Court Opinion

ID: 9963498
Source: CourtListenerOpinion
Date Created: 2024-04-25 16:11:05.420693+00
Date Added: 2024-06-11T08:24:50.542512
License: Public Domain

04/25/2024
       IN THE COURT OF CRIMINAL APPEAL S OF TENNESSEE
                        AT KNOXVILLE
                                March 26, 2024 Session

             STATE OF TENNESSEE v. WARREN J. NOSTROM

              Appeal from the Criminal Court for Cumberland County
                     No. 18-CR-326     Gary McKenzie, Judge
                      ___________________________________

                           No. E2023-00299-CCA-R3-CD
                       ___________________________________

A Cumberland County jury found Defendant, Warren J. Nostrom, guilty of two counts of
first degree premeditated murder. The trial court imposed concurrent life sentences. On
appeal, Defendant argues that (1) the evidence was insufficient to support his convictions,
and the trial court erred by (2) finding Defendant competent to stand trial and precluding
an attorney from testifying as an expert at the competency hearing, (3) admitting
Defendant’s pretrial statement to police, and (4) denying Defendant’s motion for a
continuance. After review, we affirm the judgments of the trial court.

 Tenn. R. App. P. 3 Appeal as of Right; Judgments of the Criminal Court Affirmed

MATTHEW J. WILSON, J., delivered the opinion of the court, in which ROBERT W.
WEDEMEYER and JOHN W. CAMPBELL, SR., JJ., joined.

Howard L. Upchurch, Pikeville, Tennessee, and Samuel F. Hudson, Dunlap, Tennessee,
for the appellant, Warren J. Nostrom.

Jonathan Skrmetti, Attorney General and Reporter; Abigail H. Rinard, Assistant Attorney
General; Bryant C. Dunaway, District Attorney General; and Phillip A. Hatch and Amanda
Worley, Assistant District Attorneys General, for the appellee, State of Tennessee.
                                            OPINION

                                          I. Background

      Defendant was convicted for the September 14, 2018 killings of his estranged wife,
Joy Nostrom, and her boyfriend, Mark Gunter. At the time of the victims’ deaths,
Defendant and Ms. Nostrom were involved in a pending divorce case. Defendant also shot
himself during the incident, but that bullet grazed the top of his head.

                                     A. Suppression Hearing

        On January 7, 2019, the Cumberland County Grand Jury indicted Defendant for two
counts of first degree premeditated murder of Ms. Nostrom and Mr. Gunter. Defendant
later filed a motion to suppress his statement that he gave to police officers following the
killings. At the June 22, 2021 hearing on Defendant’s motion to suppress, Dr. Mark Fox,
a surgeon who also served as the medical director for Cumberland County’s Emergency
Medical Services at the time of the offenses, testified that around 2:45 p.m. Central time
on September 14, 2018, he responded to the Cumberland County Schools’ transportation
office and school bus garage on Genesis Road in Crossville, where the shootings of the
victims and Defendant took place. When Dr. Fox first saw Defendant at the location,
Defendant had already been given a breathing tube and administered medication. A
medical helicopter arrived at 3:07 p.m. and left fifteen minutes later, transporting
Defendant to Erlanger Hospital in Chattanooga. Hospital records indicate Defendant was
first seen at Erlanger at 3:59 p.m.1 While Dr. Fox did not treat Defendant at the scene or
accompany Defendant to the hospital, the trial court accredited Dr. Fox as an expert in
trauma care and emergency medicine, so he was able to review Defendant’s medical
records and offer his opinion testimony accordingly.

       Dr. Fox testified that Defendant was treated with ten milligrams of midazolam, a
sedative, and eight milligrams of morphine, a narcotic pain medication, before being flown
to Erlanger. On the flight, he was given a five-milligram dose of midazolam along with
two one-hundred-microgram doses and one fifty-microgram dose of fentanyl, another
narcotic pain medication. Dr. Fox testified these medications were “[r]apid onset, short in
duration, meant to control pain.” Throughout his testimony, Dr. Fox emphasized that the
medications Defendant was administered had “a relatively short[-]acting effect.”

       1
          “For clarity, we have eliminated distinctions between time zones referenced in the appellate
record. The facts set forth in this opinion reflect the time the event occurred in Central time.

                                                -2-
       At Erlanger, doctors stapled closed a scalp laceration on the crown of Defendant’s
head. The laceration was three centimeters long and one-and-a-half centimeters deep; Dr.
Fox described the injury as “superficial.” X-rays showed no skull fracture. At the hospital
Defendant was given four additional doses of fentanyl, totaling three hundred micrograms:
one-hundred-microgram doses at 4:10 and 5:20 pm., and fifty-microgram doses at 4:52 and
5:17 p.m. Defendant was also given a two-milligram dose of midazolam at 4:11 p.m.

       Hospital records indicated Defendant was cleared for discharge at 6:20 p.m. on the
evening of September 14, 2018. A notation in Defendant’s medical records states, “A.O.
times three,” which Dr. Fox explained meant “Alert and oriented. And times three means
to person, place, and time. Or events.” Dr. Fox stated that were a patient not alert as to
these three things, the patient would, usually, not be discharged. The records also reflect
that throughout the two hours he was in the hospital, Defendant was assessed using the
Glasgow Coma Scale, which Dr. Fox described as “an industry standard that was
established . . . to provide objective assessment of one’s mental status in terms of three
components: eye movement, that is eye actions; verbal response; and motor or muscular
response.” In the last Glasgow assessment taken before Defendant’s discharge, Defendant
scored a 15, which the highest score possible on the test.

      Dr. Fox acknowledged that the Defendant’s custodial interview began shortly after
midnight the morning of September 15, 2018. Dr. Fox opined that in his “professional
opinion, within a reasonable degree of medical certainty . . . those medications would not
have had an ongoing effect on [Defendant] after midnight.” Dr. Fox acknowledged he
reviewed the video recording of Defendant’s custodial interview, and the physician denied
that Defendant suffered from “delirium, hallucinations, concentration issues, change in
mood, [or] loss of consciousness” during the interview.

        When asked whether the medications administered to Defendant “would have a
more significant or exacerbated effect on an individual who suffers from dementia,” Dr.
Fox responded, “It may have a more immediate effect, if that’s what you mean by adverse
effect.” When asked whether the effects of the medication would be longer-lasting for a
dementia patient, Dr. Fox replied that while an older person can take longer to “clear” a
medication from his system, “Alzheimer’s itself is not noted to adversely be affected or
slow the rate of [f]entanyl metabolism.”

       Lieutenant Dustin Lester of the Crossville Police Department drove Defendant from
Erlanger to the Cumberland County Jail after Defendant was released from the hospital.
The lieutenant arrived at the hospital while Defendant was being treated and saw
Defendant’s head being stapled. The lieutenant stated that Defendant did not react to the
stapling and acknowledged that the medical staff “had him out pretty well[.]” At discharge,
Defendant was placed in a wheelchair and wheeled to the lieutenant’s police cruiser. They
                                           -3-
arrived at the Cumberland County Jail at 8:10 p.m. on September 14. The lieutenant stated
that at one point, Defendant attempted to speak to him, but the lieutenant told Defendant
that “I wasn’t allowed to speak to him.” When asked if Defendant was sleeping, the
lieutenant stated that he “was pretty well out the whole time. He didn’t make any
statements or comments.”

       Tennessee Bureau of Investigation (TBI) Assistant Special Agent in Charge Jason
Legg recalled being dispatched to the crime scene on September 14, 2018. When he
arrived, the male victim, Mr. Gunter, had been removed from the scene, but the female
victim, Ms. Nostrom, was still present. Agent Legg testified that Ms. Nostrom died from
a gunshot wound to the head, and Mr. Gunter died from a gunshot wound to the chest.

       Agent Legg acknowledged that during his investigation he became aware of marital
difficulties between Defendant and his estranged wife, including Defendant’s filing for
divorce and Ms. Nostrom obtaining at least two orders of protection against Defendant.
Agent Legg noted the first order of protection was taken out April 9, 2018, and dismissed
April 16 of that year. Another order of protection was obtained May 25, 2018, and
dismissed June 11 of that year. A third order of protection was obtained August 13, 2018,
and was still active at the time of the offense. In the affidavit in support of one order of
protection, Ms. Nostrom wrote about an incident at a Crossville restaurant in which
Defendant approached the victims while they were eating and threatened to shoot Mr.
Gunter. Agent Legg noted that per the terms of one order of protection, Defendant had
agreed to turn over all his firearms. Defendant had completed a written form stating that
he had surrendered his guns to a person legally allowed to keep them. Agent Legg testified
that Defendant had filed for divorce shortly before the offenses occurred. Agent Legg also
acknowledged that Defendant was represented in his divorce by one of the attorneys
representing him in the current appeal.

