Jose Isaas Herrera AKA Jose Isaas Herrera, Sr. v. State , 2012 Tex. App. LEXIS 2940 ( 2012 )


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  • Affirmed and Opinion filed April 17, 2012.
    In The
    Fourteenth Court of Appeals
    ___________________
    NO. 14-11-00069-CR
    ___________________
    JOSE ISAAS HERRERA AKA JOSE ISAAS HERRERA, SR., Appellant
    V.
    THE STATE OF TEXAS, Appellee
    On Appeal from the 56th District Court
    Galveston County, Texas
    Trial Court Cause No. 08CR3697
    OPINION
    Jose Isaas Herrera was convicted of intentionally or knowingly causing serious
    bodily injury to his six-week-old son, J.H., resulting in the baby’s death. He argues that
    the evidence is insufficient to support his conviction; that the trial court reversibly erred in
    allowing a State expert rebuttal witnesses to testify during the State’s case in chief; that the
    indictment and jury charge failed to adequately specify the manner and means of the
    offense; and that the trial court erred in allowing the State to present certain autopsy
    photographs to the jury. We affirm.
    I. FACTUAL AND PROCEDURAL BACKGROUND
    Appellant began dating Jessica Trevino when they were in high school. In 2007,
    when she was fifteen, Jessica became pregnant with a daughter, B.H. Jessica dropped out
    of school and appellant began living with Jessica and her parents. In late 2007, the
    Trevinos asked appellant to leave and not to date Jessica anymore.
    Over the next few months, Jessica began dating the manager of the McDonald’s
    where she was working. Appellant found out about their relationship and was very angry.
    He moved back into the Trevinos’ house. When Jessica learned that she was pregnant
    with a son, appellant was convinced that the child was not his. After the baby, J.H., was
    born in 2008, appellant asked for a paternity test, and his suspicion of J.H.’s paternity
    persisted throughout the child’s short life. Although people had told appellant that his
    daughter, B.H., looked like him, J.H. did not. According to Jessica, appellant was not
    affectionate with J.H. as he had been with B.H. Appellant told Jessica that the baby was a
    “faggot” and was not his child. He also said that J.H. was a “momma’s boy” and would
    grow up to be a “little pussy.”
    Jessica testified that on one occasion, she left J.H. alone with appellant and when
    she returned she saw that the baby had a bruise on his forehead. Appellant told Jessica
    that he had accidentally bumped J.H.’s head against the bathtub while giving him a bath,
    but he did not generally bathe J.H.
    On October 27, 2008, at about 10:30 p.m., Jessica put J.H. to bed. She testified that
    she always put J.H. on his back when she left him unsupervised and that the baby could not
    turn over from that position unassisted. At about 5:00 a.m., J.H. started to make noises,
    waking the couple up. Appellant got up to feed the baby, and Jessica went back to sleep.
    At 10:15 that morning, Jessica woke up and went to check on J.H. She found him lying
    2
    face-down, stiff, cold and pale. Appellant tried to perform CPR, but the baby had been
    dead for hours.1
    Several police officers who responded to the Trevinos’ home that day noted that
    appellant did not seem very emotional about J.H.’s death. When she went into appellant’s
    and Jessica’s room the night after J.H. died, Nancy, Jessica’s mother, found appellant
    stacking J.H.’s clothes on his crib. Nancy and Jessica told appellant to stop, but appellant
    stated simply, “Well, he’s not here no more and it needs to be put up.” At the funeral later
    that week, according to the Trevinos, appellant did not seem perturbed. As the baby’s
    casket was about to be lowered into the ground, appellant told Jessica to stop crying.
    According to Jessica’s brother, who had paused in front of the casket, appellant told him,
    “Hurry up so we can get this over with.” Maria Medina, a co-worker of Nancy Trevino’s,
    testified that she approached appellant at the funeral to offer her condolences. According
    to Medina, appellant told her that “it was his fault, that he did it.” 2 Medina tried to
    reassure appellant that the baby had died a “crib death,” but, according to Medina,
    appellant continued to repeat that it was his fault.
    The day after J.H.’s death, the Galveston County Medical Examiner’s office
    conducted an autopsy of J.H.’s body. The autopsy showed that the baby had suffered
    fourteen fractures, including several broken ribs and a broken spine. Two of these were
    “old fractures,” but twelve occurred at or around the time of death. There were also
    abrasions between the baby’s shoulder blades and hemorrhaging in the baby’s chest,
    abdomen, the front left side of his head, and the back of his head. Additionally, there was
    a deep scratch above J.H.’s right eye.
    1
    Dr. Stephen Pustilnik, Chief Medical Examiner for Galveston County, testified that the
    symptoms Jessica and appellant observed occur only several hours after death. They include rigor mortis
    (a stiffening of muscular flexors and extensors due to lack of oxygen), lividity (the settling of the blood due
    to lack of oxygen and circulation), and a steep drop in body temperature.
    2
    On cross-examination, Medina read from an earlier statement she had given the police in which
    she had described appellant saying “it’s my fault, it’s my fault” but not “I did it.”
    3
    A Child Protective Services investigator, David Henry, interviewed appellant three
    days after J.H. died. Appellant said that he may have dropped or shaken J.H. while
    administering CPR, a possibility he had not mentioned in earlier interviews with the police.
