State of Tennessee v. William Thomas Bryant ( 2010 )


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  •          IN THE COURT OF CRIMINAL APPEALS OF TENNESSEE
    AT JACKSON
    Assigned on Briefs June 3, 2008
    STATE OF TENNESSEE v. WILLIAM THOMAS BRYANT
    Appeal from the Circuit Court for Obion County
    Nos. C06-422, 5-135  William B. Acree, Jr., Judge
    No. W2007-01340-CCA-R3-CD - Filed January 9, 2009
    The defendant, William Thomas Bryant, was convicted by a jury in the Circuit Court for Obion
    County of three counts of rape of a child. See T.C.A. § 39-13-522 (2003) (amended 2005, 2006,
    2007). He was sentenced to three concurrent fifteen-year sentences of confinement. In this delayed
    appeal, he claims (1) the evidence was insufficient as a matter of law to convict him of rape of a
    child, (2) the court erred in admitting the testimony of two nurses as hearsay exceptions, and (3) the
    court erred in finding the two child victims competent to testify. We affirm the convictions.
    Tenn. R. App. P. 3 Appeal as of Right; Judgments of the Circuit Court Affirmed
    JOSEPH M. TIPTON , P.J., delivered the opinion of the court, in which ALAN E. GLENN and D. KELLY
    THOMAS, JR., JJ., joined.
    Joseph P. Atnip, District Public Defender (on appeal); Noel H. Riley, II and Carla Christian,
    Dyersburg, Tennessee (at trial), for the appellant, William Thomas Bryant.
    Robert E. Cooper, Jr., Attorney General and Reporter; Cameron L. Hyder, Assistant Attorney
    General; Thomas A. Thomas, District Attorney General; and James T. Cannon and Heard B.
    Critchlow, Assistant District Attorneys General, for the appellee, State of Tennessee.
    OPINION
    At the trial, Obion County Sheriff’s Department Investigator John Davis testified that he was
    contacted in early January 2005 regarding the defendant. Mr. Davis stated that the defendant was
    living in Obion County at Thanksgiving 2004, the time of the events giving rise to the instant
    convictions. He stated the dates of birth of the two victims, J.B. and B.R., and said that at
    Thanksgiving 2004, the victims would have been five and six years old respectively.
    Elizabeth Thomas testified that she was a registered nurse with several nursing degrees,
    including a master’s degree. She said she was certified in psychological, mental health, and public
    health nursing. She also said she had a master’s certification in medical and legal death
    investigation. She stated she was a professor in the nursing program at the University of Memphis.
    She said she had worked as a sexual assault nurse examiner at the Memphis Sexual Assault Resource
    Center for thirteen years. As an examiner, she was the first medical personnel that a patient would
    see at the center. She said that she would talk to a patient to determine the patient’s medical history
    before taking samples for lab work and that she would then examine the patient.
    Ms. Thomas testified that she examined B.R. on January 11, 2005. She said that she spoke
    with B.R. about her medical history and that B.R. gave her a urine sample to screen for sexually
    transmitted diseases. She said she conducted an examination of B.R.’s oral, genital, and rectal areas.
    Although there were no “findings” in either the oral or rectal areas, she said she saw one very
    significant finding in the genital area. In a child of B.R.’s age, the hymenal tissue should be at least
    two millimeters thick. She said B.R. was missing hymenal tissue that, if viewed as a clock,
    corresponded to the positions “5 o’clock to 11 o’clock.” She stated that this lack of tissue indicated
    B.R. had experienced a “blunt penetrating trauma.” She determined that the injury was old and that
    her finding would be consistent with an injury date around Thanksgiving of the previous year. She
    said that if the wound had been more recently inflicted, the tissue would have been bleeding, bruised,
    or inflamed. She said B.R.’s injury had already healed, precluding her from dating it more
    specifically.
    Ms. Thomas testified that B.R. told her the source of her injury. Although B.R. said she was
    not currently in pain, she did point her finger to her genital area when the nurse asked her if she had
    hurt in the past. Ms. Thomas said that when she asked B.R. why that area hurt, B.R. said, “It hurt
    every time he stuck his finger in.” The nurse said she asked B.R. if that event had occurred one time
    and that B.R. replied, “No, it happens every time I go over there and sleep.” She said she asked the
    patient if she could elaborate. Ms. Thomas said that B.R. explained that every time she visited the
    defendant’s house, she was told to sleep naked, and that a finger was inserted into her which hurt.