        Agent Legg’s interview of Defendant began shortly around 12:40 a.m. on
September 15, 2018. TBI Special Agent Hunter Locke was also present for the interview.
Agent Legg recalled that when Defendant took his seat at the interview table, he
“immediately began talking.” The agent had to interrupt Defendant “numerous” times to
get him to listen to the rights set forth in the Miranda waiver. Portions of the video
recording of the interview were played in court and transcribed by the court reporter; at the
start of the video, Defendant claimed he had served in law enforcement in Suffolk County,
New York, and had aided in the investigation into the 1996 explosion of TWA Flight 800.
When Agent Legg told Defendant that he had to “waive [his] rights for us to be able to talk
to [him],” Defendant mentioned he had an attorney because he was going through a
divorce. He did not ask for the attorney to be present at that point, however. Eventually,
Agent Legg was able to read the rights waiver and have Defendant sign the waiver. During
the interview, Defendant did most of the talking, and Agent Legg asked few questions.
                                            -4-
Agent Legg acknowledged that Defendant was “cordial,” “agreeable,” and expressed a
“willingness to speak” during the interview.

        In another portion of the interview played during the suppression hearing,
Defendant told Agent Legg that when Ms. Nostrom left, “I couldn’t take that house no
more. I have too much on me. I couldn’t sell it.” Defendant said he was attempting to
“hold off on the divorce” and attend mediation, but the day of the offenses Defendant “went
nuts” because he “saw her with another guy. And I followed her. We went over to the
justice center[.]” In another portion of the video, Defendant stated that later that day,

       I don’t know, there was something inside of me. It was like an inferno, and
       was going and going and going. And I saw her go by. I went to get gas up
       here. It’s $2.39. And I saw, I saw her going. I went to—I pulled into the
       yard, and I, I pulled out the gun. I couldn’t believe I did this. I couldn’t
       believe I did this. And I shot him. First the guy come out, and I hit him.
       And then, uh, I walked over to her, and—and—and I hit her. And I went to
       put the gun to my head, and, I don’t know, I guess I must have . . . .

        In another portion of the interview, Defendant said he had previously encountered
Ms. Nostrom and Mr. Gunter at a Mexican restaurant. Defendant walked to the table where
they were seated, and Defendant told Mr. Gunter, “Excuse me, that’s my wife.” Defendant
claims Mr. Gunter replied, “You better get out of here before I call the cops.” Agent Legg
testified that this was noteworthy to him because Ms. Nostrom had filed the
aforementioned order of protection against Defendant following the restaurant incident.
Defendant also told the agent that Ms. Nostrom “dropped” two other orders of protection.

       Later in the interview Defendant told Agent Legg that pursuant to the order of
protection, he had turned over his guns to a man named Ed Jones, who supposedly still had
the guns as of the interview. Defendant said he “forgot all about” the handgun he used in
the shooting, acknowledging he had it in the console of his van before the shooting.

       Toward the end of the interview, Defendant said Ms. Nostrom “was a good woman
before. I don’t know what happened to her. Always trying to get over on me lately.”
Defendant claimed Ms. Nostrom lied to him, took money from him, and also took money
from her employer. Defendant wondered aloud, “What, what turned the woman off to me?
Am I getting too old? I’m 74 years old. She’s 58.” At this point, Agent Legg attempted
to obtain consent from Defendant for a cellular phone search; Defendant replied that he
“better wait for [his divorce attorney]. . . . I see the way that’s being read[.]” After a brief
exchange that included Defendant repeating that he should wait for his attorney, the
interview ended.

                                             -5-
       Agent Legg testified that Defendant mentioned being a law enforcement officer
several times during the interview but had never worked in law enforcement. The agent
recalled Defendant’s head was bandaged during the interview, and he also recalled that
Defendant claimed to have been awake since about 3:30 the previous morning. Agent Legg
acknowledged that Defendant had attempted suicide before the interview, and he also
acknowledged that at the time of the interview he had no information about Defendant’s
medical treatment after he was transported to Erlanger.

      Agent Legg also testified that he had seen nothing in the record suggesting
Defendant had violated an order of protection before the victims’ deaths. He further
acknowledged that Defendant had filed the divorce petition against his wife, and in the
complaint Defendant alleged health issues entitling him to spousal support.

       Regarding Defendant’s behavior during the interview, Agent Legg agreed that a
person’s inability to follow instructions and constant interruption of an officer could be
indications of impairment. Agent Legg confirmed Defendant repeatedly interrupted him
during the interview, especially while reading the Miranda warnings.

       Forensic psychiatrist Stephen Montgomery, accredited by the trial court as an expert
in forensic psychology, conducted a forensic evaluation of Defendant in June 2020. Due
to COVID-19 protocols that prevented face-to-face contact in the Cumberland County Jail,
Dr. Montgomery was unable to conduct an in-person interview with Defendant, which he
said prevented him from administering a “full evaluation[.]” Dr. Montgomery recalled that
Defendant was seventy-five years old when he completed the evaluation. Defendant had
a history of high blood pressure, chronic obstructive pulmonary disease (COPD), and
prostate cancer, and he had attempted suicide less than two years before these offenses.
Defendant attended school through ninth grade. Dr. Montgomery testified that Defendant
admitted to him that Defendant had never served in law enforcement, despite his statements
to police.

       Dr. Montgomery stated that during the “brief testing” he was able to conduct over
video conference, Defendant was “alert and oriented,” but “he could not do basic
computations, had difficulty with concentration. And I was concerned about his cognitive
functioning.” Dr. Montgomery said that Defendant was unsure about dates for certain
events and told the doctor, “I can’t remember a lot of things.” After the evaluation, Dr.
Montgomery referred Defendant to a neuropsychologist, Dr. Malcolm Spica, for additional
testing. Dr. Spica was able to conduct his testing in person, and Dr. Montgomery testified
that Defendant “performed very poorly on most of the tests.” Dr. Montgomery
acknowledged that in Dr. Spica’s report, he wrote that Defendant “appeared alert, but
mildly confused, forgetful, and unable to recall specific aspects of his past.” Dr. Spica also
administered testing for dementia, and Dr. Montgomery testified that Defendant’s test
                                            -6-
results showed Defendant to be “[v]ery far into the range associated with clinical
dementia.” Defendant’s greatest impairments, per Dr. Spica, were in the areas of visual
analysis and executive functioning, or as Dr. Montgomery described it, “putting everything
together . . . and making rational decisions.” Dr. Montgomery also testified that Defendant
“scor[ed] in the borderline intellectually disabled range with an IQ of 68[.]” Additionally,
Dr. Spica found Defendant to have poor focus and attention span and to be suffering from
anxiety and depression. In all, Dr. Spica’s testing indicated Defendant’s intellectual ability
was, at that time, “commensurate with that of a six-year-old child.”

        Dr. Montgomery stated that Defendant maintained some “delusional beliefs”;
specifically, Dr. Montgomery asserted that Defendant “has maintained . . . that his wife did
not die from a gunshot wound, but instead collapsed and died from some other reason. . . .
[H]e maintains that belief and cannot be dissuaded, even saying that perhaps the autopsy
report was done incorrectly.” Dr. Montgomery testified that Defendant suffered from
Lewy body dementia. Dr. Montgomery explained that unlike Alzheimer’s disease, which
“may be more focused on memory, Lewy body, and other dementias, may manifest more
in impairments, and judgment, and impulse control.” Dr. Montgomery explained that
Defendant’s history of heart disease and chronic lung disease placed Defendant “at risk for
developing that type of dementia,” as Lewy body dementia was a type of vascular
dementia, “where blood supply to the brain is compromised over time, where parts of the
brain tissue die from lack of oxygen supply.”