    In any case, according to Dr. Stephen Pustilnik, Galveston County’s Chief Medical
    Examiner, the hemorrhaging around the fractures indicated that they could not have been
    inflicted post-mortem.
    Appellant was initially charged with murder on December 17, 2008.                  The
    indictment alleged that appellant
    intentionally or knowingly cause[d] the death of an individual, namely,
    [J.H.], by then and there shaking the said [J.H.] with the hand or hands of
    [appellant], or by throwing the said [J.H.], or by causing the spinal cord
    and/or spinal column to extend or bend until it broke in a manner which is
    unknown to the Grand Jury . . . and [appellant] . . . used or exhibited a deadly
    weapon, to-wit: the hand or hands of [appellant], or an object which is
    unknown to the Grand Jury, during the commission of the said offense.
    Appellant was re-indicted for murder on September 16, 2010.                The
    re-indictment omitted the possibility that appellant had caused J.H.’s death by
    shaking and added two other possible means of causing his death: the infliction of
    blunt force trauma (with appellant’s hand or hands or an unknown object), and the
    dropping of J.H. It was otherwise identical to the first indictment. Appellant
    moved to quash the re-indictment on the ground that it described as “unknown to the
    Grand Jury” the object used to inflict blunt force trauma on J.H., the manner in
    which J.H.’s back was broken, and the deadly weapon used or exhibited. At a
    hearing on appellant’s motion to quash, the State represented that
    [w]e have tried to give as good a notice as we can on a very complicated
    infant death. . . . Essentially what the Medical Examiner could tell us and
    we could then in turn tell the Grand Jury is that these multiple injuries,
    essentially the cause of death was blunt force injuries. . . . [T]he evidence
    may show that it is unknowable by virtue of the fact that we do not have a
    confession. We do not have an eyewitness. We have multiple traumas to a
    4
    six-week-old infant. So, it is a circumstantial case. We do not have a
    confession.
    The trial court denied appellant’s motion to quash without explanation. Three days later,
    the State re-indicted appellant for murder.              The only substantial change was the
    reinsertion of “shaking” as a possible cause of death, but appellant again moved to quash
    the re-indictment.3 In this motion, he also requested a pretrial hearing to “ensure that the
    ‘unknown’ allegation was truly unknown to the grand jury and is not being used to surprise
    or manipulate the defendant. . . . [and elicit] all evidence that is now known so that the
    ‘unknown’ aspect of the case can be eliminated.” At a hearing on this second motion, the
    State represented that
    [e]ssentially what we have is due diligence on the part of the State and on the
    part of the Medical Examiner to try to piece together the evidence and come
    up with a conclusion beyond a reasonable doubt of what we can prove as to
    the manner and means. We know that it was blunt force trauma. We know
    that there are old injuries, that there are new injuries. We know that it could
    be consistent with hand or hands or vigorous shaking. But quite frankly, it’s
    unknown and it may be unknowable because this was a six-week-old infant.
    And the only person that we believe was present was the Defendant. . . .
    And he did not give a confession.
    The trial court again denied appellant’s motion to quash.                       In appellant’s final
    re-indictment, dated November 4, 2010, the charge was changed from murder to
    intentionally or knowingly causing serious bodily injury to J.H.
    by then and there inflicting blunt force trauma to the head and/or torso of the
    said [J.H.] with the hand or hands of [appellant], and/or with or against an
    object unknown to the Grand Jury, and/or by shaking, and/or throwing,
    and/or dropping the said [J.H.], and/or by causing the spinal cord and/or
    3
    Between appellant’s first and second motions to quash, the Court of Criminal Appeals decided Sanchez v.
    State, No. PD-0961-07, 
    2010 WL 3894640
    , at *1 (Tex. Crim. App. Oct. 6, 2010) (motion for rehearing
    pending). Sanchez provides for a pretrial hearing to determine if the defendant has been given proper
    notice to prepare for trial and to determine whether the “unknown” aspect of the case can be minimized or
    eliminated by amending the indictment or presenting a superseding indictment. Id., 
    2010 WL 3894640
    , at
    *5.
    5
    spinal column of the said [J.H.], to extend and/or bend until broken in a
    manner which is unknown to the Grand Jury.
    The indictment also contains a notice of intent to seek a deadly weapon finding in which it
    is alleged that appellant
    used or exhibited a deadly weapon, to-wit: the hand or hands of [appellant] or
    an object which is unknown to the Grand Jury, during the commission of the
    said offense.
    Appellant moved to quash the re-indictment on the same grounds as in his earlier
    motions, and the trial court denied his motion without a hearing.
    Dr. Pustilnik and Dr. Nobby Mambo, Deputy Medical Examiner for Galveston
    County, were the State’s primary medical experts. Both testified that they believed J.H.’s
    death was a homicide and that the cause of death was blunt force trauma. Dr. Mambo
    stated that he believed the trauma was caused by vigorous shaking. According to Dr.
    Pustilnik, J.H.’s injuries were consistent with his having been slammed, thrown, dropped
    “from a height onto some object across its back,” or “an injurious shake, one where the
    head is going back and forth so far that you’re thinking the neck is going to snap off . . . .”
    Dr. Pustilnik also said that the injuries could have been caused by someone applying force
    to J.H.’s back as he lay face-down, hyper extending J.H.’s back to the point that the spine
    broke.