    She said that B.R. identified her step-uncle, the defendant, as the perpetrator.
    On cross-examination, Ms. Thomas testified that she did not diagnose B.R. with anything
    during the examination because she did not have the results of the urinalysis at that time. She
    explained that she did not swab for a semen sample because B.R. was not an emergency client but
    instead was referred as a child abuse evaluation with “no report of any contact.” She said that
    swabbing was not part of the protocol for that type of patient. Ms. Thomas said she did not treat
    B.R. for any ailment because she was an appointment patient and not an emergency case. While she
    stated that a blunt trauma finding could be caused by several things, she ruled out a straddle-type
    injury as the cause of B.R.’s lack of tissue because a straddle injury would not penetrate the hymenal
    tissue. She stated that viewing the opening as a clock, B.R. had some tissue “from 12 to 4” but that
    she had a “notch in her tissue from 4 to 5.” She said that the healed injury could have occurred
    weeks or even months before the January appointment date.
    Sally DiScenza testified that she examined J.B. She stated she was a family nurse
    practitioner and a nurse examiner at the Memphis Sexual Assault Resource Center. She said she
    obtained a master’s degree in nursing, was nationally certified as a family nurse practitioner, and
    completed the internship program at the center. She said she had worked at the center for eleven and
    one-half years.
    -2-
    Ms. DiScenza testified that J.B. came to the center for an “assessment for sexual assault.”
    She said that she spoke with both J.B. and her mother separately to gather J.B.’s medical history and
    that she subsequently examined J.B. and found abnormalities in the vaginal and anal areas. These
    abnormalities showed “some type of penetrative injury” to the hymenal tissue and anal areas. She
    stated that for a five-year-old, any wearing away of hymenal tissue indicates penetrative injury. She
    said that J.B. had a notch in her hymenal tissue at “4 o’clock” and that the tissue from “4 o’clock”
    to “11 o’clock” had been worn away. She said that J.B. also had an enlarged hymen diameter of
    fifteen millimeters. Ms. DiScenza stated that although the size can vary with the stature of the child,
    she would have expected a six- or seven-millimeter range for a child of J.B.’s age. She stated that
    she saw two fissures in J.B.’s anal area, a sign of damaged tissue that has healed. She said that J.B.
    had a dilated anus and that this was a reflexive response to penetrative injury. Furthermore, J.B. had
    anal “scalloping,” which is indicative of healed tissue at the “border of the anal opening.”
    Ms. DiScenza testified that there was no way to tell what caused the penetrating injuries. She
    said she could not tell how old the trauma was even though J.B. had a general redness in her vaginal
    area, but she said these types of injuries were consistent with penetration occurring at the time of
    Thanksgiving 2004. She stated that problems other than recent injury, such as poor hygiene and
    infection, could cause this redness. She said she documented this general redness along with the
    patient’s history of dysuria (painful urination) and recommended subsequent follow-up regarding
    the urinalysis results. She said that she also screened for sexually transmitted diseases.
    Ms. DiScenza testified that when she was talking to J.B. about her medical history, J.B. told
    her how she had been injured. She stated that J.B. told her that her uncle, the defendant, had touched
    her vaginal area and buttocks with his hands, once in the front and twice in the back. She said that
    J.B. told her that her uncle had been naked at the time. She said J.B. responded to her questioning
    whether her uncle had touched her with his genitals by saying “Yes” and pointing to her front and
    back sides to indicate where he had touched her. Ms. DiScenza also said that this kind of contact
    was consistent with her physical findings.
    On cross-examination, Ms. DiScenza restated that she found redness and fissures in J.B.’s
    anal canal and redness in her perihymenal area. In response to defense questioning whether redness
    indicated recent injury, she repeated that many things could cause redness and that she was unable
    to identify the cause. She stated that she did not collect any DNA evidence from J.B. because it was
    not protocol to take such evidence if an assault had occurred more than seventy-two hours before
    the examination. She stated that the assault giving rise to these proceedings occurred before
    December 25, as this was the last time the patient “had contact with a perpetrator or someone that
    is disclosed to have assaulted someone” as stated in her medical history. She said if she had
    suspected DNA were present, she would have taken a kit. She said that she did not think the redness
    was indicative of recent injury and that she did not swab for DNA for this reason. She stated that it
    was always possible that there had been DNA evidence. She also said she did not have J.B.’s
    clothing tested for DNA evidence.
