Opinion ID: 2171187
Heading Depth: 1
Heading Rank: 2

Heading: was the evidence sufficient to support serebin's conviction of twelve counts of abuse of nursing home residents?

Text: Initially, we note that Serebin was convicted of permitting the personnel at Glendale to neglect patients between about December 20, 1975, and about June 30, 1976. Serebin argued at the court of appeals level that these twelve counts of abuse cannot be sustained, because he was not the official designated administrator during part of the time in which the offenses took place. This claim is without merit. Section 940.29, Stats. 1975, provides in part, Any person in charge of or employed in any of the following institutions who abuses, neglects or ill-treats any person confined in or an inmate of any such institution or who knowingly permits another person to do so may be fined not more than $500 or imprisoned not more than one year in county jail or both: . . . (7) A nursing home as defined in s. 50.02. [3] Quite obviously, Glendale is one of the institutions embraced by the coverage of sec. 940.29. The uncontradicted testimony of several witnesses reveals that in late February or early March of 1976, Rebecca Ellenson was appointed administrator of Glendale, while the defendant took a temporary appointment as administrator of the Brown Deer Bayside Nursing Home, also owned by the owners of Glendale. However, we do not find it critical that Ellenson, and not the defendant, was the administrator for part of the time during which these offenses occurred. The statute encompasses any person in charge of or employed in a nursing home. The evidence shows that Serebin continued in a supervisory role at Glendale even after Ellenson was named administrator. For example, Darla Senn, the state nursing consultant, testified that she dealt with Serebin periodically between March and June of 1976, discussing conditions and code violations at Glendale with him. Arlene Kopshe, a state-employed social worker who supervised the placement of mentally retarded individuals in nursing homes, testified that in March of 1976, Serebin told her that he was assisting Ellenson, who was acting administrator of Glendale. Serebin also told Kopshe that he would be attending a meeting Kopshe had scheduled concerning care plans at Glendale, because he was still responsible for the nursing home. Serebin testified at trial that Kopshe was incorrect concerning his statements. Several nurses testified that Serebin was often present at Glendale between February and June of 1976. The defendant himself testified that he was at Glendale approximately three times a week while Ellenson was administrator. He had previously stated at the John Doe proceeding, when asked if he returned to Glendale every day, I don't know whether I returned every single day, but I checked in usually by telephone and asked if there was any help that they needed, and on occasion went down there in the evening to, you know, to assist in whatever I could. He also stated that he assisted Ellenson in whatever way he could. Ellenson and a nursing director testified that Glendale's weekly department-head meetings were not held unless the defendant was able to attend. As we noted above, the function of the jury is in weighing the credibilty of the witnesses. Fells v. State, 65 Wis. 2d 525, 529, 223 N.W.2d 507 (1974). In this case, the jury was justified in concluding that the defendant retained his supervisory capacity at Glendale even when he was not designated as the official administrator. Therefore, the first element of sec. 940.29, Stats., that the defendant was in charge of or employed in Glendale, has been satisfied. The jury was instructed that the state must prove beyond a reasonable doubt that the defendant knowingly permitted the personnel to abuse, neglect, or ill-treat the residents at Glendale. See, Wis. J ICriminal 1270 (1974). The state has argued that Serebin, as the person in charge of Glendale, followed directions from the owners of the nursing home concerning the available budget and made decisions to cut the staff, as well as the food given to the residents. The state maintains that as a result of Serebin's decisions, the patients could not be and were not cared for adequately, nor given sufficient food, which resulted in bedsores, or decubitus ulcers, and weight loss. Serebin was made aware of these problems by the staff, yet permitted this neglect to continue by enforcing the staffing and feeding policies he had adopted. Therefore, the state asserts that the evidence is sufficient to find the defendant guilty of abuse of inmates. Initially, we note that the state must prove that the victims were inmates at the Glendale Convalescent Center. Serebin has not challenged this evidence. We next note that a number of patients with whose neglect Serebin was charged suffered from bedsores. The state introduced testimony from experts on nursing practices and education, including one expert who specialized in skin care and another who specialized in gerontological nursing, who testified that the major cause of bedsores is pressure which results if there are not enough welltrained staff available to turn patients. In other words, bedridden patients or those confined to wheelchairs should not remain in the same position for more than two hours. The experts testified that factors which contribute to this major factor include general malnutrition, especially protein deficiencies, and the patient's own incontinence, which may result in soiled, macerated skin and causes erosion of the skin and lesion formation. One of the state's experts testified that in cases of patient