Case Title: State v. Stafford

Citation: 

Docket Number: 

State: kansas

Court: Kansas Supreme Court

Date: 2020-12-23T00:00:00Z

Document:
1 
 
IN THE SUPREME COURT OF THE STATE OF KANSAS 
 
 
No. 120,481 
 
STATE OF KANSAS, 
Appellee, 
 
v. 
 
DONNELL STAFFORD, 
Appellant. 
 
 
SYLLABUS BY THE COURT 
 
1. 
When the facts demonstrate a criminal defendant could have formed premeditation 
after an initial confrontation, but before the final blow, a premeditation instruction may 
explain that premeditation does not have to be present before a fight, quarrel, or struggle 
begins.   
 
2. 
Mere words cannot constitute sufficient provocation for a heat of passion 
voluntary manslaughter instruction, even if those words solicited murder. "Mere" does 
not bear on the gravity of the words, but on the fact that words alone are always 
insufficient to justify a lesser included instruction for voluntary manslaughter. 
 
3. 
Hearsay exceptions are not relevant to the merits of a Confrontation Clause 
challenge. Instead, a court must determine whether the challenged out-of-court statements 
were testimonial in nature and whether the criminal defendant was deprived of the ability 
to cross-examine beforehand. 
 
2 
 
Appeal from Sedgwick District Court; FAITH A.J. MAUGHAN, judge. Opinion filed December 23, 
2020. Affirmed. 
 
Kasper Schirer, of Kansas Appellate Defender Office, was on the brief for appellant.  
 
Lance J. Gillett, assistant district attorney, Marc Bennett, district attorney, and Derek Schmidt, 
attorney general, were on the brief for appellee. 
 
The opinion of the court was delivered by 
 
STEGALL, J.:  Donnell Stafford directly appeals his premeditated first-degree 
murder and two cruelty to animals convictions. Stafford alleges the district court erred 
when it included additional language in his premeditation instruction, failed to instruct 
the jury on heat of passion voluntary manslaughter, admitted allegedly impermissible 
hearsay evidence, and claims cumulative error. Finding no error, we affirm the district 
court. 
 
FACTUAL AND PROCEDURAL BACKGROUND 
 
Leuh Moore's body was found on April 8, 2018, in a dumpster behind two Wichita 
businesses. The dumpster also contained a bloody McDonald's employee polo shirt and a 
bloody black door mat draped over the body. Home security footage from the home 
behind the businesses depicted a Jeep Grand Cherokee enter the alleyway between the 
house and shops at approximately 4:33 a.m. A large male was seen in the footage 
carrying Moore's body from the SUV to the dumpster, removing a black mat, taking his 
shirt off, and placing those items in the dumpster. Someone found Moore's body later that 
afternoon. An autopsy revealed fatal stab wounds to Moore's neck, evidence of 
strangulation, sharp force injuries to Moore's head and neck, and incised wounds to 
fingers on Moore's left hand. 
 
3 
 
Moore owned a 1998 Jeep Grand Cherokee. She had previously obtained 
protection orders against Stafford. The protection from abuse orders alleged Stafford 
strangled Moore, placed a knife to her throat, and threatened to kill her. Stafford worked 
at McDonald's until the week or two before Moore's death. 
 
In the front yard of Moore's duplex police found blood, a bloody women's shirt, 
and blood on the front porch railing and front door. They observed a visible outline from 
a missing doormat in front of the door. Clumps of hair dotted the living room floor and 
blood was present throughout the living room and kitchen. Two pit bull dogs sat in 
stacked cages, were covered in blood, and suffered stab wounds to their bodies. A third 
pit bull roamed the house unharmed. The bedroom contained more blood and a cut 
mattress with several visible handprints. A wooden-handled serrated blade knife lay on 
the nightstand. 
 
Investigators tracked Stafford to Nebraska, and then to Davenport, Iowa, using his 
cell phone. Iowa authorities arrested Stafford at a motel with Moore's stolen Jeep Grand 
Cherokee, which contained blood. A pawn shop receipt showed Stafford pawned a 
television on April 8, 2018, for money shortly after Moore's death.  
 
The Iowa intake officer asked Stafford if he was married. Stafford smirked, 
paused, and asked the officer if he had his file. The officer replied he did not. Stafford 
told the intake officer "he had killed his wife in Wichita, which is why he was under 
arrest in Davenport" and added he is "usually a very laid-back guy" and "likes to read his 
Bible," but "didn't know why he did it, he just snapped." 
 
At trial, Moore's son, I.M., testified he woke up the night of April 7 to the dogs 
fighting. Stafford told I.M. to go back to sleep, and I.M. did. Stafford later took I.M. to 
I.M.'s grandmother's house, and as Stafford led I.M. from the house, I.M. saw a "lot of 
blood." I.M. also described domestic violence between "Donterio," who I.M. identified as 
4 
 
Stafford, and Moore. Donterio is Stafford's middle name. I.M.'s grandmother explained 
that Stafford brought I.M. over around 7:30 a.m. on April 8, 2018. Stafford told I.M.'s 
grandmother he had to work and would pick I.M. up around 4:00 p.m., but never 
returned. 
 
