State of Tennessee v. Stephanie Brown ( 2020 )


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  •                                                                                        06/25/2020
    IN THE COURT OF CRIMINAL APPEALS OF TENNESSEE
    AT KNOXVILLE
    November 20, 2019 Session
    STATE OF TENNESSEE v. STEPHANIE BROWN
    Appeal from the Circuit Court for Sevier County
    No. 21718 Rex H. Ogle, Judge
    ___________________________________
    No. E2019-00223-CCA-R3-CD
    ___________________________________
    A Sevier County Jury found Defendant, Stephanie Brown, guilty of reckless homicide.
    The trial court imposed a sentence of four years to be served in confinement. On appeal,
    Defendant raises the following issues: (1) whether the trial court properly admitted
    testimony about the hydrostatic or float test performed on the baby’s lungs; (2) whether
    the trial court properly admitted Defendant’s confession and denied her motion to dismiss
    the indictment; (3) whether the evidence was sufficient to support Defendant’s conviction
    for reckless homicide; and (4) whether the trial court properly sentenced Defendant.
    Upon reviewing the record and the applicable law, we affirm the judgment of the trial
    court.
    Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed
    THOMAS T. WOODALL, J., delivered the opinion of the court, in which JAMES CURWOOD
    WITT, JR., and D. KELLY THOMAS, JJ., joined.
    Edward C. Miller, District Public Defender, Dandridge, Tennessee, for the appellant,
    Stephanie Marie Brown.
    Herbert H. Slatery III, Attorney General and Reporter; Katharine K. Decker, Assistant
    Attorney General; James B. (Jimmy) Dunn, District Attorney General; and Tim Norris,
    Assistant District Attorney General, for the appellee, State of Tennessee.
    OPINION
    BACKGROUND
    Pretrial Daubert Hearing
    Defendant filed a pretrial “MOTION REQUESTING DAUBERT HEARING”
    seeking to exclude Dr. Amy Hawes’ testimony concerning the “float” test that was
    performed on the victim’s lungs and to hold a hearing pursuant to Daubert v. Merrell
    Dow Pharmaceuticals, Inc., 
    509 U.S. 579
    (1993), to determine the relevance and
    reliability of Dr. Hawes’ testimony.
    At the pretrial hearing, Dr. Hawes testified as an expert in forensic pathology. She
    explained that one of the tests that forensic pathologists are trained to conduct to
    determine whether a child is stillborn or born alive is called the flotation (float) or
    hydrostatic test. She said that the float test is a very simple test during which the lungs
    are removed and placed in a bucket or container of water. If the lungs float, it can be an
    “indicator in certain circumstances of live birth.” If the lungs do not float, “it can be an
    indicator that the child was potentially stillborn.” Dr. Hawes further testified: “There are
    some caveats to the interpretation of the hydrostatic test, but in the simplest of terms,
    that’s what it means.” Dr. Hawes performed the float test in this case, and her autopsy
    findings on the baby girl were indicative of a live birth and that the baby died of
    asphyxia. In determining that the baby was born alive, Dr. Hawes found that her lungs
    were fully inflated and floated in water.
    Dr. Hawes agreed that there are circumstances when the float test is less reliable
    than other tests, such as when a child is decomposed. In that circumstance, the gas
    produced causes the lungs to float which in turn causes a potential false positive result.
    Dr. Hawes noted that mouth-to-mouth resuscitation may also cause a false positive. She
    testified that there are also false negatives with the float test where a child is documented
    to have been born alive but their lungs sink during the float test. Dr. Hawes testified that
    she did not find any type of decomposition present in the baby in this case, and to her
    knowledge no mouth-to-mouth resuscitation was performed on the child. As far as she
    knew, chest compressions would not affect the validity of the float test. Dr. Hawes
    explained that a false positive means that the lungs float on a child that was actually
    stillborn. A false negative means that the lungs sink on a child that was live born.
    Dr. Hawes testified that the float test has been around for “a long, long time.” She
    noted that in medical literature “there are multiple articles about discussing its usefulness
    and its limits and in what context it must be interpreted.” Dr. Hawes was familiar with a
    study from the International Journal of Legal Medicine published in 2013 titled, “Is the
    lung floating test a valuable tool or obsolete? A prospective autopsy study.” She
    -2-
    testified that the study was done on infants who were autopsied in which the float test
    was performed. The findings of the study were summarized as follows:
    The study proves that for contemporary medicine, the lung floating test
    is still a reliable indicator of a newborn’s breathing. As there was no
    false-positive result, [. . .] a wrongful conviction for killing a newborn
    just on behalf of the floating test cannot be expected. On the other hand,
    the study shows a negative floating test result is not proof for a stillbirth.
    Summing up the study allows the advice to still perform the lung floating
    test in every medicolegal investigation with the uncertainty, if a newborn
    has breathed or has not. The known restrictions, as well as study’s
    findings, must be taken into account, however.
    Dr. Hawes noted that 194 stillborn babies were tested in the study, and none of the lungs
    floated indicating a false positive result. Fourteen additional babies in the study were
    verified to have been born alive and lived for two days up to ten months. The lung
    floating test was positive in ten of fourteen cases. Dr. Hawes testified:
    Four times it showed a negative result, although life and breathing had
    been reported by medical staff. In all of these four cases, the whole lung,
    as well as the separated left lung and right lung and single pieces from
    both sides sank; no piece was able to swim. These four newborns were
    born prematurely between the 27th and 35th week of pregnancy.
    Dr. Hawes agreed that the four cases indicated a false negative result, a twenty-nine
    percent rate of error. She asserted that false negatives are not an issue in Defendant’s
    case.
    Dr. Hawes testified that she has been employed by three different medical
    examiner’s offices during her career, and they all employed the float test to determine
    whether an infant was born alive or stillborn. Dr. Hawes also identified the “Handbook
    of Forensic Pathology” produced by the College of American Pathologists. She noted
    that the book also discussed the float test as one test used in the context of an overall
    investigation to determine live birth versus stillborn. Dr. Hawes testified that she had not
    performed the float test very often because she does not often investigate whether a live
    birth occurred.
    On cross-examination, Dr. Hawes agreed that the float test has caused controversy
    and discussion. She further agreed that the float test is not perfect and that it has
    limitations and must be interpreted in the appropriate context. Dr. Hawes acknowledged
    that the float test is a simple test, “[b]ut just because the lung floats doesn’t mean that I’m
    going to state to a medical certainty that the child was born alive.” Likewise, Dr. Hawes
    -3-
    testified that she would not say that a child was stillborn solely because the lungs sank.
    She reiterated that “it has to be taken in the context of all the other findings.”
    Dr. Hawes acknowledged that she did not follow the steps recommended by Chris
    Milroy, a forensic pathologist. in his publication for conducting the float test. Rather, she
    relied on the “Handbook of Pathology, Second Edition.” Dr. Hawes testified that she
    performed the test the way that she was trained at Vanderbilt University which was the
    current recommended way. Dr. Hawes was also familiar with a book titled “Knight’s
    Forensic Pathology.” She acknowledged that an article in the textbook indicates that
    there are too many false positive and false negative results to allow the float test to be
    used in a criminal trial. The article concluded that is it “pointless to apply the hydrostatic
    [float] test, which will impair the material for other and more important investigations.”
    Dr. Hawes acknowledged that the article also indicated that attempts at
    resuscitation such as mouth-to-mouth, external cardiac massage, and the administration
    of oxygen “completely negate any of the already fragile tests for respiration in a newborn
    infant.” Dr. Hawes pointed out that chest compressions were done in the present case,
    and she did not consider that to be external cardiac massage because artificial respiration
    was not given. She again stated: “[D]espite its limitations, in my training and experience
    and based on my reading of the medical literature, is that you still do the [float] test, but
    you interpret the findings in context of everything else you know about the scene
    investigation and autopsy.” Dr. Hawes agreed that movement of the baby’s body by
    others could potentially cause air to enter the baby’s lungs. Dr. Hawes also
    acknowledged a case report by Greg Davis, a forensic pathologist, in which Dr Davis
    stated that the float test was unreliable in unattended births. She interpreted Dr. Davis’
    statement to mean that there are restrictions to the interpretation of the float test and that
    he was discussing the results of the test as applied to his particular case.
    Anna Mooney testified that she never heard the baby cry before learning that
    Defendant had given birth in the bathroom. She said that the baby was in a plastic bag
    with towels on top. She removed the towels and performed chest compressions with two
    fingers on the baby for approximately thirty seconds. Ms. Mooney testified that Matthew
    Mooney then took the baby, who was still in the bag, and placed her in a box.
    Dr. Thomas A. Andrew, a forensic pathologist at White Mountain Forensic
    Consulting Services, testified as an expert in forensic pathology. He is also a board-
    certified pediatrician. He reviewed the autopsy performed in this case, the preliminary
    hearing testimony, an interview, and pictures and microscopic slides of the baby’s lungs.
