2019 WI App 49

COURT OF APPEALS OF WISCONSIN

PUBLISHED OPINION

Case No.: 2018AP649-CR

Complete Title of Case: 

STATE OF WISCONSIN,

 PLAINTIFF-RESPONDENT,

 V.

DANIEL A. GRIFFIN,

 DEFENDANT-APPELLANT.

Opinion Filed: August 21, 2019

Submitted on Briefs: June 4, 2019

Oral Argument: 

JUDGES: Neubauer, C.J., Reilly, P.J., and Gundrum, J.

Concurred:

Dissented:

Appellant

ATTORNEYS: On behalf of the defendant-appellant, the cause was submitted on the 

briefs of Jaymes K. Fenton of Fenton Law Office, Milwaukee. 

Respondent

ATTORNEYS: On behalf of the plaintiff-respondent, the cause was submitted on the 

brief of Donald V. Latorraca, assistant attorney general, and Joshua L. 

Kaul, attorney general.
2019 WI App 49

COURT OF APPEALS

DECISION

DATED AND FILED

August 21, 2019

Sheila T. Reiff

Clerk of Court of Appeals

NOTICE

This opinion is subject to further editing. If 

published, the official version will appear in 

the bound volume of the Official Reports. 

A party may file with the Supreme Court a 

petition to review an adverse decision by the 

Court of Appeals. See WIS. STAT. § 808.10 

and RULE 809.62. 

Appeal No. 2018AP649-CR Cir. Ct. No. 2015CF411

STATE OF WISCONSIN IN COURT OF APPEALS

STATE OF WISCONSIN,

 PLAINTIFF-RESPONDENT,

 V.

DANIEL A. GRIFFIN,

 DEFENDANT-APPELLANT.

APPEAL from a judgment of the circuit court for Fond du Lac 

County: DALE L. ENGLISH, Judge. Affirmed. 

Before Neubauer, C.J., Reilly, P.J., and Gundrum, J. 

¶1 REILLY, P.J. Daniel A. Griffin appeals from a judgment 

convicting him of first-degree reckless homicide and two counts of child abuse 

intentionally causing great bodily harm in the death of fourteen-month-old MHP 

and the injuries suffered by his twin brother, MDP. Griffin argues that the court 
No. 2018AP649-CR

2

erroneously excluded evidence that the twins’ mother caused MHP’s death and the 

injuries to MDP. Griffin also argues that the court erroneously admitted videos of 

Griffin interacting with the twins as other-acts evidence. We reject all of Griffin’s 

arguments and affirm.

BACKGROUND

¶2 On July 7, 2015, emergency personnel responded to a residence in 

Fond du Lac, Wisconsin, where MHP was unresponsive at the scene and 

subsequently pronounced dead.1 An autopsy revealed that MHP died from a 

lacerated liver and that he also had broken ribs, bruising and bleeding on his penis, 

additional internal and external injuries, and a blood alcohol concentration (BAC) 

of .08. A doctor described the circumstances under which MHP died as a punch 

or kick to the area of the liver or stepping on or slowly pressing a foot down on a 

child’s abdominal area. MDP was also brought to the hospital that same day with 

similar injuries, including a lacerated liver, broken ribs, additional internal 

injuries, and a BAC of .02. 

¶3 Before trial, the State moved to prohibit Griffin from introducing 

evidence that the mother or another adult roommate were responsible for the 

twins’ injuries. Griffin, in turn, sought to admit such evidence, citing a forensic 

interview of C.J. where he reported that the mother gave one of the twins “a 

whooping with a belt,” that she kicked the twins, and “cracked” one of the twin’s 

hands. Griffin also cited several incriminating statements the mother allegedly 

 

1

 Three days before MHP’s death, Griffin and the mother had moved to Fond du Lac and 

were living with one of the mother’s friends, S.P., and her five-year-old son, C.J., along with the 

mother’s other children. 
No. 2018AP649-CR

3

made during police interviews, including that she stepped on the children “in a 

‘playful’ manner.” The circuit court considered whether it should admit the 

evidence under State v. Denny, 120 Wis. 2d 614, 357 N.W.2d 12 (Ct. App. 1984), 

ultimately concluding that the mother lacked a direct connection to the crime.

¶4 The State also moved to admit other-acts evidence under WIS. STAT.