    The State also designated two rebuttal witnesses who would primarily testify that
    J.H.’s rib and back fractures could not have occurred post-mortem. Dr. Randall Frost is
    the Chief Medical Examiner of Bexar County and one of the State’s rebuttal witnesses. At
    the end of the first week of trial, the State approached the bench to request that Dr. Frost be
    allowed to testify the next week before Dr. Pustilnik had been cross examined. The State
    represented that Dr. Frost would base his testimony on slides taken at J.H.’s autopsy.
    Because Dr. Frost was not present at the autopsy, however, the State would rely on Dr.
    Pustilnik to validate the slides. Due to scheduling issues, the State requested that Dr. Frost
    be allowed to testify before the State had completed Dr. Pustilnik’s direct examination.
    6
    Appellant asked the trial court to exclude Dr. Frost’s testimony because appellant was
    entitled to cross examine Dr. Pustilnik about the slides before Dr. Frost testified to
    conclusions based on them. Appellant also objected to allowing a rebuttal witness to
    testify during the State’s case in chief, asserting that this would violate a discovery order in
    which the trial court had required the State to provide appellant with “a list of all the names
    of prospective prosecution witnesses who . . . likely will be used a[t] the guilt/innocence
    phase . . . with a continuing duty on the part of the State to disclose the names of rebuttal
    witnesses as soon as they become known.” The State had identified Dr. Frost as a rebuttal
    witness but not as a primary witness. Finally, appellant argued that Dr. Frost’s testimony
    was hearsay and cumulative. The trial court denied appellant’s motion to exclude Dr.
    Frost’s testimony, with the proviso that “should the state not be able to prove up those
    slides as coming from the deceased victim in this case, then I will give an instruction to the
    jury to disregard any and all testimony by Dr. Frost.”
    When the State introduced Dr. Frost’s testimony midway through Dr. Pustilnik’s
    testimony the following week, appellant raised the same objections as at the previous
    week’s bench conference. He additionally argued that he was unfairly surprised by Dr.
    Frost’s testimony because the State had listed Dr. Frost’s first name as “Robert” rather than
    “Randall.” The trial court allowed appellant two hours to “review whatever you need”
    before Dr. Frost testified. After two hours, appellant did not request more time and Dr.
    Frost testified. During his testimony, the slides were admitted with the instruction that
    they were not to be considered for the purpose of proving J.H. suffered the injuries shown.
    During the next part of Dr. Pustilnik’s direct examination, the slides were admitted in full.
    The State also introduced the testimony of Christopher Altizer, who met appellant
    when the two were in jail together after appellant’s arrest. Altizer testified that appellant
    approached him one day in the recreation yard and said he needed to get something off his
    chest. According to Altizer, appellant told him that “he was on drugs and his baby
    wouldn’t stop crying and he hit it.” Appellant denied that this conversation took place.
    7
    The trial court submitted, in relevant part, the following jury charge:
    Now, if you find from the evidence beyond a reasonable doubt that on or
    about the 27th day of October, A.D., 2008, in Galveston County, Texas
    [appellant] did then and there intentionally or knowingly cause serious
    bodily injury to [J.H.], a child 14 years of age or younger, by then and there
    inflicting blunt force trauma to the head and/or torso of the said [J.H.], with
    the hand or hands of the said [appellant], and/or with or against an object
    unknown to the Grand Jury, and/or by shaking, and/or throwing, and/or
    dropping the said [J.H.], and/or by causing the spinal cord and/or spinal
    column of the said [J.H.] to extend and/or bend until broken in a manner
    which is unknown to the Grand Jury, then you will find the Defendant guilty
    of Intentional or Knowing Serious Bodily Injury to a Child.
    Appellant asked the trial court to strike those portions of the jury charge referencing
    matters “unknown to the Grand Jury.” The trial court denied appellant’s motion. The
    jury convicted appellant of intentionally or knowingly causing serious bodily injury to a
    child, sentenced him to life in prison, and assessed a $10,000 fine. Appellant’s motion for
    new trial was denied and he timely appealed.
    II. ISSUES PRESENTED
    In five issues, appellant contends that (1) the evidence is insufficient to support his
    conviction; (2) the trial court erred in allowing the State to call Dr. Frost out of order; (3)
    the indictment was not specific enough about the manner and means of the offense; (4) the
    trial court erred in incorporating the language of the indictment into the jury charge; and (5)
    the trial court erred in allowing the jury to see autopsy photographs.
    III. ANALYSIS
    A.     Sufficiency of the Evidence
    Appellant first argues that the evidence is insufficient to support his conviction. In
    evaluating this challenge to the sufficiency of the evidence, we consider all the evidence in
    the light most favorable to the verdict. Jackson v. Virginia, 
    443 U.S. 307
    , 319, 
    99 S. Ct. 2781
    , 2789, 
    61 L. Ed. 2d 560
    (1979); Brooks v. State, 
    323 S.W.3d 893
    , 895 (Tex. Crim.
    App. 2010) (plurality op.); id at 912–13 (Cochran, J. concurring). If, when viewed in this
    8
    light, any rational factfinder could have found the essential elements of the offense beyond
    a reasonable doubt, then the evidence is sufficient to support the verdict. 
