1 

In The

Court of Appeals

Ninth District of Texas at Beaumont

__________________

NO. 09-22-00154-CR

NO. 09-22-00155-CR

__________________

JEFF TAYLOR BELL, Appellant

V.

THE STATE OF TEXAS, Appellee

__________________________________________________________________

On Appeal from the 359th District Court

Montgomery County, Texas

Trial Cause Nos. 20-06-06597-CR (Count I) and 20-06-06597-CR (Count II)

__________________________________________________________________

MEMORANDUM OPINION

Fabian Ramirez died after a motor vehicle collision on June 2, 2020. A grand 

jury indicted Appellant Jeff Taylor Bell (“Appellant,” “Jeff,” “Bell,” or “the 

defendant”) on two counts: (1) accident involving personal injury or death, for 

failing to stop and render aid at the scene of the accident, and (2) intoxication 

manslaughter, for driving while intoxicated and causing Ramirez’s death. See Tex. 

Penal Code Ann. § 49.08(a); Tex. Transp. Code Ann. § 550.021(a). Bell pleaded not 
2

guilty, but a jury found him guilty and, after a hearing on punishment, the jury 

assessed punishment at twenty years of confinement on each count. The trial court 

ordered the sentences to run concurrently. Bell appealed. In two issues, Bell argues 

that the trial court erred by denying the admission of evidence of the victim’s blood 

alcohol content and in denying a jury instruction on the law of concurrent causation. 

We affirm as modified.

Pretrial Hearing

Prior to trial, the State filed a motion in limine seeking, in relevant part, to 

exclude from evidence “[a]ny statements during the guilt/innocence phase of trial 

concerning Fabian Ramirez consuming alcohol prior to the crash or any evidence 

concerning his blood alcohol concentration[]” because “[t]hese statements are not 

relevant to guilt or innocence.” At a hearing on the motion, the prosecutor told the 

trial court that the defendant had bypassed a light and failed to yield right-of-way, 

which caused the crash involving Bell’s vehicle and Ramirez’s motorcycle, and there 

was no evidence that the driver of the motorcycle was at fault. The prosecutor also 

stated that although Ramirez’s speed “could potentially be an issue[,]” any evidence 

of his possible intoxication was not relevant. Defense counsel responded that not 

allowing evidence of Ramirez’s blood alcohol content would deny the defendant due 

process and the right to present a defense. The defense also argued that evidence of 

Ramirez’s intoxication was relevant to causation. The trial court granted the motion 
3 

in limine and stated that evidence of Ramirez’s blood alcohol content should not be 

mentioned without a discussion at the bench.

Evidence at Trial

Testimony of Alex Collier

Alex Collier testified that he was inside a gas station in Grangerland near the 

intersection of FM 2090 and FM 3083 on June 2, 2020, when he heard a loud noise. 

Collier ran outside, where he saw a motorcycle on the ground and a man lying to 

one side who did not look good, and he saw a woman lying on the ground about fifty 

yards away. Collier also observed scattered pieces of the motorcycle. Collier recalled 

that he saw a front bumper and a man standing by the vehicle with the missing 

bumper, and Collier said to him, “I think you killed him.” Collier identified the 

defendant as the man he saw standing by his vehicle that day. Collier testified that 

about two minutes after the crash, the defendant then drove off, Collier yelled at him 

to stop, but the driver “just kept driving as fast as he could.” Collier did not see the 

defendant call for assistance, provide his information or license, nor make any 

attempt to render aid. Collier stayed at the scene for several hours, and he did not 

see the defendant return.

Testimony of William Wayne

William Wayne testified that he was at the Exxon station in Grangerland on 

June 2, 2020, at about 7 p.m. when he heard “the sound of two vehicles smacking 
4 

into something.” When Wayne ran outside, he saw that a motorcycle had run into a 

trailer and a man and a woman were lying on the ground. Wayne recalled that a gray 

car was involved in the crash, a white male had gotten out of the car and was looking 

at the scene, the man said either, “I’m so sorry or I messed up[,]” and then the man 

ran to his car and left the scene, but the bumper of the car was left behind. Wayne 

testified that he stayed at the gas station for a couple of hours, and he did not see the 

white male give his information to anyone, attempt to call for emergency assistance, 

render aid, nor return to the scene.

Testimony of Iftikhar Mehboob

Iftikhar Mehboob testified that he is the manager of the Exxon store in 

Grangerland on FM 3083. He testified he had known Roy Bell for some time, Jeff 

Bell had just moved back to the area shortly before the crash, and Jeff became a 

“regular customer” at his store and came to the store three to four times a day. 

Mehboob identified the defendant as Jeff Bell. Mehboob recalled that sometime in 

the early afternoon of June 2, 2020, Jeff Bell had come to his store, and Mehboob 

believed that Jeff was intoxicated based on his body language and he asked Jeff to 

go home and sleep. He also told Jeff not to drive. Mehboob testified that Jeff had 

bought beer at the store before. Mehboob also testified that he did not see Jeff drink 

that day.
5 

Testimony of Roy Bell

Roy Bell (“Roy”), the defendant’s father, testified that he lived very near the 

location where the accident happened, and that his son Jeff goes to the Exxon station 

to buy sodas and beer. According to Roy, Jeff arrived at his house early on June 2, 

2020 driving a small passenger car he had just bought. Roy testified that Jeff had 

two 24-ounce beers on the table, and Roy saw Jeff drink one of the beers. Roy 

recalled that about 7 p.m., Jeff left to get a haircut, and Roy went to the store, where 

he heard ambulances, he saw a motorcycle lying on the ground and a bumper that 

looked like Jeff’s bumper. According to Roy, when he was at the scene of the 

accident, he told law enforcement that Jeff had been drinking. Roy testified that he 

said Jeff had three or four beers because he considers one 24-ounce beer to be two 

beers, and he had seen two 24-ounce beers at the house that day. Roy agreed that, at 

the time of the accident, Roy stated that Jeff “didn’t act drunk, but I assumed that he 

was drunk because he took off, and [] I just couldn’t understand all that.” According 

to Roy, Jeff has mental health issues, and he observed Jeff to be having 

“bipolar/schizophrenic episodes” the day of the accident.

