State v. Eddie N. C. , 178 Conn. App. 147 ( 2017 )


Menu:
  • ***********************************************
    The “officially released” date that appears near the be-
    ginning of each opinion is the date the opinion will be pub-
    lished in the Connecticut Law Journal or the date it was
    released as a slip opinion. The operative date for the be-
    ginning of all time periods for filing postopinion motions
    and petitions for certification is the “officially released”
    date appearing in the opinion.
    All opinions are subject to modification and technical
    correction prior to official publication in the Connecticut
    Reports and Connecticut Appellate Reports. In the event of
    discrepancies between the advance release version of an
    opinion and the latest version appearing in the Connecticut
    Law Journal and subsequently in the Connecticut Reports
    or Connecticut Appellate Reports, the latest version is to
    be considered authoritative.
    The syllabus and procedural history accompanying the
    opinion as it appears in the Connecticut Law Journal and
    bound volumes of official reports are copyrighted by the
    Secretary of the State, State of Connecticut, and may not
    be reproduced and distributed without the express written
    permission of the Commission on Official Legal Publica-
    tions, Judicial Branch, State of Connecticut.
    ***********************************************
    STATE OF CONNECTICUT v. EDDIE N. C.*
    (AC 39878)
    DiPentima, C. J., and Prescott and Mihalakos, Js.
    Syllabus
    Convicted of the crimes of risk of injury to a child and sexual assault in
    the first degree in connection with his alleged sexual abuse of the minor
    victim, who was his cousin, the defendant appealed to this court. He
    claimed, inter alia, that the trial court improperly admitted into evidence,
    under the applicable provision of the Connecticut Code of Evidence
    (§ 4-5 [b]), certain prior sexual misconduct testimony from his cousin,
    S, and certain statements that the victim had made to her mother, to
    the victim’s treating physicians, P, W and L, and to a social worker, V,
    under the medical diagnosis and treatment exception to the hearsay
    rule. Held:
    1. The trial court did not abuse its discretion in admitting the prior uncharged
    misconduct evidence concerning the defendant’s alleged sexual abuse
    of S: the twelve year gap between the uncharged conduct and the conduct
    with which the defendant was charged here was not too remote in time,
    the charged and uncharged conduct were sufficiently similar, and S and
    the victim were sufficiently similar to each other, as many of the acts
    the defendant performed on S and the victim were identical, the abuse
    of S and the victim occurred in the defendant’s home and in the vicinity
    of other family members, and S and the victim were cousins of the
    defendant who were nearly identical in age when he began abusing
    them; moreover, the prior uncharged misconduct evidence involving S
    was highly probative, and the prejudicial effect of S’s testimony was no
    more severe or egregious than the conduct with which the defendant
    was charged here.
    2. The defendant could not prevail on his claim that the trial court improperly
    admitted into evidence, under the medical diagnosis and treatment
    exception to the hearsay rule, certain of the victim’s statements to her
    mother, and to P, W and V, the record having amply supported that
    court’s determination that the victim’s statements were made for the
    purpose of, and were reasonably pertinent to, obtaining medical diagno-
    sis and treatment: it was necessary for P to ask the victim about the
    duration, frequency, method and extent of the abuse for P to be able
    to treat the victim and to determine whether to transfer her to a hospital
    that specialized in treating child victims of sexual abuse, the victim’s
    statements to W about the acts committed by the defendant and about
    the victim’s pain level, as well as W’s observations regarding injuries to
    the victim’s genitalia, were necessary to determine the appropriate scope
    of treatment and the extent of the victim’s physical and psychological
    abuse, and although the defendant claimed that the purpose of V’s
    forensic interview of the victim was investigatory, the court did not
    abuse its discretion in admitting the victim’s statements to V under the
    medical diagnosis and treatment exception to the hearsay rule after
    finding that at least one purpose of the interview was to assist P’s
    medical examination of the victim; moreover, any error in the admission
    of the victim’s statement to her mother that the defendant had licked
    her private parts was harmless, as the victim’s statement was cumulative
    of similar statements she made to others, the overall strength of the
    state’s case was high, and the victim’s allegations were bolstered by S’s
    testimony that the defendant had abused S in the same way when S
    was the victim’s age.
    3. The defendant’s unpreserved claims that the trial court committed plain
    error by admitting the opinions of P and W that the victim had been
    sexually assaulted and by permitting P and W to improperly vouch for
    the victim’s credibility were unavailing: even if the admission of the
    challenged evidence was improper, any evidentiary impropriety under
    the circumstances at issue did not result in manifest injustice thereby
    requiring reversal of the judgment, as defense counsel brought to the
    jury’s attention P’s diagnosis of sexual assault and, on cross-examination
    of P and W, ameliorated significantly any harmful effect of their testi-
    mony and the admission of certain medical records, and the state, during
    closing argument, did not rely on the opinions of P or W as to whether
    the victim had been sexually assaulted but, instead, emphasized the
    medical findings of physical injury to the victim and that those findings
    were consistent with the victim’s allegations of sexual assault; moreover,
    defense counsel made clear during closing argument that the jury was
    not bound by any of the physicians’ diagnoses of sexual assault, and
    even if L’s testimony improperly vouched for the victim’s credibility,
    any error did not rise to the level of manifest injustice, as the state’s
    case against the defendant was strong, and the victim’s allegations were
    corroborated by S’s testimony and W’s findings that the victim had
    sustained physical injuries to her genitals after the victim alleged that
    the defendant had sexually assaulted her earlier that day.
    Argued September 7—officially released November 21, 2017
    Procedural History
    Substitute information charging the defendant with
    four counts of the crime of risk of injury to a child and
    three counts of the crime of sexual assault in the first
    degree, brought to the Superior Court in the judicial
    district of Waterbury, where the court, Crawford, J.,
    denied in part the defendant’s motion to preclude cer-
    tain evidence and granted the state’s motion to intro-
    duce certain evidence; thereafter, the matter was tried
    to the jury; verdict and judgment of guilty, from which
    the defendant appealed to this court. Affirmed.
    Heather Clark, assigned counsel, for the appellant
    (defendant).
    Kathryn W. Bare, assistant state’s attorney, with
    whom, on the brief, were Maureen Platt, state’s attor-
    ney, and Catherine Brannelly Austin, supervisory
    assistant state’s attorney, for the appellee (state).
    Opinion
    PRESCOTT, J. The defendant, Eddie N. C., appeals
    from the judgment of conviction, rendered after a jury
    trial, of three counts of sexual assault in the first degree
    in violation of General Statutes § 53a-70 (a) (2); three
    counts of risk of injury to a child in violation of General
    Statutes § 53-21 (a) (2); and one count of risk of injury
    to a child in violation of General Statutes § 53-21 (a)
    (1). The defendant claims that the trial court improperly
    admitted (1) prior misconduct testimony, (2) state-
    ments made by the victim, A, to her mother, treating
    physicians, and a social worker under the medical diag-
    nosis and treatment exception to the hearsay rule, and
    (3) opinion evidence regarding the ultimate issue of
    whether A had been sexually assaulted, which the
    defendant claims constitutes plain error. We disagree
    and, accordingly, affirm the judgment of the trial court.
    The jury reasonably could have found the following
    facts. A was five or six years old when the defendant
    began sexually assaulting her. The defendant is the first
    cousin of A’s mother, J. In 2013, J worked as a dialysis
    technician three or more days a week. Her shift began
    at 4:30 a.m. and ended at 8 p.m. Due to the lack of
    available day care, J approached the defendant and his
    wife, Ashley C., and asked whether they would be able
    to babysit A on the days J worked. The defendant and
    Ashley C. agreed, and began babysitting A around Sep-
    tember, 2013.
    The dialysis center where J worked was approxi-
    mately forty-five minutes away from her home, so J
    would drop A off at the defendant’s house at approxi-
    mately 3 a.m. A would then sleep or watch television
    on the couch in the defendant’s living room until it was
    time for school. A returned to the defendant’s house
    after school and remained there until J was able to pick
    her up after work—usually between 8 and 10 p.m.
