i i i i i i



### MEM ORA ND UM OP INION No
. 04 -0 6- 00 37 5- CR Carl os RIVAS , Appellant
v . T h e STA TE of

Te xas, Appellee Fr om the 175th J udicial District Court, Be x ar County , Texas

Trial Court No. 2003CR10018 Honora ble Mary Román, J udg e Presiding Opinion by : Kar en Ang elini, J ustice Sitt ing: Catherine Stone, Chief Justice

Kar en Ang elini, J ustice Steven C. Hilbig, Just ice Deliver ed and F iled: J uly 8, 2009 AFF I RMED Carlos Rivas was found guilty of four counts of ag g ravated sexual assault and one c ount of ind e c e nc y wi th a c hil d. On or ig ina l su bmi ssi on , he argue d that (1 ) the re po rt of the se xua l as saul t
nurse e x aminer should not have b e e n a d mi tt ed in evidenc e bec ause it constituted improper bolster ing of the c omplainant’s testimony ; (2) the repor t of the nurse examiner should not have bee n admitted in evidence beca

use it violated Texas Rule of Evidence 403; and (3) the trial court should have04

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1 ... C
. C
. de scr i b ed t hese act i o ns b y vari o us eup hem i sms ( “pri vat e p art , ” “ b ack p art , ” et c. ); how ever, al t ho ugh C
. C
. us ed eup hem i sms, her t est i m o ny cl earl y i d ent i f i ed t he p art s o f

t he f em al e and m al e b o d i es at i ss ue and t he act i o ns t hat s he cl ai med t oo k pl ace .

- 2- g ra nte d h is m oti on

fo r m istri a l be c a

us e duri ngc los ingargume nt i n th e punis hme nt p ha se of the tr ia l, the pr os e c uto r c ha

ra c te ri zed him a s a “ mon ste r. ” On

June 6, 20 07 , w e iss ue d an op ini on in t his c a se holding that ( 1) “bolster ing” was not suffic ient to preser ve error for appeal; (2) the tr ial court did not
a bu se its dis c re tio n in

de te rm ini ngthat th e a dmi ssi on of the nurs e e xami ne r’ s r e po rt did no t vi olate rule 403; and ( 3) the State’s use of “monster” wa s not improper ar g ument. Ri v as v . S tate , No. 04-06- 00375-CR, 2007 W L1608550 (Tex. App.—San Antonio 2007), rev’d , 2 75 S.W. 3d 88 0 ( Te x. Cr im. App. 2009) (

Ri v as I ). Riv a s th e n f

ile d a pe tit ion fo r d isc re tio na

ry re vie w atta c kin g on ly

our f ir st ho ldi ngre g ard ingpr e se rv a tio n o f e rr or . O n Jan ua ry 28 , 200 9, the Te xas Court of Cr imi na l App e a ls
re mand e d th is c a se ba c k to us fo r fu rt he r c on sid e ra

tio n, ho ldi ngthat Riv a s h a d ma de mor e sp e c if ic ob je c tio ns tha

n “ bo lst e ri ng ” and

thu s h a d p re se rv e d e rr or wi th r e sp e c t to tho se sp e c if ic ob je c tio ns . Ri v as v . S tate , 275 S.W .3d 880, 887 (Tex. Crim. App. 2009) ( Rivas II ). There fore , we now consider the se sp e c if

ic ob je c tio ns ide nti fi e d b y

the c ourt of c ri min a l a

pp e a ls. B ACKG ROUND Riv a s’ s st e p- da

ug hte r, C.C ., te sti fi e d at tr ial that Riv a s se xua lly a ssa ult e d h e r o n mu lti ple
occa sions. C.C., a ten y ear -old-g irl, testified t hat when she was seven y ear s-old, Rivas touched her g e nit a ls w ithhis ha

nd s, pe rf or me d or a l se x on h e r, and

pe ne tr a te d b oth

he r v a g ina

and he r a nu s w ith his pe nis
. 1 Ac c or din g to C.C ., Riv a s ma de he r tou c h he rs e lf wh ile he ma sturb a te d, and the y wo uld then have a conte st to “see who could make the white stuff come out first.” C.C. also testified that Rivas made her