Testimony of Maria Montano

Maria Montano testified that she owns a hair salon at the intersection of FM 

2090 and FM 3083, where she was working on June 2, 2020. According to Montano, 

a man came into the salon after her closing time of 5 p.m. that day and asked for a 
6 

haircut, and she asked him to come back the next day. Montano testified that she had 

not seen the man before, he was “a little bit nervous and kind of stumbling[,]” and 

she thought maybe he was drunk or under the influence of something. Montano 

identified the defendant as the man who came into her salon that day after closing 

time.

Testimony of Kevin Culver

Kevin Culver, a Captain Paramedic with Montgomery County Hospital 

District, testified that he responded to a serious motor vehicle crash on June 2, 2020, 

just south of the intersection of FM 2090 and FM 3083 in front of an Exxon gas 

station. Culver recalled that the paramedic team arrived at the scene at 7:56 p.m., 

and they identified two patients—a man and a woman, and the woman was lying 

about thirty feet from the man. Culver testified that he treated the man, who was 

unconscious, had signs of internal hemorrhage, abrasions, a severe wound to his 

back, and signs of brain trauma. According to Culver, the woman’s injuries were not 

as severe as the man’s. Culver testified that the paramedics were very worried about 

whether the man might die and they did not try to assess the man for alcohol or 

drugs.

The patient care records for the man and the woman were admitted into 

evidence. The man’s patient care report states that bystanders reported that the 

motorcycle was struck by a car, the motorcycle lost control and went off the road, 
7 

where it struck the back of a utility trailer, and both riders on the motorcycle were 

thrown from the bike. The woman’s patient care report states that the woman told a 

paramedic, “we nearly got hit with a car. And my husband swerved into the parking 

lot to avoid a crash.”

Testimony of Trooper Andrew Evans

Andrew Evans, a trooper with the Department of Public Safety (“DPS”), 

testified that he was called to investigate a crash scene in Grangerland on June 2, 

2020. Evans identified several photo exhibits that showed the roadway and accident 

scene, and he testified that the photos show marks for gouges, skid marks, and body 

slide marks that are later used to scale and measure the scene. On cross-examination, 

Evans did not agree that the evidence showing the long distance the woman on the 

motorcycle traveled in the accident suggested that the motorcycle was traveling at a 

high rate of speed.

Testimony of Trooper Benjamin Polansky

Benjamin Polansky testified that he was a trooper with DPS and had attended 

six levels of crash school and a motorcycle-pedestrian reconstruction class. Polansky 

became involved in this case two days after the accident and assisted in 

measurements used for a scaled diagram. Polansky testified, that based on 

measurements at the scene, the post-impact speed of the motorcycle was between 56 
8

and 64 miles an hour, and the speed limit on FM 3083 is 50 miles an hour, but that 

post-impact speeds do not indicate how fast the motorcycle was going before impact.

Polansky testified that a person on the roadway would have the right-of-way 

over a person coming out of the private drive at the convenience store, and the person 

leaving the private drive would be responsible to determine if there is enough space 

to exit onto the road. According to Polansky, if a person pulling out of a private drive 

caused an accident because someone on the road could not stop in time, the person 

leaving the drive would get a ticket. Polansky testified that the line of sight on the 

roadway is “pretty far[]” with nothing blocking a driver’s view for about a mile and 

the improved shoulder where FM 3083 meets the convenience store private drive is 

“relatively large.” Polansky agreed that a driver exiting the convenience store private 

drive could pull “pretty far forward” into the road without crossing the fog line.1

On cross-examination, Polansky agreed he did not know how fast the 

motorcycle was going at the time of the accident. He testified that the woman had 

travelled a little over 142 feet past where the motorcycle was after the accident. He 

also testified that the defendant caused the crash by failing to yield the right-of-way 

on a private drive. 

1 Trooper Polansky explained that the “fog line” is the white line at the far 

right of the road that separates the road from the shoulder.
9 

Testimony of Sergeant Jason Smith

Jason Smith, a sergeant with the Montgomery County Precinct 2 Constable’s 

Office, testified that he is a mental health peace officer and has received training in 

detecting whether persons are under the influence of alcohol or controlled 

substances. He agreed he responded to an accident at the intersection of FM 2090 

and FM 3083 on June 2, 2020, where the shoulder of the road was “wide enough for 

a vehicle to be able to pull off onto the shoulder and be completely out of the moving 

lane of traffic.” Based on paint on the tire of a trailer that was parked at the gas 

station, Smith determined that “the motorcycle had made impact with the trailer.” 

Smith testified that he ran the license plate of a detached car bumper found at the 

scene and learned it belonged to a 1999 Honda Accord. Smith also found a helmet 

and protective motorcycle vest for the male victim and a jacket and helmet for the 

female victim. According to Smith, it was not dark at the time of the collision. Based 

on the evidence he collected and interviews he conducted, Smith determined that an 

offense had occurred—failure to stop and render aid resulting in serious bodily 

injury to Fabian Ramirez.

