Opinion ID: 1135325
Heading Depth: 2
Heading Rank: 3

Heading: The Legality of the Convictions Involving Susan Y.

Text: In addition to our determination that Susan was not competent to testify about events that occurred at the day care center, there are four more errors that require the reversal of the convictions concerning Susan. First, the videotape of Susan's testimony at the preliminary hearing was introduced after Susan testified, and an additional allegation was stated on the tape to which Susan had not previously testified. Second, the district court erred in making the determination that Susan's hearsay statements were reliable pursuant to NRS 51.385 and there is insufficient evidence in the record to affirmatively establish that such statements are reliable. Third, the receipt into evidence of so many accusatory hearsay statements made by Susan without a proper determination of their reliability and necessity cumulatively prejudiced the appellants. Fourth, psychologist Fisher testified that Susan was a forthright person, thereby impermissibly commenting directly on her veracity.
If a child testifies and is subject to cross-examination, the State may introduce the child's hearsay statements pursuant to NRS 51.385, without violating the Confrontation Clause of the United States Constitution. However, in this case, the State continued to introduce statements recounting Susan's accusatory hearsay statements after Susan had been excused as a witness. These statements were presented through the testimony of Susan's mother and psychologist Payne, and by Susan in her videotaped preliminary hearing testimony. The videotape of Susan's preliminary hearing testimony contained her allegation that Ontiveros stuck a knitting needle up her crotch, which may have supported the one count involving Susan for which Ontiveros was convicted. The defense was unable to cross-examine Susan on several statements that others claimed she had made. California v. Green, 399 U.S. 149, 90 S.Ct. 1930, 26 L.Ed.2d 489 (1970), requires that cross-examination be full and effective. Id. at 158, 90 S.Ct. at 1935. As a practical matter, if a child is excused before her hearsay statements are proffered, the defense has no opportunity to cross-examine the child on those statements. On remand in Green, the California Supreme Court held that admission of an unsworn hearsay statement did not violate the Confrontation Clause because the declarant was recalled to the stand after the police officer recounted the declarant's prior statement. People v. Green, 3 Cal.3d 981, 92 Cal.Rptr. 494, 479 P.2d 998 (1971) (en banc). This procedure gave the defense an opportunity to cross-examine the declarant about the hearsay statement. The same opportunity should have been afforded the defense in this case. We adopted a similar procedure in Jacobs v. State, 101 Nev. 356, 705 P.2d 130 (1985), for allowing the admission of prior consistent statements to rebut claims of undue influence of a witness pursuant to NRS 51.035(2)(b). In Jacobs, the defendant was charged with murdering his ex-wife. His five-year-old son testified against him and left for Arkansas before the trial was over. Defendant's counsel then attempted to impeach the boy's testimony by suggesting that his grandmother improperly influenced him. With the boy out of the jurisdiction, the trial court admitted prior consistent statements the boy had made to police. We decided that admitting this evidence was reversible error because the boy could not be cross-examined on these statements. Id. at 358, 705 P.2d at 131-32. Admittedly, NRS 51.035(2)(b) specifically requires that the defendant have the right to cross-examine the declarant and NRS 51.385 does not. However, the requirement that a defendant be permitted to examine the declarant about an earlier hearsay statement received into evidence after declarant's trial testimony is desirable and would protect the integrity of the court's truth-finding mission. Arguably, the defense could have recalled Susan and other children for cross-examination. However, we conclude that placing that burden on the defense is unfair. In Long v. State, 742 S.W.2d 302, 319 (Tex.Ct.App.1987), the court considered a statute which admitted child testimony, so long as the child was available to testify. The court held that requiring the defense to call a child to the stand for cross-examination regarding the videotape would violate due process. Long notes that such a requirement would put the defense in a Catch-22 position. If the State does not call the child to testify, the defense must either forego the right of cross-examination or call the child to the stand with the very real risk of incurring the wrath of the jury, which would blame the defense for forcing the child to testify. Id. at 320. The Catch-22 posed to the defense in this case was as serious as that in Long. In this