incontinence, prompt cleansing of the skin is required in order to prevent bedsores. That same expert also stated that a nutritious, high-protein diet is helpful in the prevention of bedsores as well. The basic thrust of all three experts' testimony was that the prevention of bedsores is possible with sufficient nursing care and that the prevention of such sores is the responsibility of the nurse because of the frequency of the nurse's contact with the patients. The record also indicates that nurses from Glendale testified that they agreed with the expert's testimony concerning the prevention of bedsores. Two nurses from Glendale testified that it was standard nursing practice to reposition bedridden residents every two hours. Therefore, we believe that the jury could have reasonably concluded that the Glendale staff knew of the proper treatment to be utilized in order to prevent bedsores. There is evidence in the record that prior to the staff reduction in December of 1975, the director of nursing and several other members of the nursing staff informed Serebin that, .... if we did not have adequate staff we would have less time to walk our patients, we would not be able to feed them promptly, we would not be able to toilet them promptly. More patients would have to remain in bed and we would have less time to do adequate perineal care [care of the genital area] and consequently our patients would be subjected to the possibility of getting a more skin breakdowns [sic], more contractures, and when skin breakdown and bacteria gets into you, you have bed sores or decubiti. The record is also replete with testimony concerning what occurred following this staff reduction. Several nurses testified that the residents could no longer be repositioned every two hours and that the staff had to determine who would suffer the least by being left in bed instead of being taken out of bed to sit or walk. Both of these conditions were contrary to the practices required by the Wisconsin Administrative Code. [4] Often the heavy residents were left in bed all day, since it required more than one staff member to assist those residents, and the testimony indicates that the staff members simply were not available. There is also testimony that incontinent patients were not promptly cleansed. Added to this, nurses testified that following the staff cuts, the staff was not available to feed patients who required feeding before their food became cold. Nor could they observe patients who were able to feed themselves closely enough to be sure that those residents ate adequately. The record also indicates that at the time of the staff reduction, food portions were reduced. The procedure for serving meals was changed as well. Prior to December of 1975, the food was sent to the various units on large hot food carts, with trays filled with large quantities of various items which the staff served onto the patients' trays. Thus, the staff could determine the size of the portions being served to the individual patients, and the food remained warm in the food carts. After the staff reduction, the food was sent up on individual trays to be distributed to a designated patient, and the food carts were no longer available. Thus, the staff had no control over the size of the servings being given to the residents, and the food often became cold before the patients could be fed. As we noted above, the portions also became smaller. The record indicates that the staff complained of this to Serebin, who told them to order supplemental feedings or get a doctor's order for supplemental feedings. However, two nurses testified that when aides were sent down to the kitchen for supplemental feedings, they often returned and said that none were available. Staff members also testified that they told Serebin that there was not enough food on the trays and that the patients were losing weight. To corroborate these complaints, they showed him a list of patients who had lost a substantial amount of weight. Once again, Serebin told the nurses to call the patient's doctor and get an order for supplemental feedings. One nurse testified that employees used their own money to buy snacks from the vending machines to supplement the residents' diets or brought snacks from home. Another testified that prior to December of 1975, kitchenettes on the units contained snack food for the residents on regular diets, which disappeared following the staff and food reductions. After that time, only patients with a doctor's order for snacks got them. The nurse stated, All that was there was what the Dietary Department would bring to the floor at about 7:00 o'clock at night. Those were labeled for certain people. They had to have a doctor's order that said they could have an h.s. snack, h.s. meaning bedtime or before bedtime. So people without that order would see that given out but they couldn't have any. It was difficult. As we noted above, many staff members complained directly to Serebin concerning the insufficient portions of food and the simultaneous weight loss of the residents. In section I of this opinion, we noted that the staff also complained to Serebin concerning their inability to care for the patients because of their reduced number. Finally, we note that numerous staff members made notes on the 24-hour reports, which Serebin testified he reviewed, concerning their inability to promptly reposition and cleanse incontinent residents, and the bedsores which simultaneously appeared. When we review the evidence concerning the twelve residents whom Serebin was convicted of abusing, we note that the testimony of the nurses indicates that six were