Smith testified that Roy Bell identified himself to Smith at the scene, and 

Smith took Roy’s statement. According to Smith, he heard a conversation between 

Jeff and Roy because Jeff had called Roy at about 9:23 p.m. while Roy was still at 

the scene, and Roy had the speaker of his phone on. Smith testified that he heard Jeff 
10

ask if the victim was deceased, make comments about wanting to harm himself, and 

sounding anxious, excited, and “very slurry when he talked.” 

Smith testified that he was not able to locate Jeff Bell that night, but he later 

learned that Jeff Bell was in the Wharton County Jail. Smith got an offense report of 

Bell’s arrest in Wharton County from DPS, and he also learned that Bell’s vehicle 

had been towed. Smith identified photos he took of Bell’s vehicle, which show the 

vehicle is missing the front bumper cover and the right front headlight was broken, 

and Smith testified that the damage to Bell’s vehicle was consistent with what Smith 

found at the crash scene.

Smith testified that he met with Jeff Bell at the Wharton County Jail the day 

after the crash and a DVD copy of the video of his interview with Bell was admitted 

into evidence and played for the jury. Smith testified that the defendant told him that 

“after the crash” he got out and looked at the victim and saw that he had “pretty bad”

injuries and got scared and left the scene and just started driving. Bell told Smith he 

had stopped at a store in the “Wharton area” and purchased one big beer. Smith 

testified he understood that Bell initially went to the Grangerland post office to get 

a haircut and was told that the hair salon was around the corner, however according 

to Smith, Bell did not remember being at the post office the day of the crash or why 

he was there, and Smith thought that was significant because “it’s not like [] there 

had been such a time period that you wouldn’t remember going to the post office[]” 
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and it could be a sign of intoxication. Bell told Smith that he was driving from the 

store onto FM 3083. Bell also told Smith that he drank the beer early in the day, but 

then he went to sleep. At one point in the interview, Bell told Smith that he was 

“buzzed” on the afternoon of the crash, he went to sleep, and he was dehydrated 

when he woke up. When asked whether he had concerns about the defendant saying 

he had slept the afternoon of the crash, Smith replied, “yes[,]. . . [b]ecause somebody 

that’s been drinking to an extent that was described to me, becoming tired or sleepy 

or sleeping . . . at that time of day, the alcohol could be a factor in that.” Smith agreed 

that he formed an opinion that Bell was intoxicated on the night of the crash based 

on the totality of the circumstances learned during his investigation.

According to Smith, Bell had the legal duty to stop at the scene, to provide his 

identification and insurance, to render aid to the victim by calling EMS for assistance 

or to provide aid himself to the best of his ability, but based on his investigation, 

Smith testified that Bell did not do this. Smith testified that it was “[a]bout 90 to 95 

miles[]” from the crash scene to the location where the defendant was arrested in 

Wharton County at about 9:45 p.m. As a result of his investigation and interviews, 

Smith concluded that the defendant caused the crash 

. . . because the defendant failed to yield the right-of-way resulting in 

the motorcycle striking his vehicle; and the motorcycle occupants being 

ejected from the vehicle; and then the deceased victim further striking 

the trailer that was parked at the gas station. 
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Smith further testified that the defendant violated the traffic code by intentionally 

bypassing the traffic light at the intersection and cutting through a parking lot. Smith 

also testified that intoxication was a factor because it impairs judgment and slows 

reaction time.

Smith also testified that the traffic light by the intersection near where the 

crash happened was working on the day of the crash, that the skill level of the driver 

of the motorcycle could affect determination of the cause of the crash, and that the 

distance between the point of impact and where the female passenger lay did not 

necessarily mean the motorcycle was going at an extremely high speed. Smith 

testified that Neftali Ramirez—Fabian Ramirez’s wife and a passenger on the 

motorcycle at the time of the crash—told him the traffic light was green when they 

drove through the intersection, but that Bell had a duty to yield right-of-way whether 

the light was red or green.

Testimony of Neftali Ramirez

Neftali Ramirez testified that Fabian Ramirez was her husband, that he bought 

a motorcycle on the day of the accident, but he had been riding motorcycles since he 

was fourteen years old. Neftali also testified that she and Fabian had motorcycle 

jackets and helmets because they had “driven bikes before.” According to Neftali, 

Fabian drank a beer after work at about 3 p.m. on the day of the crash, but when they 

got on the motorcycle later to go to dinner, she did not believe Fabian was 
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intoxicated. Neftali recalled that Fabian was driving at a reasonable speed that night, 

the traffic light at the intersection was green, and Fabian moved the bike to the right 

because a vehicle on the left side of the road was coming toward them. According 

to Neftali, the car did not have the right-of-way, it was not supposed to be traveling 

in their lane, and they were not able to get the motorcycle out of the way. Neftali did 

not remember anything that happened right before or after the collision. Neftali 

testified there was nothing Fabian could have done to avoid the collision.