case, the defense had to either forego its right to cross-examination, or prejudice itself by calling children like Susan to the stand to be examined a second time. Our conclusion is supported by other authorities. Sosebee v. State, 257 Ga. 298, 357 S.E.2d 562 (1987) (interpreting a statute similar to NRS 51.385, court concluded that prosecution or court must make declarant available to defense for further cross-examination if hearsay statements of declarant alleging additional crimes are received into evidence after declarant testified); see also Michael H. Graham, The Confrontation Clause, the Hearsay Rule, and Child Sexual Abuse Prosecutions: The State of the Relationship, 72 Minn. L.Rev. 523, 580-86 (1988) (supporting this view, and stating other reasons why the burden to call the child rests with the proponent of the hearsay statements). Some courts have suggested that requiring defense counsel to recall a witness whose hearsay statements have been introduced subsequent to his or her testimony in CSA cases is not unconstitutional. One court even placed this burden on the defense when the child's hearsay statement was admitted under an exception which is not firmly rooted, the residual reliability exception. U.S. v. Cree, 778 F.2d 474 (8th Cir.1985). We find this view unsound because it leaves the defense in the Catch-22 heretofore described. See Long, 742 S.W.2d at 320. In order to avoid placing the defense in such an unfair dilemma, the Sosebee court concluded that Georgia's child hearsay statute (a statute quite similar to NRS 51.385) requires that at the close of the State's case-in-chief, either the defense or the State may request that a child witness or hearsay declarant be called or recalled for cross-examination regarding hearsay statements already admitted. Sosebee, 357 S.E.2d at 563. The court also must inform the jury that the court, not the State or defense, is calling the witness. In order to avoid interfering with the defense's opportunity to cross-examine effectively, we construe NRS 51.385 to require that either the State or the court recall a child witness upon the request of the defense, if hearsay statements not firmly rooted in a hearsay exception are introduced subsequent to the child's testimony, and the child-victim did not cover the statements in his or her testimony.
Many of Susan's accusatory hearsay statements were received at trial through the testimony of a number of witnesses. But, since Susan testified at both the preliminary hearing and at trial, no Confrontation Clause issue is presented other than that addressed in the previous section. However, NRS 51.385 requires that an affirmative showing of trustworthiness be made before hearsay statements are received. We must consider whether the district court made such a determination as contemplated by this statute. The district court found that none of Susan's statements fell within a firmly rooted exception to the hearsay rule. Susan's accusatory hearsay statements were testified to by her mother, Detective Coffey, psychologists Fisher and Payne, and Dr. Scully. These hearsay statements were not spontaneous and were not made under excitement of the event and therefore were not excited utterances admissible pursuant to NRS 51.095. See also Dearing v. State, 100 Nev. 590, 691 P.2d 419 (1984); Hogan v. State, 103 Nev. 21, 23, 732 P.2d 422, 423 (1987) (victim's hearsay statement was excited utterance because made shortly after defendant threatened to kill her and while she was still frightened by it). Whether Susan's hearsay statements made to Dr. Scully and the psychologists should have been admitted as statements made for the purpose of medical diagnosis or treatment pursuant to NRS 51.115 [8] requires further analysis. The rationale behind admitting hearsay statements made to a health care provider is that these statements are very reliable because a patient would not lie or deceive his or her physician when describing his or her condition or discomfort for the purpose of diagnosis or treatment. See 2 John William Strong, McCormick on Evidence § 277, at 246-47 (4th ed. 1992); White v. Illinois, ___ U.S. ___, ___, 112 S.Ct. 736, 742-43, 116 L.Ed.2d 848 (1992); see generally 6 John H. Wigmore, Evidence in Trials at Common Law §§ 1719-22 (Chadbourn rev. 1976). Reliability therefore only exists where the patient understands the need to tell the truth and the health information given by the patient is necessary for assisting or treating the patient. When a patient is giving information to a psychiatrist, a psychologist, or a family therapist or counselor for diagnosis or treatment of a psychological or mental problem, the rationale behind reliability of these statements becomes less convincing because the declarant is not requesting immediate relief for a physical ailment. This belief was well stated in People v. LaLone, 432 Mich. 103, 437 N.W.2d 