§ 904.04(2) (2017-18),2 which included three cell phone videos showing Griffin 

interacting with the twins in an abusive manner. Griffin objected, arguing that the 

videos did not fall within any permissible purpose under § 904.04(2). The State 

claimed that the videos were admissible to demonstrate Griffin’s “motive, intent, 

and plan, to be verbally abusive and physically discipline ... MHP and MDP” as 

well as place the actions of Griffin in the “proper context and complete the story 

of the defendant’s criminal behavior.” The court found the evidence probative and 

that its value substantially outweighed the danger of unfair prejudice. 

¶5 After a five-day jury trial, Griffin was found guilty of all charges. 

Griffin appeals, arguing that the circuit court erred in denying the Denny evidence 

and allowing the cell phone videos to be admitted. For the reasons that follow, we 

conclude that the circuit court did not err.

DISCUSSION

¶6 This case involves the circuit court’s decision to both admit and 

refuse to admit evidence, which we review for an erroneous exercise of discretion. 

State v. Wilson, 2015 WI 48, ¶47, 362 Wis. 2d 193, 864 N.W.2d 52. “Although a 

 

2

 All references to the Wisconsin Statutes are to the 2017-18 version unless otherwise 

noted.
No. 2018AP649-CR

4

circuit court generally has the discretion to deny the admission of evidence, that 

discretion is subject to constitutional limitations; a circuit court may not refuse to 

admit evidence if doing so would deny the defendant’s right to a fair trial,” but 

that evidence must be relevant. Id., ¶48. Where evidence is denied admission and 

it implicates a defendant’s constitutional right to present a defense, that is a 

question of constitutional fact and we review the circuit court’s decision de novo. 

Id., ¶47.

Denny Evidence

¶7 Our supreme court affirmed that the Denny “legitimate tendency” 

test “is the correct and constitutionally proper test for circuit courts to apply when 

determining the admissibility of [known] third-party perpetrator evidence.” 

Wilson, 362 Wis. 2d 193, ¶52. Denny “created a bright line standard requiring 

that three factors be present” for admissibility of evidence that an alleged thirdparty perpetrator committed the crime. Wilson, 362 Wis. 2d 193, ¶51 (citing 

Denny, 120 Wis. 2d at 623-25). “When a defendant seeks to present evidence that 

a third party committed the crime for which the defendant is being tried, the 

defendant must show ‘a legitimate tendency’ that the third party committed the 

crime; in other words, that the third party had motive, opportunity, and a direct 

connection to the crime.” Wilson, 362 Wis. 2d 193, ¶3 (citation omitted).

¶8 Under the motive prong, the court must question whether “the 

alleged third-party perpetrator [had] a plausible reason to commit the crime?” Id., 

¶57. The second prong of the Denny test—the opportunity prong—asks: 

“[C]ould the alleged third-party perpetrator have committed the crime, directly or 

indirectly? In other words, does the evidence create a practical possibility that the 

third party committed the crime?” Wilson, 362 Wis. 2d 193, ¶58. The third, and 
No. 2018AP649-CR

5

final, prong asks whether there is “evidence that the alleged third-party perpetrator 

actually committed the crime, directly or indirectly?” Id., ¶59. “The ‘legitimate 

tendency’ test asks whether the proffered evidence is so remote in time, place or 

circumstances that a direct connection cannot be made between the third person 

and the crime.” Denny, 120 Wis. 2d at 624 (citation omitted). “[C]ircuit courts 

must assess the proffered evidence in conjunction with all other evidence to 

determine whether, under the totality of the circumstances, the evidence suggests 

that a third-party perpetrator actually committed the crime.” Wilson, 362 Wis. 2d 

193, ¶71. Courts must “look for some direct connection between the third party 

and the perpetration of the crime.” Id.

¶9 Here, the circuit court determined that Griffin had met the motive 

and opportunity prongs of the Denny legitimate tendency test, and the parties 

agree on appeal that this case turns only on the direct connection prong. Proof of 

motive and opportunity alone are not enough to introduce the evidence of the 

mother’s conduct. See Wilson, 362 Wis. 2d 193, ¶64 (“[T]he Denny test is a 

three-prong test; it never becomes a one- or two-prong test.”). Considering 

whether the mother has a direct connection to the crimes of first-degree reckless 

homicide and child abuse intentionally causing great bodily harm, we conclude 

that the circuit court properly denied Griffin’s Denny motion.