perf orm oral se x on him.04

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- 3- Detec tive Fr eder i ck Allen Rouss el of the San A ntonio Pol ice De partment’s se x crimes division testified that he investigated the alleg ations ag ainst Rivas. W hen he inter viewed C.C., he
a sk e d h e r t o d

ra w a pic tur e to ill us tr a te wh a t ha d ha pp e ne d to he r. Ac c or din g to D e te c tiv e Rou sse l,
w h e nC. C. w a s un a

b le to dr aww h a t s h e w an te d to il lu s tr a te , s h e b e g anto s im u late o r a l s e x: L ike I said, she wa s unable to dra w what she wa

nted to g et ac ross, so she knelt down on the floor and was sitti ng on the back of her calve s. She took her hand a nd made kind of a fist and . . . She double d over, le aned f orwa rd with her hand like that, and was motioning her hand up and down with he r mouth ope n, moving her he ad up and down . . . . Acc ordingto Detec tive Roussel, he bec ame so unc omfortable that he opene d the closed door to the
room: “So, I just ope ned the door a littl e bit, just beca use it was a little uncomfor table. I don’t know
ex ac t l y wh y I fe l t l i k e I h ad t o o p en th e do o r, b u tIwa n t edth e d o o r o p en ed
. S o , i twa s j u s ts tra n ge seeinga seve n-y ear -old demonstrate something like that that was fa irly g raphic and ac curate.” Detec tive Roussel also tes ti f ie d th a t h e inte rviewe d Rivas. When asked on cr oss-examination by defe nse counse l what Rivas had told him, Detective Roussel testified that Riv as s ai d the
a lle g a tio ns we re un tr

ue and that the a lle g a tio ns we re mot ivate d by a c us tod y iss ue ov e r h is a

nd his wi fe ’s inf ant d a ug hte r, R.R
. Detec tive Roussel also testified that he sear ched the apar tment where Rivas, his wife, C.C., and R.R. lived. During the s ear ch, an evidenc e technician, Detective Ga rcia , took photogr aphs and
remove d th e b e d d in g f

r o m C
. C. ’ s r o o m. K im

b e r ly F
. L an d e r s , a

f o r e n s ic s c ie n ti s t w it

hth e B exar County Criminal Investig ation L aboratory , conducte d testing on the beddingand testified at trial that she wa s able to identify

the pre sence of sper

m on the blue blanket take n from C.C.’s bottom bunk bed. Robert Sailors, also a fore nsic scientist with the Be x ar C o u nty Criminal I nvestig ation L aboratory , perf

ormed DN A analy sis on the bl ue blanket and compared it to Rivas’s DNA sample.04

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- 4- Acc ordingto Sailors, Ri vas wa s not ex cluded a s a contributor of t he human DNA identified on the blanket; “[t] hat means the t wo gen et i c p rofiles, the one from the bla nket and the one from Carlos Rivas, the y matched.” Be cause he had a match, Sailors the n considere d whether the match was
c oin c ide nta l or

wa s a tr ue matc h. Sa ilo rs de te rm ine d th a t th e pr of ile ob se rv e d o n th e bla

nk e t w ou ld be e xpe c te d to oc c ur in on e in e ig hty -s e ve n qu a dr ill ion ind ivi du a ls in the South wes ter n Hi sp anic po pu lat ion. T he pr of

ile wo uld be e xpe c te d to oc c ur

in o ne in e ve ry

12 7 q ua dr ill ion ind ivi du a ls i n the Southeastern H ispanic population. And, the profile would be ex pecte d to occur in one in eve ry 746 quadrillion individuals in the Cauca sian population. For the Afric an-A merica n population, the pr of ile wo uld oc c ur in o ne in e ve ry

