COURT OF APPEALS OF VIRGINIA
Present: Judges Humphreys, Mal veaux and Senior Judge Frank Argued at Hampton, Virginia

LENA KATHERINE PULLIN MEMORANDUM OPINION * BY v. Record No . 1117-18-1 JUDGE MAR Y BENNETT MALVEAUX OCTOBER 15, 2019 COMMONWEALTH OF VIRGINIA

FROM THE CIRCUIT COURT OF THE CITY OF PORTSMOUTH Joel P. Crowe, Judge W. McMillan Powers, Assistant P ublic Defender, for appellant. Liam A. Curry, Assistant Attorn ey General (Mark R. Herring, Attorney General, on br ief), for appellee.

Lena Katherine Pullin (“appellant”) was co nvicted of felony ch ild abuse, in violation of Code § 18.2-371.1 (B). On appeal, she argues that the trial cou rt erred in denying her motion to strike and motion to set aside th e verdict because the evidence failed to show that she committed an act or omission that was so gross , wanton, or culp able as to sh ow a reckless disregard for human life. For the following reasons, we affirm.
I. BACKGROUND On appellate review, we consider the evidence presented at tria l in the light most favorable to the Commonwealth, t he prevailing party below, and “accord [it] the benefit of all inferences fairly deducible from the evidence.” Riner v. Commo nwealth, 268 Va. 296, 303 (2004).

* Pursuant to Code § 17.1-413, this op inion is not designated fo r publication.UNPUBLISHED- 2 - In September 2016, P.P., the victim, was fourteen months old. At that time, Tina Blair, P.P.’s grandmother, had legal cu stody of the child and P.P.’s m other, appellant, had “liberal visitation.” Appellant and Blair ha d arranged for P.P.’s visit ation with appellant from Thursday, September 8, 2016, to Sunday, September 11, 2016 at appellant’s home in Portsmouth. Blair testified at trial that she bathed P.P. around 6:45 a.m. on the day that the visitation was to begin and did not notice any bruising on the child at that time. She gave P.P. to appellant less than two hours later, between 8:15 a.m. and 8:30 a.m. That same day, ap pellant sent Blair a text message stating that her blood pressure w as high and that she was probably going to have to go to the emergency room. Appellant also sta ted that P.P. was “being a l ittle fussy” and asked if she could bring P.P. to Blair’s house if appe llant went to the emergency room. Blair told appellant that she could, but appellant did not bring the child back to Blair’s ho use. Appellant did not send any additional written text messages to Blair for the remainder of the weekend, but “may have sent [Blair] a picture or something.” Around noon on Sunday, September 11, 2016, appellant and her fi ancé brought P.P. back to Blair’s house in Virginia B each. Appellant d id not tell Bla ir that P.P. had sustained any injuries or fallen during the weekend. When P.P. arrived back at Blair’s home, Blair could tell that P .P. had been given a bath recently because her hair was wet, so she did not bathe or chec k P.P.’s body at that time. Blair fed P.P. lunch, and after lunch the child took a three-hour nap . When P.P. woke up, Blair laid her on the floor in a hallway to c hange her diaper. She did no t notice anything unusual about P.P. at that time but testified that the hallway w as “a little dark” and that she “[c]ouldn’t really see.” After that, P.P. got up and played. Blair left the hous e at 5:00 p.m. to pick up a friend. She left P.P. with her son and daughter-in-law, Joseph and Meli ssa Pullin, at their nearby home.- 3 - Blair collected P.P. from th eir house at 6:00 p.m. and returned to her home. Blair put P.P. to bed between 6:30 p.m. and 7:00 p.m. The next day, Monday, September 12, P.P. woke up around 6:30 a. m. At that time, Blair removed P.P.’s diaper and “notic ed a little bru ise on the side of her butt.” When P.P. started to crawl away, Blair saw “purply gr een” bruises on “her behind and on her back and just a little bit on . . . one leg.” She had not seen these bruises when she had bathed P.P. on the morning of September 8 prior to P.P. leavi ng Blair’s home for her visitati on with appellant. Blair called a caseworker with V irginia Beach Child Protective Services (“VBCPS”) and then drove P.P. to the Virginia B each Department of Human Servi ces (“VBDHS”). 1 Blair testified that she had not hit or struck P.P. during the period of time when she got the child back from appellant to when she dr ove her to the VBDHS. Joseph Pullin testified at tr ial that on September 11, 2016, Bl air brought P.P. to his house and left her there so that he and his wife could watch her for about an hour. He stated that he watched P.P. during the entire ti me she was at his house. He t estified that he did not see her fall, and neither he nor his wife hit P.P. while she was in their hom e. Detective B.L. Davis of the Portsmouth Police Department spoke with appellant on November 9, 2016. Appellant told Davis that she was at home wi th P.P. the entire weekend in question. She stated that her roo mmate was also present, but w as never with the child by herself. Appellant also told the detectiv e that her boyfriend was with t hem “off and on, but . . . was never there alone with the child.” Rather, appellant stated that “sh e was the only one who had sole care and custody for the whole weeke nd.” When Davis asked appellant“what happened with [P.P.’s] injuries,” appellant “abruptly ended the interview.”