Testimony of Trooper Glen Taft

Glen Taft testified that he works for the highway patrol in Wharton County, 

and he encountered Jeff Bell at about 9:35 p.m. on June 2, 2020, on Highway 59 

while on routine patrol. Taft noticed Bell’s vehicle had a defective headlamp, and 

when he prompted Bell to pass him, it took a while for the car to stop. According to 

Taft, the vehicle pulled over to the left side of the road at the center median, and 

when Taft used his PA system to tell the driver to pull over on the right side of the 

road, the driver did not do so. Bell testified that he pulled his vehicle next to Bell’s 

and he “noticed right away his [] expression on his face and his red glassy eyes[,]” 

and Taft thought “this person looks like they could be intoxicated.” Taft recalled that 

when he approached Bell’s vehicle, Bell’s hands were outside the window, Bell’s 

eyes were red and glassy, he looked disheveled, and some kind of liquid was on his 

shirt. According to Taft, as soon as Bell stepped outside his car, Bell’s balance was 
14

unsteady. Taft testified that Bell told him he was coming from Houston and that he 

was going to Surfside, which stood out to Taft because Bell was “substantially off 

course from going to Surfside.” According to Taft, Bell told him he had drunk three 

beers. Taft recalled that when Bell flicked his cigarette into the grass, Taft noticed 

an open container of beer in the grass a few feet away and Bell told him it was his 

beer. Taft testified that when he picked up the can, he noticed it was still cold, and 

that meant “somebody had an open container in the vehicle with him while they were 

operating a motor vehicle.” Taft testified that Bell admitted he had thrown out the 

beer, and Taft recalled that it looked like it was larger than a 12-ounce beer. Taft 

also testified that, while he was in his patrol car running Bell’s information through 

dispatch, Bell “took off running on foot[,]” Taft then ran after him and took Bell into 

custody. When Taft did an inventory of Bell’s vehicle, he noticed there was damage 

to the front and no front license plate.

Taft agreed he was qualified to conduct standardized field sobriety tests, 

which he conducted with Bell at the Wharton County jail. According to Taft, Bell 

displayed six of a possible six clues on the horizontal gaze nystagmus test, four out 

of a possible eight clues on the walk-and-turn test, and three out of a possible four 

clues on the one-leg stand test. Based on these test results and the way Bell looked 

and acted, Taft formed an opinion that Bell was intoxicated, and he placed Bell under 

arrest for driving while intoxicated. Taft also asked Bell to provide a breath 
15

specimen, but Bell refused, so Taft filled out an affidavit for a blood warrant that 

was issued at 12:11 a.m. on June 3, 2020. According to Taft, he sealed the blood 

specimen in an evidence box and delivered it to the DPS crime lab in Houston on 

June 5, 2020.

According to Taft, Bell never mentioned to him the crash that occurred in 

Montgomery County. Taft identified State’s Exhibit 78 as a recording of the DWI 

and evading arrest investigation he did on Jeff Bell on June 2, 2020, and the exhibit 

was admitted and played for the jury. In the recording, at one point Bell tells Taft 

that he has had three beers, and at another point, Bell tells Taft he had five beers. 

Testimony of Jack McKelvy

Jack McKelvy testified that he works as a paramedic, and that in June 2020, 

he was working in Wharton. McKelvy agreed he performed a blood draw on Jeff 

Bell and created a report and that Bell was initially agitated and said they were not 

going to draw his blood, but that he later calmed down and allowed the blood draw. 

McKelvy recalled that he arrived at the Wharton County Jail at about 12:42 a.m. and 

left at 1 a.m. 

Testimony of Cheryl Szkudlarek

Cheryl Szkudlarek testified that she is a forensic scientist with the DPS crime 

lab where she has worked for more than eight years analyzing controlled substances 

and blood or urine samples for alcohol concentration. She agreed she analyzed a 
16

blood sample from Jeff Bell and that Glen Taft submitted the sample on June 5, 

2020. According to Szkudlarek, if a blood sample sits in an officer’s vehicle for two 

days before submitting it to the lab, it does not have an effect on her analysis and 

“[t]he most likely effect that you would see by it not being refrigerated is a decrease 

in the ethanol concentration[]” so that any change in the sample would only benefit 

the defendant.

Szkudlarek testified that she uses “headspace gas chromatography with flame 

ionization detection[]” in her analysis, and that this method has been around for 

many years and is widely accepted by the scientific community. Szkudlarek 

identified State’s Exhibit 80 as her report on Bell’s blood sample, and her analysis 

showed “0.238 grams of alcohol per 100 milliliters of blood.” Szkudlarek also 

testified that the legal limit in Texas is 0.08 grams of alcohol per 100 milliliters of 

blood, and that “just under 12 standard drinks[]” would produce the blood alcohol 

content results observed in this case. 

Testimony of Dr. Alex John

Dr. Alex John testified that he is a forensic pathologist and works for the 

Montgomery County Forensic Services Department, and he performed an external 

examination of Fabian Ramirez. Dr. John testified that the death certificate admitted 
17

into evidence is for “Fabian Ramirez Sierra AKA Raymond Raul Sanchez Planas.”2

The doctor testified that Ramirez was a thirty-year-old Hispanic male who was taken 

to HCA Houston Healthcare Conroe after a motor vehicle-motorcycle collision 

where he was diagnosed with “multiple fractures, including rib fractures and other 

injuries, including lumbar fibular fractures and head trauma.” According to the 

doctor, hospital personnel “worked on him for about two days” and Ramirez was 

pronounced dead on June 4, 2020. Dr. John determined that Ramirez’s cause of death 

was multiple blunt-force trauma, consistent with being in a motor vehicle crash and 

the manner of death was accident. 

On cross-examination, the defense sought to introduce evidence of Ramirez’s 

blood alcohol content. The State objected that no proper foundation for the evidence 

had been established. After argument to the bench, the trial court denied admission 

of a toxicology report for Ramirez, and the defense withdrew Dr. John’s report 

because it included a reference to “toxicology.” 