    On April 9, 2014, the defendant and Ashley C. were
    babysitting A when A disclosed to Ashley C. that the
    defendant did ‘‘nasty stuff’’ to her in the kitchen. Ashley
    C. called J and relayed that A had told her that the
    defendant was ‘‘doing things’’ to her and that A ‘‘wanted
    it to stop.’’ Ashley C. was too upset to repeat A’s exact
    words and told J that she should leave work.
    On her way to the defendant’s house, J called the
    police and asked them to meet her because A was alone
    with the defendant and Ashley C. and J ‘‘didn’t feel safe.’’
    J and the responding police officer, James McMahon,
    arrived at the defendant’s home at approximately the
    same time. When J entered the defendant’s home, A
    began to cry. The defendant, who was sitting in the
    kitchen, said to J, ‘‘[J], you know me. You know I
    wouldn’t do this.’’
    McMahon then spoke with the defendant and asked
    dant initially responded that he had not, but later in
    the conversation admitted that there were times he was
    alone with her in the morning when Ashley C. was in the
    shower. McMahon also asked the defendant whether he
    had had physical contact with A, to which the defendant
    responded that he occasionally would make ‘‘farting
    noises on her belly’’ when the two were playing around.
    After a short period, J and A left the defendant’s
    house and drove to Waterbury Hospital. In the car on
    the way to the hospital, J asked A to tell her the truth
    about what happened. A responded, ‘‘Mom, he was lick-
    ing my private parts.’’
    J and A arrived at Waterbury Hospital, and A was
    seen by Dr. Lauren Py in the emergency department.
    Dr. Py conducted a general examination of A. During
    the examination, A told Dr. Py that the defendant had
    abused her earlier that day, as well as on previous
    occasions. Specifically, A told Dr. Py that the defendant
    would sometimes take her pants down, touch her, and
    ‘‘lick her in her private parts.’’ A also told Dr. Py that
    she had pain in her genital region. After Dr. Py’s exami-
    nation, she recommended to J that A be transferred
    to either Yale-New Haven Hospital or the children’s
    hospital in Hartford, both of which specialize in treating
    cases of child sexual abuse.
    A was then seen at Yale-New Haven Hospital by Dr.
    Susan Walsh in the pediatric emergency department. A
    reported to Dr. Walsh that the defendant had touched
    her breasts, mouth, and vagina, as well as penetrated
    her vaginally with his penis. A also reported that she
    had pain in her genital region and vaginal discharge.
    In addition to conducting an interview, Dr. Walsh
    performed an external physical examination of A. Dur-
    ing the evaluation, Dr. Walsh observed that A’s vagina
    was extremely tender to the touch and that A was tear-
    ful. Dr. Walsh further observed that there was discharge
    on A’s labia, that the flap of skin over A’s clitoris was
    especially tender and red, and that A had sustained an
    abrasion on the lips of her vagina. Dr. Walsh also took
    swabs from A’s vagina and anus using a sexual assault
    kit, and took an additional sample from A of what Dr.
    Walsh believed was bodily fluid.1
    After the examination, Dr. Walsh referred A to the
    Yale Child Sexual Abuse Clinic. Monica Vidro, a licensed
    clinical social worker at the Yale Child Sexual Abuse
    Clinic, called J to set up a follow-up examination of A.
    On April 16, 2014, Vidro conducted a forensic interview
    of A, which was observed by Dr. Lisa Pavlovic of the
    Yale Child Sexual Abuse Clinic; Daniel Dougherty, a
    detective in the sex crimes unit of the Waterbury Police
    Department; and a representative from the Department
    of Children and Families.
    During the forensic interview, A disclosed to Vidro
    that the defendant had licked her genitals, as well as
    put his penis in her vagina and anus. A identified the
    vagina and buttocks of a prepubescent female and the
    penis of a male on respective anatomically correct
    drawings. A also told Vidro that the defendant had mas-
    turbated in front of her to the point of ejaculation, and
    demonstrated how the defendant had moved his hands
    up and down his penis. Finally, A disclosed to Vidro
    that the defendant had shown her pornography and
    described certain characteristics of the individuals fea-
    tured in the film.
    After attending the forensic examination of A con-
    ducted by Vidro, Dougherty contacted the defendant
    and asked whether he would be willing to meet. The
    defendant indicated that he would. The meeting took
    place at the Waterbury Police Department, during
    which the defendant voluntarily waived his rights and
    agreed to answer Dougherty’s questions. The defendant
    told Dougherty that on the afternoon of April 9, 2014,
    Ashley C. told him that A had said that the defendant
    was doing ‘‘nasty things’’ to her. The defendant told
    Ashley C. that he had ‘‘fart[ed]’’ on A. The defendant
    also voluntarily submitted a cheek swab for DNA and
    allowed Dougherty to search his phone for por-
    nography.2
    At trial, the state presented testimony from A, J,
    McMahon, Dr. Py, Dr. Walsh, Vidro, Dougherty, A’s kin-
    dergarten teacher, Sarah Feola,3 Dr. Pavlovic, and A’s
    maternal aunt, S. The state also introduced into evi-
    dence A’s medical records from Waterbury Hospital
    and Yale-New Haven Hospital, as well as a portion of
    A’s forensic interview.
    At the time of trial, A was seven years old. A testified
    that the defendant had penetrated her anally with his
    penis, as well as performed oral sex on her. A supple-
    mented her testimony by circling the parts of her body
    that the defendant touched with his penis on an anatom-
    ically correct drawing of a young female. A also demon-
    strated the acts that the defendant had subjected her
    to using anatomically correct dolls.
    A further testified that after the defendant engaged
    in anal intercourse with her, he masturbated until a
    ‘‘light green . . . light yellow’’ substance came out of
    his penis, and that he wiped his ejaculate on a piece
    of toilet paper and showed it to A before throwing it
    away. Finally, A testified that the defendant had showed
    her pornographic movies and described to the jury cer-
    tain characteristics of the actors. Specifically, A
    described the actors’ gender, race, clothing, the size of
    the bed featured, and the acts performed.
    When A was asked whether any of the defendant’s
    body parts besides his tongue had touched her vagina,
    she responded that they had not. The state then entered
    into evidence segments of A’s forensic interview, con-
    ducted by Vidro, in which A disclosed that the defendant
    had penetrated her vagina with his penis.
    The defendant testified in his own defense,4 as well
    as presented testimony from Ashley C.,5 neighbor Fran-
    sauch Marleen Castillo, and family friend Christy C.6
    The defendant also submitted as evidence a stipulation
    that stated that he had not contributed to any DNA
    found in a biological sample taken from A shortly after
    she reported the abuse on April 9, 2014.
    Subsequently, the jury returned a verdict of guilty on
    all seven counts: three counts of sexual assault in the
    first degree in violation of § 53a-70 (a) (2) (count one:
    cunnilingus; count three: penile-vaginal penetration;
    count five: penile-anal penetration); three counts of risk
    of injury to a child in violation of § 53-21 (a) (2) (count
    two: mouth-genital area; count four: penis-genital area;
    count six: penis-buttocks area); and one count of risk
    of injury to a child in violation of § 53-21 (a) (1) (count
    seven: pornography). The court sentenced the defen-
    dant to a total effective term of twenty-five years of
    incarceration and twenty-five years of special parole.
    This appeal followed. Additional facts and procedural
    history will be set forth as necessary.
    I
    The defendant first claims on appeal that the trial
    court improperly admitted into evidence prior miscon-
    duct testimony through the defendant’s cousin, S, to
    prove the defendant’s propensity to engage in sexual
    misconduct. Specifically, the defendant argues that the
    misconduct complained of by S was (1) remote in time
    compared to the offenses charged; (2) dissimilar to the
    offenses charged; and (3) not committed on someone
    similar to A. The defendant further argues that the evi-
    dence should have been excluded because its probative
    value does not outweigh its prejudicial effect. We
    disagree.