        Dr. Montgomery testified he reviewed the video of Defendant’s interview with the
TBI agents after his arrest. Dr. Montgomery observed that during Agent Legg’s advising
Defendant of his Miranda rights, “It appeared that . . . [Defendant] was very talkative and
was not paying very close attention. He was just wanting to . . . talk himself and not listen
to what he was being told.” Conversely, at the end of the video, when the TBI agents
attempted to obtain consent to search Defendant’s cellular phone, Defendant was not as
talkative. By that point of the interview, Dr. Montgomery testified, Defendant “seemed
calmer.” Dr. Montgomery observed that “it does not make a lot of sense that he would
give a confession like that, and then all of a sudden want to be concerned about contacting
his lawyer about the cellphone issue. It does not seem consistent.”

        When asked whether he had an opinion as to whether Defendant “knowingly,
intelligently, and voluntarily waived his Miranda rights,” Dr. Montgomery responded,

       I think it’s unclear. I think there are certain reasons to question whether or
       not he was, because of his dementia, that was already present at that point,
       because of his depression, because of sleep deprivation, the injury he
       sustained that day, the trauma of the whole incident, being sedated, being
       intubated. So, I think, for all of those reasons, and the way he was acting, he
                                            -7-
       was very talkative, he was tearful, he was emotional, he was saying things
       that were not true. And so, I think, the only way to be sure that he really fully
       understood what he was—what rights he was waiving would have been for
       them to ask each of those portions of rights, to get him to paraphrase that, to
       saw what exactly are you agreeing to. I think, based on the video, he could
       have been read pretty much anything, and he would have agreed to sign it,
       because he wanted to talk.

      As explored in greater detail below, the trial court concluded that Defendant
executed a “knowing and voluntary waiver of his Miranda rights,” and thus the trial court
denied Defendant’s motion to suppress his statement to law enforcement. The case then
proceeded to trial.

                                           B. Trial

        Brooke Golden, a deputy clerk with the Cumberland County Circuit Court Clerk’s
Office, testified that Ms. Nostrom was granted an order of protection against Defendant on
August 13, 2018. As part of that order of protection, Defendant agreed to turn over his
firearms. The day after the order of protection was granted, Defendant signed a written
declaration stating he had surrendered his firearms accordingly. Ruthie Potter, an
employee with the Cumberland County Clerk and Master’s Office, testified that Defendant
filed for divorce on August 24, 2018.

       Joel Padgett owned Plateau Truck and Tractor (“Plateau”), an equipment rental
business located next to the Cumberland County Schools transportation office, which also
housed the county’s school buses. Surveillance video from cameras outside Plateau were
introduced into evidence; Mr. Padgett acknowledged that video of the incident showed that
several “pieces of machinery” in Plateau’s parking lot partially obstructed the view
between his business and the school bus garage. However, he stated there were spaces
between the equipment which made it possible to see between the two locations, depending
on where one stood. Mr. Padgett did not see the shootings himself.

       On the afternoon of the offenses, Eddie Pugh was at Plateau with his son returning
a Kubota farm tractor. Mr. Pugh testified that after dropping off the tractor, he and his son
went to their truck in Plateau’s parking lot to retrieve paperwork. As the two men
approached their truck, Mr. Pugh heard a gunshot. Mr. Pugh then ran to the fence between
the truck business and the school bus garage. He saw a man lying on the ground and
another man with a gun walking around a school bus. After hearing the first gunshot, Mr.
Pugh heard a woman scream. Mr. Pugh then heard two additional gunshots, and after the
second of these gunshots, Mr. Pugh did not hear the woman screaming any longer. A few

                                             -8-
seconds later, Mr. Pugh heard a fourth gunshot, after which Mr. Pugh called out for help.
When someone exited Plateau’s office, Mr. Pugh went to the school bus garage.

       Upon arriving at the garage, Mr. Pugh saw a man lying on the ground. Mr. Pugh
then walked around the bus and saw a man and a woman lying close to each other. Mr.
Pugh said the man lying close to the woman had “the exact same clothes on” as the man
he had seen walk around the bus earlier. Mr. Pugh was then approached by another man
who said he was a mechanic; this person said one of the men lying on the ground was the
shooter, and the weapon used had been kicked under the bus.

       Mr. Pugh acknowledged he did not know any of the persons involved in the
shooting. He also reiterated that he did not see the first man get shot. Mr. Pugh also
acknowledged he told TBI agents who interviewed him previously that after the one man
walked around the school bus, Mr. Pugh was only able to see this man’s legs.

       Wayne Upchurch, a bus driver and mechanic with the Cumberland County school
system, was at the school bus garage the day of the shooting. At around 2:25 p.m., Mr.
Upchurch was in the secretary’s office at the school bus garage with the school system’s
transportation director, Becky Reed, waiting to begin his bus driving shift. Mr. Upchurch
heard a “bang,” which caused him and the other employees in the office to look out the
window. Mr. Upchurch saw Ms. Nostrom’s “legs and her feet . . . at the side of the bus.”
Mr. Upchurch saw another person lying near a white van; when Mr. Upchurch went to the
van, he saw this person was a man lying motionless. Mr. Upchurch then noticed Ms.
Nostrom and another man lying close together near a school bus. When Mr. Upchurch
reached these two persons, he saw a handgun near the man’s right hand, so Mr. Upchurch
moved the gun with his foot away from the man’s hand and underneath a bus. Mr.
Upchurch acknowledged he did not see anyone get shot.

       Ms. Reed testified that Ms. Nostrom was a bus driver with the Cumberland County
school system, and Ms. Nostrom normally arrived at the school bus garage between 2:00
p.m. and 2:30 p.m. daily to retrieve her bus for her afternoon route. Ms. Reed knew Ms.
Nostrom was married to Defendant, whom she identified in court. Like Mr. Upchurch,
Ms. Reed testified that she was working in the secretary’s office around 2:30 p.m. on
September 14, 2018, when she heard what sounded like a gunshot. She looked out the
window and heard two more gunshots but did not see anyone get hit. Ms. Reed then dialed
911 and spoke to the dispatcher briefly before handing the phone to another employee and
heading outside. When she arrived outside, she saw Ms. Nostrom’s body on the ground
near Defendant, who was also on the ground. Ms. Reed did not recall whether she saw a
gun. She also recalled seeing a third body lying next to a white van. Ms. Reed testified
that before the day of shooting, she had spoken with Defendant, who had “assured [her]

                                          -9-
that there would not be any problems at the school bus garage.” She did not know the other
victim.

       Agent Legg was the lead TBI investigator in this case. At trial, he testified he went
to the school bus garage after the victims had been pronounced dead and Defendant was
flown to Chattanooga to be treated for his gunshot wound. Upon arriving at the scene,
Agent Legg observed a white van and a red Dodge Neon, in addition to the school buses.
The agent testified that Mr. Gunter’s body was found eight to ten feet away from the van,
and the crime scene investigation showed that a bullet struck one of the school buses at the
garage. Investigators also found three shell casings; one was found a considerable distance
from Ms. Nostrom’s body, in the “window well” of the van, while the other two casings
were found close to her body. Agent Legg testified a gun was found “almost underneath
the bus, about halfway between the wheel wells.” Based on its location, Agent Legg
believed the gun had been moved to where it was found. He testified that the magazine
found in this handgun had a capacity of seven rounds, and three rounds were found in the
magazine at the gun’s recovery, leading him to believe the gun was fired four times. A
similar magazine was found inside the van at the crime scene.

       Agent Legg testified that Mr. Gunter, the male shooting victim, had a criminal
history, including two 1989 convictions for driving under the influence and assault with a
deadly weapon on a police officer and two 2006 convictions for felon in possession of a
weapon and assault with a deadly weapon on a government official. Agent Legg denied
that Defendant told him that Defendant had prior knowledge of Mr. Gunter’s criminal
history.

        The video of Agent Legg’s interview with Defendant was played at trial. In addition
to the sections detailed above, at the beginning of the interview Defendant told Agent Legg
that he had a “beautiful marriage” with Ms. Nostrom for over thirty years, but in the last
two years of the marriage she became addicted to diet pills. Defendant also told the agent
that one day, Defendant’s wife told him that “she was in bankruptcy.” Defendant also
claimed his wife then “got into a bad crowd” and was involved in “prostitution . . . on the
weekends.” According to Defendant, these things led him to believe “there must be
somebody else.” However, his suspicions were not confirmed until he saw Ms. Nostrom
with Mr. Gunter at a local restaurant.