16 .7 qu int ill ion

ind ivi du a ls. Annette Santos, a se x ual assault nurse examiner at the Alamo Children’s Advoca cy Center examined C.C. S h e took a hist ory from C.C. and per formed a head- to-toe and a

n anal- g enital examination. S he noted in her medical r eport that the r esults from the examination were normal. Rivas testified on his behalf a nd denied the a lleg ations. He c laimed that he a nd his wife had ha d se xua l re latio ns on

the blu e bla

nk e t f ound in C .C. ’s ro om; that th e blu e bla nk e t ha d b e e n o n h is
and his wi fe ’s be d; a

nd that he ha d n o id e a

ho w t he bla nk e t ha d f

ound its wa y to C .C. ’s ro om. Although Rivas a

nd his wife ha d only

been ma rried a short time, Rivas testified that he and his wife ha d a sto rmy and argume ntativ e re latio ns hip
. Ac c or din g to R iva s, the y ha d a rgue d, and

he tol d h is wife that she could leave but could not take the ir infant daughter. Rivas was subseque ntly found guilty of four counts of ag g ravated sexual assault and one count of indecenc y

with a child. He w as sentenc ed to twenty -five year s imprisonment for the
a g g ra vate d s e xua l a ssa

ult c ounts and

to t we lve y e ars imp ri so nme nt f or the ind e c e nc y

wi th a c hil d count, all to run conc urre ntly
.04

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- 5- M EDICA L RE P ORT In its opini on, the cour

t of criminal appe als noted that “[ b]ecause of the multifarious orig ins of ‘bolst ering ,’ courts have found conce rn wit h it as an objection on its face .” Rivas II , 275 S.W .3d at8 8 7
. T h e c o urt th en n o t edth e f o l l o wi n g: Many appellate courts have cited the Cohn concur renc e a s au thority

to abandon “bolstering ” as a

valid objection to prese rve e rro r for r eview. Aparty ’s objection must inform the trial court why or on what basis the otherwise a dmissibl e evide nce sh ou ld be e xclu de d. Th e Court of Ap pe a ls re lie d on thi s pr inc ipl e in the ins tant c a se when it held that “a

g ener al objecti o n t o ‘bolstering ’ is not sufficient to pre serve err or, bec ause it does n o t s u ff i ciently inform the trial c ourt of the nature of the objection.” But the a ppellant’s objections wer e not just ge nera l objection to “bolstering .” We set out h i s o b j ec t i o n s ats o m e l en gt hab o v e. S ev er al gro un d s o th er th an “b o l s t er i n g ” we re specifie d. One wa s that the m edica l exception to the hearsay rule did not apply in the absenc e of phy s i ca l evidence of a buse. This was spe cified in the a ppellant’s first a

nd third ob je c tio ns . Another w as that t he evide nce w as inadmissible beca use the c hild had not been imp e a c he d. Th is w a s sp e c if ie d in the se c on d, fo ur

th, se ve nth , a

nd ninth o bje c tio ns . Yet anothe r wa s connec ted to an appe llate opi n i o n (o r opinions) on which the a pp e lla nt r e lie d, wh ic h ( he sa id) sto od fo r t he pr op os iti on

that th e c hil d’ s st a te me nts would be used a s a basis for the nurse’s “bac k door” dia g nosis or opinion that sex ual abuse ha d occur

red. This g round wa s made whe n he pre sented the opinions to the c ourt and wh e n h e ma de his fi ft

h, sixth , a nd te nth ob je c tio ns . Id. In his first issue, Rivas argues that “[t] he trial court err ed when it overruled [his] objection and admitt ed into evidence the re port of the se x ual assault nurse examiner bec ause the evidenc e constituted improper bolst ering of t he complaina nt’s testimony .” He then discusses the pr ocedur al his tor y of the nurs e e xami ne r’ s re po rt be ing a dmi tte d in e vid e nc e , no tin g that a bu se of dis c re tio n is the a pp ro pr iate sta

nd ard of re vie w on

a pp e a l. R iva s th e n q

uo te s Coh n v . S

tate , 849 S.W .2d 817, 81904

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- 6- (T e x. C r i m . Ap p . 1 9 9 3 ) , f o r t h e p r o p o s i t i o nth a tb o l s t e r i n g o c c ur s “ w h e no n e i t e mo f e v i d e n c e is improperly used by a party to add crede nce or weig ht to some ear lier unimpeac hed piec e of e vidence of fe re d b y the same pa