 
Dr. Tiffany Warren, a forensic nurse, testified she met with Moore on May 23, 
2017, after Stafford assaulted Moore. Dr. Warren testified Moore told her Stafford 
slapped, choked, hit her, sat on top of her, and threatened to kill her on several occasions. 
Moore passed out several times from being choked and Stafford used a jagged edged 
knife during one of the altercations. Dr. Warren's testimony included direct quotes from 
Moore. 
 
The State admitted an email chain between Stafford and Moore from May 27, 
2017, to June 20, 2017, while Stafford was in jail. Stafford and Moore argued about 
money and the poor status of their marriage. Stafford also warned she was "'still going to 
get [hers]'" and accused Moore of "sleeping around." 
 
A jury convicted Stafford of first-degree murder and two counts of cruelty to 
animals. See K.S.A. 2016 Supp. 21-5402(a)(1); K.S.A. 2016 Supp. 21-6412(a)(1), (b)(1). 
The district court sentenced Stafford to a hard 50 sentence for the murder conviction and 
two concurrent 12-month sentences for the animal cruelty convictions. Stafford directly 
appeals. 
  
DISCUSSION 
 
Stafford raises four claims of error. He argues (1) the district court erred when it 
expanded the standard premeditation PIK instruction; (2) the district court failed to 
instruct the jury on heat of passion voluntary manslaughter; (3) the district court 
5 
 
impermissibly admitted hearsay evidence; and (4) cumulative error. Finding no error, we 
affirm. 
 
The district court did not err when it included additional language in the premeditation 
instruction. 
 
 
Stafford claims the district court erred when it included several additional 
paragraphs in the standard premeditation PIK instruction. The jury received jury 
instruction No. 9, which provided the elements for first-degree murder and defined 
premeditation, including the italicized additional language: 
 
"Premeditation means to have thought the matter over beforehand, in other 
words, to have formed the design or intent to kill before the act. Although there is no 
specific time period required for premeditation, the concept of premeditation requires 
more than the instantaneous intentional act of taking another's life. 
 
"Premeditation is the process of thinking about a proposed killing before 
engaging in homicidal conduct. 
 
"Premeditation does not have to be present before a fight, quarrel, or struggle 
begins. Premeditation is the time of reflection or deliberation. Premeditation does not 
necessarily mean that an act is planned, contrived or schemed beforehand. 
 
"Premeditation can be inferred from other circumstances including:  (1) the 
nature of the weapon used, (2) the lack of provocation, (3) the defendant's conduct before 
and after the killing, (4) threats and declarations of the defendant before and during the 
occurrence, or (5) dealing of lethal blows after the deceased was felled and rendered 
helpless. 
 
"Premeditation can occur during the middle of a violent episode, struggle or 
fight." (Emphasis added.) 
 
6 
 
 
Stafford recognizes this instruction is cut straight from State v. Bernhardt, 304 
Kan. 460, 464-65, 472, 372 P.3d 1161 (2016), in which we upheld the same language. 
Stafford distinguishes Bernhardt by pointing out that the Bernhardt victim died from a 
series of blows inflicted over a long time period—warranting a clarification in the PIK. 
Stafford argues a single injury—a knife wound to the neck—caused Moore's death, so 
clarification was unnecessary.  
 
Stafford believes this court should adopt Chief Justice Luckert's or Justice 
Johnson's dissenting opinion in Bernhardt arguing the paragraphs are confusing and 
therefore legally inappropriate. See 304 Kan. at 483-89 (Johnson, J., dissenting); 304 
Kan. at 489 (Luckert, J., dissenting). He concludes the State cannot show the error was 
harmless because trial evidence suggested Moore's killing was not premeditated. Stafford 
directs us to his law enforcement interview where he said "he just snapped."  
 
"When analyzing jury instruction issues, we follow a three-step process:  
'(1) determining whether the appellate court can or should review the issue, i.e., whether 
there is a lack of appellate jurisdiction or a failure to preserve the issue for appeal; 
(2) considering the merits of the claim to determine whether error occurred below; and 
(3) assessing whether the error requires reversal, i.e., whether the error can be deemed 
harmless.'" State v. McLinn, 307 Kan. 307, 317, 409 P.3d 1 (2018).  
 
Whether a party has preserved a jury instruction issue affects our reversibility 
inquiry at the third step. 307 Kan. at 317; see K.S.A. 2019 Supp. 22-3414(3) ("No party 
may assign as error the giving or failure to give an instruction . . . unless the party objects 
thereto before the jury retires to consider its verdict . . . unless the instruction or the 
failure to give an instruction is clearly erroneous."). At the second step, we consider 
whether the instruction was legally and factually appropriate. 307 Kan. at 318. Appellate 
courts use unlimited review to determine whether an instruction was legally appropriate. 
State v. Johnson, 304 Kan. 924, 931, 376 P.3d 70 (2016). Courts must determine whether 
there was sufficient evidence, viewed in the light most favorable to the defendant or the 
7 
 
requesting party, that would have supported the instruction. State v. Williams, 303 Kan. 
585, 598-99, 363 P.3d 1101 (2016). We do not consider "whether . . . an instruction 
would have been factually appropriate" if the instruction is not legally appropriate. State 
v. Broxton, 311 Kan. 357, 363, 461 P.3d 54 (2020) (refusing to reach factual 
appropriateness after finding an instruction was not legally appropriate). 
 