    He disagreed with Dr. Hawes’ findings that the baby was born alive. He found the float
    test particularly troubling and that it should not be relied upon. He testified that the float
    test has been used regularly since the 15th century, and “[i]t is a staple in everybody’s
    training. It is almost expected in the conduction of these autopsies.” Dr. Andrew
    asserted that the float test has yielded both documented false positive and false negative
    -4-
    results when the test is applied. He testified that the test is not as widely accepted in
    Anglo-Saxon countries as it is in Germany and that it “doesn’t have a scientific evidence
    base to back up its reliability.”
    It was Dr. Andrew’s opinion that the chest compressions performed by Anna
    Mooney negated the results of the float test in this case. He noted that the more a body is
    handled, the more air can be introduced into the lungs. Dr. Andrew testified that the
    slides of the baby’s lungs showed that the lower corner of the lungs was not as well
    expanded which to him represented patchy aeration. He also testified that what Dr.
    Hawes referred to as hemoaspiration in the lungs, he would have interpreted as petechiae,
    which can occur in the lungs or under the scalp for any number of reasons including
    birth. Dr. Hawes testified that there was nothing specific in the slides that would “allow
    [him] to opine that the child was born alive without any other possibility[.]” He noted
    that the baby’s lungs looked mottled to him as opposed to fully expanded pink lungs.
    Dr. Andrew testified concerning a British technique used to perform the float test
    where the “pluck,” which consisted of the lungs and heart with the neck organs attached,
    is floated. He said that Dr. Hawes did not use the whole pluck but only used the baby’s
    lungs and air passages. Dr. Hawes testified that the literature is “all over the place” about
    how to float the pluck. He agreed that the pictures of the baby’s lungs in this case
    showed the lungs floating. Dr. Andrew testified that the theory behind the float test is
    that “air is lighter than blood or tissue, and, therefore, the air in the lungs would provide
    the buoyancy . . . to keep those lungs up on the surface. A non-inflated lung would sink
    because it’s heavier. It’s not made buoyant by air.” Dr. Andrew agreed that it is possible
    for an infant to breathe during the birthing process and that petechiae in and of itself is
    not indicative of a live birth.
    On cross-examination, Dr. Andrew clarified that the float test is also generally
    accepted in Anglo-Saxon countries, but it is “hugely controversial” and has been debated
    for many years. Dr. Andrew further testified that the float test is commonly performed
    but “there are a myriad of caveats involved with it that makes it, in the minds of some
    forensic pathologists, relatively unreliable.” He admitted that he had been trained to
    conduct the test. Dr. Andrew noted that Dr. Hawes was correct in pointing out that the
    test must be interpreted against the background of other data, which he agreed is true of
    most tests conducted in forensic pathology. He testified: “It’s a matter of how much
    weight to give it in terms of interpreting what it means in the context of your individual
    case. And I have found and agree with most authors who find it so larded with caveats
    that it is hardly worth the effort.” Dr. Andrew testified as to how he was trained to
    conduct the float test, and he agreed that it was fair to say that forensic scientists are
    trained differently in different schools and in different areas in how to perform the test.
    He agreed that false positive results were at issue in this case. He also agreed that he did
    not find any evidence of putrefaction in this case.
    -5-
    Dr. Andrew testified that he was not given Defendant’s statement in which she
    said that she had placed her hand over the baby’s mouth and nose. Dr. Andrew said that
    he did not make any findings concerning that baby’s death and that it was “entirely
    undetermined as to whether or not this baby was live born or still born.” When asked if
    the admission of the float test would substantially assist the jury in this case, Dr. Andrew
    replied: “I think given the unreliability of the [float] test, I think a confused jury would
    not find it very helpful at all.”
    The trial court denied Defendant’s motion and allowed Dr. Hawes to testify
    finding that the testimony concerning the float test met the standards of admissibility
    under Daubert and that if the jury accepted the test as true, accurate, or helpful that it
    “would very much substantially assist the trier of fact.”
    State’s Proof at Trial
    Bobby H. Laws, Jr. testified that he and Defendant became romantically involved
    while the two were working together, and Defendant eventually began staying with him
    in the home that he shared with his mother Lisa Mooney, brother Matthew Mooney, and
    sister-in-law Anna Mooney in Kodak.
    On January 13, 2016, Defendant woke up and complained that her stomach was
    hurting, but she refused to see a doctor. Later than night, sometime between 10:00 and
    11:00 p.m., Defendant told Mr. Laws that she was going to take a shower. Mr. Laws fell
    asleep and woke up at 12:30 a.m. because the dog was barking. He did not see
    Defendant, and he got up to look for her. Mr. Laws walked through the house and did
    not see Defendant. Although the bathroom door was shut, Mr. Laws saw a light under
    the door and assumed that Defendant was still in the bathroom. Mr. Laws testified that
    he laid back down in the bed, and Defendant walked out of the bathroom and into the
    bedroom. He said that Defendant told him that she had just given birth to a stillborn
    baby, later determined to be a girl. Mr. Laws testified that he asked Defendant where the
    baby was located, and she said that the baby was still in the bathroom. Mr. Laws testified
    that he got dressed and started his truck while the Defendant walked back into the
    bathroom.
    Mr. Laws said that Defendant eventually walked back into the bedroom and stood
    at the end of the bed. He testified:
    And I said, “We need to go to the hospital.” And she kind of just stood
    there. I don’t know if she was in shock or what. She had this, like,
    vague look on her face like she was there physically but not, like,
    mentally there. And I was like - - I said, “We need to go. We need to go
    to the hospital now.” And I said, “Get some clothes on.” And she starts
    - - like, she slowly starts getting her clothes, and I guess she was - - must
    -6-
    have been still in shock or something. And after that, it’s kind of a little
    blurry.
    Mr. Laws said that he told Defendant to swaddle the baby in some towels, and he also
    grabbed a box. Mr. Laws testified that he, Defendant, and Matthew and Anna Mooney
    got into the truck with the baby, and Mr. Laws drove them to the LeConte Medical
    Center in Sevierville. Defendant testified that he did not see Defendant again until the
    following day in her hospital room. He did not see his baby daughter again until the
    funeral. Mr. Laws denied that he looked into the bathroom the night that Defendant gave
    birth or that he cleaned the bathroom. He said that Defendant did not need help getting
    dressed after she gave birth or help getting in or out of the truck when they went to the
    hospital. Mr. Laws testified that approximately one to one and a half months before
    Defendant gave birth, he “jokingly” asked her if she was pregnant, and she said no. He
    noticed that Defendant had gained a little weight, and she told him that she thought she
    had a hernia.
    On cross-examination, Mr. Laws testified he was aware that Defendant had
    discussed with her mother whether she might have a hernia. There was also a discussion
    on the day that Defendant gave birth that she did not feel well because she thought that
    she had food poisoning from eating at a restaurant.
    Matthew Mooney testified that he and Anna Mooney were sitting on the couch
    watching television late at night on January 13 when Defendant went into the bathroom
    and remained for a long time. At some point, Mr. Laws walked out of his bedroom and
    used the remote to start his truck. Mr. Mooney asked Mr. Laws what was going on, and
    Mr. Laws eventually told him that Defendant had given birth in the bathroom and that the
    baby was dead. Anna Mooney then went into the bathroom to determine what had
    happened. Mr. Mooney later looked into the bathroom and saw the baby on the counter
    in a trash bag. He said that they considered whether to drive the baby to the hospital or
    wait for an ambulance but they chose to drive her to the hospital. Mr. Mooney noted that
    they decided to place the baby in a box so that no one else would see her when they took
    her into the hospital. Mr. Mooney testified that the bathroom was “very, very clean.”
    On cross-examination, Mr. Mooney noted that Defendant did not appear to be
    pregnant, and he had no “clue” that she was pregnant. He agreed that Defendant was a
    quiet person who did not talk to a lot of people. He said that she was normally in Mr.
    Laws’ room when she was in the house. Mr. Mooney testified that everyone was
    thinking “erratically” after learning that Defendant gave birth.
    Anna Mooney testified that she knocked on the door while Defendant was in the
    bathroom and asked to come in, and Defendant said yes. Mrs. Mooney looked down and
    noticed two garbage bags in front of Defendant. She asked Defendant if everything was
    alright, and Defendant told her that she had delivered a stillborn baby. Defendant
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    appeared to be in shock and pointed at the garbage bag. Mrs. Mooney opened the bag
    and found the baby underneath some towels. She attempted to resuscitate the baby by
    doing chest compressions with her two fingers but she stopped after the baby did not
    respond. Mrs. Mooney testified that she then hugged Defendant. She said that Mr.
    Mooney came into the bathroom and took the baby and the other trash bag containing the
    placenta and placed them in a box. Defendant and the baby were then taken to the
    hospital. Once they arrived at the hospital, Mrs. Mooney gave the baby girl, who was
    still in the box, to a nurse who began crying when she looked inside, and the nurse gave
    the baby to another nurse. Defendant and the baby were taken to the back, and Mrs.
