Court Opinion

ID: 9690579
Source: CourtListenerOpinion
Date Created: 2023-08-24 19:24:39.936437+00
Date Added: 2024-06-11T18:18:59.903868
License: Public Domain

Concurring opinion by
Justice COOPER.
The only issue reserved for appeal by Appellant’s conditional plea of guilty, RCr 8.09, was the trial court’s denial of Appellant’s motion to suppress the opinion of the Commonwealth’s expert medical witness, Dr. Cristin Rolf, that the manner of the decedent’s death was “homicide by heart attack.” I concur in the majority opinion as far as it goes, but write separately to further explain my view as to why the proposed testimony of Dr. Cristin Rolf would not have invaded the province of the jury.
Appellant allegedly engaged in a vocal and physical altercation with her father, following which her father died. Dr. Rolf was the medical examiner who performed the postmortem examination of the decedent’s body and was the only witness to testify at the suppression hearing. She had reviewed police reports describing the altercation. That evidence presumably would have been admissible at trial.1 Dr. Rolf testified that her postmortem examination revealed that the decedent was thin and frail and had suffered from coronary artery disease and pulmonary emphysema. She also found abrasions and contusions on his body which were not in themselves life-threatening. She concluded that the cause of the decedent’s death was a heart attack. No one challenges Dr. Rolfs qualifications as an expert forensic pathologist or the admissibility of her opinion as to the cause of death. Appellant’s only claim is that it was error to permit Dr. Rolf to express an opinion as to the manner of death.
Virtually every jurisdiction that has considered the issue has held that a homicide conviction can be predicated upon death by heart attack caused by stress resulting from actions of the defendant provided the prosecution proves both cause and effect. E.g., People v. Stamp, 2 Cal.App.3d 203, 82 Cal.Rptr. 598, 602-03 (1969) (conviction of felony murder affirmed where pathologist testified that severe stress experienced during robbery by defendant caused victim’s fatal heart attack); State v. Spates, 176 Conn. 227, 405 A.2d 656, 658-60 (1978) (conviction of manslaughter affirmed where medical testimony established that cause of death was heart attack brought on by emotional stress occurring during robbery); Maynard v. State, 660 So.2d 293, *317296 (Fla.Dist.Ct.App.1995) (conviction of manslaughter upheld where defendant’s physical assault of victim produced no discernible physical injuries but victim died of heart attack, and medical examiner testified that the altercation caused the fatal heart attack); Cromartie v. State, 275 Ga. App. 209, 620 S.E.2d 413, 416 (2005) (conviction of vehicular homicide affirmed where intoxicated driver struck pedestrian who died of heart attack, and medical examiner testified that collision “directly and materially contributed” to pedestrian’s death); Thomas v. State, 436 N.E.2d 1109, 1112 (Ind.1982) (conviction of murder affirmed where pathologist testified hypothetically that stress resulting from being robbed by the defendant would have been the primary cause of death); State v. Vaughn, 707 S.W.2d 422, 426 (Mo.Ct.App. 1986) (conviction of second-degree murder upheld where medical examiner testified that victim’s cardiac arrest resulted from stress induced by defendant’s assault); State v. Dixon, 222 Neb. 787, 387 N.W.2d 682, 689 (1986) (conviction of felony murder upheld where pathologist testified that cause of cardiac arrhythmia was shock experienced during burglary of victim’s home by defendant); In re Anthony M., 63 N.Y.2d 270, 481 N.Y.S.2d 675, 471 N.E.2d 447, 450, 452 (1984) (two cases) (juvenile adjudication of manslaughter in the second degree upheld where defendant snatched purse of elderly woman who fell and broke her hip and subsequently died of heart attack, where doctor testified that “the stress precipitated the myocardial infarction with subsequent cardiac arrest and ultimate death”); id. at 451-52 (felony murder conviction upheld where victim of burglary and robbery died next day of myocardial infarction and forensic pathologist testified it was reasonably certain “that the emotional and physical trauma of the burglary caused [the victim’s] heart attack”); State v. Atkinson, 298 N.C. 673, 259 S.E.2d 858, 864 (1979) (conviction of felony murder upheld where medical examiner testified that victim died of heart attack and that injuries and stress caused by defendant’s assault of victim contributed to and accelerated victim’s death), overruled on other grounds by State v. Jackson, 302 N.C. 101, 273 S.E.2d 666 (1981); cf. Commonwealth v. Evans, 343 Pa.Super. 118, 494 A.2d 383, 389-90 (1985) (counsel was not ineffective in failing to assert insufficiency of evidence to sustain conviction of felony murder where forensic pathologist had testified that stress caused by defendant’s robbery and kidnapping of victim aggravated victim’s arteriosclerotic heart disease, resulting in his death).