 
Stafford objected to the instruction below, so any error is reversible if there is a 
reasonable probability the error affected the outcome of the trial in light of the entire 
record. State v. Louis, 305 Kan. 453, 457-58, 384 P.3d 1 (2016). 
 
 
We hold the instruction was legally appropriate. As Stafford admits, the 
instruction's language is pulled straight from Bernhardt. The Bernhardt court approved 
the additional verbiage as "correct statements of Kansas law." Bernhardt, 304 Kan. at 
472; see also State v. Stanley, 312 Kan. ___ (No. 120,310, this day decided), slip op. at 9-
11 (discussing legal appropriateness of the Bernhardt instruction in detail). Moreover, we 
have reaffirmed the Bernhardt jury instruction language. See State v. Wright, 307 Kan. 
449, 459, 410 P.3d 893 (2018) ("Our decision on the merits of this claim is controlled by 
our recent decision in . . . Bernhardt . . . . As [defense counsel] conceded, the language is 
a correct statement of the law. It was not error for the trial judge to include it in the 
premeditation instruction." [Emphasis added.]). The only question remaining is factual 
appropriateness. 
 
 
We find the additional language was factually appropriate. Stafford emphasizes a 
single stab wound to Moore's neck was the cause of death. He contrasts this with the 
multiple blows received by the Bernhardt victim, where each contributed to that victim's 
death. This somewhat mischaracterizes the Bernhardt analysis. The Bernhardt court's 
concern was not the presence or absence of significant physical wounds, but the presence 
or absence of "'a fight, quarrel, or struggle.'" Bernhardt, 304 Kan. at 472. 
 
8 
 
 
Under Stafford's reading, so long as the criminal actor only struck a single fatal 
blow, a Bernhardt instruction would never be appropriate. This is clearly not the result 
intended by Bernhardt. Rather, we must ask whether there exists "a possibility of jury 
confusion on when premeditation can or cannot occur." 304 Kan. at 470. The lynchpin of 
Bernhardt's analysis is whether premeditation "could form during or after an initial 
altercation." 304 Kan. at 472.  
 
Potential for such confusion arises when the facts demonstrate Stafford could have 
formed premeditation after the initial confrontation, but before the fatal blow. See 
Bernhardt, 304 Kan. at 472 ("The instruction correctly informed the jury that Bernhardt 
did not have to premeditate Kostner's murder before pulling her out of the car and 
beginning to kick her."). 
 
The facts here demonstrate jury confusion was likely. First, the physical evidence 
suggested a protracted struggle between Moore and Stafford spanning Moore's duplex 
and the front yard. Bloody clothing was recovered outside and blood was found in the 
front yard, on the front porch, on the porch railing, and on the front door. Inside, hair and 
blood was scattered throughout the living room and blood was found all over the kitchen. 
The two wounded pit bulls suggested at some point during the encounter, the dogs 
intervened on Moore's behalf. Moore's bedroom was covered in blood and cut marks 
were found on the mattress and mattress pad. 
 
Moore's body also showed many injuries, despite Stafford's focus on the single 
fatal neck wound. Although a single stab wound caused Moore's death, the autopsy 
revealed she suffered several stab wounds to the neck. Further, there was evidence of 
strangulation, sharp force injuries to Moore's head and neck, defensive wounds on 
Moore's left hand fingers, and her legs bore "visible injuries" and many lacerations. 
 
9 
 
The physical evidence suggests a significant struggle lasting a substantial period 
of time and alone is sufficient to cause a juror to wonder what Kansas law has to say 
about the temporal aspects of premeditation. The instruction was factually appropriate 
and the district court did not err.  
 
The district court did not err when it failed to instruct the jury on heat of passion 
voluntary manslaughter. 
 
Stafford requested a heat of passion voluntary manslaughter instruction in his 
proposed instructions and at the jury instruction conference. The district court denied this 
request as not factually appropriate. Stafford alleges reversible error, claiming there are 
sufficient facts to require such an instruction. Stafford points to his taped interview where 
he told detectives he "snapped" after overhearing Moore on the phone with a hitman. He 
argues the jury could have concluded he caught Moore soliciting his murder, and this was 
sufficient provocation for a heat of passion voluntary manslaughter instruction. 
 
 
We apply the same three-step framework previously discussed. See McLinn, 307 
Kan. at 317-18 (describing a three-step analysis:  [1] preservation, [2] merits—including 
legal and factual appropriateness, and [3] reversibility). 
 
 
The State agrees a voluntary manslaughter instruction would have been legally 
appropriate because "[v]oluntary manslaughter is a lesser included offense of first-degree 
premeditated murder." See Bernhardt, 304 Kan. at 475. We proceed to factual 
appropriateness. 
 
For an instruction to be factually appropriate, "'there must have been evidence that 
would reasonably justify a conviction of the lesser included crime.'" 304 Kan. at 375 
(quoting State v. Story, 300 Kan. 702, 710, 334 P.3d 297 [2014]). This evidence must be 
10 
 
borne out in the record, as this court does "not 'speculate about hypothetical scenarios.'" 
Story, 300 Kan. at 710 (quoting State v. Wade, 295 Kan. 916, 925, 287 P.3d 237 [2012]). 
 