    Mooney did not see Defendant again at the hospital. Mrs. Mooney admitted that no one
    at the house called 911 after discovering the baby.
    On cross-examination, Mrs. Mooney testified that she had no idea Defendant was
    pregnant. Mrs. Mooney described Defendant as “a really anxious person.” She also said:
    “[Defendant] was really quiet, wouldn’t really talk, and I know she hated big crowds.
    Driving made her nervous.”
    On re-direct examination, Mrs. Mooney testified that Defendant told her at the
    hospital that she was nervous about her cell phone because she had looked up “baby
    stuff.” She said that Defendant was nervous about going to jail because of the phone.
    Dana McIlwain was working as a registered nurse at the LeConte Medical Center
    during the early morning hours of January 14, 2016, when Defendant came into the
    emergency room. She described Defendant as having a “flat effect,” which meant that
    she showed no emotion.
    Detective Maria Cutshaw of the Sevier County Sheriff’s Office was assigned to
    investigate the present offense. She spoke by phone to a nurse at the LeConte Medical
    Center and then drove to the hospital arriving at approximately 3:00 a.m. Detective
    Cutshaw spoke with a nurse at the hospital who briefed her on what happened. Detective
    Cutshaw then spoke to Defendant who was waiting in a room within the emergency
    room. Detective Cutshaw testified that she saw the newborn baby in an adjacent room in
    an Amazon Prime box. She noted that there were two different bags in the box with one
    containing the baby. The placenta was in the other bag. Detective Cutshaw spoke with
    someone from the medical examiner’s office, and it was determined that an autopsy
    needed to be performed on the baby. Detective Cutshaw later went to the Mooney
    residence and spoke with Lisa Mooney. She allowed Detective Cutshaw inside to look
    around and take photographs.
    Detective Cutshaw testified that after reviewing findings from the autopsy report,
    she re-interviewed Defendant on March 22, 2016, at the sheriff’s office. Defendant
    initially denied knowing that she was pregnant before giving birth, and she claimed that
    the baby was not breathing and did not have a pulse when she was born. Defendant
    -8-
    eventually admitted that she realized her pregnancy a few weeks before giving birth. She
    then admitted that she killed her newborn baby by placing her hand over the baby’s
    mouth and nose a few minutes after she was born. Defendant said that the baby had
    moved a little and had moved her arm. She told Detective Cutshaw that she did not know
    why she stopped covering the baby’s mouth, but after a few minutes she checked the
    baby’s pulse and found none. She then realized that the baby was dead. Defendant said
    that she placed the baby in one bag and put the placenta in another. She also put the bath
    mat in one of the bags. Defendant said that she sat in the bathroom for a long time and
    then cleaned the room. She asserted that she was in shock. Detective Cutshaw testified
    that a search warrant was executed on Defendant’s cell phone but they were unable to
    obtain any internet browsing history from the phone.
    Dr. Amy Hawes is a forensic pathologist at the Knox County Regional Forensic
    Center. She performed an autopsy on the baby girl in this case. Dr. Hawes determined
    that the baby was born at term or near term. She noticed a faint blue contusion around
    the baby’s left eye. Dr. Hawes testified:
    So there were several findings of note that taken together, in total, the
    findings led me to believe that this was a live-born infant, and those
    findings included inflated lungs. So the lungs contained air. There was
    petechiae, which is the term for tiny busted blood vessels, and those
    were found beneath the scalp. The term for that is subgaleal. It just
    means beneath the scalp. And there were also petechiae, or little tiny
    busted blood vessels, on the lining of the lung.
    When asked how she determined that the baby’s lungs were inflated, Dr. Hawes
    further testified that she relied on direct visual inspection of the lungs, and from sixteen
    years of performing autopsies, she had learned what inflated lungs looked like. Dr.
    Hawes also relied on a microscopic examination of the baby’s lungs. She said that under
    the microscope, the baby’s lungs appeared uniformly inflated and the lungs of a stillborn
    will not appear uniformly inflated. Dr. Hawes testified that the baby had blood in her
    lungs which indicated that she had breathed or had air in her lungs. Additionally, Dr.
    Hawes performed a float test.
    Dr. Hawes summarized her findings in the autopsy report as follows:
    [T]he term infant was live-born. There were no blunt trauma injuries, no
    congenital anomalies, which means the body was normally developed,
    and there were no other histologic or microscopic findings to explain
    death. Given the infant was placed in a plastic bag after birth,
    suffocation is the most likely cause of death. Other forms of asphyxia,
    such as smothering, cannot be excluded.
    -9-
    Dr. Hawes testified that she was later advised that Defendant admitted to placing her
    hand over the baby’s mouth and nose after birth, which was consistent with her findings
    in the autopsy report.
    On cross-examination, Dr. Hawes testified that the float test is a very simple test
    that “has been around for hundreds of years.” She described the test as follows:
    But, in summary, the way I was trained to do it, is when the lungs are
    removed, you place the lungs in a container of water. Some people do it
    both lungs in the same container. Some people separate them. Some
    people do it with the heart still attached. Some people do them
    separately. But you put it in water, or some other liquid, like formalin,
    which is a liquid preservative. And if they float, the lungs float, it could
    be an indicator of a live birth; and if they sink, it can be an indicator of a
    stillbirth.
    Dr. Hawes noted that the float test was not a perfect test and could produce both false
    negative and false positive findings. She also testified that “modern medicine agrees that
    we don’t rely on that one test to absolutely decide whether an infant is live-born or
    stillborn. It’s just one test that we are trained to do and one piece of information that we
    use in the context of the overall findings.” Dr. Hawes testified that she based her autopsy
    findings on the totality of “[t]he history, the confession, or purported confession, the
    autopsy findings, and all the other studies.” It was Dr. Hawes’ opinion that the manner of
    death of the baby was homicide.
    Defense Proof
    Dr. Thomas Andrew, a forensic pathologist, testified that he reviewed Dr. Hawes’
    findings but not to determine the baby’s cause of death. He said: “My charge in this case
    was to look at the medical evidence as presented by the autopsy to reach some sort of
    opinion, if possible, as to whether or not the infant was live-born or stillborn.” Dr.
    Andrew noted that a lack of prenatal care and an unattended delivery all increase the
    possibility of stillbirth in a pregnancy.
    Dr. Andrew disagreed with Dr. Hawes’ findings that the baby was born alive. He
    did not believe that the petechiae he observed in the baby rose to “the level of allowing a
    determination of live birth.” He noted that the petechia, which was mainly on the surface
    of the baby’s lungs, could appear passively “just as a matter of pressure passing through
    the birth canal, and underneath the scalp, may well be caused some - - in some cases by
    simply reflecting the scalp during autopsy.” Dr. Andrew reviewed the images of the
    baby’s lungs and noted that the lungs were “relatively mottled” which meant that there
    were alternating areas of red and pink. To Dr. Andrew this meant that the lungs were
    incompletely or irregularly aerated or not fully inflated, and “[t]he infant had not taken
    - 10 -
    robust breaths or anything of that nature.” Dr. Andrew testified that partial inflation of
    the baby’s lungs could have been caused by “decomposition or postmortem putrefaction
    of tissue” or some attempt to resuscitate the baby by mouth-to-mouth resuscitation or
    chest compressions. He also noted that “handling of the body of an infant after birth can
    artificially introduce various amounts - - or varying, I should say, amounts of air into the
    respiratory tract.” Dr. Andrew noted that approximately ten people handled the baby’s
    body prior to the autopsy.
    From the photographs of the baby’s lungs, Dr. Andrew disagreed with Dr. Hawes’
    finding that the victim’s lung was a well-inflated lung. Dr. Andrew further opined: “I
    have no reason to doubt that there was hemoaspiration, but on the basis of that image,
    from that part of that lung against the whole, does not allow me to reach a conclusion that
    this was a live birth.” Dr. Andrew testified that he had training in conducting the float
    test. He noted that the test was a very old one which dated back to the 15th century. Dr.
    Andrew noted that there have been many modifications of the test to overcome known
    deficiencies of the test which led to false negatives and false positives. According to Dr.
    Andrew, the float test should be “used with great caution, and as Dr. Hawes has pointed
    out, in conjunction with a lot of other information. In and of itself, it is not a reliable
    guide as to live-birth versus stillbirth.”
    On cross-examination, Dr. Andrew testified that he reviewed the autopsy report,
    the slides, and the ancillary studies in this case. He agreed that in conducting an autopsy,
    it is important to rely on case histories and witness statements, not solely on medical
    findings. He acknowledged that a mother’s statement indicating that she had seen her
    baby’s arms move and then placed her hand over the baby’s nose and mouth would
    “certainly have to be considered.” Dr. Andrew agreed that he was not saying that the
    baby was stillborn. He further testified: “I think the medicine as presented by this
    autopsy is insufficient to explain live birth versus stillbirth regardless of the placement of
    either the body or a breathing, albeit depressed infant in a plastic bag. The medicine
    can’t overcome the ambiguities of the findings here.”
