State v. Hughes

2018 Ohio 1237
Ohio Court of Appeals·Decided March 30, 2018·No. WD-16-056·Published·Cited by 3 cases

Opinion

IN THE COURT OF APPEALS OF OHIO SIXTH APPELLATE DISTRICT

WOOD COUNTY

State of Ohio Court of Appeals No. WD-16-056 Appellee Trial Court No. 2015CR0148 v. Gilbert John Michael Hughes DECISION AND JUDGMENT Appellant Decided: March 30, 2018

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Paul A. Dobson, Wood County Prosecuting Attorney, and David T. Harold, Assistant Prosecuting Attorney, for appellee.

Lawrence A. Gold, for appellant.

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JENSEN, J.

{¶ 1} Appellant, Gilbert Hughes, appeals the October 6, 2016 judgment of the Wood County Court of Common Pleas sentencing him to 8 years in prison. For the following reasons, we affirm.

I. Background and Facts

{¶ 2} On April 16, 2015, Hughes was indicted on one count of endangering children in violation of R.C. 2919.22(B)(1) and (E)(2)(d), a second-degree felony. A jury trial was held beginning on October 3, 2016. The state presented ten witnesses, including the investigating officer; emergency services personnel; several doctors who treated the victim, S.H.; a doctor who specializes in child abuse; and S.H.’s foster father. Hughes presented seven witnesses, including his wife, who is S.H.’s mother; several of his wife’s family members; and a pediatric neurology expert. The following facts were developed at trial.

A. March 6, 2015 Incident

{¶ 3} On March 6, 2015, at 9:01 a.m., the Wood County Sheriff’s Office received a 911 call about an unresponsive three-month-old baby in Bowling Green. When paramedics arrived, they found that S.H. was not breathing and had no pulse. S.H. was transported to Wood County Hospital, where she was stabilized. Her treatment included the insertion of an intraosseous line to allow doctors to infuse medication directly into her bone, the insertion of an endotracheal tube to pump oxygen directly into her lungs, the use of a ventilator to breathe for her, and the administration of several doses of epinephrine to help restart her heart. The emergency room doctor who treated S.H. believed that S.H.’s respiratory arrest was caused by respiratory syncytial virus (“RSV”) because S.H. had been admitted to the hospital with RSV a couple of weeks earlier.

{¶ 4} S.H. was transferred by air ambulance to the pediatric critical care unit at Toledo Children’s Hospital because she was on a ventilator. Dr. Susan Tourner, the critical care doctor who treated S.H., suspected that S.H.’s cardiac and respiratory arrest were not related to RSV because S.H.’s chest x-ray was clear and it was uncommon for a baby with RSV to improve for a period of time and then deteriorate to the point of respiratory arrest. This led Dr. Tourner to suspect a brain injury, so she ordered a CT scan. The scan showed subdural hematomas (which are areas of blood that collect between the skull and the brain) on both sides of S.H.’s brain. The abnormal CT scan prompted Dr. Tourner to seek an ophthalmological exam and a skeletal survey. The ophthalmological exam showed that S.H. had severe hemorrhaging in all four quadrants of both of her retinas. The skeletal survey showed that S.H. did not have any fractured bones. Based on these results, Dr. Tourner asked Dr. Randall Schlievert, who specializes in child abuse, to consult on the case. Several witnesses testified that S.H. did not have any external signs of trauma or injuries, such as bruises or lacerations. The doctors who treated S.H. in the critical care unit and Dr. Schlievert, the state’s expert, testified that S.H.’s injuries were consistent with shaken baby syndrome (also called abusive head trauma)1 even though S.H. did not have any visible external injuries.

B. The Experts’ Testimony 1. Dr. Schlievert’s Testimony

1 During his testimony, Dr. Joseph Scheller, Hughes’s expert, clarified the difference between the terms “shaken baby syndrome” and “abusive head trauma.” He explained that shaken baby syndrome is a type of abusive head trauma that refers narrowly to a group of three major symptoms: subdural hemorrhage, retinal hemorrhage, and abrupt alteration in consciousness. In 2009, the name was changed to abusive head trauma, a term that encompasses any nonaccidental head trauma, such as the trauma that occurs from a child being hit on the head with a baseball bat or thrown against something.

{¶ 5} Dr. Schlievert, who the court qualified as an expert in child abuse, provided more in-depth testimony about shaken baby syndrome and S.H.’s injuries. Dr. Schlievert defined shaken baby syndrome as a group of physical injuries, including subdural hematoma, retinal hemorrhage, fractures, and brain damage that result from repetitive, violent shaking of a baby. He said that shaken babies had bruising in only about half of cases and fractures in only about 20 to 30 percent of cases. He explained that the typical combination that leads to a caregiver shaking a baby is a baby who is crying and a caregiver who is tired, stressed, or has failed to bond with the baby.

{¶ 6} Regarding S.H.’s injuries, Dr. Schlievert said that Dr. Tourner asked him to examine S.H. because she showed signs of abusive head trauma. He noted that the pattern of retinal hemorrhaging seen in S.H.’s eyes was indicative of abusive head trauma and helped rule out other causes, such as blood clots, infections, and genetic conditions. He also said that her CT scan showed subdural hematomas that were composed of both fresh and old blood. He emphasized that the CT scan could not provide the exact dates the hematomas occurred, but he believed that the appearance of the fluid was indicative of a recent shaking incident and an earlier shaking incident. Dr. Schlievert said that a baby exhibiting symptoms of a brain injury was a better indicator of when a shaking event happens than the appearance of the brain on a CT scan. In S.H.’s case, she exhibited apnea on February 20, which Dr. Schlievert said was mistakenly attributed to RSV when it was actually likely caused by shaking. A shaking incident on February 20 would account for the old blood in S.H.’s CT scan. On March 6, S.H. exhibited respiratory and cardiac arrest, which Dr. Schlievert attributed to shaking. Shaking on March 6 would account for the fresh blood in her CT scan. Dr. Schlievert also confirmed that S.H. did not have any external signs of injury or any broken bones.

{¶ 7} Dr. Schlievert also ruled out alternate explanations for S.H.’s injuries and CT scan results. He said that S.H.’s MTHFR gene mutation could not account for her medical condition on March 6 because the risk that the mutation would lead to a blood clot is small and, although a localized clot could explain a subdural hematoma, it would not explain the presence of other signs of abusive head trauma. Dr. Schlievert also dismissed the likelihood that the old blood could be related to a birth injury because, even assuming that a birth injury caused some later bleeding, it would not cause brain damage and, thus, would not cause the serious symptoms S.H. had. In his opinion, S.H.’s injuries were caused by someone violently shaking her.

2. Dr. Scheller’s Testimony

{¶ 8} To counter Dr. Schlievert’s testimony, Hughes presented Dr. Joseph Scheller’s testimony. Dr. Scheller is a pediatric neurologist with special training in reading CT and MRI scans. In preparing his report, Dr. Scheller reviewed S.H.’s medical records, but did not examine her. His review of the records led him to believe that S.H. suffered from birth trauma that caused her to develop a hygroma, which is a collection of thick fluid between the skull and the brain. The “old blood” Dr. Schlievert identified on the CT scan was really fluid from the hygroma and the “fresh blood” was a natural result of S.H.’s body ridding itself of the hygroma. He said that his conclusion is supported by the increase in S.H.’s head circumference relative to other children her age, S.H. having the MTHFR gene mutation and elevated platelets, and his reading of S.H.’s CT and MRI scans.

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