611 (1989): It is therefore fair to say that, while medical patients may fabricate descriptions of their complaints and the general character of the causes of these complaints, we would think it less likely that they will do so than psychological patients. In addition, although there are psychological tests, fabrications of physical complaints would seem to be far easier to discover through empirical tests than are fabrications which might be heard by an examining psychologist.... Thus, statements made in the course of the treatment of psychological disorders may not always be as reliable as those made in the course of the treatment of physical disorders. Id. 437 N.W.2d at 613. Not surprisingly, courts have split on whether to admit hearsay statements made to mental health care providers for the purpose of medical treatment. Some courts have determined that the rationale for the reliability of statements made for medical purposes is so undermined when made to psychologists or psychiatrists that statements made to these health care providers are outside the exception and should not be admitted into evidence. See State v. Zimmerman, 121 Idaho 971, 829 P.2d 861 (1992); State v. Harris, 247 Mont. 405, 808 P.2d 453 (1991). Other courts have held that such statements are within the medical treatment exception if made to psychiatrists or psychologists for the purpose of diagnosis or treatment. See State v. Robinson, 153 Ariz. 191, 735 P.2d 801 (1987); State v. Altgilbers, 109 N.M. 453, 786 P.2d 680 (1990). Still other courts have held that such statements are within the medical treatment exception if made about the patient's mental or physical condition or the facts of an event related to the condition, but are not within the exception if made about the identity of the perpetrator unless it is clearly shown that such information was necessary for diagnosis or treatment. See King v. People, 785 P.2d 596 (Colo. 1990); Sluka v. State, 717 P.2d 394 (Alaska Ct.App.1986); State v. Fitzgerald, 39 Wash.App. 652, 694 P.2d 1117 (1985). We believe that statements made to a psychiatrist or psychologist can be made for the purpose of medical treatment or diagnosis, albeit for a psychological problem, and these statements may be sufficiently reliable to be included within the ambit of NRS 51.115. We do not feel that the exception should ordinarily be extended to statements made to therapists or family counselors who are not licensed psychologists or psychiatrists. In proffering statements made to psychiatrists or psychologists for the purpose of medical treatment or diagnosis, the proponent of the evidence must show, directly or indirectly, and the trial court must satisfy itself, that the patient understood the need to speak truthfully and that the statements were reasonably necessary for the treatment or diagnosis of the patient. Further, we restate the admonition of the Utah Supreme Court that the exception permitting psychologists or psychiatrists to testify to hearsay statements made by patients for medical treatment should not be an open-ended invitation to admit all evidence of any statements made to these health care providers. A psychiatrist or a psychologist of course cannot be made a conduit for testifying in court as to any and all out-of-court statements made. As with admission of evidence of any kind, great discretion is accorded the trial judge in the determination of admissibility. The trial court must, as with any evidence, assess the inherent reliability of the testimony, the relevance of the testimony, and undertake a balancing test, particularly of prejudice versus probativeness.... State v. Schreuder, 726 P.2d 1215, 1225 (Utah 1986). With this in mind, we review the hearsay statements made by Susan and testified to by Dr. Scully and psychologists Payne and Fisher. Dr. Scully is a pediatrician and examined Susan at the request of her parents and law enforcement officers to confirm that she had been the victim of CSA. There is ample evidence to sustain the district court's determination that Dr. Scully did not examine Susan for treatment or diagnosis, but rather conducted an examination in the nature of an investigative consultation. Although inquiry into the identity of the perpetrator of CSA may be necessary for treatment or diagnosis by a psychologist or psychiatrist, it is usually not necessary information for a pediatrician; and, we do not believe the reference to statements concerning the general character of the cause or external source thereof, as used in NRS 51.115, was meant to include the specific identity of the perpetrator of a criminal act. We conclude that the district court did not err in determining that Dr. Scully's statements were not admissible pursuant to NRS 51.115 because his examination was investigatory and the information he solicited from Susan was not shown to be necessary for treatment or