    Donnie Brooks testified that Defendant worked for him for approximately one
    year when he was an assistant manager at Cracker Barrel. He said that Defendant had
    some issues with anxiety, and “large crowds would bother her somewhat” and cause her
    to have shortness of breath. Cheryl Eakin also worked with Defendant at Cracker Barrel
    for approximately one year, and they later worked at Pottery House together. She last
    saw Defendant approximately one month before Defendant gave birth, and she had no
    suspicions that Defendant was pregnant. Ms. Eakin testified that Defendant was a
    friendly person but very anxious.
    April Martin, Defendant’s grandmother, testified that Defendant was an introvert,
    and she had anxiety but did not take medication for it. She noted that Defendant had
    always maintained employment and was not a troublemaker. On cross-examination, Ms.
    - 11 -
    Martin was not certain that Defendant had been diagnosed with anxiety, “[s]he just
    exhibited all of the symptoms.”
    Dr. Laura Berardi is an OB-GYN at LeConte Medical Center who treated
    Defendant on January 14, 2016. Defendant told Dr. Berardi that she delivered a stillborn
    baby and had only thought that she had a hernia. Dr. Berardi noticed that Defendant had
    a “very flat effect” and a “kind of vacant appearance.” Her notes indicated that
    Defendant was very pale when she first arrived at the emergency room and could not give
    her name. Dr. Berardi said that Defendant was able to answer some of her questions but
    was not very detailed. She was concerned about Defendant’s mental status and consulted
    with a social worker due to Defendant’s lack of any emotion. Dr. Berardi further asserted
    that “you don’t see that after you deliver a dead baby.” On cross-examination, Dr.
    Berardi described Defendant as “[n]ot very forthcoming and no emotion” when she
    responded to Dr. Berardi’s questions.
    Samantha Brown, Defendant’s mother, testified that Defendant was an introvert,
    and she began complaining that she felt anxious and stressed at work. Defendant told her
    that she would start sweating and “freak out.” Ms. Brown testified that she received a
    text message from Defendant at approximately 11:00 a.m. on January 14, 2016, that read:
    “Mom, I’m at the hospital. The strangest thing happened last night. I delivered a dead
    baby.” Ms. Brown testified that Defendant never told her that she was pregnant, and
    Defendant did not appear to be pregnant. She said that Defendant was wearing the same
    size clothing at the time that she gave birth as she always wore.
    Ms. Brown testified that she and Defendant had both discussed that Defendant had
    a hernia, and Defendant told her that she aggravated the hernia at work. The day before
    Defendant gave birth, Ms. Brown had decided that she was going to take Defendant to
    the emergency room. She called Defendant at approximately 4:00 p.m. about going to
    the hospital, and Defendant said that she was very sick due to food poisoning. Ms.
    Brown testified that she visited Defendant in the hospital after she gave birth, and
    Defendant was in shock. She admitted that she told police that Defendant had no
    emotion, and that “[i]t was just as if she was telling us what she had made for dinner the
    night before.”
    Dr. Bruce Frumpkin, a clinical and forensic psychologist, testified that he
    evaluated Defendant’s “psychological vulnerabilities as it relates to other people to see
    whether she is at a higher risk than the average person of giving a false confession.” He
    clarified that he would not be offering an opinion as to whether or not Defendant gave a
    false confession. Dr. Frumpkin testified as to the five reasons why someone would
    falsely confess to a crime that they did not commit. He noted that false confessions are
    based upon individual psychological vulnerabilities and interrogation tactics, and “the
    combination of both acting together.” On March 17, 2017, Dr. Frumpkin conducted an
    evaluation of Defendant in his office in Philadelphia. He also reviewed the audio and
    - 12 -
    video recordings of Defendant’s interrogation with law enforcement and the transcripts of
    the recordings, various court-related filings and motions, Defendant’s school and
    employment records, and information from another forensic psychologist hired by
    defense counsel to evaluate Defendant. He also reviewed Defendant’s medical records.
    Dr. Frumpkin testified that he saw Defendant for a total of six hours during her
    evaluation, which included some self-administered testing time. He stated that Defendant
    is more vulnerable than the average person to give a false confession. Dr. Frumpkin
    testified that testing showed Defendant “functions at the low average to average range of
    intelligence overall. So her intellectual functioning in particular is not necessarily a risk
    factor, but what is a risk factor is her concentration and memory.” Dr. Frumpkin testified
    that Defendant is very anxious, depressed, socially avoidant, and hypersensitive to
    sounds. He noted that a very anxious person is going to have a harder time with memory
    and concentration. Dr. Frumpkin pointed out that Defendant was in a state of shock at
    the emergency room, and she asserted to law enforcement that her memory as to what
    happened was not good because she was upset. He said: “So that becomes a major risk
    factor for someone succumbing to suggestions from law enforcement, you know, that the
    events did not happen the way you say they happened.” Dr. Frumpkin testified that at
    some point, Defendant began to doubt her own memory as to what happened and began
    to “incorporate into her memory what law enforcement is telling her is what really
    happened.”
    Dr. Frumpkin diagnosed Defendant as having a generalized anxiety disorder and
    avoidant personality disorder. He agreed that she was also having acute stress disorder at
    the time that she gave birth, and it “would have been very hard for her to be able to
    encode information in her memory at the time she was having this acute stress
    disorder[.]” Dr. Frumpkin testified that this would have caused Defendant to have
    “patchy memory” of what really happened at the time of the baby’s birth.
    On cross-examination, Dr. Frumpkin testified that Defendant was the first to
    mention suffocation during her interview with Detective Cutshaw. That was after
    Detective Cutshaw told Defendant that the baby was born alive and then died of
    asphyxiation. Dr. Frumpkin testified that “after a number of denials, eventually
    [Defendant] gave an explanation of how the baby could have died, but initially she
    rejected having anything to do with the baby’s death, saying it was born already dead.”
    Dr. Frumpkin admitted that Defendant told the nurses at the hospital that she cleaned the
    bathroom after giving birth because it “looked like a crime scene.” He agreed that
    Defendant’s judgment and common sense were poor.
    - 13 -
    ANALYSIS
    I.     Admission of Testimony about the Hydrostatic, a/k/a Float, Test
    Defendant argues that the trial court erred by admitting testimony concerning the
    hydrostatic, a/k/a float test which was used in part to determine whether the baby was
    born alive or stillborn. She contends that the float test is not reliable or scientifically
    valid. We disagree.
    Expert testimony, like other evidence, must be relevant in order to be admissible.
    See Tenn. R. Evid. 402 (“Evidence which is not relevant is not admissible.”). Relevant
    evidence is defined as any evidence “having any tendency to make the existence of any
    fact that is of consequence to the determination of the action more probable or less
    probable than it would be without the evidence.” Tenn. R. Evid. 401. This court reviews
    a trial court’s decisions concerning the admissibility of expert evidence under an abuse of
    discretion standard, and will reverse a decision only “‘when the trial court applied
    incorrect legal standards, reached an illogical conclusion, based its decision on a clearly
    erroneous assessment of the evidence, or employed reasoning that causes an injustice to
    the complaining party.’” State v. Parker, 
    350 S.W.3d 883
    , 897 (Tenn. 2011)
    (quoting State v. Banks, 
    271 S.W.3d 90
    , 116 (Tenn. 2008)).
    The admission of expert testimony is governed by Tennessee Rule
    of Evidence 702, which provides that “[i]f scientific, technical, or other specialized
    knowledge will substantially assist the trier of fact to understand the evidence or to
    determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience,
    training, or education may testify in the form of an opinion or otherwise.” Tenn. R. Evid.
    702. “The witness may acquire the necessary expertise through formal education or life
    experiences.” State v. Reid, 
    91 S.W.3d 247
    , 302 (Tenn. 2002) (citing Neil P. Cohen et
    al., Tennessee Law of Evidence § 7.02[4] (4th ed.2000)). “However, the witness must
    have such superior skill, experience, training, education, or knowledge within the
    particular area that his or her degree of expertise is beyond the scope of common
    knowledge and experience of the average person.”
    Id. The determining
    factor is
    “whether the witness’s qualifications authorize him or her to give an informed opinion on
    the subject at issue.” State v. Stevens, 
    78 S.W.3d 817
    , 834 (Tenn. 2002) (emphasis
    omitted).