    Jackson, 443 U.S. at 319
    ; Clayton v. State, 
    235 S.W.3d 772
    , 778 (Tex. Crim. App. 2007).
    A person commits injury to a child if he intentionally, knowingly, recklessly, or
    with criminal recklessness causes a child serious bodily injury. TEX. PENAL CODE ANN. §
    22.04(a)(1) (West 2011).      Serious bodily injury is a “bodily injury that creates a
    substantial risk of death or that causes death, serious permanent disfigurement, or
    protracted loss or impairment of the function of any bodily member or organ.” 
    Id., §1.07(a)(46). A
    person who causes such an injury intentionally or knowingly commits a
    felony of the first degree. 
    Id. § 22.04(e).
    A person acts intentionally with respect to a
    result of his conduct when it is his conscious objective or desire to cause the result. 
    Id., § 6.03(a).
    A person acts knowingly with respect to a result of his conduct when he is aware
    that his conduct is reasonably likely to cause the result. 
    Id., § 6.03(b).
    Viewed in the light most favorable to the verdict, the evidence shows as follows:
    When Jessica put J.H. to bed, he had not yet suffered the severe injuries found in the
    autopsy. Appellant got up to feed J.H. at 5:00 a.m.., some five hours before J.H.
    was found dead. Dr. Pustilnik testified that based on J.H.’s physical condition, J.H.
    had been dead for several hours by the time he was found at about 10:15 a.m., five
    hours later, with the injuries. Thus, he must have died no earlier than 5:00 a.m. but
    at least several hours before 10:15 a.m. The injuries also must have occurred
    around the time of J.H.’s death, as Dr. Pustilnik testified that the hemorrhaging
    around the fractures indicated that they could not have been inflicted post-mortem
    (such as by the CPR appellant conducted several hours after the baby’s death) and
    that the baby did not survive long after sustaining them. There is no evidence that
    anyone else was up with the baby between 5:00 a.m. and 10:15 a.m., when J.H. was
    found dead, and J.H. could not have caused the injuries to himself. This evidence
    points to appellant as the likely perpetrator. See Martin v. State, 
    246 S.W.3d 246
    ,
    9
    262 (Tex. App.—Houston [14th Dist.] 2007, no pet.) (citing, among other
    circumstances, the fact that defendant was alone with baby during the time in which
    the baby suffered blunt force trauma as legally sufficient evidence of guilt).
    Appellant told Christopher Altizer that he was on drugs and hit the baby because the
    baby would not stop crying.
    Appellant told Maria Medina, a co-worker of Nancy Trevino’s, that “it was his
    fault, that he did it.”
    Appellant stacked J.H.’s clothes in his crib the day J.H. died. The Trevinos were
    disturbed by this behavior, and the police also found it unusual.
    Appellant apparently believed that J.H. was not his child and sought to have
    paternity tests. He called J.H. a “faggot” and insisted that the baby was not his.
    Jessica and her brother testified that he showed little affection for J.H. compared
    with B.H.
    The Trevinos testified that appellant did not seem very emotional about the baby’s
    death or at the funeral. At the funeral, he told Jessica to stop crying. He also told
    Jessica’s brother, who had stopped at the casket, “Hurry up so we can get this over
    with.”
    Taken together in the light most favorable to the verdict, this record supports the
    jury’s finding that appellant caused serious bodily injury to J.H. See Clayton v. State, 
    235 S.W.3d 772
    , 778 (Tex. Crim. App. 2007) (circumstantial evidence alone is sufficient to
    establish guilt); 
    Martin, 446 S.W.3d at 262
    (citing as legally sufficient evidence appellant’s
    failure to call 9–1–1 and her delay in getting victim to the emergency room, several
    witnesses’ testimony regarding her demeanor and behavior in the ambulance and at the
    emergency room, child’s father’s testimony that victim’s crying got on appellant’s nerves,
    appellant’s past statements to child’s father threatening to drown victim in the bathtub if he
    did not pick her up, medical testimony that child suffered from malnutrition, and testimony
    10
    appellant was a violent and untruthful person); see also Alexander v. State, 
    229 S.W.3d 731
    , 739 (Tex. App.—San Antonio 2007, pet. ref’d) (evidence legally sufficient to support
    murder where appellant had demonstrated abusive relationship with child, appellant had
    been seen hitting child with vacuum cleaner attachment earlier in the day, child was found
    fatally injured after being alone with appellant, and medical testimony supported finding
    that child was killed with the attachment).
    The severity and number of J.H.’s injuries also support a finding that appellant
    caused them intentionally or knowingly. Intent can be inferred from the extent of the
    injuries to the victim, the method used to produce the injuries, and the relative size and
    strength of the parties. Patrick v. State, 
    906 S.W.2d 481
    , 487 (Tex. Crim. App. 1995).
    Appellant, a grown man, was with J.H. at the approximate time the baby sustained
    extremely severe injuries. According to Dr. Pustilnik, J.H.’s injuries were consistent with
    his having been slammed, thrown, dropped “from a height onto some object across its
    back,” or “an injurious shake, one where the head is going back and forth so far that you’re
    thinking the neck is going to snap off . . . .” See Montgomery v. State, 
    198 S.W.3d 67
    , 87
    (Tex. App.—Fort Worth 2006, pet. ref’d) (using the severity of the injuries sustained by
    the infant as evidence of the appellant’s intent).