diagnosis. Susan met with psychologist Payne at the instigation of law enforcement personnel. The sheriff's office wanted a better credentialed expert and one who might be able to secure better responses from the children. Payne assumed that Susan had experienced CSA and questioned her extensively about what happened and the identity of the perpetrators. We do not doubt that Payne provided therapy and treatment to Susan in the twenty-nine sessions she conducted, but there is sufficient evidence to conclude that in the early sessions, when Susan made most of her accusatory statements, Payne was acting more as an investigator and less as a treating psychologist. In the early stages of her consultation with Susan, Payne worked closely with Detective Coffey, providing her information concerning Payne's sessions with Susan. The sheriff's office paid for Susan's first three visits with Payne, and the Nevada Victims of Crime Fund paid for most of the other treatments. Again, no payment was made by the fund without a finding that Susan had been abused. Sufficient evidence supports the district court's conclusion that the statements made by Susan to Payne were not for medical treatment and diagnosis. Joanne Fisher was a private psychologist practicing with a group of psychologists in Carson City, Nevada. Susan was taken by her mother to Fisher for consultation. It cannot be denied that Susan's consultation was for treatment or diagnosis of the problems Susan was then experiencing. Neither Susan's nor Fisher's testimony focused on whether Susan understood the importance of telling the truth to Fisher, a health care professional, and Fisher was not asked at trial to explain her need for the information she elicited from Susan about the assaults and molestations Susan had allegedly suffered and about the perpetrator's identity. However, all of these facts can be inferred from the record, except for the need to know the identity of the perpetrator. Therefore, most of the accusatory statements made by Susan to Fisher should have been received into evidence pursuant to NRS 51.115 because they were statements made to a psychologist for the purpose of medical treatment or diagnosis. However, none of Susan's accusatory hearsay statements testified to by Susan's mother, Detective Coffey, psychologist Payne, or Dr. Scully fell within a firmly rooted exception to the hearsay rule. Therefore, the reliability of these hearsay statements must be examined. The district court found that Susan's hearsay statements were admissible because the defense had not clearly established that the interviewers' questioning techniques were so suggestive and improper as to render Susan's answers unreliable. Again, this was a blanket ruling on all of Susan's hearsay statements. The court started from the premise that Susan's statements were reliable and required the defense to show them to be otherwise before they would be excluded at trial. Hearsay is presumed to be unreliable and not admissible at trial. See Idaho v. Wright, 497 U.S. 805, 818, 110 S.Ct. 3139, 111 L.Ed.2d 638 (1990). To show that hearsay is trustworthy under NRS 51.385, the prosecution has the burden of affirmatively establishing that the hearsay statement is trustworthy and bears particularized indicia of reliability. With the evidence in this case so conflicting, and because substantial questions were raised about the reliability of Susan's testimony, it was critically important for the district court to start with the proper premise, and only then to make specific findings in support of its legal conclusions as to reliability. Notwithstanding the significant shortcomings in the district court's reliability finding pursuant to NRS 51.385, our analysis of the evidence to determine whether the hearsay statements were reliable leads us to the conclusion that the reliability determination of Susan's hearsay statements was a reasonably close one. As we have previously indicated, we will decline to make that determination on appeal unless the factual determination is obvious, one way or the other. In reviewing Susan's testimony, the determination of the reliability of her hearsay statements is not obvious. Susan was three years and five months old when she left the day care center. Dr. Coleman indicated that children's memories at this age consist of little more than photographic images. Susan's revelations of alleged abuse came several years after the alleged incidents and were developed only after substantial suggestive and leading questioning. However, the interviewing techniques used with Susan were not as flawed as those to which the L. children were subjected. Susan's initial denial of CSA came in response to a leading question similar to a question discussed in Idaho v. Wright, 497 U.S. 805, 110 S.Ct. 3139, 111 L.Ed.2d 638 (1990). Even though Susan later made additional spontaneous statements, those