    In McDaniel v. CSX Transportation, Inc., 
    955 S.W.2d 257
    (Tenn. 1997), our
    supreme court recited several nonexclusive factors that a court may consider in
    determining the reliability of scientific testimony, including:
    (1) whether scientific evidence has been tested and the methodology
    with which it has been tested; (2) whether the evidence has been
    subjected to peer review or publication; (3) whether a potential rate of
    - 14 -
    error is known; (4) whether . . . the evidence is generally accepted in
    the scientific community; and (5) whether the expert’s research in the
    field has been conducted independent of litigation.
    Brown v. Crown Equipment Corp., 
    181 S.W.3d 268
    , 274 (Tenn. 2005) (quoting
    
    McDaniel, 955 S.W.2d at 265
    ). Not all expert testimony will “fit” with these factors,
    thus the exact considerations that may be appropriate will vary depending upon “the
    nature of the issue, the witness’s particular expertise, and the subject of the expert’s
    testimony.” 
    Brown, 181 S.W.3d at 277
    . Our supreme court has stated, “Where the
    expert’s testimony is otherwise reliable and experts in the field would reasonably rely
    upon such evidence, concerns are more properly addressed through vigorous cross-
    examination rather than exclusion of the testimony.” State v. Scott, 
    275 S.W.3d 395
    , 409
    (Tenn. 2009).
    The trial court, in determining that testimony concerning the float test was
    admissible, noted that the testimony was troublesome. The trial court concluded:
    And as we sit here, I certainly wish there was a better test. Now,
    granted, this test is not conclusive of anything. The Court is not here - -
    and everybody gets their hackles up - - but I’m not here to determine
    what was true and what was not true. That’s for the jury to determine.
    This is a classic case of experts in disagreement, and I understand that.
    And, you know, we’ll see what happens. But this is a classic case of the
    weight as opposed to the admissibility, because I do think that based
    upon the testimony that this Court has heard that the test meets the
    standards of admissibility under Daubert and under McDaniel. And
    specifically - - I mean, you know, would it substantially aid the trier of
    fact? It would appear to me that if they accept it as true, the test as
    accurate, or the test as helpful, that it would very much substantially
    assist the trier of fact.
    And, you know, I can understand and I can see where there is a great
    debate on this and there’s a lot to be said about it, and the question - - but
    based upon what I’ve heard, this test is used. It’s been debated, heavily
    debated. Some say it’s the greatest thing since sliced bread, and the
    other one says it’s junk science. I mean, that’s - - you know, so that’s
    why you have experts who testify and give their opinions, and that’s why
    the jury has to decide if they rely upon those expert opinions and what
    weight, if any, they choose to give it.
    And so for those reasons, the Court finds that the evidence as it relates to
    the test is admissible and may be considered by the jury.
    - 15 -
    The trial court did not abuse its discretion in admitting testimony concerning the
    float test. Both Dr. Hawes and Dr. Andrew agreed that the float test is a very simple test
    that has been used regularly since the 15th century, and it is generally accepted. The test
    is based on the fundamental principle that air is lighter than blood or tissue. Therefore,
    lungs inflated with air will float when placed in water, and Defendant does not challenge
    this principle. In fact, Dr. Andrew testified that the float test “is a staple in everybody’s
    training. It is almost expected in the conduction of these autopsies.” Both Dr. Hawes
    and Dr. Andrew were trained to conduct the float test, and there is a variety of techniques
    used to conduct the test. Dr. Hawes testified that the float test was used in all three
    medical examiner’s offices in which she has been employed. Dr. Hawes testified that she
    conducted the test in this case in the manner in which she was trained at Vanderbilt
    University. Defendant argues that the variety of techniques used to conduct the test
    render it “subject to scrutiny.” However, questions about the reliability of the technique
    go to the weight rather than the reliability of the test. See State v. Reid, 
    164 S.W.3d 286
    ,
    336 (Tenn. 2005).
    The float test has been subjected to peer review and publication. Dr. Hawes
    testified that there are multiple articles discussing the usefulness of the float test, its
    limits, and in what context it must be interpreted. She further testified concerning a study
    from the International Journal of Legal Medicine published in 2013 which involved
    infants who were autopsied and on whose lungs the float test was performed. The study
    concluded that the lung floating test “is still a reliable indicator of a newborn’s
    breathing.” Defendant argues that the study showed a 29 percent rate of error. However,
    that rate of error is for false negatives, which is not at issue in this case. In the same
    study there were no false positive results. The study found that “a wrongful conviction
    for killing a newborn just on behalf of the float test cannot be expected.” Dr. Hawes also
    identified the “Handbook of Forensic Pathology” produced by the College of American
    Pathologists, which discusses the float test as one used in the context of overall
    investigation to determine live birth versus stillborn.
    Dr. Hawes and Dr. Andrew testified concerning the known factors that
    pathologists are trained to consider which could affect the interpretation of the float test.
    Such factors include whether air was introduced into a stillborn child’s lungs by
    decomposition, mouth-to-mouth resuscitation, post-mortem handling of the body, or by
    some other means that could be indicated by the degree to which the lungs are inflated.
    As pointed out by the State, Defendant does not challenge the reliability of the float test
    when these factors are considered, and they were considered in this case. Defendant
    asserts that the scientific community does not deem the float test reliable or useful.
    Defendant bases this conclusion on articles and reports introduced at the Daubert hearing
    that disagreed with the use of the float test to determine live birth versus stillborn and that
    were critical of the test. However, these criticisms center around whether the pathologist
    sufficiently identifies and takes into consideration the known factors discussed above
    when interpreting the results of the float test. The disagreements and criticisms in the
    - 16 -
    scientific community surrounding the float test can be addressed at trial on cross-
    examination and goes to the weight and not admissibility of the test. Our supreme court
    has stated:
    The party proffering expert testimony need not establish that the expert
    testimony is correct, only that the expert testimony “rests upon ‘good
    grounds.’” Ruiz-Troche v. Pepsi Cola of P.R. Bottling Co., 
    161 F.3d 77
    ,
    85 (1st Cir. 1998) (quoting 
    Daubert, 509 U.S. at 590
    ); see also In re
    Paoli R.R. Yard PCB Litig., 
    35 F.3d 717
    , 744 (3d Cir. 1994); Burley v.
    Kytec Innovative Sports Equip., Inc., 
    737 N.W.2d 397
    , 406 (S.D. 2007).
    Where such a foundation exists, even if the trial court is of the view that
    there are better grounds for an alternative conclusion, the proffered
    expert testimony “should be tested by the adversary process - competing
    expert testimony and active cross-examination - rather than excluded
    from jurors’ scrutiny for fear that they will not grasp its complexities or
    satisfactorily weigh its inadequacies.” 
    Ruiz-Troche, 161 F.3d at 85
    .
    State v. Scott, 
    275 S.W.3d 395
    , 404 (Tenn. 2009); See also Coe v. State, 17 S.W.3d, 193,
    227 (Tenn. 2000)(resolution of scientific views goes to the weight to be given an expert’s
    testimony, not the admissibility of the testimony).
    Accordingly, we conclude that the trial court properly exercised its discretion in
    allowing Dr. Hawes to testify as an expert concerning the float test that was used in part
    to determine whether the baby was born alive or stillborn in this case. Defendant is not
    entitled to relief on this issue.
    II.    Admission of Defendant’s Confession and Denial of Motion to Dismiss the
    Indictment
    Defendant contends that the trial court erred in admitting her confession and by
    denying her motion to dismiss the indictment because the evidence of corpus delicti was
    insufficient.
    A criminal conviction cannot be based solely on a defendant’s uncorroborated
    confession. State v. Wagner, 
    382 S.W.3d 289
    , 297 (Tenn. 2012). The Tennessee
    Supreme Court has adopted the “modified trustworthiness standard” in determining
    whether a confession is sufficiently corroborated. State v. Bishop, 
    431 S.W.3d 22
    , 58
    (Tenn. 2014). In State v. Clark, 
    452 S.W.3d 268
    (Tenn. 2014), the Supreme Court stated:
    In State v. Bishop, 
    431 S.W.3d 22
    (Tenn. 2014), we recently clarified the
    corroboration rule in Tennessee. Tennessee follows the “modified
    trustworthiness standard” rather than the traditional corpus delicti rule.
    - 17 -
    State v. 
    Bishop, 431 S.W.3d at 59-60
    . We explained that under this
    standard:
    When a defendant challenges the admission of his
    extrajudicial confession on lack-of-corroboration grounds, the trial
    court should begin by asking whether the charged offense is one
    that involves a tangible injury. If the answer is yes, then the State
    must provide substantial independent evidence tending to show that
    the defendant’s statement is trustworthy, plus independent prima
    facie evidence that the injury actually occurred. If the answer is
    no, then the State must provide substantial independent evidence
    tending to show that the defendant’s statement is trustworthy, and
    the evidence must link the defendant to the crime.
    State v. 
    Bishop, 431 S.W.3d at 60
    . “Prima facie” evidence is “[e]vidence
    that will establish a fact or sustain a judgment unless contradictory
    evidence is produced.” Black’s Law Dictionary 638-39 (9th ed. 2009).