rt y .” Riv a s’ s e nti re le g a l ana ly sis of the iss ue c on sis ts o f t

he fo llo wi ng : When a sexual abuse examin at i o n is at issue, and there is no phy sical evide nce of abuse, the testimony of t he sexual assault examiner “c an only be see n as an attempt to directly

bolster the cr edibility

of the c o m p l ai n ant and a direc t comment on the complainant’s truthfulne ss.” Sa lin as v . S tate , 166 S.W .3d 368, 371 (Tex. App.—For t Worth 2005, pet. ref’ d). The line of que stions to Annette Santos re gar d i n g C.C.’s declar ations during the SAN E e xam w a s im

pr op e r b ols te ri ng , a

nd the a c tua l examre po rt

wa s und ou

bte dly bolstering also. No aspe ct of C.C.’s dec larations had b ee n impeache d prior to the State’s question s , and her decla rations in the SANE examination were consistent with her prior

testimony

– if more de tailed and c omplet e. The questions and the repor t “under lined” the child’s credibility to the j ury , to the extent that thi s evidenc e cover ed items about which she had alre ady testified. Wit h reg ard to the item a bout wh ic h C. C. d id n ot t e sti fy – Co un t I Iof

the in di ctmen t – t

he e vid e nc e wa s st ill improper, beca

use it was a c omment on the child’s truthfulness. Id. The c ourt abused its discretion when it overr uled the objec tion. Th e St a te ar g u e d

a t t r ia l t h a t t h e e v id e n c e w a s a dmi s s ib le a s a h e ar s ay decla ration made f or t h e p u rpose of

medical diagnosis and treatment. T EX . R. E V ID . 803(4) provides that stateme nts made for the purpose of m edica l diag nosis and treatment are n o te x c l u d e d

b y th e h e ar s ay r

u l e e v e nth o u g hth e d e c l ar an ti s a v a i l a b l e t o t e s t i f

y. Appellant’s c ounsel argued that ther e wa s n o d iagnosis of sexual assault and there fore the dec laration was not made for the purpose of diag nosis or treatment. As st at ed b efore, ther e wa s a “D iag nostic I mpressions” sec tion of the repor t, and that section stated that the “ normal” phy sical exam “[c]an be consistent with the history provided.” I t is argued here that this is not a diagnosis, but even if it is, it is a dire ct c omm e nt o n th e tr

uth fu lne ss of the c omp la ina nt, and is the re fo re ina dmi ssi ble b o l s t er i n g. Thus, Rivas r elies on two leg al authorities: the F ort Worth Court of Appeals’ opinion in Salinas and Texas Rule of Evidence 803(4). We d is agre e wi th R iva s’ s a sse rt ion that Salinas stands for the pr oposition t hat when the re is no phy sical evide nce of abuse, a sexual assault ex aminer ma y never testify . The F ort Worth Court of Appe als in Salinas , 166 S.W .3d at 369, dealt with the issue of whe ther a llowing the State’ s expert04

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- 7- to testify about her diag nosis of sex ual abuse, which wa s based solely on the self- repor

ted medica l h i s t o r y o f t h e c o mp l a i n an t , c o n s t i tu t e d a d i r e c to p i n i o no nt h e c r e d i b i l i ty o f t h e c o mp l a i n an t
. In Salinas , the complainant testified that the def endant ha d penetr ated he r anus with his fing er. Id. at 370. The State’ s ex p er t t estified that, g ener ally , there will be no phy sical evide nce of the mere insertion o f a fing er into the a nus of a six-y ear -old child. Id. Neve rtheless, the e x pert diag nosed sexual abuse base d solely upon the history

provided by

the complainant, notingthat the medica l exam was consistent with that history
. Id. T h at i s , t h e expert “dia g nosed sexual abuse by digital pe ne tr a tio n o f the anu s bec a us e the c hil d told he r that di g ita l pe ne tr a tio n h a d o c c ur re d a nd be c a us e there was no phy sical evide nce of any sexual abuse.” Id. The For t Worth Court of Appea ls he ld that such testim o n y was “ a dire ct comment on the c redibility of the c omplaining witness.” Id. at 371. Acc ordingto the court, “ [b] eca use there was no phy sical indication of dig ital penetration, [ the expert]’s testi mony

