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State v. Ashcraft

Court of Appeals of Missouri, Eastern District, First Division

October 3, 2017


         Appeal from the Circuit Court of Audrain County Honorable Wesley C. Dalton



         Monte C. Ashcraft ("Ashcraft") appeals from the judgment of the trial court, entered after a jury trial, convicting him of one count of first-degree endangering the welfare of a child and one count of abusing a child. Ashcraft challenges the sufficiency of the evidence supporting his child-abuse conviction and further contends that the trial court plainly erred in admitting testimony about the victim's immunization history. Because there was sufficient evidence to sustain Ashcraft's child-abuse conviction and the admission of testimony regarding the victim's immunization history did not result in manifest injustice, we affirm the trial court's judgment.

         Factual and Procedural History

         The State charged Ashcraft with one count of first-degree endangering the welfare of a child for failing to provide adequate nutrition to his three-month-old son ("Child"). The State also charged Ashcraft with one count of neglecting a child, or in the alternative of abusing a child, for injuring Child's arm. J.S., the mother of Child, was a co-defendant in the case, but was prosecuted separately. The case proceeded to a jury trial.[1]

         Detective Stuart Jay Thompson ("Det. Thompson") testified that Ashcraft and J.S. brought Child to the Audrain Medical Center Emergency Room with an injured arm on May 30, 2014. Child's right forearm showed significant and visible swelling. Ashcraft and J.S. told Det. Thompson that they did not know how Child injured his arm. Ashcraft claimed that he had noticed Child's swollen arm a few days before the emergency-room visit, and speculated to Det. Thompson that Child had injured his arm by sleeping on it or by pushing up on it. Ashcraft and J.S. reported that no one else had watched Child since May 25 and that Child had been in their exclusive care. As Det. Thompson went to speak with Child's doctors, Ashcraft fled the hospital. Det. Thompson left the hospital with J.S. and told her to call Ashcraft and tell him to return to their residence.

         Upon arriving at the residence, Det. Thompson arrested Ashcraft on an outstanding warrant. During further questioning, Ashcraft stated that Child was fine during the day of May 27. Ashcraft acknowledged that, on the night of May 27, he grabbed Child's right forearm when picking him up, and Child then began crying very loudly. Ashcraft admitted that he first noticed Child's swollen right forearm on May 28. Ashcraft proclaimed that only he, J.S., and God knew what caused Child's injuries.

         Jessica Blackwell ("Blackwell") was a friend of Ashcraft and occasional caregiver for Child. Blackwell testified that Ashcraft showed her Child on May 30, 2014. Seeing that Child's right forearm was raised, bruised, and red, Blackwell told Ashcraft that Child needed emergency medical care. Blackwell stated that she would sometimes watch Child without Ashcraft present, but denied that she or any of her kids broke Child's arm. Blackwell adamantly denied ever leaving her children unattended with Child. Blackwell supervised Child alone on May 20, but she did not notice anything wrong with Child at that time. Stating that she had a sexual relationship with Ashcraft during Child's first three months of life, Blackwell explained that Ashcraft instructed her to lie about this aspect of their relationship at trial.

         Bianca Connor ("Connor") testified that, on May 30, 2014, she arrived at Ashcraft's residence to visit Child. Connor stated that Child started crying when she picked him up. Ashcraft and J.S. told Connor that Child injured his arm by rolling over on it. Connor then transported Ashcraft, J.S., and Child to the hospital.

         Dr. James Brillhart ("Dr. Brillhart"), a doctor in the Audrain Medical Center Emergency Room, examined Child. Dr. Brillhart confirmed that Child was not using his right arm and ordered x-ray photos. The x-ray photos determined that Child's right forearm was broken. Specifically, the x-ray photos revealed that there was a transverse fracture of the radius and ulna in Child's right forearm. Dr. Brillhart testified that it would take "a lot of force" to break Child's forearm. Dr. Brillhart explained that this forearm injury was inconsistent with an injury caused by a baby sleeping on his or her arm or pushing up on it. After stabilizing Child's arm, Dr. Brillhart transferred Child to the Women's and Children's Hospital in Columbia.

         Dr. Dana Vietti ("Dr. Vietti"), an internal medicine pediatric resident, testified that she provided care to Child upon his transfer. Dr. Vietti ordered additional x-ray photos, revealing that Child had three rib fractures. Specifically, the x-ray photos established that Child had experienced posterior fractures of the right tenth and eleventh ribs, as well as a posterior fracture of the left tenth rib. These rib fractures were callused to different degrees, indicating that they had started healing. Dr. Vietti opined that, based on the different stages of healing and the fractures' locations, she highly suspected that Child's injuries were caused by non-accidental trauma. After inspecting Child's medical history, Dr. Vietti also confirmed that Child gained only an average of eight grams per day since birth, whereas most infants gain between twenty and thirty grams per day. Dr. Vietti testified that Child was significantly under the weight curve and malnourished. Dr. Vietti stated that the hospital staff fed Child consistently through his hospitalization, and Child gained 200 grams in his first twelve hours at the hospital.

         Dr. Rashmi Srivistava ("Dr. Srivistava"), a pediatric hospitalist, testified that Child demonstrated appropriate cues for feeding and hunger but his muscle tone was substantially underdeveloped. After observing Child, Dr. Srivistava stated that, because of his subsequent weight gain, Child's initial inability to gain weight was not due to any underlying medical condition; instead, Child simply needed to be fed. Dr. Srivistava also explained that Child's injuries were the result of abusive trauma. In particular, Dr. Srivistava explained that the rib fractures were consistent with non-accidental compression from forcefully being held.

         Dr. Ahmad Muraywid ("Dr. Muraywid"), Child's primary pediatrician, also testified for the State. Dr. Muraywid maintained that he instructed Ashcraft and J.S. on how to properly feed and care for Child. Dr. Muraywid noted that Child's poor weight gain concerned him and he communicated his concerns over Child's weight to Child's parents.

         Dr. Douglas Beal ("Dr. Beal"), a pediatrician and a member of the State Technical Assistance Team, reviewed Child's case. After examining Child's history as reported by his caregivers, Dr. Beal opined that Child's right forearm injury occurred late on May 27. Dr. Beal believed that the swelling of Child's forearm would have started immediately after the fracture occurred. Dr. Beal concluded that, within a reasonable degree of medical certainty, Child's injury was due to neglect and abuse, and not an accident. Even considering Child's malnourished state, Dr. Beal contended that it would require "a great deal of abusive force" to break Child's forearm.

         The State offered into evidence Child's medical records without objection. Child's medical records noted his lack of immunizations due to parental choice. The State then asked Drs. Vietti, Muraywid, and Beal about Child's immunization history without objection. Dr. Vietti testified that Ashcraft and J.S. decided not to vaccinate Child, which concerned her because vaccines prevent numerous childhood diseases. Dr. Muraywid also explained the benefits of vaccination, but noted that J.S. refused to vaccinate Child for her own personal beliefs. Dr. Muraywid commented that some parents refuse immunization for religious reasons, for medical concerns, or for their own personal beliefs. Dr. Beal testified that "Well, I believe in immunizations. We've come a long way in the last hundred years preventing deaths from measles, mumps, chickenpox, diptheria [sic], tetanus. There's a big movement under way, kind of a cult ...

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