        At the time of the offenses, Defendant told Agent Legg, Ms. Nostrom was not living
at the family house. He claimed he told his wife to come back to the house, but she did
not. Instead, Defendant helped her move her belongings from the home to a storage unit,
and she did not tell Defendant where she was moving when asked. The breakup of
Defendant’s marriage was particularly difficult on him; specifically, Defendant stated, “I
ain’t been feeling good ever since she left. I tell you, I’m broken hearted. Thirty-six years.
                                            - 10 -
That’s a long time.” The breakup of this marriage reminded Defendant of the end of his
first marriage, which ended in divorce and was also difficult on him. Defendant also told
Agent Legg that before the shooting, Ms. Nostrom had taken a truck from him and hidden
it in North Carolina. Defendant also claimed his wife had “stolen” another vehicle from
him the day before the shooting.

        In describing the events leading to the offense, in addition to the portions of the
video played at the suppression hearing and detailed above, Defendant said he had gone to
see Ed Jones at the gas station on West Avenue at 3:30 a.m., but the door was locked and
Mr. Jones was asleep inside the station. Defendant said he “went out in my car, and . . .
laid across the back seat with a pillow.” Defendant claimed to have stayed there until
“maybe a quarter till 2:00 [p.m.], something like that,” before heading “[r]ight to
Speedway.” Defendant told Agent Legg that when he was at the Speedway across the
street from the bus garage and saw Ms. Nostrom drive into the garage, he “made a U-turn
in the middle of the road” and drove to the garage. He said he only intended to ask his
wife, “What are you doing to me” and ask about dropping the most recent order of
protection against him. Defendant told Agent Legg that Ms. Nostrom previously contacted
him from numbers that showed as “restricted” on Defendant’s cellular phone, which
“brought up some red flags” to the Defendant, who then claimed that “prostitutes do that.”
When Defendant arrived at the school bus garage, he saw Ms. Nostrom “ready to get in
[her] bus.” He then said he saw Mr. Gunter walking quickly toward Defendant’s van;
Defendant pulled a handgun from the van’s center console and shot Mr. Gunter through an
open van window while still seated in the van. Defendant then walked toward Ms.
Nostrom, who was walking toward him. Defendant told Agent Legg that he (Defendant)
then “hit” her in the head; Defendant clarified that he shot her in the head. Ms. Nostrom
did not say anything to Defendant before she was shot. Defendant then put the gun to his
head and pulled the trigger, but he survived, with the bullet grazing the top of his head.

       Defendant told Agent Legg that he had learned about his wife’s bankruptcy the
spring before the shooting. He had never noticed any money problems because Ms.
Nostrom paid the bills. However, he claimed that persons at the bank told him that Ms.
Nostrom was “pulling money out and pulling money out,” which led Defendant to change
his wife’s bank access. Defendant also noted that after his wife first moved out of the
house, she would call him at night, but after a while she stopped calling him. Defendant
explained that after his wife moved out of the house, she would leave her apartment on
Fridays and not return until Sundays; he claimed Ms. Nostrom “couldn’t wait to get gone”
on weekends. Defendant told Agent Legg that after his wife left, Defendant would drive
around town, but he denied that he was looking for his wife on these trips.

       Defendant admitted to Agent Legg that he was supposed to turn over his guns per
the order of protection. As stated above, Defendant admitted he kept the handgun used in
                                          - 11 -
these offenses in the center console of his van. Defendant initially told the interviewers
that he “forgot all about it,” but he later said, “I probably kept that one. It was a small gun.
I just kept it, you know? What else can I tell you?”

       Agent Legg recalled Defendant’s interview began shortly after midnight the
morning of September 15, 2018, and the agent denied noticing anything at the start of the
interview that caused him concern. Agent Legg testified that Defendant was able to discuss
the previous day’s events and the events which led to the shootings, and Defendant
appeared eager to do so. As at the suppression hearing, Agent Legg testified that Defendant
began talking as soon as he entered the interview room, and the agent “had to stop him,
slow him down, so . . . I could read him his waiver of rights.” This straying off course
continued throughout the interview, with Defendant “always talking about other things,
bankruptcy, being a police officer in New York, and so on[.]” Agent Legg testified that
Defendant did not say anything during the interview about seeing Mr. Gunter carrying a
gun or other weapon.

        Agent Legg acknowledged that in addition to his prior felony convictions, Mr.
Gunter had also gone by the name Mark Wagner. The agent also acknowledged that the
Dodge Neon, in which the victims arrived at the bus garage (with Mr. Gunter driving), was
found by crime scene investigators with its driver’s door open and engine running. When
cross-examined about his contention that four shots were fired based on the bullet strike to
the bus and three victims being shot, Agent Legg surmised that the fourth shell casing could
have become stuck in the boot of EMS or fire department personnel who responded to the
scene—especially considering that the .380 caliber shell casing “is a smaller diameter shell
casing than your standard rounds.” However, Agent Legg acknowledged that the boots of
first responders were not checked for shell casings. Agent Legg also acknowledged the
possibility that fewer than seven rounds were loaded into the magazine that Defendant put
into his gun before the shooting. Agent Legg further noted that the gunshot that grazed
Defendant’s head could have hit the bus, but the agent found this unlikely because the
bullet strike on the bus was below the height of Defendant’s hair line (where he was shot),
and therefore the Defendant would have had to fire his gun at a downward angle to hit both
his scalp and the bus. Agent Legg acknowledged that the two school transportation
employees, Ms. Reed and Mr. Upchurch, testified that they heard three shots. Mr. Pugh
testified he heard four shots, but Agent Legg acknowledged that Mr. Pugh was farther away
from the shooting than were the school transportation employees.

       Agent Legg confirmed that at the time of the interview, he was aware Defendant
had been flown from the bus garage to Erlanger Hospital before being driven back to
Cumberland County. Agent Legg was not aware at that time that Defendant had been given
fentanyl as part of his treatment. The agent acknowledged that Defendant claimed he had
no idea why he did what he did and did not say that he planned to kill the victims. Agent
                                             - 12 -
Legg also acknowledged that a 911 call placed the day before the shootings corroborated
Defendant’s claim that Ms. Nostrom had taken a truck from a repair shop after Defendant
brought in the truck for service. As of the interview, Agent Legg was unaware of
Defendant approaching the victims at the restaurant the summer before the shootings.
Agent Legg acknowledged that in Defendant’s statement, Defendant told the agent that
Ms. Nostrom said nothing before he shot her, contrary to Mr. Pugh’s assertion about
hearing her scream before she was shot.

       Gulpreet Bowman, a forensic pathologist, conducted the victims’ autopsies. Dr.
Bowman testified that Ms. Nostrom died from a gunshot wound to the head. Dr. Bowman
found no soot or pattern tattooing on the entrance wound, which led the pathologist to opine
that Ms. Nostrom was not shot at close range. Ms. Nostrom had traces of phentermine, an
appetite suppressant, in her system when she died. Dr. Bowman concluded Mr. Gunter
died from a gunshot wound to the chest; this wound also had no soot or pattern tattooing
present, which led Dr. Bowman to opine that the fatal gunshot did not come from close
range. Dr. Bowman concluded the manner of both victims’ deaths was homicide.

      Defendant did not testify or present any witnesses on his behalf. His only evidence
was a photograph of the two victims, which was found at Ms. Nostrom’s apartment, and
Defendant’s treatment records from Erlanger Hospital and the flight to the hospital.

        After its deliberations, the jury found Defendant guilty as charged of two counts of
first degree premeditated murder. Upon agreement of the parties, the trial court imposed
concurrent life sentences. This appeal followed.

                                        II. Analysis

                              A. Sufficiency of the Evidence

       Defendant contends the evidence produced at trial was insufficient for the jury to
find him guilty of first degree premeditated murder. Specifically, Defendant contends that
the evidence was insufficient to establish premeditation because Mr. Gunter provoked
Defendant’s actions “by aggressively charging him,” and therefore Defendant “was
not free from excitement and passion” when he shot the victims. We disagree.

                                  1. Standard of Review

       The standard of review for a claim challenging the sufficiency of the evidence is
“whether, after viewing the evidence in the light most favorable to the prosecution, any
rational trier of fact could have found the essential elements of the crime beyond a
reasonable doubt.” Jackson v. Virginia, 443 U.S. 307, 319 (1979) (citing Johnson v.
                                           - 13 -
Louisiana, 406 U.S. 356, 362 (1972)), abrogated on other grounds by Ramos v. Louisiana,
140 S. Ct. 1390 (2020); see Tenn. R. App. P. 13(e); State v. Davis, 354 S.W.3d 718, 729
(Tenn. 2011). This standard of review is identical whether the conviction relies on direct
evidence, circumstantial evidence, or a combination of both. State v. Williams, 558 S.W.3d
633, 638 (Tenn. 2018) (citing State v. Dorantes, 331 S.W.3d 370, 379 (Tenn. 2011)).