can only

be se en as an at t empt to directly bolster the cr edibility

of the
co m p lainant and a

direc t comment on the complainant’ s truthfulness.” Id. “ A l th o u g h[t h e e xpe rt ] could p ro pe rl y

te sti fy tha t th e phy sic a l e xam w a s n or ma l, t he tr ia l c ourt

a bu se d it s d isc re tio n in admitting [the expert] ’s t estimony that she had diag nosed sex ual abuse based on the child’s medica l history .” Id. Th e fa c ts o f t

his c a se , h ow e ve r, are dis tin g uis ha ble . Sa nto s’ s d ia g no sti c imp ression w a s a “norma l examination,” which “[c]an be c onsistent with his tory provided.” Unlike in Salinas , Santos
ma de no dia g no sis of se xua l a bu se . “ Mo re ov e r, te sti mony that inf or ms the jur

y that sex ual a

bu se does not al wa y s result in phy sical trauma is at best neutra l testimony – this fact alone does not milit ate in favor

or ag ainst a findingof sexual abuse.” Ur ibe s v . S tate , No. 04-07-00774- CR, 200904

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2 ... In d e e d , d u rin g c lo sin g a rg u m e n t, R iva s h igh ligh te d the se p o ints: Le t ’ s t al k a l i t t l e b i t ab o ut t he t i m e l i ne i n t hi s c a se , l ad i es and gent l em en. W hen d i d t hi s case t ake pl ace ? W hen di d t he out cr y co me? Jul y t he 25 t h, 200 3, at t he bapt i s m o f t he l i t t l e s i s t er . W hat does she t el l y o u? W el l , s he t o l d y o u t here was a l o t of argui ng i n t he f am i l y. W h a t d i d C arl o s t el l y o u? T hey argued ove r t he b ab y . H e was at t ent i ve, b ut he was i nat t ent i ve. T here was st res s. W hat d i d t he l i t t l e g i r l s ay ? I ’ m s ad. I we n t t o my r oom. Sh e wa s u ps et
. T h e v er y s ame da y s h e’ s g oi n g t o t el l y ou r i g h t t h e r e on t h a t r e po r t , y ou k n ow , t h a t ’ s St a t e ’ s Ex h i bi t 23
. W h a t di d s h e s a y s h e di d? I w e n t t o m y r oom. I w i t h dr ew . T h e s ame l i t t l e g i r l w h o w as l ef t i n W as h i n g t on by h er mot h er f or s i x mon t h s , n ot wi t h her nat ural fat her. W o nd er why? N o t wi t h – w i t h her s t ep f at her, who wasn’ t her nat ural f at her. She co m es t o Sa n A nt o ni o , T exas, i n D ecem b er. . . . T he l i t t l e gi rl i s t aken t o s cho o l
. She’s picked up b y a sc h o o l b u s . H e r m o the r m e e ts he r e v e ry d a y. C a rlo s, ha rd w o rk ing , d riv e s 6 0 0 m iles a d a y. Leav es i n t he af

t er noon, comes back i n t he mo r ni ng or l at e a f t er noon, d ependi ng on h ow l ong h e t ake s a n ap wh i l e h e’s o n t he ro ad . T he m o t he r is the re. T he b ab y is b o rn i n M arc h. C arlo s’ s att en t i o n shif t s. W here do es t he at t ent i o n s h ift ? T o h is o nl y chi l d , hi s f i rs t b o rn. Just l i ke al l f

at hers , pro ud
. . . . In a ho m e where t here i s st res s, i n a hom e where t here i s argui ng, i n a hom e where t hey are f i ght i ng, who wer e t hey f

i gh t i ng o ver ? A baby
. Chi l dren ar en’ t s t upi d, l adi es an d gen t l emen. T hey kn ow whe n t hey a r e f i g h t i n g ov e r a ba by
. An d w h a t di d Ca r l os s a y ? He t ol d h e r , y ou c a n g o, bu t y ou a r e n ot t a k i n g my b a b y. S o , w h a t go e s thr o u g h th e m ind o f a se v e n ye a r-o ld ? O b v io u sly, as sh e to ld yo u , sa d , un h a p p y.