K.S.A. 2019 Supp. 21-5404(a)(1) defines heat of passion voluntary manslaughter 
as "knowingly killing a human being committed . . . [u]pon a sudden quarrel or in the 
heat of passion." The corresponding PIK instruction explains "'[h]eat of passion' means 
any intense or vehement emotional excitement which was spontaneously provoked from 
circumstances. The emotional state of mind must be of such degree as would cause an 
ordinary person to act on impulse without reflection." PIK Crim. 4th 54.170 (2019 
Supp.). 
 
Again, Bernhardt is instructive.  
 
"'"The key elements of voluntary manslaughter under K.S.A. 21-3403 are an 
intentional killing and legally sufficient provocation. When reviewing whether 
provocation was legally sufficient, an objective test is used. 'Heat of passion' has been 
defined as 'any intense or vehement emotional excitement of the kind prompting violent 
and aggressive action, such as rage, anger, hatred, furious resentment, fright, or terror,' 
based 'on impulse without reflection.' The provocation "'must be sufficient to cause an 
ordinary man to lose control of his actions and his reason.'"' [Citations omitted.] 
 
. . . . 
 
"'"[I]n order to reduce a homicide from murder to voluntary manslaughter, there 
must be an adequate provocation that deprives a reasonable person of self-control and 
causes that person to act out of passion rather than reason. Mere words or gestures, 
however offensive, do not constitute legally sufficient provocation for a finding of 
voluntary manslaughter."'" 304 Kan. at 475-76 (quoting State v. Hayes, 299 Kan. 861, 
864-66, 327 P.3d 414 [2014]). 
 
11 
 
 
Further, the Bernhardt court explained "[a] sudden quarrel can be one form of heat 
of passion" and continued that an unforeseen dispute can constitute sufficient provocation 
for a heat of passion voluntary manslaughter instruction. 304 Kan. at 476 ("'The hallmark 
of heat of passion is taking action upon impulse without reflection.'") (quoting State v. 
Hilt, 299 Kan. 176, 194, 322 P.3d 367 [2014]). 
 
 
Bernhardt argued his victim's slapping him during a dispute "was objectively 
sufficient provocation to warrant a voluntary manslaughter instruction." Bernhardt, 304 
Kan. at 476. We analyzed Bernhardt's case to see if the provocation was objectively 
sufficient: 
 
"The evidence in this case—even from Bernhardt's own mouth—showed that he 
and Kostner began arguing while they were at the bar, and the argument continued during 
their car ride home. During that ride, Kostner slapped Bernhardt, and, at that point, he 
stopped, pulled her out of the car, and kicked her repeatedly. He then threw Kostner into 
the backseat of the car and began driving. After hearing Kostner's 'garbled' breathing, 
Bernhardt stopped the car again, put Kostner in the trunk, and continued driving until he 
stopped a third time and abandoned Kostner in a roadside ditch. He believed Kostner was 
still alive at the time." 304 Kan. at 476-77. 
 
 
We characterized Bernhardt's request for a heat of passion voluntary manslaughter 
instruction as "problematic." 304 Kan. at 477. First, the initial argument was not 
sufficient provocation because mere words cannot constitute sufficient provocation. 304 
Kan. at 477. Second, Bernhardt agreed that arguments akin to the one directly preceding 
Kostner's death were common between the pair—undercutting his "sudden" quarrel 
claim. 304 Kan. at 477. Third, even though Kostner slapped Bernhardt, "the slap occurred 
during their ongoing argument and 'mere evidence of an altercation between parties does 
not alone support finding sufficient provocation.' See State v. Northcutt, 290 Kan. 224, 
234, 224 P.3d 564 (2010)." Bernhardt, 304 Kan. at 477. We held the instruction was not 
factually appropriate. 304 Kan. at 477. 
12 
 
 
 
We considered a similar claim in State v. Johnson, 290 Kan. 1038, 236 P.3d 517 
(2010), and arrived at the same place. Of note, the Johnson record showed Johnson and 
his "victim had been discussing their situation and relationship all day." 290 Kan. at 
1044. Because the quarrel was an all-day affair, it could not, by the plain meaning of the 
word, be "sudden." 290 Kan. at 1046. Proof of this long, low simmer included the fact 
Johnson already threw his wife's "'clothes out into the yard'" and "'told her son that she 
was leaving because she was cheating.'" 290 Kan. at 1046. 
 
 
The Johnson court contrasted the lengthy and protracted disagreement in Johnson's 
case with the quarrel in State v. Graham, 275 Kan. 831, 69 P.3d 563 (2003). Johnson, 
290 Kan. at 1045. Unlike Johnson's feud, Graham's facts warranted a heat of passion 
voluntary manslaughter instruction. 290 Kan. at 1045. The Johnson court summarized: 
 
"In Graham, it appears that Graham's wife let it be known throughout the day in question 
that she was angry with Graham. Later that day, Graham ordered her into his truck, but 
she refused. Graham threatened her, and the victim, Crow, intervened. Graham and Crow 
then had an angry exchange and Graham drove off. Sometime later, Graham returned and 
approached Crow, cursing and saying he was going to kill him. They got into a physical 
altercation, resulting in Crow being stabbed. The actual quarrel that immediately led to 
the murder in Graham did occur quite suddenly, and the stabbing occurred during the 
physical altercation that immediately followed the sudden quarrel. The Graham court 
noted that . . . 'there was some evidence of "heat of passion" or "sudden quarrel." Thus, 
. . . the defendant was entitled to have the jury consider such evidence during its 
consideration of the elements of attempted second-degree murder.'" (Emphasis added.) 
290 Kan. at 1045. 
 
