that she had never heard before. J.M. was placed in the ambulance and V.B. rode with him to Calvert Memorial Hospital. During the ride to the hospital, appellant and V.B. exchanged text messages. When paramedics asked V.B. if J.M. had hit his head, she sent a text message to appellant. Appellant responded that J.M. hit his head "just when I took him out of the car seat earlier, but nothing major[.]"

Katie Krieder, a critical care transport team paramedic for Children's National Medical Center in Washington, D.C. ("Children's National"), and a volunteer paramedic, was dispatched to the daycare at 3:28 p.m. to provide pediatric equipment and an increased level of care for J.M. When she arrived, J.M. was in the ambulance secured to a stretcher. She placed him on a cardiac monitor and checked his vital signs. She observed that J.M. was mostly unresponsive, that he had waxing and waning mental status, that he would not respond to pain, and that he would cry, then become unresponsive, and then cry again. In her report, Ms. Krieder wrote that, in light of the waxing and waning mental status and the absence of a fever or signs of sepsis, there was a strong suspicion of a head injury or brain bleed.

The ambulance took J.M. to Calvert Memorial Hospital, where he was placed in a neck brace, intubated, and received a CAT scan. He was then flown to Children's National, where he was treated by a pediatric neurosurgeon, Dr. Suresh Magge. Dr. Magge reviewed the CAT scan from Calvert Memorial Hospital, which showed blood and fluid on the right side of J.M.'s brain that was creating a midline shift, pushing the brain to the left and increasing pressure on it. In addition, Dr. Magge received a report that one of J.M.'s pupils had been "blown," meaning that it was very large, indicating an increase in pressure on the brain stem. J.M. had been given medicine to temporarily decrease the pressure and, when he arrived at Children's National, his pupil was "back down again." According to Dr. Magge, J.M. was "basically in a coma" and had life-threatening injuries.

Dr. Magge's initial diagnosis was an "acute on-chronic" subdural hematoma. Dr. Magge based his diagnosis on the CAT scan, which showed the presence of both new blood and old blood under the dural membrane, a strong membrane that covers the brain. Dr. Magge performed a craniotomy to evacuate the blood and fluid that were beneath J.M.'s dural membrane, and determined that J.M. had a subdural hematoma. As soon as Dr. Magge made small cuts in the dura during surgery, "blood and fluid came out under pressure." The fluid was a red mixture of blood and cerebral spinal fluid. Dr. Magge did not observe any old blood but only fresh blood that was clotting. According to Dr. Magge, the injury to J.M. was acute, as opposed to chronic, meaning it occurred "within generally a day or so." He explained that if the blood had been old or sitting for weeks or months, it would have been very thin and brown like motor oil. Dr. Magge did not see any old blood or other signs to suggest a chronic or congenital condition or injury affecting the right side of J.M.'s brain.

Dr. Magge did not recall observing any bruising or trauma to the exterior of J.M.'s skull, but opined that significant force would have been necessary to cause J.M.'s injury. He concluded that J.M.'s injury was consistent with abusive head trauma and could have been caused by shaking. Dr. Magge had never seen the type of injury J.M. suffered occur spontaneously and he ruled out the possibility that J.M. suffered from other conditions such as hydrocephalus or hygroma. In follow up appointments with J.M. after the surgery, Dr. Magge observed that the blood clot and midline shift of the brain were gone, but there was lingering damage to the right side of J.M.'s brain.

Dr. Heather de Beaufort, a pediatric ophthalmologist at Children's National, examined J.M. on April 16 and 18, 2016. She found that there were twenty to thirty hemorrhages in the center and periphery of his right eye, but there were no hemorrhages in his left eye, which appeared normal. According to Dr. de Beaufort, bleeding in the peripheral area of the right retina could indicate abusive trauma. Dr. de Beaufort opined that J.M.'s condition was "most consistent with an abusive head trauma" caused by shaking. She stated that there was nothing in his medical treatment, and no other explanation for, the pattern of hemorrhages in his retina that extended into the periphery of his eye. Dr. de Beaufort acknowledged that shaking, with the possibility of a soft impact, also fit within her findings.

On April 15, 2016, Detective Meggan Quinn of the Calvert County Sheriff's Office and Janice Walker from Child Protective Services were dispatched to Children's National to investigate a possible case of child abuse. She interviewed J.M.'s parents and obtained a timeline of events leading up to the time of J.M.'s injury. The following day, Detective Quinn interviewed J.M.'s siblings, P.G. and S.M., and determined that they were not present for J.M.'s injury. Detective Quinn photographed appellant's home and the home of J.M.'s parents. She also obtained screen shots from the cell phone "app" that appellant used to keep V.B. advised of J.M.'s activities each day. Appellant consented to a recorded interview, which was played for the jury...

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