The jury found Bell guilty on both counts and, after a hearing on punishment, 

the jury assessed punishment at twenty years of confinement on each count. The trial 

court ordered the sentences to run concurrently. Bell timely filed his notice of appeal 

in both cases. 

2 Although the defense challenged the identity of the victim at trial, the 

victim’s identity is not an issue on appeal.
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Admission of Evidence

In his first issue, Appellant argues that the trial court erred in excluding 

evidence of Ramirez’s blood alcohol level at the time of the accident. According to 

Appellant, there was evidence that Ramirez was traveling faster than the speed limit 

and was found to have a blood alcohol level more than 0.08 when tested at the 

hospital. Appellant argues that Ramirez would have had an impaired response time 

due to his blood alcohol level that “could have made a difference between collision 

and no collision.” For this reason, Appellant argues that Ramirez’s blood alcohol 

content was “quite relevant[]” and the trial court erred by sustaining the State’s 

motion in limine and excluding the evidence at trial.

We review a trial court’s ruling on the admission of evidence under an abuse 

of discretion standard of review. Gonzalez v. State, 616 S.W.3d 585, 594 (Tex. Crim. 

App. 2020). A trial court abuses its discretion when it acts without reference to any 

guiding rules and principles or acts arbitrarily or unreasonably. Rhomer v. State, 569 

S.W.3d 664, 669 (Tex. Crim. App. 2019). “As long as the trial court’s ruling is 

within the ‘zone of reasonable disagreement,’ there is no abuse of discretion, and the 

trial court’s ruling will be upheld.” De La Paz v. State, 279 S.W.3d 336, 343-44

(Tex. Crim. App. 2009) (quoting Montgomery v. State, 810 S.W.2d 372, 391 (Tex. 

Crim. App. 1991) (op on reh’g)); State v. Mechler, 153 S.W.3d 435, 449-40 (Tex. 

Crim. App. 2005). If the trial court’s decision is correct on any theory of law 
19

applicable to the case, we will uphold the decision. De La Paz, 279 S.W.3d at 344; 

Osbourn v. State, 92 S.W.3d 531, 538 (Tex. Crim. App. 2002).

The erroneous admission or exclusion of evidence is generally reviewed under 

the standard for non-constitutional error contained in Rule 44.2(b) of the Texas 

Rules of Appellate Procedure if the trial court’s ruling merely offends the rules of 

evidence. See Walters v. State, 247 S.W.3d 204, 218-19 (Tex. Crim. App. 2007); 

Solomon v. State, 49 S.W.3d 356, 365 (Tex. Crim. App. 2001). Under Rule 44.2(b), 

even if the trial court erred in admitting the evidence, we may not overturn a criminal 

conviction for non-constitutional error if, after examining the record as a whole, we 

have fair assurance that the error did not have a substantial and injurious effect or 

influence in determining the jury’s verdict. Casey v. State, 215 S.W.3d 870, 885 

(Tex. Crim. App. 2007). In our determination of whether error adversely affected 

the jury’s decision, we consider everything in the record, including testimony, 

physical evidence, jury instructions, the State’s theories, any defensive theories, 

closing arguments, and voir dire. Schmutz v. State, 440 S.W.3d 29, 39 (Tex. Crim. 

App. 2014).

Evidence is relevant if it has any tendency to make the existence of any fact 

of consequence more or less probable than it would be without the evidence. 

Gonzalez v. State, 544 S.W.3d 363, 370 (Tex. Crim. App. 2018) (citing Tex. R. Evid. 

401). Relevant evidence is generally admissible. See Tex. R. Evid. 402; Gonzalez, 
20

544 S.W.3d at 370. Even if the evidence is relevant, a trial court may determine that 

it is not admissible because the danger of unfair prejudice outweighs the evidence’s 

probative value. See Tex. R. Evid. 403.

The Rules of Evidence require that evidence must be authenticated or 

identified, and “the proponent must produce evidence sufficient to support a finding 

that the item is what the proponent claims it is.” Tex. R. Evid. 901(a). Authentication 

may be accomplished by testimony from a witness with knowledge that the item is 

what it is claimed to be. See id. 901(b)(1).

To establish the facts necessary to admit the results of a blood test, the 

proponent must show proof of a proper chain of custody of the blood sample that 

shows the beginning and end of a chain of custody, including proof that the sample 

came from the person the proponent alleged. See Stoker v. State, 788 S.W.2d 1, 10 

(Tex. Crim. App. 1989), abrogated on other grounds by Leday v. State, 983 S.W.2d 

713 (Tex. Crim. App. 1998) (Proof of the beginning and end of a chain of custody 

will support the admission of the evidence in the absence of any evidence of 

tampering or alteration.); Brown v. State, 240 S.W.2d 310, 311 (Tex. Crim. App. 

1951) (blood test results were not admissible where there was no evidence that the 

specimen taken by a nurse at the hospital was the same specimen forwarded for 

analysis); Dugar v. State, 629 S.W.3d 494, 502 (Tex. App.—Beaumont 2021, pet. 

ref’d) (chain of custody was satisfied where there was “evidence showing where the 
21

chain of custody began, with the nurse, and where it ended in the lab[]”); Martinez 

v. State, 186 S.W.3d 59, 62 (Tex. App.—Houston [1st Dist.] 2005, pet. ref’d) (stating 

that chain of custody is proved when the proponent has shown the beginning and the 

end of the chain of custody, particularly when the chain ends at a laboratory).