Relying on Bernhardt, Johnson, and Graham, a heat of passion voluntary 
manslaughter instruction was not factually appropriate in this case. The record does not 
provide "'evidence that would reasonably justify a conviction of the lesser included 
crime.'" See Bernhardt, 304 Kan. at 475. Foremost, in the videotaped interview, Stafford 
13 
 
claims he witnessed Moore plotting with a hitman for only a brief moment and again 
briefly when he re-summarizes the events. We find this brief mention insufficient for the 
burden required for the heat of passion instruction and akin to the "'hypothetical 
scenarios'" warned of by the Story court. See Story, 300 Kan. at 710. 
 
 
Further, mere words—even if those words solicited murder—cannot constitute 
sufficient provocation. See Bernhardt, 304 Kan. at 477. Stafford argues these mere words 
provoked him to kill Moore: 
 
"Mr. Stafford told them that he had been arguing with Moore and left the house to cool 
down. When he returned, Mr. Stafford heard Moore on the phone, arranging to have 
another man kill him. . . . At that point, Mr. Stafford 'lost it' and 'snapped.' . . . He did not 
appreciate the gravity of his actions until the fatal wound had already been inflicted." 
 
The State summarizes this well—"To be certain, the term 'mere' bears not on the 
gravity of the words themselves; rather, it means that words alone, absent more, are 
always insufficient to justify a lesser included instruction for voluntary manslaughter." 
This alone defeats Stafford's claim. See Bernhardt, 304 Kan. at 477. 
 
Comparing Stafford's case to the altercations in Bernhardt, Johnson, and Graham 
strengthens this conclusion. Much like Bernhardt, Stafford focuses on a single tree in a 
much larger forest to give the illusion the quarrel between he and Moore suddenly sprung 
up when he allegedly heard Moore on the phone with a hitman. But, this is the same 
maneuver contemplated by Bernhardt, who focused on a single slap during an argument 
that spanned a bar visit and a lengthy car ride home. See Bernhardt, 304 Kan. at 476-77. 
Stafford explained in his interview he and Moore argued for a significant period of time, 
including time for Stafford to leave the house for a walk and later return to continue the 
argument. This clearly was not a quarrel that suddenly sprang up. See Bernhardt, 304 
14 
 
Kan. at 477; see also Johnson, 290 Kan. at 1044 (Johnson and his "victim had been 
discussing their situation and relationship all day."). 
 
 
Stafford only mentions the hitman phone call in passing without any further 
elaboration. Because mere words cannot constitute sufficient provocation for a voluntary 
manslaughter instruction and because the record shows the quarrel between Stafford and 
Moore was long and protracted and did not suddenly arise, a heat of passion voluntary 
manslaughter instruction was not factually appropriate. Therefore, the district court did 
not err when it denied Stafford the instruction. 
 
Dr. Warren's testimony did not violate the Confrontation Clause. 
 
 
Next, Stafford argues Dr. Warren's primary motivation was to collect evidence for 
Stafford's later prosecution, and not to diagnose or provide Moore medical treatment. If 
so, Stafford alleges Moore's direct quotes were testimonial and violated the Confrontation 
Clause. 
 
The Confrontation Clause's protections apply in both state and federal 
prosecutions. Pointer v. Texas, 380 U.S. 400, 406, 85 S. Ct. 1065, 13 L. Ed. 2d 923 
(1965). The Kansas Constitution further provides a criminal defendant the right to "meet 
the witness face to face." Kan. Const. Bill of Rights, § 10. Stafford's argument is "subject 
to a de novo standard of review because he challenges the legal basis of the trial court's 
admission of evidence, specifically that the evidence was admitted in violation of the 
Confrontation Clause of the Sixth Amendment to the United States Constitution." State v. 
Miller, 293 Kan. 535, 555, 264 P.3d 461 (2011) (citing State v. Dukes, 290 Kan. 485, 
487, 231 P.3d 558 [2010]). 
 
 
In Miller, we explained the implications of Crawford v. Washington, 541 U.S. 36, 
68, 124 S. Ct. 1354, 158 L. Ed. 2d 177 (2004): 
15 
 
 
"Crawford held a witness' testimonial statements against a defendant are inadmissible 
unless the witness appears at trial or, if the witness is unavailable to testify at trial, the 
defendant had a prior opportunity for cross-examination. If the statements are 
nontestimonial, the Confrontation Clause guarantees are not implicated. Consequently, 
post-Crawford, the threshold question in any Confrontation Clause analysis is whether 
the hearsay statement at issue is testimonial in nature. [Citations omitted.]" Miller, 293 
Kan. at 556-57. 
 
 
We established a four-factor test to determine whether statements are testimonial: 
 
"'(1) Would an objective witness reasonably believe such a statement would later be 
available for use in the prosecution of a crime? 
 
"'(2) Was the statement made to a law enforcement officer or to another government 
official? 
 