1 The caseworker had been involve d with P.P. sin ce the child’s b irth and testified that several parties, including B lair and appellant, had attempted t o gain custody of the child throughout the child’s life.- 4 - The Commonwealth introduced sev eral photographs of P.P.’s bruis es taken on September 12, 2016, including photographs take n that morning at VBDHS. Dr. Michelle Clayton, the medical director of the Children’s Ho spital of the King’s Daughters child abuse program, w as qualified at trial as an exp ert in child abuse pediatrics. She testified that on November 1, 2016, she reviewed a report aboutP.P. that was prepared by Dr. Alex Young, another doctor she supervised. Specifically, D r. Clayton reviewed the photographs of P.P.’s bruises take n while the child was at VBDH S on the morning of September 12. Neither she nor Dr. Young personally evaluated P.P., and D r. Clayton completed her evaluation solely on the basis of the photographs. Dr. Clayton described her evaluation as an “investigative consult” that occurred because medical professio nals did not have the “opportunity to physically examine the child at the time the in juries occurred.” S he stated that this evaluation was a “standar d practice in [her] field.” In the photographs, Dr. Clayton observed multiple bruises to P. P.’s lower back and extensive bruises to her butto cks. She opined that these injur ies occurred “as a result of repetitive blunt force trauma t o [P.P.’s] lower back and her bu ttocks.” Dr. Clayton based her conclusion on “the widespread na ture of the injuries,” noting t hat there were “multiple bruises in areas that are outside the expect ed location for accidental inj uries” and that the injuries “were quite extensive.” Dr. Clayton asc ertained that the blunt force trauma was “repetitive” because multiple areas of P.P.’s body wer e bruised, which indicated tha t “extensive blunt force trauma [was] applied to multiple body areas to cause these injuries.” Dr. Clayton also testified that th e bruises were “linear” and t hat such bruises could result from “forceful impact with an objec t that leaves a linear impre ssion mark or just leaves an object outline on the tissue.” She state d that she typically saw line ar bruising caused by “belts, rulers, [and] toys with a linear edge.” However, Dr. Clayton agreed th at such items were “just- 5 - possibilities” and that she c ould not “determine from looking a t the injuries what object caused them.” Dr. Clayton testified tha t the bruises as depicted in t he photographs were fading, meaning that the tissue injuries w ere “significantly worse” and “likely more widespread” at the time the injuries occurred. In a ddition, there was likely swel ling of the affected body areas and “the impression marks would have be en clearer and more widespre ad.” Dr. Clayton opined that P.P.’s inj uries could not have resulted from the child falling from a standing position, tumbling down the stairs, or falling on a toy. In addition, she noted that the injuries could not have resulted from an accidental touching. Dr. Clayton testified that injuri es like those she saw in the p hotographs could pose a risk of “widespread tissue damage because of the application of blun t force trauma to an extensive body area” and that “any child who has injuries such as these[ ] actually can develop kidney issues as a result if there is enough widespread tissue damage and tissue death.” Further, because the bruises in the photographs w ere fading, Dr. Clayton was “co ncern[ed] . . . that the injuries were a lot more extensive in the immediate timeframe after thei r occurrence, and widespread injury certainly can cause . . . l ong term injury to the child’ s internal organs.” On cross-examination, Dr. Clayton t estified that she cannot date a bruise by its appearance and instead dates them by the information provided by a child’s car egiver. When asked whether there was no way to tell how ol d the bruises in the photographs were without such information, Dr. Clayton stated that “for young children generally bruises w ill often disappear completely several days to a week or more a fter the injury, but it is not possible to say with clarity how many days it takes for bruises to resolve” and that “it is info rmation from caregivers that gives you the most precise dating information.” Following the Commonwealth’s cas e-in-chief, appellant moved to strike the evidence, and the court denied the moti on. Appellant did not present evi dence. The court found appellant- 6 - guilty of felony child abuse or ne glect, in violation of Code § 18.2-371.1(B). The court noted that it found Dr. Clayton’s tes timony “extremely persuasive” wi th respect to “the extensive blunt force trauma to multiple areas.” Further, the court found Blai r and Joseph Pullin’s testimony “to be extremely credible” and did not “find that there was any bia s that was shown on cross-examination.” Following trial, appellant filed amotion to set aside the verd ict. After hearing argument on the motion at the sentencing he aring, the trial court denied the motion. The court again stated that it had found Dr. Clayton “ex tremely” credible and noted th at she testified that “there was extensive blunt force trauma to multiple areas, with multiple b lows.” This appeal followed.