¶10 Griffin admits that the circuit court “did assess all three [Denny] 

prongs in great detail” at the hearings. Griffin argues, however, that the circuit 

court erred as Griffin established that the mother had a direct connection to the 

commission of the crime. First and foremost, Griffin claims that the mother’s own 

admission that she had stepped on the twins in the past “in a playful manner” 

established a strong direct connection as the medical examiner testified that the 

injuries to the twins could have been caused by an adult standing on the child or 
No. 2018AP649-CR

6

stepping on the child’s abdomen. We disagree. We note that while a party’s selfincriminating statement can be used to demonstrate a direct connection, see

Wilson, 362 Wis. 2d 193, ¶72, the record in this case does not support such a 

finding.

¶11 In his brief-in-chief, Griffin states that “[i]n one of her interviews 

with law enforcement officers, [the mother] admitted to stepping on the twins ‘in a 

playful manner’ on past occasions.” In support of that statement in his appellate 

brief, Griffin cites to his own response to the State’s Memorandum to Preclude 

Third Party Liability Evidence, which fails to cite any support for the mother’s 

alleged statement except to reference “one of these [law enforcement] interviews,” 

as well as the transcript from the hearing where the court commented that the 

mother “did admit to stepping on the kids in a playful manner.” Griffin further 

notes in his reply brief:

 The state refuses to concede, however, that [the mother]

admitted to stepping on the twins. In its responsive brief 

the state downplays [the mother’s] admission to such 

conduct by reducing them only to unproven allegations by 

Griffin. This could not be further from the truth. In his 

motion to the circuit court seeking admission of the Denny

evidence, Griffin first raised [the mother’s] admission to 

stepping on the twins. At no point before the circuit court 

was this disputed by the state.

 Taking it one step further, the circuit court itself 

recognized that [the mother] admitted to such conduct. The 

court explicitly noted that [the mother] admitted to stepping 

on her children, and that her efforts to minimize that 

conduct by calling it “playful” was absolutely nonsensical. 

Again, the state did not object to or dispute this statement 

from [the mother] cited by the court. 
No. 2018AP649-CR

7

¶12 This court’s independent review of the record on appeal reveals a 

decidedly different factual scenario than the one we are led to believe by Griffin. 

During the recording of the mother’s second interview by law enforcement 

conducted at the hospital on July 8, 2015,3 one of the officers asked the mother if 

she “ever play[ed] this game where you act like you are going to step on [MHP’s] 

tummy with a foot and then step off?” She responded, “Yes, with my older kids I 

have. With my older son. But it don’t be nothing like ‘let me hurt you’ type 

thing. It be more of like wrestling type thing.” The officer then went on to 

explain that MHP’s liver could have been damaged from playing around in this 

way, suggesting that maybe the mother went “to step on the baby to do the joking 

thing and you lose your balance.” The recording indicates that the mother 

adamantly responded that “it don’t be with the twins. They are too young.... 

Why would you step on the twins. Come on now.” When the officer tried to push 

the topic again, the mother stated matter-of-factly, “But see, it hasn’t happened.” 

Based on this record, Griffin’s statement that “[the mother] admitted to stepping 

on the twins” is false. In fact, the mother flat out denied to police that she ever 

stepped on the twins playfully or otherwise.

¶13 As for Griffin’s statement that “the circuit court itself recognized 

that [the mother] admitted to such conduct,” we note that while the circuit court 

stated that she “did admit to stepping on the kids in a playful manner,” it also 

admitted prior to that statement that it did not “have the discovery here, so. All I 

have is what you provide to me with these motions.” Thus, the court’s reference 

to the mother stepping on the twins came directly from Griffin’s own response to 

 

3

 The recording of this interview was included in the appellate record on a flash drive.
No. 2018AP649-CR

8

the State’s motion and not from the mother’s direct statements. Given this record 

on appeal, we cannot find a direct connection between the mother and the crimes 

committed based on her self-incriminating statements as she never admitted to 

stepping on the twins.