"'(3) Was proof of facts potentially relevant to a later prosecution of a crime the primary 
purpose of the interview when viewed from an objective totality of the circumstances, 
including circumstances of whether 
 
(a) the declarant was speaking about events as they were actually happening, 
instead of describing past events; 
 
(b) the statement was made while the declarant was in immediate danger, i.e., 
during an ongoing emergency; 
 
(c) the statement was made in order to resolve an emergency or simply to learn 
what had happened in the past; and 
 
(d) the interview was part of a governmental investigation; and 
 
16 
 
"'(4) Was the level of formality of the statement sufficient to make it inherently 
testimonial; e.g., was the statement made in response to questions, was the statement 
recorded, was the declarant removed from third parties, or was the interview conducted in 
a formal setting such as in a governmental building?'" 293 Kan. at 559 (quoting State v. 
Brown, 285 Kan. 261, 291, 173 P.3d 612 [2007]). 
 
 
"Testimonial" at least "'applies at a minimum to prior testimony at a preliminary 
hearing, before a grand jury, or at a former trial; and to police interrogations,'" but 
determining if statements were testimonial is often fact-intensive. See Miller, 293 Kan. 
557-58 (quoting Crawford, 541 U.S. at 68.) 
 
 
We momentarily address the State's claim Moore's statements could be saved by a 
number of hearsay exceptions. In its brief, the State emphasizes Stafford failed to 
challenge the district court's conclusion Moore's statements were admissible under K.S.A. 
2019 Supp. 60-460(1)(1), (1)(2), and (d)(3)—the exceptions for existing state of mind, 
statements made for medical diagnosis, and contemporaneous statements, respectively. 
 
 
This is true—Stafford does not challenge the admissibility of Moore's statements 
through Dr. Warren under any of those hearsay exceptions. But the operative question 
before us is not whether Moore's statements can be saved with statutory hearsay 
exceptions. We must ask whether the statements are testimonial in nature. See Miller, 293 
Kan. at 557 ("Nevertheless, the fact the evidence may be admissible under a hearsay 
exception does not cure the confrontation problem if N.A.'s statements made to the 
SANE are found to be testimonial."). The State may be correct these statements would be 
admissible under several hearsay exceptions, but Stafford's claim may still ultimately 
prevail if the statements were testimonial in nature, and he was deprived the ability to 
cross-examine beforehand. 
 
 
In Miller, we explained "statements made for the sole purpose of medical 
treatment, regardless of the employer of the medical professional to whom the statements 
17 
 
are made, are not testimonial." (Emphasis added.) 293 Kan. at 575-76. To determine 
whether a questioner solely pursued medical treatment we should ask "whether the 
interrogator is an agent of law enforcement charged with gathering information for 
purposes of trial" and examine the specific questions and responses because some 
questions could be interpreted as serving either a medical function or a law enforcement 
function, or both. 293 Kan. at 576-77. We discussed several helpful factors—including 
the witness' consent; whether the medical professional followed evidence-collection 
protocols; whether the witness or law enforcement requested the examination; and 
whether the witness requested information to not be shared with law enforcement. 293 
Kan. at 577-78. 
 
Stafford argues Dr. Warren acted as a state agent because she recorded Moore's 
statements and took photographs—actions he calls traditional investigatory tools to serve 
law enforcement functions. We disagree. In a pretrial motion hearing, Dr. Warren 
testified her employer was Via Christi Hospital in Wichita and the record is silent if any 
police were present during Moore's interview with Dr. Warren. Dr. Warren did not testify 
she collected evidence, but instead offered "comprehensive care" to "sexual assault, 
domestic violence, child abuse, [and] human trafficking" victims. Dr. Warren explained 
she took Moore's history—"[f]or the purpose of diagnoses, treating injuries, and assault 
related issues" and helped formulate a future safety plan. Dr. Warren said the safety plan 
was "part of [Moore's] treatment." At trial, Dr. Warren explained she informs her patients 
they do not have to talk with her and she will not interview them without their consent.  
 
Dr. Warren never indicated she used KBI forms, or "collected evidence" in any 
capacity—factors important to the Miller court. See 293 Kan. at 578. Her pretrial motion 
hearing testimony indicated she believed her only role was to provide Moore with an 
appropriate medical history for a "holistic" medical approach and to equip Moore with 
tools she needed to be safe in the future. On these facts, we hold Dr. Warren was not a 
state agent. 
18 
 
 
 
So what was the primary purpose of the interview? See 293 Kan. at 580. 
According to Stafford, Dr. Warren's primary purpose was evidence collection. He again 
points to the photographs taken during the interview and suggests Moore's medical 
treatment ended before Dr. Warren's interview began. We don't agree.  
 
The record certainly suggests a medical purpose for Moore's examination. See 293 
Kan. at 580-81. Moore sustained injuries from Stafford's attack and Moore received 
medical evaluation and treatment for those injuries. See 293 Kan. at 581-82. The injuries 
Moore sustained during the first attack were extensive—Moore told Dr. Warren Stafford 
slapped, choked, hit, and sat on top of her. Moore blacked out from a lack of oxygen and 
blood flow to her brain. Stafford squeezed Moore's throat so tightly, her ability to breathe 
and swallow was restricted. Stafford grabbed Moore by the hair, threw her to the floor, 
and punched her on the head and chest. Moore certainly "suffered injuries from the 
attack." See 293 Kan. at 581. Dr. Warren described her role as providing treatment and 
comprehensive care to domestic violence victims and to help create victim safety plans. 
 