    Finally, with respect to the deadly weapon finding, Dr. Pustilnik testified as follows:
    [STATE]: Now, in your experience of having done hundreds of the
    autopsies, do you have an opinion as to whether or not somebody’s hand or
    hands, depending on how it’s used, can be deadly weapons?
    [DR. PUSTILNIK]: Yes.
    [STATE]: And can they be deadly weapons?
    [DR. PUSTILNIK]: They most certainly can.
    [STATE]: Hypothetically if you use your hand or hands to strike someone or
    to punch someone, could they—if they then cause death, could that be a
    deadly weapon?
    [DR. PUSTILNIK]: Yes, the hands could be a deadly weapon in that
    situation.
    11
    This testimony permitted the jury to find that appellant used or displayed his hands
    as a deadly weapon. Appellant nonetheless argues that the evidence is insufficient to
    support his conviction because the State failed to prove the means by which appellant
    injured J.H. and could only prove that the death resulted from blunt force trauma.
    According to appellant, “the means . . . is the entire crux of the trial.” But for the purpose
    of appellant’s conviction (as opposed to the specificity required in the indictment or jury
    charge, which we address later), the means by which appellant injured J.H. is
    irrelevant—what matters is that he intentionally or knowingly caused a serious bodily
    injury by at least one of the means listed in the indictment. See Kitchens v. State, 
    823 S.W.2d 256
    , 258–59 (Tex. Crim. App. 1991) (when jury returns general “guilty” verdict on
    an indictment charging alternative theories of committing the same offense, the verdict
    stands if evidence supports any of the theories alleged). Viewed in a light most favorable
    to the verdict, the evidence supports such a finding. We overrule appellant’s first issue.
    B.     Expert Testimony
    Appellant next argues that the trial court erred in allowing Dr. Frost to testify during the
    State’s case in chief before appellant had cross examined Dr. Pustilnik. At trial and on
    appeal, appellant argues that (1) the trial court deprived appellant of his Sixth Amendment
    right to confront Dr. Pustilnik, whose staff created the slides for the autopsy report, before
    Dr. Frost could testify based on the slides; and (2) the State violated the trial court’s
    discovery order by calling Dr. Frost during the State’s case in chief even though he had
    been designated as a rebuttal witness. Appellant also argues that the trial court erred in
    allowing another State rebuttal witness, Dr. Harrell Gill-King, to testify “out of order as a
    rebuttal witness” during appellant’s case in chief. We apply an abuse-of-discretion
    standard of review to all of these issues except for appellant’s Sixth Amendment issue.
    See State v. Dixon, 
    206 S.W.3d 587
    , 590 (Tex. Crim. App. 2006) (a trial court’s ruling
    admitting or excluding evidence is reviewed for an abuse of discretion). As to appellant’s
    Sixth Amendment issue, we review the trial court’s ruling de novo. See Wall v. State, 184
    
    12 S.W.3d 730
    , 742 (Tex. Crim. App. 2006) (a trial court’s ruling as to whether a statement is
    testimonial or non-testimonial for Sixth Amendment purposes is reviewed de novo).
    The Sixth Amendment right to confront witnesses applies not only to in-court
    testimony but also to out-of-court statements that are testimonial in nature. Crawford v.
    Washington, 
    541 U.S. 36
    , 50–51, 
    124 S. Ct. 1354
    , 1364, 
    158 L. Ed. 2d 177
    (2004). The
    Confrontation Clause forbids the admission of testimonial hearsay unless the declarant is
    unavailable to testify and the defendant had a prior opportunity to cross-examine the
    declarant. 
    Id., 541 U.S.
    at 
    68, 124 S. Ct. at 1374
    . In Melendaz-Diaz v. Massachusetts,
    the Supreme Court held that reports prepared by analysts at a state crime laboratory stating
    that a substance was cocaine were testimonial statements, and that the analysts who
    prepared the report were therefore witnesses whom the defendant had the right to
    cross-examine under the Sixth Amendment. 
    557 U.S. 305
    , 310, 
    129 S. Ct. 2527
    , 2532,
    
    174 L. Ed. 2d 314
    (2009).          As the Court explained, the reports issued were
    “incontrovertibly a ‘solemn declaration or affirmation made for the purpose of establishing
    or proving some fact . . .’” and therefore testimonial. 
    Id. (quoting Crawford,
    541 U.S. at
    51, 
    124 S. Ct. 1354
    ).     Appellant argues that that the autopsy slides were similarly
    testimonial in nature because Dr. Pustilnik’s office used them in preparing the autopsy
    report, and he therefore had a right to cross-examine Dr. Pustilnik before Dr. Frost
    testified. An autopsy photograph, however, is not a testimonial statement. See Wood v.