¶14 Griffin also argues that other evidence that Griffin proffered was 

sufficient to show a direct connection between the mother and the injuries to the 

twins, specifically her own admissions that she physically punished the children in 

the past as well as C.J.’s statements that he had seen the mother and Griffin abuse 

the twins. In reaching its determination on the Denny evidence, the court 

appeared skeptical as to “the comments attributed to [the mother] that [Griffin’s 

attorney] put in his memorandum,” and, thus, the court indicated that it “wanted to 

watch the DVD” of the interview. At the hearing, the circuit court summarized the 

evidence presented by C.J.’s interview4:

 So what C.J. said was that [the mother] whoops kids 

hard. That she whooped the twins. That she had whooped 

Fat-Fat with a belt every place. That Chocolate got a 

whooping last week by [the mother] with a belt, including a 

whooping on Chocolate’s head. That Fat-Fat was in 

trouble the week prior. Fat-Fat cries when he gets a 

whooping. That [the mother] said shut up, mother fucker 

when Fat-Fat was crying.

 ....

 That [the mother] whoops with a hangar. That the twins 

had been whooped by a hangar by [the mother]. That [the 

mother], Mr. Griffin, C.J.’s mom kicked the kids. That [the 

mother] ... [k]icked Fat-Fat in the leg and hurt Chocolate’s 

hands. 

 

4

 C.J. refers to the twins as “Fat-Fat” and “Chocolate” during the interview, but there is 

no indication in the record of which twin is connected to which nickname. The State, however, 

suggests that MDP is “Chocolate” and MHP is “Fat-Fat.” 
No. 2018AP649-CR

9

¶15 Similarly, the court summarized the interview law enforcement 

conducted with the mother eight days after the alleged offense where she 

“admitted that she used a belt to whoop her kids” and vacillated between stating 

that C.J. was lying and then changing her mind claiming that she must have hit her 

children “because C.J. does not lie.” The mother repeatedly stated that “she didn’t 

do it,” that “[s]he would never intentionally hurt her babies,” and that 

“Mr. Griffin had to do it” as “Mr. Griffin had the kids the day that the one child 

was killed.” The mother also acknowledged that “she knows it looks bad but she 

is innocent” and “she knows she didn’t kill her baby but that she had to take 

responsibility for it” as “she felt it was her fault that she didn’t protect her kids.” 

During the interview, the mother admitted that she came out of the bathroom to 

find Griffin 

standing on one of the twins with his foot kind of 

diagonally over the chest and stomach area, kind of 

balancing on the twin.... And then she said something 

about the noodles and ran downstairs.

 She said that the reason she didn’t say anything to 

Mr. Griffin was that she was in shock and she was afraid.

The court concluded, based on its review of the mother’s interview, that she never 

“admitted to hurting or killing the twins.” 

¶16 We conclude that C.J.’s allegations of physical abuse by the mother 

do not provide a sufficient direct connection between the mother and the 

perpetration of the crime charged. At most, C.J. claimed that the mother kicked 

one of the twins in the leg and hit them with a hanger and a belt, which a doctor

opined would not have caused the damage suffered by the twins. Further, within 

the court’s discussion of Griffin’s motion to admit C.J.’s recorded interview at 

trial, the court questioned the admissibility of C.J.’s interview, expressing 
No. 2018AP649-CR

10

concerns with the trustworthiness of C.J.’s statements.5 The court observed that in 

the first part of the interview, the interviewer did not appear to obtain any relevant 

information, and it was only after the interviewer began asking leading questions 

that more information came. C.J.’s answers, however, “didn’t make any sense at 

all” and “[s]ome of the answers he gave were inconsistent with answers he had 

given 10 minutes earlier.” For example, C.J. first denied knowing a child named 

Chocolate, and he did not know if Fat-Fat had a brother. Given the court’s 

reservations about the trustworthiness of C.J.’s statements, we find that its value in 

creating a direct connection between the mother and the charged crimes is lacking.