    “Substantial evidence” is “[e]vidence that a reasonable mind could
    accept as adequate to support a conclusion; evidence beyond a scintilla.”
    Black’s Law Dictionary 640 (9th ed. 2009).
    “The corroboration requirement is a low threshold. Its purpose is
    twofold: to weed out false confessions to nonexistent crimes (by
    requiring some independent evidence that the injury occurred) and to
    weed out false confessions to actual crimes (by requiring some
    independent evidence that implicates the accused). State v. 
    Bishop, 431 S.W.3d at 59-60
    . The standard of proof required to clear this hurdle is
    even lower than the “preponderance of the evidence” standard. State v.
    
    Bishop, 431 S.W.3d at 60
    n. 33 (quoting Smith v. United 
    States, 348 U.S. at 156
    , 
    75 S. Ct. 194
    ).
    
    Clark, 452 S.W.3d at 279-80
    .
    In this case, the trial court properly admitted Defendant’s confession and denied
    her motion to dismiss the indictment. Defendant’s confession was corroborated by
    sufficient independent evidence. Dr Hawes testified that the baby was alive at birth
    establishing that an injury occurred to cause her death. Defendant told police that she
    smothered the baby by holding her hand over the child’s mouth and nose after birth. This
    was corroborated by Dr. Hawes’ testimony that the baby died of asphyxiation, and
    smothering was consistent with her autopsy findings. In her confession, Defendant said
    that she cleaned the bathroom after smothering the baby. Both Anna and Matthew
    Mooney testified that the bathroom was very clean after Defendant told them that she
    gave birth. Defendant told police that she placed the baby in one bag, the placenta in a
    bag, and a bath mat in one of the bags. These details of Defendant’s confession were
    - 18 -
    corroborated by Detective Cutshaw and Anna and Matthew Mooney. Furthermore, there
    were photographs to corroborate those details. “The corroboration requirement is a low
    threshold.” 
    Clark, 452 S.W.3d at 280
    . We conclude that Defendant’s confession was
    sufficiently corroborated. Defendant also asserts that the trial court properly denied her
    pretrial motion to dismiss the indictment. However, “[w]hether the [S]tate has
    sufficiently established the corpus delicti is primarily a jury question.” State v. Jones, 
    15 S.W.3d 880
    , 891 (Tenn. Crim. App. 1999); State v. Jeremy Lynden Myrick, No. E2017-
    00588-CCA-R3-CD, 
    2018 WL 3430337
    , at *22 (Tenn. Crim. App. July 16, 2018).
    Therefore, the trial court properly denied the motion to dismiss the indictment. Defendant
    is not entitled to relief on this issue.
    III.   Sufficiency of the Evidence
    Defendant argues the evidence was not sufficient to support her conviction for
    reckless homicide. “Because a verdict of guilt removes the presumption of innocence
    and raises a presumption of guilt, the criminal defendant bears the burden on appeal of
    showing that the evidence was legally insufficient to sustain a guilty verdict.” State v.
    Hanson, 
    279 S.W.3d 265
    , 275 (Tenn. 2009) (citing State v. Evans, 
    838 S.W.2d 185
    , 191
    (Tenn. 1992)). “Appellate courts evaluating the sufficiency of the convicting evidence
    must determine ‘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.’” State v. Wagner, 
    382 S.W.3d 289
    , 297 (Tenn. 2012)
    (quoting Jackson v. Virginia, 
    443 U.S. 307
    , 319 (1979)); see Tenn. R. App. P. 13(e).
    When this court evaluates the sufficiency of the evidence on appeal, the State is entitled
    to the strongest legitimate view of the evidence and all reasonable inferences that may be
    drawn from that evidence. State v. Davis, 
    354 S.W.3d 718
    , 729 (Tenn. 2011)
    (citing State v. Majors, 
    318 S.W.3d 850
    , 857 (Tenn. 2010)).
    Guilt may be found beyond a reasonable doubt where there is direct evidence,
    circumstantial evidence, or a combination of the two. State v. Sutton, 
    166 S.W.3d 686
    ,
    691 (Tenn. 2005); State v. Hall, 
    976 S.W.2d 121
    , 140 (Tenn. 1998). The standard of
    review for sufficiency of the evidence “‘is the same whether the conviction is based upon
    direct or circumstantial evidence.’” State v. Dorantes, 
    331 S.W.3d 370
    , 379 (Tenn. 2011)
    (quoting 
    Hanson, 279 S.W.3d at 275
    ). The jury as the trier of fact must evaluate the
    credibility of the witnesses, determine the weight given to witnesses’ testimony, and
    reconcile all conflicts in the evidence. State v. Campbell, 
    245 S.W.3d 331
    , 335 (Tenn.
    2008) (citing Byrge v. State, 
    575 S.W.2d 292
    , 295 (Tenn. Crim. App. 1978)). Moreover,
    the jury determines the weight to be given to circumstantial evidence, the inferences to be
    drawn from this evidence, and the extent to which the circumstances are consistent with
    guilt and inconsistent with innocence. 
    Dorantes, 331 S.W.3d at 379
    (citing State v. Rice,
    
    184 S.W.3d 646
    , 662 (Tenn. 2006)). When considering the sufficiency of the evidence,
    this court “neither re-weighs the evidence nor substitutes its inferences for those drawn
    - 19 -
    by the jury.” 
    Wagner, 382 S.W.3d at 297
    (citing State v. Bland, 
    958 S.W.2d 651
    , 659
    (Tenn. 1997)).
    Reckless homicide is defined as the “reckless killing of another.” T.C.A. § 39-13-
    215(a).
    “Reckless” refers to a person who acts recklessly with respect to
    circumstances surrounding the conduct or the result of the conduct when
    the person is aware of but consciously disregards a substantial and
    unjustifiable risk that the circumstances exist or the result will occur.
    The risk must be of such a nature and degree that its disregard constitutes
    a gross deviation from the standard of care that an ordinary person would
    exercise under all the circumstances as viewed from the accused
    person’s standpoint.
    Tenn. Code Ann. § 39-11-106(a)(31). In this case, viewing the evidence in a light most
    favorable to the State, a reasonable juror could have concluded that the evidence was
    sufficient to support Defendant’s conviction for reckless homicide.
    Defendant in this case gave birth to a baby girl in the bathroom of her boyfriend’s
    house. In her confession to Detective Cutshaw, which we have found was sufficiently
    corroborated, Defendant initially denied knowing that she was pregnant before she gave
    birth, and she said that the baby was stillborn. Defendant eventually admitted that she
    realized her pregnancy a few weeks before giving birth. She said that the baby was born
    alive and had moved a little bit before she placed her hand over the baby’s mouth and
    nose. After a few minutes, Defendant checked the baby’s pulse and found none. At no
    point did Defendant seek help for the child. Instead, she placed the baby in a plastic bag
    with some towels, and she placed the placenta in another bag and cleaned the bathroom
    before notifying anyone in the house that she had given birth and claiming that the baby
    was stillborn.
    Dr. Hawes testified that her findings in total, which included inflated lungs, led her
    to believe that the baby was born alive and died of asphyxiation. Dr. Hawes further
    testified that Defendant’s admission of placing her hand over the baby’s mouth and nose
    after birth was consistent with her findings. It was her opinion that the manner of death
    of the baby was homicide. Defendant points to Dr Andrew’s testimony and studies that
    disagree with the use of the float test to challenge Dr. Hawes’ autopsy findings and her
    reliance on the float test to determine that the baby was born alive. However, the jury
    resolved any conflicts in the testimony in favor of the State, as was its prerogative.
    See State v. Bland, 
    958 S.W.2d 651
    , 659 (Tenn. 1997).
    Defendant contends that she was in shock and could not form the “proper
    culpability needed for reckless homicide because she was not aware of or did not
    consciously disregard a substantial and unjustifiable risk that the circumstances existed or
    - 20 -
    that the particular result would occur.” However, there was no testimony that Defendant
    was in such a state shock after giving birth that she could not appreciate that holding her
    hand over the baby’s mouth and nose immediately after birth would suffocate the child
    and cause death. Although there was some testimony that Defendant appeared to be in
    shock after the baby’s death, this did not prevent her from cleaning the bathroom after
    giving birth, telling everyone that the baby was stillborn, and expressing fear that she
    would be going to jail because of searches that she had performed on her cell phone.
    Again, this was for the jury to decide.
    We conclude that the evidence was sufficient beyond a reasonable doubt to
    support Defendant’s conviction for reckless homicide.              Defendant consciously
    disregarded a substantial and justifiable risk that the baby would suffocate by placing her
    hand over the baby’s mouth and nose after birth, and the risk was of such a nature and
    degree that its disregard constituted a gross deviation from the ordinary standard of care.
    Defendant is not entitled to relief on this issue.