 
Viewing this testimony objectively, we hold "there is evidence . . . that suggests a 
medical purpose to the examination." See 293 Kan. at 581. Moore's statements made 
through Dr. Warren were not testimonial and did not implicate the Confrontation Clause. 
We find no error. 
 
Cumulative error did not deny Stafford a fair trial. 
 
 
Stafford claims cumulative error denied him a fair trial. Because we find no error, 
the cumulative error doctrine does not apply. State v. Marshall, 303 Kan. 438, 451, 362 
P.3d 587 (2015); see also State v. Blansett, 309 Kan. 401, 402, 435 P.3d 1136 (2019) 
(explaining that under the cumulative error doctrine, the court must identify "multiple 
errors to accumulate"). 
19 
 
 
 
Affirmed. 
 
 
BEIER, J., not participating. 
 
MICHAEL E. WARD, Senior Judge, assigned.1 
 
* * * 
 
 
LUCKERT, C.J., dissenting:  I dissent because I would hold the confusing and 
contradictory jury instruction No. 9, which defined premeditation, could have misled the 
jury. Specifically, the instruction could have caused the jury to understand that Donnell 
Stafford needed to have thought only about striking Leuh Moore with a knife before he 
did so, not that he needed to have formed an intent to kill her. Given this mistaken 
understanding, a reasonable probability exists that the erroneous instruction affected the 
outcome of Stafford's trial given the entire record. 
 
My dissent stems from the erroneous wording in the premeditation instruction—
not with a disagreement as to the majority's holding that Stafford could have formed 
premeditation after his confrontation with Moore began but before he struck the fatal 
blow. A reasonable jury could have relied on Stafford's testimony and concluded he at 
first intended to commit domestic battery without inflicting death—much as he had on 
prior occasions. But a reasonable jury could have also concluded a prolonged fight 
occurred during which violence escalated, anger grew, and Stafford's intent to cause 
 
 
 
1REPORTER'S NOTE:  Senior Judge Ward was appointed to hear case No. 120,481 
under the authority vested in the Supreme Court by K.S.A. 20-2616 to fill the vacancy on 
the court by the retirement of Chief Justice Lawton R. Nuss.  
 
20 
 
bodily injury short of death morphed into a design to kill that he deliberated—perhaps 
between assaults on Moore—before carrying out that intent.  
 
I dissent because the instruction did not clearly explain the concept that 
premeditation could occur after the fight started. Instead, as I said in another case 
analyzing the same instruction, the "instruction was so contradictory and misleading that 
a lay juror could not have clearly understood premeditation." State v. Bernhardt, 304 
Kan. 460, 489, 372 P.3d 1161 (2016) (Luckert, J., dissenting). The result is an erroneous 
instruction. See State v. Horton, 300 Kan. 477, 491, 331 P.3d 752 (2014) (citing State v. 
Appleby, 289 Kan. 1017, 1059, 221 P.3d 525 [2009]) (jury instructions must "properly 
and fairly state[] the law as applied to the facts of the case and . . . not have reasonably 
misled the jury"). 
 
Again, jury instruction No. 9 stated: 
 
"Premeditation means to have thought the matter over beforehand, in other 
words, to have formed the design or intent to kill before the act. Although there is no 
specific time period required for premeditation, the concept of premeditation requires 
more than the instantaneous intentional act of taking another's life. 
 
"Premeditation is the process of thinking about a proposed killing before 
engaging in homicidal conduct. 
 
"Premeditation does not have to be present before a fight, quarrel, or struggle 
begins. Premeditation is the time of reflection or deliberation. Premeditation does not 
necessarily mean that an act is planned, contrived or schemed beforehand. 
 
"Premeditation can be inferred from other circumstances including:  (1) the 
nature of the weapon used, (2) the lack of provocation, (3) the defendant's conduct before 
and after the killing, (4) threats and declarations of the defendant before and during the 
21 
 
occurrence, or (5) dealing of lethal blows after the deceased was felled and rendered 
helpless. 
 
"Premeditation can occur during the middle of a violent episode, struggle or 
fight." 
 
It is true that the instruction derives from statements in decisions of this court. But 
the instruction removes these statements from the context in which they were first made, 
and the statements often do not come with the explanations or qualifications found in the 
original text. Incorrect statements of law result. Plus, some of these statements contradict 
other portions of the instruction that give a full explanation. The instruction is thus 
misleading and confusing. Parsing the instruction helps explain why.  
 
The first paragraph in the Bernhardt/Stafford premeditation jury instruction 
follows PIK Crim. 4th 54.150(d), Kansas' standard jury instruction defining 
premeditation. This pattern instruction—and thus this first paragraph of the 
Bernhardt/Stafford premeditation jury instruction—correctly explains that premeditation 
(1) means to have formed a design or intent to kill before the act and (2) requires 
something more "than the instantaneous, intentional act of taking another's life." So far, 
so good. The error arises because the rest of the instruction restates the first of these two 
points in ways that blurs or contradicts the meaning.  
 
Compare two statements that make the first point of explaining that premeditation 
means to have formed a design or intent to kill before the act. The instruction's first 
paragraph makes this point by saying:  "Premeditation means to have thought the matter 
over beforehand, in other words, to have formed the design or intent to kill before the 
act." The second paragraph of the Bernhardt/Stafford instruction essentially repeats the 
first portion of this sentence:  "Premeditation is the process of thinking about a proposed 
killing before engaging in homicidal conduct." But it leaves out the critical requirement 
22 
 
that this process of thinking about the killing must lead to the formation of a design or 
intent to kill.  
 