    Ms. DiScenza testified that a straddling injury would not penetrate hymenal tissue. She said
    it was unlikely that a child could inflict that type of injury herself. She stated she recommended J.B.
    for follow-up because the center had to send the sample to a laboratory to determine whether J.B.
    -3-
    had any infections that would explain the general redness she had observed. She said the urine
    screens for chlamydia and gonorrhea were negative. She said that it was possible that the injuries
    to the hymenal tissue were caused by penile penetration and that such penetration would not
    completely remove all the hymenal tissue. She stated that J.B. still had hymenal tissue from “12
    [o’clock] to 4 [o’clock],” where the notch was.
    She stated the results of the STD screens. She stated that she referred J.B. for a follow-up
    visit because of her redness. She said that she did not diagnose “sexual assault” because that was
    a legal, and not medical, term.
    Cheryl Robinson testified that she was B.R.’s mother and the cousin of J.B., who was her
    aunt’s daughter. She said she knew the defendant because he was this aunt’s ex-husband. She stated
    her daughter, B.R., stayed with the defendant at least one weekend a month and that J.B. often stayed
    with the defendant at the same time. She said that her daughter went to the defendant’s home on
    November 23, 2004. She said he had called to ask if B.R. could visit, as J.B. was going to be there.
    Ms. Robinson said that he had called on other occasions to have B.R. visit him and that she did not
    consider this an odd request. She stated that B.R. and J.B. were at the defendant’s home on Tuesday,
    Wednesday, and Thursday nights. She said the defendant brought the children home on Friday. She
    said that since she learned of the defendant’s actions, she had not permitted her daughter to go back
    to the defendant’s home.
    On cross-examination, Ms. Robinson testified that she had known the defendant since she
    was a child and that she was then thirty years old. She said she had never called the defendant to ask
    him to come get her daughter. Instead, she said it was the defendant who always asked to come get
    B.R. She stated that other children visited the defendant, as well. Ms. Robinson said she spoke with
    her daughter on the telephone almost daily when B.R. was at the defendant’s home over
    Thanksgiving. She denied that a government agency had removed B.R. from Ms. Robinson’s home
    and that B.R. had been sexually assaulted by a neighbor.
    Vivian Grooms testified that she worked for the Women’s Resource and Rape Assistance
    Program. She said she was a therapist and the sexual assault coordinator for the program. She said
    she had been giving the two victims therapy since January 2005. She said they were making
    progress and that she met with them monthly. She said the therapy goal for the girls was to return
    them to “more normal behavior.”
    J.B. testified that she was six years old. She used girl and boy dolls in her testimony to show
    where “private parts” were and the record reflects that she pointed to the genitals and buttocks.
    When asked whether anyone had touched her “private parts,” she said that her uncle had touched her
    in his bedroom in Union City when both she and B.R. were in the bedroom. Using the dolls, she
    indicated that her uncle had pulled down his pants and inserted his penis into her anus. She said she
    had not been wearing clothes at the time. She said she saw her uncle penetrate B.R. anally with his
    penis.
    On cross-examination, J.B. testified that she had been living with a woman she called both
    her “auntee” and “foster mother.” She also said that a man named “Tim” lived with them. She
    -4-
    admitted that she no longer lived with them and that she had been removed from their household
    because she had been permitted to visit her uncle. She remembered visiting her uncle for
    Thanksgiving in 2004, but she did not remember how many nights she had been there. She said she
    was there with B.R., Akasha Lovell, and another child. She said that she did not remember what she
    and they had been doing but that Tarneka Jackson had taken her upstairs to bathe her along with the
    other children. She said that the other child and Akasha slept in the other bedroom and that she and
    another child slept in her uncle’s bed with Tarneka. She said it was dark. She stated that she
    remembered telling an investigator that nothing had occurred that night. She also remembered
    telling the investigator that her uncle had not done anything to B.R. She said she liked her uncle.
    She said she was not scared when she went back to her uncle’s house after Thanksgiving. She
    admitted that she said during the voir dire that she had once lied daily.
    B.R. testified that she was eight years old. She pointed to the vaginal and chest areas of a girl
    doll to indicate where “private parts” were. She said that her uncle had touched her private parts
    while she was at his house. She said she and her cousin J.B. had been watching television in his bed.