    IV.    Sentencing
    Defendant contends that the trial court erred by imposing the maximum sentence
    of four years for her reckless homicide conviction and by rejecting her request for
    probation and judicial diversion.
    Our standard of review of the trial court’s sentencing determinations is whether
    the trial court abused its discretion, and we apply a “presumption of reasonableness to
    within-range sentencing decisions that reflect a proper application of the purposes and
    principles of our Sentencing Act.” State v. Bise, 
    380 S.W.3d 682
    , 707 (Tenn. 2012). The
    party challenging the sentence on appeal bears the burden of establishing that the
    sentence was improper. T.C.A. § 40-35-401 (2017), Sentencing Comm’n Cmts. In
    determining the proper sentence, the trial court must consider: (1) the evidence, if any,
    received at the trial and the sentencing hearing; (2) the presentence report; (3) the
    principles of sentencing and arguments as to sentencing alternatives; (4) the nature and
    characteristics of the criminal conduct involved; (5) evidence and information offered by
    the parties on the mitigating and enhancement factors set out in Tennessee Code
    Annotated sections 40-35-113 and -114; (6) any statistical information provided by the
    administrative office of the courts as to sentencing practices for similar offenses in
    Tennessee; (7) any statement the defendant made in the defendant’s own behalf about
    sentencing; and (8) the result of the validated risk and needs assessment conducted by the
    department and contained in the presentence report. See T.C.A. § 40-35-210; State v.
    Taylor, 
    63 S.W.3d 400
    , 411 (Tenn. Crim. App. 2001). The trial court must also consider
    the potential or lack of potential for rehabilitation or treatment of the defendant in
    determining the sentence alternative or length of a term to be imposed. T.C.A. § 40-35-
    103 (2017).
    - 21 -
    The trial court in this case made the following findings concerning sentencing:
    First of all, let me deal with the mitigating factors that have been filed
    and then the Court will deal with the aggravating factors that have been
    filed, which now I cannot but I will find momentarily.
    But there is absolutely, in the record, nothing upon which a Court could
    excuse or justify the actions of this defendant in this case. There is
    absolutely no reason to excuse the defendant based upon her age alone.
    People much younger than this defendant bear[] children to live birth.
    And therefore, there is no reason to excuse her or to find any basis of
    leniency based upon her age as it relates to the facts of this case.
    Likewise, at the trial, there was absolutely no medical evidence, no
    medical evidence, of any significant mental health issues that likewise
    could be determined to have a bearing upon this case.
    Now, the mitigating factor about the facts - - it is alleged that the facts do
    not show a sustained intent to violate the law. The Court would hold just
    the opposite based upon the uncontradicted testimony in this record that
    this defendant admitted smothering this child and then placing this child
    in gar[b]age bags or covering the child up with garbage bags. And so
    that would indicate to the Court a sustained intent to violate the law and
    to cause and to cover up this death.
    Now, the jury did, in its discretion - - and the Court is in no way
    criticizing the jury. They are the people that have to make that decision.
    And this Court is very respectful of a jury for doing the very best that
    they can, and this jury considered the facts and applied the law as they
    saw it. And they chose to convict her of reckless homicide which carries
    a range of penalties of from two to four years.
    The Court would note that the affect of this defendant is much different
    here today than it was during the trial of this case. The Court would just
    note its observations. The conclusions of the Court’s observations [are]
    that this defendant appeared that she did not understand what was going
    on here. That was the way she acted at trial. And the way she acts today
    is much different. That was the Court’s impression, and that is a factor
    for this Court to consider. The Court must also consider as it relates to
    probation and as it relates to judicial deferral what the attitude of the
    defendant is at sentencing. And the Court would note that there is
    absolutely no evidence of any remorse by this defendant in this case.
    This defendant is sorry it happened. Being sorry that it happened is not
    - 22 -
    sorry for what you’ve done. This child was killed at birth. [. . .] There
    was no opportunity for this child because of its recent birth for it to have
    any opportunity to defend itself, and being placed in a trash bag or
    covered up by a trash bag is a very troubling event. And the Court,
    again, is troubled by the fact that there is absolutely world without end
    no remorse shown by this defendant, which the Court thinks is a factor
    which should be considered in granting or denial of probation or, in fact
    judicial deferral. As I say, there’s not been any - - this defendant has
    expressed no remorse for the death, what she did to cause the death of
    this child. And she admitted placing her hand - - her testimony was
    different - - or her statement. I’m sorry. She did not testify, and the
    Court is not holding that against her. She has the right not to testify.
    And the jury did not punish her for that, by the way. The Court is
    satisfied that the jury didn’t. But there’s not been a lot said except by the
    Court about this baby. About this baby. A child who will never walk
    this earth, the most defenseless of human beings, that will never, never
    get to enjoy playing, growing up. A serious matter. A very serious
    matter. And again, no remorse.
    Now, [defense counsel] is exactly right. This is a case that does, under
    the law, qualify in the appropriate circumstance for probation and
    judicial deferral. But - - and the fact that a death occurred, under the
    law, does not preclude either of those. The Court is well aware of that.
    And the Court in no way as to its - - the granting or denial of probation
    or judicial deferral is considering just the fact that someone died. But
    you must look to the totality of the circumstances of every case in
    deciding whether to grant probation or to deny probation or to grant
    judicial deferral or to deny judicial deferral.
    Now - - and in addition to the extreme age and physical capabilities of
    this deceased in this case and the - - the Court finds - - I mean, it
    happened very, very quickly. The acts of this defendant show that she
    had no hesitation about committing an offense like this.
    And for those reasons, the Court findings that the enhancement factors
    outweigh the mitigating factors, the Court does again find that they
    outweigh the mitigating factors, and the Court feels like that based upon
    the facts and circumstances of this case, that the maximum four years is
    justified and hereby orders the sentence to be served in the Department
    of Correction.
    - 23 -
    Length of Sentence
    Trial courts are “required under the 2005 amendments to ‘place on the record,
    either orally or in writing, what enhancement or mitigating factors were considered, if
    any, as well as the reasons for the sentence, in order to ensure fair and consistent
    sentencing.’” 
    Bise, 380 S.W.3d at 698-99
    (quoting T.C.A. § 40-35-210(e)). Under the
    holding in Bise, “[a] sentence should be upheld so long as it is within the appropriate
    range and the record demonstrates that the sentence is otherwise in compliance with the
    purposes and principles listed by statute.”
    Id. at 709-10.
    Although the trial court should
    consider enhancement and mitigating factors, the statutory enhancement factors are
    advisory only. See Tenn. Code Ann. § 40-35-114; see also 
    Bise, 380 S.W.3d at 701
    .
    Moreover, a trial court is “guided by - but not bound by - any applicable enhancement
    factors when adjusting the length of a sentence[,]” and its “misapplication of an
    enhancement or mitigating factor does not invalidate the sentence imposed unless the trial
    court wholly departed from the 1989 Act, as amended in 2005.” 
    Bise, 380 S.W.3d at 706
    .
    In this case, Defendant faced a sentencing range of two to four years as a Range I,
    standard offender for her conviction of reckless homicide, a Class D felony. The trial
    court imposed the maximum sentence of four years to be served in confinement.
    Defendant does not challenge the court’s findings on enhancement and mitigating factors.
    Rather, she argues that the imposition of the maximum sentence is unfair when taken into
    consideration with the purposes and intent of sentencing and that her sentence was
    greater than deserved.
    The record reflects that the trial court considered the enhancement and mitigating
    factors and appears to have found that the victim in this case was particularly vulnerable
    because of age or physical or mental disability. T.C.A. § 40-35-114(4). Application of
    this factor is supported by the record. As found by the trial court, the baby in this case
    was unable to defend herself because of her recent birth. Additionally, the record shows
    that Defendant abused a position of private trust in a manner that significantly facilitated
    the commission of the offense. T.C.A. § 40-35-114(14). Defendant was the victim’s
    mother and did not disclose her pregnancy to the victim’s father or anyone else until after
    she gave birth and had killed the victim. The trial court did not find any applicable
    mitigating factors.
    Having reviewed the record before us, we conclude that the trial court clearly
    stated on the record its reasons for the sentence imposed, and Defendant’s sentence is
    within the appropriate range and “justly deserved in relation to the seriousness of the
    offense.” T.C.A. §40-35-102(1). The record reflects that the trial court considered the
    purposes and principles of the Sentencing Act. Therefore, the trial court’s imposition of
    the maximum sentence of four years for reckless homicide is presumed reasonable.