incontinent, and one suffered from multiple sclerosis and required regular cleansing. The testimony also reveals that following the December staff cuts, four of the incontinent patients who entered Glendale without bedsores developed them, while the remaining incontinent patient and the patient with multiple sclerosis, both of whom had entered with small bedsores, developed more extensive ones. [5] The record indicates that most of these patients were left in bed or in wheelchairs for long periods of time without cleansing because of the lack of personnel available to reposition them or assist them in moving about. Of the incontinent residents, one required feeding because of partial paralysis. The testimony indicates that this patient was often not fed until his food became cold and that he lost weight. Another incontinent patient lost weight, although it is not clear from the record whether or not he required assistance when eating. The testimony indicates that the remaining five residents whom Serebin was convicted of abusing suffered from weight loss between December of 1975 and June of 1976. The testimony also reveals that some of these residents complained of being hungry during this period. The testimony concerning the weight loss consisted in some cases of the actual loss of pounds; the other testimony was in the form of the change in physical appearance of the residents. This included the nurses' observations of clothing becoming too loose, sunken cheeks, etc. Wisconsin Jury InstructionCriminal 1270 defines abuse, neglect, or ill treatment as follows: The phrase `abuse, neglect, or ill-treat' includes any act or failure to act which causes suffering, misery or physical harm to a person confined. (Footnote omitted.) [6] Utilizing this definition, we find there is substantial evidence in the record by which the jury could have found Serebin guilty of permitting the abuse or neglect of these twelve residents. Viewing the evidence most favorably to the state and the convictions, the record contains an overabundance of testimony from the staff concerning bedsores, which clearly may be characterized as an act of physical harm; and weight loss, which may be deemed suffering. The record also contains testimony from which the jury could have inferred that these conditions resulted from Serebin's decision to reduce the number of staff per unit and shift, yet to continue admissions of new residents. The testimony of the staff reveals that they knew of the proper care required by residents, such as repositioning and cleansing, but that the reduced number of staff members made performance of these tasks virtually impossible. The testimony also reveals that the food portions were reduced, and residents subsequently lost weight. Numerous witnesses testified that the defendant was informed of these conditions, yet took no measures to correct them. The jury obviously considered the credibility of the witnesses, studied the evidence presented, and found Serebin guilty. We do not find that the evidence was so lacking in probative value that no jury could have found guilt beyond a reasonable doubt. State v. Alles, 106 Wis. 2d at 381-82. Accordingly, we reverse the court of appeals on this conviction. We note that the court of appeals reversed this conviction because it observed that none of the experts had examined any of the twelve residents with bedsores or weight loss, nor had any expert given an opinion on a specific cause for a specific resident's weight loss or bedsores, nor had any expert given an opinion as to whether these conditions were due to Serebin's neglect. State v. Serebin, 114 Wis. 2d at 319. The court of appeals compared this case to a medical malpractice case and concluded that the state's use of experts ultimately allowed the jury to rely on its own common knowledge in order to draw a reasonable inference from circumstantial evidence, similar to the application of res ipsa loquitur. Id. at 319, citing Kelly v. Hartford Casualty Insurance Co., 86 Wis. 2d at 134-35. We disagree with the court of appeals' analysis. Concerning expert testimony, this court has stated the following: Expert testimony should be adduced concerning those matters involving special knowledge or skill or experience on subjects which are not within the realm of the ordinary experience of mankind, and which require special learning, study or experience. Payne v. Milwaukee Sanitarium Foundation, Inc., 81 Wis. 2d 264, 276, 260 N.W.2d 386 (1977) (footnote omitted). See also, Froh v. Milwaukee Medical Clinic, S.C., 85 Wis. 2d 308, 318, 270 N.W.2d 83 (Ct. App. 1978). Obviously, the jury did not require expert testimony concerning the causal connection between the weight loss and the reduction of food portions and number of staff available to assist the residents in eating. Utilizing common knowledge, a reasonable juror is able to infer that weight loss, especially when accompanied by complaints of hunger, is due to insufficient food intake. Therefore, the jury was entitled to reasonably conclude that Serebin's reduction of the residents' diets and his cut in the number of staff available to feed the residents caused the weight loss. Concerning the causal connection between the reduction of the staff and the residents' bedsores, we find that the experts' testimony addressing the need to reposition patients every two hours was most likely outside the jurors' common knowledge. Section 907.02, Stats., provides, Testimony by experts. If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise. Although a reasonable juror might realize that prolonged periods of remaining in one position may cause pressure which results in