    The following additional facts and procedural history
    are relevant to this claim. On June 1, 2015, the state
    filed a motion stating its intent to offer uncharged mis-
    conduct evidence at trial, through S, the then twenty-
    three year old first cousin of the defendant, to prove
    that the defendant had a propensity to engage in the
    type of sexual misconduct complained of by A. The
    state proffered that the defendant had sexually abused
    S when she was a child, beginning when she was four
    or five and continuing until the age of ten.7 The state
    further proffered that the majority of the abuse
    occurred at the defendant’s family home. For the first
    two or three years, the defendant inappropriately
    touched S’s chest and vagina over her clothes. When
    S was seven, however, the abuse progressed to the
    defendant performing oral sex on her, anally penetrat-
    ing her with his penis, and vaginally penetrating her
    with his fingers. The state also proffered that the defen-
    dant had shown S pornographic movies.
    The state argued that the prior misconduct evidence
    was relevant because (1) S and A were the same age
    when the alleged abuse began; (2) S and A are both
    cousins of the defendant; (3) the instances of the alleged
    abuse occurred in the defendant’s home; and (4) the
    charged and uncharged conduct was nearly identical.
    The state further argued that, considering these similari-
    ties, the twelve years between the charged and
    uncharged acts did not render the prior misconduct too
    remote in time.
    On June 8, 2015, the defendant filed a motion in limine
    seeking to preclude the prior misconduct testimony of
    S. In support of his motion, the defendant argued that S
    and A were not similarly situated because the defendant
    was a minor himself when he allegedly abused S. The
    defendant further argued that the conduct complained
    of by S was too remote in time relative to the charged
    conduct because it occurred more than one decade
    beforehand. Finally, the defendant argued that the pro-
    bative value of the evidence was minimal and out-
    weighed by its prejudicial effect.
    On June 16 and 24, 2015, the court heard oral argu-
    ment on the defendant’s motion in limine. The court
    subsequently denied the defendant’s motion to preclude
    prior misconduct testimony offered by the state through
    S. The court concluded that S and A were sufficiently
    similar persons, noting that both victims were similar
    in age when the misconduct began and were cousins
    of the defendant. The court further concluded that the
    alleged conduct was sufficiently similar, and that the
    gap in time between S’s allegations and A’s allegations
    was not too remote in light of relevant case law dis-
    cussing remoteness. Finally, the court determined that
    the probative value of the evidence outweighed its prej-
    udicial effect. Accordingly, S was allowed to testify at
    trial about the defendant’s prior misconduct.8
    We begin our analysis of the defendant’s claim by
    setting forth the applicable standard of review. ‘‘The
    admission of evidence of prior uncharged misconduct
    is a decision properly within the discretion of the trial
    court. . . . [E]very reasonable presumption should be
    given in favor of the trial court’s ruling. . . . [T]he trial
    court’s decision will be reversed only where abuse of
    discretion is manifest or where injustice appears to
    have been done.’’ (Internal quotation marks omitted.)
    State v. Heck, 
    128 Conn. App. 633
    , 638, 
    18 A.3d 673
    ,
    cert. denied, 
    301 Conn. 935
    , 
    23 A.3d 728
     (2011).
    As a general rule, prior misconduct evidence is inad-
    missible to prove the defendant’s bad character or crim-
    inal tendencies. See Conn. Code Evid. § 4-5 (a)
    (‘‘[e]vidence of other crimes, wrongs or acts of a person
    is inadmissible to prove the bad character, propensity,
    or criminal tendencies of that person except as provided
    in subsection [b]’’). In State v. DeJesus, 
    288 Conn. 418
    ,
    470, 
    953 A.2d 45
     (2008), however, our Supreme Court
    recognized ‘‘a limited exception to the prohibition on
    the admission of uncharged misconduct evidence in sex
    crime cases to prove that the defendant had a propen-
    sity to engage in aberrant and compulsive criminal sex-
    ual behavior.’’ (Emphasis in original.) This exception to
    the admission of propensity evidence was subsequently
    codified in § 4-5 (b) of the Connecticut Code of
    Evidence.
    Under § 4-5 (b) and DeJesus, evidence of uncharged
    sexual misconduct is admissible ‘‘if it is relevant to
    prove that the defendant had a propensity or a tendency
    to engage in the type of aberrant and compulsive crimi-
    nal sexual behavior with which he or she is charged.’’
    Id., 473. ‘‘[E]vidence of uncharged misconduct is rele-
    vant to prove that the defendant had a propensity or a
    tendency to engage in the crime charged only if it is
    (1) . . . not too remote in time; (2) . . . similar to the
    offense charged; and (3) . . . committed upon persons
    similar to the [complaining] witness.’’ (Internal quota-
    tion marks omitted.) Id. In addition, the court must also
    find that the probative value of the evidence ‘‘outweighs
    the prejudicial effect that invariably flows from its
    admission.’’9 (Internal quotation marks omitted.) Id.
    The defendant first argues that the prior misconduct,
    which occurred twelve years before the charged con-
    duct, is too remote in time. In assessing remoteness,
    ‘‘we compare the time with reference to the period
    between the cessation of the prior misconduct and the
    beginning of the charged sexual abuse.’’ (Internal quota-
    tion marks omitted.) State v. Antonaras, 
    137 Conn. App. 703
    , 716, 
    49 A.3d 783
    , cert. denied, 
    307 Conn. 936
    , 
    56 A.3d 716
     (2012). Our Supreme Court has declined to
    ‘‘adopt a bright line rule for remoteness, or a rule that
    establishes a presumption that after ten years the
    uncharged conduct is too remote.’’ State v. Acosta, 
    326 Conn. 405
    , 414, 
    164 A.3d 672
     (2017). Thus, although
    ‘‘increased remoteness in time does reduce the proba-
    tive value of prior misconduct evidence . . . it alone
    is not determinative.’’ (Citations omitted; internal quota-
    tion marks omitted.) 
    Id.,
     414–15. ‘‘[R]elatively remote
    uncharged sexual misconduct evidence’’ may be admis-
    sible ‘‘if the other relevant similarities [warrant] it.’’
    Id., 415.
    Here, the twelve year gap between the uncharged and
    charged conduct does not render the prior misconduct
    evidence per se inadmissible. Our Supreme Court has
    concluded that prior misconduct evidence is admissible
    even if it occurred twelve years before the charged
    misconduct in light of the relative strength of the other
    two DeJesus prongs. See id. (holding that twelve year
    gap between uncharged and charged conduct not too
    remote); State v. Jacobson, 
    283 Conn. 618
    , 632–33, 
    930 A.2d 628
     (2007) (ten year gap not too remote); State v.
    Romero, 
    269 Conn. 481
    , 498, 
    849 A.2d 760
     (2004) (nine
    year gap not too remote). Although our Supreme Court
    has acknowledged that ‘‘twelve years is not an insignifi-
    cant period of time,’’ it has maintained that courts
    should not consider individual prongs of the DeJesus
    test in isolation. (Internal quotation marks omitted.)
    State v. Acosta, supra, 
    326 Conn. 415
    .
    It is therefore necessary to consider the remoteness
    of the uncharged misconduct together with the other
    two DeJesus prongs. Regarding the second prong of
    DeJesus, that is, the similarity of the uncharged and
    charged conduct, the defendant argues that the fre-
    quency and severity of the conduct alleged by S and A
    differed substantially. The defendant asserts that his
    alleged abuse of S progressed far more slowly than his
    alleged abuse of A because S alleged that it took two
    to three years for the abuse to progress to oral and
    anal intercourse. With A, however, the abuse seemingly
    occurred over just a period of months.10 The defendant
    also argues that the severity of the charged and
    uncharged conduct is dissimilar because A reported
    that the defendant had penetrated her vagina with his
    penis, while S did not. Furthermore, the defendant
    argues that the charged and uncharged conduct is dis-
    tinguishable because S alleged that the defendant’s sis-
    ter was often present in the same room when the abuse
    occurred, whereas A reported that she and the defen-
    dant were alone during these times.
