Court Opinion

ID: 9717866
Source: CourtListenerOpinion
Date Created: 2023-08-26 07:11:48.28654+00
Date Added: 2024-06-11T11:12:41.669389
License: Public Domain

SCOTT, Justice,
Concurring in Part and Dissenting in Part Opinion:
Although I concur with the majority on the other issues, I must respectfully dissent from the majority’s opinion that this Court’s decision in Edwards v. Commonwealth, 833 S.W.2d 842 (Ky.1992) (overruled on other grounds by B.B. v. Commonwealth, 226 S.W.3d 47 (Ky.2007)) was “based upon an ill-advised and unsound extension of a traditional exception to the hearsay rule.” Op. at 244.

I. Edwards and Renville

Edwards, id. at 844, was premised on United States v. Renville, 779 F.2d 430 (8th Cir.1985), wherein the logic of the rule as applied to young children was explained, to wit:
Statements by a child abuse victim to a physician during an examination that the abuser is a member of the victim’s immediate household are reasonably pertinent to treatment.
Statements of this kind differ from the statements of fault ... and properly excluded under our past decisions in a crucial way: they are reasonably relied on by a physician in treatment or diagnosis. First, child abuse involves more than physical injury; the physician must be attentive to treating the emotional and psychological injuries which accompany this crime. The exact nature and extent of the psychological problems which ensue from child abuse often depend on the identity of the abuser. The general rule banning statements of fault is premised on the assumption that the injury is purely somatic. This is evident from the examples put forth by the courts and commentators discussing the rule. In each example, the medical treatment contemplated was restricted to the physical injuries of the victim; there is no psychological component of treatment which could relate to the identity of the individual at fault. Furthermore, in each example the statement of fault is not relevant to prevention of recurrence of the injury. Sexual abuse of children at home presents a wholly different situation.
Second, physicians have an obligation, imposed by state law, to prevent an abused child from being returned to an environment in which he or she cannot be adequately protected from recurrent abuse. This obligation is most immediate where the abuser is a member of the victim’s household, as in the present case. Information that the abuser is a member of the household is therefore “reasonably pertinent” to a course of treatment which includes removing the child from the home.
*253Id. at 436-438 (internal citations and footnotes omitted); see also J.M.R. v. Commonwealth of Kentucky, Cabinet for Health and Family Services, 239 S.W.3d 116 (Ky.App.2007).
As our predecessor Court noted in Edwards:
In Renville, the Court made this exception to the general rule that physicians rarely have reason to rely on statements of identity because of two important aspects involved in the case: (1) the physician was not merely diagnosing and treating the child/patient for physical injuries but psychological injuries as well, and (2) the abuser was a family, household member.
The physician in that case testified that he was treating the child for her emotional and physical trauma. He also said that the identity of the abuser was extremely important to him in helping the child work through her problems. The identity was also particularly important if the abuser lived with the child, because the abuse would likely continue as long as the child remained in the household with the abuser.
833 S.W.2d at 844. And, as was noted by the Court in J.M.R.:
The therapists testified that the boys feared their stepfather would harm them in the future and that they did not want to reunify with their mother because of her inability or unwillingness to leave their stepfather. While the mother contends that these statements were inadmissible hearsay, we conclude that these statements qualified as hearsay exceptions pursuant to KRE 803(4) because the statements were made to therapists who were determining what happened to the children and what treatment they needed to receive and the statements were made for the purpose of receiving medical treatment.
239 S.W.3d at 119 -120; see also Gadd v. Commonwealth, 2005-SC-000880-MR, 2007 WL 858811 (Ky.2007). Gadd, in turn, led to an expansion in Plotnick v. Commonwealth, 2007-CA-000160-MR, 2008 WL 162881 at *3 (Ky.App.2008), wherein the Court recognized:
While not a “family member” in the traditional sense, D.R. called Plotnick “daddy,” D.R. had a half-sibling fathered by Plotnick, D.R. had resided with Plot-nick at times, and the victim’s mother had an ongoing relationship with Plot-nick from which it may be inferred that there would be ongoing contact between the victim and the alleged perpetrator. Therefore, we believe the Edwards exception applies, and that the physician’s assistant properly repeated D.R.’s identification of Plotnick as the perpetrator.
Each of these opinions are based on common ground — that it is medically relevant to the health and safety of young children that their injuries not only be recognized and treated, but also that further injury prevented — i.e., their perpetrators, if connected with the children’s home life, could be identified and reported so that the child would be made safe.
Moreover, even State v. Jones, 625 So.2d 821, 824-25 (Fla.1993), upon which the majority bases its logic, admits that “[t]he majority of state courts confronted with this issue have followed Renville and permitted medical personnel to testify regarding statements of identity made by child victims of abuse.” Id. at 824-25 (emphasis added) (citations omitted).

