Ambrashia Marie Chrzan v. State of Iowa

Court of Appeals of Iowa·Decided May 22, 2024·No. 23-0207·Published

Opinion

IN THE COURT OF APPEALS OF IOWA

No. 23-0207

Filed May 22, 2024

AMBRASHIA MARIE CHRZAN, Applicant-Appellant,

vs.

STATE OF IOWA, Respondent-Appellee.

Appeal from the Iowa District Court for Washington County, Joel D. Yates, Judge.

An applicant appeals the denial of her application for postconviction relief.

AFFIRMED.

Thomas M. McIntee, Williamsburg, for appellant.

Brenna Bird, Attorney General, and Zachary Miller, Assistant Attorney General, for appellee State.

Considered by Tabor, P.J., and Badding and Chicchelly, JJ.

BADDING, Judge.

At the postconviction-relief hearing following her conviction for child endangerment resulting in death, Ambrashia Chrzan’s trial counsel testified: “Theoretically you can always do something else,” but “we put on the . . . best defense we could.” The district court agreed and rejected Chrzan’s claims that counsel performed deficiently. Chrzan appeals, claiming trial counsel was ineffective for failing to (1) move for a court-appointed expert medical witness; (2) “object to or prevent introduction of prior bad acts evidence” that she used “street drugs” while pregnant with the child; (3) investigate and present family members as witnesses to Chrzan’s parenting abilities; and (4) move for a change of venue. We affirm upon our de novo review of the record.1 I. Background Facts and Proceedings A.M. was born prematurely to Chrzan in late May 2015. The infant tested positive for amphetamines at birth and weighed just four pounds when she was discharged from the hospital into foster care. Because of A.M.’s low birth weight, the foster mother took A.M. to frequent appointments with her primary care physician, Dr. David Nacos. Chrzan attended only two of those appointments.

Patient visit notes from A.M.’s appointments with Dr. Nacos were admitted as exhibits two through fourteen at Chrzan’s criminal trial without objection from the defense. All but one of those exhibits noted a “[p]renatal maternal history of street drug use during pregnancy.” The State used the patient visit notes to show

1 See Sothman v. State, 967 N.W.2d 521, 522 (Iowa 2021) (reviewing the denial

of an application for postconviction relief alleging ineffective assistance of counsel de novo).

the dates of A.M.’s appointments, the reasons for treatment, and A.M.’s weight at each appointment.

The Iowa Department of Health and Human Services returned A.M. to Chrzan’s care on December 4 but continued to provide services to the family. Dr. Nacos testified that A.M.’s weight gain while in foster care was satisfactory. Indeed, she weighed fourteen pounds and two and one-half ounces the day before removal ended—a gain of just over ten pounds while in foster care. A.M.’s weight gain continued through her seven-month appointment in January 2016, when she weighed fifteen pounds. But her parents didn’t bring her to her nine-month appointment in March. The appointment was rescheduled for May, but no one came to that appointment either.

Chrzan and A.M.’s father did take her to an appointment in July, but her weight had dropped to fourteen pounds and five ounces even though the parents reported that she was eating well. Dr. Nacos was concerned for A.M.’s failure to thrive and recommended an appointment with a pediatric diagnostics specialist at the University of Iowa Hospitals and Clinics (UIHC). He explained to Chrzan how important it was that A.M. attend this appointment.

Dr. Nacos expected that A.M. would see the specialist before her next appointment with him. But at that appointment in September2—which was the last time Dr. Nacos saw A.M.—Chrzan told Dr. Nacos that she never got a call about the specialist appointment. His office, however, had documented their contact

2 This appointment was originally scheduled for September 6.

But after Chrzan

did not show up for the appointment with A.M., it was rescheduled to September 23.

attempts. By then, even though A.M. had gained some weight, she was still only fifteen pounds. Dr. Nacos again stressed to Chrzan that A.M. needed to be seen at the UIHC, and he put in a second referral. The department conditioned dismissal of the child-in-need-of-assistance case on the child being seen by a specialist at the UIHC. Dr. Nacos’s office spoke to A.M.’s father at the end of September and rescheduled the appointment for October 11. A week before the appointment was set to take place, the family’s juvenile court case was dismissed. Conditions in A.M.’s home quickly went downhill, according to Chrzan’s mother, and A.M. missed her specialist appointment.

On November 9, Chrzan found A.M. deceased in her crib. Forensic pathologist Dr. Dennis Firchau conducted the autopsy of A.M. the next day. She weighed only eleven pounds and was in “a state of malnourishment or undernourishment.” Dr. Firchau reached an overall conclusion of “undetermined cause of death with malnutrition and associated neglect.” He ruled the manner of death was homicide, which means “death at the hands of another.” Dr. Firchau explained “that the neglectful actions, whether active or inactive, . . . resulted or helped contribute to the malnourishment which significantly helped cause death in this case.” Those neglectful actions included the failure to nourish the child and the neglect of her medical care, according to Dr. Firchau. His autopsy report was admitted into evidence at Chrzan’s criminal trial. While the report noted that A.M. had a “meconium drug screen positive for amphetamines,” the jury was never directed to that information in the report.

Chrzan was arrested and charged with child endangerment resulting in death close to one year after A.M.’s death. At Chrzan’s jury trial, she called

department caseworker Ellyn Hildebrand as a witness. When asked by defense counsel why the department became involved with A.M. at birth, Hildebrand testified the department was already involved with A.M.’s siblings and A.M. tested positive for amphetamines at birth. She explained that after A.M. was returned to her parents’ custody, the department continued to monitor the family. While the child’s weight remained a concern, Hildebrand testified that she recommended dismissing the juvenile court proceeding in October 2016 because Chrzan had provided negative drug tests throughout the case and she felt A.M. was “conditionally safe” in Chrzan’s care.

In her own testimony, Chrzan blamed A.M.’s death on Dr. Nacos, stating he discontinued A.M.’s high-calorie formula despite Chrzan’s objection. She also maintained that information about the appointment and its urgency were not sufficiently communicated to her. While Chrzan agreed that she knew about the October 11 appointment at UIHC, she could not give any concrete reason for missing it.

The jury found Chrzan guilty as charged. On direct appeal, Chrzan raised claims of ineffective assistance of counsel. See State v. Chrzan, No. 18-1327, 2019 WL 5067174, at *1 (Iowa Ct. App. Oct. 9, 2019). We rejected one of those claims but preserved her claim that counsel was ineffective for failing to object to prior-bad-acts evidence for postconviction relief. Id. at *4. Procedendo issued on December 19, 2019.

Chrzan applied for postconviction relief in January 2020. She claimed criminal trial counsel was ineffective for, among other things, (1) “failing to object to prior bad acts evidence that the State repeatedly referred to on trial day 3,”

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