statements probably do not meet the Wright standard for reliability, given the antecedent leading questions, the length of time between the alleged events and disclosure, and the manipulative interviewing techniques that could have caused Susan to confuse truth and falsity. An example of the coercive technique that a psychologist used with Susan is as follows: Q: Let's remember when we were talking about how they put their mouth on you and they kissed you. . . . What term do you want to use for that? Do you want to say sex? Do you want to say they had sex? A: Yeah. . . . Q: Did Martha and Paco have sex with your little brother? A: Yes. Yet, in another interview four days later, the psychologist asked Susan if she knew what sex was, and she said, Not really. Susan's accusations of CSA are very general and were often inconsistent. She testified that Ontiveros stuck his penis, a knife, a knitting needle, and his finger up her vagina, and that Felix stuck her finger in her crotch. As to the frequency, she stated it happened all the time or a lot of times. Susan gave no indication when it happened during her one year attendance at the day care center. While we have granted reasonable latitude to children when describing sexual assault, we do require that some reliable indicia be shown as to the facts of the crimes and their frequency. As this court recently observed in LaPierre v. State, 108 Nev. 528, 836 P.2d 56 (1992): We have repeatedly held that the testimony of a sexual assault victim alone is sufficient to uphold a conviction. However, the victim must testify with some particularity regarding the incident in order to uphold the charge. . . . We do not require that the victim specify exact numbers of incidents, but there must be some reliable indicia that the number of acts charged actually occurred. Id. at 531, 836 P.2d at 58 (citations omitted). We are not called upon to determine whether Susan's testimony is sufficiently particularized to support the convictions, but the lack of specificity certainly does reflect on the reliability of her accusatory statements. Although we are analyzing the reliability requirements set forth in NRS 51.385 and are not compelled to follow the federal format established in Idaho v. Wright, 497 U.S. 805, 110 S.Ct. 3139, 111 L.Ed.2d 638 (1990), and White v. Illinois, ___ U.S. ___, 112 S.Ct. 736, 116 L.Ed.2d 848 (1992), because Susan testified at trial and was subject to cross-examination, we have generally adhered to their analyses. However, unlike the majority in Wright, we do believe that corroborating evidence is an important consideration in determining the reliability of an out-of-court statement, and it should not be excluded in making a reliability determination that does not involve federal Confrontation Clause considerations. See Wright, 497 U.S. at 827-34, 110 S.Ct. at 3153-57 (Kennedy, J., dissenting); People v. Meeboer, 439 Mich. 310, 484 N.W.2d 621, 627 (1992). Therefore, while we will generally follow the format set forth in the Wright case when determining the reliability of an out-of-court statement pursuant to NRS 51.385, we will look outside the statement itself and to corroborating evidence in making that assessment when federal Confrontation Clause considerations are not implicated. According to all of the physicians who testified, Susan's accusations that a knife, knitting needle, and long fingernail were inserted in her crotch and that she was subjected to full penile penetration were wholly inconsistent with the physical evidence of her body, and each physician felt these events could not have occurred. Susan's accusations were also intertwined with unbelievable tales of additional events that happened to her and of the killing of animals and humans at the day care center. Excavation of Felix's backyard and of a hillside grave outside of town identified by Susan failed to corroborate her testimony. In fact, excluding the CSA accusations, all of Susan's testimony of the events at Felix's day care center was incredible. We do recognize that Susan appears to be a bright child who has a good memory about other events and who can describe the layout of Felix's house. However, courts have found a child's testimony unreliable when the child's accusatory statements are coupled with additional fantastic observations. See State v. Lenaburg, 781 P.2d 432 (Utah 1989) (child's videotaped accusations of sexual assault were held unreliable when coupled with fantastic observations and assertions that assailant had a gun and wore a mask when adult witnesses testified otherwise). We cannot see how the evidence can be viewed in any other light than that a close reliability determination is presented, perhaps leaning more toward unreliability than trustworthiness. This being the case, we decline to make the evidentiary determination that Susan's statements were affirmatively reliable.