    She said that her uncle was in the middle of the bed and that J.B. was on his other side. She used
    the dolls to show that her uncle had placed his hands on her genitals. She said that she was wearing
    pajamas at the time and that her uncle reached underneath them to touch her. She said she saw her
    uncle touching J.B., and she demonstrated, using the dolls, that her uncle touched J.B.’s genitals.
    She stated that no one other than her uncle had touched her in this way and that she had not been
    back to her uncle’s house since this incident.
    On cross-examination, B.R. testified that she did not remember telling an investigator that
    she “lied all the time.” She said her uncle would take both her and J.B. to movies, skating, and
    Chuck E. Cheese. She said she arrived at her uncle’s home the day before Thanksgiving. She said
    Tarneka was with her uncle when he picked her up. She stated that Tarneka and the other two girls
    did not get into bed with her, J.B., and the defendant. She said she could see in the bedroom because
    light was coming from the television. She acknowledged that she had said the defendant had rubbed
    their “front [private] parts.”
    Tarneka Jackson, the defendant’s niece, was the defense’s first witness. She testified that she
    lived with her father and step-mother. She said she had known the defendant for six months, which
    was the amount of time she had been living in Dyer. She also had known the two victims for six
    months. She said the defendant picked her up the day before Thanksgiving and that they picked up
    the two victims. She said that she, the defendant, her cousin Akasha, Akasha’s children, and the two
    victims went grocery shopping for their holiday meal. She said that after they arrived at the
    defendant’s house, she watched the children while the defendant and Akasha prepared the
    Thanksgiving meal. She described the defendant’s apartment as having two upstairs bedrooms and
    a first floor with a living room, kitchen, and bathroom. She said that she and the children were
    downstairs and that she took them upstairs to bathe them and put them to bed in the guest bedroom.
    When she went to bed later, she slept in that bed with the four children. She said that Akasha came
    upstairs later that night but that the defendant did not. She said he slept on the couch downstairs.
    She said she fed the children on Thanksgiving after they woke up. She said that while bathing them
    that day, J.B. said her “privacy” was hurting. In response to her questioning, J.B. had said that she
    -5-
    and her father had “rough played.” She said that she and the girls went home after eating their
    Thanksgiving meal.
    On cross-examination, Ms. Jackson said that she and the victims arrived at the defendant’s
    house the day before Thanksgiving. She admitted that she had told an investigator that she had
    arrived at the defendant’s house the previous Friday and stayed until Tuesday before returning for
    Thanksgiving. She admitted that she had made that statement only a few months after Thanksgiving.
    She stated that her trial statement was the correct one. She said that her uncle took her with him for
    his National Guard trips and that she and her uncle would share a room on these trips. She also said
    that she and the victims spent Thanksgiving night at the defendant’s home and that she went with
    them on Friday when they left.
    Akasha Lovell, the defendant’s daughter and mother of the defendant’s three grandchildren,
    testified that her father and Tarneka had picked up the victims the night before Thanksgiving. She
    drove to his house in her car with her children. She said she was Tarneka’s cousin. She said that
    she, her father, and the children went grocery shopping and that she and her father prepared the meal
    at his house. She stated that Tarneka was babysitting the children and prepared them for bed. She
    said that she and her father had allowed Tarneka to stay up with them. She said that everyone except
    herself and her father slept in the other bedroom upstairs, where there was a nightlight. She stated
    that she checked on the children at one point, that she was up all night cooking, and that her father
    slept downstairs on the couch. She said that B.R. was upset the following morning because the meal
    was not yet ready.
    On cross-examination, Ms. Lovell said that she did not remember who drove her to her
    father’s house the day before Thanksgiving. She also claimed that she and the two victims left the
    defendant’s house on Thanksgiving Day after the meal.
    Laura Spears testified that she and her two sons were at the defendant’s house for
    Thanksgiving. She said that the two victims left Thanksgiving night. She said that Ms. Lovell took
    her children and J.B. home and that she, her sons, the defendant, and Tarneka Jackson drove B.R.
    home. She said the two victims neither acted unusually nor complained about anything that day.
    On cross-examination, Ms. Spears acknowledged that she initially told Investigator Davis
    in 2005 that the defendant had been walking around shirtless in his boxer shorts when she arrived,
    but that her present recollection was that the defendant had been wearing shorts and not just
    underwear. She told Investigator Davis that Tarneka had slept with the two victims. She stated at
    trial that the others had told her about their sleeping arrangements but that she had no first-hand
    knowledge of the arrangements because she had not been there.