       A guilty verdict removes the presumption of innocence and replaces it with one of
guilt on appeal, therefore, the burden is shifted to the defendant to prove why the evidence
is insufficient to support the conviction. Davis, 354 S.W.3d at 729 (citing State v. Sisk,
343 S.W.3d 60, 65 (Tenn. 2011)). On appeal, “we afford the prosecution the strongest
legitimate view of the evidence as well as all reasonable and legitimate inferences which
may be drawn therefrom.” Id. at 729 (quoting State v. Majors, 318 S.W.3d 850, 857 (Tenn.
2010)); State v. Cabbage, 571 S.W.2d 832, 835 (Tenn. 1978). In a jury trial, questions
involving the credibility of the witnesses and the weight and value to be given to evidence,
as well as all factual disputes raised by such evidence, are resolved by the jury as the trier
of fact. State v. Bland, 958 S.W.2d 651, 659 (Tenn. 1997); State v. Pruett, 788 S.W.2d
405, 410 (Tenn. 1990). Consequently, we are precluded from re-weighing or reconsidering
the evidence when evaluating the sufficiency of the convicting proof. State v. Stephens,
521 S.W.3d 718, 724 (Tenn. 2017).

                           2. First Degree Premeditated Murder

        Defendant was charged with and convicted of first degree murder. As charged,
“first degree murder is: [a] premeditated and intentional killing of another[.]” Tenn. Code
Ann. § 39-13-202(a)(1). A person acts intentionally “when it is the person’s conscious
objective or desire to engage in the conduct or cause the result.” Id. § 39-11-302(a).
Premeditation is defined in Tennessee Code Annotated section 39-13-202(e) as:

       An act done after the exercise of reflection and judgment. “Premeditation”
       means that the intent to kill must have been formed prior to the act itself. It
       is not necessary that the purpose to kill preexist in the mind of the accused
       for any definite period of time. The mental state of the accused at the time
       the accused allegedly decided to kill must be carefully considered in order to
       determine whether the accused was sufficiently free from excitement and
       passion as to be capable of premeditation.

“The element of premeditation is a factual question to be decided by a jury from all the
circumstances surrounding the killing.” State v. Jackson, 173, S.W.3d 401, 408 (Tenn.
2005) (citing State v. Davidson, 121 S.W.3d 600, 614 (Tenn. 2003)). The jury “may infer
premeditation from the manner and circumstances of the killing.” Id. (citing Bland, 958
S.W. 2d at 660).
                                            - 14 -
      Tennessee courts “have long recognized that premeditation may be proved by
circumstantial evidence’ because ‘premeditation involves the defendant’s state of mind,
concerning which there is often no direct evidence.” State v. Morgan, No. E2018-02245-
CCA-R3-CD, 2020 WL 3032878 at *6 (Tenn. Crim. App. June 5, 2020) (quoting
Davidson, 121 S.W.3d at 614-15). Our supreme court has identified several specific
circumstances that may demonstrate the existence of premeditation:

       (1) The use of a deadly weapon on an unarmed victim;
       (2) The particular cruelty of the killing;
       (3) Threats or declarations of intent to kill;
       (4) The procurement of a weapon;
       (5) Any preparations to conceal the crime undertaken before the crime was
       committed;
       (6) The destruction or secretion of evidence of the killing;
       (7) Calmness after the killing;
       (8) Evidence of motive;
       (9) The use of multiple weapons in succession;
       (10) The infliction of multiple wounds or repeated blows;
       (11) Evidence that the victim was retreating or attempting to escape when
       killed;
       (12) The lack of provocation on the part of the victim; and
       (13) The failure to render aid to the victim.

State v. Reynolds, 635 S.W.3d 893, 916-17 (Tenn. 2021). This list “is not exhaustive,” and
“the trier of fact is not limited to any specific evidence when determining whether a
defendant intentionally killed the victim after the exercise of reflection and judgment.” Id.
at 917 (quotation marks omitted).

       Here, when the evidence produced at trial is viewed in the light most favorable to
the State, Defendant and Ms. Nostrom were going through an arduous divorce that left him
“broken hearted.” In his interview with Agent Legg, Defendant gave several other possible
motives for killing both victims: his wife’s infidelity with Mr. Gunter, Ms. Nostrom’s
spending habits causing a bankruptcy, and her stealing vehicles from Defendant (including
once within twenty-four hours of the shootings). Defendant admitted that upon seeing the
victims drive to the school bus garage, he followed them there. While Defendant told
Agent Legg that he only intended to talk to Ms. Nostrom, Defendant possessed a handgun
that he was supposed to have turned over pursuant to the order of protection. Defendant
claimed he shot the victims after Mr. Gunter charged toward him, but neither victim was
armed and Defendant was in a car while Mr. Gunter was on foot. After shooting Mr.
Gunter, Defendant exited the car, walked toward Ms. Nostrom and shot her without any
                                           - 15 -
words exchanged. After shooting each victim, Defendant made no attempt to render aid.
The jury considered all of this and rejected any possible heat of passion defense by finding
Defendant guilty of first degree murder, as was the jury’s right.

        Defendant’s motives for the killing, his use of a weapon upon the unarmed victims,
his refusal to render aid, and the lack of provocation from Ms. Nostrom were all
circumstances from which, in connection with the entirety of the evidence, the jury could
infer that Defendant acted with premeditation in killing the victims. Defendant contends
the inapplicability of many factors listed in Reynolds, coupled with Mr. Gunter’s rushing
toward Defendant upon Defendant’s arrival at the school bus garage, all support his
contention that Defendant did not act with premeditation. However, as the State notes in
its brief, even if Defendant felt some excitement and passion during the killings,
Tennessee’s first degree murder law only requires a person to be “sufficiently free” from
excitement and passion to be capable of premeditation. See Tenn. Code Ann. § 39-13-
202(e). The evidence detailed above was sufficient for the jury to find the existence of
premeditation beyond a reasonable doubt, and there is no dispute that the proof established
beyond a reasonable doubt that Defendant intentionally killed the victims by shooting
them.

       Accordingly, the proof was sufficient for the jury to find Defendant guilty of two
counts of first degree murder, and he is not entitled to relief on this issue.

                              B. Competency to Stand Trial

       Defendant contends the trial court erred in finding him competent to stand trial and
in refusing to allow criminal defense attorney Hank Hill to offer expert testimony as to
Defendant’s ability to communicate with counsel and aid in preparing his defense. We
disagree.

                            1. Competency Hearing Testimony

       On the same day as the hearing on Defendant’s motion to suppress, the trial court
also conducted a hearing on Defendant’s competency motion. Dr. Montgomery testified
on Defendant’s behalf. In addition to the testimony summarized above, Dr. Montgomery
acknowledged that when he prepared his report in November 2020, he concluded that
Defendant was competent to stand trial. He further concluded that Defendant understood
the nature of the proceedings against him “basically by asking [Defendant] a series of
questions about his knowledge and familiarity with courtroom personnel and their
respective duties and obligations within that system[.]” Dr. Montgomery acknowledged
he was not a defense attorney, but when asked whether trial preparation went beyond “very
basic and rudimentary knowledge of the court system,” Dr. Montgomery responded, “I
                                           - 16 -
mean, we take that in[to] consideration. We will speak with attorneys when we do these
types of evaluations, ask them if they’re having any specific difficulties with the person
that they’re trying to assist.”

          The State presented the testimony of Marsha Slatten, a psychologist, who the trial
court accredited as an expert in certified forensic evaluations. She administered Defendant
the McGarry Competency Assessment Instrument (“McGarry Test”), which she described
as “a structured interview” which “addresses all the areas of competency, whether the
person has a basic understanding of court works, understanding of court. And it also looks
at. . . if they have any self-defeating behaviors, if they are able to work with their attorney.”