Business records may be admissible if there is some “indicia of reliability” 

and “fundamental trustworthiness[.]” See Burleson v. State, 585 S.W.2d 711, 713

(Tex. Crim. App. 1979). A business record may be authenticated when presented by 

an affidavit from the business’s custodian of records that complies with Rules of 

Evidence 803(6) or (7) and 902(10). See Tex. R. Evid. 803(6), (7), 902(10). “Rule 

803(6) allows an affidavit in lieu of calling a witness to authenticate the records, 

without which the documents become merely inadmissible hearsay.” Venable v. 

State, 113 S.W.3d 797, 800 (Tex. App.—Beaumont 2003, pet. ref’d).

A document prepared by a third party may be admissible under Rule 

803(6) if: (1) it is incorporated and kept in the course of the testifying 

witnesses’ business; (2) that business typically relies upon the accuracy 

of the contents of the document; and (3) the circumstances otherwise 

indicate the trustworthiness of the document. 

Bell v. State, 176 S.W.3d 90, 92 (Tex. App.—Houston [1st Dist.] 2004, pet. ref’d).

Scientific evidence—such as results of blood testing at issue here—must be 

reliable to be admitted, and the reliability of scientific evidence requires that “(a) the 

underlying scientific theory must be valid (b) the technique applying the theory must 

be valid and (c) the technique must have been properly applied.” Bekendam v. State, 
22

441 S.W.3d 295, 303 (Tex. Crim. App. 2014) (citing Kelly v. State, 824 S.W.2d 568, 

573 (Tex. Crim. App. 1992)); see also Schard v. State, No. 09-16-00291-CR, 2018 

Tex. App. LEXIS 2390, at **16-19 (Tex. App.—Beaumont Apr. 4, 2018, no pet.) 

(mem. op., not designated for publication) (applying the Kelly factors when 

considering the admissibility of blood test results).

In this case, the defendant sought to admit Ramirez’s blood test results during 

cross-examination of Dr. John, the forensic pathologist who examined Ramirez’s

body after death. The doctor testified on voir dire that his report included a 

toxicology section that stated a sample of blood was received from the hospital. Dr. 

John did not know who drew the blood sample for Ramirez. Outside the presence of 

the jury, the defense questioned Dr. John about the toxicology report which showed 

that Ramirez had a blood alcohol concentration of 0.081. 

The defense also sought to admit a Toxicology Report from NMS Labs in 

Horsham, Pennsylvania, that reflected blood test results for Raymond Sanchez, 

showing a blood alcohol concentration of 0.081. Dr. John testified that he asked for 

a toxicology report on the blood, and the report from NMS Labs was a copy of the 

report he requested. No business records affidavit from NMS Labs accompanied the 

Toxicology Report. The NMS Labs report states the source of the blood specimen 

was “001 - Hospital Blood” and the analysis was “Headspace GC[.]” 
23

Dr. John testified that he regarded the NMS Labs report as trustworthy. When 

asked if he knew who drew the hospital blood that was sent to NMS Labs, Dr. John 

replied, “No.” He also testified that he did not draw the blood personally. Dr. John 

testified he did not have to rely on the NMS Labs report for his findings. No witness 

from NMS Labs testified about the origin of the sample or the methodology or 

procedures used in the toxicology analysis.

The State objected to the toxicology report and the reference to toxicology in 

the doctor’s report because there was no proper foundation. The State argued that 

Dr. John, the witness through whom the evidence was offered, did not draw the 

blood, and the defense did not have a witness to testify about who performed the 

blood draw. The State also argued that there was no business records affidavit for 

the lab report and that the defense could not say who drew the blood that was tested.

In denying admission of the NMS Labs report, the court stated that there was 

no indication who drew the blood, that no witness was available to testify that the 

blood samples were properly drawn, labeled, and tested, and that the lab report did 

not have the required indicia of trustworthiness.3 After the trial court did not allow 

3 The trial court also questioned whether the probative value of the toxicology 

results would be substantially outweighed by the danger of unfair prejudice, however 

we do not read the record to say that the trial court denied admission expressly on 

this basis.
24

the NMS Labs report to be admitted, the defense withdrew its Exhibit 8, Dr. John’s 

report, that included a reference to “Toxicology[.]”4

The trial court’s ruling excluding the report is within the zone of reasonable 

disagreement. We cannot say the trial court abused its discretion in excluding the 

blood test results of the NMS Labs report. See Gonzalez, 616 S.W.3d at 594. No 

business records affidavit accompanied the report, as required by Rule of Evidence 

803(6). See Tex. R. Evid. 803(6). There was no evidence of who drew the blood 

specimen and no testimony about the chain of custody. See Dugar, 629 S.W.3d at 

502. No witness from NMS Labs testified about the method used to analyze the 

blood specimen and whether the method was performed accurately. See Bekendam, 

441 S.W.3d at 303; Kelly, 824 S.W.2d at 573. Dr. John testified that he did not rely 

on the NMS blood test results to make his findings. The trial court could have 

reasonably determined that the defense did not lay the proper foundation and did not 

properly authenticate the NMS Labs report or its toxicology results. See Tex. R. 

Evid. 901. Therefore, the trial court did not err by excluding it. Because we conclude 

that the trial court did not abuse its discretion in excluding the blood alcohol report, 

we do not address whether the report was relevant or whether any relevance was 

4 The trial court stated that Dr. John’s report could be admitted provided the 

reference to “toxicology” was redacted, but the defense objected to the redaction.
25

outweighed by the danger of unfair prejudice. See Tex. R. App. P. 47.1. We overrule 

Appellant’s first issue.

