State v. Fletcher

2026 Ohio 1072
Procedural entryThis page is a short order in State v. Fletcher. Read the opinion of the Court — 2024 Ohio 5117
Ohio Court of Appeals·Decided March 27, 2026·No. 2025-CA-10·Published

Opinion

[Cite as State v. Fletcher, 2026-Ohio-1072.]

IN THE COURT OF APPEALS OF OHIO SECOND APPELLATE DISTRICT DARKE COUNTY

STATE OF OHIO : : C.A. No. 2025-CA-10 Appellee : : Trial Court Case No. 22CR00306 v. : : (Criminal Appeal from Common Pleas ASHLEY FLETCHER : Court) : Appellant : FINAL JUDGMENT ENTRY & : OPINION

...........

Pursuant to the opinion of this court rendered on March 27, 2026, the judgment of the

trial court is affirmed.

Costs to be paid as stated in App.R. 24.

Pursuant to Ohio App.R. 30(A), the clerk of the court of appeals shall immediately

serve notice of this judgment upon all parties and make a note in the docket of the service.

Additionally, pursuant to App.R. 27, the clerk of the court of appeals shall send a certified

copy of this judgment, which constitutes a mandate, to the clerk of the trial court and note

the service on the appellate docket.

For the court,

RONALD C. LEWIS, PRESIDING JUDGE

TUCKER, J., and HUFFMAN, J., concur. OPINION DARKE C.A. No. 2025-CA-10

JOHNNA M. SHIA, Attorney for Appellant DEBORAH S. QUIGLEY, Attorney for Appellee

LEWIS, J.

{¶ 1} Ashlee Fletcher 1 appeals from her conviction for involuntary manslaughter

following a jury trial in the Darke County Common Pleas Court. For the following reasons,

we affirm the judgment of the trial court.

I. Facts and Course of Proceedings

{¶ 2} This appeal involves the death of C.N., the 14-year-old son of Fletcher and

Justin Noll. C.N. was diagnosed with Type 1 diabetes when he was 8 years old. The State’s

case against Fletcher turned on her criminally reckless failure to manage C.N.’s diabetes,

so the record in this matter regarding this serious disease is extensive. Type 1 diabetes is

a lifelong disease caused by the autoimmune destruction of insulin-producing cells in the

pancreas. Insulin is a hormone that the body needs to metabolize glucose (blood sugar).

The destruction of insulin-producing cells leads to a loss of insulin production and abnormal

glucose regulation, often leading to high glucose levels in the blood. Unable to use blood

glucose for energy, the body attempts to compensate by breaking down muscle and fat,

leading to the buildup of ketones in the blood, which can become toxic. This can result in

diabetic ketoacidosis (“DKA”), which can be life-threatening.

{¶ 3} Living with Type 1 diabetes requires lifelong treatment with insulin. People with

Type 1 diabetes need to give themselves multiple injections of insulin per day or use an

1 The record establishes that the correct spelling of appellant’s first name is Ashlee. The trial court used “Ashley” in the final judgment entry, which is what we use to create our case captions.

2 insulin pump that is attached to the body. They must also check their blood sugar levels

frequently and closely manage their diet and exercise. Without enough insulin,

uncontrolled high blood sugars can, over time, lead to serious complications including death.

Conversely, too much insulin can cause low blood sugar, which can lead to loss of

consciousness or even death.

{¶ 4} An A1C test measures the average amount of glucose in a person’s blood over

the previous three months. The result is reported as a percentage. The higher the

percentage, the higher a person’s blood glucose levels have been on average. An A1C

test can give the patient and physician a glimpse into how well the patient’s diabetes

management plan has been working over the previous three months and help them

determine if any part of the treatment plan should be adjusted.

{¶ 5} C.N. died on June 7, 2022. Six months later, a Darke County grand jury

indicted Fletcher on one count of endangering children, a third-degree felony in violation of

R.C. 2919.22(A), and one count of involuntary manslaughter, a first-degree felony in

violation of R.C. 2903.04(A). The case proceeded to trial.

{¶ 6} The State presented several witnesses at trial, including various medical

professionals who had treated C.N. and assisted Fletcher with managing C.N.’s diabetes.

After considering the evidence presented at trial, the trial court provided the jury with

instructions that did not address the mens rea that was required to find Fletcher guilty of the

endangering children charge. Following deliberations, the jury found Fletcher guilty of both

endangering children and involuntary manslaughter. The trial court sentenced Fletcher to

36 months in prison for endangering children and an indefinite term of 8 to 12 years in prison

for involuntary manslaughter. The trial court ordered those sentences to be served

3 concurrently for a total, indefinite prison sentence of 8 to 12 years. Fletcher timely appealed

from the trial court’s judgment.

{¶ 7} On appeal, we reversed the conviction for endangering children because the

trial court committed plain error by failing to instruct the jury on the essential element of

recklessness. State v. Fletcher, 2024-Ohio-5117, ¶ 107 (2d Dist.). We also reversed the

conviction for involuntary manslaughter because Fletcher’s endangering children offense

was the predicate felony for the involuntary manslaughter conviction. Id. at ¶ 109. We

remanded the case to the trial court for the purpose of holding a new trial.

{¶ 8} A second jury trial was held in April 2025 on the endangering children and

involuntary manslaughter charges. Fourteen witnesses testified. Linda Duvall, a

registered nurse and nurse practitioner at Dayton Children’s Hospital, testified about the

education provided to C.N. and his parents to help them manage C.N.’s diabetes upon his

diagnosis. Dayton Children’s Hospital typically provides two days of diabetes education to

the parents or caregivers when a child is first admitted to the hospital and diagnosed with

Type 1 diabetes. The education includes how to measure blood sugar levels, how to test

for ketones, how to administer insulin, and what to do when the child is sick. It was stressed

to Fletcher, as the primary caretaker, that C.N. should be taken to the hospital when he

showed signs of illness and repetitive vomiting. Duvall had concerns with both parents

because neither performed well on a written test covering the diabetes education that they

had just received.

{¶ 9} Kathleen Caldwell, a medical social worker at Dayton Children’s Hospital,

provided services to caregivers who struggled with bearing the costs of diabetes

management or who needed additional resources to assist them in effectively managing

diabetes. She explained that consistently elevated A1C numbers or multiple admissions

4 for DKA were signs of medical neglect. Caldwell recalled that both parents struggled with

a written test, which covered the initial education they received while at Dayton Children’s

Hospital. Ideally, C.N.’s parents would have stayed for a third day of education, but they

did not do so due to work constraints. Caldwell noted that C.N.’s parents seemed motivated

by other stressors in their lives, and she worried about whether they fully grasped the

seriousness of managing their son’s diabetes. While the parents showed love for C.N.,

Caldwell wanted to see more understanding from the parents about the seriousness of

managing diabetes.

{¶ 10} After C.N. suffered multiple DKAs, Fletcher received additional diabetes

education. Caldwell noted that several appointments were canceled by Fletcher due to

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