    State, 
    299 S.W.3d 200
    , 214–15 (Tex. App.—Austin 2009, no pet.) (“The admission in
    evidence of the [autopsy] photographs, Dolinak’s descriptions of the injuries shown in the
    photographs, and Dolinak’s conclusions as to likely causes of those injuries did not
    disclose to the jury any testimonial hearsay and thus did not violate the Confrontation
    Clause.”); Hamilton v. State, 
    300 S.W.3d 14
    , 22 (Tex. App.—San Antonio 2009, pet. ref’d)
    (expert opinion based on data generated by scientific instruments operated by other
    scientists not testimonial hearsay); accord TEX. R. EVID. 801(a) (a photograph is not an
    out-of-court statement for hearsay purposes). Because the autopsy photographs were not
    testimonial and Dr. Frost was subject to cross-examination about his own interpretation of
    13
    the slides, appellant fully enjoyed his Sixth Amendment rights as to all testimonial
    evidence introduced against him.          Moreover, appellant ultimately did have the
    opportunity to cross-examine Dr. Pustilnik. The opportunity to do so did not arise until
    after Dr. Frost had testified, but in the interim, the trial court instructed the jury not to
    consider Dr. Frost’s testimony as evidence that J.H. suffered the injuries shown in the
    slides unless and until their admissibility was established. See Moore v. State, 
    822 S.W.2d 844
    , 847 (Tex. Crim. App. 1994) (we presume that the jury follows the trial court’s
    instructions and that a limiting instruction cures any harm).
    We next turn to appellant’s argument that the trial court should have excluded Dr.
    Frost’s testimony because the State violated the trial court’s discovery order by introducing
    Dr. Frost’s testimony during its case-in-chief after designating him as a rebuttal witness.
    Appellant argues that this designation deprived him of time to prepare for Dr. Frost’s
    testimony. When appellant objected at trial, the trial court allowed appellant two hours to
    prepare for Dr. Frost’s testimony. At the end of this time, appellant did not request a
    further continuance or voice any objection. We conclude that appellant has waived
    further complaint about this issue. See Duff-Smith v. State, 
    685 S.W.2d 26
    , 33 (Tex. Crim.
    App. 1985) (“It is well settled that the proper procedure when alleging surprise due to
    violation of a trial court’s order for discovery is to object or ask for a postponement or
    continuance of the trial.”).
    Finally, appellant argues that the trial court erred in allowing Dr. Gill-King to testify
    “out of order as a rebuttal witness.” The State designated Dr. Gill-King as a rebuttal
    witness before trial and called him to the stand after appellant had cross-examined Dr.
    Pustilnik and called his own expert witness. The following exchange took place:
    [THE STATE]: State would request being able to call a witness out of order
    for rebuttal, if we may.
    [THE COURT]: Is that okay with you, Mr. Verret?
    [APPELLANT]: Yes.
    14
    Thus, appellant failed to preserve error as to this point. We overrule appellant’s
    second issue.
    C.     Indictment
    Appellant next contends that the trial court erred in denying his motion to quash the
    indictment. After his first two motions to quash were denied at hearings, appellant moved
    to quash his final re-indictment for causing serious bodily injury to J.H. The trial court
    denied his motion by written order. Appellant argues that the trial court erred in denying
    his motion to quash the final indictment because it failed to give him adequate notice of the
    manner and means of the charged offense.
    We review de novo a trial court’s denial of a motion to quash an indictment.
    Lawrence v. State, 
    240 S.W.3d 912
    915 (Tex. Crim. App. 2007). A motion to quash
    should be granted only where the language concerning the defendant’s conduct is so vague
    or indefinite as to deny the defendant effective notice of the acts he allegedly committed.
    DeVaughn v. State, 
    749 S.W.2d 62
    , 67 (Tex. Crim. App. 1988). A charging instrument
    which tracks the language of a criminal statute possesses sufficient specificity to provide a
    defendant with notice of a charged offense in most circumstances. State v. Edmond, 
    933 S.W.2d 120
    , 128 (Tex. Crim. App. 1996) (citing Bynum v. State, 
    767 S.W.2d 769
    , 778
    (Tex. Crim. App. 1988)).
    The indictment in this case tracked the language of the statute. As noted above, the
    statute provides that a person commits injury to a child if he intentionally, knowingly,
    recklessly, or with criminal recklessness causes a child serious bodily injury. TEX. PENAL
    CODE ANN. § 22.04(a)(1). The indictment charges that appellant
    did then and there intentionally or knowingly cause serious bodily injury to
    [J.H.], a child 14 years of age or younger, by then and there inflicting blunt
    force trauma to the head and/or torso of the said [J.H.] . . . .
    See Perez v. State, 
    261 S.W.3d 760
    (Tex. App.—Houston [14th Dist.] 2008, pet. ref’d)
    (where appellant was charged with causing serious bodily injury to a child “by causing
    15
    forceful trauma to the Complainant’s head in a manner and means unknown to the Grand
    Jury, and during the course of the offense the Defendant did use a deadly weapon, the
    nature and description of which is unknown to the Grand Jury,” court held that the
    indictment provided adequate notice to appellant).
    Appellant cites a recent Court of Criminal Appeals case, Sanchez v. State, as proof
    that the State can no longer allege that the manner and means of committing an offense are
    unknown. See Sanchez, No. PD-0961-07, 
    2010 WL 3894640
    , at *1 (Tex. Crim. App. Oct.