¶17 Without C.J.’s statements, all that remains is the mother’s own 

admissions in her interview with police that she “whoop[ed]” her kids. Her 

statements do not establish a direct connection to the events that took place on that 

date, to the injuries that the twins received, or to the specific crimes charged such 

 

5

 At the hearing, there were several matters before the court, including Griffin’s motion 

regarding third-party perpetrator evidence under State v. Denny, 120 Wis. 2d 614, 357 N.W.2d 

12 (Ct. App. 1984), and his motion to introduce C.J.’s interview recording at trial. The court’s 

comments regarding the reliability or the trustworthiness of C.J.’s statements came from its 

discussion of Griffin’s Defense Motion to Utilize Audio\Visual Recorded Statement of Child at 

the Jury Trial, Pursuant to WIS. STAT. § 908.08. The court, noting that the relevancy of the video 

interview was linked to the introduction of the Denny evidence, provided Griffin the opportunity 

to withdraw his motion as C.J.’s interview also implicated Griffin as being abusive. Griffin later 

withdrew his motion to admit C.J.’s recorded statement, calling its usefulness contingent on the 

court granting the Denny motion. Griffin does not appear to be reasserting an argument that the 

video recording of C.J.’s interview should have been admitted on appeal, and we address it no 

further.
No. 2018AP649-CR

11

that it can be said that she “actually committed the crime[s].”6 See Wilson, 362 

Wis. 2d 193, ¶71. Accordingly, the circuit court properly concluded that the 

mother lacked a direct connection to the perpetration of the crimes.

Other-Acts Evidence

¶18 Griffin also argues that the circuit court erred in admitting other-acts 

evidence consisting of cell phone videos depicting allegedly abusive interactions 

between Griffin and the twins. The State moved to admit three video files 

extracted from Griffin’s cell phone.7 In one video from July 5, 2015, Griffin was 

on the bed next to MHP and MDP, who were both sleeping. The video showed 

“the defendant then move[] his head to within 6-12 inches of the twins’ heads and 

yells extremely loud, causing the twins to flinch” and then catches one of the 

twin’s reactions. The second video is similar and from the same date, and in it the 

“defendant is again recording himself and after a few seconds of silence again 

yells ‘HEY’ and again moves the camera toward the infants.” The two videos 

were received at trial, and the court provided the jury with a cautionary 

 

6

 Griffin argues that the circuit court erroneously exercised its discretion by improperly 

taking into consideration the strength of the State’s case against Griffin when it made its 

determination, citing State v. Wilson, 2015 WI 48, ¶61, 362 Wis. 2d 193, 864 N.W.2d 52. 

Specifically, Griffin challenges the court’s mention of text messages Griffin sent in the days after 

the crime suggesting that the mother could not have committed the crime and asserting instead 

that S.P. was the perpetrator. We note that Wilson provides that “[o]verwhelming evidence 

against the defendant may not serve as the basis for excluding evidence of a third party’s 

opportunity (or direct connection to the crime).” Id., ¶69 (emphasis added). While the court 

mentioned the text messages, we see no statement precluding the court from considering Griffin’s 

statements or other evidence against him so long as it did not serve as “the basis” for excluding 

the evidence without more. The court sufficiently considered multiple evidentiary factors in 

reaching its decision.

7

 The court initially admitted the third video, but then excluded it at trial when it was 

determined that it did not involve the twins. 
No. 2018AP649-CR

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instruction, directing the jury to consider the videos “only on the issues of intent 

and background” and not “to conclude that the defendant has a certain character.” 

¶19 We review a circuit court’s admission of other-acts evidence for an 

erroneous exercise of discretion. State v. Sullivan, 216 Wis. 2d 768, 780, 576 

N.W.2d 30 (1998). “An appellate court will sustain an evidentiary ruling if it 

finds that the circuit court examined the relevant facts; applied a proper standard 

of law; and using a demonstrative rational process, reached a conclusion that a 

reasonable judge could reach.” Id. at 780-81. WISCONSIN STAT. § 904.04(2) 

provides that “evidence of other crimes, wrongs, or acts is not admissible to prove 

the character of a person in order to show that the person acted in conformity 

therewith,” but the statute “does not exclude the evidence when offered for other 

purposes, such as proof of motive, opportunity, intent, preparation, plan, 

knowledge, identity, or absence of mistake or accident.” Courts apply a three-step 

analysis to determine the admissibility of other-acts evidence. Sullivan, 216 

Wis. 2d at 771. Other-acts evidence is properly admitted if: it is offered for a 

permissible purpose under § 904.04(2), it is relevant under the two relevancy 

requirements found in WIS. STAT. § 904.01,

8

and its probative value is not 

substantially outweighed by the risk of unfair prejudice under WIS. STAT.

§ 904.03. Sullivan, 216 Wis. 2d at 772-73.