       Dr. Slatten testified that she did not have difficulty communicating with Defendant,
though at times she “had to redirect him. He had some circumstantial speech, which is
kind of getting off, like, what we were talking on, he would give me irrelevant information
sometimes. But I was able to redirect him back to the questions.” She was able to conduct
the McGarry Test in its entirety. Before conducting the test, Dr. Slatten had reviewed the
evaluations conducted by Dr. Montgomery and Dr. Spica, and based on their reports she
“wanted to make sure of [Defendant’s] ability to reason, his abstract reasoning. I wanted
to make sure how much he had left of abstract reasoning with dementia.” After her testing,
Dr. Slatten “found him to still have quite a bit of abstract reasoning,” as well as “some
concrete reasoning.” Dr. Slatten acknowledged that after asking Defendant about his
understanding of certain roles in the court system, Defendant’s answers reflected he
understood those roles (such as those of judge, prosecutor, and defense counsel). Based
on Defendant’s performance on the assessment, Dr. Slatten concluded Defendant was
competent to stand trial.

       Defense counsel also attempted to introduce the testimony of Chattanooga criminal
defense attorney Hank Hill. The defense wanted Mr. Hill to offer expert testimony as to
whether Defendant was competent to stand trial under the appropriate Tennessee legal
standard. Specifically, defense counsel wanted Mr. Hill to testify on the third prong of the
competency test—whether Defendant was capable of assisting in the preparation of his
defense. Counsel stated, “for Your honor to understand that, it takes a lawyer to testify
what is required.” The trial court expressed concern about a defendant’s potential
malingering as to that question, asking, “[W]hat if the defendant is choosing, by his own
accord, that he’s not going to participate, or he’s putting on a [ruse] about whether or not
to participate?” The court reasoned that while an attorney could testify as to a client’s
purported inability to participate in his defense, a mental health expert was needed to
determine whether “that choice he’s making [is] rational or not, or is it some mental defect
or disease[.]” The court added:

                                             - 17 -
       [I]t’s this [c]ourt’s opinion, for a witness to testify one’s not capable to assist,
       that becomes a—that becomes a decision that an expert makes on the
       psychological issues of the defendant. Because you are making a decision at
       that point that that person does not possess the mental acumen or the ability
       to assist, and that is to me, you’ve crossed the line into expert testimony in
       psychology and things of that nature. So that’s the reason why I’m not going
       to allow [Mr. Hill] to do that.

The trial court concluded Mr. Hill could not offer expert testimony on Defendant’s ability
to assist in his defense, but the court did permit the defense to offer Mr. Hill’s testimony
as an offer of proof into the record.

        Mr. Hill testified that he met with Defendant four times before the hearing
(including the morning of the hearing) and reviewed crime scene video, the psychological
evaluations, and Defendant’s interview with TBI. Mr. Hill explained that Defendant
consistently told him that the shootings were accidental and that his wife either died from
something unrelated to the shooting or she was still alive. Mr. Hill said that at one meeting,
Defendant would talk only about issues related to his housing at the local jail rather than
the facts of the case. Mr. Hill testified, “I don’t think that he’s capable of assisting you and
preparing for a defense in any sort of rational discussion with either counsel, with counsel
he has now, or with me.” Mr. Hill added that he could not diagnose Defendant with
dementia, “but if he does have dementia, it’s gotten significantly worse since the first time
I talked to him until today.” Mr. Hill spoke with Defendant shortly before the competency
hearing, and he was “almost unable to get . . . any rational discussion with him today at
all.” On cross-examination, Mr. Hill acknowledged that in the past, he has retained
psychologists or psychiatrists to opine whether a client is competent to stand trial.

       At the end of the competency hearing, the trial court concluded, based on the experts
from both sides concluding Defendant was competent to stand trial, that Defendant had not
carried his burden to establish that he was incompetent.

                                    2. Standards of Review

       “Both the Fourteenth Amendment to the United States Constitution and Article I,
section 8 of the Tennessee Constitution prohibit the trial of a person who is mentally
incompetent.” State v. Kiser, 284 S.W.3d 227, 283 (Tenn. 2009) (first citing Pate v.
Robinson, 383 U.S. 375, 378 (1966); and then citing State v. Blackstock, 19 S.W.3d 200,
205 (Tenn. 2000) (other citations omitted)). “In Tennessee, a criminal defendant is
presumed to be legally competent.” State v. Johnson, 401 S.W.3d 1, 17 (Tenn. 2013) (first
citing State v. Reid, 164 S.W.3d 286, 306-07 (Tenn. 2005); and then citing State v. Oody,
823 S.W.2d 554, 559 (Tenn. Crim. App. 1991)). “A defendant bears the burden of proving
                                              - 18 -
his or her incompetency by a preponderance of the evidence.” Johnson, 401 S.W.3d at 17
(Tenn. 2013) (citing Reid, 164 S.W.3d at 308) (other citations omitted).

       “To be competent to stand trial, a defendant in a criminal case must have ‘the
capacity to understand the nature and object of the proceedings against him, to consult with
counsel[,] and to assist in preparing his defense.’” Reid, 164 S.W.3d at 306 (first quoting
State v. Black, 815 S.W.2d 166, 174 (Tenn. 1991); and then citing Mackey v. State, 537
S.W.2d 704, 707 (Tenn. Crim. App. 1975)). “The trial court’s findings ‘are conclusive on
appeal unless the evidence preponderates otherwise.’” Reid, 164 S.W.3d at 306 (quoting
Oody, 823 S.W.2d at 559).

        Regarding the admissibility of expert testimony, Tennessee Rule of Evidence 702
provides, “[i]f scientific, technical, or other specialized knowledge will substantially 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 in the form
of an opinion or otherwise.” The admissibility of expert testimony is entrusted to the sound
discretion of the trial court, and “[r]eviewing courts will not reverse a decision regarding
the admission or exclusion of expert testimony unless the trial court has abused its
discretion.” State v. Scott, 275 S.W.3d 395, 404 (Tenn. 2010) (first citing State v. Reid, 91
S.W.3d 247, 294 (Tenn. 2002) (appendix)); State v. Copeland, 226 S.W.3d 287, 301 (Tenn.
2007). “A trial court abuses its discretion when it applies incorrect legal standards, reaches
an illogical conclusion, bases its decision on a clearly erroneous assessment of the
evidence, or employs reasoning that causes an injustice to the complaining party.” Scott,
275 S.W.3d at 404 (citing Konvalinka v. Chattanooga-Hamilton Cnty. Hosp. Auth., 249
S.W.3d 346, 358 (Tenn. 2008)).

        A proposed expert witness “may acquire the necessary expertise through formal
education or life experience.” Reid, 91 S.W.3d at 302 (citation omitted). “However, the
witness must have such superior skill, experience, training, education, or knowledge within
the particular area that his or her degree of expertise is beyond the scope of common
knowledge and experience of the average person.” Id. The determining factor is “whether
the witness’s qualifications authorize him or her to give an informed opinion on the subject
at issue.” State v. Stevens, 78 S.W.3d 817, 834 (Tenn. 2002).

       In this case, both Dr. Montgomery and Dr. Slatten testified that after their testing,
they concluded Defendant was competent to stand trial. In his report, Dr. Montgomery
wrote that as of testing, Defendant “had an adequate understanding of his legal peril to
enable him to assist his own attorney.” Based on this testimony, the trial court concluded
that Defendant failed to establish his lack of competency by a preponderance of the
evidence, and our review of the record shows nothing to suggest that the evidence
preponderates against the trial court’s conclusions.
                                             - 19 -
        The Defendant’s contentions on appeal focus largely on the trial court’s refusal to
allow Mr. Hill, a criminal defense attorney, to offer expert testimony regarding Defendant’s
competency. Although the trial court did not reference Rules 702 and 703 in concluding
Mr. Hill was not qualified to offer expert testimony, we conclude the trial court did not
abuse its discretion in refusing to allow Mr. Hill to offer expert testimony. We agree with
the trial court that its assessment that a defendant’s competency to stand trial is largely a
medical and psychological determination was a reasonable one. We agree with the trial
court that while an attorney can testify as to a defendant’s apparent inability to assist
counsel or otherwise aid in preparing his defense, a person without medical or
psychological training would be ill-suited to determine whether the defendant’s actions
result from a genuine inability to assist counsel due to a mental disease or defect or medical
issue, or from the defendant’s attempts to manipulate legal proceedings for his benefit. But
even if Mr. Hill were somehow qualified to offer opinion testimony as to Defendant’s
inability to assist counsel or aid in his defense, defense counsel admitted that Mr. Hill’s
testimony could not have aided the trial court in determining whether Defendant
understood the nature of the proceedings against him. Without any proof favorable to the
Defendant as to the first prong of the competency analysis, Mr. Hill’s testimony as to the
other two prongs of the competency analysis would have held little to no weight. And even
if the trial court had considered Mr. Hill’s testimony in determining Defendant’s
competency, his testimony would have been far outweighed by the credible testimony of
Dr. Montgomery and Dr. Slatten, both of whom concluded Defendant was competent to
stand trial.