Concurrent Causation Instruction

In his second issue, Appellant contends that the trial court erred by failing to 

include a jury charge instruction on concurrent causation under section 6.04(a) of 

the Texas Penal Code. According to Appellant, there was evidence that Ramirez’s 

excessive speed may have contributed to his death, and Appellant also argues that 

evidence of Ramirez’s intoxication was relevant to causation. Appellant argues that 

the failure to include a jury instruction on concurrent causation was harmful, 

constitutional error that resulted in an unfair trial.

Where an appellant raises jury charge error on appeal, the degree of harm 

necessary for reversal depends on whether the appellant preserved error by a timely 

objection at trial. Villarreal v. State, 453 S.W.3d 429, 433 (Tex. Crim. App. 2015). 

When, as here, the defendant fails to object or states in the trial court that he has no 

objection to the charge, we will not reverse for jury-charge error unless the record 

shows “egregious harm” to the defendant. See State v. Ambrose, 487 S.W.3d 587, 

595 (Tex. Crim. App. 2016) (“[U]npreserved jury-charge error does not require a 

new trial, even when the error is complained of in a motion for new trial, unless the 

error causes ‘egregious harm.’”); Ngo v. State, 175 S.W.3d 738, 743-44 (Tex. Crim. 

App. 2005). In reviewing claims of jury charge error, we use a two-step process. 
26

First, we determine whether error exists in the charge. Ngo, 175 S.W.3d at 743. If 

error exists, we then determine whether it was “egregious harm” using the 

framework outlined in Almanza v. State, 686 S.W.2d 157 (Tex. Crim. App. 1985) 

(op. on reh’g). See Villarreal, 453 S.W.3d at 433. 

We review a trial court’s refusal to include a defensive issue in the charge for 

an abuse of discretion. Wesbrook v. State, 29 S.W.3d 103, 122 (Tex. Crim. App. 

2000). An accused is entitled to an instruction on every defensive issue raised by the 

evidence. Hayes v. State, 728 S.W.2d 804, 807 (Tex. Crim. App. 1987). This is true 

whether the evidence is strong or weak, unimpeached or contradicted, and regardless 

of what the trial court may think about the credibility of the evidence. Hamel v. State, 

916 S.W.2d 491, 493 (Tex. Crim. App. 1996). We must view the evidence in the 

light most favorable to the defendant’s requested submission. Bufkin v. State, 207 

S.W.3d 779, 782-83 (Tex. Crim. App. 2006).

Section 6.04(a) of the Penal Code states, “A person is criminally responsible 

if the result would not have occurred but for his conduct, operating either alone or 

concurrently with another cause, unless the concurrent cause was clearly sufficient 

to produce the result and the conduct of the actor [was] clearly insufficient.” See 

Tex. Penal Code Ann. § 6.04(a). To be entitled to such an instruction, the defendant 

must specifically show that (1) a force or agency in addition to the actor was a “but 

for” cause of the result charged, and (2) some evidence demonstrates the defendant’s 
27

conduct was clearly insufficient to cause the harm and the other, concurrent cause 

was clearly sufficient to cause the harm. Cyr v. State, 665 S.W.3d 551, 557-58 (Tex. 

Crim. App. 2022).

“The scope of causation under the Texas Penal Code is broad, allowing courts 

to find causation where ‘the result would not have occurred but for [the] conduct, 

operating either alone or concurrently with another cause.’” Id. at 557 (quoting Tex. 

Penal Code § 6.04(a)). However, if a concurrent cause other than the defendant’s 

conduct “was clearly sufficient to produce the result and the conduct of the actor 

clearly insufficient[,]” then causation is not established. Tex. Penal Code § 6.04(a); 

see also Quintanilla v. State, 292 S.W.3d 230, 234 (Tex. App.—Austin 2009, pet. 

ref’d).

Appellant argues that “[t]he trial court failed to include an application 

paragraph following the criminal responsibility paragraph, paragraph III, [] which 

should have explained the concept of concurrent causation.” The record does not 

reflect that Appellant made such an objection at trial. In addition, the record does 

not include a proposed jury charge submitted by the defense nor a motion for new 

trial. Therefore, we first determine whether there was error in the jury charge, and if 

there was, whether the defendant suffered egregious harm. See Lozano v. State, 636 

S.W.3d 25, 29 (Tex. Crim. App. 2021); Villarreal, 453 S.W.3d at 433.
28

The trial court must charge the jury on the law applicable to the case. Tex. 

Code Crim. Proc. Ann. art. 36.14. Paragraph III of the jury charge actually submitted 

to the jury reads,

III.

A person is criminally responsible if the result would not have 

occurred but for his conduct, operating either alone or concurrently with 

another cause, unless the concurrent cause was clearly sufficient to 

produce the result and the conduct of the Defendant clearly insufficient. 

IV.

Now bearing in mind the foregoing instructions, if you find from 

the evidence beyond a reasonable doubt that on or about the 2nd day of 

June, 2020, in Montgomery County, Texas, the Defendant, Jeff Taylor 

Bell, did then and there operate a motor vehicle in a public place while 

the Defendant was intoxicated, and by reason of that intoxication, cause 

the death of Fabian Ramirez Sierra, by accident or mistake, and you 

find from the evidence beyond a reasonable doubt that the death of 

Fabian Ramirez Sierra would not have occurred but for the Defendant’s 

conduct, operating either alone or concurrently with another cause, and 

you find that the concurrent cause was not clearly sufficient to produce 

the result or that the conduct of the Defendant was not clearly 

insufficient to produce the result, then you will find the Defendant 

guilty of intoxication manslaughter as charged in Count II of the 

Indictment.