¶20 The circuit court reasonably concluded that the other-acts evidence 

was admissible. First, the circuit court determined that the State was offering the 

 

8

 “Relevance under WIS. STAT. § [] 904.01 has two components; the evidence must relate 

to some fact that is of consequence to the determination of the action, and it must have some 

tendency to make that fact more or less probable than it would be without the evidence.” State v. 

Davidson, 2000 WI 91, ¶64, 236 Wis. 2d 537, 613 N.W.2d 606.
No. 2018AP649-CR

13

other-acts evidence for “motive, intent, plan and context,” which are all 

“acceptable purposes.” Relying on State v. Gray, 225 Wis. 2d 39, ¶34, 590 

N.W.2d 918 (1999), the court noted that “[i]ntent involves knowledge, hostile 

feeling, or the absence of accident, inadvertence, or casualty—a varying state of 

mind which is the contrary of an innocent state of mind.” Further, quoting from 

State v. Payano, 2009 WI 86, 320 Wis. 2d 348, 768 N.W.2d 832, the court 

explained that evidence relating to context or background is admissible as it 

provides “a more complete presentation of the evidence relating to the offense

charged.” Id., ¶64 n.13 (citation omitted). We agree with the circuit court that the 

videos were offered for an acceptable purpose.

¶21 Next, the court found, under the second prong, that the videos were 

relevant “at the very least with respect to [the child abuse counts]” as “intent is an 

element of the offense.” Noting specifically that the two videos in question were 

near in time and place to the incident as they were recorded two days before 

MHP’s death in the same house and involving the same children, it also found that 

the videos were probative with respect to intent and showed the “context of the 

relationship between the defendant and the twins.” See Whitty v. State, 34 Wis. 2d 

278, 294, 149 N.W.2d 557 (1967). We see no error.

¶22 Finally, the circuit court concluded that the probative value of the 

evidence would not be substantially outweighed by any unfair prejudice. Again, 

we agree. “By its very nature, nearly all evidence operates to the prejudice of the 

party against whom it is offered.” State v. Murphy, 188 Wis. 2d 508, 521, 524 

N.W.2d 924 (Ct. App. 1994).

 Unfair prejudice results when the proffered evidence has 

a tendency to influence the outcome by improper means or 

if it appeals to the jury’s sympathies, arouses its sense of 

horror, provokes its instinct to punish or otherwise causes a 
No. 2018AP649-CR

14

jury to base its decision on something other than the 

established propositions in the case.

Sullivan, 216 Wis. 2d at 789-90. The court determined that

[t]his isn’t a situation where the other acts evidence is as 

serious or worse than what’s alleged here. It’s quite the 

contrary. The allegations here are very, very serious and I 

think egregious. And the other acts evidence of yelling by 

the sleeping twins ... doesn’t come anywhere close to 

rising to that level.

Not only was the content of the videos less serious than the allegations in the 

complaint, but it was also not similar enough to the charged conduct where “there 

is danger the jury will simply presume the defendant’s guilt in the current case.” 

See Payano, 320 Wis. 2d 348, ¶¶90, 94 (“The situation in which unfair prejudice 

is most likely to occur is when one party attempts to put into evidence other acts 

allegedly committed by the opposing party that are similar to the act at issue in the 

current case.”).

¶23 Moreover, the circuit court minimized any risk of unfair prejudice to 

Griffin by its cautionary jury instruction, which “eliminate[s] or minimize[s] the 

potential for unfair prejudice.” State v. Hammer, 2000 WI 92, ¶36, 236 Wis. 2d 

686, 613 N.W.2d 629; see also State v. Grande, 169 Wis. 2d 422, 436, 485 

N.W.2d 282 (Ct. App. 1992) (jurors are presumed to follow such cautionary 

instructions). Accordingly, we conclude the circuit court’s determination that the 

other-acts evidence should be admitted had a reasonable basis and the court did 

not erroneously exercise its discretion.

CONCLUSION

¶24 In summary, we conclude that the circuit court properly denied 

Griffin’s request to admit Denny evidence that the mother was responsible for the 

injuries to the twins as she lacked a direct connection to the perpetration of the 
No. 2018AP649-CR

15

crimes. We further affirm the circuit court’s decision to admit the other-acts 

evidence as it satisfied all three prongs of the Sullivan test for admissibility.

By the Court.—Judgment affirmed.