    6, 2010) (motion for rehearing pending).                 However, the Sanchez court expressly
    disavowed appellant’s interpretation of its opinion. See id., 
    2010 WL 3894640
    , at *6
    (“Our opinion should not be read to restrict or alter the use of the “unknown” allegation in
    an indictment. This new standard merely provides the opportunity to avoid confusion and
    error in the jury charge with respect to unknown allegations.”). Under Sanchez, appellant
    is only entitled to a pretrial hearing to determine if he had been given proper notice to
    prepare for trial and to clarify whether the “unknown” aspect of the case could be
    minimized or eliminated by amending the indictment or presenting a superseding
    indictment. Id., 
    2010 WL 3894640
    , at *5. Appellant essentially obtained two such
    hearings on his motions to quash the two murder re-indictments, which contained
    substantially the same language as his final re-indictment for causing a serious bodily
    injury.4 Appellant did not obtain a hearing on his final motion to quash, which pertained
    to the re-indictment for causing serious bodily injury to a child, but the contested language
    was common to all of the indictments. We overrule appellant’s third issue.
    D.      Jury Charge
    In his fourth issue, appellant argues that the trial court erred in incorporating into the
    jury charge the language in the indictment describing as “unknown to the Grand Jury” the
    means by which appellant inflicted blunt force trauma on J.H., the manner in which J.H.’s
    4
    The State did not produce evidence at these hearings, but it represented to the trial court that the
    unknown matters could not be clarified by the State’s witnesses at that time.
    16
    spine broke, and the deadly weapon appellant used or displayed. In our review of a jury
    charge, we first determine whether error occurred. See Abdnor v. State, 
    871 S.W.2d 726
    ,
    731–32 (Tex. Crim. App. 1994). If error occurred, we then evaluate whether sufficient
    harm resulted from the error to require reversal. 
    Id. The trial
    court charged the jury as follows:
    Now, if you find from the evidence beyond a reasonable doubt that on or
    about the 27th day of October, A.D., 2008, in Galveston County, Texas
    [appellant] did then and there intentionally or knowingly cause serious
    bodily injury to [J.H.], a child 14 years of age or younger, by then and there
    inflicting blunt force trauma to the head and/or torso of the said [J.H.], with
    the hand or hands of the said [appellant], and/or with or against an object
    unknown to the Grand Jury, and/or by shaking, and/or throwing, and/or
    dropping the said [J.H.], and/or by causing the spinal cord and/or spinal
    column of the said [J.H.] to extend and/or bend until broken in a manner
    which is unknown to the Grand Jury, then you will find the Defendant guilty
    of Intentional or Knowing Serious Bodily Injury to a Child.
    The jury was also asked to return a deadly weapon finding as to “the hand or hands of
    [appellant] or an object which is unknown to the Grand Jury.”
    We understand appellant to argue that the “unknown” matters became known by the
    time the judge charged the jury, and that this language should have been replaced
    accordingly. First, we disagree that the evidence at trial in fact clarified the unknown
    matters. But we need not address whether it did, because any charge error was harmless
    given that the evidence supports a conviction under one or more of the other theories
    charged in the indictment and submitted to the jury. When a jury returns a general
    “guilty” verdict on an indictment charging alternative methods of committing the same
    offense, the verdict stands if the evidence is sufficient to support a finding under any of the
    theories submitted. Kitchens v. State, 
    823 S.W.2d 256
    , 258–59 (Tex. Crim. App. 1991).
    If the evidence is sufficient to support a finding of guilt based on at least one of the
    alternative theories, then the verdict stands. Rosales v. State, 
    4 S.W.3d 228
    , 231 (Tex.
    Crim. App. 1999); 
    Kitchens, 823 S.W.2d at 258
    –59. Thus, even if one of the alternative
    theories was erroneously submitted to the jury, a conviction still may stand if found under
    17
    another submitted theory. In the case under review, the evidence supports a conviction
    based upon a finding that appellant committed the offense by shaking, throwing, or
    dropping J.H. The jury could have convicted on any one of these theories without ever
    reaching the “unknown” language.         Similarly, the jury could have concluded that
    appellant inflicted the trauma with his hands rather than with an unknown object, and that
    he used or exhibited his hands—rather than an unknown weapon—in the commission of
    the offense. In no part of the indictment was an “unknown” matter the sole basis on which
    the jury could convict. Thus, even if there were error in the charge as alleged by appellant,
    that error would be harmless because the evidence is sufficient to support a finding of guilt
    on at least one of the alternative theories. See 
    Rosales, 4 S.W.3d at 231
    ; 
    Kitchens, 823 S.W.2d at 258
    –59.     We overrule appellant’s fourth issue.
    E.     Autopsy Photographs
    Finally, appellant argues that the trial court erred in admitting photographs from
    J.H.’s autopsy because they were “cumulative and inflammatory.” Under Texas Rule of
    Evidence 403, a photograph is admissible if it has probative value that is not substantially
    outweighed by the photograph’s inflammatory nature. TEX. R. EVID. 403; Williams v.
    State, 
    301 S.W.3d 675
    , 690 (Tex. Crim. App. 2009). Rule 403 favors the admission of
    relevant evidence and carries a presumption that relevant evidence will be more probative
    than prejudicial.   Shuffield v. State, 
    189 S.W.3d 782
    , 787 (Tex. Crim. App. 2006).
    Analysis under the rule should generally consider: (1) how probative the evidence is, (2)
    the potential of the evidence to impress the jury in some irrational, but nevertheless
    indelible way, (3) the time the proponent needs to develop the evidence; and (4) the
    proponent's need for the evidence. 