    Turning to the relevant law, ‘‘[i]t is well established
    that the victim and the conduct at issue need only be
    similar—not identical—to sustain the admission of
    uncharged misconduct evidence.’’ (Internal quotation
    marks omitted.) Id., 416. Additionally, although not an
    exhaustive list, some factors our appellate courts have
    considered in evaluating similarity of the charged and
    uncharged conduct are the frequency and severity of
    the abuse, as well as the location where the abuse took
    place and whether it occurred in the vicinity of others.
    State v. Antonaras, supra, 
    137 Conn. App. 717
    –19.
    Here, there was evidence before the court from which
    it reasonably could conclude that the charged and
    uncharged conduct was sufficiently similar. Many of
    the acts the defendant performed on S and A were
    identical. Specifically, both S and A alleged that the
    defendant had engaged in oral and anal intercourse,
    touched their chest and genitalia, and showed them
    pornographic films. Furthermore, although it is true
    that A also accused the defendant of engaging her in
    vaginal intercourse while S did not, S reported that
    the defendant told her that he wanted to ‘‘take [her]
    virginity’’ and ‘‘be the first one to put his penis in
    [her] vagina.’’
    The defendant argues that the fact that his sister was
    often in the same room when the abuse occurred, while
    A and the defendant were alone during these times,
    distinguishes the charged and uncharged conduct. S
    stated, however, that the defendant’s sister was asleep
    or watching television and did not know what was tran-
    spiring—much like Ashley C. and the defendant’s chil-
    dren being in the defendant’s house but asleep or
    otherwise unaware of the abuse. Notably, in both
    instances the abuse occurred in the defendant’s home
    and in the vicinity of other family members.
    Finally, considering the many other similarities
    between the charged and uncharged conduct, the fact
    that the defendant abused S for a much longer period
    of time than he abused A does not significantly weigh
    against the admission of S’s testimony. See State v.
    James G., 
    268 Conn. 382
    , 394, 
    844 A.2d 810
     (2004)
    (defendant’s abuse of complaining witness lasted less
    than one year because her half-sister, whom defendant
    had been abusing for eight years, reported abuse; fact
    that complaining witness and half-sister ‘‘suffered sex-
    ual abuse for different lengths of time [did] not illustrate
    a behavioral difference of any significance’’).
    The third and final prong of DeJesus assesses the
    similarity of the misconduct witness to the complaining
    witness. The defendant argues that S and A are not
    sufficiently similar because the nature of the defen-
    dant’s relationship with S was different from the nature
    of his relationship with A. Specifically, the defendant
    was a minor himself throughout the years he allegedly
    abused S, and, arguably, S’s peer. With respect to A,
    however, the defendant was an authority figure.
    ‘‘As with conduct, the victim[s] . . . at issue need
    only be similar—not identical—to sustain the admission
    of uncharged misconduct evidence.’’ (Internal quota-
    tion marks omitted.) State v. Acosta, supra, 
    326 Conn. 417
    . The age of each witness at the time of the abuse,
    as well as their familial relationship to the defendant,
    are both factors a court may properly consider. See id.,
    418. The nature of the defendant’s relationship with
    each witness is also significant. State v. Gupta, 
    297 Conn. 211
    , 229–30, 
    998 A.2d 1085
     (2010).
    In support of his claim, the defendant cites State v.
    Ellis, 
    270 Conn. 337
    , 
    853 A.2d 676
     (2004), and State v.
    Gupta, 
    supra,
     
    297 Conn. 211
    . In Ellis, the defendant, a
    softball coach, was charged in separate cases with hav-
    ing sexually assaulted three teenage girls: Sarah S., Julia
    S., and Kristin C. State v. Ellis, supra, 339–40. The three
    cases were consolidated and tried together. Id., 342.
    The defendant argued on appeal that the trial court
    had improperly admitted prior misconduct evidence
    regarding Julia S., Kristin C., and a fourth victim, Kaitlyn
    M., in Sarah S.’s case. Id., 352.
    Our Supreme Court agreed with the defendant that
    the trial court had, in fact, improperly admitted the
    three instances of prior misconduct in Sarah S.’s case.
    Id., 358. In so holding, our Supreme Court found that
    the defendant’s abuse of Sarah S. was much more fre-
    quent and severe than his abuse of the other victims.
    Id., 359–60. The defendant had subjected Sarah S. to a
    ‘‘wide range of misconduct,’’ including masturbating
    and ejaculating in her presence, digital penetration,
    attempting to climb on top of her while she was in bed,
    and attempting to force her to perform oral sex, among
    other things. Id., 359. The defendant’s abuse of the three
    prior misconduct witnesses—including fondling their
    breasts in public, touching one of the victims’ legs, and
    attempting to force his tongue into her mouth—was far
    less egregious in comparison. Id., 359–60.
    Furthermore, in Ellis, the defendant’s relationship
    with Sarah S. ‘‘differed in several key respects from his
    relationships with the other girls.’’ Id., 360. Specifically,
    the prior misconduct witnesses were all players on vari-
    ous softball teams coached by the defendant, had devel-
    oped close personal relationships with the defendant
    over a period of several years, and regarded him as a
    confidant. Id., 361. Sarah S., however, had not been
    coached by the defendant and had not developed a close
    relationship with him. Id. Thus, our Supreme Court
    concluded that ‘‘[Sarah S.] did not feel compelled, as
    did the other girls, to cultivate or continue a relationship
    with the defendant following the abuse because of his
    ability to assist her in obtaining a college softball schol-
    arship. Therefore, it cannot be inferred logically that, if
    the defendant was guilty of the charged and uncharged
    offenses involving Julia S., Kristin C. and Kaitlyn M.,
    he also must have been guilty of the charged offenses
    involving Sarah S.’’ Id.
    The defendant also cites to State v. Gupta, 
    supra,
    297 Conn. 211
    . In Gupta, three women alleged that the
    defendant, a physician, sexually assaulted them during
    various examinations. 
    Id.,
     215–19. The three cases were
    consolidated for trial. 
    Id., 214
    . Our Supreme Court held
    that the trial court had improperly admitted prior mis-
    conduct evidence from one victim, M, in the cases of
    the other two victims. 
    Id., 233
    . Specifically, as in Ellis,
    the defendant’s abuse of M was far more egregious than
    his abuse of the other two victims. 
    Id.,
     226–28. M alleged
    that the defendant had grabbed her breasts, pinched
    her nipples, exposed her vagina, tapped her pelvic bone,
    and exclaimed that she was ‘‘so hot.’’ (Internal quotation
    marks omitted.) 
    Id.,
     226–27. The other two victims, how-
    ever, alleged only that the defendant had exposed and
    fondled their breasts. 
    Id.,
     216–18. Additionally, the fact
    that M was employed with the defendant’s medical
    group and had a continuing relationship with him fur-
    ther distinguished her from the other two victims.
    
    Id., 230
    .
    The present case is distinguishable from Ellis and
    Gupta because in both those cases there were material
    differences regarding the severity of misconduct in
    addition to differences between the misconduct and
    the complaining witnesses. Here, however, the severity
    of the charged and uncharged conduct was sufficiently
    similar—both S and A complained that the defendant
    had performed oral sex on them, as well as penetrated
    them anally with his penis. Furthermore, we conclude
    that the trial court reasonably could have found that S
    was sufficiently similar to A to admit the prior miscon-
    duct testimony. Both S and A are cousins of the defen-
    dant. Additionally, S and A were nearly identical in age
    when the defendant began abusing them. Although S
    and the defendant are much closer in age, S was only
    four or five when the abuse began. The defendant, being
    eleven or twelve, still would have been able to exert
    considerable influence over S, much like he was able
    to exert influence over A as her older cousin and baby-
    sitter. Thus, although the court reasonably could have
    weighed the differences between S and A more heavily,
    it did not abuse its discretion in concluding that S and
    A were sufficiently similar.