II. ANALYSIS On appeal, appellant argues thatthe trial court erred in deny ing her motions to strike and to set aside the verdict because the evidence was insufficient to prove that her acts or omissions were so gross, wanton, or culpabl e as to show a reckless disreg ard for human life. The motions denied by the trial court challenged the sufficienc y of the evidence. See Hawkins v. Commonwealth, 64 Va. App. 650, 654 (2015); McGee v. Commonwealth, 4 Va. App. 317, 321 (1987); see als o Code § 8.01-680. When consi dering the sufficiency of the evidence on appeal, we “‘presume the judgment of the trial cour t to be correct’ and reverse only if the trial court’s decision i s ‘plainly wrong or without evid ence to support it.’” White v. Commonwealth, 68 Va. App. 111, 118 (2017) (quoting Kelly v. Com monwealth, 41 Va. App. 250, 257 (2003) ( en banc )); see also Code § 8.01-680. “[U]nder this familiar standard of review, ‘[a]n appellate court does not ask itself whether it believes that the evi dence at the trial established guilt beyond a reasonable doubt.’” Dalton v. Commo nwealth, 64 Va. App. 512, 525 (2015) (second alteration in original) (quoting Williams v. Com monwealth, 278 Va. 190, 193- 7 - (2009)). “Rather, the relevant question is whether any rational trier of f act could have found the essential elements of the c rime beyond a reasonable doubt.” Id . (quoting Williams, 278 Va. at 193). In addition, “[t]he credibility of the witnesses and the weight accorded the evidence are

matters solely for the fact finder who has the opportunity to see a nd hear that evidence as it is presented.” Commonwea lth v. Perkins, 295 Va. 323, 328 (2018) ( quoting Elliott v. Commonwealth, 277 Va. 457, 462 (2009)). T he fact finder is als o responsible for determining “what inferences are to be draw n from proved facts,” provided t hat the inferences reasonably flow from those facts . Commonwealth v. Hudson, 265 Va. 505, 51 4 (2003) (quoting Inge v. Commonwealth, 217 Va. 360, 366 (1976)). In order to sustain a con viction under Code § 18.2-371.1(B), th e accused must have committed a willful act or omission that was “so gross, wanton, and culpable as to show a reckless disregard for huma n life.” Code § 18.2-371.1(B)(1). “[W]hether the statutory requirement [under Code § 18.2-371.1(B )(1)] that the act or omi ssion ‘so gross, wanton, and culpable as to show a reckless disregard for hum an life’ has be en met turns on whether an injury to the child is likely to occur as a result of the act or omiss ion.” Hannon v. Commonwealth, 68 Va. App. 87, 94 (2017); see also F lowers v. Commonwealth, 49 Va . App. 241, 247 (2007) (“[T]o support a conviction for felony ch ild neglect, the Commonwealthmust establish that the defendant, through her willful actor omission, created a situa tion placing the child at risk of actual physical harm.”). A willful act “necessarily implies ‘k nowledge that particular conduct will likely result in injury or illegality.’” Mangano v. Commo nwealth, 44 Va. App. 210, 214 (2004) (quoting Ellis v. Co mmonwealth, 29 Va. App. 548, 554 (19 99)). In other words, “[t]he defendant must have been aware t hat [the] conduct was likely to result in serious injury.” Id. at
215.- 8 - However, unlike Code § 18.2-371.1(A) , which makes it a crime fo r “[a]ny parent, guardian, or other person responsib le for the care of a child” to willfully cause or permit “serious injury to the life or health of such child,” subsection (B)(1) of the statute “does not require that a child actually suffer serious inj ury as a result of a defendant ’s acts or omissions.” Commonwealth v. Duncan, 267 Va. 377, 385 (2004). The language of subsection (B)(1), particularly the absence of an i njury requireme nt and the autho rization of a less severe punishment, “demonstrates a legis lative intent to prohibit conduct that also has the potential of endangering a child’s life.” I d. Therefore, the statutory ele ment of “‘reckless disregard [for human life]’ can be shown by conduc t that subjects a child to asubstantial risk of serious injury, as well as to a risk of death, because exposure to either type of risk can endange r the child’s life.” Id. Applying these principles and view ing the evidence under the ap plicable standard of review, we conclude that the evid ence was sufficient to prove t hat appellant’s acts were so gross, wanton, and culpable as to show a r eckless disregard for