bedsores, most jurors would not know the exact time period within which a person could remain in one position without suffering such effects. Therefore, the experts' testimony concerning the need for repositioning every two hours, or the potential risk of bedsores without such repositioning, was sufficient without the need of an examination of the individual resident, or an ultimate opinion as to whether the bedsores were caused by Serebin's staff reduction. The jury could reasonably infer that the lack of staff available to reposition the residents caused the bedsores. Although an opinion or inference on an ultimate issue is admissible under sec. 907.04, Stats., this is not a case where the inference of causation between the staff cut and bedsores is `so distinctively related to some science, profession, business or occupation as to be beyond the ken of the average layman ... that [the expert's] opinion or inference will probably aid the trier in his search for truth.' Cramer v. Theda Clark Memorial Hospital, 45 Wis. 2d 147, 150-51, 172 N.W.2d 427 (1969), citing McCormick, Evidence, sec. 13 at 28-29 (1954). Consequently, we hold the evidence sufficient to sustain these convictions and reverse the court of appeals. In addition to the above two issues, the defendant raised ten other issues at the court of appeals. Because of its disposition of the case on the sufficiency of the evidence, these other issues were not considered by the court of appeals. Therefore, it is appropriate to remand this case to the court of appeals for consideration of the unresolved issues as they relate to the misdemeanor conviction. State v. Marshall, 113 Wis. 2d 643, 656, 335 N.W.2d 612 (1983); State v. Derenne, 102 Wis. 2d 38, 48, 306 N.W.2d 12 (1981); and State v. Bettinger, 100 Wis. 2d 691, 699a-699b, 303 N.W.2d 585 (1981). By the Court. The decision of the court of appeals is affirmed in part and reversed in part, and the cause is remanded to the court of appeals for further proceedings consistent with this opinion. SHIRLEY S. ABRAHAMSON, J. (concurring). I join the court's opinion. I write separately, as I have previously, to comment on a recurring problem in appellate practice, namely, how appellate counsel and this court should handle issues presented to the court of appeals but not decided by that court. See State v. Lossman, 118 Wis. 2d 526, 547, 348 N.W.2d 159 (1984), and cases cited therein. In this case, the court does not address issues left unresolved by the court of appeals. It remands the issues to the court of appeals. See pp. 862, 863. In some cases in the past, we have decided the unresolved issues. In other cases in the past, we have remanded the unresolved issues to the court of appeals. See State v. Lossman, supra . Ordinarily the court of appeals decides these issues on the briefs previously submitted to that court and available to this court. We have not explained why we take one approach or the other. Counsel are unable to predict whether this court will decide the undecided issues or remand them to the court of appeals. Counsel therefore are uncertain whether to raise and brief again these unresolved issues in this court. If the issues have been briefed either in this court or the court of appeals and counsel are willing to rely on the briefs, I would prefer, in the interest of judicial economy, speedy resolution of appeals, reduced costs to the litigants, and finality of decisions, that this court decided the unresolved issues. I write, as I did in State v. Lossman, supra , to call counsels' attention to take care in their petitions for review and in their briefs and oral arguments in this court to consider which court should decide the unresolved issues. STEINMETZ, J. (Dissenting in part; concurring in part.) I agree with the majority in reversing the court of appeals as to the convictions for abuse of inmates of an institution, party to a crime and holding the evidence sufficient to sustain them. However, I dissent from the majority in affirming the court of appeals which reversed the conviction of the defendant for homicide by reckless conduct arising from a resident's death while the defendant acted as administrator of the Glendale Convalescent Center. As to that conviction, the majority finds the evidence insufficient in demonstrating that the defendant's actions were a substantial factor in causing Bruno Dreyer's death. The majority cites the standard of review to be applied in considering the conviction as stated in State v. Alles, 106 Wis. 2d 368, 376-77, 316 N.W.2d 378 (1982), as follows: `the jury verdict will be overturned only if, viewing the evidence most favorably to the state and the conviction, it is inherently or patently incredible, or so lacking in probative value that no jury could have found guilt beyond a reasonable doubt.' However, after stating the standard for reviewing the verdict, the majority never applies it to the facts which it reviews and on which the jury based its conclusion. Even though it is not stated, the majority must have considered Bruno Dreyer's walking out of the building to his death as an intervening fact which relieved the defendant of any cause he had in the death. Based on this record, I disagree with the majority's analysis. Section 940.06(2), Stats. (1975), states: Reckless conduct consists of an act which creates a situation of unreasonable risk and high probability of death or great bodily harm to another and which demonstrates a conscious disregard for the safety of another and willingness to take known chances of perpetrating an injury.... That was what the defendant did in placing budget considerations over the safety and