    Having considered and weighed the similarity of the
    charged and uncharged conduct, as well as the similar-
    ity of S and A, we return to the remoteness prong of
    DeJesus. In light of the relative strength of the other
    two DeJesus prongs, we conclude that the court did
    not abuse its discretion in determining that the twelve
    year gap in time between the uncharged conduct and
    the charged conduct was not too remote. See State v.
    Acosta, supra, 
    326 Conn. 417
    –19 (trial court did not
    abuse discretion in admitting uncharged sexual miscon-
    duct evidence that occurred twelve years prior to
    charged conduct because both victims were prepubes-
    cent when misconduct occurred and nieces of defen-
    dant, and initial stages of charged and uncharged
    misconduct were sufficiently similar).
    Finally, the defendant argues that the probative value
    of S’s prior misconduct evidence does not outweigh its
    prejudicial effect. The defendant does not explain how,
    exactly, the prior misconduct evidence is unduly preju-
    dicial. Rather, he concludes that the probative value of
    the evidence is quite minimal because of the disparity
    in age difference between the defendant and S (approxi-
    mately seven years) and the defendant and A (approxi-
    mately twenty-two years). Furthermore, the defendant
    argues that he exhibited a ‘‘lack of compulsivity’’
    because he had access to other young girls who did
    not report abuse.
    ‘‘In balancing the probative value of such evidence
    against its prejudicial effect . . . trial courts must be
    mindful of the purpose for which the evidence is to
    be admitted, namely, to permit the jury to consider a
    defendant’s prior bad acts in the area of sexual abuse
    or child molestation for the purpose of showing propen-
    sity.’’ (Internal quotation marks omitted.) State v.
    DeJesus, 
    supra,
     
    288 Conn. 473
    –74. ‘‘Although evidence
    of child sex abuse is undoubtedly harmful to the defen-
    dant, that is not the test of whether evidence is unduly
    prejudicial. Rather, evidence is excluded as unduly prej-
    udicial when it tends to have some adverse effect upon
    a defendant beyond tending to prove the fact or issue
    that justified its admission into evidence.’’ (Emphasis
    omitted; internal quotation marks omitted.) State v.
    Antonaras, supra, 
    137 Conn. App. 722
    –23. ‘‘The test for
    determining whether evidence is unduly prejudicial is
    not whether it is damaging to the defendant but whether
    it will improperly arouse the emotions of the jury.’’
    (Internal quotation marks omitted.) State v. Morales,
    
    164 Conn. App. 143
    , 179, 
    136 A.3d 278
    , cert. denied, 
    321 Conn. 916
    , 
    136 A.3d 1275
     (2016).
    Turning to the present case, the record indicates that
    the court carefully considered the admissibility of the
    prior misconduct evidence offered by S and ultimately
    found that it was highly probative, considering the simi-
    larities between the alleged conduct, as well as between
    S and A Furthermore, in assessing the prejudicial effect
    of S’s testimony, we conclude that S’s allegations of
    misconduct were no more severe or egregious than the
    conduct for which the defendant was charged. In fact,
    unlike S, A alleged that the defendant had subjected
    her to vaginal intercourse, in addition to oral sex and
    anal intercourse. Therefore, S’s testimony was no more
    likely than A’s testimony to arouse the emotions of the
    jury. In sum, we conclude that the trial court did not
    abuse its discretion in admitting the prior misconduct
    evidence offered by S.
    II
    The defendant next claims on appeal that the trial
    court improperly admitted into evidence statements
    that A made to J, Dr. Py, Dr. Walsh, and Vidro under
    the medical diagnosis and treatment exception to the
    hearsay rule. The defendant argues that the court
    abused its discretion in admitting A’s statements
    because the purpose of A’s interactions with J, Dr. Py,
    Dr. Walsh, and Vidro was investigatory. The defendant
    further argues that A’s out-of-court statements were not
    reasonably pertinent to medical diagnosis or treat-
    ment.11 The defendant cannot prevail on his claim.
    The following facts are relevant to the defendant’s
    claim. On or about June 30, 2015, the state filed a motion
    in which it argued that statements made by A to J, Dr. Py,
    Dr. Walsh, and Vidro, among others,12 were admissible
    under § 8-3 (5) of the Connecticut Code of Evidence as
    statements made for the purpose of obtaining medical
    diagnosis or treatment.
    On July 13, 2015, the court held a hearing on the
    state’s motion and, outside the presence of the jury,
    asked the state to make a proffer as to each witness.
    With respect to J, the state proffered that she did not
    feel comfortable with Officer McMahon questioning A
    at the defendant’s residence. Rather, J wanted to trans-
    port A to a hospital so she could be seen by a medical
    doctor or psychiatrist. J then drove to the hospital
    with A.
    On the way to the hospital, J told A that she was
    taking her to see a doctor and needed to know the truth
    about what happened. A responded that the defendant
    had licked her private parts. J did not question A further.
    The state argued that A’s statement was admissible
    under the medical treatment hearsay exception because
    J’s motivation in gathering that information from A was
    to seek further medical assistance for her child.
    With respect to Dr. Py, the state proffered that, when
    A was initially examined at Waterbury Hospital, she
    told Dr. Py that the defendant had sexually abused her
    earlier that day. A also told Dr. Py that the defendant
    sometimes took A’s pants off when she was alone
    watching television and licked her privates.
    With respect to Dr. Walsh, the state proffered that A
    was examined by her upon referral by Dr. Py to the
    emergency department at Yale-New Haven Hospital for
    treatment. During Dr. Walsh’s physical examination of
    A, A told Dr. Walsh that the defendant had touched
    her privates with his hands, licked her privates, and
    penetrated her vagina with his penis. A also told Dr.
    Walsh that her privates hurt and that the defendant
    sometimes said mean things to her. Dr. Walsh observed
    that A’s labia minora were red and tender, and that A
    had an abrasion on her clitoral hood.
    With respect to Vidro, the state proffered that Dr.
    Walsh had referred A to the Yale Child Sexual Abuse
    Clinic for a follow-up examination by Dr. Pavlovic to
    determine whether A’s injuries had healed. Dr. Pavlovic
    asked Vidro to conduct an interview of A so that Dr.
    Pavlovic could fully understand the nature of the com-
    plaint before her examination. Detective Dougherty and
    a representative from the Department of Children and
    Families also observed the interview. During the inter-
    view, A told Vidro that the defendant had licked her
    private parts, humped her, penetrated her with his penis
    vaginally and anally, and masturbated to the point of
    ejaculation.
    At the hearing, the defendant objected to the prof-
    fered testimony from J, Dr. Py, and Vidro. With respect
    to J, the defendant argued that her credibility was lim-
    ited because she was A’s mother, and not a medical
    professional. The defendant further argued that J’s pur-
    pose in asking A what had happened was investigatory
    in nature. With respect to Dr. Py, the defendant argued
    that A’s statements were not pertinent to treatment.
    With respect to Vidro, the defendant argued that the
    forensic interview served an investigatory as well as
    medical purpose, and was therefore improperly
    admitted.
    Subsequently, the court issued an oral ruling permit-
    ting each of the witnesses to testify regarding the state-
    ments A made to them under the hearsay exception for
    medical diagnosis and treatment. The court found that,
    with respect to Dr. Py and Dr. Walsh, A’s statements
    were made ‘‘in connection with determining what had
    happened and what [Dr. Py and Dr. Walsh] needed to
    do in terms of diagnosis and treatment.’’
    With respect to Vidro, the court found that the fact
    that at least one purpose of the interview was to aid
    Dr. Pavlovic in her follow-up examination of A was
    sufficient to qualify A’s statements under the medical
    diagnosis and treatment exception. The court further
    found that Vidro had the expertise and training neces-
    sary to conduct the interview. Finally, the court ruled
    that J could testify to the statement A made to her in
    the car, ‘‘given that [J] was taking the child to the hospi-
    tal, given the reason she responded to the house, why
    she was taking the child to the hospital, and what [J]
    expressed in terms of the evaluation and the assess-
    ment . . . .’’