        In sum, we conclude the evidence produced at the competency hearing does not
preponderate against the trial court’s conclusion that Defendant was competent to stand
trial, and the trial court did not abuse its discretion in refusing to allow Mr. Hill to testify
as an expert. Defendant is not entitled to relief on this issue.

                    C. Miranda Waiver and Voluntariness of Statement

       Defendant argues the trial court erred in admitting his statement given to TBI after
his arrest and treatment at Erlanger Hospital. He asserts that, contrary to the trial court’s
conclusions, his waiver of Miranda rights was not voluntarily, knowingly, and intelligently
given.

       On appeal, a trial court’s factual findings on a motion to suppress are conclusive
unless the evidence preponderates against them. State v. Binette, 33 S.W.3d 215, 217
(Tenn. 2000); State v. Odom, 928 S.W.2d 18, 23 (Tenn. 1996). Questions of credibility,
the weight and value of the evidence, and resolution of conflicting evidence are matters
entrusted to the trial court, and a reviewing court shall uphold the trial court’s findings of
                                             - 20 -
fact unless the evidence in the record preponderates against them. Odom, 928 S.W.2d at
23; see also Tenn. R. App. P. 13(d). However, we review the trial court’s application of
the law to the facts de novo. State v. Keith, 978 S.W.2d 861, 864 (Tenn. 1998).

        Both the Fifth Amendment to the United States Constitution and article I, section 9
of the Tennessee Constitution protect a person against compelled self-incrimination. The
Supreme Court has held that “the prosecution may not use statements, whether exculpatory
or inculpatory, stemming from custodial interrogation of the defendant unless it
demonstrates the use of procedural safeguards effective to secure the privilege against
self-incrimination.” Miranda v. Arizona, 384 U.S. 436, 444 (1966). These procedural
safeguards require an accused to be advised, prior to a custodial interrogation, that “he has
the right to remain silent, that any statement he does make may be used against him, and
that he has a right to the presence of an attorney, either retained or appointed.” Id.
“Pursuant to Miranda, custodial interrogation entails ‘questioning initiated by law
enforcement officers after a person has been taken into custody or otherwise deprived of
his freedom of action in any significant way.’” State v. Goss, 995 S.W.2d 617, 628 (Tenn.
Crim. App. 1998) (quoting Miranda, 384 U.S. at 444). The protections provided under
Miranda apply “when the defendant is in custody and is subjected to questioning or its
functional equivalent.” State v. Walton, 41 S.W.3d 75, 82 (Tenn. 2001) (emphasis added)
(citing Rhode Island v. Innis, 446 U.S. 291 (1980)). There is no dispute that in this case,
Defendant was subject to a custodial interrogation.

        The State may not use an accused’s statements from a custodial interrogation unless:
(1) the accused has been previously advised of his constitutional rights to remain silent and
to an attorney, and (2) the accused knowingly, voluntarily, and intelligently waives those
rights. See Miranda, 384 U.S. at 444. Whether the accused’s Miranda waiver is
voluntarily, knowingly, and intelligently made is determined by the totality of the
circumstances under which the right was waived. See State v. Middlebrooks, 840 S.W.2d
317, 326 (Tenn. 1992). The waiver must be “made with full awareness of both the nature
of the right being abandoned and the consequences of the decision to abandon it.” State v.
Blackstock, 19 S.W.3d 200, 208 (Tenn. 2000) (citing State v. Stephenson, 878 S.W.2d 530,
544-45 (Tenn. 1994)). The State bears the burden of proving a knowing, intelligent, and
voluntary waiver by a preponderance of the evidence. State v. Bush, 942 S.W.2d 489, 500
(Tenn. 1997).

       The Supreme Court has also held that a confession that is the product of coercive
State action is involuntary. See, e.g., Colorado v. Connelly, 479 U.S. 157, 163-64, (1986).
At a suppression hearing, the State must prove the voluntariness of a confession by a
preponderance of the evidence. See State v. Stamper, 863 S.W.2d 404, 405-06 (Tenn.
1994) (citing Lego v. Twomey, 404 U.S. 477, 486-87 (1972)). “The test of voluntariness
for confessions under article I, § 9 of the Tennessee Constitution is broader and more
                                           - 21 -
protective of individual rights than the test of voluntariness under the Fifth Amendment.”
State v. Smith, 933 S.W.2d 450, 455 (Tenn. 1996) (citing State v. Stephenson, 878 S.W.2d
530, 544 (Tenn.1994)). A confession may be considered voluntary if it is not the product
of “any sort of threats or violence, . . . any direct or implied promises, however slight, nor
by the exertion of any improper influence.” State v. Smith, 42 S.W.3d 101, 109 (Tenn.
Crim. App. 2000) (quoting Bram v. United States, 168 U.S. 532, 542-43 (1897)). However,
“[a] defendant’s subjective perception alone is not sufficient to justify a conclusion of
involuntariness in the constitutional sense.” State v. Berry, 154 S.W.3d 549, 577 (Tenn.
2004) (citing Smith, 933 S.W.2d at 455). Rather, the essential question is “whether the
behavior of the State’s law enforcement officials was such as to overbear [the defendant’s]
will to resist and bring about confessions not freely self-determined . . . .” State v. Kelly,
603 S.W.2d 726, 728 (1980) (quoting Rogers v. Richmond, 365 U.S. 534, 544 (1961)).

        Courts look to the totality of the circumstances in determining whether a confession
is voluntary. See Smith, 933 S.W.2d at 455. In State v. Huddleston, 924 S.W.2d 666, 671
(Tenn. 1996), the Tennessee Supreme Court identified a non-exclusive list of factors for
the trial court to consider in determining the voluntariness of a confession:

       The age of the accused; his lack of education or his intelligence level; the
       extent of his previous experience with the police; the repeated and prolonged
       nature of the questioning; the length of the detention of the accused before
       he gave the statement in question; the lack of any advice to the accused of
       his constitutional rights; whether there was an unnecessary delay in bringing
       him before a magistrate before he gave the confession; whether the accused
       was injured[,] intoxicated[,] or drugged, or in ill health when he gave the
       statement; whether the accused was deprived of food, sleep, or medical
       attention; whether the accused was physically abused; and whether the
       suspect was threatened with abuse.

(citations omitted).

        “The ingestion of drugs and alcohol does not in and of itself render any subsequent
confession involuntary.” State v. Morris, 24 S.W.3d 788, 805 (Tenn. 2000) (quoting State
v. Robinson, 622 S.W.2d 62, 67 (Tenn. Crim. App. 1980)); see also State v. Perry, 13
S.W.3d 724, 738 (Tenn. Crim. App. 1999) (citations omitted) (“[A] statement provided by
a suspect who is under the influence of drugs is admissible so long as the statement is
coherent.”). “Mental unsoundness will not render a confession invalid, so long as the
evidence demonstrates that the suspect was capable of understanding and waiving his
rights.” Perry, 13 S.W.3d at 738 (citing State v. Bell, 690 S.W.2d 879, 882 (Tenn. Crim.
App. 1985)).

                                            - 22 -
       Here, Defendant points to several factors in arguing that his rights waiver was not
knowing, intelligent, and voluntary. Defendant asserts that Dr. Montgomery testified that
Defendant was not paying attention at the time he was advised of his Miranda rights.
Defendant also emphasizes that he was seventy-four years old at the time of the interview,
was not familiar with the interview process because he had never been in trouble with the
law, and suffered from dementia and “severe cognitive issues which adversely affected his
executive functioning, and correspondingly, his ability to pay attention and stay focused[.]”
Defendant also asserts that he “was intellectually functioning on the level of a
six[-]year[-]old child” and that “the aforementioned significant factors were compounded
by lack of sleep, the acute trauma from the day’s events, [and] the sedatives and narcotic
pain medications [he] had received earlier that day due to the gunshot wound to his head[.]”