We upheld a murder conviction in Adcock v. Commonwealth, 702 S.W.2d 440 (Ky.1986), based on evidence that the defendant raped and severely beat an eighty-year-old woman who died from a heart attack twenty-nine days later.
There was medical testimony from which a jury was entitled to believe that the beating caused the death of Mrs. Relkin. Although she was old, had suffered a previous heart attack and had serious coronary artery disease, the evidence would amply support a finding that the beating hastened her death in that she would not have died when she did except for the precipitating factor of the beating.
Id. at 444 (emphasis added). Although the opinion does not recite the nature of the evidence that amply supported the verdict, it presumably included an expert opinion as to causation. Sommers v. Commonwealth, 843 S.W.2d 879, 884 (Ky.1992) (“In the present case, ... both the cause of death and the genesis of the fire were matters of crucial dispute, resolvable only through circumstantial evidence and expert opinion.”).
*318Though we have no cases specifically addressing whether a medical examiner who is a forensic pathologist may express an opinion as to the “manner of death,” it is not a question of first impression. A qualified expert may express an opinion about a matter requiring scientific, technical, or specialized knowledge if that opinion “will assist the trier of fact to understand the evidence or to determine a fact in issue.” KRE 702. Accordingly, most jurisdictions that have addressed the issue hold that a qualified expert can express an opinion that the manner of a disputed death was homicide, ie., that the death of one person was due to an act or omission of another, as opposed to natural causes or suicide, though not that the homicide was intentional, wanton, reckless, or accidental, which would constitute an opinion as to the guilt or innocence of the defendant. Stringer v. Commonwealth, 956 S.W.2d 883, 889-90 (Ky.1997) (“Presumably, jurors do not need assistance in the form of an expert’s opinion that the defendant is guilty or not guilty.”).
See, e.g., Bell v. State, 435 So.2d 772, 775-76 (Ala.Crim.App.1983) (holding that it was not plain error to permit state forensic pathologist to characterize child’s death as “homicidal murder” and not error of any kind to permit same witness to characterize death as “homicide”); Smith v. State, 276 Ga. 97, 575 S.E.2d 450, 452-53 (2003) (medical examiner properly permitted to express opinion that manner of death was homicide based on observations made during autopsy as well as facts obtained from other witnesses); Medlock v. State, 263 Ga. -246, 430 S.E.2d 754, 756 (1993) (medical examiner properly permitted to express opinion that manner of death was “homicide,” though it would have been error if witness had expressed opinion as to whether homicide was intentional or accidental); People v. Perry, 229 Ill.App.3d 29, 170 Ill.Dec. 823, 593 N.E.2d 712, 715-16 (1992) (expert’s opinion that manner of death was “homicide” not prejudicial where only issue was whether mother intentionally smothered child or accidentally rolled over on top of child while sleeping); Booker v. State, 270 Ind. 498, 386 N.E.2d 1198, 1202 (1979) (once trial court made preliminary finding that purse-snatching incident would have been a stressful event for the elderly female victim, doctor could properly express opinion that stress engendered by the robbery was a direct cause of victim’s cardiac arrest, ie., that the death was a homicide); State v. Young, 662 A.2d 904, 907 (Me.1995) (medical examiner’s opinion that manner of death was homicide was within witness’s area of expertise and did not invade the province of the jury); Schlossman v. State, 105 Md.App. 277, 659 A.2d 371, 373 (1995) (medical examiner properly permitted to testify that cause of death was heart attack and that manner of death was homicide), overruled on other grounds by Bailey v. State, 355 Md. 287, 734 A.2d 684 (1999); State v. Bradford, 618 N.W.2d 782, 793 (Minn.2000) (medical examiner’s opinion that manner of death was homicide was helpful to jury’s determination whether fatal gunshot wound was self-inflicted or inflicted by another); State v. Baluch, 341 N.J.Super. 141, 185, 775 A.2d 127, 155 (2001) (medical examiner’s testimony that manner, of death was homicide “assist[ed] the jury in analyzing ... the sequence and severity of Imelda’s various injuries and pneumonia relative to the cause of her death”); Commonwealth v. Daniels, 480 Pa. 340, 390 A.2d 172, 178-79 (1978) (where victim died of bronchial pneumonia after physical abuse consisting of holding his head under water and exposing him to cold weather, forensic pathologist properly permitted to express opinion that manner of death was “homicide,” noting that homicide is a “neutral” term not always indicat*319ing criminal conduct); State v. Washington, 581 A.2d 1031, 1033 (R.I.1990) (where victim died of heart attack during course of rape, trial court did not abuse discretion in permitting medical examiner to characterize manner of death as “homicide,” defined as “[t]he killing of one human being by the act, procurement, or omission of another”); State v. Richardson, 158 Vt. 635, 603 A.2d 378, 379 (1992) (upholding admission of medical examiner’s opinion that victim died by homicide, noting that such did not amount to a comment on guilt or innocence); State v. Scott, 206 W.Va. 158, 522 S.E.2d 626, 632 (1999) (upholding admission of medical examiner’s opinion that manner of death was homicide, noting that because “homicide can be committed without criminal intent and without criminal consequences[,] ... [t]he term ... is neutral [and] ... pronounces no judgment on its moral or legal quality”).