    Turning now to the relevant standard of review, ‘‘[t]o
    the extent [that] a trial court’s admission of evidence
    is based on an interpretation of the Code of Evidence,
    our standard of review is plenary. . . . We review the
    trial court’s decision to admit evidence, if premised on
    a correct view of the law, however, for an abuse of
    discretion. . . . In other words, only after a trial court
    has made the legal determination that a particular state-
    ment is or is not hearsay, or is subject to a hearsay
    exception, is it vested with the discretion to admit or
    to bar the evidence based upon relevancy, prejudice,
    or other legally appropriate grounds related to the rule
    of evidence under which admission is being sought.’’
    (Citations omitted; internal quotation marks omitted.)
    State v. Miguel C., 
    305 Conn. 562
    , 571–72, 
    46 A.3d 126
     (2012).
    Regarding the relevant law, ‘‘[i]t is well settled that
    . . . [a]n out-of-court statement offered to prove the
    truth of the matter asserted is hearsay and is generally
    inadmissible unless an exception to the general rule
    applies.’’ (Internal quotation marks omitted.) State v.
    Carrion, 
    313 Conn. 823
    , 837, 
    100 A.3d 361
     (2014); Conn.
    Code Evid. § 8-2. An exception exists, however, for
    statements made for the purpose of obtaining medical
    diagnosis or treatment. Conn. Code Evid. § 8-3 (5). A
    hearsay statement is admissible under the medical diag-
    nosis or treatment exception when it is ‘‘made for pur-
    poses of obtaining a medical diagnosis or treatment
    and describing medical history, or past or present symp-
    toms, pain, or sensations, or the inception or general
    character of the cause or external source thereof, inso-
    far as reasonably pertinent to the medical diagnosis or
    treatment.’’ Conn. Code Evid. § 8-3 (5).
    ‘‘The rationale underlying the medical treatment
    exception to the hearsay rule is that the patient’s desire
    to recover his health . . . will restrain him from giving
    inaccurate statements to a physician employed to
    advise or treat him.’’ (Internal quotation marks omit-
    ted.) State v. Cruz, 
    260 Conn. 1
    , 7, 
    792 A.2d 823
     (2002).
    ‘‘Although [t]he medical treatment exception to the
    hearsay rule requires that the statements be both perti-
    nent to treatment and motivated by a desire for treat-
    ment . . . in cases involving juveniles, our cases have
    permitted this requirement to be satisfied inferentially.’’
    (Citation omitted; internal quotation marks omitted.)
    State v. Telford, 
    108 Conn. App. 435
    , 441–42, 
    948 A.2d 350
    , cert. denied, 
    289 Conn. 905
    , 
    957 A.2d 875
     (2008).
    Furthermore, ‘‘[i]n sexual abuse cases, statements made
    by the complainant about the identity of the person
    causing the injury may be found relevant to proper
    diagnosis and treatment.’’ Id., 440.
    Moreover, the statement sought to be admitted need
    not be made to a physician. State v. Cruz, supra, 
    260 Conn. 10
    . ‘‘The rationale for excluding from the hearsay
    rule statements that a patient makes to a physician in
    furtherance of obtaining medical treatment applies with
    equal force to such statements made to other individu-
    als within the chain of medical care.’’ (Emphasis
    added.) 
    Id.
     For example, our Supreme Court held in
    Cruz that ‘‘statements made by a sexual assault victim
    to a social worker who is acting within the chain of
    medical care may be admissible under the medical treat-
    ment exception to the hearsay rule.’’ (Emphasis added.)
    Id.; see also State v. Maldonado, 
    13 Conn. App. 368
    ,
    372, 
    536 A.2d 600
     (holding that hospital security guard
    who assisted treating physician in interpreting medical
    history of three and one-half year old abuse victim could
    testify at trial that victim had identified her father as
    abuser), cert. denied, 
    207 Conn. 808
    , 
    541 A.2d 1239
    (1988). Furthermore, ‘‘statements may be reasonably
    pertinent . . . to obtaining medical diagnosis or treat-
    ment even when that was not the primary purpose
    of the inquiry that prompted them, or the principal
    motivation behind their expression.’’ (Citation omitted;
    emphasis in original; internal quotation marks omitted.)
    State v. Griswold, 
    160 Conn. App. 528
    , 552–53, 
    127 A.3d 189
    , cert. denied, 
    320 Conn. 907
    , 
    128 A.3d 952
     (2015).13
    Turning to the facts of the present case, the record
    amply supports the trial court’s determination that A’s
    statements to Dr. Py were made for the purpose of,
    and were reasonably pertinent to, obtaining medical
    diagnosis and treatment. In order to treat A, it was
    necessary for Dr. Py to ask A about the duration, fre-
    quency, method, and extent of the abuse. This informa-
    tion was also necessary to determine whether to
    transfer A to a hospital that specializes in treating child
    victims of sexual abuse. Additionally, this court has held
    that statements relating to the identity of the victim’s
    abuser are relevant to diagnosis and treatment. State
    v. Telford, supra, 
    108 Conn. App. 440
    .
    Similarly, the statements A made to Dr. Walsh were
    properly admitted. A was transferred to Dr. Walsh at
    Yale-New Haven Hospital because Dr. Py had deter-
    mined that Waterbury Hospital did not have the
    resources necessary to treat A’s injuries. A’s statements
    relaying the acts committed by the defendant and her
    pain level, as well as Dr. Walsh’s observations regarding
    the injuries to A’s genitalia, were necessary to deter-
    mine the extent of the physical and psychological abuse
    as well as the appropriate scope of treatment.
    The defendant’s argument that the statements made
    by A to Vidro during the forensic interview were improp-
    erly admitted because the purpose of the interview was
    investigatory is without merit. This court held in Gris-
    wold that statements may be admissible even if the
    primary purpose of the inquiry is not medical so long
    as there is sufficient evidence that the statements were
    reasonably pertinent to obtaining medical diagnosis and
    treatment. See State v. Griswold, supra, 
    160 Conn. App. 552
    –53, 557. In the present case, the state argued that
    the purpose of Vidro’s interview was to help Dr. Pav-
    lovic better understand the nature of A’s complaint so
    that Dr. Pavlovic could conduct a thorough medical
    examination of A. The court therefore did not abuse
    its discretion in admitting A’s statements to Vidro under
    the medical diagnosis and treatment exception to the
    hearsay rule after finding that at least one purpose
    of the interview was to assist Dr. Pavlovic’s medical
    examination of A.
    Finally, the defendant argues that A’s statement to J
    that the defendant had licked A’s privates was improp-
    erly admitted because J took A to the hospital ‘‘for the
    purpose of further investigation, not treatment.’’ Even if
    we assume, without deciding, that the court improperly
    admitted A’s statement to J, we conclude that any error
    was harmless.
    ‘‘When an improper evidentiary ruling is not constitu-
    tional in nature, the defendant bears the burden of dem-
    onstrating that the error was harmful.’’ (Internal
    quotation marks omitted.) State v. Rodriguez, 
    311 Conn. 80
    , 89, 
    83 A.3d 595
     (2014). ‘‘[A] nonconstitutional error
    is harmless when an appellant court has a fair assurance
    that the error did not substantially affect the verdict.’’
    (Internal quotation marks omitted.) 
    Id.
     Whether the
    defendant was harmed by the trial court’s evidentiary
    ruling is guided by a number of factors, such as the
    importance of the testimony to the state’s case, whether
    the testimony was cumulative, the presence or absence
    of evidence corroborating or contradicting the testi-
    mony, the extent of cross-examination permitted, the
    impact of the evidence on the trier of fact and the
    result of the trial, and the overall strength of the state’s
    case. 
    Id.
    The defendant does not directly argue why the state-
    ment A made to J in the car was harmful. Regardless, it
    is clear that if any such error was made, it was harmless.
    First, A’s statement to J that the defendant had licked
    her privates was cumulative of similar statements she
    made to others. A repeated that same allegation—spe-
    cifically, that the defendant had performed oral sex on
    her—to Dr. Py and Vidro, both of whom we have already
    determined properly testified to A’s respective state-
    ments at trial.