We have previously concluded that the right of confrontation does not preclude the admission of hearsay statements made by a CSA victim pursuant to NRS 51.385 if the child testifies and is subject to full and effective cross-examination. However, our inquiry does not end there. The admission of hearsay accusations pursuant to NRS 51.385 requires additional consideration of how such hearsay testimony interfaces with our rules generally prohibiting the admission of prior consistent statements, prohibiting the admission of cumulative evidence, prohibiting one witness from vouching for the testimony of another witness, and permitting the district judge to exercise discretion in ruling evidence inadmissible when its probative value is outweighed by its potentially prejudicial effect. We have long held that prior consistent statements are not admissible unless the credibility of the victim-declarant has been brought into question. Daly v. State, 99 Nev. 564, 568-69, 665 P.2d 798, 802 (1983). And, even when the credibility of the victim is challenged, there is a limit to the prior consistent statements that should be received. The rationale behind this rule is that it would be unfair to permit a victim to tell his or her version of an incident numerous times through the testimony of different witnesses because such testimony would be tantamount to allowing these other witnesses to vouch for the veracity of the victim. Also, prior consistent statement testimony is almost always cumulative and serves no purpose other than to repeat what the victim has or will testify to at trial. See 4 John H. Wigmore, Evidence in Trials at Common Law § 1124 (Chadbourn rev. 1972). NRS 51.385, on the other hand, runs counter to the rule because it permits the introduction of prior consistent statements of CSA accusations, whether the declarant-victim testifies or not. NRS 51.385 was enacted to ensure that a CSA victim's accusations are fully and accurately recounted, and we wholeheartedly endorse that purpose. However, the unlimited admission of repetitive hearsay testimony can jeopardize the fundamental fairness of the entire trial proceeding. To harmonize NRS 51.385 and its laudable purpose with the seemingly conflicting provisions of Nevada law, the receipt of hearsay statements pursuant to this statute should not be completely open-ended. A child's hearsay accusation certainly should be admissible pursuant to NRS 51.385 if the child is unable or unavailable to testify. A parent, police officer, interviewing psychologist, or physician should be able to testify to what a child stated about sexual assault or sexual abuse if this testimony meets the requirements of NRS 51.385 and the United States Constitution. However, once the child's CSA accusations have been fairly presented by one or more witnesses as to the time, the place, and the incident and any challenges to the victim's credibility are fairly met, additional hearsay allegations should be restricted. This limitation is reasonable because: (1) the additional recounting of the alleged crime is usually a prior consistent statement that becomes unnecessary once the victim's allegations have been fully asserted; (2) such testimony is cumulative and usually amounts to the witness vouching for the victim's testimony; and (3) the continued repetition of CSA accusations would usually render such testimony more prejudicial than probative. When a CSA victim testifies, the State should be able to elicit additional testimony recounting the child-victim's hearsay accusations of CSA if the child has not fully and accurately described the crime and its surrounding facts and circumstances. There are numerous instances in which a child witness cannot remember the specifics of an incident, such as when an assault took place or the sequence of events, but may have clearly recited them at a prior time. This hearsay should be admissible if it meets the requirements of NRS 51.385. However, once sufficient testimony is received to fully assert the child's allegations, additional hearsay testimony should be judiciously limited for the reasons previously stated. Other courts have been concerned with the impact that repetition of CSA hearsay allegations may have on the fundamental fairness of a trial. In Traver v. State, 568 N.E.2d 1009 (Ind.1991), the court reviewed a defendant's convictions for sexually assaulting two children. The evidence against the accused consisted of a videotaped interview with each child and hearsay statements made by the children and recounted by social workers, teachers, physicians, and foster parents. The court first held that the videotapes should not have been received into evidence because a sufficient foundation for reception under Indiana law had not been laid. The court then considered the admission of the adult testimony as to the children's hearsay statements and reached the following conclusion: The sum of the adults' hearsay testimony and A.G.'s videotaped Patterson statement was much greater than the child's live