    The defendant testified that he was forty-seven years old and that he had two daughters and
    three grandchildren. He said he was in the National Guard and participated in military funeral
    honors. He said that he and his daughter, Akasha, organized their Thanksgiving celebration. He said
    he picked up Tarneka and the two victims. He said his daughter Akasha drove to his house with her
    children because his car would not accommodate so many passengers. He said they went grocery
    shopping. He said that Tarneka babysat the younger children and prepared them for bed while he
    -6-
    and Akasha prepared the next day’s meal. He said the children slept upstairs in the two bedrooms.
    He said he did not go upstairs the entire night, as he had a bathroom downstairs and had moved what
    he needed for the night downstairs before the arrival of his family. He stated he never molested
    either victim. He stated that although he was aware J.B. had been acting unusually due to another
    incident, she did not do so while at this house for Thanksgiving. He said that B.R. had not acted
    unusually. He said it was normal for his family to come to his house and to spend the night. He said
    everyone went home after the Thanksgiving meal. He said that the children had returned to his
    house after the alleged incident and that no one had ever mentioned anything about the allegations
    to him.
    On cross-examination, the defendant said he had heard the victims’ testimony and could not
    explain what they had to gain by fabricating charges against him. He stated that J.B. had been
    molested by someone else, that she had told Tarneka Jackson about her symptoms at bath time, and
    that when Ms. Jackson informed the defendant, he called the child’s mother to inquire.
    I. SUFFICIENCY OF THE EVIDENCE
    The defendant claims the evidence was insufficient to convince a reasonable jury of the
    defendant’s guilt beyond a reasonable doubt. He argues that inconsistencies in the witnesses’
    testimony preclude a finding of guilt.
    The State argues that the defendant has waived this issue by not citing any legal authority.
    Additionally, the State claims that the defendant has not met his burden of showing why the
    evidence is insufficient to support the verdict pursuant to State v. Evans, 
    108 S.W.3d 231
    , 236
    (Tenn. 2003). The State contends the evidence presented at trial showed that the defendant had
    digitally penetrated two children when the children were five and six years old respectively. The
    defendant in his reply brief provides citations to Tennessee Rule of Appellate Procedure 13(e) and
    State v. Cabbage, 
    571 S.W.2d 832
     (Tenn. 1978), to show that he has not waived the issue, and we
    will decide the issue on the merits.
    Our standard of review when the sufficiency of the evidence is questioned on appeal 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, 
    99 S. Ct. 2781
    , 2789 (1979). This means that we may not reweigh
    the evidence, but must presume that the jury has resolved all conflicts in the testimony and drawn
    all reasonable inferences from the evidence in favor of the State. See State v. Sheffield, 
    676 S.W.2d 542
    , 547 (Tenn. 1984); State v. Cabbage, 
    571 S.W.2d 832
    , 835 (Tenn. 1978).
    We agree with the State that the evidence is sufficient to convict the defendant of three
    counts of rape of a child. The offense consists of showing beyond a reasonable doubt that (1) the
    defendant unlawfully sexually penetrated the victim, (2) who was less than thirteen years old, and
    that (3) the defendant acted intentionally, knowingly, or recklessly. T.C.A. § 39-13-522 (2003)
    (amended 2005, 2006, 2007). In the cases at bar, the evidence showed that at Thanksgiving 2004,
    the two child victims were ages five and six. The evidence showed that the defendant penetrated
    J.B.’s vagina and anus and B.R.’s anus. The fact finder accredited the testimony of the two children
    -7-
    and the nurses. The children testified that their uncle, the defendant, had touched and penetrated
    them. The nurses testified that the children’s injuries were caused by penetration and that the healed
    tissue was consistent with injuries occurring at Thanksgiving 2004. We note that the jury found the
    defendant not guilty on two counts and that three of the counts were dismissed during the trial. The
    defendant has not met his appellate burden of showing how the evidence is insufficient to support
    the verdict. The defendant’s argument on appeal essentially asks this court to weigh the credibility
    of the two victims and the other witnesses, which we cannot do. See State v. Evans, 
    108 S.W.3d 231
    , 236 (Tenn. 2003) (citing State v. Bland, 
    958 S.W.2d 651
    , 659 (Tenn.1997)). We hold that there
    was sufficient evidence to convict the defendant of three counts of rape of a child.