    Second, the overall strength of the state’s case was
    quite high. A alleged that the defendant had sexually
    assaulted her on April 9, 2014. That afternoon, A
    reported the abuse. Just hours later, A underwent a
    physical examination. The findings of that physical
    examination—that A was tearful to the touch, had red-
    ness and discharge on her labia, and an abrasion on
    the lips of her vagina—corroborated A’s allegations that
    she had been sexually assaulted earlier that day. More-
    over, A’s allegations were further bolstered by S’s testi-
    mony that the defendant had abused her in the same
    way when she was A’s age.
    On the basis of the foregoing evidence, we conclude
    that the trial court did not abuse its discretion by admit-
    ting the victim’s statements to Dr. Py, Dr. Walsh, and
    Vidro because the statements were reasonably perti-
    nent to obtaining medical diagnosis or treatment. We
    further conclude that any error the court may have
    made in admitting A’s statement to J was harmless.
    III
    Finally, the defendant claims that the trial court com-
    mitted plain error by admitting evidence (1) of the opin-
    ions of A’s medical providers that A had been sexually
    assaulted, and (2) that improperly vouched for A’s credi-
    bility. We disagree.
    The following facts are relevant to the defendant’s
    claim. At trial, Dr. Py testified generally about the proto-
    col Waterbury Hospital follows when a patient comes
    in complaining of sexual abuse. Specifically, Dr. Py
    testified that she would obtain the history of the patient,
    perform a general physical examination, and, if neces-
    sary, transfer the patient to ‘‘an appropriate level of
    care’’ because ‘‘certain sexual assault cases require spe-
    cialists that Waterbury Hospital does not have.’’ Dr. Py
    also testified that on April 9, 2014, A came in complain-
    ing of sexual abuse and, after taking A’s history and
    performing a general physical examination, Dr. Py rec-
    ommended that A be transferred to a hospital with a
    team of physicians that specialized in treating sexual
    abuse. Furthermore, the state offered into evidence A’s
    medical record from Waterbury Hospital, which con-
    tained Dr. Py’s differential diagnosis of ‘‘sexual assault.’’
    The state did not question Dr. Py regarding the contents
    of the record.
    On cross-examination, defense counsel questioned
    Dr. Py about the differential diagnosis. When defense
    counsel asked what a differential diagnosis consisted
    of, Dr. Py responded, ‘‘it’s just basically something that
    we put based on the chief complaint, what it could
    be, why she’s here.’’ Dr. Py further clarified that the
    differential diagnosis was not conclusive and reflected
    only A’s verbal allegation that she had been sexually
    assaulted.
    Thereafter, the state offered the testimony of Dr.
    Walsh. Dr. Walsh testified that Waterbury Hospital had
    referred A to Yale-New Haven Hospital ‘‘for evaluation
    of a sexual assault.’’ The state asked Dr. Walsh whether
    she was able to diagnose A, to which Dr. Walsh
    responded that ‘‘based on her history and what she
    . . . and her mother told us, and based on her physical
    exam findings, it was consistent with sexual assault,
    so we gave her the diagnosis of sexual assault with a
    small abrasion, a small scrape on her genital area.’’ Dr.
    Walsh further testified that she referred A to the Yale
    Child Sexual Abuse Clinic for a follow-up because
    ‘‘[t]hey’re experts in detecting and treating child abuse,’’
    and ‘‘have social workers and staff that are skilled in
    treating kids that have been sexually assaulted.’’ The
    state offered into evidence the medical report generated
    by Dr. Walsh.
    The state also offered the testimony of Dr. Pavlovic,
    who testified that she is board certified in child abuse
    pediatrics, which is a ‘‘specialty involving evaluation
    of children who are suspected to be abused, either
    physically or sexually.’’ When the state asked Dr. Pav-
    lovic what she did at the Yale Child Sexual Abuse Clinic,
    she responded that ‘‘[m]ost patients seen at the clinic
    are victims of sexual abuse—occasionally we will see
    children who are victims of physical abuse . . . .’’ Dr.
    Pavlovic explained that children complaining of sexual
    abuse undergo a physical examination of their genitalia
    and anus, including an examination of the hymen if the
    child is female. Dr. Pavlovic further testified that A had
    a ‘‘normal exam,’’ which was not unusual for a child
    that complained of sexual abuse, and that ‘‘ninety-five
    percent of the time . . . the exam is normal . . . .’’
    The defendant did not object to the admission of any
    of this evidence at trial. Nevertheless, the defendant
    seeks to prevail on this claim under the plain error
    doctrine. ‘‘[T]he plain error doctrine . . . is not . . .
    a rule of reviewability. It is a rule of reversibility. That
    is, it is a doctrine that this court invokes in order to
    rectify a trial court ruling that, although either not prop-
    erly preserved or never raised at all in the trial court,
    nonetheless requires reversal of the trial court’s judg-
    ment, for reasons of policy. . . . In addition, the plain
    error doctrine is reserved for truly extraordinary situa-
    tions [in which] the existence of the error is so obvious
    that it affects the fairness and integrity of and public
    confidence in the judicial proceedings. . . . Plain error
    is a doctrine that should be invoked sparingly. . . .
    Implicit in this very demanding standard is the notion
    . . . that invocation of the plain error doctrine is
    reserved for occasions requiring the reversal of the
    judgment under review. . . . [Thus, an appellant] can-
    not prevail under [the plain error doctrine] . . . unless
    he demonstrates that the claimed error is both so clear
    and so harmful that a failure to reverse the judgment
    would result in manifest injustice.’’ (Citations omitted;
    internal quotation marks omitted.) State v. Myers, 
    290 Conn. 278
    , 289, 
    963 A.2d 11
     (2009).
    Even if we were to conclude that this evidence, upon
    proper and timely objection, should not have been
    admitted because it either (1) constituted improper
    opinion testimony on the ultimate issue in the case; see
    State v. Favoccia, 
    306 Conn. 770
    , 786–87, 
    51 A.3d 1002
    (2012) (expert witnesses ordinarily may not express
    opinion on ultimate issue of whether complainant has
    been sexually abused); or (2) improperly vouched for
    the credibility of the complaining witness; see id., 786;
    we conclude that any evidentiary impropriety under the
    circumstances of this case was not so harmful that a
    failure to reverse the judgment would result in mani-
    fest injustice.
    To begin, the state did not question Dr. Py on direct
    examination about the diagnosis of sexual assault con-
    tained in her medical record. Rather, it was defense
    counsel, on cross-examination, who brought the jury’s
    attention to the diagnosis. In doing so, defense counsel
    was successfully able to elicit from Dr. Py that the
    diagnosis was differential in nature, meaning that it
    reflected nothing more than A’s allegation that the
    defendant had assaulted her, and that Dr. Py’s examina-
    tion of A had not necessarily confirmed that allegation.
    Ultimately, the defendant was able to ameliorate signifi-
    cantly any harmful effect of the admission of the medi-
    cal record, at least to such extent that a manifest
    injustice did not occur.
    As with Dr. Py, defense counsel’s cross-examination
    of Dr. Walsh similarly ameliorated the harmful effect
    of her testimony on direct examination that she ‘‘gave
    [A] the diagnosis of sexual assault with a small abrasion
    . . . .’’ Specifically, defense counsel questioned Dr.
    Walsh about the results of A’s physical examination
    and was able to elicit from Dr. Walsh that there were
    potentially many alternative causes of A’s injuries, such
    as wearing tight clothing or self-injury. Defense counsel
    also elicited from Dr. Walsh that, although A had exhib-
    ited some injuries, she had not suffered more significant
    trauma such as bleeding, bruising, or damage to her
    hymen.
    Moreover, during closing argument, the state did not
    rely on the expert opinion of Dr. Py or Dr. Walsh regard-
    ing whether A had been sexually assaulted. Rather, to
    the extent that the state referred to these witnesses, it
    was to emphasize the medical findings of physical injury
    to A and that those findings were consistent with her
    allegations of sexual assault. Furthermore, during the
    defendant’s closing argument, counsel for the defense
    made clear to the jury that it was not bound by any of
    the physicians’ diagnoses of sexual assault.
