State v. Rupp

586 P.2d 1302, 120 Ariz. 490, 1978 Ariz. App. LEXIS 636
CourtCourt of Appeals of Arizona
DecidedSeptember 21, 1978
Docket1 CA-CR 2402, 1 CA-CR 2403
StatusPublished
Cited by20 cases

This text of 586 P.2d 1302 (State v. Rupp) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State v. Rupp, 586 P.2d 1302, 120 Ariz. 490, 1978 Ariz. App. LEXIS 636 (Ark. Ct. App. 1978).

Opinion

OPINION

EUBANK, Judge.

William Thomas Allen Rupp (Billy), appellants’ son, died on April 21, 1975, three days before his second birthday. It was stipulated in the trial court that he died of starvation. Appellants were subsequently charged, jointly tried and convicted of the crime of involuntary manslaughter (A.R.S. § 13—456(A)(2). The appellants have filed separate appeals which have been consolidated in this Court for disposition. We will consider the various contentions raised by each of the appellants after stating the generally relevant facts.

Billy was appellants’ third child. He appeared to be healthy as a newborn baby. His mother stated to an investigating officer that he achieved a maximum weight of 15 pounds. When he died, he weighed 10 pounds and his body was 26 inches in length. The pathologist who performed the autopsy testified that the average weight for a child of his age at the time of death is 27.7 pounds and that the average body length is 34.4 inches.

Although neither of appellants testified at the trial, there was evidence presented that people who observed the child became concerned about his condition at the age of six months and thereafter. He was described as being thin, small, pale and listless. As time passed, it became apparent that his motor development was slow. He did not talk or crawl in the usual manner of a normal child prior to his death. He did not sit up by himself and he had difficulty holding his head up. He was less than normally responsive to his surroundings. His tongue was described as thick and it frequently hung out of his mouth. Billy vomited frequently and suffered from diarrhea. Identifiable undigested food often appeared in his stool.

It appears that Billy was not taken to a doctor until November 12, 1974, when he was little over 18V2 months old. On two occasions prior to that time, persons related to one or the other of appellants contacted public welfare authorities out of a concern for Billy’s health. These calls resulted in three visits to appellants’ house by representatives of the Children’s Protective Services Agency of the Department of Economic Security. During each of these visits, the representatives advised and urged appellants, or one of them, to obtain medical attention for Billy. The last such visit was in October, 1974, and resulted from appellants’ failure to comply with a previous recommendation of the agency to take Billy to a doctor. By this time, appellants suspected that Billy might be mentally retarded and during this last visitation by a Chil *494 dren’s Protective Services’ worker, Jacqueline Rupp was informed of facilities in the community for evaluating retarded or possibly retarded children.

After this visit, Jacqueline made an appointment to take Billy to Dr. William Luke, a general practitioner of the osteopathic school of medicine, on November 12, 1974. What occurred at Dr. Luke’s office at this time was the subject of considerable testimony at the trial, much of it conflicting.

Luke testified that Billy was brought in solely for the standard “DPT” and polio immunization shots. He further testified that his procedure in such cases was to perform no more than a routine chest examination to negative the existence of upper respiratory infection. He testified that he performed this with a stethoscope without undressing the child. He took no history of the child and he testified that Jacqueline Rupp made no mention of Billy’s vomiting or digestive problems. He did notice that Billy was thin like appellants’ other children (“they are not healthy children”), but stated that he did not consider him to appear undernourished. In response to a question at trial, Luke estimated Billy’s weight at the time at 18 to 20 pounds.

Luke testified that Jacqueline Rupp asked him if Billy was retarded. Luke did not respond either affirmatively or negatively but stated that this could be determined “in six months” when the child was two years old. There was evidence to the effect that Luke placed the child on the floor so as to better observe his manner and responsiveness. Luke testified that he actually formed an opinion at this time that Billy was retarded but that he felt it best not to communicate his opinion to Jacqueline Rupp. There was testimony from another source that Luke advised appellant that Billy also had a problem with his spine. Luke testified that he “had the feeling” after seeing Billy that the child might not live to adolescence. He did not communicate that thought to Jacqueline Rupp.

Either Luke or his assistant administered the first series of inoculations to Billy on November 12. Pursuant to instructions, Billy was brought back to Luke’s office on December 27, 1974, for the second series of immunization shots. These were administered by Luke without his making any new or different observations. Jacqueline Rupp was instructed to bring Billy back for the third and final round of shots in four to eight weeks. This was not done and Billy was not taken to any other physician or medical practitioner prior to his death. However, Jacqueline Rupp took one of her older sons to Dr. Luke’s office for treatment of a cold or flu condition on April 17, 1975. There was testimony that on the latter occasion, she stated to Dr. Luke that Billy was not eating well. This was four days before Billy died.

At the time of death, Billy’s nose was observed to be caked with mucous. He was suffering from severe diaper rash accompanied by severe excoriation and ulceration of the skin in the genital area. There were decubitus ulcers (pressure or “bed sores”) in the buttocks and lower back areas. There had been a substantially complete loss of subcutaneous fat which made the bones and joints appear prominent. Dr. Luke testified that pictures of the child taken immediately after death indicated a marked loss of weight since Billy’s visits to his office. The physician who performed the autopsy testified that there was a total absence of food or traces of food in the gastrointestinal tract and that normally it takes two to three days for food to pass entirely through the tract. This physician found no disease process present and therefore concluded that starvation was the cause of death.

One of appellants’ principal contentions at trial was that Billy’s starvation death was caused by celiac disease or some other type of “malabsorption syndrome.” Celiac disease is caused by an intolerance to the gluten found in many grain products and is accompanied by a blunting of the villi or absorbing arms of the small bowel. This and any other form of “malabsorption syndrome” results in an inability to absorb food into the blood stream. The autoptic physician found no evidence of celiac disease or any other malcondition relating to digestion but acknowledged that he could not eliminate the possibility of some such condition.

*495 PRELIMINARY HEARING

Appellants claim that they were denied due process of law at the preliminary hearing when the county attorney assertedly carried on an ex parte conversation with the magistrate during a court recess, depriving them of an opportunity to argue their legal position against the admissibility of certain evidence.

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Cite This Page — Counsel Stack

Bluebook (online)
586 P.2d 1302, 120 Ariz. 490, 1978 Ariz. App. LEXIS 636, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-v-rupp-arizctapp-1978.