    II. ADMISSION OF THE NURSES’ STATEMENTS
    After the voir dire of both nurses outside the presence of the jury, the court ruled that the
    testimony identifying the perpetrator might be relevant for both diagnosis and treatment. The court
    found that the evidence supported the State’s claim that the victims went to this specific facility for
    diagnosis and treatment. The witnesses testified that the identification of the abuser was important
    for two reasons: (1) to report the presence of sexually transmitted disease, if present, to the
    Department of Health for it to be “traced and treated,” and (2) to prevent recurring harm to the victim
    if the abuser were a member of the household. The court also stated that it would admit this
    evidence because the State said it would introduce evidence that the victims had been in the
    defendant’s home on other occasions.
    The defendant claims that the court erred in admitting the testimony of two sexual assault
    center nurses recounting the victims’ statements because the nurses’ testimony was not a hearsay
    exception under Tennessee Rule of Evidence 803(4). Citing State v. McLeod, 
    937 S.W.2d 867
    , 873
    (Tenn. 1996), the defendant claims their testimony was inadmissible as the children’s statements
    were not made for both diagnosis and treatment, but instead were merely for “evaluation” of possible
    sexual assault that the center would forward to the patient’s primary care physician.
    The State responds that the court did not abuse its discretion when admitting the testimony
    because the facts of the case indicate that the statements were made for diagnosis and treatment.
    State v. Stinnett, 
    958 S.W.2d 329
     (Tenn. 1997). It asserts the court looked to the circumstances
    surrounding the statement of the child declarant as required by McLeod to determine whether the
    statement was made for diagnosis and treatment and used State v. Livingston, 
    907 S.W.2d 392
    , 397
    (Tenn. 1995), to support its decision to admit the identification testimony of the minor declarants.
    The Tennessee Rules of Evidence allow the admission of certain hearsay exceptions,
    including statements made for diagnosis and treatment. Tenn. R. Evid. 803(4). Our supreme court
    stated in Stinnett that this type of statement is reliable for two reasons: (1) “a statement made by a
    patient to a [medical provider] is presumptively trustworthy because a patient is strongly motivated
    to speak the truth in order to receive proper diagnosis and treatment” and (2) “any statement upon
    which a [medical provider] will rely as a basis for diagnosis and treatment is also sufficiently reliable
    for consideration by a court of law.” Stinnett, 958 S.W.2d at 331 (citations omitted). The court also
    found that if a statement is made for diagnosis and treatment and the statement “regard[s] the general
    character, cause, or source of the problem,” this statement is admissible if it is “reasonably pertinent
    -8-
    to diagnosis and treatment.” Id. (citing McLeod, 937 S.W.2d at 870). In determining whether a
    child declarant made a statement for diagnosis and treatment that would be admissible as a hearsay
    exception, the trial court must consider the “circumstances surrounding the making of the statement,”
    including whether a custody battle is pending and whether the child’s statement followed suggestive
    or leading questioning. McLeod, 937 S.W.2d at 871.
    The children at the time of their examinations were five and six years old. The nurses’
    testimony reflected that the children stated how they were injured and who injured them in order to
    be examined by the nurses. The nurses used this information to determine their treatment response.
    The nurses testified that after hearing the victims’ medical histories, they took urine samples from
    the victims to test for sexually transmitted infections. The testing was not gratuitous. The nurses
    ordered the testing to determine if the victims had any infections resulting from the penetration. If
    these samples had revealed any infection, the nurses would have treated the victims. Ms. DiScenza
    stated that she recommended that J.B. follow up to treat her general redness, which the nurse
    suspected was symptomatic of a urinary tract infection, as J.B. had told her that urinating caused
    pain. The tests were negative. As noted in State v. Spratt, 
    31 S.W.3d 587
    , 600-01 (Tenn. Crim.
    App. 2000), the fact that actual treatment was not necessary is irrelevant to the inquiry.
    Additionally, the victims in the instant case differ significantly from the second victim of
    State v. McLeod, 
    937 S.W.2d 867
     (Tenn. 1996), where our supreme court found similar statements
    were inadmissible hearsay. In McLeod, our supreme court found that a second victim’s statements
    were not made for diagnosis and treatment. This particular person told her medical provider that she
    had been fondled. Her examiner testified that she had examined the patient but that she had not
    expected to find signs of abuse. The supreme court found that “[t]he nature of the abuse made it
    unlikely that a physical examination would uncover trauma or other evidence of sexual abuse.” 937
    S.W.2d at 873. Thus, the statement had not been made for purposes of diagnosis and treatment and
    was inadmissible hearsay.