    Finally, with respect to Dr. Pavlovic, even if we
    assume, without deciding, that her testimony improp-
    erly vouched for A’s credibility, any error was not so
    harmful as to rise to the level of manifest injustice. This
    case was not one wherein ‘‘the defendant was convicted
    largely on the strength of the complainant’s testimony
    standing by itself—a situation that elevates the risk that
    inadmissible expert opinion testimony might have the
    effect of improperly bolstering the complainant’s credi-
    bility.’’ See State v. George A., 
    308 Conn. 274
    , 292, 
    63 A.3d 918
     (2013); 
    id.,
     292–93 (expert witness’ improper
    vouching for complainant’s credibility was not so harm-
    ful as to require reversal because complainant’s testi-
    mony was corroborated by prior misconduct evidence
    as well as physical evidence). Rather, the state’s case
    against the defendant was quite strong, as discussed in
    part II of this opinion. A’s allegations were corroborated
    by S’s testimony describing prior similar misconduct
    of the defendant, as well as Dr. Walsh’s findings that
    A had sustained physical injuries to her genitals after
    A alleged that the defendant had sexually assaulted her
    earlier that day. For these reasons, we conclude that
    any evidentiary impropriety did not result in manifest
    injustice requiring reversal of the judgment.
    The judgment is affirmed.
    In this opinion the other judges concurred.
    * In accordance with our policy of protecting the privacy interests of the
    victims of sexual abuse and the crime of risk of injury to a child, we decline
    to use the defendant’s full name or to identify the victim or others through
    whom the victim’s identity may be ascertained. See General Statutes § 54-86e.
    1
    The defendant later entered into evidence a stipulation concerning the
    DNA testing results of the biological sample taken from A shortly after A
    reported the abuse. The stipulation provided that the defendant was not
    the source of any DNA found in the sample. There was no evidence presented
    at trial that any other person was a contributor to the DNA profile obtained
    from the testing.
    2
    No pornography was found on the defendant’s phone.
    3
    Feola testified that she never had any academic concerns about A prior
    to the April 9, 2014 incident. After Feola became aware of A’s complaint,
    however, she began noticing behavioral changes in A. Specifically, A had
    trouble completing a phonetics lesson one morning. The phonetics lesson
    was meant to help the students pronounce the letter ‘‘e,’’ and featured the
    name ‘‘Eddie.’’ During the lesson, A began rocking back and forth and crying.
    When Feola asked A what was wrong, she responded that ‘‘Eddie was the
    name of the bad guy . . . .’’ Feola then switched the name ‘‘Eddie’’ with
    the word ‘‘elephant,’’ and A no longer had trouble completing the lesson.
    4
    The defendant testified that he had not sexually assaulted A or shown
    her pornography.
    5
    Ashley C., as well as the defendant’s neighbor, Fransauch Marleen Cas-
    tillo, testified that A had not accused the defendant of sexual misconduct
    on April 9, 2014. Rather, Ashley C. and Castillo testified that A only said
    that the defendant had done ‘‘nasty stuff’’ to her. Ashley C. further testified
    that when she asked A what kind of ‘‘nasty stuff’’ the defendant did, A lifted
    up her leg, farted, and said, ‘‘that.’’ Ashley C. also testified that, around the
    time the incident occurred, A had been misbehaving, and that she called J
    on April 9, 2014, because she had ‘‘had enough of [A’s] behaviors’’—not
    because she was concerned that A had been sexually assaulted.
    6
    Christy C. is not related to the defendant or to Ashley C.
    7
    The state’s proffer was based on a written statement S made to the police.
    8
    S testified consistently with the state’s proffer. Specifically, S testified
    that: (1) she was the first cousin of the defendant, and J’s sister; (2) she
    would often stay overnight at the defendant’s house as a child; (3) the
    defendant began abusing her when she was four or five years old by touching
    and rubbing her chest and vagina over her clothes; (4) when she was seven,
    the defendant began performing oral sex on her, as well as penetrating her
    anus with his penis; (5) the defendant showed her pornographic movies;
    and (6) the abuse stopped when she was ten years old.
    9
    The defendant asserts on appeal that, in order to be admissible, evidence
    of the defendant’s prior sexual misconduct must also tend to demonstrate
    a ‘‘common plan or scheme.’’ See Conn. Code Evid. § 4-5 (c) (‘‘[e]vidence
    of other crimes, wrongs or acts of a person is admissible for purposes . . .
    such as to prove intent, identity, malice, motive, common plan or scheme,
    absence of mistake or accident, knowledge, a system of criminal activity,
    or an element of the crime, or to corroborate crucial prosecution testi-
    mony’’). The defendant is mistaken. Subsection (b) of § 4-5 establishes a
    limited exception to the rule prohibiting the admission of propensity evi-
    dence, and specifically permits the trier of fact to consider prior misconduct
    evidence to establish that the defendant has a propensity to engage in
    aberrant and compulsive sexual behavior. The admissibility of evidence
    under this exception is not, by its terms, dependent upon the evidence
    meeting any other exception contained in other provisions of the code.
    Subsection (c) of § 4-5, on the other hand, permits uncharged misconduct
    to be admitted, not as evidence of the defendant’s propensity to engage in
    criminal behavior, but as evidence to prove other issues in the case such
    as intent, identity, a common plan or scheme, or an element of the crime.
    Accordingly, subsections (b) and (c) have fundamentally different purposes,
    and evidence sought to be admitted under subsection (b) is admissible even
    if it does not meet one of the recognized exceptions in subsection (c).
    10
    The defendant and Ashley C. did not continuously babysit A from the
    fall of 2013 until A reported the abuse on April 9, 2014. From November,
    2013 to sometime in February, 2014, J could not afford to pay the defendant
    and had another family member babysit A. It is therefore unclear whether
    the defendant began abusing A in the fall of 2013 or after she returned to
    the defendant’s home in February, 2014.
    11
    The defendant also contends that the admission of A’s statements vio-
    lates the sixth amendment’s confrontation clause. Again, he is mistaken.
    A testified and was cross-examined by the defendant. See Crawford v.
    Washington, 
    541 U.S. 36
    , 51–53, 
    124 S. Ct. 1354
    , 
    158 L. Ed. 2d 177
     (2004)
    (confrontation clause not violated when declarant testifies and is subject
    to cross-examination regarding out-of-court statements).
    12
    The state also sought to admit A’s statements through a number of
    nurses and other medical personnel present during A’s various examinations.
    The court ruled that these individuals would not be permitted to testify
    under the medical diagnosis and treatment exception because their testi-
    mony would be cumulative, and because A did not make the statements to
    those persons directly.
    13
    After our Supreme Court decided State v. Arroyo, 
    284 Conn. 597
    , 625–35,
    
    935 A.2d 975
     (2007), and State v. Maguire, 
    310 Conn. 535
    , 563–71, 
    78 A.3d 828
     (2013), it was unclear whether statements made during a forensic inter-
    view were inadmissible unless the primary purpose of the interview was
    for medical diagnosis or treatment. Subsequent to those cases, this court
    decided in Griswold that, if statements made during a forensic interview
    of the child are offered solely under the medical diagnosis and treatment
    exception, and the child is subject to cross-examination at trial, then such
    statements need only be reasonable pertinent to medical diagnosis and
    treatment to be admissible. State v. Griswold, supra, 
    160 Conn. App. 552
    –53.
    Accordingly, pursuant to Griswold, such statements are admissible even if
    the primary purpose of the declarant’s statements was not to obtain medical
    diagnosis and treatment. 
    Id.
                                

Document Info

Docket Number: AC39878

Citation Numbers: 174 A.3d 803, 178 Conn. App. 147

Judges: Dipentima, Prescott, Mihalakos

Filed Date: 11/21/2017

Precedential Status: Precedential

Modified Date: 10/19/2024