human life. While appellant argues that the evidence was insufficient because there was no direct evide nce of how the bruising occurred or when it occurred, circumstan tial evidence tended to prove th at P.P.’s injuries were inflicted by appellant while P.P. was in appella nt’s care. Blair testified that she did not observe bruising on P.P. on the morning of Thursday, September 8. Appellant had P. P. in her care from later that morning until noon on Sunday, Septe mber 11. Blair did not noti ce anything unusual about P.P. that Sunday but did observe bruisi ng on P.P.’s buttocks, back, and leg on the morning of Monday, September 12. Appellant her self told Detective Davis that while her roommate and boyfriend were present at times during her visita tion with P.P. , neither was ever alone with the child. Rather, appellant state d that she “was the only one who had sole care and custody for the whole weekend.” See Christian v. Commonwealth, 221 Va. 1078, 1 082 (1981) (“[W]here it- 9 - appears that a criminal assau lt was made upon a child within a particular period of time, evidence which shows that the accused was sole custodian of the child during that period may be sufficient, standing alone, to prove criminal agency.”); see al so Collado v. Commonwealth, 33 Va. App. 356, 364-65 (2000) (affirm ing defendant’s conviction f or child abuse where defendant had sole custody and control of the child during period when ch ild suffered severe brain injury). Further, Dr. Clayton opined that the multiple bruises to P.P.’s lower back and buttocks occurred “as a result of repet itive blunt force trauma to her lower back and her buttocks.” She also noted that the bruises were linear, whi ch could “come from forceful i mpact with an object that leaves a linear impression mark or just leaves an object outline on the tissue.” Dr. Clayton stated that she typically saw linear bruising cau sed by “belts, rulers, [and] t oys with a linear edge.” She further testified that the bruises as depicted in the photographs were fading, meaning that the tissue injuries were “significantly worse” and likely more widespread at the time the injuries occurred. Dr. Clayton opined that P.P.’s inj uries could not have resulted from P.P. accidentally falling or from accidental touching. Here, the evidence was sufficient to demonstrate that while appellant had sole care and custody of P.P. between September 8 and 11, 2 016, she inflicted injuries on the child that were not caused by accident but rather by her willfu l acts. Appellant also argues that the e vidence was insufficient to pro ve that P.P.’s injuries were “life-threatening.” However, a s noted above, the statutory ele ment of reckless disregard for human life can be shown by conduct that subjects a child to a s ubstantial risk of serious injury, as well as to a risk of death. D uncan, 267 Va. at 385. Dr. Clayt on testified that the injuries P.P. suffered posed a risk of “widespread tissue damage because of t he application of blunt force trauma to an extensive body area” and that “any child who has i njuries such as these[] actually can develop kidney issues as a re sult if there is enough widesp read tissue damage and tissue death.” In addition, because the bruises in the photographs we re fading, Dr. Clayton was- 10 - “concern[ed] . . . that the injuries were a lot more extensive in the immediate timeframe after their occurrence, and widespread injury certainly can cause . . . long term injury to the child’s internal organs.” Based on the testimony of Dr. Clayton that P .P.’s injuries created a risk of tissue and long-term organ damage to the child, we conclude tha t the evidence was sufficient to establish that appellant’s acts created a substantial risk of s erious injury to P.P. Viewed in the light most favorab le to the Commonwealth, a ratio nal fact finder could have found that appellant inflic ted non-accidental injuries on P.P. while the child was in her care and that this conduct exposed the child to a substantial risk o f serious injury. Therefore, we conclude that the evidence in t he instant case, viewed under th e applicable standard of review, was sufficient to prove beyond a r easonable doubt that appellan t was guilty of felony child neglect.
III. CONCLUSION We hold that the trial court did not err in de nying appellant’ s motion to strike and motion to set aside the verdict. Accordingly, we affirm. Affirmed.