    Unlike the second victim in McLeod, the children in the present case stated that they had
    been penetrated vaginally and anally. The nurses conducted the subsequent examinations to check
    for physical signs of this abuse. The nurses used these statements to diagnose and to treat the
    children, if necessary, for any conditions resulting from penetration, and they noted their findings
    of healed tissue and missing tissue. At trial, they stated that their findings were consistent with the
    events their patients recounted.
    The trial testimony also does not indicate any custody or familial dispute that our supreme
    court stated could “affect trustworthiness” of the statement. McLeod, 937 S.W.2d at 871. Also, the
    trial transcript does not reveal suggestive questioning of the victims. We conclude the trial court
    properly admitted the testimony of the nurses after determining that the statements were made for
    the purposes of diagnosis and treatment.
    III. COMPETENCE OF THE CHILDREN TO TESTIFY
    During voir dire, although J.B. initially agreed that she had once lied daily, she stated that
    her mother had sent her to a corner when she lied. She also said that she knew what it meant to make
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    a promise. She said that if someone made and then broke a promise, then “people [would be] sad.”
    She stated that she understood “oath” meant she was promising to tell the truth and that she would
    tell the truth while testifying. She also claimed she had told the truth to investigators. The trial court
    found that the State had demonstrated that J.B. understood the necessity of telling the truth and the
    consequences for not telling the truth.
    B.R. said during the voir dire that she knew the difference between the truth and a lie. She
    correctly answered true-or-false questions about the colors of clothing and hair of people in the
    courtroom. She said she could promise to tell the truth and that this would mean she could be
    trusted. She said that it was bad to break promises. During cross-examination, however, she did not
    remember telling an investigator that she lied “all the time.” She said she understood that she could
    be punished if she did not tell the truth on the witness stand. The court held that she was competent
    to testify.
    The defendant contends that the trial court erred in determining that the two young victims
    were competent to testify. He cites State v. Ballard, 
    855 S.W.2d 557
     (Tenn. 1993), to question the
    children’s ability to distinguish between the truth and a lie. He relies on a reproduced section of the
    voir dire without further analysis.
    The State responds that the defendant has waived this issue pursuant to Rule 10(b) of the
    Rules of the Court of Criminal Appeals by failing to support the issue with argument, citing one
    case, and reproducing a section of the voir dire without analysis. Alternatively, the State argues that
    the defendant failed to demonstrate that the trial court abused its discretion by determining that the
    children were competent to testify pursuant to Ballard. The defendant in his reply brief refutes the
    State’s claim of waiver, and we will decide the issue on its merits.
    Under Tennessee law, “[e]very person is presumed competent to be a witness except as
    otherwise provided.” Tenn. R. Evid. 601. “Before testifying, every witness shall be required to
    declare that the witness will testify truthfully by oath or affirmation, administered in a form
    calculated to awaken the witness’s conscience and impress the witness’s mind with the duty to do
    so.” Tenn R. Evid. 603. “The question of whether a child-victim is competent to testify . . . rests
    within the sound discretion of the trial court.” State v. Griffis, 
    964 S.W.2d 577
    , 592 (Tenn. Crim.
    App. 1997) (citing State v. Hallock, 
    875 S.W.2d 285
    , 293 (Tenn. Crim. App. 1993)). “The pivotal
    issue in the court’s determination is the child-victim’s ability to understand the necessity of telling
    the truth while testifying during the course of the trial.” Griffis, 964 S.W.2d at 592 (citing State v.
    Ballard, 
    855 S.W.2d 557
    , 560 (Tenn. 1993)). We will not overturn the trial court’s competence
    determination absent the abuse of discretion. Hallock, 875 S.W.2d at 293.
    In the instant case, the trial court found that the State had demonstrated that each of the two
    children understood the necessity of telling the truth and the consequences for not telling the truth.
    Before each of the child witnesses testified, the court heard the child’s responses to questions from
    counsel. Each witness said that when she had lied in the past, she had been punished for not telling
    the truth. In each hearing, the State demonstrated that the young witness understood what a promise
    was, and each witness promised to tell the truth while testifying. We conclude the trial court did not
    abuse its discretion when the court found the child victims were competent to testify.
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    Based on the foregoing and the record as a whole, we affirm the judgments of the trial court.
    ___________________________________
    JOSEPH M. TIPTON, PRESIDING JUDGE
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