Opinion ID: 1788162
Heading Depth: 1
Heading Rank: 4

Heading: Medical Testing Evidence

Text: Ferrell claims that defense counsel rendered ineffective assistance by failing to seek additional expert assistance in order present medical evidence of brain damage. At trial, neuropsychologist Dr. James Upson testified that Ferrell suffers from brain damage and opined that the statutory mental mitigators of extreme mental disturbance and substantial impairment were present in Ferrell's case. Dr. Upson based his opinions on a number of psychological tests he had administered to Ferrell and on his interviews of Ferrell. Ferrell contends that trial counsel should have supported Dr. Upson's testimony with medical testing evidence. In his motion for postconviction relief, Ferrell claimed that Dr. Upson's testimony and expertise were called into question by the State's cross-examination of Dr. Upson [9] and by testimony of the medical examiner who opined that brain damage caused by long term alcohol abuse needs to be confirmed by medical testing. The motion also stated that Ferrell had been examined after conviction by neuropsychologist Dr. Henry Dee and diagnosed with brain damage that could be verified by a PET (Positron Emission Tomography) scan. Thus, Ferrell asserted, counsel rendered ineffective assistance by failing to have a PET scan, or equivalent testing, conducted in order to support Dr. Upson's finding of organic brain damage. To the extent that PET scan testing was not available at the time of Ferrell's trial, he argued that it is newly discovered evidence. Ferrell also claimed that counsel was ineffective in never asking the court to find brain damage as a mitigating circumstance. Ferrell also argued that he had the right to have a SPECT (Single Photon Emission Computed Tomography) brain scan conducted during the postconviction proceedings to show brain damage and to support his claim that counsel could have presented better demonstrative evidence of brain damage at trial. The court bifurcated the evidentiary hearing on this medical testing claim from the evidentiary hearing on Ferrell's other postconviction claims. At a status hearing in March 2001, the State argued that Ferrell had to show a particularized need for brain scans to be conducted, as required by this Court's decision in Rogers v. State, 783 So.2d 980, 999 (Fla.2001). While the trial court ruled that neuropsychiatrist Dr. Walter Afield could conduct testing of Ferrell and the State could depose Dr. Afield after the testing, the court did not order that a scan be conducted. By the next status hearing in May 2001, the parties were arguing the merits of a SPECT scan instead of a PET scan. [10] At this May hearing, the State conceded that, based on the deposition of Dr. Afield, Ferrell had mild to moderate brain damage to his frontal lobe and that a SPECT scan would show a black and white picture of the damage. However, the State still objected to the SPECT scan being conducted and argued that there was no particularized need for the scan because Dr. Afield's testing confirmed the diagnoses of frontal lobe brain damage made by Drs. Dee and Upson; the SPECT scan could not show how the physical brain damage affected Ferrell's capacity to function; and the sentencing judge had already found brain impairment as a mitigating factor. Ferrell's counsel responded that the SPECT scan was necessary to confirm the brain damage as evidence of counsel's ineffectiveness at trial. The trial court ruled that no SPECT scan would be conducted, but acknowledged that a SPECT scan would show a black and white image of current mild to moderate damage in the frontal lobe of Ferrell's brain. At the September evidentiary hearing, the trial court heard testimony from Ferrell's trial counsel Michael Irwin, diagnostic radiologist Dr. Michael Foley, neuropsychiatrist Dr. Afield, clinical neuropsychologist Dr. Dee, and neuropsychologist Dr. Upson, who also testified on Ferrell's behalf at the trial. In summary, the testimony at the evidentiary hearing indicated that PET and SPECT scans were not widely used at the time of Ferrell's trial in 1992; while a SPECT scan would confirm Ferrell's brain damage, a clinician would still have to discern his level of impairment; the experts were able to diagnose Ferrell as being intellectually impaired based on their observations, testing, and Ferrell's records without conducting a SPECT scan; the experts attributed the frontal lobe damage to Ferrell's chronic alcohol abuse; the evaluations and diagnoses of the postconviction experts were very similar to Dr. Upson's pretrial evaluation and diagnosis; Dr. Upson did not advise trial counsel to conduct a brain scan; and there was no evidence that such scans were being used in capital cases at the time of Ferrell's trial. [11] At the close of the hearing, Ferrell renewed his motion to have a SPECT scan to confirm the testimony of his experts. The court ordered Ferrell's postconviction counsel to identify cases in which a court had ordered such brain scans in 1992, the time of Ferrell's trial, but the cases cited did not support counsel's assertion. The court did not order the SPECT scan to be conducted. The court also denied postconviction relief on the claim that counsel was ineffective in this regard. Ferrell contends that the trial court erred in denying him relief and in denying his request to conduct a SPECT scan to confirm the testimony of his postconviction experts. [A] particularized showing of necessity is the polestar for whether any diagnostic test should be authorized by the trial court. Rogers v. State, 783 So.2d 980, 999 (Fla.2001) (concluding that trial court did not abuse its discretion in denying request for PET scan); see also Robinson v. State, 761 So.2d 269, 275-76 (Fla. 1999) (same as to SPECT scan). This Court established the following guidelines for evaluating a claim relating to the denial of a diagnostic test: (1) the defendant must establish a particularized need for the test, that is, that the test is necessary for experts to make a more definitive determination as to whether the defendant's brain is functioning properly and to provide their opinions about the extent of the defendant's brain damage; and (2) this Court must consider whether the defendant was prejudiced by the trial court's denial of the motion requesting a scan. See Rogers, 783 So.2d at 999. In the instant case, the record supports the trial court's conclusion that there was no particularized need for the SPECT scan. The postconviction experts independently determined that Ferrell suffered from the same injury, i.e., mild to moderate diffuse brain damage to the frontal lobe caused by chronic alcohol abuse. While the scan would have confirmed the experts' diagnoses, it was not necessary in formulating their medical opinions about his brain damage. Further, Ferrell cannot show any prejudice from the trial court's denial of the SPECT scan. His experts were still able to testify that he had mild to moderate brain damage, which was consistent with the testimony presented at trial. The scan would not have provided any additional information about Ferrell's functional impairment than that presented. Thus, the trial court did not abuse its discretion in denying this request. As to Ferrell's claim that counsel rendered ineffective assistance in not requesting a SPECT scan in 1992, we agree with the trial court that he is not entitled to relief. Under the Strickland standard, Ferrell must prove both deficient performance by counsel and prejudice from this deficiency. See Strickland v. Washington, 466 U.S. 668, 104 S.Ct. 2052, 80 L.Ed.2d 674 (1984). There was no evidence that such scans were being ordered in capital cases in Florida in 1992. Thus, counsel's failure to obtain a scan was not deficient performance. In addition there is no reasonable probability that the presentation of a scan would have resulted in a different outcome here. The jury heard Dr. Upson's testimony and was aware of Ferrell's problems. The scan results could have confirmed Dr. Upson's diagnosis of brain damage but were not necessary in forming that diagnosis. Thus, Ferrell was not prejudiced by any alleged failure of counsel in this regard. Accordingly, we affirm the trial court's denial of postconviction relief on this claim.