The jury instruction in paragraph III tracks the language of section 6.04(a) of the 

Penal Code. See Tex. Penal Code Ann. § 6.04(a). Paragraph IV applies the law stated 

in paragraph III to the facts in this case. Appellant has not identified how the jury 

charge actually given was inadequate. See Tex. R. App. P. 38.1(h), (i) (requiring an

appellate brief to contain a “succinct, clear, and accurate statement of the arguments” 

and to provide appropriate citations to the record and to authorities).
29

Appellant cites to Saenz v. State, 474 S.W.3d 47, 53 (Tex. App.—Houston 

[14th Dist.] 2015, no pet.), wherein the Houston Fourteenth Court concluded that the 

trial court erred by not including an application paragraph on concurrent causation. 

In Saenz, the defendant was convicted of “intoxication manslaughter and accident 

involving injury or death.” Id. at 49. The evidence suggested that the victim, Torres, 

was likely struck by the defendant’s truck. Id. at 50. A toxicology report showed that 

Torres had a blood alcohol concentration of .172 when he died and that he had also 

used marijuana and cocaine at some point before he died. Id. The trial court excluded 

the toxicology report, which the defendant sought to admit as evidence that Torres’s 

behavior was a concurrent cause sufficient to have caused his own death. Id. Other 

evidence showed that Torres was walking in the road and was “likely somewhere 

between the shoulder line and the middle of the lane when he was struck[.]” Id. at 

52. The jury also heard evidence that Torres was dressed in dark clothes, that there 

was no evidence that the defendant’s vehicle left the roadway, and that the highway 

shoulder was very narrow with little room to walk on the shoulder. Id. On appeal, 

the Fourteenth Court explained,

there was at least some evidence before the jury that appellant’s 

intoxication did not necessarily cause the collision and Torres’s 

resulting death. Equally important, the jury heard some testimony that 

it was essentially Torres’s actions that caused his death, and that it 

would have been difficult for any driver, sober or intoxicated, to avoid 

hitting Torres. 
30

Id. The Houston Fourteenth Court of Appeals found the trial court erred in failing to 

include a concurrent causation instruction, but the court did not explain or state what 

the application paragraph applying the law of concurrent causation to the facts of the 

case should state. 

We find Saenz factually distinguishable from this case. In Saenz, there was 

testimony that many drivers would have had a hard time seeing Torres in time to 

avoid hitting him and there was evidence before the jury that appellant’s intoxication 

did not necessarily cause the collision. Here, there is no testimony or evidence in our 

case that drivers would have had a hard time seeing Ramirez. Although there was 

some testimony that Ramirez was traveling faster than the speed limit, Appellant 

points to no testimony that Ramirez’s speed alone was sufficient to have caused the 

accident. The jury heard Neftali testify that Ramirez had a beer after work, and 

although the trial court excluded the toxicology results, and there was no testimony 

that Ramirez’s drinking or blood alcohol concentration was sufficient on its own to 

have caused the accident. Unlike in Saenz, Appellant also fails to identify any

“evidence before the jury that appellant’s intoxication did not necessarily cause the 

collision and [the victim’s] resulting death.” See id. He only argues that evidence of 

Ramirez’s excessive speed and of intoxication “should have been considered within 

a construct of concurrent causation” and that “harmful, constitutional error” resulted. 

Appellant identifies no evidence showing that Ramirez’s conduct was “clearly 
31

sufficient” to cause the accident and his death and no evidence that Bell’s conduct 

was insufficient. See Tex. Penal Code Ann. § 6.04(a). Without such evidence, the 

trial court had no obligation to include an application paragraph on concurrent 

causation in the jury charge. See id. at 52-53; see also Cyr, 665 S.W.3d at 557-58 

(requiring a defendant to produce evidence to support an instruction on concurrent 

causation). Also, even if the trial court was required to include an instruction on 

concurrent causation, Appellant does not identify how the instruction actually given 

was inadequate or deficient. See Tex. R. App. P. 38.1(h), (i). Because we find the 

jury charge given in this case was not in error, we need not determine whether harm 

resulted. See Ngo, 175 S.W.3d at 743. We overrule Appellant’s second issue.

Even though we have overruled both of Appellant’s issues, we note that the 

section of the judgment on Count I entitled “Statute for Offense[]” recites 

“550.021(a) Penal Code[.]” However, the indictment for the underlying offense lists

the offense as “Accident Involving Personal Injury or Death” and tracksthe language 

of section 550.21 of the Texas Transportation Code. This Court has the authority to 

reform the trial court’s judgment to correct clerical errors. See Tex. R. App. P. 

43.2(b); Bigley v. State, 865 S.W.2d 26, 27 (Tex. Crim. App. 1993). We therefore 

reform the judgment on Count I to reflect that the “Statute for Offense” for Count I

is “550.021(a) Transportation Code[.].”
32

Having overruled both of Appellant’s issues, we affirm the trial court’s 

judgment on Count I as modified, and we affirm the trial court’s judgment on Count 

II.

AFFIRMED AS MODIFIED; AFFIRMED.

 LEANNE JOHNSON

Justice

Submitted on May 22, 2023

Opinion Delivered September 13, 2023

Do Not Publish

Before Golemon, C.J., Johnson and Wright, JJ.