The cases holding to the contrary are easily explained on their facts. E.g., Maxwell v. State, 262 Ga. 73, 414 S.E.2d 470, 473-74 (1992) (error to permit medical examiner to testify that manner of death was homicide where witness could not determine cause of death, relied solely on evidence of other lay witnesses, and admitted opinion was based on factors the jury could determine for themselves), overruled on other grounds by Wall v. State, 269 Ga. 506, 500 S.E.2d 904 (1998); State v. Pinero, 70 Haw. 509, 778 P.2d 704, 709 (1989) (error to permit forensic pathologist to express opinion that victim’s death was a homicide and not an accident where defendant admitted that he fired the fatal gunshot); State v. Vining, 645 A.2d 20, 21 (Me.1994) (medical examiner’s opinion that manner of death was homicide should have been excluded where opinion was based solely on information received from police and not on any physical evidence adduced during autopsy, thus not a product of witness’s expertise); State v. Flick, 425 A.2d 167, 171 (Me.1981) (upholding exclusion of medical testimony as to defendant’s state of mind at the time of crime); State v. Jamefson, 153 N.J. 318, 708 A.2d 1183, 1194-95 (1998) (forensic pathologist could not render opinion that vehicular collision was a homicide as opposed to an accident because pathologist was no more competent than the jury to determine cause of vehicle collision as opposed to physiological cause of death).
The consensus of these cases is that an expert medical examiner or forensic pathologist can express an opinion not only as to the cause of death, but also that the manner of death was homicide, i.e., by the act or omission of another person, where such would not be readily ascertainable by a layperson, thus would assist that trier of fact in determining a fact in issue. However, the expert cannot express an opinion as to the mental state of the accused which would constitute an expression as to guilt or innocence, and cannot base the opinion solely on facts that are just as easily understood by a layperson.
Here, the decedent died of a heart attack. It would not be readily apparent to a layperson that the heart attack was a result of Appellant’s physical and verbal altercation with the decedent as opposed to natural causes. Dr. Rolf only proposed to testify that the heart attack was a “homicide,” indicating that it resulted from stress induced by the altercation with Appellant. The doctor did not propose to testify that Appellant intended the victim’s death or that she wantonly, recklessly, or accidentally caused his death, thus did not propose to testify to Appellant’s guilt or innocence. As noted by some of the cases cited supra, homicide is not always the result of criminal conduct. Killing in self-defense is not a crime. Unintentional killing is not a crime absent evidence giving rise to wantonness or recklessness. The *320definition of wantonness (the mental state required for conviction of manslaughter in the second degree) would have required the Commonwealth also to prove that Appellant initiated the altercation and was aware of and disregarded a substantial and unjustifiable risk that the altercation would result in her father’s death. KRS 501.020(3); see Turner v. Commonwealth, 153 S.W.3d 823, 827-28 (Ky.2005) (directed verdict of acquittal required where there was no evidence that defendant was aware of victim’s heart condition, thus no basis for jury to find that she disregarded substantial risk that victim would suffer heart attack). For these same reasons, it would have been error to permit Dr. Rolf to identify the medical article upon which she partially relied for her opinion by its title, viz: J.H. Davis, Can Sudden Cardiac Death Be Murder?, 23 J. of Forensic Sci. 384 (1978).
GRAVES and ROACH, J.J., join.

. Appellant’s conditional guilty plea did not reserve any objection to the admissibility of that evidence at trial, thus any objection was waived. Cf. Gabbard v. Commonwealth, 887 S.W.2d 547, 549-50 (Ky.1994) (defendant adequately preserved for appeal issue of whether he was competent to stand trial).