II. The Occurrence

The relevant events precipitating this analysis occurred on March 2, 2006, in Louisville, Kentucky, when the victims, D.J. and D.Y., were six and seven years old, respectively. That day, their mother, *254G.W., met them as they got off the school bus and was told by the bus driver that the girls had misbehaved on the trip home. She then took them home, ordering them to their room and bed as punishment for their behavior on the bus. G.W., who was seven months pregnant at the time, then went to the kitchen to fix her daughters a snack, but became ill and went to the bathroom.
During this time, Appellant entered the home and went to D.Y. and D.J.’s bedroom. D.J. testified that Appellant climbed onto the top bunk where she was lying and used belts to tie her arms and legs to the bed. He then hit her in the face and raped her. Though D.J. could not remember what he said, Appellant threatened her. In addition, Appellant raped D.Y. He told DY. that he would kill her mother and the baby her mother was carrying if she told anyone what he was doing. Appellant then climbed out the window.
While in the bathroom, G.W. heard a door close and shouted to her daughters, asking who was in the house. D.Y., the older of the two victims, then asked to come into the bathroom to wash herself. D.Y. initially refused to tell her mother why, but she was holding herself. On undressing her, G.W. noticed that D.Y.’s vagina was red, and had a strong odor. G.W. then went to her daughter’s room and noticed an odor of feces. After briefly questioning the children, G.W. realized that both her daughters had been raped. At her insistence, both girls identified Appellant as their attacker.
G.W. then looked out the window and saw Appellant leaving. She grabbed a butcher knife from the kitchen, left the apartment, and confronted Appellant. Initially, he denied the allegations, but became silent when G.W.’s mother, W.D., Appellant’s former fiancee, confronted and physically attacked him.
The police and EMS were then called to G.W.’s apartment. No injuries or blood was seen on the girls and EMS left the scene. G.W. and W.D. then took the girls to the hospital. Dr. Condra, who saw the children at the hospital, testified that D.J.’s examination showed some mild redness between the vulva and vagina, but there was no evidence of tears or bruising to the vagina. An abnormality of the hymen was also noted. Dr. Condra concluded that D.J.’s examination was consistent with her complaint of sexual assault and was consistent with some type of penetration, although he could not specify the nature of the penetration.
D.Y.’s examination showed some mild redness or inflammation at the opening of the vagina, but there were no tears or bruising. The history D.Y. gave Dr. Con-dra, along with his examination, was consistent with a sexual assault. D.Y. also had anal dilatation of about 1.5 centimeters. Such a dilatation was consistent with a penetrating trauma.
Vaginal swabs, anal swabs, and a vaginal smear of the panties did not disclose the presence of any seminal fluid or sperm cells on D.J. or D.Y. However, an unidentified 11-inch, light brown, Caucasian head hair was found in D.Y.’s anal region that did not belong to Appellant, an African-American. No semen, pubic hair or body hair was found on any of the bed clothing or the towel removed from the girl’s bedroom. Rape kits taken from the children did not contain any semen that could be examined or analyzed as Appellant had not ejaculated.

III. The Medical Testimony

A. Dr. Condra

Prior to seeing Dr. Condra at the hospital, D.J. and D.Y. were interviewed by the *255triage nurse. Dr. Condra relied upon these notes in treating the victims. The notes reflected that D.J. told the triage nurse that Appellant sexually abused her. Dr. Condra also testified that D.J. told him and the nurse what Appellant had been doing to her. He also testified that both D.J. and D.Y. informed him that they were sexually assaulted that day “and over the past months.”

B. Dr. Pfitzer

Dr. Pfitzer was a treating pediatrician who provided follow-up examination and treatment to D.J. and D.Y. She testified that she saw the children as a result of sexual abuse allegations made against “a neighbor” named “Fred” and that the allegations involved vaginal and anal penetration.

