The Iowa Court of Appeals has affirmed a first degree murder conviction, finding that the jury was free to conclude that the State’s expert medical cause of death testimony “within a reasonable degree of scientific certainty” satisfied the legal standard for proof beyond a reasonable doubt. In Lopez, the jury heard that a father brought an unresponsive child to the emergency department. The child later died from what appeared to be traumatic brain injury. The child’s father had reported that the child fell out a high chair. Treating physicians, the State’s medical experts, and the Polk County medical examiner testified that was unlikely “within a reasonable degree of medical certainty.”
Pediatrician Kenneth McCann was identified in the Court’s opinion as a “child abuse expert.” It is unclear from the opinion itself whether Dr. McCann was brought in to forensically examine the patient before her death—or whether he was brought in for purposes of actual treatment.
In any case, Dr. McCann developed an opinion as to the unlikeliness of the high chair accident as the cause of the injuries. In addition to the examination of the patient, Dr. McCann also attended the autopsy. He concluded that the cause of the injuries was “potential[ly] nonaccidental”
According to the Court’s opinion, Dr. Gregory Schmunk testified that he performed the decedent’s autopsy. Dr. Schmunk attributed the injuries to “an abusive act” and the cause of death was craniocerebral trauma, or, “injury to the brain and skull.”
The benchmark Dr. Schmunk was asked to meet regarding his scientific conclusions was “within a reasonable degree of medical certainty,” a phrase with which defendant took umbrage on appeal and one that is commonly summoned with regard to scientific expert opinions.
The Lopez defendant challenged the expert opinions of the prosecution’s six medical experts, all doctors. Defendant called two doctors. A total of eight doctors thus testified in this jury trial.
Seven of those doctors testified that they reached their scientific conclusions “within a reasonable degree of certainty.” Dr. McCann testified that “reasonable degree of scientific certainty . . . may not be 100 percent agreement on every detail” but essentially stated that reasonable degree of medical certainty was agreement between at least two medical professionals—“overall they come to the same opinion as I would.” Another doctor, Dr. Thomas Carlstrom, testified that it was “greater than 50 percent.”
Citing Black’s Law Dictionary, the Court held that it is “[a] standard requiring a showing that the injury is more likely than not caused by a particular stimulus, based on the general
consensus of recognized medical thought.”
The court noted that:
“A lack of absolute certainty goes to the weight of the expert’s testimony, not to its admissibility,” quoting an earlier case.
The Court clarified that “reasonable degree of medical certainty” was a phrase comprised of legal buzzwords. They apply, wrote the Court, to the judge’s gatekeeping function in order to allow or disallow the testimony offered by experts. However, once it is admitted, the jury is free to conclude a medical expert’s hypothesis carries great enough weight to convict beyond their own reasonable doubts.
The Lopez defendant objected—arguing that the “expert” testimony was mere conjecture and that, without proof he caused the injuries, there was not enough proof to convict him. He distinguished his own case from an earlier case where expert scientific opinions had been approved by the Iowa Supreme Court—but with other corroborating evidence.
The Court rejected the purported distinction, noting that evidence other than expert testimony was offered by the State. Moreover, when the dust clears on a trial, an appellate court reviews such “insufficient evidence” challenges to the verdict in a light most favorable to the jury verdict, it noted. It found the evidence in the case “substantial” enough to affirm the conviction.
The Court further held that requesting a “novel” instruction on the definition of a reasonable degree of medical certainty was unrequired and thus did not fall within those duties required of the Lopez defendant’s attorney. The Court noted that it was the Lopez defendant’s job to convince the appeals court that a change in his attorney’s strategy would have changed the jury’s verdict in order to make this argument.
“But we are not convinced the definitional instruction he proposes on appeal would have advanced that defense theory,” the Court wrote.
NOTE: David A. Cmelik Law PLC had no involvement in the Lopez case. Expect additional levels of appeal.
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