    - 24 -
    Probation
    As for the denial of full probation, “the abuse of discretion standard, accompanied
    by a presumption of reasonableness, applies to . . . questions related to probation or any
    other alternative sentence.” State v. Caudle, 
    388 S.W.3d 273
    , 278-79 (Tenn. 2012). A
    defendant “who is an especially mitigated or standard offender convicted of a Class C, D,
    or E felony should be considered as a favorable candidate for alternative sentencing
    options in the absence of evidence to the contrary[.]” T.C.A. § 40-35-102(6). In
    determining whether to grant or deny probation, a trial court should consider the
    circumstances of the offense, the defendant’s criminal record, the defendant’s social
    history and present condition, the need for deterrence, and the best interest of the
    defendant and the public. State v. Grear, 
    568 S.W.2d 285
    , 286 (Tenn. 1978). “[T]he
    burden of establishing suitability for probation rests with the defendant.” T.C.A. § 40-
    35-303(b). “This burden includes demonstrating that probation will ‘subserve the ends of
    justice and the best interest of both the public and the defendant.’” State v. Carter, 
    254 S.W.3d 335
    , 346 (Tenn. 2008) (quoting State v. Housewright, 
    982 S.W.2d 354
    , 357
    (Tenn. Crim. App. 1997)). A trial judge must consider the following factors before
    imposing a sentence of incarceration:
    (A) Confinement is necessary to protect society by restraining a
    defendant who has a long history of criminal conduct;
    (B) Confinement is necessary to avoid depreciating the seriousness of
    the offense or confinement is particularly suited to provide an effective
    deterrence to others likely to commit similar offenses; or
    (C) Measures less restrictive than confinement have frequently or
    recently been applied unsuccessfully to the defendant.
    T.C.A. § 40-35-103(1). Additionally, the sentence imposed should be the least severe
    measure necessary to achieve its purpose, and the defendant’s potential for rehabilitation,
    or lack thereof, should be considered when determining whether to grant alternative
    sentencing. T.C.A. 40-35-103(4) and (5). Trial judges are encouraged to use alternative
    sentencing when appropriate. T.C.A. 40-35-103(6).
    The trial court’s findings of fact in this case support a basis to conclude that
    Defendant was not a suitable candidate for probation and that incarceration is necessary
    to avoid depreciating the seriousness of the offense and to deter others from committing a
    similar offense. T.C.A. § 40-35-103(1)(B); State v. Sihapanya, 
    516 S.W.3d 473
    , 476
    (Tenn. 2014) (deferring to the trial court’s decision to deny probation where the court
    “combined the need to avoid depreciating the seriousness of the offense with the need for
    deterrence and the nature and circumstances of the offense”). The trial court noted the
    “very serious” nature of the offense in this case where Defendant smothered her newborn
    baby, the “most defenseless of human beings,” by placing her hand over the baby’s
    mouth and nose after she was born. The trial court also considered the particular
    - 25 -
    circumstances of the killing which included the “extreme age and physical capabilities”
    of the baby and that Defendant killed her very quickly indicating no hesitation about
    committing the offense and then placed the baby in a garbage bag. The trial court further
    found that Defendant showed no remorse for her actions. The court noted that “there is
    absolutely world without end no remorse shown by this defendant.” A lack of remorse
    can be utilized by a trial court during the consideration of probation. State v. Dowdy, 
    894 S.W.2d 301
    , 306 (Tenn. Crim. App. 1994); State v. Celeste Hall, No. M2005-00715-
    CCA-R3-CD, 
    2005 WL 3543416
    , at *5 (Tenn. Crim. App. Dec. 27, 2005); and State v.
    Brian Goodrich, No. M2002-03017-CCA-R3-CD, 
    2004 WL 367719
    , at *3 (Tenn. Crim.
    App. Feb. 27, 2004).
    The trial court did not abuse its discretion in denying probation in this case given
    Defendant’s lack of remorse, combined with the need to avoid depreciating the
    seriousness of the offense.
    Judicial Diversion
    The standard of review in Bise extends to decisions involving judicial diversion as
    well. 
    Caudle, 388 S.W.3d at 278-79
    . (“[T]he abuse of discretion standard, accompanied
    by a presumption of reasonableness, applies to within-range sentences that reflect a
    decision based upon the purposes and principles of sentencing, including the questions
    related to probation or any other alternative sentence.”); State v. King, 
    432 S.W.3d 316
    ,
    324 (Tenn. 2014)(“the abuse of discretion standard accompanied by a presumption of
    reasonableness applies to all sentencing decisions, including the grant or denial
    of judicial diversion, when the trial court properly supports its decision on the record in
    accordance with the purposes and principles of sentencing”).
    Tennessee Code Annotated section 40-35-313 outlines the requirements
    for judicial diversion. After a qualified defendant is either found guilty or pleads guilty
    to a misdemeanor or a class C, D, or E felony, a trial court has the discretion to defer
    further proceedings and place that defendant on probation without entering a judgment of
    guilt. T.C.A. § 40-35-313(a)(1)(A). Eligibility for judicial diversion does not entitle the
    defendant to judicial diversion as a matter of right. State v. Parker, 
    932 S.W.2d 945
    , 958
    (Tenn. Crim. App. 1996). Rather, the statute states that a trial court “may”
    grant judicial diversion in appropriate cases. See T.C.A. § 40-35-313(a)(1)(A). When
    making a determination regarding judicial diversion, the trial court must consider the
    following factors: (1) the defendant’s amenability to correction, (2) the circumstances of
    the offense, (3) the defendant’s criminal record, (4) the defendant’s social history, (5) the
    defendant’s mental and physical health, (6) the deterrent effect of the sentencing decision
    to both the defendant and other similarly situated defendants, and (7)
    whether judicial diversion will serve the interests of the public as well as the defendant.
    State v. Electroplating, Inc., 
    990 S.W.2d 211
    , 229 (Tenn. Crim. App. 1998)
    (citing 
    Parker, 932 S.W.2d at 958
    ). The record must reflect that the trial court
    - 26 -
    considered and weighed all these factors in arriving at its decision. Electroplating, 
    Inc., 990 S.W.2d at 229
    (citing State v. Bonestel, 
    871 S.W.2d 163
    , 168 (Tenn. Crim. App.
    1993), overruled on other grounds by State v. Hooper, 
    29 S.W.3d 1
    , 9-10 (Tenn. 2000)).
    As noted above, our supreme court in King has concluded that the proper standard
    of review for judicial diversion decisions is that established in Bise. The King Court
    explained,
    [W]hen the trial court considers the Parker and Electroplating factors,
    specifically identifies the relevant factors, and places on the record its
    reasons for granting or denying judicial diversion, the appellate court
    must apply a presumption of reasonableness and uphold the grant or
    denial so long as there is any substantial evidence to support the trial
    court’s decision. Although the trial court is not required to recite all of
    the Parker and Electroplating factors in order to obtain the presumption
    of reasonableness, the record should reflect that the trial court considered
    the Parker and Electroplating factors in rendering its decision and that it
    identified the specific factors applicable to the case before it. Thereafter,
    the trial court may proceed to solely address the relevant factors.
    If, however, the trial court fails to consider and weigh the applicable
    common law factors, the presumption of reasonableness does not apply
    and the abuse of discretion standard, which merely looks for “any
    substantial evidence” to support the trial court’s decision, is not
    appropriate. . . . In those instances, appellate courts may either conduct a
    de novo review or, if more appropriate under the circumstances, remand
    the issue for reconsideration.
    
    King, 432 S.W.3d at 327-28
    (internal citations omitted) (footnote omitted).
    We have set forth in detail the trial court’s findings of fact regarding whether to
    grant judicial diversion. Here, the trial court considered the Parker and Electroplating
    factors as argued by Defendant at the sentencing hearing, and the trial court identified
    those factors that it found applicable to this case. It is not necessary that a trial court
    recite all of the Parker and Electroplating factors when justifying its decision on the
    record in order to obtain the presumption of reasonableness. 
    King, 432 S.W.3d at 323
    .
    As noted above, the trial court was particularly concerned with Defendant’s lack of
    remorse, which the trial court obviously believed militated against Defendant’s potential
    for rehabilitation. Lack of remorse relates to Defendant’s amenability to correction.
    State v. Kristi Dance Oakes, No. E2006-01795-CA-R3-CD, 
    2007 WL 2792934
    , at *9
    (Tenn. Crim. App. Sept. 27, 2007)(citing State v. Edward Arnold Rivera, No. W2001-
    00857-CCA-R9-CD, 
    2002 WL 1482655
    , at *3)(Tenn. Crim. App. Feb. 4, 2002)(“Lack of
    remorse is an appropriate factor for a trial court to consider in deciding whether to grant
    - 27 -
    judicial diversion.”)). There is substantial evidence in the record to support the trial
    court’s decision, and applying a presumption of reasonableness, we affirm the decision to
    deny judicial diversion.
    Having reviewed the record and applied the applicable law to the trial court’s
    sentencing determinations, we find no error by the trial court in sentencing Defendant to
    four years in confinement for her reckless homicide conviction. Defendant is not entitled
    to relief in this appeal.
    CONCLUSION
    Based on foregoing analysis, we affirm the judgment of the trial court.
    ____________________________________________
    THOMAS T. WOODALL, JUDGE
    - 28 -