State v. Denby

58 So. 3d 1096, 10 La.App. 3 Cir. 983, 2011 La. App. LEXIS 280, 2011 WL 832498
CourtLouisiana Court of Appeal
DecidedMarch 9, 2011
DocketNo. 10-983
StatusPublished

This text of 58 So. 3d 1096 (State v. Denby) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State v. Denby, 58 So. 3d 1096, 10 La.App. 3 Cir. 983, 2011 La. App. LEXIS 280, 2011 WL 832498 (La. Ct. App. 2011).

Opinion

PICKETT, Judge.

hThe defendant, Jeffrey Paul Denby, appeals his conviction for first degree murder. For the following reasons, we affirm the defendant’s conviction.

FACTS

On June 18, 2009, eighteen-month-old John Thomas Anthony Brewer, known as J.T., arrived at the Beauregard Memorial Hospital with severe head injuries. He was having a seizure when his mother ran into the emergency room with him. His mother told emergency room physician John McMillan that her son had fallen on the steps and hit his head on the steps and stairs. Dr. McMillan found a number of bruises to the child’s head and to the body. J.T.’s eyes were irregular. One pupil appeared enlarged and the other was a pinpoint, a sign of severe brain injury. J.T. was also not breathing appropriately. His score on the Glasgow Coma Scale was a three, indicating that he had a traumatic brain injury that was major and life-threatening.

Dr. McMillan explained at trial that J.T.’s symptoms indicated a brain herniation. The injury to J.T.’s head caused his brain to swell to the point it was no longer able to fit inside his skull. A subdural hematoma compressed the brain, and the pressure of that hematoma pushed J.T.’s brain through the opening at the lower portion of his skull, where the brain stem connects the skull and the spinal cord.

As he tried to determine the mechanism of J.T.’s injuries, Dr. McMillan found multiple sets of bruises on the child’s face and head, with different phases of bruising. Of most concern to Dr. McMillan was a significant amount of bruising to J.T.’s left eye as well as the left ridge of his cheekbone and to the ear. Dr. McMillan found blood behind the left eardrum, which was a serious concern. Dr. McMillan suspected | ¡.abuse because the history was not consistent with the mechanism of injury and the series of injuries. He gave J.T. medication to stop his seizure activities and to sedate and paralyze him to prepare him for transport to Lake Charles Memorial Hospital. Dr. McMillan took seven photographs of J.T. that were admitted into evidence:

• Exhibit A-l shows bruising to both eyes of the intubated child.
• Exhibit A-2 was taken from the child’s left side showing bruising to both eyes, predominantly on the left; old and new bruises to the cheekbone; and an old bruise to the forehead.
• Exhibit A-3 is another frontal photograph showing the different ages of the bruises and a bite block in place in the case of seizure activity.
[1098]*1098• Exhibit A-4 shows the left side, primarily the cheekbone bruising, and also bruising to the left ear.
• Exhibit A-5 is another photograph showing bruising to the eyes and upper part of the forehead, causing Dr. McMillan to suspect “assault that occurred more than just this one time.”
• Exhibit A-6 shows the most significant bruises to the eye, cheekbone, and pin-na of the ear.
• Exhibit A-7 shows a new bruise to the back part of J.T.’s head and bruising behind the ear.

The photographs were admitted over the defendant’s objection. Dr. McMillan documented an immediate need for neurosurgery because of the traumatic brain injury and time was of the essence because J.T. was going to die unless neurosurgical intervention could take place.

At Lake Charles Memorial Hospital, J.T. had another CT scan. Dr. Jamel Saqer, a pediatric intensive care specialist with the Children’s Clinic of Southwest Louisiana, testified as an expert in pediatric critical care. His comparison of the | .¡Beauregard and Lake Charles CT scans showed that J.T. had brain swelling on the entire left side, and also on the front of the right side, causing herniation of the brain. An accumulation of blood, a subdural he-matoma, was in the membrane between the skull and the brain. The swelling ultimately affected blood circulation to the brain and deprived the brain of oxygen, causing an anoxic infarction that would lead to brain death.

J.T. underwent surgery to relieve the pressure in his brain and to prevent further damage from increased brain pressure. Dr. Wolf removed a portion of the skull so that possible continued swelling would not be detrimental to the circulation in the brain. The pressure in J.T.’s brain initially came down, but the force supplying blood to his brain also gradually declined.

After the surgery, J.T. experienced tensing motions referred to as “posturing movements,” where he would involuntarily stretch his arms and legs. The posturing movements, treated with sedatives, pain medication, and seizure medication, were caused by increasing pressure inside J.T.’s head. By June 20, 2009, it was evident that the swelling was actually infarction, and the posturing movements were the only movements that J.T. exhibited. On June 21, 2009, Dr. Wolf and Dr. Saqer shared the opinion that “[tjhere [was] no reasonable, recovery of brain function.” Despite mechanical ventilation by a breathing machine, blood pressure medication, intravenous fluids to prevent dehydration, medications to regulate body temperature and brain activity, and the use of a cooling blanket, intracranial pressure continued to escalate, and CT scans showed no improvement. Life support was stopped at 9:30 p.m. on June 21, and J.T.’s heart stopped at 12:15 a.m. on June 22.

L4Pr. Saqer could not say with medical certainty that J.T. would have died if the life support had not been discontinued. However, he opined that J.T.’s best case scenario would have been a vegetative state requiring machine support and a feeding tube, and he would have had no intellectual activity. J.T.’s brain damage was irreversible, and he was being kept alive by the ventilator. Dr. Saqer did not reach the point of declaring J.T. brain dead because of the family’s request to discontinue life support. Severe brain injury was the sole cause of death.

A video and eight photographs were taken at Lake Charles Memorial Hospital. The state sought to admit the still photos [1099]*1099which depicted the same scene as the video. It sought to use:

approximately a minute or so of the video to fulfill the purpose of showing the extent of injuries and the treatment required as a result of those injuries and the movement of the child known as seizures or posturing as will be described by Dr. Saquer [sic].

Over the defendant’s objection, the trial judge allowed the first minute of the video to be shown, but none of the still pictures. Dr. Saqer testified that the video showed the posturing movements. Although J.T. had multiple bruises on the frontal part of his face, a laceration and bleeding in the left ear, and a bruise on the right temple, those injuries were not visible on the video because of the bandage on J.T.’s head.

Dr. Terry Welke performed the autopsy on J.T. and testified as an expert in forensic pathology. He found bruises above J.T.’s left eyebrow, in the left ear, on the right ear, in front of the right ear, on the mid-portion of the forehead, another bruise above the left eyebrow, and one in the left back of the head. He also found petechia, little red marks on the nose area, often seen in individuals that have died as a result of asphyxia. Dr. Welke reviewed photographs consistent with a possible bite wound on J.T.’s right upper arm. J.T.

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Related

State v. Davis
637 So. 2d 1012 (Supreme Court of Louisiana, 1994)
State v. Strickland
398 So. 2d 1062 (Supreme Court of Louisiana, 1981)

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Bluebook (online)
58 So. 3d 1096, 10 La.App. 3 Cir. 983, 2011 La. App. LEXIS 280, 2011 WL 832498, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-v-denby-lactapp-2011.