        However, several other facts support the trial court’s conclusion that the State
established Defendant knowingly, intelligently, and voluntarily waived his rights at the
time of the interview. Agent Legg characterized his interactions with Defendant as cordial
and observed that Defendant was eager to talk. Although Defendant occasionally strayed
from relating his version of the events relating to the victims’ deaths, Agent Legg was able
to redirect Defendant accordingly. While Defendant mentioned he had been awake since
the previous morning at 3:30 a.m., he also mentioned lying “across the back seat with a
pillow” until “maybe a quarter till 2:00 [p.m.], something like that,” before heading “[r]ight
to Speedway.” Further, Lt. Lester’s testimony shows Defendant napped while the
lieutenant drove him after he was discharged from Erhlanger in Chattanooga until they
arrived at Crossville. There is no proof in the record suggesting that Defendant suffered
from food or sleep deprivation at the time of the interview; Defendant did not mention
being tired or hungry during the interview. Defendant was given pain medications and
sedatives before and during his treatment at Erlanger, but there is nothing in the record
suggesting that the medications’ effects on Defendant were anything other than what Dr.
Fox opined they were: short-lasting. Agent Legg did not observe Defendant acting as if he
were feeling the ill effects of any medication, and perhaps more convincingly, hospital
records reflect Defendant was alert at the time he was discharged from the hospital.
Additionally, there is nothing in the record suggesting that Defendant was threatened or
abused in any way before or during the interview. Finally, while Defendant asserts that his
waiving his constitutional rights at the beginning of the interview before invoking his right
to counsel at the end of the interview reflected Defendant acted irrationally, we agree with
the State’s assessment that such actions reflect Defendant understood his rights and knew
when to invoke them.

      In light of the above evidence, we conclude that the evidence at trial does not
preponderate against the trial court’s conclusion that the State established Defendant
knowingly, voluntarily, and intelligently waived his rights at the start of the interview.
Those same facts also lead this court to conclude Defendant’s resulting statement was
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voluntary and did not result from coercion. Defendant is therefore not entitled to relief on
this issue.

                                    D. Denial of Continuance

        Defendant contends the trial court abused its discretion when it refused to grant a
continuance “based on the last minute change of opinion” of Dr. Montgomery, who had
testified for the defense at the pretrial hearings addressing Defendant’s competency and his
motion to suppress his statement. Defendant argues the trial court’s denial of the
continuance denied his ability to retain an alternate mental health expert to provide critical
evidence that was both relevant and material.

                                       1. Hearing on Motion

       On Monday, September 13, 2021, the day before trial in this case was to begin,
defense counsel filed a motion to continue the trial based in part 2 on Dr. Montgomery’s
unwillingness to offer testimony that Defendant lacked the capacity to form the requisite
mental state of premeditation. At the hearing on the motion, defense counsel stated that
Dr. Montgomery had worked with the defense since 2019.3 On the Saturday before this
hearing, Dr. Montgomery informed defense counsel that “his previous opinion regarding
[Defendant’s] ability to form any degree of premeditation had potentially changed, and he
would no longer be able to offer any opinion that might benefit us, or help in assisting the
defense.” Defense counsel asserted that Dr. Montgomery’s decision caused the defense
strategy to “change[] abruptly. And, again, we believe that affects directly and adversely
[Defendant]’s constitutional rights[.]” Counsel sought a continuance “in order to seek out
and obtain an additional expert that may be better able to assist us in his defense.”

       The State acknowledged that the evaluation conducted by Dr. Montgomery and the
testing conducted by Dr. Spica indicated that Defendant suffered from Lewy body
dementia, which would “have an effect on . . . [Defendant’s] ability to form
premeditation[.]” The State emphasized that the Dr. Montgomery’s report was compiled
“approximately a year and nine months after the event, not at the time of the event.”
Furthermore, Dr. Spica’s evaluation “was done in excess of two years . . . following the

       2
       The motion to continue raised two grounds; the only ground being addressed in this appeal is Dr.
Montgomery’s withdrawal from the case on the eve of trial.

       3
         In his report, completed November 2, 2020, Dr. Montgomery wrote that Defendant, on the day of
the offense, “was not thinking calmly and rationally” and suffered from depression and dementia. Dr.
Montgomery added that Defendant’s “mental disorders of major disorder and major neurocognitive
disorder caused him to lack the capacity for premeditation. . . . [H]e was not sufficiently free from
excitement and passion as to have been capable of exercising reflection and judgment prior to acting.”
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homicide. And [Dr. Montgomery’s] testimony on cross-examination was, he didn’t look
at anything other than some old medical records.” Thus, the State contended that Dr.
Montgomery’s assessment that he could no longer testify about diminished capacity “was
likely.”

       In denying the continuance, the trial court recounted that Defendant’s indictment
was returned January 7, 2019. The court continued, “And since then, we’ve had numerous
hearings, but we’ve also been interrupted by Covid, for sure[.]” The court continued that
even during pandemic-related court system slowdowns, “the process never complete[ly]
stopped on [Defendant]’s case.” The trial court added,

       I think the Tennessee Constitution and the United States Constitution
       guarantees a fair trial, but it doesn’t guarantee a perfect trial. There’s no such
       thing. Perfect trials don’t happen. We get as good as we can, and we try to
       make them as good as we can, but they’re human, and there may be human
       parts, and human parts always fall short.

               And so we’ve got an expert that was working with the defense
       throughout all of this, and he’s changed his opinion. And I don’t know that
       there’s any prejudice in that. And the defense could argue, [“]Well, Judge,
       we can’t find anybody else that can say there is in this amount of time.[”]
       And I appreciate that, and I understand that. But it seems to me, that expert,
       just like a witness, at the last second could change their mind and decide that
       they see things—you know, they see the color is blue instead of red, and it
       throws a monkey wrench into the case. These are the things that happen at
       trial. And if the [c]ourt grants a continuance on every single time that we
       have a witness that changes their opinion, then, it seems to me like, these
       types of cases could go on indefinitely. And so I don’t—at this point, we’re
       going to move forward with the trial.

                                   2. Standard of Review

       The grant or denial of a continuance rests within the sound discretion of the trial
court. State v. Rimmer, 250 S.W.3d 12, 40 (Tenn. 2008) (citing State v. Odom, 137 S.W.3d
572, 589 (Tenn. 2004)). This court will reverse the trial court’s decision to deny a
continuance “only if it appears that the trial court abused its discretion to the prejudice of
the defendant.” Odom, 137 S.W.3d at 589 (citing State v. Hines, 919 S.W.2d 573, 579
(Tenn. 1995)). “An abuse of discretion is demonstrated by showing that the failure to grant
a continuance denied defendant a fair trial or that it could be reasonably concluded that a
different result would have followed had the continuance been granted.” Hines, 919
S.W.2d at 579 (citing State v. Wooden, 658 S.W.2d 553, 558 (Tenn. Crim. App. 1983)). If
                                             - 25 -
a defendant claims that the denial of a continuance constitutes a denial of due process, the
defendant bears the burden of establishing actual prejudice. Rimmer, 250 S.W.3d at 40
(citing Odom, 137 S.W.3d at 589).

        Here, we agree with the State that Defendant has failed to establish the trial court
abused its discretion in denying Defendant’s continuance motion. Defendant failed to
show actual prejudice because at the motion for new trial hearing, Defendant failed to
present evidence (in the form of witness testimony, affidavit, or otherwise) that had a
continuance been granted, Defendant would have found an expert able to conclude
Defendant lacked the capacity to premeditate his actions. See, e.g., State v. Russell, 10
S.W.3d 270, 275 (Tenn. Crim. App. 1999) (“If the defendant wished to demonstrate
prejudice, he could have done so by submitting an affidavit of the [supposed] material
witness in support of the motion for continuance or presenting the witness’s testimony at
the hearing on the motion for new trial”); State v. Winston, No. W2021-01315-CCA-R3-
CD, 2022 WL 17665684, at *18 (Tenn. Crim. App. Dec. 14, 2022) (defendant failed to
show prejudice when he “did not present any proof at the hearing on the motion for new
trial establishing that additional time to review the records and conduct a further
investigation could have provided additional helpful evidence”), perm. app. denied (Tenn.
Mar. 8, 2023). Furthermore, even if Defendant had presented proof at trial concerning his
inability to premeditate, such proof would have had to be weighed against the ample proof
of premeditation set forth above. Because Defendant has failed to establish the trial court’s
denial of the continuance prejudiced him, we conclude the trial court did not abuse its
discretion in denying the continuance motion. Defendant is not entitled to relief on this
issue.

                                      III. Conclusion

        In consideration of the foregoing and the record as a whole, the judgments of the
trial court are affirmed.

                                                    _________________________________

                                                    MATTHEW J. WILSON, JUDGE

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