TV. The Majority’s Departure From Edwards

In discarding Edwards’ precedent of eighteen years, the majority asserts that it “cannot reasonably conclude that the statements identifying the perpetrator, such as those at issue in this case, were made by young children ‘for the purpose of medical treatment or diagnosis.’ ” Op. at 246. The majority further asserts “the reliability of a child’s identification of the perpetrator of the abuse to a medical professional contains the same tangible risk of unreliability generally inherent in all hearsay testimony.” Id. at 246-47. Outside the medical field, one could assert this conclusion to be valid as long as it rested “on the obvious assumption that the declarant is responding under the impression that [he or she] is being asked to make an accusation that is not relevant to the physician’s diagnosis or treatment.” Renville, 779 F.2d at 438. However,
[t]his assumption does not hold where the physician makes clear to the victim that the inquiry into the identity of the abuser is important to diagnosis and treatment, and the victim manifests such an understanding. In such circumstances, the victim’s motivation to speak truthfully is the same as that which insures reliability when he recounts the chronology of events or details symptoms of somatic distress.
Id. Here, there is nothing in the record to indicate “that the child’s motive in making these statements to medical personnel was other than as a patient responding to a physician questioning for prospective treatment.” Id. at 439 (citing United States v. Iron Shell, 633 F.2d 77, 84 (8th Cir.1980)); see also U.S. v. Kappell, 418 F.3d 550, 557 (6th Cir.2005) (“The record supports the district court’s finding that ‘there is sufficient indicia that these statements were made for the purpose of medical diagnosis or treatment ... to be admissible under 803(4).’ ”).
The reasoning for retaining the Edwards/Renville exception was also aptly noted by the Supreme Court of Arkansas in Hawkins v. State, 348 Ark. 384, 72 S.W.3d 493, 498 (2002):
R.T.’s identification of appellant as her abuser allowed Dr. Hawawini to take steps to prevent further abuse by her stepfather, who was a member of her household. Additionally, R.T.’s identification of appellant as her abuser allowed Dr. Hawawini to take steps to treat the emotional and psychological injuries which accompanied the rape. Moreover, we note that based on R.T.’s statements, Dr. Hawawini referred her to a physician at Children’s Hospital who specialized in treating children who are sexually abused. Finally, R.T.’s identification of appellant as her abuser permitted Dr. Hawawini to fulfill her legislatively imposed duty of calling the child-abuse hotline and reporting the crime.
*256And, the Court in Morgan v. Foretich, also noted that “[w]e agree with the judgment of the Eighth Circuit [in Renville ] that ‘[sjexual abuse of children at home presents a wholly different situation’ from that normally encountered in Rule 803(4) cases and that situation requires great caution in excluding highly pertinent evidence.” 846 F.2d 941, 949 (4th Cir.1988) (citing Renville, 779 F.2d at 437). In State v. Tracy, 482 N.W.2d 675 (Iowa 1992), the Iowa Supreme Court agreed, noting that “[bje-cause of the nature of child sexual abuse, the only direct witnesses to the crime will often be the perpetrator and the victim. Consequently, much of the State’s proof will necessarily have to be admissible hearsay statements made by the victim to relatives and medical personnel.” Id. at 682. Thus, “ ‘[ijnformation that the abuser is a member of the household is therefore ‘reasonably pertinent’ to a course of treatment which includes removing the child from the home.’ ” Id. at 681-82 (quoting Renville 779 F.2d at 438); see also State v. Robinson, 153 Ariz. 191, 735 P.2d 801, 810 (1987) (“[I]n child sexual abuse cases, we therefore join the growing number of jurisdictions which recognize that statements regarding the abuser’s identity fall within Rule 803(4) whenever, as here, identity is relevant to proper diagnosis and treatment.”); State v. Aguallo, 318 N.C. 590, 350 S.E.2d 76, 80 (1986) (“[I]n the context of a child sexual abuse or child rape, a victim’s statements to a physician as to an assailant’s identity are pertinent to diagnosis and treatment.”); Goldade v. State, 674 P.2d 721, 725 (Wyo.1983) (“[Tjhe function of the court must be to pursue the transcendent goal of addressing the most pernicious social ailment which afflicts our society, family abuse, and more specifically, child abuse.”); U.S. v. George, 291 Fed.Appx. 803, 805 (9th Cir.2008) (“The district court also did not abuse its discretion by admitting D.B.’s statement to a nurse practitioner that George touched her inappropriately because the statement was made for the purposes of a medical diagnosis.”); People of Territory of Guam v. Ignacio, 10 F.3d 608, 613 (9th Cir.1993) (“Thus, a child victim’s statements about the identity of the perpetrator are admissible under the medical treatment exception when they are made for the purposes of medical diagnosis and treatment.”) (emphasis added).

V. Conclusion

For these reasons, I cannot so easily cast away an exception wisely adopted by our predecessor Court for the protection of the children of Kentucky and thus I must dissent.
ABRAMSON, J., joins.