in-court testimony. The hearsay statements were not merely cumulative, because there is a substantial likelihood that the repetition of the hearsay through adult testimony unfairly and prejudicially created the impression that the adult witnesses were vouching for the credibility of the child. The evidence against Traver was a product of the accusations made by A.G. We must conclude that the admission of hearsay repeating those accusations was prejudicial error. Id. at 1013-14. Similarly, in State v. Thompson, 167 Ariz. 230, 235, 805 P.2d 1051, 1056 (1990), on reh'g, 169 Ariz. 471, 820 P.2d 335 (1991), in which an eleven-year-old CSA victim testified in court, the court held that it was reversible error to admit into evidence the cumulative and repetitive hearsay testimony of a school health aide and a friend of the victim. The court determined that it would not disturb the trial court's determination that the child's hearsay statements were reliable and therefore admissible under the residual hearsay exception. However, the court went on to observe that the trial court had not considered whether this cumulative evidence was more prejudicial than probative. The court determined that the cumulative evidence was prejudicial, and it reversed the conviction and remanded the case for a new trial. Under such circumstances, the continued repetition of the child's statements through the videotape and the testimony of Melanie and Freeman was highly prejudicial. Id. 805 P.2d at 1056. The case at bar is a good example of how the repetition of multiple hearsay statements may unfairly magnify the testimony of a victim and call into question the fundamental fairness of the trial. Susan testified to the allegations of CSA and to a variety of unusual and incredible events. Cross-examination seemed very effective in casting doubt on her testimony. But first, Susan's mother, then psychologist Fisher, subsequently repeated Susan's accusatory hearsay statements. Susan's preliminary hearing testimony was then played and the jury heard some of Susan's accusations a third time. Psychologist Payne then testified and also recounted Susan's hearsay allegations of CSA. She was followed by Dr. Scully and Detective Coffey who repeated some of the hearsay allegations made by Susan. Thus, Susan's accusations were recounted a total of six times by other witnesses and by the videotape showing of her preliminary hearing testimony. Fisher, Payne, Susan's mother, Dr. Scully, and Coffey were all cross-examined by defense counsel, but this cross-examination was limited by the fact that these individuals were not percipient witnesses to the alleged abuse. The defense was wholly unable to cross-examine these witnesses concerning what was taking place at the time the alleged CSA occurred, the sequence of events, and the declarant's ability to have observed that which she reported. Furthermore, adults repeating a child's CSA accusation usually have better verbal communication skills than the child and can often state the allegations in more persuasive terms. What can result is an adult witness who is able to testify more convincingly about the CSA than the child who experienced it, but with the defense less able to conduct an effective cross-examination. The repetition of multiple child hearsay accusations through several adult witnesses presents the very real possibility of placing the person accused of CSA at an unfair disadvantage. Although some may opine that this is what such an offender deserves, we must remember that a trial is a procedure to determine whether the accused is the offender and not simply a process to confirm allegations made by the State. No person, neither the alleged victim nor the accused, should be placed at a substantial disadvantage in a criminal trial by the rules of procedure and evidence. We believe that the appellants were disadvantaged in this case by the unbridled introduction into evidence of repetitive hearsay allegations made by Susan when much of this evidence was merely cumulative and unnecessary.
Over defense objections, psychologist Joanne Fisher was permitted to testify as to Susan's veracity. Specifically, Fisher stated that she is a forthright-type person. This statement by a health care professional is direct testimony on the credibility of the child-victim. We have previously held that such opinions are inadmissible. See Lickey v. State, 108 Nev. 191, 827 P.2d 824 (1992); Townsend v. State, 103 Nev. 113, 734 P.2d 705 (1987). It cannot be said that in this case such a statement was harmless. The jury decisions on the counts involving Susan hinged on whether the jury believed Susan's testimony and her numerous hearsay statements which were related by others. Statements by her psychologist that her accusations were not the product of fantasy and that she was forthright in her answers could well have substantially contributed to the result that the jury reached on these counts. The receipt of this opinion testimony as to the veracity of Susan was reversible error.