protection of the residents. After being warned by his staff of the needs for more personnel for the number of residents, he not only refused to add employees but continued to accept additional residents which increased the hazard. The majority concedes: Serebin's main concern was operating within the budget. (P. 844.) That means that his secondary concern was for the residents and when having been warned of potential consequences by his staff and by the state, he continued to place budget considerations over the welfare of the residents and that was the reckless conduct which caused the inability of the limited staff to properly supervise the residents in order to guard against what in fact occurred. The evidence the jury considered in arriving at the conviction and which the majority must have found led to an inherently or potentially incredible verdict was: (1) A health facility surveyor for the state found staffing deficiencies at Glendale of such character as to jeopardize the health, safety, and welfare of the patients and she ordered Glendale to correct these deficiencies. That finding and order were issued a year before Mr. Dreyer's death. (2) Twelve staff nurses testified that after the previous warning from the state, the defendant reduced, not increased, the nursing staff further even though they specifically told him these reductions would make it impossible to supervise and care for patients, especially those who had a tendency to wander around and try to leave the building. (P. 845.) (3) One nurse testified she resigned from Glendale twice in 1975 and 1976 because of insufficient staffing and she spoke with the defendant weekly about the inadequate care and supervision the residents were receiving due to the insufficient staffing. (4) Two nurses testified they asked defendant to employ more staff or stop admitting patients. He told one of them he had to keep admitting residents and that hiring more staff would exceed his budget. (5) Approximately one week before Mr. Dreyer's death, a nursing consultant for the state submitted a correction order to the defendant characterizing the understaffing as an occurrence which endangered the patients' health, welfare and safety. The majority concedes the evidence from which the jury could have concluded the defendant's actions evinced reckless conduct is overwhelming. Although Serebin denied his participation in staffing decisions at trial, the testimony of other witnesses from which the jury could have concluded that Serebin's actions evinced reckless conduct is overwhelming. The above evidence indicates that Serebin was repeatedly warned by his own staff and state officials that the insufficient staffing created a situation in which patients did not receive adequate care and supervision and especially that wandering residents could not be adequately watched. From this, a reasonable jury could have inferred that Serebin's actions regarding staff cuts and continued admissions created a high probability of death or great bodily harm. For example, if residents left the building and were exposed to the elements during harsh weather, or became ill or injured and required prompt medical attention, the lack of staff could aggravate those conditions, resulting in death or great bodily harm. It is common knowledge that elderly patients require close supervision and care because of the physical and mental conditions which often accompany the aging process. The evidence indicates that Serebin knowingly allowed the probability of such dangers to exist, from which the jury could infer a conscious disregard for the residents entrusted to his care and a willingness to take known chances of risks. The jury, therefore, could have concluded that in acting as he did, Serebin should have realized that he created a situation of unreasonable risk to the residents at Glendale. See, Hart v. State, 75 Wis. 2d 371, 397, 249 N.W.2d 810 (1977). (Pages 845-846.) The majority finds, however, that his reckless conduct was not shown to be a substantial factor in producing Mr. Dreyer's death. A licensed practical nurse and two aides were assigned to Mr. Dreyer's ward, 1 North, but the aides were not assigned to that ward for the whole night. The same nurse was in charge of other units as well. In the three units for which the nurse was responsible there were 200 residents. Before the budget cuts three aides, not two, worked on 1 North and the nurse on the night shift was only responsible then for 1 North and one other unit, not two. The doors leading from 1 North to the outside could not be kept locked because it was an emergency exit. There was an alarm installed on one door to alert the staff that it was opened. However, the sliding glass doors through which Dreyer apparently left had no such alarm. (P. 847.) In other words, for the sake of a budget saving by not placing an alarm on the sliding doors or one attendant to watch the hall while the other went into residents' rooms, Mr. Dreyer wandered out of the building without notice and froze to death. The jury must have believed that there was a cause and effect between the defendant's conduct and Mr. Dreyer's wandering out of the building and freezing to death. I agree. I do not find that causal connection to be inherently or patently incredible or lacking in probative value as the majority must find. Wisconsin Jury InstructionCriminal 1160, dealing with homicide by reckless conduct which was given to this jury and quoted with approval by the majority, states in relevant portions to the issue of cause the following: That is to say, that it was a factor actually operating and which had substantial effect in producing