    Id. A number
    of additional factors may also be
    relevant in determining whether the probative value of photographs is substantially
    outweighed by the danger of unfair prejudice, including: the number of photographs
    offered, their gruesomeness, their detail, their size, whether they are in color or
    black-and-white, whether they are close-up images, whether the body depicted is clothed
    or naked, the availability of other means of proof, and other circumstances unique to the
    18
    individual case. 
    Williams, 301 S.W.3d at 690
    (citing Long v. State, 
    823 S.W.2d 259
    , 272
    (Tex. Crim. App. 1991)). Autopsy photographs are generally admissible unless they
    depict mutilation of the victim caused by the autopsy itself. 
    Id. However, mutilation
    caused during an autopsy is not necessarily fatal to the admissibility of a photograph if the
    photograph is highly probative of the medical examiner’s findings and conclusions or
    when it allows the jury to see an internal injury. See Gallo v. State, 
    239 S.W.3d 757
    , 763
    (Tex. Crim. App. 2007); Harris v. State, 
    661 S.W.2d 106
    , 108 (Tex. Crim. App. 1983).
    We review a trial court’s decision to admit or exclude evidence under an abuse-of
    -discretion standard. Torres v. State, 
    71 S.W.3d 758
    , 760 (Tex. Crim. App. 2002). We
    will uphold the trial court’s ruling as long as it was within the zone of reasonable
    disagreement. Rayford v. State, 
    125 S.W.3d 521
    , 529 (Tex. Crim. App. 2004).
    During Dr. Pustilnik’s testimony, the State tendered several photographs for him to
    identify and explain to the jury. Of these, appellant objected to those marked as exhibits
    61, 69, 75, and 76, and the trial court overrruled his objections. Exhibit 61 is a frontal
    picture of J.H. with several marks on his body. Exhibit 69 is a frontal picture of the baby’s
    body with much of the skin flayed back to show internal damage. Exhibit 75 is a picture
    of J.H.’s skull with the skullcap removed, and Exhibit 76 is a picture of the exposed skull
    with the skin around it flayed back. Having examined each contested photograph and Dr.
    Pustilnik’s testimony, we conclude that the trial court did not abuse its discretion in
    admitting the photographs. Dr. Pustilnik testified that he had chosen these pictures from a
    much larger set in order to identify and explain J.H.’s injuries to the jury. He used each
    photograph to explain J.H.’s injuries to the jury in ways that were probative of appellant’s
    guilt. Exhibit 61, for example, shows “the pattern of lividity around the face and the
    paleness on the right side of the face, nose, right cheek area. That is where the face
    rested . . . after the heart stopped beating and the blood stopped circulating.” Jessica
    testified that she put J.H. on his back when she put him to bed and that J.H. could not move
    himself from that position. Exhibit 61 demonstrates that the baby was on his side or back
    after his death, meaning either that Jessica was wrong or that someone else turned the baby
    19
    over. Exhibit 69 shows hemorrhaging that, according to the State’s medical experts, is not
    consistent with a post-mortem injury, indicating that J.H’s ribs were not broken by
    appellant’s CPR after the baby’s death. Exhibit 75 shows no subdural hemorrhaging,
    meaning, according to Dr. Postilnik, that the baby likely did not die from being shaken
    back and forth repeatedly. Exhibit 76 shows hemorrhaging on the back of the head, which
    Dr. Pustilnik testified is independent evidence of blunt force trauma.
    The images are gruesome, but autopsy photographs often will be; sometimes it is
    impossible to show an injury that the defendant caused without altering the body in some
    way. See, e.g., Davis v. State, 
    313 S.W.3d 317
    , 331 (Tex. Crim. App. 2010) (photograph
    of cross-sectioned tongue was admissible because it showed an injury that was not
    otherwise visible); 
    Gallo, 239 S.W.3d at 763
    (concluding trial court did not err by
    admitting photographs of the decedent's rib, skull cap, and brain, all visible due to the
    decedent’s autopsy, because they were necessary to show the injuries sustained); 
    Harris, 661 S.W.2d at 108
    (concluding trial court did not err by admitting photograph of decedent's
    skull with skin refracted because it was necessary to show a skull fracture); Drew v. State,
    
    76 S.W.3d 436
    (Tex. App.—Houston [14th Dist.] 2002, pet. ref’d) (where relevant to
    explain injuries, trial court did not err in admitting autopsy photographs showing victim’s
    head with the top part of the skull sawed off, exposing the brain; the skull with the scalp
    pulled over victim’s face; the interior part of the skull with the brain removed; the brain
    outside the skull; and the excised windpipe).
    We hold that the trial court did not abuse its discretion by concluding that the
    probative value of the photographs was not substantially outweighed by the potential for
    unfair prejudice and overrule appellant’s final issue.
    IV. CONCLUSION
    We conclude that the evidence is sufficient to support appellant’s conviction; that
    the trial court did not err in allowing Dr. Frost to testify during the State’s case in chief; that
    the trial court did not err in denying appellant’s motion to quash the indictment; that even if
    20
    the charge contains error as alleged by appellant, that error is harmless; and that the trial
    court did not abuse its discretion in admitting J.H.’s autopsy photographs. Accordingly,
    we affirm.
    /s/     Tracy Christopher
    Justice
    Panel consists of Justices Frost, Brown, and Christopher.
    Publish — TEX. R. APP. P. 47.2(b).
    21