. . . T he l i t t l e gi rl co ul d n’ t rem em b er. A nd y o u saw her. T he Stat e was equa l l y f rus t rat ed , l ad i es and gen t l emen, becau s e a bo ut t he l as t f our t i mes, al l I r ememb er , f r ont or back, f

r ont o r back , nu mb er one, n u mb e r t w o, be c a u s e t h e y l e d, l e d, l e d, l e d, l e d h e r . W h e n w a s t h i s , l a di e s a n d g e n t l e me n , e v e r y t i me t hey as ked h er a que s t i on. W hat was t hat about ? And t hen al l of a s udden, oh, y eah , I r ememb er now.

. . . She ca n’ t remem b er much, excep t w hat t he Stat e asks her and t el l s her. N o w, chi l d ren are chi l d ren, and t he m o re y o u ask a chi l d ab o ut s o m et hi ng, y o u know , t he m o re f i rm t hey b eco m e i n t hei r po si t i o n.

- 8- WL330972, at *1 (Te x . App.—San Antonio 2 0 0 9 , no pet.). Santos neve r testified dire ctly about C.C.’s credibility

or honesty
. See id. Fur ther, we disag ree with Rivas’ s asser tion that C.C.’s de clar ations had not bee n impeache d befor e the a dmission of t he medical repor t. C.C. t estified bef

ore Santos and w as cr oss-examined by Rivas, who attempted to show that C.C.’s memory of the e vents was not ac curate, t h at she wa s jealous of he r mother’ s rela t i o n s h i p wi t h Rivas and her new ba by sister, and that he r mother a nd Rivas foug ht a lot a

nd wer e fig hting on the da y she outcrie d to her mother. 2 The whole point of the
c ro ss- e xami natio n wa s to sh owtha t C. C. w a s n ot t e lli ngthe tr uth . T his imp e a c hme nt b y Riv a s, which sug g ested fa

brication, permitted corr oboration of C.C.’s testimony by Santos. See id. F ina lly , w e ho ld that the me dic a l r e po rt wa s a dmi ssi ble a s a

state me nt m a de fo r t

he purp os e of medical diag nosis or t re at m en t
. See U ribes , 2009 WL 330972, at *2. Texas Rule of Evidenc e04

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- 9- 803(4 ) p r o v id e s th a t “ [s ]t a te me n ts ma d e f o r p ur p o s e s o f me d ic a l d ia g n o s is o r tr e a tme nt and descr ibing medic al history , o r p as t or pre sent sy mptoms, pain, or sensations, or the ince ption or g ener al cha

rac ter of the cause or ex terna l source there of” are admissible as ex ceptions t o the hea rsay rule a s long as they

are “re asonably

pertinent to diag nosis or treatment.” T EX . R. E V ID . 8 0 3 ( 4 )
. We have int e rp re te d r

ule 80 3( 4) to i nc lud e state me nts by vic tim s of c hil d a

bu se a s to the so ur c e of

the ir alleg ed injuries. See U

ribes , 200 9 WL 33 09 72 , at *2 ; se e als o B ur ns v . S tate , 122 S.W .3d 434, 438- 39 (Tex. App.—Houston [1s t Dist.] 2003, pet. re f’d) . Santos testified t hat s he ini tially takes a history for diagnosis and treatment. Accor ding to Santos, the history aids her in de termining wh ether the patie nt n e e ds te sti ngfo r i nf e cti on or se xua lly tr ans mitte d d ise a se s. “ Th is t e sti mony fa lls sq ua re ly within rule 803(4).” Uribes , 2009 WL330972, at *2. Findingno abuse of

discretion by

the trial cour

t, we over rule Rivas’s issue. C ONCL US I ON We affir m the judgme nt of the trial cour t.

Kar en Ang elini, J ustice Do no t pu bli sh