the death as a natural result. (P. 849.) The defendant's budget constraints and failure to hire necessary staff to care for and to supervise the residents, including Mr. Dreyer, was a factor actually operating and which had substantial effect in producing the death [of Mr. Dreyer] as a natural result. On page 851 of the majority opinion, the majority uses conjecture to state that even if an aide monitored the hall while the others checked in the rooms, Mr. Dreyer still might have frozen. The reality is that there was no aide to watch the halls and there was no alarm on the sliding doors. We do not know what the population of residents was before the budget cuts so it is not relevant to know whether aides monitored the halls then. We do know, however, that the defendant continued to cut the staff and to increase the number of residents. To me, that is cause and effect, especially since as an administrator he had been told by his chief nurse that if you do not have enough registered nurses and licensed practical nurses you do not have the supervision of the patients to see that their care is done and to supervise your wanderers. ... [ who ] have a tendency to try to get out of the building. (Emphasis added.) The defendant had been warned by state supervisors of care facilities, by his own staff nurses and by Glendale employees of the consequences of inadequate staff and of increasing the number of residents. He had been warned that his supervision was so inadequate as to be reckless and a result of that recklessness would be wanderers leaving the building. That is what occurred. Justice Abrahamson in a concurring opinion decries the fact that his court is not consistent as to whether we will decide the undecided issues or remand them to the court of appeals. She states that therefore counsel are uncertain whether to raise and brief these unresolved issues in this court. This decision must be made by this court on a case-by-case basis and no general rule can be established. We are well aware that the court of appeals is inundated with appeals and that if appropriate, we will decide all issues bringing finality to the case. However, we are mindful that decisions of the Supreme Court are published and have a precedential status and, therefore, we have an obligation not to fill the law books with matters that are not truly of precedential value. The court of appeals in deciding issues before it may or may not publish a decision and unless published, the decision has no precedential value. In the present case the state petitioned this court for review and stated the two issues as being: (1) Was the evidence sufficient to support Serebin's conviction of homicide by reckless conduct arising from the death of a resident of a nursing home which Serebin administered? (2) Was the evidence sufficient to support Serebin's conviction of twelve counts of abuse of residents of institutions? This court has decided both of those issues. In addition, the defendant in opposition to the petition for review stated another issue which had several sub-challenges. That issue was: Were the constitutional rights of the defendant flagrantly violated during the prosecution? The sub-challenges under that issue were: (1) The number of charges brought against the defendant, 58 misdemeanor violations and one felony, was oppressive and unnecessarily excessive. (2) The defendant was not allowed to present any evidence at the April 14-15, 1980, hearing in support of his motion concerning selective discriminatory enforcement. (3) The nursing home records which were introduced against the defendant were seized without a warrant and the defendant's motion to suppress was denied. (4) The defendant's motion to change venue was summarily denied. (5) The trial court refused to grant the defendant's motion to waive a jury trial. (6) Although the voir dire examination was not reported, the prosecution used it as a vehicle to appeal to the passions of the jurors and to infect them with erroneous and inadequate legal standards. (7) The defendant's attempt to introduce polygraph testimony to support his defense that he had no knowledge of neglect of patients or that Mr. Dreyer was unattended on the night he eloped was barred by the court. (8) The prosecution introduced testimony which brought collateral issues before the jury (including material which would incite feelings of religious and racial prejudice). (9) The defendant was not allowed to introduce black character witnesses on his behalf before a jury that was composed of many black citizens. (10) The prosecutor made remarks during opening and closing statements imploring the jury to consider those unheard voices of the aged who could not come into the courtroom and made an appeal that a conviction was expected as a community responsibility. The defendant is entitled to have all of these claims of constitutional denial resolved; however, they were not presented to this court in detailed oral argument consistent with our usual practice, since the two issues before this court were as a result of the prior determination by the court of appeals as to the sufficiency of evidence. The court of appeals in ruling on the remaining issues stated above may or may not consider them as matters deserving of publication and of precedential value in the context of the record in this case and for that reason alone, it is appropriate for these issues to be returned to that court for resolution. I would reverse the court of appeals as to both the reckless homicide and abuse of inmate's convictions and remand the cause to the court of appeals for determination of the other unresolved issues.