Because the instruction states the principle one way in the first paragraph and 
another way in the second, a reasonable jury could conclude there are two paths for 
finding premeditation—the first where Stafford formed the intent to kill and the second 
where he thought about killing but rejected it. The second statement, without the critical 
requirement that the defendant must form a design or intent to kill, could lead a 
reasonable jury to conclude Stafford committed first-degree murder even though, as he 
testified, he did not intend to kill Moore. The instruction was thus erroneous.  
 
 
To add to the confusion, the third paragraph conflicts with the statement in the 
first paragraph. It informed the jury:  "Premeditation does not necessarily mean that an 
act is planned, contrived or schemed beforehand." Compare this sentence with the first 
sentence of the instruction that defined premeditation as "to have formed the design or 
intent to kill before the act." How does a reasonable juror not well-versed in the law of 
premeditation reconcile a requirement that a defendant form a design to kill before 
committing the act with the statement that premeditation does not necessarily mean the 
act was planned, contrived, or schemed? As Justice Johnson stated in his Bernhardt 
dissent:  "How does one reflect or deliberate about killing the victim without planning, 
contriving, or scheming to kill the victim? If the defendant was not planning, contriving, 
or scheming to kill the victim, he or she was not premeditating the murder." Bernhardt, 
304 Kan. at 486 (Johnson, J., dissenting).  
 
If given context or explained, one can reconcile the two statements. The reference 
to "the act" in the first sentence refers to the killing—that is, to deliberating and reflecting 
on an intent to cause death. But the sentence in the third paragraph seems to refer to the 
type of act that leads to the death. At least that is the best way I can reconcile the two and 
that conclusion reflects distinctions in our caselaw. See State v. Deal, 293 Kan. 872, 885, 
23 
 
269 P.3d 1282 (2012) (discussing distinction between intent to commit a specific act and 
intent to cause a type of injury, such as death or great bodily harm). With an explanation 
that a design or intent to kill is required but that the precise mechanism of death does not 
have to be plotted beforehand, both statements can be correct. But the lack of context or 
explanation for the statement in the third paragraph could have misled Stafford's jury.  
 
 
Likewise, the lack of context makes the fourth paragraph of the Bernhardt/Stafford 
instruction misleading. That paragraph states:  
 
"Premeditation can be inferred from other circumstances including:  (1) the 
nature of the weapon used, (2) the lack of provocation, (3) the defendant's conduct before 
and after the killing, (4) threats and declarations of the defendant before and during the 
occurrence, or (5) dealing of lethal blows after the deceased was felled and rendered 
helpless. 
 
Usually judges surround this instruction with a contextual explanation as shown in State 
v. Wright, 307 Kan. 449, 459, 410 P.3d 893 (2018), a case the majority cites to support its 
holding. The additional explanation more clearly conveyed that the purpose of the 
instruction was not to define premeditation but to explain circumstances a jury could 
consider when evaluating if the State had proved premeditation. 307 Kan. at 455-56.  
 
 
Here, the judge placed the five circumstances in the middle of an instruction that 
defined premeditation. While the language was sufficient to explain to one with a law 
degree the limited purpose of the circumstances, the purpose would not have been 
apparent to the average reasonable juror. The instruction thus could have misled the jury 
to believe that the circumstances defined premeditation as opposed to describing the type 
of evidence that could show whether Stafford had formed a design or intent to kill Moore 
before he stabbed her in the neck and caused her death. In other words, given the fifth 
circumstance, the jury could have believed Stafford deliberated the intent to kill Moore 
after he stabbed her in the neck.  
24 
 
 
 
For these reasons, I would hold that the premeditation instruction was erroneous.  
 
Having reached that conclusion, I must determine whether this error required 
reversal. Stafford objected to the instruction, which means the error is reversible if there 
is a reasonable probability the error affected the outcome of the trial given the entire 
record. State v. Louis, 305 Kan. 453, 457-58, 384 P.3d 1 (2016); see K.S.A. 2019 Supp. 
22-3414(3) ("No party may assign as error the giving or failure to give an instruction . . . 
unless the party objects thereto before the jury retires to consider its verdict . . . unless the 
instruction or the failure to give an instruction is clearly erroneous."). I conclude this 
reasonable probability exists.  
 
When Stafford first discussed the incident with law enforcement, he said that "he 
just snapped." He later told detectives that he went into a rage when he heard his wife on 
the phone plotting to have him killed. In other words, his testimony suggested he acted 
impulsively and without reflection. While I recognize there is substantial evidence 
supporting premeditation, a reasonable probability the error affected the outcome of the 
trial arises because of the second paragraph in the instruction. There is a reasonable 
probability that this portion of the instruction led the jury to conclude Stafford committed 
first-degree murder based on a premeditated intent to stab Moore, even though, as he 
testified, he did not intend to kill her. The lack of explanation and context accompanying 
other statements in the instruction would not have countered this misstatement but only 
added to the confusing morass of words the jury had to fight through.  
 
 
Stafford is entitled to a new trial in which a clear instruction guides the jury.